Question: Normal anteflexion of uterus

Normally the uterus lies in anteversion & anteflexion. Fuhermore, the long axis of the body of the uterus is bent forward at the level of the internal os with the long axis of the cervix. This position is termed anteflexion of the uterus. ref - BDC 6e vol2 pg 387


Question: Meckel's cailage develops from

The cailage of the first arch is called Meckel's cailage. the incus and malleus are derived from its dorsal end. the ventral pa of the mandible is surrounded by the developing mandible and is absorbed Ref: Human Embryology, Inderbir Singh, 10th edition, page no: 131


Question: Otic ganglia are related to

Otic ganglion is a peripheral parasympathetic ganglion which relays secretomotor fibres to the parotid gland. Topographically, it is intimately related to the mandibular nerve, but functionally it is a pa of the glossopharyngeal nerve. The motor or parasympathetic root is formed by the lesser petrosal nerve. The preganglionic fibres are derived from the inferior salivary nucleus - the ninth nerve, its tympanic branch, the tympanic plexus -the lesser petrosal nerve to reach the ganglion. The postganglionic or secretomotor fibres pass through the auriculotemporal nerve to the parotid gland. The sympathetic root is derived from the plexus on the middle meningeal aery. The sensory root comes from the auriculotemporal nerve and is sensory to the parotid gland. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 6th edition 127,311


Question: Enzyme that protects the brain from free radical injury is

Superoxide dismutase ref Robbins 7/e p17 , Harrison 17/e p 2572 ,9/e p48.


Question: Excision of hyoid bone is done in

Thyroglossal Cyst Cystic swelling developed in the remnant of the thyroglossal duct or tract Present in any pa of the thyroglossal tract (extends from foramen caecum to isthmus of thyroid) Common sites Subhyoid (MC) Floor of mouth Region of thyroid cailage Suprahyoid Beneath the foramen caecum Clinical features It is a midline swelling, except in the region of thyroid cailage, where thyroglossal tract is pushed to one side, usually to the left Though its a congenital swelling MC age of presentation is between 15 and 30 years Cyst can be moved sideways but not veically Peculiar characteristics which helps in distinguishing thyroglossal cyst from other neck swelling Moves up with protrusion of tongue as the thyroglossal tract is attached to the tongue Moves with deglutition so do all thyroid swellings, subhyoid bursitis Cyst is lined by pseudostratified columnar epithelium and squamous epithelium with hetero topic thyroid tissue present in 20% of cases Complications Recurrent infections Formation of thyroglossal fistula Carcinomatous change (papillary carcinoma) Treatment Sistrunk operation : En-bloc cystectomy and excision of central hyoid bone to minimize recurrence Ref: Sabiston 20th edition Pgno :1861


Question: Germs cells derived from

All the germ layers ectoderm, meroderm and endoderm derived from epiblast.


Question: mood stabilizer used in the management of depression

Lamotrigine is a mood stabilizer which works best in BIPOLAR DEPRESSION Lithium is a mood stabilizer which works best in BIPOLAR MANIA valproate is a mood stabilizer which works best in RAPID CYCLING Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 935


Question: The most abundant glycoproteins present in basement membrane is

Lamininis the most abundant glycoproteins in the basement membrane .the type 4 collagen .laminin and nidrogen are present in basement mem Ref.robbins Harrison.17/e p2462


Question: Opening of the nasolacrimal duct is in

Ans. is 'a' i.e. Inferior meatus Openings in the lateral wall of nasal cavity *Inferior meatus : Nasolacrimal duct*Middle meatus : Anterior ethmoidal sinus*Frontal sinus*Maxillary sinus*Superior meatus : Posterior ethmoidal sinuses*Sphenoethmoidal recess : Sphenoid sinus*Note: that the nasolacrimal duct opens into the inferior meatus but if its blocked and a DCR (Dacryocystorhinostomy) operation is performed the new opening is in the middle meatus*


Question: Most common muscle damaged in rotator cuff is

Refer Williams Vil 1.p 330 The tendons of the rotator cuff, not the muscle are most commonly involved and of the four, The supraspinatus us effected most frequently as it passes below the acromian


Question: Punched out ulcer in oesophagus on endoscopy in a immunocompromised patient is seen in

Dysphagia and odynophagia are the symptoms caused by herpes. There may be history of heretic lesion on lip some days earlier. Endoscopy reveals vesicles or small ulcers with raised margins, usually in the upper half of the oesophagus. Ref: Bailey and love 27th edition Pgno: 1104


Question: Structure not forming watershed area

Watershed area is the medical term referring to regions of the body that receive dual blood supply from the most distal branches of two large aeries, such as the splenic flexure of the large intestine. Watershed areas are found in the brain, where areas are perfused by both the anterior and middle cerebral aeries, and in the intestines, where areas are perfused by both the superior and inferior mesenteric aeries (i.e., splenic flexure). Additionally, the sigmoid colon and rectum form a watershed zone with blood supply from inferior mesenteric, pudendal and iliac circulations. Hypoperfusion in watershed areas can lead to mural and mucosal infarction in the case of ischemic bowel disease. When watershed stroke occurs in the brain, it produces unique focal neurologic symptoms that aid clinicians in diagnosis and localization.


Question: blue grey discolouration of skin

chlorpromazine is a typical anti psychotic that has lot of mentioned side effects namely Blue grey discolouration of skin reverse lens granular deposits obstructive jaundice retrograde ejaculation REf. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no 925


Question: Solitary hypoechoic lesion of the liver without septa or debris is most likely to be

A solitary hypoechoic lesion without any septae or debris is most likely to be a simple cyst. However rarely a hydatid cyst can have a similar sonologic appearance. Simple cysts are the most common benign lesions found in liver. On imaging studies they appear as unilocular, homogenous fluid-filled structures with a thin wall without projections, septa or debris. Ultrasound appearances of - Hydatid cyst - It presents either as a simple cyst with hydatid sand or daughter cysts or floating endocyst or calcification. Caroli's disease - Its the type V choledochal cyst Multiple intrahepatic biliary cysts are seen on ultrasound. Sludge & stones may also be visible within the cysts. Liver abscess - Sonographic appearance may include a cystic lesion with floating internal echoes and irregular margins. Septations, debris and fluid-fluid interfaces may also be seen. Ref : Rumack's Diagnostic Ultrasound 3rd/e, p. 86, 89, 94, 1865


Question: Hypogastric sheath is a condensation of

The hypogastric sheath is a pelvic fassia condensation. It lies along the posterolateral pelvic wall and carries the neurovascular bundles towards the pelvic visera. It also provides the pelvic visera suppo. image ref - wikipedia.org


Question: Posterior ethmoidal sinus drains into (JIPMER May 2019)

- There are 3 groups of ethmoidal air sinuses Anterior Middle Posterior - Posterior ethmoidal sinus is opening in lateral wall of the nose. - Lateral wall of the nose has 3 elevations called superior, middle & inferior turbinates / conchae - Under each turbinate, there is space called meatus called superior, middle & inferior meatus - Posterior ethmoidal sinus is opening in superior meatus - Anterior & middle sinus is opening in middle meatus - Middle meatus have hiatus semilunaris At front of hiatus semilunaris frontal air sinus opens The anterior, middle ethmoidal sinus respectively Maxillary sinus opens slightly posterior; In the region of hiatus semilunaris in middle meatus - Naso-lacrimal duct opens in the inferior meatus on Anterior aspect - Inferior turbinate is largest turbinate & its meatus is largest meatus - Eustachian tube opens behind inferior turbinate in lateral wall of nasopharynx


Question: Fracture of the proximal humerus in an elderly patient is best treated by

(Refer: Watson Jones Textbook of Ohopedics & Trauma, 6thedition,pg no: 536-538)


Question: Shoest pa of colon

ascending colon 15 cm descending colon 25 cm transverse colon 50 cm sigmoid colon;40 cms The ascending colon is the first of four sections of the large intestine. It is connected to the small intestine by a section of bowel called the cecum. The ascending colon runs upwards through the abdominal cavity toward the transverse colon for approximately eight inches.One of the main functions of the colon is to remove the water and other key nutrients from waste material and recycle it. As the waste material exits the small intestine through the ileocecal, it will move into the cecum and then to the ascending colon where this process of extraction stas. Ref - BDC vol2 6e pg271-273


Question: dihydroerigotamine differs from ergotamine in the following respect

hydrogenation of ergot alkaloids decrease their vasoconstrictor action and increase the Alpha blocking activity Ref-KDT 6/e p168

it is more potent alpha adrenergic blocker and less potent vasoconstrictor


Question: Capitonnage is used in treatment of

Methods of management of the residual cavity after cyst evacuation External tube drainage Capsulorrhaphy Capitonnage Myoplasty Omentoplasty Internal collapse Introflexion Marsupialization Introflexion plus omentoplasty Cysto jejunostomy or cysto gastrostomy Ref: Blumga 5th edition Pg no : 1045


Question: A patient with AIDS and a CD4 cell count of 100/ul , has a persistent fever and Weight Loss associated with invasive pulmonary disease due to M avium complex. Optimal management of this case requires

Ref-KDT 6/e p750 Mycobacterium avium complex infection is treated with combination of rifabutin,ethambu eth and clarithromycin

Select an antibiotic regimen based on drug susceptibility of the cultured organism

Sta treatment with isoniazide and rifampicin

Treat the patient with clarithromycin,ethambutol and rifabutin

Treat with trimethoprim sulfamethoxazole


Question: A three years old boy presents with the poor urinary stream. Most likely cause is

Poor urinary stream in 3 years old boy suggests urinary tract obstruction (usually intravesical) and the most common cause of obstructive uropathy in a male child is posterior urethral valve. Posterior urethral valve These are symmetrical folds of urothelium extending distally from prostatic urethra to external urinary sphincter. It most commonly lies just distal to the verumontanum or at the verumontanum* It occurs only in males. It behaves as flap valves so, although urine does not flow normally a urethral catheter can be passed without difficulty. Sometimes, the valves are incomplete and the patient remains without symptoms until adolescence or adulthood. Approximately 30% of patients experience end stage renal disease Vesicoureteral reflux occurs in 50% of patients. Diagnosis is made by voiding cystourethrogram* & endoscopy Both of these investigations clearly depict the site of obstruction. The diagnosis can be established prenatally by ultrasound.* Management First, a small polyethene feeding tube is inseed in the bladder and left for several days. Then fuher management is done according to serum creatinine level. with normal serum creatinine - transurethral ablation of the valve leaflets. * With increased serum creatinine and the worsening of condition - vesicostomy to bypass the obstruction and when normal creatinine levels are achieved, transurethral ablation is done. Ref : Bailey & Love 25/e 1362


Question: Anti ds DNA antibiodies are commonly seen in

Antibiodies to do DNA and the so called Smith antigens are viually diagnostic of SLE .Anti ds-,DNA is common in SLE (40-60%,) ref Robbins 9/e p 128


Question: If the 4th infralabial is larger than others on either side, the snake may be

If the 3rd supra labial is not touching eye and nasal shield, then look at the ventral aspect of head. If the 4th infra labial is larger than the others on either side, it is poisonous (krait) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 511


Question: The Broca's area is situated in the

(B) Inferior frontal gyrus # BROCA'S AREA is a section of the human brain that is involved in language processing, speech or sign production, and comprehension.> Broca's area is located in the opercular and triangular sections of the inferior frontal gyrus of the frontal lobe of the cortex.> Broca's and Wernicke's areas are found unilaterally in the brain (left 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.

Posterior part of Inferior frontal gyrus


Question: Suture present between parietal & occipital bones is

The lambdoid suture lies between the occipital bone and the two parietal bones. Sutural bones are common along this suture. Lambdoid sutures are usually visible clearly. The lambdoid suture traverses the posteriormost pa of the skull. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Conjoint tendon is formed by

CONJOINT TENDON:- Falx inguinalisFormation: fusion of lowest aponeurotic fibres of internal oblique and of the transversus muscle. Medially : continuous with the anterior wall of rectus sheath.Laterally: free It may be continuous with an inconstant ligamentous band, interfoveolar ligament,which connects lower border of transversus abdominis to the superior ramus of pubis. Conjoint tendon strengthens the anterior abdominal wall at site where it is weakened by the superficial inguinal ring. <img src=" /> {Reference: BDC 6E}


Question: Preganglionic supply to the submandibular gland is

The sensory root is from the lingual nerve. It is suspended by two roots of lingual nerve.The sympathetic root is from the sympathetic plexus around the facial aery. This plexus contains postganglionic fibers from the superior cervical ganglion of the sympathetic trunk. These fibers pass express through the ganglion and are vasomotor to the submandibular glandThe secretomotor root is from superior salivatory nucleus through nervous intermedius chords tympani which is a branch of cranial nerve VII. Chorda tympani joins lingual nerve. The parasympathetic fibers get relayed in the submandibular ganglion.Ref: BD Chaurasia; volume 3; 6th edition; Page no: 308


Question: Structures passing between superior and middle constrictor muscles are

Stylopharyngeus muscle and glossopharyngeal nerve are structures passing between superior and middle constrictors of pharynx.

Superior laryngeal vessels, internal laryngeal nerve

Stylopharyngeus muscle, superior laryngeal vessels

Glossopharyngeal nerve, stylopharyngeus muscle

Internal laryngeal nerve, stylopharyngeus muscle


Question: Ansa cervicalis supplies

Ansa cervicalis supplies to the sternohyoid, the sternothyroid, and the inferior belly of the omohyoid Notes; ansa cervicalis is a thin nerve loop that lies embedded in the anterior wall of the carotid sheath over the lower pa of the larynx.it supplies the infrahyoid muscles Ref: BDC volume 3;Sixth edition pg 103


Question: Facial vein communicates with the cavernous sinus through

Retromolar vein and internal jugular vein

External jugular vein and internal jugular vein

Internal jugular vein and retromandibular vein

Superior ophthalmic vein and pterygoid venous plexus


Question: Stain used for the diagnosis of granulocytic sarcoma


Question: Patients with chronic pancreatitis gives chain of lakes appearance in ERCP examination. Management is

Surgical procedures in chronic pancreatitis Ideal procedure : DPPHR(Beger's procedure) In presence of poal vein thrombosis : Frey's Small duct disease : V- Shaped excision Disease recurrence in body and tail (after DPPHR, Whipple's or Longmire-Transverso procedure) : V-shaped drainage Disease limited to tail: Spleen - preserving distal pancreatectomy Ref: Sabiston 20th edition Pgno :1535

Resecting the tail of pancreas and performing a pancteaticojejunostomy


Question: Froments sign is seen in

Froments sign, or the book test tests the adductor pollicis muscle. When the patient is asked to grasp a book firmly between the thumbs and other fingers of both hands, the terminal phalanx of thumb on the paralysed side becomes flexed at the interphalangeal joint (by the flexor pollicis longus which is supplied by median nerve)


Question: The lowest rib level reached by the parietal pleura in the midaxillary line is


Question: Storage form of iron

Ref Robbins 9/e p650 The normal total body iron mass is about 2.5 g for women and 3.5 g for men. Approximately 80% of func- tional body iron is present in hemoglobin, with the remain- der being found in myoglobin and iron-containing enzymes (e.g., catalase, cytochromes). The iron storage pool, consist- ing of hemosiderin and ferritin-bound iron in the liver, spleen, bone marrow, and skeletal muscle, contains on average 15% to 20% of total body iron. Because serum fer- ritin is largely derived from this storage pool, the serum ferritin level is a good measure of iron stores. Assessment of bone marrow iron is another reliable but more invasive method for estimating iron stores. Iron is transpoed in the plasma bound to the protein transferrin. In normal persons, transferrin is about 33% saturated with iron, yielding serum iron levels that average 120 ug/dL in men and 100 ug/dL in women. Thus, the normal total iron-binding capacity of serum is 300 to 350 ug/dL.


Question: Muscle responsible for opening of mandibular

Masseter and medial pterygoid form a amuscular sling which holds and suspends the mandible. By cambining the actions of both muscles in to a functional unit, this sling enables powerful closure of the jaws.


Question: Presence of nephroblastomatosis in a biopsy specimen from Wilm's tumor of left kidney indicates high possibility of

Presence of nephrogenic rests (nephroblastomatosis) in resected specimen indicates an increased risk of developing Wilm's tumor in contralateral kidney. Nephrohlastomatosis also k/a "nephrogenic rests" or nodular renal blastema, refer to the abnormal persistence of embryonal renal tissue. These are supposed to be precursor lesions of Wilm's tumor. These are seen in renal paraenchyma adjacent to tumors in approx. 25% to 40% of unilateral and 100% of bilateral tumors. Presence of nephrogenic rests in resected specimen indicates an increased risk of developing Wilm's tumor in contralateral kidney. So these patients will require frequent and regular radiological surveillance with CT scan for many years. Ref : Nelson Pediatrics 18/e p2140-2143


Question: atypical depression is managed with

MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 966


Question: Inversion of foot is at


Question: In genetic deficiency of MPO the increased susceptibility to infections is due to

Ref Robbins 8/e p53 ,56,9/e p76 Myeloperoxidase (MPO) is a hemoprotein expressed in azurophilic granules of neutrophils and in the lysosomes of monocytes. The enzyme has strong antibacterial propeies and is unique in its ability to generate potent bactericidal compounds such as hypochlorous acid (HOCl) from hydrogen peroxide and the halide, chloride

Inability to produce hydroxyl halide radicals


Question: Ebsteins anomaly is a side effect of

side effects of mood stablizers are impoant questions to be asked in entrance examination lithium causes Ebstiens anamoly valproate causes neural tube side effects Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 935


Question: Plague epidemic in Surat in 1995 has occurred after a 'silence period' of

The last case of plague in India was repoed in 1966 and after that there was a 'silence period' of 28 years till the reappearance of the disease in September 1994, when there was an outbreak of bubonic plague in Beed district of Maharashtra and pneumonic plague in Surat (Gujarat).


Question: Naloxone is the physiological antidote of

Naloxone is the physiological antidote. It competes with opioids at the receptor sites and reverses their action. It can reverse not only the respiratory, analgesic, and euphoric actions but the dysphoric, delusional and hallucinatory propeies also. Naloxone in the dose of 2 mg i.v can be taken and repeated every 20-30 minutes, upto a total dose of 10 mg. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 488


Question: A patient is admitted with severe pain in the abdomen, nausea, vomiting and fever. The most likely diagnosis

Clinical features of acute pancreatitis Cardinal symptoms : Epigastric and /or peri umbilical pain that radiates to the back, relieved by sitting & leaning forward Upto 90% of patients have nausea and/or vomiting that typically does not releive on pain Nature of the pain is constant Dehydration, poor skin turgor, tachycardia, hypotension & dry mucous membranes are commonly seen in patients with AP Mild-pancreatitis: Abdomen may be normal of reveal only mild epigastric tenderness Severe pancreatitis : Significant abdominal distension, associated with generalised rebound tenderness and abdominal rigidity Flank (Grey Turner), peri umbilical (cullen's sign) & inguinal ecchymosis (Fox sign) are indicative of retro peritoneal bleeding associated with severe pancreatitis Dullness to percussion and decreased breathing sounds in left or less commonly, in the right hemithorax suggest pleural effusion Ref: Sabiston 20th edition Pgno :1524-1528


Question: The type of suture represented by sagittal suture of the cranial vault is

The joints in the skull are mostly sutures.
Various types of sutures in the skull are,

Plane suture - Eg. Internasal suture, mid palatal suture.
Serrated suture - Eg. Sagittal and coronal suture (interparietal suture).
Denticulate suture - Tooth like projections. Eg. Lambdoid suture.
Squamous suture - Eg. Parieto-temporal suture.


Question: Most common type of Supracondylar fracture in children is

Extension type is the most common type (97-99 percnt) and the most commonest displacement of distal fragment is Posteromedial (70-80 percnt)


Question: Nephrocalcinosis in a systemic granuomatous disease is due to

Ref Robbins 8/e p 433-436 Nephrocalcinosis, once known as Albright's calcinosis after Fuller Albright, is a term originally used to describe deposition of calcium salts in the renal parenchyma due to hyperparathyroidism. The term nephrocalcinosis is used to describe the deposition of both calcium oxalate and calcium phosphate. It may cause acute kidney injury

Over production of 1,25 dihydroxy vitamine D


Question: The sensation of posterior aspect of tongue is by

The glossopharyngeal nerve is the nerve for both general sensation and taste for the posterior one third of the tongue including the circumvallate papillae.The posterior most pa of the tongue is supplied by the vagus nerve through the internal laryngeal branch.The sensory supply of anterior two thirds is lingual nerve where as the taste sensation from the anterior two thirds is carried out by chorda tympani except vallate papillae(pre-trematic branch of first arch). REF.BDC VOL 3,Fifth edition.


Question: According to pughs classification moderate to severe hepatic insufficiency is managed by

Patient of cirrhosis with variceal bleeding or ascites can be controlled by shunt surgery only if he falls in CTP class A or B Moderate to severe grade liver insufficiency can only be managed by liver transplantation Ref: Sabiston 20th edition Pgno : 1436


Question: Length of the cailaginous pa of "Eustachian tube"

The external auditory meatus is 4 cm long and conducts sound waves from the auricle to the tympanic membrane. The framework of the anterior and medial two-thirds of the meatus is elastic cailage (measures 25 mm in length), and the posterior and lateral one third is bony, formed by the tympanic plate (measures 12 mm in length). The sensory nerve supply of the lining skin is derived from the auriculotemporal nerve and the auricular branch of the vagus nerve.The lymph drainage is to the superficial parotid, mastoid, and superficial cervical lymph nodes.


Question: Meiosis occurs in human males in

Human embryology; Inderbir Singh; Tenth editionIn males, meiosis occurs in seminiferous tubules


Question: Joint between sphenoid & vomer is

Schindylesis is that form of aiculation in which a thin plate of bone is received into a cleft or fissure formed by the separation of two lamina in another bone, as in the aiculation of the rostrum of the sphenoid and perpendicular plate of the ethmoid with the vomer, or in the reception of the latter in the fissure between the maxilla and between the palatine bones. Ref: Henry Gray. Anatomy of the Human Body.


Question: Thyroid carcinoma with pulsatile vascular skeletal metastasis is

Pulsatile secondaries are seen in: Follicular carcinoma Thyroid Renal cell carcinoma ref - Srb's manual of surgery 5e p481


Question: In hydatidiform mole, blood cells does not develop because of defect in

As organs form, a process called organogenesis, mesoderm interacts with endoderm and ectoderm to give rise to the digestive tract, the hea and skeletal muscles, red blood cells, and the tubules of the kidneys, as well as a type of connective tissue called mesenchyme. Ref:Human embryology Inderber singh


Question: Steriocilia of hair cells are embedded in


Question: Acute osteomyelitis of long bones commonly affects the

Metaphysis of long bones is the earliest and most common site involved in osteomyelitis. x ray showing acute osteomyliyis of long bones ref : maheswari 9th ed


Question: Cutaneous nerve supply of region marked X

1st web space is supplied by Deep peroneal nerve


Question: Ture about Mafucci syndrome is

Maffucci syndrome is multiple Enchondromas assosciated with soft tissue Hemangioma and thrombophlebitis MAFUCCI&;S SYNDROME : * Maffucci syndrome is a congenital non hereditary mesodermal dysplasia characterised by multiple enchondromas with soft-tissue cavernous haemangiomas. * Imaging findings are multiple enchondromas seen associated with soft tissue swelling and phleboliths. * Enchondromas degenerate into chondrosarcomas in 15-51% of cases and soft-tissue haemangiomas to vascular sarcomas in 3-5%. Refer ohopedic pathology by Vincent PG p 401

Multiple osteochindroma with soft tissue Hemangioma


Question: The Glossopharyngeal nerve supplies the posterior pa of the tongue because it develops from the

D i.e. Hypobranchial eminence- Tongue muscles originate from myoblast of occipital somitesQ. Thus tongue musculature is innervated by hypoglossal nerve.- Glossopharyngeal (9th) nerve supplies posterior (1/3) pa of tongue because it develops from hypobrachial eminence (copula)Q.Parathyroid glands develop from 4th (superior) & 3rd (inferior para thyroid glands) pharyngeal endodermal pouchQ.


Question: Bronchial adenoma commonly present as

Bronchial adenoma are hypervascular and can bleed profusely. Other causes chronic cough,oobstruction with atelectasis,lobar collapse, pneumonitis, and abscess formation Ref Harrison 19th edition pg 1676


Question: Best marker for iron deficiency is

Ref Harrison 19 th ed pg 627-628 The serum ferritin level is a better indicator of iron overload than the marrow iron stain. However, in addition to storage iron, the marrow iron stain provides information about the effective delivery of iron to develop- ing erythroblasts.


Question: Resting membrane potential is determined by

Resting membrane potential CellsResting membrane potentialSkeletal muscle -90 mVSmooth muscle -50 to -75 mVCardiac muscle -85 to -95 mVNerve fibre -70 mVRods -40 mVInner ear cell-60 mVResting Membrane Potential is due to K+ Resting membrane Potential is close to the isoelectric potential of Cl-IPSP is due to Cl- influxEPSP is due to the K+ influx (Refer: Ganong's Review of Medical Physiology 24thedition, pg no: 87-89)


Question: Hea beat in conceptus can be detected earliest by

The CVS is the earliest system to become functional is human. Hea begins to beat in the fouh week of development( Day 22 ).


Question: The amino acid that acts as a precursor in the production of urea is

(Refer: Harper's Illustrated Biochemistry, 26th edition, pg no: 265)


Question: Skin over the angle of mandible is supplied by

Ans. d (Great auricular nerve) (Ref. BDC Vol. Ill 4th ed. 57)The great auricular nerve originates from the cervical plexus, composed of branches of spinal nerves C2 and C3. It provides sensory innervation for the skin over angle of mandible (parotid area) and mastoid process, and both surfaces of the outer ear.INNERVATION OF THE SKIN OF FACE# Innervation of the skin is mainly through the three branches of the trigeminal nerve (CN V).# Some skin over the angle of the mandible and anterior and posterior of the auricle is supplied by the great auricular nerve from the cervical plexus.# Some cutaneous branches of the auricular branch of the facial nerve also supply skin on both sides of the auricle.# The trigeminal nerve is the general sensory nerve to the head, particularly the face, and is the motor nerve to the muscles of mastication.


Question: Sensory nerve supply to angle of jaw is through

The trigeminal nerve through its three branches is the chief sensory nerve of the face. The skin over the angle of the jaw and over the parotid gland is supplied by the great auricular nerve (C2,C3)


Question: Thymus develops from

Pharyngeal pouchDerivativesDorsal ends of I and II pouches form --Tubotympanic recessThe proximal pa of tubotympanic recess gives rise to auditory tube.Distal pa gives rise to tympanic cavity and mastoid antrum. Mastoid cellsdevelop at about 2 years of ageVentral pa of II pharyngeal pouchEpithelium covering the palatine tonsil and tonsillar crypts, lymphoid tissueis mesodermal in originIII Pharyngeal pouchThymus and inferior parathyroid gland or parathyroid III.IV Pharyngeal pouchSuperior parathyroid or parathyroid IVV Pharyngeal pouch (ultimobranchial body)Parafollicular or 'C' cells of the thyroid glandRef: Chaurasia; Volume 3; 6th edition; Page no: 30


Question: Least chances of cord prolapse are seen with

Maximum chances of cord prolapse seen in breech are in footling where as min chances in frank frank breech


Question: Olfactory epithelium is

INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:225Olfactory epitheliumThe olfactory epithelium is pseudo stratified it imuch thicker than the epithelium lining the respiratory mucosa


Question: Gerlach tonsil is

A collection of lymphoid tissue is present in the nasopharynx, behind the tubal opening. It is called the tubal tonsil, also known as Gerlach tonsil. It is continuous with the lateral pa of the pharyngeal tonsil. In Waldeyer's lymphatic ring, the most impoant aggregations are the right and left palatine tonsils. Posteriorly and above there is the pharyngeal tonsil; laterally and above there are the tubal tonsils, and inferiorly there is the lingual tonsil over the posterior pa of the dorsum of the tongue. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Sternohyoid is supplied by

The ansa cervicalis or ansa hypoglossal is a thin nerve loop that lies embedded in the anterior wall of the carotid sheath over the lower pa of the larynx.It supplies the infrahyoid muscles. Distribution Superior root:To the superior belly of the omohyoid. Ansa cervicalis:To the sternohyoid,the sternothyroid and the inferior belly of the omohyoid. The throhyoid and geniohyoid are supplied by seperate branches from the first cervical nerve through the hypoglossal nerve. REF.BDC VOL.3,FIFTH EDITION


Question: Solitary bone cyst is most common in the

Simple bone cysts commonly occurs at Metaphysis of long bones Most common site is proximal humerus, followed by proximal femur SIMPLE BONY CYST : ACTIVE : Develop in patients under 10 years of age * Cyst arises adjacent to growth plate & may grow to fill most of metaphysis Bone may be slightly expanded within coical shell * May cause pathologic fracture PASSIVE : Passive cysts patients are usually over 12 years of age &; become increasingly separated from gmwth plate (more ) than 1-2 an) have thicker bony wall than active lesions may show evidence of healing or ossification less likely to result in fracture CAUSES : * The cause of a unicameral bone cyst remains unknown. Theories have been proposed but none have been definitively proven. * One of these theories is that the cysts result from a disorder of the growth plate. * Another is that the cysts result from problems with circulation that are caused by a developmental anomaly in the veins of the affected bone. * The role trauma plays in the development of these cysts is unknown. Symptoms: * Unless there has been a fracture, bone cysts arc without symptoms. * They may occasionally be discovered by chance on x-rays obtained for other reasons. * There is no mass or tenderness unless there is a fracture. * There may be an abnormal angulation of the limb secondary to the fracture or shoening of the limb if the adjacent growth plate is involved. Location lesion appears to arise from the growth plate & in early stages, lesion is lies adjacent to growth plate; typically the simple bone cyst will have a central location, whereas an ABC will have a slightly eccentric location; predilection for the metaphysis of long bones; - proximal humerus (SO% of cases) - proximal tibia - proximal femur (40%) - foot:Calcaneal Bone Cysts Radiographs show a central, well marginated & symmetric radiolucent defect in metaphysis metaphyseal bone does not remodel normally metaphysis is broader than normally seen but not broader than with width of epiphyseal plate thin rim of non reative bone borders the unicameral bone cyst Refer Maheshwari 9th/e p 248


Question: Most common symptom of chronic pancreatitis is

Clinical features of Chronic pancreatitis Classical triad : DM+ Pancreatic calcification + Steatorrhea(DPS) Abdominal pain is the primary manifestation and most common symptom of CP Intensity, frequency & duration of pain gradually increase with worsening disease Pancreatic inflammation and fibrosis decrease the number & function of acinar cells At least 90% of the gland needs to be dysfunctional before steatorrhoea, diarrhea and other symptoms of malabsorption develop Exocrine insufficiency occurs in 80-90% of patients with long standing CP Diabetes is developed in 40-80% of patients, typically occurs many years after the onset of abdominal pain and pancreatic Exocrine insufficiency Ref: Sabiston 20th edition Pgno :1531


Question: Bile ductopenia seen in

Ductopenia Ductopenia refers to a reduction in the number of ducts in an organ. It is the histological hallmark of vanishing bile duct syndrome (typically <0.5 bile ducts per poal triad). The most common cause of ductopenia is primary biliary cholangitis. Other causes failing liver transplant Hodgkin's lymphoma graft-versus-host disease (GVHD) sarcoid cytomegalovirus infection, HIV medication toxicity. Ref: Harrison's 19th edition Pgno :2027-2028


Question: Chronic granulomatous inflammation in upper lid (painless swelling);

Chalazion is a chronic granulomatous inflammation of the meibomian gland. Chalazion (tarsal cyst/meibomian cyst) Presents as painless swelling of eye lid More common in adults than children Treatment Incision and curettage Intralesional injection of triamcinolone acetate. CHALAZION


Question: McEwan's pupil is seen in

Stage of coma in ethyl alcohol poisoning The person may go to a stage of coma at a blood alcohol concentration of more than 300mg%. There will be steorous breathing. The pulse is rapid and temperature is subnormal. Pupils remaining constricted. On slapping or pinching on the face, causes pupils to dilate and gradually return to constriction (McEwan's pupils) ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 437


Question: Base of femoral triangle is formed by

Base of femoral triangle is inguinal ligament which is aponeurosis of external oblique muscle. Medial border of adductor longus forms the medial boundary. Medial border of Saorius forms the lateral boundary. Floor is formed by adductor longus,pectineus and iliacus. Femoral aery, femoral vein and lymphatics are involved in femoral sheath.

Abdominal wall ,Inguinal and Femoral region


Question: Spinal cord ends at the level of

(A) L1 vertebra # Spinal cord:> At birth, spinal cord terminates at lower border of L2.> In Adults, it extends from the level of the upper border of the atlas to the lower border of vertebra L1, or the upper border of vertebra L2.> Spinal cord is about 45 cm long.> Spinal cord extends from the level of the upper border of the atlas to the lower border of L1 vertebra or the upper border of L2 vertebra. It is about 45 cm long.> The lower end is conical and is called conus medullaris.> The apex of the conus is continued down as the filum terminate> There are 31 pairs of spinal nerves.


Question: The relation of common bile duct

The anterior border of the liver is lifted upwards. Gallbladder with Longitudinal section, pancreas, and duodenum with frontal one. Intrahepatic ducts and stomach in transparency. It is formed by the union of the common hepatic duct and the cystic duct (from the gallbladder). ref - BDC 6e vol2 pg289

Lies posterior to hepatic aery and poal vein


Question: bulimia nervosa is assosiated with

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


Question: Sphincter of Oddi consists of

The sphincter of Oddi is a muscular valve that controls the flow of digestive juices through the ampulla of vater into the second pa of the duodenum. It is named after ruggero oddi. Ref - BDC 6e vol2 pg259 , britannica.com


Question: A 20 Yr old male presented with repeated episodes of hemetemesis. There is no history of jaundice or liver decompensation. On examination the significant findings include splenomegaly (8cms below costal margin), and presence of esophageal varices. There is no ascites or peptic ulceration. The liver function tests are normal. The most likely diagnosis is

Non cirrhotic poal fibrosis Condition of liver characterized by widespread fibrosis of liver(mainly poal, subcapsular and rarely perisinusoidal) causing wide variation in normal architecture There is no true cirrhosis Etiology Chronic ingestion of arsenic, copper, vinyl chloride Clinical features Youny age patient with features of poal hypeension with conspicuous absence of liver cell failure Patient are usually on 2nd or 3rd decade Onset of symptoms is gradual Most common presenting symptom is GI bleed (90% cases) Splenomegaly Jaundice, Hepatomegaly, ascites and stigmata of liver cell failure are uncommon Diagnosis Site of block is smaller branches (3rd or 4th order branches) Ultrasound shows normal splenopoal axis. Withered tree appearance and peripoal fibrosis is seen in NCPF Ref: Blumga 5th edition Pgno : 1099-1105

Hepatic venous outflow tract obstruction


Question: Thiamine acts as a cofactor in

Thiamine as a cofactor in ReactionsEnzymesPyruvate - Acetyl CoAPyruvate dehydrogenasea-ketoglutarate - Succinyl CoAa-ketoglutarate dehydrogenaseErythrose-4-PO4 + Xylulose-5-PO4 - Fructose-6-PO4 + Glyceraldehyde-3-PO4TransketolaseBranched-chain amino acids - Branched chain keto acidsBranched-chain amino acid dehydrogenase(Refer: DM Vasudevan, Textbook of Biochemistry, 7th edition, pg no: 478)


Question: Middle aged man presents with complaints of weakness, fatigue and hyperpigmentation. On examination hepatomegaly and Hypoglycemia are present. Diagnosis

Manifestation of Hemochromatosis Liver : Hepatomegaly, cirrhosis, HCC Pancreas : Diabetes mellitus Hea: CHF, cardiomyopathy Skin: Hyperpigmentation(bronzing of skin) Joints : Ahropathy Hypogonadism Ref:Harrison's 19th edition Pgno :2516


Question: Ansa nephroni is lined by

Ansa nephroni is lined by simple squamous epithelium


Question: In a female child at bih oocyte is in a stage of


Question: Cyclosporine is an


Question: In HCC

Clinical features of HCC Vascular bruit (25%) GI bleed (10%) Tumor rupture (2-5%) Jaundice due to biliary obstruction (10%) Paraneoplastic syndrome (<5%) Ref:Sabiston 20th edition Pgno : 1456-1463

Two-third patients presents with signs of liver disease

Percutaneous biopsy is mandatory for diagnosis


Question: Study light is caused by

Sterlite and secondary leukemias are distinguish adverse effects of alkylation agents


Question: Poosystemic shunt is not seen in

Poosystemic shunt is not seen in spleen. Poosystemic shunt is abnormal connection between hepatic poal vein and the systemic circulation. It can be either congenital or acquired condition. A poosystemic shunt (PSS) is an abnormal connection between the poal vascular system and systemic circulation. Blood from the abdominal organs which should be drained by the poal vein into the liver is instead shunted to the systemic circulation by the PSS. Ref - sciencedirect.com


Question: The pleura that covers the surface of the lungs is the

C: The visceral pleura covers the surface of the lung.
A, B: The pleural cavity, between the parietal and visceral pleurae, is filled with a small volume of pleural fluid produced by the pleural membranes.
D: The parietal pleura lines the walls of the thorax, diaphragm, and mediastinum


Question: Submandibular Acinar Cells secrete

Lysozyme, an enzyme with antibacterial activity, is produced primarily by the Submandibular Salivary Gland Acinar Cells


Question: The pa of internal capsule associated with acoustic radiation is


Question: Largest opening in the Right atrium

Right Atrioventricular Orifice Blood passes out of the right atrium through the right atrioventricular or tricuspid orifice and goes to the right ventricle. The tricuspid orifice is guarded by the tricuspid valve which maintains unidirectional flow of bloodReference: Vishram Singh Anatomy; 2nd edition; Page no: 265


Question: Lipid in the tissue is detected by

Ref Bancroft histology 6/e p53 Oil Red O is a lysochrome diazo dye used for staining of neutral triglycerides and lipids on frozen sections and some lipoproteins on paraffin sections. It has the appearance of a red powder with maximum absorption at 518 nm


Question: Benedict's hand is due to injury to

BENEDICTION ATTITUDE:-Injury to median nerve at elbow Causes:- supracondylar fractures of humerus, application of tight tourniquet during venepuncture, entrapment of the nerve between two heads of pronator teres.When patient tries to make fist, the index and middle fingers remain straight, due to paralysis of both superficial and deep flexors of fingers.The ring and little fingers can be kept in flexed position due to intact nerve supply of medial half of the FDP.{Reference:Vishram Singh, page no.195}


Question: Ochronosis is seen in

Ochronosis It is the greenish black discoloration of tissues, mainly cailages, fibrous tissues, and sclera. It is seen in alkaptonuria. It can also occur due to exposure to various substances like phenol, trinitrophenol, resorcinol, hydroquinone, benzene, picric acid, mercurry or antimalarials. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 415


Question: Lines of Blaschko&;s are along

Blaschko&;s lines, are lines of normal cell development in the skin. These lines are invisible under normal conditions.


Question: Fairy 23 year old pregnant female having severe sensitivity to amoxicillin drug used to treat Gonorrhea in a single dose should be

Ref-Katzung 10/e p761,762 Ceftriaxone is contraindicated in patients having severe allergy to penicillins. Tetracvclines are not etfective against gonorrhoea. Although ciprotloxacin is etfective as a single dose treatment ot gonorrhoea but it is contraindicated in pregnancy. Spectinomycin can be given as single dose treatment of PPNG.


Question: This arrangement of myofibrils are found in

Refer robbins 9/e 569 Hyperophic cardiomyopathy (HCM) is a disease in which the hea muscle (myocardium) becomes abnormally thick (hyperophied). The thickened hea muscle can make it harder for the hea to pump blood. Hyperophic cardiomyopathy often goes undiagnosed because many people with the disease have few, if any, symptoms and can lead normal lives with no significant problems. However, in a small number of people with HCM, the thickened hea muscle can cause shoness of breath, chest pain or problems in the hea's electrical system, resulting in life-threatening abnormal hea rhythms (arrhythmias).


Question: Investigation of choice for diagnosis of Epilepsy is

All patients who have a possible seizure disorder should be evaluated with an EEG as soon as possible. The EEG is most useful in evaluating patients with suspected epilepsy. The presence of electrographic seizure activity - i.e., abnormal, repetitive, rhythmic activity having an abrupt onset and termination and a characteristic evolution - clearly establishes the diagnosis.


Question: Number of veebrae in veebral column

There are total thiy-three veebrae, upper twenty-four are aiculating and separated from each other by interveebral discs, seven cervical veebrae, twelve thoracic veebrae and five lumbar veebrae. The lower nine are fused, five in the sacrum and four in the coccyx.


Question: The length of the feeding tube to be inseed for transpyloric feeding is measured from the tip of

The feeding tube length can be measured by following the normal route for tube i.e. Nasal ala - to ear lobe - to epigastium Since the distance between the nasal ala and ear lobe is almost equal to the distance between the epigastrium and umbilicus, the length can be measured from ear lobe to umbilicus.


Question: Serotonin can be synthesized from

In bacteria that synthesize tryptophan, high cellular levels of this amino acid activate a repressor protein, which binds to the trpoperon. Binding of this repressor to the tryptophan operon prevents transcription of downstream DNA that codes for the enzymes involved in the biosynthesis of tryptophan Refer kDT 7/e p170


Question: Intermediate filaments in glial cells are

Intermediate filaments are used as tumor markers GFAP is the intermediate filament present in glial cells, they are used to indicate astrocytoma Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:8,9,14


Question: Inguinal ligament forms the boundaries of

INGUINAL LIGAMENT:- Extends from anterior superior iliac spine to pubic tubercle. Forms boundaries of femoral triangle and Hesselbach&;s triangle. 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 Superficial circumflex iliac Deep branches-profunda femoris, muscular branches and deep external pudendal 2. Femoral vein and its tributaries 3. Femoral sheath 4. Femoral nerve 5. Nerve to pectineus 6. 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) HESEELBACH&;S TRIANGLE:- Boundaries- 1. Medially-Lateral border of rectus abdominis 2. Laterally- inferior epigastric aery. 3. Base - inguinal ligament. {Reference:BDC 6E pg no. 45}


Question: In spinal groove, radial nerve is accompanied by

radial nerve- At the beginning of the brachial aery, the radial nerve lies posterior to the aery. Soon the nerve leaves the aery, by entering the radial (spiral) groov on the back of the arm where it is accompanied by th profunda brachii aery. Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 1 , pg. no. 96 fig. Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 1 , pg. no.74 ( fig. no. 6.11 )


Question: JG cells (juxta glomerular apparatus) are

INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:313Juxtaglomerular cells the muscle cells in the wall of the afferent aerioles are modified.they are large and rounded(epithelium)and have spherical nuclei. their cytoplasm contains granules that can be stained with special methods. these are called juxtaglomerular cells

Smooth muscullar cells of afferent aeriole

Smooth muscullar cells of efferent aeriole


Question: Alpha fetoprotein is a marker of

Ref Robbins 8/e p 327; 7/e P339,9/e p869_870 AFP is Glycoprotein synthesized in fetal life by yolk sac,fetal liver,fetal GIT.It is a marker of hepatocellular carcinoma,non seminomatous germ cell tumor Of testis Elevated level of AFP Is found less regularly in carcinoma of lung,colon, pancreas IImpoant points about hepatoblastoma arising from hepatic parenchymal cells The most common tumor in Child hood A characteristic features of hepatoblastoma is frequent activation of WTN/catenin signalling pathway,by stabilizing mutation of beta catenin,contributes to the process of carcinogenesis


Question: Collecting pa of kidney develops from

HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:285The collecting pa of the kidney is derived from a diveiculum called the Ureteric bud which arises from the lower pa of the mesonephric duct


Question: External auditory meatus develops from


Question: VNS works by

Vagus nerve stimulation * Electrical stimulation of left vagus nerve * Stimulation of raphe nucleus and locus cereleus * Release of norepinephrine and serotonin * Side effects * Voice alteration Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 1075


Question: Lateral cutaneous nerve of thigh arises from

LUMBAR PLEXUSFormed by ventral rami of LI, L2, L3, and pa of L4. These rami divide into dorsal and ventral divisions.From the ventral divisions: ilioinguinal (LI), genitofemoral (LI, L2) obturator (L2, L3, L4), accessory obturator (L3, L4) nerves.From the dorsal divisions: Lateral cutaneous nerve of thigh (L2, L3), femoral nerve (L2, L3, L4).Iliohypogastric contains fibers of both ventral and dorsal divisions (LI).Reference: Chaurasia Volume II; 7th edition; Page no: 41


Question: Tendon present in third extensor compament of wrist is

6 iteofascial compaments are formed on the back of the wrist ( extensor retinaculum ). The structures passing through each ompament, from lateral to the medial side are - 1st compament - (i) Abductor pollicis longus (ii) Extensor pollicis brevis IInd compament - (i) Extensor carpi radialis longus (ii) Extensor carpi radialis brevis IIIrd compament - (i) Extensor pollicis longus IVth compament - (i) Extensor digitorum (H) Extensor indicts (iii) Posterior interosseous nerve (iv) Anterior interosseous aery Vthcomparment - (i) Extensor digiti minimi VIth compament - (i) Extensor carpi ulnaris. Ref : B D Chaurasia's Human Anatomy, Seventh edition , volume 1 , pg. no., 135


Question: Upper two posterior intercostal aeries arise from

First and second posterior intercostal aeries arise from superior intercostal aery B D CHAURASIA&;S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME-1 SIXTH EDITION,Page no-219


Question: Length of anal canal

The length of the anal canal is about 4 cm (range, 3-5 cm), with two thirds of this being above the pectinate line (also known as the dentate line) and one third below the pectinate line ref - BDC 6e vol2 pg413


Question: The lymphatic drainage of testes is

Blood Supply and Lymphatic Drainage. The testis and epididymis are supplied by the testicular aery , and their veins drain into the pampiniform plexus, which forms the bulk of the spermatic cord. The veins of the pampiniform plexus often become varicose, a condition termed varicocele. Ref - BDC 6e vol2 pg224 , semantischolar.org


Question: Cremaster muscle is supplied by

Ans. a (Genital branch of genito-femoral nerve). (Ref. BD Chaurasia, Human Anatomy Vol. II 3rd ed. 172)CREMASTER# Cremaster Muscle consist of muscle fasciculi embedded in the cremasteric facia.# Fasciculi form loop that are attached laterally to inguinal ligament & medially to pubic tubercle, pubic crest, the conjoint lendon.# It is fully developed only in male.# It is supplied by Genital branch of the genitofemoral nereve (LI).# Its action is to suspend testis & can elevate it.# It also closes superficial inguinal ring by 'ball valve' mechanism when intraabdominal pressure is raised.# In UMN lesions above segment LI, Cremaster reflex is lost.


Question: An example of tumor suppressor gene is

Ref Robbins 7/e p300; , Harrison 17/e p499; 9/e p290 Tumor suppressor genes are the genes whose products down regulate the cell cycle. RB Gene: Governor of the Cell Cycle It is useful to begin with the retinoblastoma gene (RB), the first tumor suppressor gene to be discovered and, as it happens, a prototypical representative. As with many advances in medicine, the discovery of tumor suppressor genes was accomplished by the study of a rare disease--in this case, retinoblastoma, an uncommon childhood tumor. Approximately 60% of retinoblastomas are sporadic, and the remaining ones are familial, the predisposition to develop the tumor being transmitted as an autosomal dom- inant trait. To account for the sporadic and familial occur- rence of an identical tumor, Knudson, in 1974, proposed his now famous two-hit hypothesis, which in molecular terms can be stated as follows: * Two mutations (hits) are required to produce retinoblas- toma. These involve the RB gene, which has been mapped to chromosomal locus 13q14. Both of the normal alleles of the RB locus must be inactivated (hence the two hits) for the development of retinoblastoma (Fig. 5-21). * In familial cases, children inherit one defective copy of the RB gene in the germ line; the other copy is normal. brakes to cellular proliferation Rb gene is a tumor suppressor gene whereas My ,fos and Ra's are all example of proto oncogene Retinoblastoma develops when the normal RB gene is lost in retinoblasts as a result of somatic mutation. Because in retinoblastoma families only a single somatic mutation is required for expression of the disease, the familial transmission follows an autosomal dominant inheritance pattern. * In sporadic cases, both normal RB alleles are lost by somatic mutation in one of the retinoblasts. The end result is the same: a retinal cell that has lost both of the normal copies of the RB gene becomes cancerous. Although the loss of normal RB genes initially was discovered in retinoblastomas, it is now evident that homo- zygous loss of this gene is a fairly common feature of several tumors, including breast cancer, small cell cancer of the lung, and bladder cancer. Patients with familial retinoblastoma also are at greatly increased risk for development of osteosarcomas and some soft tissue sarcoma The RB gene product is a DNA-binding protein that is expressed in every cell type examined, where it exists in an active hypophosphorylated state and an inactive hyperphosphor- ylated state. The impoance of Rb lies in its regulation of the G1/S checkpoint, the poal through which cells must pass before DNA replication commences. As background for an understanding of how tumor sup- pressors function, it is useful to briefly revisit the cell cycle: In embryos, cell divisions proceed at an amazing clip, with DNA replication beginning immediately after mitosis ends. As development proceeds, however, two gaps are incorpo- rated into the cell cycle: gap 1 (G1) between mitosis (M) and DNA replication (S), and gap 2 (G2) between DNA replica- tion (S) and mitosis (M) (Fig. 5-20). Although each phase of the cell cycle circuitry is monitored carefully, the transi- tion from G1 to S is believed to be an extremely impoant checkpoint in the cell cycle "clock." Once cells cross the G1 checkpoint they can pause the cell cycle for a time, but they are obligated to complete mitosis. In G1, however, cells can remove themselves entirely from the cell cycle, either tem- porarily (quiescence, or G0) or permanently (senescence). Indeed, during development, as cells become terminally differentiated, they exit the cell cycle and enter G0. Cells in G0 remain there until external cues, such as mitogenic sig- naling, push them back into the cell cycle. In G1, therefore, diverse signals are integrated to determine whether the cell should progress through the cell cycle, or exit the cell cycle and differentiate, and Rb is a key hub integrating external mitogenic and differentiation signals to make this decision. To appreciate this crucial role of Rb in the cell cycle, it is helpful to review the mechanisms that enforce the G1/S transition. * The initiation of DNA replication (S phase) requires the activity of cyclin E/CDK2 complexes, and expression of cyclin E is dependent on the E2F family of transcription factors. Early in G1, Rb is in its hypophosphorylated active form, and it binds to and inhibits the E2F family of transcription factors, preventing transcription of cyclin E. Hypophosphorylated Rb blocks E2F-mediated transcription in at least two ways (Fig. 5-22). First, it sequesters E2F, preventing it from interacting with other transcriptional activators. Second, Rb recruits chromatin remodeling proteins, such as histone deacetylases and histone methyltransferases, which bind to the promoters of E2F-responsive genes such as cyclin E. These enzymes modify chromatin at the promoters to make DNA insen- sitive to transcription factors. This situation is changed on mitogenic signaling. Growth factor signaling leads to cyclin D expression and activa- tion of cyclin D-CDK4/6 complexes. These complexes phosphorylate Rb, inactivating the protein and releasing E2F to induce target genes such as cyclin E. Expression of cyclin E then stimulates DNA replication and pro- gression through the cell cycle. When the cells enter S phase, they are committed to divide without additional growth factor stimulation. During the ensuing M phase, the phosphate groups are removed from Rb by cellular phosphatases, regenerating the hypophosphorylated form of Rb. * E2F is not the sole target of Rb. The versatile Rb protein binds to a variety of other transcription factors that regulate cell differentiation. For example, Rb stimulates myocyte-, adipocyte-, melanocyte-, and macrophage- specific transcription factors. Thus, the Rb pathway couples control of cell cycle progression at G0-G1 with differentiation, which may explain how differentiation is associated with exit from the cell cycle. In view of the centrality of Rb to the control of the cell cycle, an interesting question is why RB is not mutated in every cancer. In fact, mutations in other genes that control Rb phosphorylation can mimic the effect of RB loss; such genes are mutated in many cancers that seem to have normal RB genes. For example, mutational activation of CDK4 or overexpression of cyclin D ors cell proliferation by facil- itating Rb phosphorylation and inactivation. Indeed, cyclin D is overexpressed in many tumors because of gene ampli- fication or translocation. Mutational inactivation of CDKIs also would drive the cell cycle by unregulated activation of cyclins and CDKs. As mentioned earlier, the CDKN2A gene is an extremely common target of deletion or muta- tional inactivation in human tumors. The emerging paradigm is that loss of normal cell cycle control is central to malignant transformation and that at least one of the four key regulators of the cell cycle (CDKN2A, cyclin D, CDK4, Rb) is mutated in most human cancers. Fuhermore, the transforming proteins of several oncogenic human DNA viruses act, in pa, by neutralizing the growth inhibi- tory activities of Rb. For example, the human papillomavi- rus (HPV) E7 protein binds to the hypophosphorylated form of Rb, preventing it from inhibiting the E2F transcrip- tion factors. Thus, Rb is functionally deleted, leading to uncontrolled growth


Question: Neutrophils secrete

Ref Robbins 9/e p 73 Myeloperoxidase (MPO) is a peroxidase enzyme that in humans is encoded by the MPO gene on chromosome 17. MPO is most abundantly expressed in neutrophil granulocytes (a subtype of white blood cells), and produces hypohalous acids to carry out their antimicrobial activity. It is a lysosomal protein stored in azurophilic granules of the neutrophil and released into the extracellular space during degranulation. Neutrophil myeloperoxidase has a heme pigment, which causes its green color in secretions rich in neutrophils, such as pus and some forms of mucus. The green color contributed to its outdated name verdoperoxidase


Question: Ala of sacrum is not crossed by

Ans. is 'd' i.e., UreterThe smooth medial pa of the ala of sacrum is associated with the subsequent 4 structures from medial to lateral side: 1. Sympathetic chain. 2. Lumbosacral trunk. 3. Iliolumbar aery. 4. Obturator nerve.The ventral ramus of L5 nerve is really tight that it grooves the ala.The rough lateral pa of the ala provides origin to iliacus muscle anteriorly and connection to the lumbosacral ligament posteriorly.


Question: One bullet get lodged in the barrel in the previous firing and dislodged with the second bullet in the subsequent firing in

Tandem bullet( Piggy tail bullet) One bullet gets lodged in the barrel in the previous firing and dislodged with the second bullet in the subsequent firing. These bullets may separate before entering the body and produce two entrance wounds on a single firing. Sometimes, they may separate after entering the body and make two exit wounds. Sometimes, two bullets may remain inside the body making no exit wound. In some cases, one bullet will go producing one exit wound and the other will remain inside. In a single catridge, one bullet is set behind the other by notching on the base and in one shot two bullets are discharged. It is called duplex or tandem catridge. These types of catridges are used in some military rifles. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 141


Question: anorexia management is assosiated with

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

avoid using rest room for 2 hours after food intahke


Question: Lambda is the junction between

The lambdoid suture lies between the occipital bone and the two parietal bones.sutural or Wormian bones are common along this suture. Lambda, parietal foramina, and obelion have been examined in the norma veicalis. Ref BDC volume:3,6th edition


Question: Ligament of poupart is

Ligament of poupart is another name for Inguinal ligament


Question: External anal sphincter is innervated by

External anal sphincter is controlled by spinal nerves from the S2, S3 and S4 levels of your spinal cord, which form the pudendal nerve. ref - BDC vol2 pg 412-416


Question: The normal narrowing in the middle of the oesophagus is caused by

Middle constriction of oesophagus is due to left bronchus .27.5cm/11 inch from insisor teeth. BD CHAURASIA&;S HUMAN ANATOMY VOLUME 1, 6TH Edition . page no 282, fig 20.7


Question: Cell surface molecules involved in peripheral tolerance

Ref Robbins 7/e p225 , Harrison 16/e p1907, Robbins 9/e p213 B7 is a type of peripheral membrane protein found on activated antigen presenting cells that, when paired with either a CD28 or CD152 surface protein on a T cell, can produce a costimulatory signal


Question: First sign of wound injury is

ref Robbins 8/e p46 ,102 ; 7/e p107,9/e p106 Some redness is normal at the wound site, but it should diminish over time. However, if your surgical incision or wound continues to be red or exhibit radiating streaks known as lymphangitis, this is a warning sign of awound infection .red Ness due to vasodilation


Question: The following parasite infection predispose to malignancies

Ref Robbins 8/e p880; 9/e p874 The following two parasites have definitive ethilogical association with malignancies: Clonorchis sinensis : cholangiocarcinoma Opisthorchis viveerini: cholangiocarcinoma Schistosoma japonicum: colorectal cancer


Question: Yellowish discoloration of the mucus membrane and teeth is produced by

Nitric acid- signs and symptoms They are similar to that of sulphuric acid. The abdominal pain and belching may be more. There may be severe cough, dysnoea, and breathlessness due to inhalation of fumes and irritation of air passages. There will be corrosion and yellow discoloration of the mucus membrane and teeth. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 409


Question: In case of direct occipito posterior position most commonly encountered problem is

In face to pubis delivery the most common complication is perineal tear as the occiput is posterior and thus the longer biparietal diameter distends the perineum rather than the smaller bitemporal diameter.Hence in all such cases liberal episotomy should be given


Question: Brainstem nucleus not derived from the alar plate

Hypoglossal nucleus is a pure motor nucleus derived from the anterior basal plate neural tube Posterior alar plate gives sensory (not motor) nuclei. Ref: Gray's39e/p-518


Question: In giant cell tumor of the bone.,the cell of origin is

The Neoplastic cells of giant cell tumor are primitive osteoblast precursors but they represent only a minority of the tumor cells.The bulk of the tumor consists of non Neoplastic osteoclast and their precursors Ref Robbins page no 1203


Question: Schiller Duval bodies are seen in


Question: Assesment of progress of labor is best done by

Paogram is the best method to assess progress of labor


Question: A 26 years male person has got injury to mid arm patient developed wrist drop, finger drop, loss of sensation and dorsum of hand, patient is able to do elbow extension, the diagnosis is

Very high radial nerve palsy ----elbow extension lost, wrist drop, finger drop High radial nerve palsy ----wrist drop, finger drop Low radial nerve palsy ----finger drop, no wrist drop Refer maheswari 9th ed


Question: A 21 year old patient attended a pay the previous night and gives the following symptoms, pain in abdomen radiating to back, pulse 100/min, BP 100/76, Temp 39degC and vomiting before coming. Most probable diagnosis is

Clinical features of acute pancreatitis Cardinal symptoms : Epigastric and /or peri umbilical pain that radiates to the back, relieved by sitting & leaning forward Upto 90% of patients have nausea and/or vomiting that typically does not releive on pain Nature of the pain is constant Dehydration, poor skin turgor, tachycardia, hypotension & dry mucous membranes are commonly seen in patients with AP Mild-pancreatitis: Abdomen may be normal of reveal only mild epigastric tenderness Severe pancreatitis : Significant abdominal distension, associated with generalised rebound tenderness and abdominal rigidity Flank (Grey Turner), peri umbilical (cullen's sign) & inguinal ecchymosis (Fox sign) are indicative of retro peritoneal bleeding associated with severe pancreatitis Dullness to percussion and decreased breathing sounds in left or less commonly, in the right hemithorax suggest pleural effusion Ref : Sabiston 20th edition Pgno :1524-1528


Question: Skin pigmentation resembling 'rail road tracks' seen in

Chronic opium poisoning They have dry skin with needle puncture marks and sometimes masked by tattooing. Abscesses and thrombosed veins may be seen. I. V users may develop pigmentation and scars on front of the elbow called railroad tracks. Drug addicts may tattoo this area to mask the scars. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 489


Question: Abduction of Hand is caused by

The flexor carpi radialis muscle originates from the medial epicondlyle of humerus and inses into the bases of 2nd and 3rd metacarpal bones. Its action is abduction of hand at the wrist joint. BD CHAURASIA 7th edition ,page 108 table 9.2


Question: Mitochondrial chromosomal abnormality leads to

Ref Robbins 8/e p171;9/e p172 Example of mitochondrial inheritance is leber's hereditary optic neuropathy.leigh's disease ,MELAS - Mitochondrial encephalopathy Lactic acid Stroke like syndrome Neuropathy , ataxia, retinitis, Kearns Sayre syndromes, chronic progressive external opthalmoplegia,Pearson syndrome M


Question: Rosette shaped arrangement of cells is seen in

An ependymoma is a glial tumor of the ependymal cells that line the center of the spinal cord and the ventricles of the brain. There are several different types of ependymoma cancers, which are also classified by grade. The three grades used for ependymoma cancers are determined by how closely the cancer cells resemble normal cells. The lower the grade, the more closely the cancer cells resemble normal cells. The different types of ependymomas appear in different locations within the spinal column or brain. Grade I tumors - These include subependymomas and myxopapillary ependymomas, and are typically slow growing. Myxopapillary ependymomas tend to appear at the lower end of the spinal column. Subependymomas appear near a ventricle in the brain. These ventricles are involved in the creation of cerebrospinal fluid. Grade II tumors - These are the most common ependymomas. Many ependymoma subtypes exist in this grade, including cellular, papillary, tancytic, RELA fusion-positive, and clear cell ependymomas. These may appear anywhere along the ventricular system where cerebrospinal fluid is produced. Grade III tumors - These are known as anaplastic ependymomas and are typically faster growing than the other grades. Anaplastic ependymomas are usually found in the skull, brain, and brain stem. They are rarely found in the spinal cord. Refer robbins 9/e 1334


Question: Nerve supply to the perineum is

Pudendal nerve, its course through the lesser sciatic foramen, and branches, including inferior anal at bottom right. The superficial branches of the internal pudendal aery. The perineal nerve is a nerve arising from the pudendal nerve that supplies the perineum. Ref - BDC 6e vol2 pg363


Question: Peripheral hea is another name for

There are large valveless venous sinuses in the substance of soleus. When it contracts, the blood is pumped out of them and during rest the blood stagnates in them. Soleus is also known as because it actively helps in the venous return from the lower limb. (Ref: Gray's Anatomy, Churchill Livingstone, New York; 2005; 879 - 880.)


Question: In Hashimotos thyroiditis there is infiltration of

Robbins page no 1087MORPHOLOGY The thyroid is often diffusely enlarged, although more localized enlargement may be seen in some cases. The capsule is intact, and the gland is well demarcated from adjacent structures. The cut surface is pale, yellow-tan, firm, and somewhat nodular. There is extensive infiltration of the parenchyma by a mono- nuclear inflammatory infiltrate containing small lympho- cytes, plasma cells, and well-developed germinal centers (Fig. 24-11). The thyroid follicles are atrophic and are lined in many areas by epithelial cells distinguished by the presence of abun- dant eosinophilic, granular cytoplasm, termed Huhle cells. This is a metaplastic response of the normally low cuboidal follicular epithelium to ongoing injury. In fine-needle aspiration biopsy samples, the presence of Huhle cells in conjunction with a heterogeneous population of lymphocytes is character- istic of Hashimoto thyroiditis. In "classic" Hashimoto thyroiditis, interstitial connective tissue is increased and may be abundant. Unlike Reidel thyroiditis (see later), the fibrosis does not extend beyond the capsule of the glands


Question: systematic sensitization is used in

SYSTEMATIC DESENSITIZATION JOSEPH WOLPE Joseph Wolpe gave the concept of systematic desensitization This is a treatment used in phobia In phobia there is a conditioned fear response to aversive neutral stimulus and avoidance of that response leads to phobia Whenever there is a fear response there is stimulation of sympathetic system In that case stimulation of parasympathetic system by relaxation there is reduction in anxiety First step is to make a step ladder which are arranged based on the severity Then is go step by step and along with doing applied relaxation Slowly the the sympathetic system is reduced The patient will be able to approach stimulus without anxiety Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 845


Question: Premature fusion of coronal, sphenofrontal and ethmoidal sutures seen in

Turricephaly : Cone shaped head caused by premature fusion of coronal sphenofrontal and frontoethmoidal sutures. Dolichocephaly: Due to premature closure of sagittal suture , produces a long and narrow skull, Also called scaphocephaly Plagiocephaly: Asymmetrical distoion or flattening of one side of the skull. Trigoncephaly: Caused by premature fusion of metopic suture; Keel shaped forehead, and hypotelorism, increased risk for associated developmental abnormalities of the forebrain. Ref: Nelson's 20th edition, page- 71-72.


Question: Concha and Eminent Concha are supplied by

The auricular branch arises from the superior ganglion of the vagus. It crosses the facial canal 4 mm above the stylomastoid foramen, emerges through the tympanomastoid fissure, and ends by supplying the concha and root of the auricle, the posterior half of the external auditory meatus, and the tympanic membrane (outer surface)Reference: Chaurasia Head and Neck; 6th edition; Vagus nerve


Question: U shaped dose response curve is seen in

U shaped response curve is seen in vitamins Ref-Goodman and Gillman 12/e p74


Question: Pseudorosettes are seen in

Microscopic pathological study in Retinoblastoma shows various patterns like Homer-wright Flexner wintersteiner Fleurettes Refer khurana 6/e


Question: The free edge of the falciform ligament encloses

The liver is divided into right and the left lobes by the attachment of the falciform ligament anteriorly and superiorly; by the fissure for the ligamentum teres inferiorly; and by the fissure for the ligamemtum venosum posteriorly. Ligamentum teres is a degenerative string of tissue that exists in the free end of the falciform ligament. Ref -researchgate.net


Question: Fear of height is

Acrophobia- fear of height Agoraphobia- fear of open place Claustrophobia- fear of closed spaces Hapnophobia - fear of touch Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 361


Question: Infection draining the index finger goes to

Infection in the index finger drains into thenar space Infection from 3, 4, 5th fingers drains into mid-palmar space Spaces: Flexor pollicis longus tendon have radial bursa towards radius bone. Ulnar bursa is on the synol sheath of flexor tendons which continues with the little finger (flexor digitorum Tendon) If there is infection in pulp space of thumb there would be radial bursitis. Lumbrical 1 relates with thenar space But lumbricals 2, 3, 4 canals would be continuous with mid-palmar space forearm space of Parona (which is filled with pus sometimes due to ulnar / radial bursitis) Midpalmar and Thenar Spaces FDS:Flexor digitorum superficialis FDP: Flexor digitorum profundus FPL: Flexor pollicis longus


Question: Increase in the height of child from 1 to 3 yrs

Height at 1yr is 75cm and at 4 yrs is 100cms. So increase in height from 1-4 yrs is 25cms Height at 2yrs is 90 cms.So increase in height from 1-2 yrs is 15cms Hence, increase in height from 1-3 yrs should fall between 15 to 25cms. Ref: Ghai,9th edition, Table 2.3


Question: Contraindication of Enteral Nutrition A) Intestinal obstruction B) Severe pancreatitis C) Severe diarrhoea D) IBD E) Intestinal fistula

Enteral Nutrition Indications Protein - Energy malnutrition with inadequate oral intake Dysphagia except for fluids Major trauma (or surgery) when return to required dietary intake is Prolonged Inflammatory bowel disease Distal, low output (<200 ml/day) enterocutaneous fistula To enhance adaptation after massive enterectomy Contraindications Small bowel obstruction or ileus Severe diarrhoea Proximal small intestinal fistula Severe pancreatitis Ref: Sabiston 20th edition Pgno :112


Question: Thinnest pa of the skull

The anterior pa of the floor of the temporal fossa is crossed by an H shaped suture where four bones,frontal,parietal,greater wing of sphenoid and temporal adjoin each other.This area is termed the pterion. REF.B D Chaurasia's Human Anatomy VOL.3,Fouh edition


Question: Scar in lung tissue may get transformef into

Impoant points about squamous cell carcinoma of lung MC type of lung cancer in smokers MC type in males Usually central in location Intracellular bridges or junction is very specific Hyercalcemia due to PTHrP is the NC paraneoplastic syndrome. Refer robbindp716-717f


Question: Poal vein supplies

The poal vein or hepatic poal vein is a blood vessel that carries blood from the gastrointestinal tract and spleen to the liver. This blood is rich in nutrients that have been extracted from food, and the liver processes these nutrients; it also filters toxins that may have been ingested with the food. Ref - BDC 6e vol2 pg282


Question: The given histological specimen is


Question: The pectoralis major is classifies as a

Pectoralis major muscle is typically classified as a spiral Muscle. Muscles with spiral or twisted fasciculi are found in Trapezius, Pectoralis major, Latissimus dorsi, and supinator. Spiral or Twisted: The muscle fibers undergo a twist of approximately 180 degrees between their medial and lateral attachement. Spiral or Twisted Muscle: Pectoralis major Latissimus dorsi Trapezius Supinator Some skeletal muscles may be classified into more than one category. Pectoralis Major muscle has been classified both as convergent (or Triangular muscle) and Spiral Muscle in different textbooks. Note that Pectoralis major has been classified as &;Spiral &; in Gray&;s text and hence this has been selected as the single best answer of choice for this question. Convergent may be selected as the correct answer if spiral is not provided amongst the options. Ref: Gray&;s anatomy 41st edition Pgno: 113


Question: Colon contains

Mucous glands: Cell of mucous acini are tall with flat nuclei at their bases. The lumen of these acini is larger than the serous acini. In mucous glands the secretion contains mucopolysaccharides. The secretion collects in the apical pas of the cells. As a result nuclei are pushed to the base of the cell, and may be flattened. In classroom slides stained with haematoxylin and eosin, the secretion within mucous cells remains unstained so that they have an 'empty' look. However, the stored secretion can be brightly stained using a special procedure called the periodic acid Schiff (PAS) method. Unicellular cells secreting mucus are numerous in the intestines, they are called goblet cells because of their peculiar shape. REF : Inderbir Singh's Textbook of Human Histology, Seventh edition,pg.no.,56.


Question: 'Nodding face sign' is seen in

Hinge/Transverse fracture: Transverse fracture of the base of the skull occurs on middle that completely splits it into two halves, creating hinge (nodding face sign) .This may result from an impact on either side of head or side to side compression of head as in run over by vehicle. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 165


Question: The optic foramen is located between

The optic foramen/canal is the opening of the optic canal. It is bounded medially by the body of the sphenoid and laterally by the lesser wing of sphenoid. Contents: Optic nerve and ophthalmic aery Ref: BD Chaurasia; 6th edition

Greater wing and lesser wing of sphenoid


Question: Nerve supply of trapezius is by

the and sternocleidomastoid are supplied by spinal accessory nerve. Both of them develop from brachial arch mesoderm. The principal action of trapezius is to rotate scapula during abduction of arm beyond 90deg. Clinically the muscle is tested by asking the patient to shrug his shoulder against resistance. REF: BD Chaurasia 7th edition Page no: 64.


Question: G couple protein receptor is

Ref-katzung 11/e p359 Metabotropic receptor are G-protein receptors


Question: Indications for needle aspiration in liver abscess are

Therapeutic needle aspiration of amebic abscesses has been proposed. However, a Cochrane systematic review did not suppo any benefit of therapeutic aspiration in addition to metronidazole treatment over metronidazole treatment alone to hasten clinical or radiologic resolution of amebic liver abscesses.19 In general, aspiration is recommended for diagnostic unceainty, with failure to respond to metronidazole therapy in 3 to 5 days, or in abscesses thought to be at high risk for rupture. Abscesses Larger than 5 cm in diameter and in the left liver are thought to carry a higher risk of rupture, and aspiration should be considered. Ref: Sabiston 20th edition Pgno :1452

Refractory to treatment after 48- 72 hours


Question: Acute osteomyelitis is caused by

It is caused most commonly by staphylococcus aureus Refer Maheshwari 6th/e p 168


Question: Loss of corneal reflex is due to injury of

Loss of corneal reflex may result due to injury of Ophthalmic division of trigeminal nerve (afferent limb) or injury of Facial nerve (efferent limb).


Question: Palpation on the costoveebral angle produces pain and tenderness in acute adrenal insufficiency.This is

Costoveebral angle pain and tenderness in acute adrenal insufficiency is known as Rogoff's sign.


Question: A woman presents with chest pain and shoulder pain. On examination, she is found to have pericarditis with pericardial effusion. This shoulder pain is mediated by

The pain of pericarditis is mediated by the phrenic nerve. The somatic sensation from the pericardium is carried by the somatic afferent fibers of the phrenic nerve. The pericardial pain may be referred to the supraclavicular region of the shoulder or lateral neck area (dermatomes C3, C4 and C5. Ref: Gray&;s Anatomy for students 3rd edition Pgno: 183


Question: Not a pa of epithalamus

The epithalamus consists of the habenular trigones on each side of the third ventricle, the pineal body (pineal gland or epiphysis cerebri), and the habenular commissure


Question: In transverse lie presentation is

In transverse lie shoulder presentation is seen


Question: Early adolescence age is

Adolescence is the stage of transition from childhood to adulthood. Early adolescence ( 10-13yrs) Mid adolescence ( 14-16yrs) Late adolescence (17-19yrs) Ref: Ghai, 9th edition, Chapter 5


Question: For blood and urine, preservative used is

For blood, CSF, vitreous humor and urine, sodium fluoride is the preservative (100mg/10ml) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 404


Question: Platysma


Question: Deep perineal pouch contains

Deep perineal pouch is the anatomic space enclose by the perineum and located superior to the perineal membrane. the contents are deep transverse perineal muscle, external sphincter muscle of urethra, membranous poion of urethra, bulbourethral gland. Ref - BDC 6e Vol2 pg355


Question: First dorsal interosseous muscle of hand is supplied by

Deep branch of ulnar nerve supplies all the 4 dorsal interossei muscles.Superficial branch of ulnar nerve supplies the palmaris brevis muscle.Median nerve supplies the muscles of thenar eminence.Radial nerve have no supply to any intrinsic muscle of hand.B D Chaurasia 7th edition Page no: 182


Question: Most common cause of death in measles is


Question: Lateral dislocation of patella is prevented by

The lateral border provides inseion to vastus lateralis in its upper one-third or half. The medial border provides inseion to the vastus medialis in its upper two-thirds or more. Ref : B D Chaurasia's Humsn Anatomy , seventh edition , volume 2 , pg, no. 22


Question: The number of laticiferous ducts that open into the nipple is

Breast is a compound tubulo-alveolar gland which secretes milk. The gland consists of 15 to 20 lobes. Each lobe is a cluster of alveoli, and is drained by a lactiferous duct. The lactiferous ducts converge towards the nipple and open on it. Near its termination each duct has a dilatation called a lactiferous sinus. Ref - BDC Vol1 6th edition pg 34


Question: Management of pancreatic abscess is

Sterile and Infected Pancreatic Fluid Collection (Pancreatic Abscess) The presence of acute abdominal fluid during an episode of AP has been described in 30-57% of patients In contrast to pseudocyst and cystic neoplasia of the pancreas, fluid collections are not surrounded or encased by epithelium or fibrotic capsule Treatment is suppoive because most fluid collections will be Spontaneously reabsorbed by the peritoneum Pancreatic Abscess: The presence of fever, elevated WBC count, and abdominal pain suggest infection of this fluid and percutaneous aspiration is confirmatory Percutaneous drainage and IV administration of antibiotics should be instituted if infection (Pancreatic abscess) is present Ref: Sabiston 20th edition Pgno :1529


Question: The lymphatic drainage to central part of the lip is

(Sub mental nodes) (207-BDC-3) (769 - Snell 7th)LYMPHATIC DRAINAGE1. LIPS(i) Central part of the lower lip and skin of the chin - Submental nodes(ii) Rest of the lower lip drains to - Sub mandibular nodes2. Cheeks (Buccae) - drain chiefly into submandibular and preauricular nodes and partly also to the buccal and mandibular nodes3. Oral cavity proper(i) Anterior part of the floor of the mouth - sub mental nodes(ii) The gums and the rest of the floor - sub mandibular nodes4. Gums (Gingivae)(i) Upper gum - Submandibular nodes(ii) Anterior part of gum - sub mandibular nodes(iii) Posterior part of gum - submandibular nodes5. Hard palate & Soft palate - The lymphatics drain mostly to the upper deep cervical nodes and partly to the retro pharyngeal nodes* The lymphatic drainage of Tonsil - Jugulodiagastric nodes* Lymph from the forehead and the anterior part of the face drains in to the submandibular lymph nodes. The lateral part of the face including the lateral part of the eyelids is drained by lymph vessels that end in the parotid lymph nodes


Question: Spermatogenesis

i.e. (Occurs in seminiferous tubules): (11-12-IBS-Embryology 8th)Spermatozoa are formed in the walls of the seminiferous tubules of the testesSPERMATOGENESIS - formation of gametes (spermatozoa) takes only during the reproductive periods which begins at the age of puberty (12 to 16 years) and continue even though old age* The process of spermatogenesis, including spermiogenesis requires about two months** for its completion.Difference between Spermatogenesis and SpermiogenesisSpermatogenesis is the complete process of formation of a spermatozoon from a spermatogonium. It includes first and second meiotic division and spermiogenesisSpermiogenesis - is the process of transformation of a rounded spermatid into a spermatozoanSERTOLI CELLSSertoli cells are specialized cells within the seminiferous tubules and are involved in the orchestration and coordination of all of the key events in spermatogenesis (including spermiogenesis)Function of Sertoli cells1. Provide support, nutrition to developing spermatozoa2. Protect developing germ cells by forming the blood testes barrier (BTB)3. Secretion of important substances - Androgen binding protein (ABP)*, Inhibin*, Mullerian Inhibiting substance (MIS)*, contain aromatase (CYP)*4. Presence of FSH receptors5. Important role in the final maturation phase of spermiogenesis which is characterized by shedding of excess or residual cytoplasm of the spermatids (Phagocytosis)

Time required for a spermatogonium to develop into mature spermatozoan is 6 weeks


Question: Nitroblue tetrazolium test is used for

Ref, Harrison pg 76 In immunohistochemistry the alkaline phosphatase is often used as a marker, conjugated to an antibody. The colored product can either be of the NBT/BCIP reaction reveals where the antibody is bound, or can be used in immunofluorescence. The NBT/BCIP reaction is also used for colorimetric/spectrophotometric activity assays of oxidoreductases. One application is in activity stainsin gel electrophoresis, such as with the mitochondrial electron transpo chain complexes. Nitro blue tetrazolium is used in a diagnostic test,paicularly for chronic granulomatous disease and other diseases of phagocyte function. When there is an NADPH oxidase defect, the phagocyte is unable to make reactive oxygen species or radicals required for bacterial killing. As a result, bacteria may thrive within the phagocyte. The higher the blue score, the better the cell is at producing reactive oxygen species.


Question: The most common cause of tricuspid regurgitation is secondary to

Ref Harrison 19 th ed pg 1548 In at least 80% of cases, TR is secondary to marked dilation of the tricuspid annulus from RV enlargement due to PA hypeension .Functional TR may complicate RV enlargement of any cause, however, including an inferior myocardial infarction (MI) that involves the RV.

Endocarditis due to intravenous drug abuse


Question: Thoracic duct opens into

In the neck, it arches laterally at the level of the transverse process of seventh cervical veebra. Finally it descends in front of the first pa of the left subclan aery and ends by opening into the angle of junction between the left subclan and left internal jugular veins ( both these left subclan and left internal jugular vein drains into left brachiocephalic vein ) <img src=" /> Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 1, pg. no. 302


Question: Clergyman&;s knee is due to

Subcutaneous Infrapatellar BursaIt lies in front of lower pa of the tibial tuberosity and of the lower pa of the ligamentum patellae.Subcutaneous infrapatellar bursitis is called "clergyman&;s knee."Ref: Chaurasia; Volume 2; 6th edition; Page no: 44


Question: In corneal reflex efferent is carried by


Question: Epithelium of cornea is

A. i.e. Stratified Squamous non Keratinizing


Question: Most sensitive imaging for ductal carcinoma insitu breast is

Screening with MRI is superior to mammography in detecting invasive breast cancer in younger women, where the sensitivity of mammography is low due to presence of mammographically dense breast parenchyma. Ref: Grainger 5th edition Pgno: 1190, 1188


Question: Ligament with vessels includes

(B) Gastro splenic # Gastrosplenic ligament (ligamentum gastrosplenicum or gastrolienal ligament) is part of the greater omentum.> Embryonically the gastrosplenic ligament is derived from the dorsal mesogastrium.> Gastrosplenic ligament is made of peritoneum that connects the greater curvature of stomach with the hilum of the spleen.> Contains: Short gastric vessels & left gastro-epiploic vessels.


Question: Winging of scapula is due to paralysis of (FMGE Dec 2018)

Origin-Lateral surfaces of upper 8 to 9 ribs and deep fascia overlying the related intercostal spaces Inseion-Costal surface of medial border of scapula Innervation-long thoracic nerve (C5,6,7) Function-protraction and rotation of scapula, keeps medial border and inferior angle of scapula opposed to thoracic wall Winging of scapula: -As long thoracic nerve passes down the lateral thoracic wall on external surface of serratus anterior muscle just deep to skin & subcutaneous tissue, it is vulnerable to damage. -Loss of function of this muscle cause medial border, paicularly inferior angle of scapula, to elevate away from thoracic wall | (Resulting in) "winging" of scapula (on pushing forward with arm) - Normal elevation of arm a no longer possible. Trapezius: supplied by motor spinal pa of accessory nerve (X1); sensory (proprioception) anterior rami of C3 & C4 Function: powerful elevator of scapula, rotates scapula during abduction of humerus above Horizontal. Middle fibers = retract scapula Lower fibers = depress scapula Latissimus dorsi: supplied by thoraco- dorsal nerve (C6, C7, C8) Function: adduction, medial rotation & extension of arm at glenohumeral joint. Pectoralis major: innervated by medial & lateral pectoral nerves.


Question: Preganglionic parasympathetic fibres to parotid gland relay at

Sensory root by the auriculotemporal nerve. Sympathetic root is by the sympathetic plexus around middle meningeal aery. Secretomotor root is by the lesser petrosal nerve from the tympanic branch of cranial nerve IX. Motor root is by a branch from nerve to medial pterygoid. Ref BDC volume3,6th edition pg 311


Question: Anti topoisomerase 1 is marker of

Ref Robbins 9/e p228 B cell activation also occurs, as indicated by the pres- ence of hypergammaglobulinemia and ANAs. Although there is no evidence that humoral immunity plays a signifi- cant role in the pathogenesis of SS, two of the ANAs are viually unique to this disease and are therefore useful in diagnosis (Table 4-10). One of these, directed against DNA topoisomerase I (anti-Scl 70), is highly specific; it is present in as many as 70% of patients with diffuse scleroderma (and in less than 1% of patients with other connective tissue diseases) and is a marker for the devel- opment of more aggressive disease with pulmonary fibro- sis and peripheral vascular changes. The other ANA is an anticentromere antibody, found in as many as 90% of patients with limited scleroderma (i.e., the CREST syn- drome); it indicates a relatively benign course.


Question: Bladder develops from

Ref Human embryology Inderbier singh 10 th edition Page no 292 The epithelium of urinary bladder devolep from cranial pa of vesicourethral canal (endoderm). The epithelium trigone of baldder is absorbed from absorbed mesonephric ducts(mesoderm) The muscular and serous wall of the oragab are derived fron spalnchnopleuric mesoderm


Question: In Wilms tumor the following leads to emergence of resistance to chromotherapy

5 percnt of tumors have Anpalsia, defined as the presence of cells with large hyperchromatic pleomprphic nuclei and abnormal mitosis and the presrnc of anapladsia coreltes with p53 mutation


Question: First polar body is extruded at

Oogenesis is formation of ovum i.e. female gamete. First polar body is released after LH surge (i.e. at or before ovulation) LH surge occurs 36 hrs before ovulation. LH peak occurs 12 hrs before ovulation. (first polar body released )


Question: Drug induced poal hypeension is seen with

Vitamin A induced Hepatotoxicity Normal dose of vitamin A are not associated with liver injury or liver test abnormalities, but higher doses can be toxic Mechanism of injury : Excess Vitamin A is stored in stellate cells in the liver and accumulation can lead to their activation and hyperophy, excess collagen production, fibrosis and liver injury Serum bilirubin is typically only mildly elevated Liver biopsy is diagnostic Ref: Internet sources


Question: Milwakulee classification is used for

Modified Milwaukee classification is used for Biliary sphincter of oddi classification Types Sphincter of oddi stenosis : Also known as papillitis Benign intrinsic obstruction of the CBD outlet. Sphincter of oddi dyskinesis : It is an intermittent functional Blockage of the high pressure zone of the sphincter. Basal pressure is elevated, but administration of smooth muscles relaxants(nitrates) causes decrease of the basal sphincter pressure in functional dyskinesis Ref: Sabiston 20th edition Pgno :1497

Abnormal pancreaticobiliary duct junction


Question: Sclerotherapy failure is defined as

Failure of endoscopic treatment is declared when two sessions fail to control hemorrhage Ref: Sabiston 20th edition

Unresponsiveness to consecutive 2 energy sclerotherapies

Unresponsiveness to consecutive 3 energy sclerotherapies

Remnant bleeding even after sclerotherapy for successive 2 hospital admissions

Failure to heal after a single treatment