AIIMS nov07 Q & A with explanation

Discussion in 'AIIMS Nov 2013' started by DR.KAVISH CHOUHAN, Nov 6, 2007.

  1. Hampton's hump is seen in
    Ans-pulmonary embolisam



    Hampton's hump, also Hampton hump, is a radiologic sign seen on chest X-rays indicating pulmonary infarction and classically due to pulmonary embolism induced atelectasis.
    It consists of a pleura based shallow wedge-shaped consolidation in the lung periphery with the base against the pleural surface. It is named after Aubrey Otis Hampton


    Q.2 TELEFONA is
    ans-beating on ear
    REF:given in reddy
    its a method of torture like
    falanga beating(on soles),dry & wet submarine





    Q.3which of the following does not have cicatricial alopecia?
    a)lichen planus
    b)DLE
    c)alopecia areata



    Q.4water lilly sign on X ray chest ?
    Ans is hyaditid cyst
    REF:Hydatid disease, pulmonary involvement
    a parasitic infection caused by the tapeworms Echinococcus granulosus and Echinococcus multilocularis (alveolaris). The pastoral form of the disease is more common and occurs in sheep, cows or pigs and humans as the intermediate hosts (Echinococcus granulosus), and dogs as the definitive host. The disease is endemic in sheep farming areas of South America, the Mediterranean Basin and in Australia . The so-called sylvatic form has the dog, wolf or arctic fox as definitive hosts (Echinococcus multilocularis). It occurs in northern Europe and America. Larvae develop in the duodenum of the new host, where they enter the blood stream and travel to the liver and lungs. Human disease is due to the cysts that form around the parasite. The hydatid cyst itself is composed of two layers, an exocyst and an endocyst, within which the daughter cysts develop. The pulmonary cysts may grow rapidly and rupture into the surrounding lung and bronchial tree. Secondary infection of the ruptured cyst is common. Occasionally the cyst ruptures into the pleural cavity. Uncomplicated cysts are asymptomatic. Rupture may result in an acute allergic reaction, sometimes inducing life-threatening hypotension.
    The cardinal radiographic features are one or more well-defined round or oval-shaped smooth masses, of homogeneous density in the lungs, usually in the mid or lower zones. CT scanning reveals the fluid content of the cyst with a density close to that of water (Fig.1). The daughter cysts, when present, appear as curved septations. Calcification of a pulmonary hydatid cyst is very rare. Surrounding inflammation may cause the margins of the cyst to be ill-defined. If communication develops between the cyst and the bronchial tree, air may enter between the fibrotic lung forming the pericyst and the exocyst, producing the appearance of a crescent of air at the periphery of the cyst. This sign is known as a meniscus or air crescent sign. If the cyst itself ruptures an airfluid level results, and daughter cysts may even be seen floating in the residual fluid. The floating ruptured membrane may also float giving rise to the classic water lily sign (Fig.2). All these signs are particularly well demonstrated at CT. With secondary infection, the membranes may be destroyed and the walls thickened, the appearance being indistinguishable from bacterial lung abscess. Primary or secondary hydatid cyst may also be present in the pleura. Mediastinal cysts are relatively rare. They may compress adjacent mediastinal structures or erode the bone of the thoracic cage. For a general description of the disease, see hydatid disease.
    _________________


    Q.5which does not occur in ulnar nerve injury?
    a)claw hand
    b)atrophy of hypothenar eminence
    c)loss of sensation of medial one third of hand
    d)adduction of thumb


    Q.6egg on side apprearence?A)uncorrected TGAB)ebstein"s
    C)TOF
    _________________

    WHICH OF THE FOLLOWING IS NOT COMPONENT USED TO DEVICE DIATERY REFERENCE INDICES ?
    A-UPPER LIMIT.
    B-RDA
    C-LOWER LIMIT FOR GIVEN AGE & SEX(NOT EXACT WORDINGS)
    D-FOOD NUTRITIVE VALUE FOR INDIVIDUAL FOOD CONSTITUENTS???
    ANSWER- D.....


    http://fnic.nal.usda.gov/nal_displa...&tax_subject=256&topic_id=1342&level3_id=5140


    goniometer is used for
    ans:urethrovesical angle


    A goniometer is an instrument that either measures angles or allows an object to be rotated to a precise angular position. The term goniometry is derived from two Greek words, gonia, meaning angle and metron, meaning measure

    The urethral axis during stressurethrovesical junction. Using an orthopedic gonio-. meter, the mobility of the urethrovesical .... ing angle is greater than 30 from the horizontal [5,11]. ...




    Q.which vaccine does not given to a child suffering from a convulsion?
    1.measles
    2.dpt
    3.bcg
    4.opv
    _________________

    Q.which vaccine does not given to a child suffering from a convulsion?
    1.measles
    2.dpt
    3.bcg
    4.opv[/quote]

    ans is DPT
    _________________
    good clinical practices equired in all except
    a. preclinical phase
    b. phase 1
    c. phase 2
    d. phase 4


    Good Clinical Practice is an international quality standard that is provided by International Conference on Harmonisation (ICH), an international body that defines standards, which governments can transpose into regulations for clinical trials involving human subjects.

    Good Clinical Practice guidelines include protection of human rights as a subject in clinical trial. It also provides assurance of the safety and efficacy of the newly developed compounds.

    Good Clinical Practice Guidelines include standards on how clinical trials should be conducted, define the roles and responsibilities of clinical trial sponsors, clinical research investigators, and monitors. In the pharmaceutical industry monitors are often called Clinical Research Associates.

    Q.schizophrenia,all except
    1.third person auditory hallucination
    2.inappropriate emotional liability
    3.persistant mood change
    4.formal thought disorder


    Q.type A personality all/except
    1.hostility 2. mood fluctuations



    In some psychological theories, the Type A personality, also known as the Type A Behavior Pattern, is a set of characteristics that includes being impatient, excessively time-conscious, insecure about one's status, highly competitive, hostile and aggressive, and incapable of relaxation.[1] Type A individuals are often highly achieving workaholics who multi-task, drive themselves with deadlines, and are unhappy about the smallest of delays. Although they may exhibit some or all of these characteristics, it does not mean that people with the type A personality are incapable of showing love, affection or other types of non-pessimistic behavior. Many are also capable of "couching" some of these behavior attributes with proper treatment and medication. Those who do not seek treatment have been described as stress junkies, and often display some of the following characteristics:

    An intrinsic insecurity or insufficient level of self-esteem, which is considered to be the root cause of the syndrome. This is believed to be covert and therefore less observable.
    Time urgency and impatience, which causes irritation and exasperation.
    Free floating hostility, which can be triggered even over little incidents.[2]
    The Type B personality, in contrast, is patient, relaxed, and easy-going. There is also a Type AB mixed profile for people who cannot be clearly categorized and have a combination of both types of personality.

    down's syndrome what is not seen..
    A)absent nasal bone,
    B)increase in papa-a



    Q>excessive inversion of foot wityh 5th metatarsal # is associated with which tendon injury,

    peronius longus,
    P.brevisP.tertius
    Extensor digitorum brevis


    Q.misinterpretaion of the stimulus as other thing is called as....
    a.illusion
    b.hallucination
    c.delusion
    d.delirium

    Q.acridine orange stain dye is used in?
    1.dna/rna
    2.protein
    3.lipid

    Acridine orange is a nucleic acid selective fluorescent cationic dye useful for cell cycle determination. It is cell-permeable, and interacts with DNA and RNA by intercalation or electrostatic attractions. When bound to DNA, it is very similar spectrally to fluorescein, with an excitation maximum at 502 nm and an emission maximum at 525 nm (green). When it associates with RNA, the excitation maximum shifts to 460 nm (blue) and the emission maximum shifts to 650 nm (red). The dye is often used in epifluorescence microscopy.

    Acridine orange is prepared from coal tar and creosote oil.
    Acridine orange can be used in conjunction with ethidium bromide to differentiate between live and apoptotic cells


    .Kanavel’s sign present in
    1) Tenosynovitis
    2) Carpal tunnel syndrome
    3) Trigger finger
    4) Duputreyans contractures


    Stains for lipid are all except
    1) Oil red O
    2) Congo red
    3) Sudan III
    4) Sudan black

    True about protease inhibitors are A/E
    1) MDR-1 gene
    2) Metabolized by hepatic enzymes
    3) Drug interaction
    4) Saquinavir most potent action on CYP3A4


    Q.Nephelometry depends on following law
    1) Lambert Beer law
    2) Scattering of light from particles
    3) refraction of light
    4) decread intensity of light




    Nephlometry is a technology based on the principle of scattering of light. When a particle comes on the path of light rays, the rays bang with it and change their direction of movement. This phenomenon is called scattering. Size, concentration and shape of the molecules altogether determines the amount of scattered light. Size and shape determines the angle of scatter and concentration intensifies the scattered at that particular angle. Generally molecules would vary either by size or by shape or by both. Hence, they will become unique from these aspects. Amount of light scattered will also be determined by the wavelength of the incident
  2. most common type of seizure in neonates
    1) tonic
    2) clonic
    3) subtle
    4) myoclonic
  3. DR.KAVISH

    DR.KAVISH Guest

    subtile seizure the most frequently observed category of neonatal seizures, which include repetitive buccolingual movements, orbital-ocular movements, unusual bicycling or peddling, and autonomic findings
  4. DR.KAVISH

    DR.KAVISH Guest

    collapsing glomarulopathy following is seen
    1) proliferation of parietal cells
    2) visceral epithelial cell destruction
    Collapsing glomerulopathy is an aggressive form of glomerular disease defined for its histopathological features of glomerular collapse, visceral epithelial cell damage and tubulointerstitial changes that are characteristic. Patients with collapsing glomerulopathy present with severe nephrotic syndrome, marked proteinuria, generally more than 10 g/day and rapid progression to chronic renal failure, or death due to complications of nephrotic syndrome, despite any form of treatment.


    Collapsing glomerulopathy presents as de novo or recurrent disease in the renal allograft. There is slight predominance in males and strong predominance in blacks as renal diseases in general. Collapsing glomerulopathy shares several clinical and histopathological features with focal and segmental glomerulosclerosis and HIV-nephropathy; nevertheless, there is enough evidence to support collapsing glomerulopathy as a different entity. It must be mentioned that collapsing glomerulopathy, focal and segmental glomerulosclerosis and HIV-nephropathy may have a similar pathophysiological mechanism of damage to the visceral epithelial cell.
  5. DR.KAVISH

    DR.KAVISH Guest

    In systemic capillary blood flow, all are seen except
    1) Increased protein content
    2) decreased pH
    3) shift of oxygen dissociation curve to left
    4) increased hematocrit.

    .methode of hb estimation except
    1) drabkins
    2) sahl’s
    3) spectrophotometry
    4) wintrobes


    Q.PCR following is used
    1) Ca++
    2) Mg++
    3) Li+
    4) Na+

    Transparency of cornea is maintained by A/E
    1) Mitotic figures in the cornea
    2) Wide separated collagen bands
    3) Hydration of corneal epithelium
    4) Unmyelinated nerve fibers


    Furesemide, true is
    1) Acts on PCT
    2) Given only by parenteral route
    3) Used in pulmonary oedema



    Thiazide causes all except
    1) Hyperglycemia
    2) Increased calcium excretion
    3) Increased blood uric acid levels
    4) Used in CCF


    child with H/O respiratory problem. best investigation to rule out cystic fibrosis after sweat chloride test 25 and 35
    1)f508 mutation
    2) Foecal fat estimation
    3) CT chest
    4) potential difference at nasal epithelium

    refrence nelson 17th edition page 1442

    More than 60?mEq/L of chloride in sweat is diagnostic of CF when one or more other criteria are present. Threshold levels of 40?mEq/L for infants have been suggested. Values between 40 and 60?mEq/L suggest CF at all ages and have been reported in cases with typical involvement. In healthy adults, the sweat chloride values increase slightly, but a value of 60?mEq/L still adequately differentiates CF from other conditions. Chloride concentrations in sweat are somewhat lower in individuals who retain exocrine pancreatic function but remain within the diagnostic range. False-negative test results may be encountered in children with hypoproteinemic edema.


    so here you can say that sweat chloride is normal

    now read following lines

    The finding of increased potential differences across nasal epithelium, the loss of this difference with topical amiloride application, and the absence of a voltage response to a ß-adrenergic agonist have been used to confirm the diagnosis in patients with equivocal or frankly normal sweat chloride values.

    other refrence harrison 16th 1545 1546

    Because of the large number of CF mutations, DNA analysis is not
    used for primary diagnosis. The diagnosis of CF rests on a combination
    of clinical criteria and analyses of sweat Cl values. The values for
    the Na and Cl concentration in sweat vary with age, but typically
    in adults a Cl concentration of 70 meq/L discriminates between
    patients with CF and patients with other lung diseases.DNA analyses are being performed increasingly in patients with
    CF. Comprehensive genotype-phenotype relationships have not yet
    been established sufficiently for prognosis. A relationship between
    F508 homozygosity and pancreatic insufficiency has been established,
    but no predictive relationship holds for F508 homozygosity and lung
    disease.[/b]Between 1 and 2% of patients with the clinical syndrome of CF
    have normal sweat Cl values. In most of these patients, the nasal
    transepithelial potential difference is raised into the diagnostic range
    for CF, and sweat acini do not secrete in response to injected -
    adrenergic agonists.

    so you can see that there no predictive value between 508 mutation and lung disease value and second thing they have clearly given potential differnce is the diagnostic test for normal sweat chloride test.

    and 25 and 35 is normal range as you can see that it should be greater than 60.

    so answer is 4 potential difference at nasal epithelium.
  6. DR. Aayush.

    DR. Aayush. Guest

    avulsion of foot in fracture of 5th metatarsal which muscle is involved
    peroneus brevis
    per. longus
    per tertius
    ext dig longus

    Ans reye’s syndrome, histopathological finding
    1) Mitochondrial blebs and enlarged mitochondria
    2) Endoplasmic reticulum/lysosome
    3) Glycogen depletion
    4) Perinuclear staining

    answer 1 mitochondrial blebs and enlarged mitochondria

    harrison 16th edition page 1871

    There is mitochondrial dysfunction with decreased activity of hepatic
    mitochondrial enzymes

    schiff diseases of liver 10th edition page 1319 1320

    This disorder shares many features with mitochondrial hepatopathy, and indeed, abnormal mitochondria are an important
    ultrastructural feature.

    electrom microscopy reveals marked microvesicular steatosis (Fig. 47.9) and characteristic
    mitochondrial changes with swelling of matrix, dissolution of cristae and intramatrical granules, and ameboid shapes (per. tertius
  7. DR. Aayush.

    DR. Aayush. Guest

    fracture penis with intact Buck’s facia. Blood extravasates in
    1) butterfly shaped
    2) scrotum and penis only
    3) Scrotum, penis, anterior abdominal wall
    4) penile shaft only


    answer 4 penile shaft only

    refrence campbell urology 9th edition

    The diagnosis of penile fracture is often straightforward and can be made reliably by history and physical examination alone. Patients usually describe a cracking or popping sound as the tunica tears, followed by pain, rapid detumescence, and discoloration and swelling of the penile shaft. If Buck's fascia remains intact, the penile hematoma remains contained between the skin and tunica, resulting in a typical eggplant deformity ( Fig. 83-1 ). If Buck's fascia is disrupted, hematoma can extend to the scrotum, perineum, and suprapubic regions.
  8. DR. Aayush.

    DR. Aayush. Guest

    fracture penis with intact Buck’s facia. Blood extravasates in
    1) butterfly shaped
    2) scrotum and penis only
    3) Scrotum, penis, anterior abdominal wall
    4) penile shaft only


    answer 4 penile shaft only

    refrence campbell urology 9th edition

    The diagnosis of penile fracture is often straightforward and can be made reliably by history and physical examination alone. Patients usually describe a cracking or popping sound as the tunica tears, followed by pain, rapid detumescence, and discoloration and swelling of the penile shaft. If Buck's fascia remains intact, the penile hematoma remains contained between the skin and tunica, resulting in a typical eggplant deformity ( Fig. 83-1 ). If Buck's fascia is disrupted, hematoma can extend to the scrotum, perineum, and suprapubic regions.
  9. DR. Aayush.

    DR. Aayush. Guest

    question what maintains primitive streak..answer is nodal gene. Langman 8th pg-68
  10. DR. Aayush.

    DR. Aayush. Guest

    Semen analysis

    Semen analysis is usually performed on a sample collected after at least 36 to 72 hours of sexual abstinence. The specimen is most often obtained after masturbation, but some centres have approved a special condom for collection of the semen during normal intercourse. After the sample has been obtained, it must be taken to the clinic as soon as possible.

    The analysis is carried out under direct visual and microscopic examination.

    First, the sample is assessed for the physical characteristics of the semen, sperm density, motility and morphology (cellular characteristics).

    In addition, it is usual to check the pH of the semen (which should be neutral or slightly acid: alkaline pH may indicate the presence of infection), to check liquefaction and viscosity and to carry out a test for the presence of antisperm antibodies.

    Seminal levels of the sugar, fructose, are also measured as an absence of fructose in the ejaculate implies obstruction distal to the seminal vesicles. This is one of the few cases in which a testicular biopsy may be indicated.

    A concentration of white blood cells (leukocytes) in the semen has an adverse effect on fertilisation and, especially with an alkaline pH, may indicate a genital tract infection.

    The table below lists the World Health Organisation (WHO) criteria for normal semen analysis.

    WHO criteria for normal semen analysis
    Criteria Parameters
    Volume 2.0-5.0 ml
    pH 7.2 to 7.8
    Sperm concentration 20 x 106 per ml or more
    Total sperm count 40 x 106 spermatozoa or more
    Motility 50% or more with forward progression or 25% or more with rapid linear progression within 60 min after collection
    Morphology 50% or more with normal morphology
    Viability 75% or more live (i.e. excluding dye)
    White blood cells Fewer than 1 x 106 per ml
    Zinc (total) 2.4 mol or more per ejaculate
    Citric acid (total) 52 mol (10 mg) or more per ejaculate
    Fructose (total) 13 mol or more per ejaculate
  11. DR. Aayush.

    DR. Aayush. Guest

    Q.which Is not essential feature of TOF
    1) pulmonary valvular stenosis
    2) infundibular stenosis
    3) overriding of aorta



    REF:langman"s embryology
    confirmed
  12. DR. Aayush.

    DR. Aayush. Guest

    Who criteria for semen analysis, all are true for normal except
    1) forward propelling motility >15%(strict criteria)
    2) normal morphology >25%
    3) volume of 1ml
    4) Sperm count >20million
  13. DR. Aayush.

    DR. Aayush. Guest

    The differential diagnosis of CT hyperdensities of basal ganglia thalami and cerebellum include Alexander's disease, Fahr's syndrome, tuberous sclerosis and Cockayne's disease, Sandhoff and Tay Sach's disease
    Alexander's DiseaseIt has two distinctive imaging features, namely macrocephaly and a predilection for the frontal white matter. Contrast enhancement can be seen during the acute phases of dysmyelination and demyelination. In late stage disease more global involvement of the white matter is the rule, and brain atrophy also develops
  14. DR. Aayush.

    DR. Aayush. Guest

    pt with white mater disease with "hyperintense thalami" is -
    a-Alexander's disease
    b-Kanavan's disease
    c-PML



    Q-Which anti-emetic has highest affinity for 5HT receptor?
    1-ondansetron
    2-granisetron
    3-pavalosetron
    4-dolasetron

    FNA needle size
    a]22-26G
    b]27-29G
    C)18-22G
    D)16-18G

    ans 22-26 G

    current FNA procedure uses needle ranging from 21 to 27 guage.
    21 g needle provide more cellular samples than 25 g but may not provide increased Dg accuracy.

    -Which anti-emetic has highest affinity for 5HT receptor?
    1-ondansetron
    2-granisetron
    3-pavalosetron
    4-dolasetron
  15. DR. Aayush.

    DR. Aayush. Guest

    Structures pierced during pleurocentesis In mid-axillary line are all except
    1.innermost intercostal
    2.ext. intercostal
    3.int. intercostal
    4.trans.thoracis

    In Fine Needle Aspiration Cytology, needle used is
    1.16-18no
    2.18-22no
    3.22-26no
    4.26-30no

    Part to be examined last in asphyxia death,
    1.Head
    2.Neck
    3.Thorax
    4.Abdomen

    Which dye is not used for staining lipid?
    1.sudan black
    2.congo red
    3.sudan 3
    4.Oil Red O

    What is true of Metabolic alkalosis
    1.Mineralocorticoid excess
    2.Mineralocorticoid deficiency
    3.excess base excretion
    4.decreased hydrogen ion excretion

    Langerhans cell histiocytosis is a T cell tumor. The marker is
    1.CD 68.
    2.CD 3.
    3.CD 1a.
    4.CD 57.

    Hampton sign
    1.Pulmonary embolism
    2.Aspergillosis
    3.Tuberculosis
    4.Bronchogenic Ca


    Transparency of cornea is not caused by?
    1.hydration
    2.non myelinated nerve fibre
    3.increase in space between collagen fibre
    4.increase mitotic figures in the stroma.

    Not a constant feature of TOF
    1.RVH
    2.Valvular Stenosis
    3.Overriding aorta
    4.Infundibular stenosis

    Most common type of epilepsy in infants
    1.myoclonic
    2.tonic
    3. clonic
    4.subtle

    Which of the following match is correct
    1.Delta cells - glucagon
    2.Beta cells - somatostatin
    3.Alpha cells -insulin
    4.G cells - Gastrin

    In cerivical pap smear examination the ideal fixative used is
    1.alcohol
    2.acetone
    3.Xylol
    4.

    In PAS stainning all the structures are stained are magenta blue except
    1.fungal cell wall
    2.basement membrane
    3.Glycogen
    4.Lipids

    Urothelium lines all except
    1.calyces
    2.ureter
    3.urinary bladder
    4.collecting duct

    Bone tumours classified on basis of
    1.TNM
    2. Manchester
    3.Edmonston

    Ureter develops from?
    1.Mesonephric duct
    2.Pronephros
    3.Paramesonephric duct
    4.Mesonephros.

    Which does not occur in ulnar nerve injury?
    1.claw hand
    2.atrophy of hypothenar eminence
    3.loss of sensation of medial one third of hand
    4.adduction of thumb

    Most common tumour seen in pts wid neurofibromatosis type 1
    1.Optic glioma
    2.Pilocytic astrocytoma
    3.Glioblastoma
    4.Brainstem glioma

    HACEK Group of Organisms include all except
    1.Haemophilus aphrophilus
    2.Acineobacter comitans
    3.Cardiobacterium hominis
    4.Eikenella corrodens

    OC pill is contraindicated in patients receiving
    1.rifampicin
    2.pyrizinamide
    3.ethambutol
    4.streptomycin

    Scrub typhus vector is
    1.Thrombiculid mite
    2.Reduvid bug
    3.Enteric pathogens
    4.Cyclops

    During Tracheostomy following structure is least likely to be injured
    1.Isthmus of gland
    2.Thyroida Ima A.
    3.Inf. thyroid veins
    4.Inf. thyroid A.

    A 40yr old smoker presents with chest pain and pain in the epigastrium, ecg shows ST elevation in inferior leads.The next best treatment modality is
    1.Aspirin
    2.Thrombolysis
    3.Beta blocker
    4.Pantoprazole

    A 20yr old female undergoes laparoscopic appendicectomy. next day the patient slips in the ward and sustains injury to the face.
    a swelling is noted in the anterior aspect of the nasal septum. the swelling is soft and obstructing the airway. what is the best line of treament
    1. Drain the swelling
    2. I.V antibiotics for 7 days
    3.Oral antibiotics for 2 weeks followed by follow up.
    4. Keep under observation.
  16. DR. Aayush.

    DR. Aayush. Guest

    The acronym HACEK refers to a grouping of gram-negative bacilli; Haemophilus species (H parainfluenzae, H aphrophilus, and H paraphrophilus), Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella species.
  17. DR. Aayush.

    DR. Aayush. Guest

    ) Regarding Y chromosome true is:
    a)determines dev. of ovary
    b)Genital dev. starts by 5th week
    c)Male genitalia develops before female
    d)genital differentiation complete by 10th week

    2)In changing from standing to supine position, what is true:
    a)HR increases & setles at higher level.
    b)Ven. return increases immediately
    c)Cerebral bld. flow increases & settles at higher level.

    3)corneal endoth. pump blocked by:
    a)inhibiting anaerobic glycolysis
    b)stimulating aner. glycolysis
    c)stimulating aerobic glycolysis
    d)stimulating Electron Transport Chain

    4)Regards O2 utilization by heart, true is:
    a)inverse proportional to HR
    b)negligible in quiscent heart
    c)Directly proportional to ?mean systolic pressure
    d)Bears constant relation to work done by heart

    5)peroxidase enzyme is used to determine:
    a)creatinine b)glucose c)Hb

    6)Same protein structure with different amino acid sequence. The evolution is:
    a)convergent b)divergent c)incidental

    7)Sound clinical practice not applicable in:
    a)Preclinical trials b)PhaseI c)PhaseII d)PhaseIV

    8)In senile cardiac amyloidosis, protein resembles:
    a)Transthyretin b)ANP c)beta2m

    9)Invasive cervical carcinoma is maximum with:
    a)low grade squamous metaplasia
    b)high grade sq. metaplasia
    c)HPV 16 associated
    d)HIV associated

    10)What is used to clean blood stains:
    a)Iodine b)Sod. hypochlorite c)Absolute alcohol
    d)Quaternary ammonium compounds
  18. DR. Aayush.

    DR. Aayush. Guest

    which of the following is false abt csf..
    1.ph is lower then that of blood
    2.csf is secreted by arachonoid villi
    3.one of the imp cuase of persistent headache is dural tap
  19. Dr.Bose

    Dr.Bose Guest

    Q. A child presents with non blanching rash over the extensor aspect of arm with swelling over knee urine analysis show proteinurea 1 + and RBC 3+ on kidney biopsy which finding will be seen
    a) fusion of podocytes
    b) ATN
    c) depositions of Ig A
    d)thickening of membrane

    ANS- c) depositions of Ig A.
    This is a case of IgA NEPHROPATHY (BERGER DISEASE)/HENOCH-SCHONLEIN PURPURA,
    This syndrome consists of purpuric skin lesions characteristically involving the extensor surfaces of arms and legs as well as buttocks; abdominal manifestations including pain, vomiting, and intestinal bleeding; nonmigratory arthralgia; and renal abnormalities. The renal manifestations occur in one-third of patients and include gross or microscopic hematuria, proteinuria, and nephrotic syndrome.This form of glomerulonephritis is characterized by the presence of prominent IgA deposits in the mesangial regions, detected by immunofluorescence microscopy. A small number of patients, mostly adults, develop a rapidly progressive form of glomerulonephritis with many crescents. Not all components of the syndrome need to be present, and individual patients may have purpura, abdominal pain, or urinary abnormalities as the dominant feature. The disease is most common in children 3 to 8 years old, but it also occurs in adults, in whom the renal manifestations are usually more severe. There is a strong background of atopy in about one-third of patients, and onset often follows an upper respiratory infection. IgA is deposited in the glomerular mesangium in a distribution similar to that of IgA nephropathy. This has led to the concept that IgA nephropathy and Henoch-Schönlein purpura are spectra of the same disease.

    ROBBIN'S Pathology 7th ed pg-990
  20. Dr.Bose

    Dr.Bose Guest

    Que. Collapsing glomarulopathy following is seen
    A) proliferation of parietal cells
    B) tuft necrosis
    C)visceral epithelial cell destruction
    d)

    ANS-C)visceral epithelial cell destruction.

    A morphologic variant of focal segmental glomerulosclerosis, called collapsing glomerulopathy, is characterized by collapse and sclerosis of the entire glomerular tuft in addition to the usual focal segmental glomerulosclerosis lesions.A characteristic feature is proliferation and hypertrophy of glomerular visceral epithelial cells. This lesion may be seen in situations in which it is idiopathic, but it is the most characteristic lesion of HIV-associated nephropathy.
    PATHOGENESIS-
    The characteristic degeneration and focal disruption of visceral epithelial cells are thought to represent an accentuation of the diffuse epithelial cell change typical of minimal change disease. It is this epithelial damage that is the hallmark of focal segmental glomerulosclerosis. The hyalinosis and sclerosis represent entrapment of plasma proteins in extremely hyperpermeable foci with increased ECM deposition.

    ROBBIN'S Pathology 7th Ed Pg- 9 8 3
  21. Dr.Bose

    Dr.Bose Guest

    Phenytoin, all are true except-

    a) Induces enzymes
    b) Zero order kinetics at low dose
    c) Half life increases with increasing dose
    d) Highly protein bound

    ANS-b) Zero order kinetics at low dose.

    The elimination of phenytoin is dose-dependent. At very low blood levels, phenytoin metabolism follows first-order kinetics.Further increases in dosage, even though relatively small, may produce very large changes in phenytoin concentrations. In such cases, the half-life of the drug increases markedly
    -Phenytoin is highly bound to plasma proteins(90% bound to plasma proteins).
    -Phenytoin has been shown to induce microsomal enzymes responsible for the metabolism of a number of drugs.

    Ref- Katzung Basic & Clinical Pharmacology , 10th Ed
  22. Dr.Bose

    Dr.Bose Guest

    bisphosphonates are used in all except
    a) hypercalcemia
    b) cancer
    c) osteoporosis
    d) hypervitaminosis D

    Ans- d) hypervitaminosis D chronic hypercalcemia of sarcoidosis, vitamin D intoxication, and certain cancers may respond within several days to glucocorticoid therapy.The treatment of hypervitaminosis D with glucocorticoids probably does not alter vitamin D metabolism significantly but is thought to reduce vitamin D-mediated intestinal calcium transport
    -bisphosphonates are useful for the treatment of hypercalcemia associated with malignancy, for Paget's disease, and for osteoporosis.

    Ref- Katzung Basic & Clinical Pharmacology , 10th Ed
  23. hawk

    hawk Guest

    conversion of one differentiated type to stem cell to other type known as??

    a.transdifferntiation
    b.redifferntiation
    c.regenration
    d.metaplasia(???)(not sure about the options but answer is definately a)


    answer a.trandifferntiation

    refrence lanza essentials of stem cell biology
    page 87

    Metaplasia is defined as the conversion of one cell type to
    another, and it can include conversions between tissuespecific
    stem cells. Transdifferentiation, on the other hand,
    refers to the conversion of one differentiated cell type to
    another and should therefore be considered a subset of metaplasia.
    Historically, metaplasia has been the term used by
    pathologists, but in recent years transdifferentiation has
    become the favored term, even when discussing the conversion
    of tissue-specific stem cells to unexpected lineages.
    Within the medical community, the idea of metaplasia is not
    controversial, but in the scientific community, some skepticism
    still surrounds the phenomenon of transdifferentiation—
    it being attributed to tissue culture artifacts or cell fusion.
    Nevertheless, it is important to study metaplasia and transdifferentiation
    to gain a better understanding about the regulation
    of cellular differentiation, which may lead to new therapies for a variety of diseases, including cancer.
  24. hawk

    hawk Guest

    ondansetron, granisetron, dolasetron, and palonosetron. The first three agents (ondansetron, granisetron, and dolasetron, Figure 63–6) have a serum half-life of 4–9 hours and may be administered once daily by oral or intravenous routes. All three drugs have comparable efficacy and tolerability when administered at equipotent doses. Palonosetron is a newer intravenous agent that has greater affinity for the 5-HT3 receptor and a long serum half-life of 40 hours.

    its from katzung : and so answer is palonosetron....
  25. kavish

    kavish Guest

    bisphosphonates are used in all except
    a) hypercalcemia
    b) cancer
    c) osteoporosis
    d) hypervitaminosis D

    Ans- d) hypervitaminosis D

    chronic hypercalcemia of sarcoidosis, vitamin D intoxication, and certain cancers may respond within several days to glucocorticoid therapy.The treatment of hypervitaminosis D with glucocorticoids probably does not alter vitamin D metabolism significantly but is thought to reduce vitamin D-mediated intestinal calcium transport
    -bisphosphonates are useful for the treatment of hypercalcemia associated with malignancy, for Paget's disease, and for osteoporosis.

    Ref- Katzung Basic & Clinical

    BISPHOSPHONATES are used in cancer induced hypercalcemia,not in cancer.
  26. kavish

    kavish Guest

    BISPHOSPHONATES are used in cancer induced hypercalcemia,not in cancer.



    goodman gillman 11th edition 2005

    use of bisphosphonates

    Therapeutic Uses

    Hypercalcemia. The use of pamidronate in the management of malignancy-associated hypercalcemia was described earlier. Zoledronate appears to be more effective than pamidronate and at least as safe and can be infused over 15 minutes rather than 2 to 4 hours. It therefore has received FDA approval for this indication.

    Postmenopausal Osteoporosis. Much interest is focused on the role of bisphosphonates in the treatment of osteoporosis (see "Osteoporosis," below). Clinical trials show that treatment is associated with increased bone mineral density and protection against fracture.

    Cancer. Bisphosphonates also may act as anticancer drugs by inhibiting the activation of cancer-associated proteins, such as Ras, through suppression of geranylgeranylation and farnesylation. Second- and third-generation bisphosphonates inhibit the proliferation of some cancer cells by preventing post-translational prenylation of Ras-related proteins. Zoledronate has been used successfully as an adjunct in treating Philadelphia chromosome-positive chronic myelogenous leukemia
  27. kavish

    kavish Guest

    Que.1 Tryptans act through
    1)5HT1a
    2)5HT1b
    3)5HT1c
    4)5HT3
    answer 2.ref tripathi

    Que.2 Therapeutic monitoring is required for all except
    1) Phenytoin
    2) Cyclosporine
    3) Tacrolimus
    4) Metformin
    ans.4.not sure

    Que.3 Kanavel’s sign present in
    1) Tenosynovitis
    2) Carpal tunnel syndrome
    3) Trigger finger
    4) Duputreyans contractures
    ans,1 ref,net

    Que.4 Acridine dye used to stain
    1) DNA-RNA
    2) Protein
    3) Lipid
    4) Carbohydrate
    ans,?

    Que.5 Stains for lipid are all except
    1) Oil red O
    2) Congo red
    3) Sudan III
    4) Sudan black

    ans,2 ref robbins

    Que.6 True about protease inhibitors are A/E
    1) MDR-1 gene
    2) Metabolized by hepatic enzymes
    3) Drug interaction
    4) Saquinavir most potent action on CYP3A4


    Que.7 Shoulder pain in laparoscopy is due to
    1) Subphrenic abscess
    2) CO2 narcosis
    3) Positioning of patient
    4) Compression of lungs

    Que.8 PAS positive a/e
    1) Glycogen
    2) lipid
    3) fungal Cell wall
    4) basement membrane

    ans,2

    Que.9 for Vibrio cholera, medium used
    1) Thayer martin
    2) TCBS
    3) Scirrow
    4) ..

    ans,2

    Que.10 Primary impact injury is most common in
    1) head
    2) chest
    3) abdomen
    4) leg



    Que.11 Telefona
    1) Pulling of hair
    2) Beating on soles
    3) Beating on ears
    4) …

    ans.3 ref reddy

    Que.12 In tandem [bleep], number of [bleep] fired
    1) 1
    2) 2
    3) 3
    4) 4

    ans.2

    Que.13 Vitreous humor is sent in
    1) Phenol
    2) HCl
    3) Xylol
    4) alcohol

    Que.14 Fixing of cervical smear is done by
    1) Ethanol
    2) Acetone
    3) Xylene
    4) ..

    ans,2

    Que.15 Blood spills on floor are cleaned by
    1) Sodium hypochlorite
    2) Iodine
    3)
    4)

    ans.1

    Que.16 true about dietery allowance are all except
    1) RDA
    2) adequate intake
    3) dietary intake according to the food composition
    4) food intake according to the upper limit of RDA


    Que.17which of the following person is present in a sub centre
    1) multi purpose worker
    2) doctor
    3) lab technician
    4) health educator

    ans.1

    Que.18 Ionic exchange in the corneal endothelium depends upon the

    metabolic rate. In which of the following Ionic exchange is blocked
    1) Anaerobic glycolysis inhibition
    2) Aerobic glycolysis
    3) Phosphodiesterease inhibitors
    4)inhibitors of ETC

    Que.19 Gall bladder epithelium is
    1) simple columnar
    2) simple columnar with brush border
    3) squamous
    4) cuboidal with stercocilia

    ans.1

    Que.20 3 year old girl posted for tonsillectomy, found to have midline

    cystic swelling which is painless below the hyoid. What should be done

    next
    1) Surgery
    2) X-ray chest
    3) antibiotics
    4) Aspiration

    ans.1

    Que.21 After laparoscopic appendicectomy, patient had fall from bed on

    her nose, after whish she had swelling in the nose and slight difficulty in

    breathing. What should be done next
    1) Antibiotics for 7 to 14 days and discharge
    2) Intravenous antibiotics for 7-10 days
    3) Surgical drainage
    4) Observation in hospital

    ans.3


    Que.22 Goniometry is measurement of
    1) urethrovesical angle
    2) number of gonococci
    3)width of genital hiatus

    ans.1

    Que.23 Metabolic alkalosis is seen in
    1) Increased mineralocorticoid
    2) decreased mineralocorticoids
    3) increased base excretion
    4) decreased H+ ion secretion


    Que.24 Following drugs act on GABA-A except
    1) thiopentone
    2) midazolam
    3) zopiclone
    4) promethazine


    Que.25 Nephelometry depends on following law
    1) Lambert Beer law
    2) Scattering of light from particles
    3) refraction of light
    4) decread intensity of light


    Que.26 Thiopentone true are A/E
    1) induction agent of choice in shock
    2) cerebroprotective
    3) contraindicated in porphyria
    4) mixed with sodium bicarbonate

    Que.27 18 year old girl presents with amenorrhoea, milk discharge,

    weight loss. Diagnosis is
    1) Cancer
    2) Anorexia nervosa
    3) Hypothyroidism
    4)HIV

    ANS.2

    Que.28 True about vitiligo are all except
    1) Genetic predisposition
    2) Leucotrichia is associated with good prognosis
    3) PUVA-B is used for treatment
    4) Topical steroids give good results.


    Que.29 Down’s syndrome, true is A/E
    1) PAPP- A increased
    2) Increased b-HCG
    3) Absence of nasal bone
    4)


    Que.30 In patient with high clinical suspicion of pulmonary

    thromboembolism, best investigation would be
    1) D-dimer
    2) CT angiography
    3) Catheter angiography
    4)multisector CT angio


    Que.31 70 year old hypertensive with unconsiousness with normal ECG

    cause is
    1) pulmonary thromboembolism
    2) vasovagal attack
    3) temporal lobe epilepsi
    4)complete heart block


    Que.32 Thrombo prophylaxis are all except
    1) aspirin
    2) warfarin
    3) heparin
    4) AT 3

    ANS.4

    Que.33 pt of myocardial ischemia
    1)heparin
    2)pantoprezole
    3)aspirin
    4)thrombolytic therapy


    Que.34 in a pt with retro caecal appendicitis following maneuvers will

    produce pain
    1) flection at hip
    2) extension at hip
    3)medial rotation
    4)lateral rotation


    Que.35 cryoprecipitate not seen
    1)factor 8
    2) factor 9
    3) vWF
    4) fibrinogen

    ans.2 ref harrison

    Que.36 in a caase due to asphyxia last to be opened during

    dissections
    1) neck
    2) thorax
    3) abdomen
    4) brain


    Que.37 what is seen in normal person on lying down
    1) increase in venous return
    2)
    3)
    4)


    Que.38 exercise causes which of the following
    1) increase in muscle blood flow occurs after ½ min
    2) increase in body tempeture
    3)
    4)


    Que.39 most common type of seizure in neonates
    1) tonic
    2) clonic
    3) subtle
    4) myoclonic


    Que.40 block in the 2 nd part of axilary nearve what will searve as

    collateral
    1) subscapular and poster circumflex humeral
    2) circumflex scapular and ant circumflex scapular
    3)
    4)


    Que.44 post ductal compression of aorta collateral to serve are
    1) inteercostal and inferior epigastric
    2)
    3)
    4)

    Que.45 a child presents with non blanching rash over the extensor

    aspect of arm with swelling over knee urine analysis show proteinurea 1

    + and rbc 3+ on kidney biopsy which finding will be seen
    1) fusion of podocytes
    2) ATN
    3) depositions of Ig A
    4)thickening of membrane

    ans.3 ref ghai

    Que.46 collapsing glomarulopathy following is seen
    1) proliferation of parietal cells
    2) tuft necrosis
    3)mesangiolysis
    4)


    Que.47 Peristalsis of ureter depends on
    1) sympathetic flow
    2) parasympathetic flow
    3) both
    4) pacemaker in smooth muscle of ureter


    Que.48 In MVP, valve degeneration is
    1) hyaline degeneration
    2) myxomatous degeneration
    3) .. ..
    4) .. ..


    Que.49 In rheumatic carditis with MR, following finding will be seen
    1) Increased residual volume
    2) Increased PEFR
    3) decreased TLC
    4) Increased ventilatory capacity


    Que.50 # 5th metatarsal following forceful inversion is due to forceful

    contraction of following muscle.
    1) peroneus longus
    2) peroneus brevius
    3) peroneus tertius
    4) extensor digitorum brevis

    Que.51 In emergrncy tracheostomy following structures are damaged

    except
    1) Isthmus of thyroid
    2) inferior thyroid vein
    3) inferior thyroid artery
    4) thyoidea ima


    Que.52 Whats the uppermost structure in left lung hilus
    1) pulmonary artery
    2) pulmo. vein
    3) bronchial artery
    4) broncus

    ans.1 ref chaurashia

    Que.53 In systemic capillary blood flow, all are seen except
    1) Increased protein content
    2) decreased pH
    3) shift of oxygen dissociation curve to left
    4) increased hematocrit.


    Que.54 Cardiac O2 consumption is Directly proportional to
    1) mean arterial pressure
    2) external cardiac work done
    3) heart rate
    4)quiscent heart negligble


    Que.55 micronodular cirrhosis is seen in all except
    1) active hepatitis B
    2) Alcoholic cirrhosis
    3) Haemachromatosis
    4) Chronic cirrhosis secondary to biliary stasis


    Que.56 Phenytoin, all are true except
    1) Induces enzymes
    2) Zero order kinetics at low dose
    3) Half life increases with increasing dose
    4) Highly protein bound


    Que.57 which of the following drug binds most avidly to 5HT3
    1) granisetron
    2) ondansetron
    3) dolasetron
    4) PALAVOSETRAN


    Que.58 marker of acute hepatitis B
    1) HBV DNA
    2) IgG HBc
    3) HBs Ag
    4) HBe Ag


    Que.59 A 30 year old man, presents with 6 month history of facial pain

    and fever. On antibiotic therapy, fever subsided. After 1 month again

    had symptoms of mucopurilent discharge in middle meatus. Next best

    step
    1) Non contrast CT nose
    2) X ray maxillary sinus
    3) MRI
    4) Inferior meatus puncture


    Que.60 Tongue muscle develop from
    1) mesoderm of pharyngeal pouch
    2) Occipital SOMITE
    3)
    4) ..


    Que.61 A 3 year old child with h/o fever, dry cough with lower lobe

    consolidation, improved with antibiotics for 7 days. Follow up after 8

    weeks revealed increased consolidation. Next step in investigation
    1) bronchoscopy
    2) nasopharyngeal culture
    3) CT
    4)


    Que.62 meiosis in spermatogenesis occurs in which step
    1) Iry spermatogonia to secondary spermatogonia
    2)
    3)
    4)


    Que. 63 surfactant action
    1) Breaks structure of water
    2) lubricates CO2
    3) make capilariay surface hydrophilic
    4)


    Que.64 increase in maternal ser AFP is seen in
    1) downs
    2) molar pregnancy
    3) overestimation of gestation age
    4) renal agenasis


    Que.65 which Is not essential feature of TOF
    1) pulmonary valvular stenosis
    2) infundibular stenosis
    3) overriding of aorta
    4)right ventricular hypertrophy


    Que.66 linkage studies uses the principal of
    1) DNa polymorfism
    2)
    3)
    4)


    Que.67 methode of hb estimation except
    1) drabkins
    2) sahl’s
    3) spectrophotometry
    4) wintrobes


    Que.68 in PCR following is used
    1) Ca++
    2) Mg++
    3) Li+
    4) Na+

    Que.69 pulmonary hypertension is a\W all except
    1) hyperventelation
    2) obesity
    3) phenfluramin
    4) high altitude


    Que.70 clomiphen citrate is a\W all except
    1) polycystic overy
    2) foetal anamoly
    3) multiple pregnency
    4) ovarian cancer

    Que.71 diagnosis of asherman syndrome is done by all except
    1) Endometrial culture
    2) hysteroscopy
    3) Hysterosalpingography
    4) saline infusion sonography


    Que.72 Pancytpenia with cellular marrow is seen in all except
    1) PNH
    2) Megaloblastic anaemia
    3) myelodysplasia
    4) congenital dyserythropoietic anaemia


    Que.73 Uterine relaxant with Least side effects
    1) Ritodrine
    2) Nifedipine
    3) Progesteron
    4) Magnesium sulphate


    Que.74 Following is associated with max risk of invasive cervical cancer
    1) HPV 16 with dysplasia
    2) Mild dysplasia
    3) High grade dysplasia
    4) HIV associated


    Que.75 Internal podalic version for transverse lie complication is
    1) uterine rupture
    2) cervical laceration
    3) Uterine inertia
    4) vaginal laceration


    Que.76 Drugs causing Hyperglycemia
    1) corticosteroids
    2) b blockers
    3)
    4)


    Que.77 Not seen in VHL
    1) Pheochromocytoma
    2) Pancreatic tumour
    3) Endolymphatic sac tumour
    4) islet cell tumour


    Que. 78 left renal vein crosses aorta at the level of
    1) Posterior at level of superior mesenteric artery
    2) anterior above the level of superior mes. A.
    3) Anterior below the superior mesenteric A
    4) Anterior below the inferior mesenteric A
    5) Anterior at the level of superior M.A.

    Que.79 Who criteria for semen analysis, all are true for normal except
    1) forward propelling motility >15%(strict criteria)
    2) normal morphology >25%
    3) volume of 1ml
    4) Sperm count >20million


    Que.80 B/L mobile true vocal cords, infiltrating of aretynoid, involving

    false cord, treatment is
    1) Transverse hemi laryngectomy
    2) Vertical hemi laryngectomy
    3) radiation and chemotherapy
    4) total laryngectomy

    Que.81 In universal immunization, which is not included
    1) Hepatitis B
    2) BCG
    3) TT
    4) Measles


    Que.82 hypertension with hypokalemia is seen in A/E
    1) Cushings
    2) Renal artery stenosis
    3) ESRD
    4) primary hyperaldosteronism

    Que.83 Absence of Corpus callosum leads to
    1) Hemiparesis
    2) Hemianaesthesia
    3) Stereognosis loss
    4) No neurological sequelae


    Que.84 Transparency of cornea is maintained by A/E
    1) Mitotic figures in the cornea
    2) Wide separated collagen bands
    3) Hydration of corneal epithelium
    4) Unmyelinated nerve fibers


    Que.85 Furesemide, true is
    1) Acts on PCT
    2) Given only by parenteral route
    3) Used in pulmonary oedema
    4) cause mild diuresis

    que.86 Thiazide causes all except
    1) Hyperglycemia
    2) Increased calcium excretion
    3) Increased blood uric acid levels
    4) Used in CCF


    Que.87 Drug stopped on the day of operation
    1) Metformin
    2) Atenolol
    3) Amlodepin
    4) Statins


    Que.88 Fourth lobe of liver by Couniyad’s classification
    1) Left lobe
    2) Right lobe
    3) Quadrate lobe
    4) Caudate lobe


    Que.89 Persistent foetal lobulation of adult kidney because of
    1) normal variant
    2) congenital BL…
    3) obstructive uropathy
    4) Intrauterine infections and scars


    Que.90 On post mortem of a new born, kidney shows radial cysts.

    Which of the following finding would be associated with this condition
    1) imperforate anus
    2) hepatic cysts with fibrosis
    3) absent ureters
    4) …


    Que.91 cervical incompetence. G3 presents with 2 previous 2nd

    trimester abortions presents at 22 weeks with funneling of cervix. What

    should be done
    1) McDonald’s suturing
    2) Fothergill’s suturing
    3) ..
    4) ..


    Que.92 Congenital anomaly associated most commonly with urothelial

    cancers
    1) Extrophy of bladder
    2) Medullary sponge kidney
    3) duplication of ureters
    4)


    Que.93 development of genital development, what is true
    1) Y chromosome is associated with ovary development
    2) Genital ridge develops at5th week
    3) male genitals develop earlier than female
    4) fully developed at 10th weeks


    Que.94 Patient with heart disease, which drug is not used in patient of

    haemorrhage to control PPH
    1) methyl ergometrine
    2) oxytocin
    3) misoprostol
    4) carboprost


    Que.95 baby not passed meconium for 48 hours, presents with vomiting

    and distension of abdomen, next investigation is
    1) contrast barium enema
    2) manometry
    3) esophagogram
    4) fecal fat estimation


    Que.96 with CSF all are true except
    1) pH less than blood
    2) No neutrophils present
    3) formed by arachnoid villi
    4) persistant leakage causes headache


    Que.97 Transitional epithelium is seen in all except
    1) collecting duct
    2) calyces
    3) ureter
    4) bladder


    Que.[snip] Gastroesophageal junctional adeno carcinoma is

    approached by following sequence
    1) abdomen-thorax
    2) thorax -abdomen
    3) thorax – abdo-neck
    4) abdo-mouth


    Que.99 dangerous area of eye
    1) ciliary body
    2) optic nerve
    3) sclera
    4) retina


    Que.100 perforators not present in
    1) ankle
    2) below inguinal ligament
    3) mid thigh
    4) distal to calf

    Que.101 pericardial pain is conducted through
    1) deep plexus
    2) superficial plexux
    3) phrenic
    4) subcostal nerves


    Que.102 which muscle is not punctured during mid-axillary line thorasic

    puncture
    1) internal intercostal
    2) external intercostal
    3) transverse thorasis
    4) innermost intercostals


    Que.103 FNAC Needle Gauze size
    1) 26-28
    2) 22-26
    3) 18-22
    4) 16-18


    Que.104 # penis with intact Buck’s facia. Blood extravasates in
    1) butterfly shaped
    2) scrotum and penis only
    3) Scrotum, penis, anterior abdominal wall
    4) penile shaft only


    Que.105 duodenal ulcer with bleeding. Haematocrit 10 after transfusion.

    Pulse 110, BP 100/70. bleeding not controlled by endoscopic

    procedure. Next line of management
    1) PPI
    2) Distal gastrectomy + removal of bleeding portion of duodenum
    3) duodenotomy,control bleeder,truncal vagotomy and antrectomy
    4) Duodenotomy, with controlling bleeder and Pyloroplasty.


    Que.106 Ogilive syndrome, true is all except
    1) mechanical obstruction
    2) Partial bowel wall obstruction
    3) Ileus after morphine ingestion
    4)


    Que.107 Most common site of sub ependymal giant cell astrocytoma
    1) temporal horn of lareral ventricle
    2) foramen of monro
    3) 4th ventricle
    4)


    Que.108 reye’s syndrome, histopathological finding
    1) Mitochondrial blebs and enlarged mitochondria
    2) Endoplasmic reticulum(don’t remember)
    3) Glycogen depletion
    4) Perinuclear staining


    Que.109a best investigation to rule out cystic fibrosis after sweat

    chloride test 25 and 35
    1) DNA test
    2) Foecal fat estimation
    3) CT chest
    4)

    Que.109b child with H/O respiratory problem. best investigation to rule

    out cystic fibrosis after sweat chloride test 25 and 35
    1) DNA test
    2) Foecal fat estimation
    3) CT chest
    4)

    Que.110 Fluorosis, true is all except
    1) most common cause of dental caries in children
    2) genu valgum
    3) nalgonda for defloridation
    4) deposited in bone and muscle


    Que.111 most common site of spinal tumour
    1) extramedullary intradural
    2) extra dural
    3) intra medullary
    4) …


    Que.112 initiation and maintenance of primitive streak is
    1) FGF8
    2) BMPr4
    3) EGRF
    4) nodagen gene

    Que.113 Mivacurium when given in high doses, all are true except
    1) bronchospasm
    2) hypertension
    3) flushing
    4) rapid onset of action


    Que.114 All are characteristic of schizophrenia except
    1) third person hallucination
    2) inappropriate emotions
    3) long stretches of mood changes
    4) formal thought disorder


    Que.115 rapid flow in the neurons is by all except
    1) dyenin
    2) kinesin
    3) neuro filaments
    4) micro filaments

    Que.116 type A personality false is
    1) hostile
    2) time pressure
    3) competitiveness
    4) mood fluctuations


    Que.117a senile cardiac amyloidosis
    1) transthyretin
    2) ANP
    3) beta 2 microglobin
    4) pyerdin

    Que.118 shock lung, histopathological finding is
    1) diffuse alveolar necrosis
    2) pulmonary oedema
    3) interstitial pneumonia
    4)


    Que.119 Most common brain tumor in NF1
    1) Optic glioma
    2) astrocytosis
    3) glioblastoma multiforme
    4)


    Que.120 bisphosphonates are used in all except
    1) hypercalcemia
    2) cancer
    3) osteoporosis
    4) hypervitaminosis D

    Que.121 Osteomalacia, true are all except
    1) increased serum calcium
    2) increased serum alkaline phosphatase
    3) looser’s zones
    4) proximal myopathy


    Que.122 Pectus excavatum, surgery is indicated in
    1) FEV1/FVC ratio <0.6
    2) 80% of expected
    3) ventilatory capacity
    4) FEV1 60% at max exercise toleration


    Que.123 FE Na <1 is seen in
    1) ATN
    2) Renal artery stenosis
    3) intrinsic renal failure
    4) pre renal

    Que.124 Good clinical practice not required in
    1) pre clinical testing
    2) Phase 1
    3) phase 2
    4) phase 4


    Que.125 hyaline cartilage collagen present is
    1) type 1
    2) 2
    3) 3
    4) 4



    Que.126 classification of bone tumors
    1) manchester
    2) TNM
    3) Einkein
    4) ..


    Que.127 white matter lesion with hyperdense image on thalamus.

    Diagnosis is
    1) Krabbe
    2) Metachromatic leucodystrophy
    3) Kanawell’s disease
    4) Alexander’s dis


    Que.128 ketoacidosis all are true except
    1) dehydration
    2) pain in abdomen
    3) bradycardia
    4) tacypnoea


    Que.129 cerebral metabolic rate is increased in
    1) propofol
    2) ketamine
    3) fluranes
    4)

    130.vaccine CI in seizures
    1.DPT
    2.measles
    3.typhoid

    131.basement membrane all except
    1.laminin
    2.nodagen
    3.entactin
    4.rhodopsin

    132.SAFE strategy
    1.trachoma



    133.scruib typhus
    1.trombiculid mite



    134.kalaazar
    1.sandfly
    2.tsetse fly


    135.hearing loss left ear pars flaccida perforation
    management
    1.tympanoplasty
    2..tympanoplasty with mastoid exploration
    3.antibiotics
    4.

    136.hamptons hump
    1. pul emboli
    2.bronchogenic ca



    137.egg on side app
    1.uncorrected TGA
    2.TA


    138.WATER LILY SIGN
    1.hydatid cyst
    2.hamartoma


    139.HACEK GROUP




    140.COMPARISON OF RESULTS WITH INTENDED OBJ
    1.EVALUATION
    2.MONITORING
    3.INPUT OUTPUT ANALYSIS
    4.NETWORK

    141.MISINTEERPRATION OF REAL OBJECTS
    1.ILLUSION
    2. DELUSION
    3.HALLUCINATION
    4.

    142.NOT APRINCIPLE OF LEARNING
    1.MODELING
    2.response prevention
    3.catharisis
    4.exposure

    143.epidemic dropsy
    1.sanguinarine



    144.bicarbonate absorption
    1.PCT
    2.DCT


    .

    145.NO except
    1.camp
    2.vasomotor tone



    146.APPARENTLY HEALTHY
    1.SCREENING




    147.low calcium for 2 wks
    1.raised parathormone



    148.schicks test




    149.irreversible injury
    1.amorphous densities in mitochondria



    150.c.diphtheria true except
    1.metachromatic granules
    2.locally not invasive
    3.elek,s test
    4.toxin chromosomal gene
  28. kavish

    kavish Guest

    columnar epithelium can be with striated border(when the microvilli are arranged regularly) or as a brush border(when microvilli are irregularly placed)

    columnar epithelium with a striated border is seen most typically in the small intestine and with a brush border in the gall bladder.

    so answer is c. epithelium with brush border
  29. kavish

    kavish Guest

    On post mortem of a new born, kidney shows radial cysts. Which of the following finding would be associated with this condition
    1) imperforate anus
    2) hepatic cysts with fibrosis
    3) absent ureters
    4) …


    answer:2) hepatic cyst with fibrosis
    refrence farnoff and martin neonatology and perinatal medicine 8th edition
    chapter 49

    AUTOSOMAL RECESSIVE POLYCYSTIC KIDNEY DISEASE

    Autosomal recessive polycystic kidney disease (ARPKD) is inherited and characterized by polycystic kidneys and congenital hepatic fibrosis; it occurs in approximately 1 in 10,000 to 40,000 live births.[22] ARPKD is distinct from renal dysplasia, a disorder usually seen in patients with chromosomal or syndromic conditions. The majority of patients with ARPKD present in the newborn period, although rare presentations in later childhood are described. Prenatal ultrasonography shows enlarged, echogenic kidneys. Although the amniotic fluid volume is initially normal, oligohydramnios is often noted in the late middle trimester. The newborn infant with ARPKD may present with palpable abdominal masses, severe hypertension, and renal insufficiency. Respiratory failure related to pulmonary hypoplasia and marked abdominal distention from the massively enlarged kidneys are common in neonates with ARPKD.[21]

    Renal histopathology reveals that after a transient phase of proximal tubular cyst formation, the principal site of subsequent cyst formation is the collecting duct ( Fig. 49–13 ). Progressive interstitial fibrosis is an additional histopathologic feature of ARPKD. In addition, virtually all infants with ARPKD have some degree of congenital hepatic fibrosis with biliary dysgenesis. However, clinical evidence of hepatic involvement is often absent at birth

    remember other thing

    Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disorder, occurring at an incidence of 1 in 1000 live births; however, neonatal presentation is relatively rare.clinical spectrum of neonatal ADPKD ranges from severe neonatal manifestations indistinguishable from those of ARPKD to variable degrees of renal insufficiency and hypertension to asymptomatic cysts seen on renal ultrasonography. Because the clinical presentation of neonatal ARPKD and ADPKD can be very similar, an examination of the patient’s parents for the presence of renal cysts is important in establishing the correct diagnosis
  30. Aayush.

    Aayush. Guest

    Absence of Corpus callosum leads to
    1) Hemiparesis
    2) Hemianaesthesia
    3) Stereognosis loss
    4) No neurological sequelae

    answer 4. no neurlogical sequelae chapter 38

    refrence farnoff neonatology and perinatal medicine 8th edition

    Agenesis of the corpus callosum is a relatively frequent malformation. Its prevalence in the general population is unknown because it might occur in a totally asymptomatic manner. Its prevalence in a population with mental retardation reaches 2% to 3%. Agenesis of the corpus callosum represents approximately 50% of the malformations of the midline.

    Agenesis of the corpus callosum can be partial (affecting in most cases the posterior portion, except when it is associated with holoprosencephaly) or complete. The lateral ventricles are deformed by the fibers of the cerebral hemispheres that were destined to form the corpus callosum and that form the Probst bundles running longitudinally along the lateral ventricles. The Probst bundles are inconsistently present, and their presence has been considered a sign of better prognosis.

    Corpus callosum agenesis can be associated with other brain malformations (such as neuronal migration disorders) or with extracerebral malformations. In the presence of associated malformations, the prognosis of agenesis of the corpus callosum is considered poor in most cases. In contrast, the prognosis of isolated agenesis of the corpus callosum (partial or complete) is much more variable, with some cases having a totally normal or near-normal neurologic outcome,[/b] some cases with moderate or severe neurologic handicap, and some cases evolving toward death within the first days or months after birth. Because of the relatively low number of reported cases and the relatively short follow-up in many of these cases, providing reliable figures for the neurologic outcome of the isolated malformation remains difficult.
  31. Aayush.

    Aayush. Guest

    afp is elevated in all except?

    1.down sydrome
    2.over estimated gestational age
    3. invasive mole
    4. congenital nephrotic syndrome

    answer 4. congenital nephrotic syndrome

    refrence williams obstretics 22nd edition chapter 13 table 13-7

    Table 13–7. Conditions Associated with Abnormal Maternal Serum Alpha-Fetoprotein Concentrations



    Elevated Levels
    Neural-tube defects
    Pilonidal cysts
    Esophageal or intestinal obstruction
    Liver necrosis
    Cystic hygroma
    Sacrococcygeal teratoma
    Abdominal wall defects—omphalocele, gastroschisis
    Urinary obstruction
    Renal anomalies—polycystic or absent kidneys
    Congenital nephrosis
    Osteogenesis imperfecta
    Congenital skin defects
    Cloacal exstrophy
    Chorioangioma of placenta
    Placental abruption
    Placenta accreta
    Oligohydramnios
    Preeclampsia
    Multifetal gestation
    Low birthweight
    Fetal death
    Improper adjustment for low maternal weight
    Underestimated gestational age
    Maternal hepatoma or teratoma
    Low Levels
    Chromosomal trisomies
    Gestational trophoblastic disease
    Fetal death
    Improper adjustment for high maternal weight
    Overestimated gestational age
  32. Aayush.

    Aayush. Guest

    Down’s syndrome, true is A/E
    1) PAPP- A increased
    2) Increased b-HCG
    3) Absence of nasal bone
    4) abnormality in ductal flow(some thing like this)


    answer 1) papp-A is increased
    refrence farnoff-martin neonatal and perinatal medicine.

    First-trimester screening has also been initiated and includes pregnancy-associated plasma protein A (PAPP-A), the free β subunit of hCG, and the ultrasonographic detection of nuchal translucency. PAPP-A is a homodimer from the placenta, and its function is unknown. In the first trimester, PAPP-A is decreased and free β-hCG increased in Down syndrome. When PAPP-A and β-hCG are combined with nuchal translucency detection, which measures skin thickness at the posterior neck, the initial studies indicate that the detection rates for Down syndrome are equal to those obtained with triple screening in the second trimester.[1] First-trimester screening can detect about 79% of Down syndrome cases, with a positive screening rate of 5%. The American College of Obstetrics and Gynecology has stated that first-trimester screening can be offered only if appropriate ultrasound training and quality monitoring programs are in place, comprehensive counseling is available, and access to diagnostic testing is available for cases with positive results.
  33. Aayush.

    Aayush. Guest

    Gall bladder epithelium is
    1) simple columnar
    2) simple columnar with brush border
    3) squamous
    4) cuboidal with stercocilia

    refrence basic histology text and atlas 11th edition by carlos and jose


    The gallbladder is a hollow, pear-shaped organ attached to the lower surface of the liver. It can store 30–50 mL of bile. The wall of the gallbladder consists of a mucosa composed of simple columnar epithelium and lamina propria, a layer of smooth muscle, a perimuscular connective tissue layer, and a serous membrane The mucosa has abundant folds that are particularly evident when the gallbladder is empty. The epithelial cells are rich in mitochondria (Figure 16–27). All these cells are capable of secreting small amounts of mucus. Tubuloacinar mucous glands near the cystic duct are responsible for the production of most of the mucus present in bileThe main function of the gallbladder is to store bile, concentrate it by absorbing its water, and release it when necessary into the digestive tract. This process depends on an active sodium-transporting mechanism in the gallbladder's epithelium. Water absorption is an osmotic consequence of the sodium pump. Contraction of the smooth muscle of the gallbladder is induced by cholecystokinin, a hormone produced by enteroendocrine cells located in the epithelial lining of the small intestine. Release of cholecystokinin is, in turn, stimulated by the presence of dietary fats in the small intestine
  34. nonu.

    nonu. Guest

    bhatia's Anatomy notes say GB has simple columnar epithelium with brush border and that's what i've marked. dnt know....
  35. nonu.

    nonu. Guest

    .which Is not essential feature of TOF
    1) pulmonary valvular stenosis
    2) infundibular stenosis ans ?
    3) overriding of aorta
    4)


    REF:langman"s embryology
    confirmed


    SORRY THAT' A MISTAKE CORRECT ANS. IS VALVULAR
    Q.which Is not essential feature of TOF [/color]
    1) pulmonary valvular stenosis
    _________________
  36. James.

    James. Guest

    which is the watershed area of colon where superior mesentric artery and inferior mesentric artery meet and is more prone to ischemic injury?

    a.ascending colon
    b.hepatic flexure
    c.splenic flexure
    d.descending colon

    answer is c. splenic flexure

    maingot abdominal operation 11th edition

    The arterial blood supply to the colon comes from the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA), which communicate in a watershed area in the splenic flexure (artery of Drummond).

    yamada text book of gastroenterology 2nd edition

    Ischemic colitis is the most common form of ischemic injury to the gut and occurs more frequently in elderly people. It can result from either occlusive or nonocclusive events, mainly in the territory of the IMA, in colonic branches of the SMA, and in the SMV and IMV. Thus, ischemic colitis is predominantly seen in the left colon. 88 The splenic flexure and rectosigmoid junction, where low perfusion exists (watershed areas), are commonly affected, whereas the rectum is not usually compromised because of excellent collateral perfusion. Right colon ischemic colitis is rare, 89 is mainly due to low-flow states, and is associated with poor prognosis.

    in this question AIIMS has asked our old question what is the most common site of ischemic colitis in a different way.
  37. James.

    James. Guest

    Q- A gravida3 female with a history of 2 previous 2nd trimester abortions presents at 22 weeks of gestation with funneling of the internal os of cervix. Most appropriate management would be:
    a. Administer Dinoprostone
    b. Administer Progesterone
    c. Apply Fothergill’s stitch
    d. Apply McDonald’s stitch

    ref:WILLIAMS obstertrics 22/E;pg.137.
    Dutta obstetrics 6/E;pg.169-172.

    This is a case of cervical incompetence causing recurrent 2nd trimester abortion
    -Classically it is assoc with painless cervical dilatation in 2nd trimester with prolapse and balloning of membranes into the vagina followed by expulsion of an immature fetus.
    -Diagnosis by,
    a.premenstrual hysterocervicogaphy shows "funnel shaped shadow".
    b.TVUS findings-cervical length <3cm,"FUNNELLING-ballooning of membranes into a dilated internal os but a closed external os",width of int. os >1.5cm in T1.
    Management;
    -during preg.-rest,reassurance,TLC[tender loving care!],US monitoring of a viable fetus
    -treatment of underlying etiologies- natural micronised progesterone for LPD[lutal phase defect],low dose aspirin or aspirin+heparin for assoc. antiPL-antibody syn,......
    -CIRCLAGE OPERATION-The tratment of classical cervical incompetence is cerclage.
    The operation is performed to surgically reiforce the weak cervix by some type of purse string suturing.
    bleeding,ruptured membranes and uterine contractions are C/I ti cerclage.
    US to confirm a living fetus and to exclude fetal anomalies should precede cerclage.also cervical specimens to r/o chlammydia or gonorrhoeal infections is sent for examination.
    cerclage is performed prophylactically b/w 12-16 wks or emergently following cervical dilatation.
    Two types of cerclage poerations are performed-MCDONALD'S operation[simple procedure] and SHIRODKAR'S operation[complicated.].both have a success rate of 85-90%,but most practitioners reserve the modified Shirodkar's procedure for women with a previous failure of MCDONALD'S cerclage or those with structural cervical abnormalities.
    so ans------->C.
  38. shashank.

    shashank. Guest

    term infant has not passed meconium for 48 hours. He presents with distension of abdomen and emesis since one day. Next most appropriate investigation would be:
    a. Genetic testing for cystic fibrosis
    b. Manometry
    c. Lower bowel contrast enema
    d. Oesophagoscopy

    nelson 17th edition

    In 15–20% of newborn infants with CF, the ileum is completely obstructed by meconium (meconium ileus). The frequency is greater (~30%) among siblings born subsequent to a child with meconium ileus, reflecting a higher prevalence in certain genotypes. Abdominal distention, emesis, and failure to pass meconium appear within the first 24–48?hr of life (see Chapter 91.1 ). Abdominal radiographs ( Fig. 393–3 ) show dilated loops of bowel with air-fluid levels and frequently a collection of granular, “ground glass” material in the lower central abdomen. Rarely, meconium peritonitis results from intrauterine rupture of the bowel wall and can be detected radiographically by the presence of peritoneal or scrotal calcifications. Meconium plug syndrome occurs with increased frequency in infants with CF but is less specific than meconium ileus for this condition. Ileal obstruction with fecal material (distal intestinal obstruction syndrome or meconium ileus equivalent) occurs in older patients, causing cramping abdominal pain and abdominal distention.
    More than 85% of affected children show evidence of maldigestion from exocrine pancreatic insufficiency. Symptoms include frequent, bulky, greasy stools and failure to gain weight even when food intake appears to be large. Characteristically, stools contain readily visible droplets of fat. A protuberant abdomen, decreased muscle mass, poor growth, and delayed maturation are typical physical signs. Excessive flatus may be a problem. A number of mutations are associated with preservation of some exocrine pancreatic function, including R117H and 3849+10kbC?T. Individuals homozygous for ?F508 virtually all have pancreatic insufficiency.
    Less common gastrointestinal manifestations include intussusception, fecal impaction of the cecum with an asymptomatic right lower quadrant mass, and epigastric pain owing to duodenal inflammation. Acid or bile reflux with esophagitis symptoms is common in older children and adults. Subacute appendicitis and periappendiceal abscess have been encountered. Rectal prolapse is relatively frequent. Occasionally, hypoproteinemia with anasarca appears in malnourished infants, especially if children are fed soy-based preparations. Neurologic dysfunction (dementia, peripheral neuropathy) and hemolytic anemia may occur because of vitamin E deficiency. Deficiency of other fat-soluble vitamins is occasionally symptomatic. For example, hypoprothrombinemia owing to vitamin K deficiency may result in a bleeding diathesis. Clinical manifestations of other fat-soluble vitamin deficiencies, such as decreased bone density and night blindness, have been noted. Rickets is rare.

    NEWBORN SCREENING.
    Most newborns with CF can be identified by determination of immunoreactive trypsinogen in blood spots, coupled with confirmatory sweat or DNA testing. This screening test is at best only 95% sensitive. Although newborn diagnoses can prevent early nutritional deficiencies and improve long-term growth, there is as yet no compelling evidence that early diagnosis improves pulmonary, and therefore long-term, outcome. A number of states now screen newborns for CF, but the case for routine newborn screening remains debatable. A stronger case for screening will emerge when therapies that reverse the fundamental defect are available.


    this is the case of meconium ileus due to cystic fibrosis guys because in congenital megacolon vomiting in first 24-48 hr is not common.

    but my only doubt is wheather trpsynogen or trpsin was amonag option or not.because i faintly remember it was in the option.if that was the case answer will be trpsynogen screening test for new born other wise genetic test for cystic fibrosis.
  39. shashank.

    shashank. Guest

    which of the following is the least toxic tocolytic?

    a.ritroderine
    b.mgso4
    c.nifedepine

    answer b. mgso4


    dutta obstretics 6th edition

    page 508

    they have mentioned toxicites of all the druges

    in mgso4 they have mentioned

    mgso4 is relatively safe.
  40. shashank.

    shashank. Guest

    -Uppermost structure seen at the hilus of the left lung is:

    a. Pulmonary artery
    b. Pulmonary vein
    c. Bronchus
    d. Bronchial artery

    ANS-a. Pulmonary artery

    The root of each lung is a short tubular collection of structures that together attach the lung to structures in the mediastinum. It is covered by a sleeve of mediastinal pleura that reflects onto the surface of the lung as visceral pleura. The region outlined by this pleural reflection on the medial surface of the lung is the hilum, where structures enter and leave.

    Within each root and located in the hilum are:

    a pulmonary artery;
    two pulmonary veins;
    a main bronchus;
    bronchial vessels;
    nerves; and
    lymphatics.

    Generally, the pulmonary artery is superior at the hilum, the pulmonary veins are inferior, and the bronchi are somewhat posterior in position.

    On the right side, the lobar bronchus to the superior lobe branches from the main bronchus in the root, unlike on the left where it branches within the lung itself, and is superior to the pulmonary artery.

    Ref- Gray's Anatomy for Students, 2004
  41. shashank.

    shashank. Guest

    Q.. A female come with complaints of chest pain.On examination she is found to have pericarditis with pericardial effusion. The pain is mediated by:
    a. Deep cardiac plexus
    b. Superficial cardiac plexus
    c. Phrenic nerve
    d. Subcostal nerve


    ref-1:Clinically oriented Anatomy 5/E,Keith.l.Moore;pg.139-140

    The nerve supply of the pericardium is from the:

    -Phrenic nerves, primary source of sensory fibers; pain sensations conveyed by these nerves are commonly referred to the skin (C3–C5 dermatomes) of the ipsilateral supraclavicular region (top of the shoulder of the same side).
    -Vagus nerves, function uncertain.
    -Sympathetic trunks, vasomotor.

    P.140
    The innervation of the pericardium by the phrenic nerves (they are somaticâ€â€not visceralâ€â€nerves, despite their location) and the course of these somatic nerves between the heart and the lungs make little sense unless the development of the fibrous pericardium is considered. It is split or separated from the developing body wall by the developing pleural cavities, which extend to accommodate the rapidly growing lungs. The lungs develop within the pericardioperitoneal canals that run on both sides of the foregut, connecting the thoracic and abdominal cavities on each side of the septum transversum. The canals (primordial pleural cavities) are too small to accommodate the rapid growth of the lungs, and they begin to invade the mesenchyme of the body wall posteriorly, laterally, and anteriorly, splitting it into two layers: an outer layer that becomes the definitive thoracic wall (ribs and intercostal muscles) and an inner or deep layer (the pleuropericardial membranes) that contains the phrenic nerves and form the fibrous pericardium (Moore and Persaud, 2003). Thus the pericardial sac can be a source of pain just as the rib cage or parietal pleura can be, although that pain tends to be referred to dermatomes of the body wallâ€â€areas from which we more commonly receive sensation.

    ref-2:B.D.C,4/E;vol1;pg.239.

    "The fibrous and parietal pericardia are supplied by the PHRENIC NERVE.The epicardium is supplied by the autonomous nerves of the heart and is NOT sensitive to pain.
    Pain of pericarditis originates in the parietal pericardium alone.
    On the other hand cardiac pain or angina originates in the cardiac musle or in vessels of the heart.
    so ans is-------->phrenic.n-c.
  42. shashank.

    shashank. Guest

    Q.In postductal coarctation of aorta which ateries will dilate to supply lower part of body,
    a. Inferior Phrenic and pericardiophrenic vessels
    b. Intercostal and Superior epigastric
    c. Subcostal and Umbilical
    d. internal thoracic

    ref:Gray's Anatomy for students,2007,pg.214

    Coarctation of the aorta is a narrowing of the aorta distal to the left subclavian artery. This narrowing can markedly reduce blood flow to the lower body. Many of the vessels above the narrowing therefore enlarge due to the increased pressure so that blood can reach the aorta below the level of the narrowing. Commonly, the internal thoracic, superior epigastric, and musculophrenic arteries enlarge anteriorly. These arteries supply the anterior intercostal arteries, which anastomose with the posterior intercostal arteries that allow blood to flow retrogradely into the aorta.The first and second posterior intercostal vessels are supplied from the costocervical trunk, which arises from the subclavian artery proximal to the coarctation, so do not enlarge and do not induce rib notching.

    ref-1:Clinically oriented Anatomy 5/E,Keith.l.Moore;pg.174.

    The most common site for a coarctation is near the site of the ductus or ligamentum arteriosum. When the coarctation is inferior to this site (postductal coarctation), a good collateral circulation usually develops between the proximal and distal parts of the aorta through the intercostal and internal thoracic arteries. This type of coarctation is compatible with many years of life because the collateral circulation carries blood to the thoracic aorta inferior to the stenosis.

    so ideally ans shud be internal thoracic art or superoir epigastric art and posterior intercostal artery,but in this Q. the best choice is B.
  43. aayush

    aayush Guest

    A term infant has not passed meconium for 48 hours. He presents with distension of abdomen and emesis since one day. Next most appropriate investigation would be:
    a. Genetic testing for cystic fibrosis
    b. Manometry
    c. Lower bowel contrast enema
    d. Oesophagoscopy

    nelson 17th edition

    In 15–20% of newborn infants with CF, the ileum is completely obstructed by meconium (meconium ileus). The frequency is greater (~30%) among siblings born subsequent to a child with meconium ileus, reflecting a higher prevalence in certain genotypes. Abdominal distention, emesis, and failure to pass meconium appear within the first 24–48?hr of life (see Chapter 91.1 ). Abdominal radiographs ( Fig. 393–3 ) show dilated loops of bowel with air-fluid levels and frequently a collection of granular, “ground glass” material in the lower central abdomen. Rarely, meconium peritonitis results from intrauterine rupture of the bowel wall and can be detected radiographically by the presence of peritoneal or scrotal calcifications. Meconium plug syndrome occurs with increased frequency in infants with CF but is less specific than meconium ileus for this condition. Ileal obstruction with fecal material (distal intestinal obstruction syndrome or meconium ileus equivalent) occurs in older patients, causing cramping abdominal pain and abdominal distention.
    More than 85% of affected children show evidence of maldigestion from exocrine pancreatic insufficiency. Symptoms include frequent, bulky, greasy stools and failure to gain weight even when food intake appears to be large. Characteristically, stools contain readily visible droplets of fat. A protuberant abdomen, decreased muscle mass, poor growth, and delayed maturation are typical physical signs. Excessive flatus may be a problem. A number of mutations are associated with preservation of some exocrine pancreatic function, including R117H and 3849+10kbC?T. Individuals homozygous for ?F508 virtually all have pancreatic insufficiency.
    Less common gastrointestinal manifestations include intussusception, fecal impaction of the cecum with an asymptomatic right lower quadrant mass, and epigastric pain owing to duodenal inflammation. Acid or bile reflux with esophagitis symptoms is common in older children and adults. Subacute appendicitis and periappendiceal abscess have been encountered. Rectal prolapse is relatively frequent. Occasionally, hypoproteinemia with anasarca appears in malnourished infants, especially if children are fed soy-based preparations. Neurologic dysfunction (dementia, peripheral neuropathy) and hemolytic anemia may occur because of vitamin E deficiency. Deficiency of other fat-soluble vitamins is occasionally symptomatic. For example, hypoprothrombinemia owing to vitamin K deficiency may result in a bleeding diathesis. Clinical manifestations of other fat-soluble vitamin deficiencies, such as decreased bone density and night blindness, have been noted. Rickets is rare.

    NEWBORN SCREENING.
    Most newborns with CF can be identified by determination of immunoreactive trypsinogen in blood spots, coupled with confirmatory sweat or DNA testing. This screening test is at best only 95% sensitive. Although newborn diagnoses can prevent early nutritional deficiencies and improve long-term growth, there is as yet no compelling evidence that early diagnosis improves pulmonary, and therefore long-term, outcome. A number of states now screen newborns for CF, but the case for routine newborn screening remains debatable. A stronger case for screening will emerge when therapies that reverse the fundamental defect are available.


    this is the case of meconium ileus due to cystic fibrosis guys because in congenital megacolon vomiting in first 24-48 hr is not common.

    but my only doubt is wheather trpsynogen or trpsin was amonag option or not.because i faintly remember it was in the option.if that was the case answer will be trpsynogen screening test for new born other wise genetic test for cystic fibrosis.
  44. aayush

    aayush Guest

    Q- Internal Podalic Version done in cases of transeverse lie is associated with the following complication,:
    a. Uterine rupture
    b. Vaginal laceration
    c. Uterine atony
    d. Cervical laceration

    ref-1:Clinical Obstetrics-the fetus and mother,3/E

    "uterine rupture is assoc with excessive use of uterotonic drugs for induction and augmentation of labor,mid-forceps delivery and breech extraction with INTERNAL PODALIC VERSION."

    also DUTTA 6/E pg.584 says"maternal risk of IPV includes placental abruption,RUPTURE UTERUS and increased morbididity.while fetal risk includes cord prolapse asphyxia and intracranial h'ge."

    so ans is obviously uterine rupture.
  45. Dr.  Aaseri

    Dr. Aaseri Guest

    Lonser et al. (2004) described 3 cases of von Hippel-Lindau disease that illustrated the following features of endolymphatic sac tumors: morbid hearing loss due to a radiologically undetectable microscopic tumor in the endolymphatic sac or duct; initial symptoms caused by hemorrhage, endolymphatic hydrops, or both; an origin in the endolymphatic duct or sac; and molecular evidence of an association with von Hippel-Lindau disease. Complete surgical resection of the endolymphatic sac tumors is curative and can be performed with the preservation of hearing and the alleviation of vestibular symptoms. Early surgical intervention is important.


    pancreatic cysts may be seen but no mention of islet cell tumors
  46. Dr.  Aaseri

    Dr. Aaseri Guest

    Q. collapsing glomarulopathy following is seen
    1) proliferation of parietal cells
    2) visceral epithelial cell destruction
    Collapsing glomerulopathy is an aggressive form of glomerular disease defined for its histopathological features of glomerular collapse, visceral epithelial cell damage and tubulointerstitial changes that are characteristic. Patients with collapsing glomerulopathy present with severe nephrotic syndrome, marked proteinuria, generally more than 10 g/day and rapid progression to chronic renal failure, or death due to complications of nephrotic syndrome, despite any form of treatment.


    Collapsing glomerulopathy presents as de novo or recurrent disease in the renal allograft. There is slight predominance in males and strong predominance in blacks as renal diseases in general. Collapsing glomerulopathy shares several clinical and histopathological features with focal and segmental glomerulosclerosis and HIV-nephropathy; nevertheless, there is enough evidence to support collapsing glomerulopathy as a different entity. It must be mentioned that collapsing glomerulopathy, focal and segmental glomerulosclerosis and HIV-nephropathy may have a similar pathophysiological mechanism of damage to the visceral epithelial cell.
  47. Dr.  Aaseri

    Dr. Aaseri Guest

    pt with white mater disease with "hyperintense thalami" is -
    a-Alexander's disease
    b-Kanavan's disease
    c-PML
    d-METACHROMATIC LEUKODYSTROPHY
  48. kavish

    kavish Guest

    during evolution protein with similar structures but differnet sequence of aminoacid occurs this phenomenun is called as??
    a)convergence
    b)divergence
    c)oppurtunistic

    answer a)convergence

    refrence david whitford's protein structure and function 2005 edition page 179

    Occasionally structural
    homology is detected where there is no discernable
    relationship between proteins. This is called convergent
    evolution and arises from the use of similar structural
    motifs in the absence of sequence homology.
  49. kavish

    kavish Guest

    FOURTH LOBE OF LIVER BY Couinaud CLASSIFICATION
    ...........LEFT LOBE
    ...........RIGHT LOBE
    .......CAUDATE LOBE
    ........QUADRATE LOBE?

    The Couinaud segments and their corresponding traditional nomenclature are summarized above. The corresponding images of the liver surface are for visualization of the relative positions of the segments. It is important to note that the view marked "anterior" is actually rotated about 30 degrees to the patients left so that the posterior segments of the right lobe (VI/VII) can be seen. In an AP view, usually only the anterior segments (V and VIII) of the right lobe are seen since they form the lateral border of the liver contour in a true frontal view.
    I) caudate/Spigel lobe
    II) left posterolateral segment
    III) left anterolateral segment
    IVa) left superomedial segment
    IVb) left inferomedial segment
    V) right anteroinferior segment
    VI) right posteroinferior segment
    VII) right posterosuperior segment
    VIII) right anterosuperior segment

    Classical Anatomy
    The classical description of the liver Anatomy is based on the external appearance.
    On the diaphragmatic surface, the ligamentum falciforme divides the liver into the right and left anatomic lobes, which are very different from the functional right and left lobes (or right and left hemiliver).


    In this classical description, the quadrate lobe belongs to the right lobe of the liver, but functionally it is part of left lobe.
    Bismuth's classification
    This classification is very similar to the Couinaud classification, although there are small differences. It is popular in the United States, while Couinaud's classification is more popular in Asia and Europe.
    According to Bismuth three hepatic veins divide the liver into four sectors, further divided into segments.
    These sectors are termed portal sectors as each is supplied by a portal pedicle in the centre.
    The separation line between sectors contain a hepatic vein.
    The hepatic veins and portal pedicels are intertwined, as are the fingers of two hands.
    The left portal scissura divides the left liver into two sectors: anterior and posterior.
    Left anterior sector consists of two segments: segment IV, which is the quadrate lobe and segment III, which is anterior part of anatomical left lobe.
    These two segments are separated by the left hepatic fissure or umbilical fissure.
    Left posterior sector consists of only one segment II. It is the posterior part of left lobe.

    was the q.specific about couninad classification?in that case ans is LEFT lobe
  50. Manisha.

    Manisha. Guest

    SHOCK LUNG IS CHARECTERISED BY
    .......ALVEOLAR DAMAGE...............



    ANSWER IS-ALVEOLAR DAMAGE

    ARDS is characterized by a diffuse inflammation of lung parenchyma. The triggering insult to the parenchyma usually results in an initial release of cytokines and other inflammatory mediators, secreted by local epithelial and endothelial cells.

    Neutrophils and some T-lymphocytes quickly migrate into the inflamed lung parynchema and contribute in the amplification of the phenomenon.

    Typical histological presentation involves diffuse alveolar damage and hyaline membrane formation in alveolar walls.

    Although the triggering mechanisms are not completely understood, recent research has examined the role of inflammation and mechanical stress.

    [edit] Inflammation

    Inflammation alone, as in sepsis, causes endothelial dysfunction, fluid extravasation from the capillaries and impaired drainage of fluid from the lungs. Dysfunction of type II pulmonary epithelial cells may also be present, with a concomitant reduction in surfactant production. Elevated inspired oxygen concentration often becomes necessary at this stage, and they may facilitate a 'respiratory burst' in immune cells.

    In a secondary phase, endothelial dysfunction causes cells and inflammatory exudate to enter the alveoli. This pulmonary edema increases the thickness of the alveolo-capillary space, increasing the distance the oxygen must diffuse to reach blood. This impairs gas exchange leading to hypoxia, increases the work of breathing, eventually induces fibrosis of the airspace.

    Moreover, edema and decreased surfactant production by type II pneumocytes may cause whole alveoli to collapse, or to completely flood. This loss of aeration contributes further to the right-to-left shunt in ARDS. As the alveoli contain progressively less gas, more blood flows through them without being oxygenated resulting in massive intrapulmonary shunting.

    Collapsed alveoli (and small bronchi) do not allow gas exchange. It is not uncommon to see patients with a PaO2 of 60 mmHg (8.0 kPa) despite mechanical ventilation with 100% inspired oxygen.

    The loss of aeration may follow different patterns according to the nature of the underlying disease, and other factors. In pneumonia-induced ARDS, for example, large, more commonly causes relatively compact areas of alveolar infiltrates. These are usually distributed to the lower lobes, in their posterior segments, and they roughly correspond to the initial infected area.

    In sepsis or trauma-induced ARDS, infiltrates are usually more patchy and diffuse. The posterior and basal segments are always more affected, but the distribution is even less homogeneous.

    Loss of aeration also causes important changes in lung mechanical properties. These alterations are fundamental in the process of inflammation amplification and progression to ARDS in mechanically ventilated patients.

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