ALL INDIA PRE PG ENTRANCE EXAM 13 JAN 2008-POST RECALLS HERE

Discussion in 'NEET 2013 All india Exam' started by Dr.Sachin1984, Jan 11, 2008.

  1. kavish.

    kavish. Guest

    Q.MIP in lens fibers is responsible for?
    a)matrix interactions
    b)regulation of water transportc)glucose




    Major intrinsic protein of lens fiber, also known as MIP, is a human gene.[1]


    Major intrinsic protein is a member of the water-transporting aquaporins as well as the original member of the MIP family of channel proteins. The function of the fiber cell membrane protein encoded by this gene is undetermined, yet this protein is speculated to play a role in intracellular communication. The MIP protein is expressed in the ocular lens and is required for correct lens function. This gene has been mapped among aquaporins AQP2, AQP5, and AQP6, in a potential gene cluster at 12q13.
  2. kavish.

    kavish. Guest

    .Flaring of anterior ends of rib is seen in?
    a)down syn.
    b)scurvy
    c)rickets


    Skeletal and Radiographic Findings Associated with Rickets

    Bowing or widening of physis

    Costochondral beading (rachitic rosary)

    Craniotabes

    Delayed closure of anterior fontanel

    Dental abnormalities

    Flaring of ribs at diaphragm level (Harrison's groove)
    Flaring of wrists

    Fractures

    Fraying and cupping of metaphysis

    Frontal bossing of skull

    Genu valgum or varum

    Lordosis/kyphosis/scoliosis

    Osteopenia
  3. kavish.

    kavish. Guest

    .MC thyroid carcinoma?

    a. papillary
    b. follicular
    c. anaplastic
    d. lymphoma

    Q.virus asso with Ca cervix..

    a. HPV

    b. HIV
    c.
    d.

    Q.Rx of 55 yr female with simple hyperplasia endometrium with atypia..
    a. hysterectomy
    b. MPA
    c. LNG IUCD
    d.

    Q.Contraindication of vaginal delivery after C/S..
    a. classical C/S
    b. no h/o vaginal delivery
    c. breech
    d.

    Q. in mullerian agenesis all are seen except?

    a. absent ovary
    b. absent uterus
    c. absent fallopian tube
    d. absent vagina



    ovary does not develop from mullerian duct



    Q.Drugs in PPH except..

    a. misoprostol
    b. syntocinon
    c. syntometrin
    d. mifepristone

    Q. M/A for clomipohene citrate..

    a. removes FEEDBACK by estrogen at hypothalamus






    Q.reversal after Tubal Ligation is maw.with..

    a. isthmo-isthmic anastomosis
    b. isthmo-ampullary anastomosis
    c. cornual obstruction
  4. kavish.

    kavish. Guest

    Q.Drugs in PPH except..

    a. misoprostol
    b. syntocinon
    c. syntometrin
    d. mifepristone

    Q. M/A for clomipohene citrate..

    a. removes FEEDBACK by estrogen at hypothalamus






    Q.reversal after Tubal Ligation is maw.with..

    a. isthmo-isthmic anastomosis
    b. isthmo-ampullary anastomosis
    c. cornual obstruction
    .

    Q.DOC for CML..

    a. imatinib
    b.
    c.
    d.

    Q. MC pancreatic tumour in MEN 1..

    a. gastrinoma
    b. insulinoma
    c. glucagonoma
    d.

    Q. best investigation for intersitial lung disease..
    a. HRCT
    b.
    c.
    d.

    Q. investigation for 20 yr female with mild jaundice with spherocytes.. repeat Q -

    Coomb's test

    Q.poorest prognosis in AML..

    a. monosomy 7
    b. no cytogenentic abnormality
    c. t (15;17)
    d.

    Q.cellular BM with pancytopenia a/e - repeat Q
    dyserythropoietic anemia .
  5. kavish.

    kavish. Guest

    Q saturated FA highest in..
    a. soyabean oil
    b. groundnut oil
    c. palm oil
    d.

    Q G-6-Phosphatase absent in..

    a. liver
    b. muscle



    Q. Okazaki fragments are seen in..

    a. dsDNA replication
    b. ssDNA replication
    c.
    d.

    Q. folding of proteins is d/t?..

    a. chaperon

    b.
    c.
    d.

    Q. intracellular protein assortment done by..

    a. Golgi apparatus
    b. lysosome
    c. mitochondria
    d. robosome

    Q. required for carboxylation of clotting factors..

    a. vitamin K
    b.
    c.
    d.



    Q basement membrane degeneration by??
    metalloproteinase

    Q. ATP does not directly form in..??

    a. glycolysis
    b. Kreb's cycle
    c. HMP shunt
    d.

    Q. phosphorylase b in inactivated state d/t

    a. ATP
    b. AMP
    c. calcium
  6. ankur.k.

    ankur.k. Guest

    commonest presentation of transfusion reaction


    Goldman: Cecil Medicine, 23rd ed.


    Chapter 164 – AUTOIMMUNE AND INTRAVASCULAR HEMOLYTIC ANEMIAS


    Hemolytic Transfusion Reactions

    Definition

    Of the various types of acute transfusion reactions ( Chapter 183 ), acute hemolytic transfusion reaction is the most dangerous. Redundant blood bank systems of crosschecks, automated blood typing and crossmatching, and computer-based techniques of patient identification have reduced the risk of a hemolytic transfusion reaction, but the possibility of this complication is ever present.

    Epidemiology and Pathobiology

    Fatal hemolytic transfusion reactions are rare—about 16 for every 10 million red cell transfusions. The cause of hemolytic transfusion reactions is intravascular lysis of the donor's red cells by antibodies (alloantibodies or isoantibodies) in the recipient that bind to one or more blood group antigens on the transfused cells. The recipient's isoantibodies can be natural anti-A or anti-B antibodies, or they can be induced by previous transfusions or pregnancy. Whether IgM or IgG, the isoantibodies trigger the assembly of lytic complement components on the surface of the donor's red cell. The rapid formation of large amounts of C3a and C5a fragments causes hypotension and bronchial and smooth muscle spasm. Renal failure is a consequence of severe, prolonged hypotension; the main renal lesion is renal cortical ischemia secondary to shunting of blood away from the kidneys. Hemoglobin itself is not nephrotoxic.

    Clinical Manifestations

    The signs and symptoms of a hemolytic transfusion reaction are nonspecific and include fever, back pain, urticaria, dyspnea, hypotension, and evidence of disseminated intravascular coagulation. These nonspecific signs appear and worsen during administration of the transfusion.

    Treatment




    Immediate steps must be taken to stop the transfusion, submit the transfused blood and a sample of the patient's blood to the blood bank, and order tests of plasma and urine for free hemoglobin. Hydration is necessary to ward off renal failure; intravenous fluid, usually normal saline, should be started at once together with a diuretic (usually furosemide) in amounts to keep urine flow at a rate of at least 100 mL/hr. A nephrologist should be consulted without delay if these measures are ineffective, if hypotension persists, or if renal failure worsens.


    SO I INFER THAT THE COMMONEST CLINICAL MANIFESTATION IS FEVER .
  7. ankur.

    ankur. Guest

    antibody implicated in cold hemolysis

    antibody implicated in cold hemolysis

    referrence-
    CECIL MEDICINE
    23RDedition
    Chapter 164 – AUTOIMMUNE AND INTRAVASCULAR HEMOLYTIC ANEMIAS


    Paroxysmal Cold Hemoglobinuria

    Definition

    Paroxysmal cold hemoglobinuria is a rare form of immune-mediated hemolytic anemia in which an IgG autoantibody binds to red cells at low temperatures and brings with it C1q. The antibody dissociates from red cells at 37° C, but C1q remains on the membrane; at the warmer temperature it triggers progression of the complement cascade to its lytic components. The result is intravascular hemolysis.

    Pathobiology

    An unsolved problem is how the lytic components of complement are generated on the red cell surface in paroxysmal cold hemoglobinuria but not in cold agglutinin disease. The antibody is named for Donath and Landsteiner, who in 1904 described it in a patient with tertiary syphilis. With the waning of late syphilis in modern times, the Donath-Landsteiner antibody is encountered most often during convalescence from a viral infection, usually a childhood exanthem.

    The Donath-Landsteiner autoantibody has no clinical effects unless the patient is exposed to the cold. With cold exposure, even of only an arm or a leg, intravascular hemolysis begins soon after return to a warm temperature. Chills, fever, back pain, abdominal cramps, and hemoglobinuria are typical. Urticaria is common, acute renal failure is rare, and anemia is an inevitable consequence of severe intravascular hemolysis. The attack is self-limited, lasting only 1 or 2 days.

    Diagnosis

    A positive Donath-Landsteiner test is diagnostic, but the test is relatively insensitive. The procedure should demonstrate hemolysis in the test tube when the patient's blood is chilled and then warmed to 37° C. Addition of normal serum as a source of complement is often necessary to bring out the hemolytic phase of the reaction.

    Treatment




    Treatment is generally unnecessary, and spontaneous recovery should be expected within weeks or a few months.


    PLS DO NOT CONFUSE WITH IgM AS THE ANSWER. THE OPTION ACTUALLY MENTIONED ANTI IgM ANTIBODIES.

    after reading this i think the correct answer was donath landsteiner antibody.
  8. ankur.

    ankur. Guest

    picks disease

    picks disease



    harrisons medicine
    16 th edition
    page 2402

    picks disease was historically described as a progressive degenerative disorder of anterior frontal and temporal neocortex accompanyied by intranuclear inclusions (picks bodies) that stain positively with silver (argyrophilic) and tau.

    CECILS MEDICINE
    23rd edition
    chapter 425- ALZHEIMERS DISEASE AND OTHER DEMENTIA

    The clinical syndrome in frontotemporal lobar degeneration is determined by the lobar location of the Pathology . Right prefrontal or anterior temporal Pathology and brain atrophy produce behavioral syndromes like frontotemporal dementia. Left frontal involvement tends to produce progressive nonfluent aphasia. Predominant left temporal lobe involvement may give rise to progressive anomic aphasia syndrome or semantic dementia.

    On histopathologic grounds, the frontotemporal lobar degenerations can be divided into those that have inclusions containing the microtubule-associated protein tau versus those that do not. Among the tau-positive varieties are Pick's disease, in which intracellular tau-positive inclusions known as Pick bodies are seen. Several other pathologic tau-positive subtypes occur, including progressive supranuclear palsy, corticobasal degeneration, and a disorder associated with mutations in the tau gene. At least 30 mutations in the tau gene on chromosome 17q21 are associated with autosomal dominant frontotemporal lobar degeneration syndromes.


    i do not resemble the exact options but the option with tau positive inclusions seems to be the correct answer
  9. ankur.

    ankur. Guest

    artery 2 ductus deference.........superior vesical....ref.BDC
  10. Lisa.

    Lisa. Guest

    Q.diagnosis of anal fissure is made by?
    a)proctoscopy
    b)history & superficial inspection
    c)P.R.



    what is used to detect vaginal cells on the penis of an accused in a rape case?

    1.KI
    2.Lugol's Iodine
    3.??
    4.??


    Examine the glans for vaginal cells.This is done by cleaning the organ with a filter paper and exposing the paper to vapours of
    Lugol's Iodine.
    The paper becomes brown if vaginal epithelial cells are present, because of the glycogen.The test s positive upto 4th day.

    REF: K.S.N. Reddy essentials of FMT 21st edition pg 348


    Delphi method
    From Wikipedia....

    The Delphi method is a systematic interactive forecasting method for obtaining forecasts from a panel of independent experts. The carefully selected experts answer questionnaires in two or more rounds. After each round, a facilitator provides an anonymous summary of the experts’ forecasts from the previous round as well as the reasons they provided for their judgments. Thus, participants are encouraged to revise their earlier answers in light of the replies of other members of the group. It is believed that during this process the range of the answers will decrease and the group will converge towards the "correct" answer. Finally, the process is stopped after a pre-defined stop criterion (e.g. number of rounds, achievement of consensus, stability of results) and the mean or median scores of the final rounds determine the results.

    One of the options mentioned "a panel of experts"...Dont remember the other options



    drug of choice for premenstrual syndrome is:-
    options:-
    1.SSRI.
    2.PG inhibitors.
    3.anxiolytics.
    4.?
    m a member.....


    SSRIs are appropriate for women with mood symptoms. Cyclical luteal phase administration of fluoxetine (Prozac), 20 mg, or sertraline (Zoloft), 25-50 mg, has shown efficacy. Initially, SSRIs should be restricted to the luteal phase of each cycle. If the patient's symptoms are not ameliorated after a trial of 2-3 months, SSRIs can be given throughout the cycle.


    :-which of the following is not a antidepressant:-
    1.bupropione.
    2.risdone....
    3.?
    4.?

    here is a list of antidepressants.....



    Tricyclic type (TCAs)
    Amitriptyline Elavil et al. 100-200
    25-400
    Amoxapine Asendin 200-300 50-600
    Clomipramine Anafranil 100-150 25-250
    Desipramine Norpramin, Pertofrane etc. 100-200 25-300
    Doxepin Sinequan et al. 100-200 25-300
    Imipramine Tofranil et al. 100-200 25-400
    Nortriptyline Aventyl, Pamelor etc 75-150 25-200
    Maprotiline Ludiomil 100-150 25-225
    Protriptyline Vivactil 15-40 10-60
    (±) Trimipramine Surmontil 5-250 25-300

    Selective serotonin re-uptake inhibitors (SSRIs)
    (±)Fluoxetine Prozac 20-40 10-80
    Fluvoxamine Luvox 100-200 25-300
    Paroxetine Paxil 20-40 10-50
    Sertraline Zoloft 100-150 50-200
    Venlafaxine Effexor 75-225 25-375

    Atypical agents
    Bupropion Wellbutrin 200-300 100-450
    Nefazodone Serzone 200--400 100-600
    Trazodone Desyrel et al. 150-200 50-600
    (±) Mirtazapine

    i can't find risperidone as antidepressant in the list....conclude accordingly



    regarding enuresis:-

    Enuresis Alarms

    Small alarms that are worn on the body are available to help teach children to awaken to the sensation of a full bladder. Most of them are audio alarms (eg, Nytone or Wetstop). One alarm (The Potty Pager) is a vibrating alarm. It has the advantage of not awakening the entire household.

    Enuresis alarms have the highest cure rate of any treatment, with a 84% cure rate.
  11. Lisa.

    Lisa. Guest

    ques.. what is true abt SKELETAL MUSLE CONTRACTION INITIATION..
    a. calcium binds with tropomyosin.
    b. calcium binds wit htroponin c..
    c.. there is cross linking of actin and myosin..
    d??
    ans is B.. CALCIUM BINDS WIT HTROPONIN C..
    ref ganong..
    under skeletal muscle contraction chapter...


    saphenous nerve supplies the area on the medial side of leg and its a the terminal cutaaneous branch of femoral nerve which was in the option list ..........so femoral nerve should be the answer...........sural is lateral aspect.............

    diptheretic colitis is caused by mercury is a fact given in many guides..........


    hyoid and thyroid cartilage seen in..????
    Manual strangln,Ligature strangln,Hanging,Traumatic asphyxia....???
  12. hirakp

    hirakp Guest

    Q was false abt kawasaki ds not true, Ans not sure but most prob marked the one which read steroids was used for cases only with aneuryms present.

    also one was cong dyserythropoetic anemia (PCP WITH CELLULAR B.M.)

    Other rpt from aiims nov 07 like

    Methergin contraindicated in heart disease.

    Mifepristone not given in PPH.

    Subtle seizure in neonates.

    Neonatal Pulmonary Alveolar Proteinosis.

    Bronchiolitis Obliterans.

    Lower Bowel Contrast Enema.

    Insert a NG tube.
  13. hirakp

    hirakp Guest

    The question about:

    What's the commonest?/most frequent?/most imp? cause for placenta accreta?
    a)Multiparity (commonest?)
    b)Curettage (Highest frequency and most important) <-Ans most prob.
    c)C/S (rare cause)
    d)....
  14. Guest

    Guest Guest

    which of the following is an organochlorine
    a. malathion
    b. parathion
    c. diazonin
    d. endrin


    ENDRIN

    malation, parathion, diazinon(tik 20) are organophosphates which are irreversible anti-cholinesterases
  15. ankur2.

    ankur2. Guest

    all are muscle protein except?

    1:perlecan
    2:dystrophin
    3:alpha dystroglycan
    4:sarcoglycan


    Answer for the muscle sarcolemmal protein is Perlecan. Ref: Ganong Figure 3-4



    REGARDING SILDENAFIL CITRATE SEE FOLLWING ABTRACT.

    P. Perimenis1 , A. Athanasopoulos1, K. Gyftopoulos1 and G. Barbalias1

    (1) Department of Urology, Medical School, University of Patras, Greece


    Abstract Objective: To assess the efficacy of sildenafil as a first-step diagnostic and therapeutic tool for erectile dysfunction (ED) and to evaluate the consequent changes in the management of male sexual insufficiency.Materials and methods: Sildenafil in titrating doses up to 100 mg was prescribed to 50 men presenting to a sexual dysfunction clinic with medically documented ED. They had not undergone any specific diagnostic test before starting sildenafil.Results: Of the 50 men, 24 (48%) responded to sildenafil. Of these, 8 (33.3%) responded to 50 mg and 16 (66.7%) to 100 mg of sildenafil. Of the responders, 9 representing 18% of all studied men were discharged achieving spontaneous erections in a mean follow-up of 5.3 months. Men with no medical history, men with hypertension and men with mild coronary artery disease responded better.Conclusions: The sildenafil test revealed that 48% of men responded to this therapy with no requirement for more invasive tests and that 18% of men required no further treatment at all. In addition this test reduced the overall cost of the diagnostic investigation. It is proposed that the sildenafil test should be used in cases with no significant medical history or in men with hypertension or mild coronary artery disease although almost all men with ED could be categorized as sildenafil-responders or sildenafil-resistant. It is also suggested that the sildenafil test would result in the ability for more men with ED to be managed exclusively in the primary care sector.

    .
    Band (Calcific) Keratopathy (Figure 6–13)

    Band keratopathy is characterized by the deposition of calcium salts in a band-like pattern in the anterior layers of the cornea. The keratopathy is usually limited to the interpalpebral area. The calcium deposits are noted in the basement membrane, Bowman's layer, and anterior stromal lamellas. A clear margin separates the calcific band from the limbus, and clear holes may be seen in the band, giving the Swiss cheese appearance. Symptoms include irritation, injection, and blurring of vision.
    Calcific band keratopathy has been described in a number of inflammatory, metabolic, and degenerative conditions. It is characteristically associated with juvenile idiopathic arthritis. It has been described in long-standing inflammatory conditions of the eye, glaucoma, and chronic cyclitis. Band keratopathy may also be associated with hyperparathyroidism, vitamin D intoxication, sarcoidosis, and leprosy. The standard method of removing band keratopathy consists of removal of the corneal epithelium by curettage under topical anesthesia followed by irrigation of the cornea with a sterile 0.01-molar solution of ethylenediaminetetraacetic acid (EDTA) (edetate calcium) or application of EDTA with a cotton applicator. It can also be achieved with the excimer laser (phototherapeutic keratectomy).

    Friends was there a q on band keratopathy . i think there was but dont recall options. i think sarcoidosis was one option
  16. ankur2.

    ankur2. Guest

    Which is the final common pathway for horizontal movements of the eye?
    a. Oculomotor nucleus
    b. Abducent nucleus
    c. Trochlear nucleus
    d. Vestibular nuleus

    5. Which cell does not line the respiratory part of the lung?
    a. Clara
    b. Kulchitsky
    c. Langerhans cells
    d. ?????

    6. Which is the best guide for clinical decision making in a patient with blunt chest trauma?
    a. Hemodynamic stability
    b. Chest tube output
    c. Symptoms of the patient
    d. Volume of aspirated blood

    7. A hemangioma was found on the left of the falciform ligament of the liver. If a surgeon operates to remove it, which liver segments is he likely to remove?
    a. 1 & 4a
    b. 1 & 4b
    c. 2 & 3
    d. 2, 3 & 4

    8. A neonate has anal atresia and meconuria. Which of the following is the next step in management?
    a. Perineal exploration
    b. Anoplasty
    c. Transverse colostomy
    d. Sigmoid colostomy

    9. A pregnant lady presents with a history of having a child with congenital adrenal hyperplasia. In case of this pregnancy, which is true?
    a. Give steroids after a chorionic villous sampling result
    b. Give steroids after knowing sex of the chid
    c. Give steroids just before labour
    d. ?????

    10. A patient develops osteosarcoma of the mandible after being treated for a retinoblastoma. Which of the following is false about the osteosarcoma?
    a. It follows radiation therapy
    b. It follows chemotherapy
    c. It is caused due to mutations of Rb gene
    d. It is caused due to mutations in p53 gene
  17. ankur2.

    ankur2. Guest

    brush cells ,clara n kulchitsky all are present in respiratory tract so answer is langerhan,,,ref:grays Anatomy
  18. ankur2.

    ankur2. Guest

    Platelet transfusion in ITP- the lines from Wintrobe

    "The response to splenectomy is better in patients who are younger, with a shorter duration of disease and possibly an initial response to corticosteroids"

    "Sustained complete responses to splenectomy (variously defined as platelet counts 100,000 or 150,000/µl) have been reported in approximately 50 to 80% of patients, depending on the series of patients. After the operation, the platelet count may increase rapidly, often within 24 to 48 hours, and may reach levels as high as 1,000,000/µl or even higher in approximately 10 days . Operative mortality is less than 1% and perioperative bleeding is rare . Platelet transfusions are usually only given if the patient has bleeding after the spleen has been removed. Post-splenectomy infections are also rare, especially if patients have received pneumococcal immunizations before splenectomy"
  19. kavish.

    kavish. Guest

    What is a composite muscle. Here is the clue i got fom the net

    "Developmentally composite muscles, on are innervated by two nerves. They include pectineus - femoral & obturator nerves; adductor magnus – sciatic & obturator nerves; biceps femoris (s) – peroneal branch of sciatic nerve; biceps femoris (l) – tibial branch of sciatic nerve"
  20. kavish.

    kavish. Guest

    .a surgeon dissectin liver 2 d left of attach ment of falciform lig resects which lobes a)2,3
    b)1,4b
    c)2,4a
    d)1,4a

    Left Lateral Segmentectomy. A left lateral segmentectomy involves removal of only segments 2 and 3—that is, all liver tissue to the left of the falciform ligament [see Figure 3, part d]. These segments are mobilized by dividing the left falciform and triangular ligaments. As this is done, care must be taken not to injure the left hepatic and phrenic veins, which lie on the medial portion of the left triangular ligament.
    The falciform ligament is retracted caudally, and the bridge of liver tissue between segment 4 and segments 2 and 3 is divided with diathermy. Dissection is then performed within the umbilical fissure to the left of the main triad. The vascular pedicles to segments 2 and 3 usually are then readily dissected and controlled (lines C and D [see Figure 13 -- omitted]). Control of these pedicles within the umbilical fissure is particularly important for tumor clearance if tumor is in proximity to the umbilical fissure: if the condition is benign or if tumor is remote from the umbilical fissure, the liver may be split anteroposteriorly just to the left of the ligamentum teres and the falciform ligament, and the vascular pedicles may be identified and ligated as they are encountered in the course of parenchymal transection.
    Once the inflow vessels have been ligated, the left hepatic vein is identified and then divided either before parenchymal transection or as the vessel is encountered near the completion of parenchymal transection. If there is tumor near the dome, it is particularly important for tumor clearance that the left hepatic vein be controlled and ligated early and outside the liver.
  21. shacks.

    shacks. Guest

    I'm giving you the boxes given in text book congenital eye disorders. the ans to the ques -

    "Persistant Hyperplastic Primary Vitreous is seen in' is undoubtfully TRISOMY 13 -
    The box will also b useful for our future exams..

    OPHTHALMIC MANIFESTATIONS
    DOWN’S SYNDROME
    Narrow, almond-shaped palpebral fissure
    Blepharitis
    Keratoconus (may be complicated by corneal hydrops)
    Cataract
    High refractive errors (hyperopia, myopia over 5 D)
    Epicanthal folds
    Strabismus (usually horizontal)
    Congenital nystagmus
    Brushfield’s spots (85% of Down’s patients)

    TRISOMY 18 – EDWARDS SYNDROME
    Microcephaly
    Eye abnormalities:
    Epicanthal folds
    Blepharoptosis
    Microcornea
    Congenital cataract
    Microphthalmus
    Congenital glaucoma
    Cyclopia

    TRISOMY 13 – PATAU SYNDROME
    Characterized by severe ocular and systemic abnormalities, with mental retardation
    Usually lethal <6 month of age
    Coloboma of the ciliary body with cartilage within the coloboma
    Cataract
    Microphakia and spherophakia
    PHPV (Persistant Hyperplastic Primary Vitreous)
    Retinal dysplasia

    SEX CHROMOSOME ANOMALIES
    Turner syndrome (45,X) – Strabismus, hypertelorism, ptosis, hyperopia, amblyopia, nystagmus, red-green colour vision deficiency, microcornea, infantile glaucoma

    Klinefelter syndrome (47, XXY) - Refractive errors, uveal coloboma, strabism, ptosis, ectopic lens
  22. shacks.

    shacks. Guest

    increased cholesterol familial hypercholestrolimia
    type2a
    type2b
    type3

    one q on von grieke ds

    why testes are placed outside human body
    core temp less than body temp
    more than body temp

    one qn on pancreatic duct stone to which one option was
    pancreatico jejunostomy

    acute pancreatitis patient treatment of choice
    jejunostomy tube feeding
    parenteral

    which is wrong bout 3rd stage of labour???
    controlled cord traction
    massaging the uterus to make it hard
    giving inj within 1 min
    ????
    two qns on hpv one has the ans of exclusion
    ct scan is the inv of choice
  23. kavish.

    kavish. Guest

    Q. which of the following is not seen in COMPLEX REGIONAL PAIN SYNDROME?
    a. Pain
    b. Edema
    c. Osteoporosis
    d. Anhydrosis



    IT IS BASED ON A SIMLE LOGIC THAT COMPLEX R.P.SYN. IS D/T EXCSSIVE SYM. ACTIVITY WCH WUD LEAD TO HYPERHIDROSIS,& B-BLOCKERS ARE GIVEN AS A PART OF T/T
  24. kavish.

    kavish. Guest

    Q.Dying back neuropathy is seen in all except?
    a)diabetes
    b)HIV
    c)gullian barre syndrome
    d)alcoholisam


    REF:http://www.aafp.org/afp/[snip]/poncelet.html

    Although peripheral neuropathy has multiple etiologies, the nerve has a limited number of ways to respond to injury.4,5 The damage can occur at the level of the axon (i.e., axonopathy). A disruption of the axons (e.g., trauma) results in degeneration of the axon and the myelin sheath distal to the site of the injury (i.e., Wallerian degeneration). In most toxic and metabolic injuries, the most distal portion of the axons degenerates, with concomitant breakdown of the myelin sheath (known as "dying-back," or length-dependent, neuropathy).


    If the neuropathy is symmetric, is it proximal or distal? Most toxic and metabolic neuropathies present as a distal symmetric or dying-back process (Table 2).9 Proximal sensory neuropathies are rare and include porphyria.6 Predominantly motor neuropathies are often proximal and include acquired inflammatory neuropathies such as Guillain-Barré syndrome8,9 (Table 3).8 An exception is lead neuropathy, which initially affects motor fibers in radial and peroneal distributions.

    TABLE 2
    Distal Symmetric Sensorimotor Polyneuropathies

    Endocrine diseases
    Diabetes mellitus
    Hypothyroidism
    Acromegaly
    Nutritional diseases
    Alcoholism
    Vitamin B12 deficiency
    Folate deficiency
    Whipple's disease
    Postgastrectomy syndrome
    Gastric restriction surgery for obesity
    Thiamine deficiency
    Hypophosphatemia
    Critical illness polyneuropathy
    Connective tissue diseases
    Rheumatoid arthritis
    Polyarteritis nodosa
    Systemic lupus erythematosus
    Churg-Strauss vasculitis
    Cryoglobulinemia
    Amyloidosis
    Gouty neuropathy Carcinomatous axonal sensorimotor polyneuropathy
    Lymphomatous axonal sensorimotor polyneuropathy
    Infectious diseases
    Acquired immunodeficiency syndrome
    Lyme disease
    Sarcoidosis
    Toxic neuropathy
    Acrylamide
    Carbon disulfide
    Dichlorophenoxyacetic acid
    Ethylene oxide
    Hexacarbons
    Carbon monoxide
    Organophosphorus esters
    Glue sniffing
    Metal neuropathy
    Chronic arsenic intoxication
    Mercury
    Gold
    Thallium
    Medications (see Table 8)

    Diabetes, HIV infection and alcoholism can cause several patterns of neuropathy. They most commonly cause a distal, symmetric axonal sensorimotor neuropathy. The second most common presentation in these conditions is a small-fiber, painful neuropathy. Involvement of autonomic fibers is common in diabetes but less common in acquired immunodeficiency syndrome (AIDS) or alcoholism. These three patterns of neuropathy occur only in the AIDS stage of HIV infection. Medications used to treat HIV infection, such as didanosine (ddI; Videx) and zalcitamine (ddC; Hivid) also cause a distal symmetric axonal sensorimotor neuropathy.
    DYING BACK N. MEANS DISTAL N. & GBS IS PROXIMAL

    the neuropathy is symmetric, is it proximal or distal? Most toxic and metabolic neuropathies present as a distal symmetric or dying-back process . Proximal sensory neuropathies are rare and include porphyria.6 Predominantly motor neuropathies are often proximal and include acquired inflammatory neuropathies such as Guillain-Barré syndrome8,9
  25. kavish.

    kavish. Guest

    Q.common occular feature in von recklinghausen disease?
    a. Glaucoma
    b. anterior chamber angle abnormalities
    c. choroidal hemangioma
    d. enlarged lens

    well i m not sure,differences in opinion are welcome
    Recklinghausen's disease

    Also known as:
    Recklinghausen's phakomatosis
    Recklinhausen neurofibromatosis
    Recklinghausen syndrome
    von Recklinghausen neuropathy
    Elephant man's syndrome (misnomer)
    von Recklinghausen's disease
    Associated persons:
    Friedrich Daniel von Recklinghausen

    Description:
    Inheritable disease characterized by spots of increased skin pigmentation (café au lait spots), combined with multiple, often soft, sessile peripheral nerve tumours and a variety of others dysplastic abnormalities of the skin, nervous system, bones, endocrine organs and blood vessels. The pigmented spots are most prominent over the trunk, in the axillae (axillary freckles), and about the pelvic. The peripheral nerve tumours are of two types, schwannomas and neurofibromas. Both types of tumour occasionally become malignant. They occur along peripheral nerves, where they are quite obvious, and on spinal and cranial nerve roots. Extremely variable in size, number, and shape.

    Onset in childhood; becomes more active at puberty, during pregnancy, and at menopause. Asymptomatic or pain when tumor produces pressure on adjacent structure. Mental retardation, seizures, hydrocephalus, and other neurological complications are frequent. Eye involvement may result in proptosis, muscle palsies, phakoma, glaucoma, corneal opacity, and other ocular complications.
    Its incidence is 1 per 3.000 births and present in about 30 persons per 10.000 population. It is inherited as an autosomal dominant trait, but about 50 percent of cases arise as mutations.
  26. watchman22

    watchman22 Guest

    interview time excludes.......recall bias.(i really does hard work online 4
    searching about this)
  27. watchman22

    watchman22 Guest

    6. Which is the best guide for clinical decision making in a patient with blunt chest trauma..........

    answer:-a. Hemodynamic stability
  28. watchman22

    watchman22 Guest

    ....KAP test .......family planning.....still not 100% sure
  29. kavish.

    kavish. Guest

    Q93 drug of choice for premenstrual syndrome is:-
    options:- 1.SSRI. 2.PG inhibitors.
    3.anxiolytics.
    4.?

    Many treatments have been suggested for PMS, including diet or lifestyle changes, and other supportive means. Medical interventions are primarily concerned with hormonal intervention and use of selective serotonin reuptake inhibitors (SSRIs).• Supportive therapy includes evaluation, reassurance, and informational counseling, and is an important part of therapy in an attempt to help the patient regain control over her life. In addition, aerobic exercise has been found in some studies to be helpful.[2] Some PMS symptoms may be relieved by leading a healthy lifestyle: Reduction of caffeine, sugar, and sodium intake and increase of fiber, and adequate rest and sleep.[12]
    • Dietary intervention studies indicate that calcium supplementation (1200 mg/d) may be useful. Also vitamin E (400 IU/d) has shown some effectiveness.[2] A number of other treatments have been suggested, although research on these treatments is inconclusive so far: Vitamin B6, magnesium, manganese and tryptophan.[12]
    • SSRIs have become the "initial drug of choice for severe PMS"[2] The drug most widely studied is fluoxetine at doses of 20-60 mg/d. Other drugs include sertraline, paroxetine, clomipramine, fluvoxamine, and nefadozone.[13] These drugs can also be given intermittently, that is when symptoms reappear.
    • Hormonal intervention may take many forms:
    o Hormonal contraception is commonly used; common forms include the combined oral contraceptive pill and the contraceptive patch.
    o Progesterone support has been used for many years but evidence of its efficacy is inadequate.
    o Gonadotropin-releasing hormone agonists can be useful in severe forms of PMS but have their own set of significant potential side effects.
    • Diuretics have been used to handle water retention. Spironolactone has been shown in some studies to be useful.[2]
    • Non-steroidal anti-inflammatory drugs (NSAIDs; eg ibuprofen) have been used.
    • Evening Primrose Oil, which contains gamma-Linolenic acid (GLA), has been advocated but lacks scientific support.


    regarding prefered route of nutriton in acute pancreatitis scharts says


    The guiding principle of resting the pancreas dictates that patients with acute pancreatitis not be fed orally until their clinical condition improves. This generally occurs in 3 to 7 days in patients with mild pancreatitis, but the situation in patients with severe pancreatitis is more complicated, requiring nutritional support for several weeks. This can be provided by total parenteral nutrition (TPN) or by enteral nutrition through a jejunal tube. 49 There is some debate regarding the preferred route, since TPN is known to result in early atrophy of the gut mucosa, a condition that favors transmigration of luminal bacteria, and intrajejunal feeding still stimulates pancreatic exocrine secretion through the release of enteric hormones. Recent animal studies and preliminary clinical trials on humans suggest that on balance, jejunal feeding may be superior to TPN

    sabiston and maingot say the same thing.

    so answer looks to be jejunostomy feeding.



    now regardin prenal diagnosis in with previous child with congenital adrenal hyperplasia see what nelson say

    Prenatal Diagnosis and Treatment.

    Prenatal diagnosis of 21-hydroxylase is possible late in the first trimester by analysis of DNA obtained by chorionic villus sampling or during the second trimester by amniocentesis. This is usually done because the parents already have an affected child. Most often, the CYP21 gene is analyzed for frequently occurring mutations, but closely linked, highly polymorphic microsatellite markers may be used instead if an affected child (i.e., the proband) is available for genetic comparison.

    Besides genetic counseling, the main goal of prenatal diagnosis is to facilitate appropriate prenatal treatment of affected females. Recommendations for pregnancies at risk consist of administration of dexamethasone, a steroid that readily crosses the placenta, in an amount of 20?µg/kg prepregnancy maternal weight daily in two or three divided doses. This suppresses secretion of steroids by the fetal adrenal, including secretion of adrenal androgens. If started by 6 wk of gestation, this ameliorates the virilization of the external genitalia in affected females. Chorionic villus biopsy is then performed to determine the sex and genotype of the fetus; therapy is continued only if the fetus is an affected female. DNA analysis of fetal cells isolated from maternal plasma for sex determination and CYP21 gene analysis may permit earlier identification of the affected female fetus, but this is not yet widely used. No specific deleterious effects have been observed in children exposed to this therapy, but at present there is insufficient information to determine whether there are any long-term risks, particularly in the males and unaffected females who derive no benefit from the treatment. Maternal side effects of prenatal treatment have included edema, excessive weight gain, hypertension, glucose intolerance, cushingoid facial features, and severe striae.


    so therapy is started by 6 week (not prepregnany as one of the option)

    and then chorionic biopsy is done to determine sex and then if female therapy is continued otherwise stopped.(now what to choose as answer chorionic biopsy or sex detrmination?)

    same veiw is expressed by farnoff neonatology and avener neonatology.

    so ideal time is 6 week. (but was something like that option)

    and if not what to choose sex determination or chornionic biopsy because chornic biopsy is done for sex detrmination..
  30. kavish.

    kavish. Guest

    Q1. What is Sudeck's Osteodystrophy ???
    ANS.it is known as reflex sympathetic dystrophy & is seen as a sequele of trauma

    2. Loss of symphathetic nerve supply causes Anhidrosis (eg Horners). Again anti cholinergics cause loss of sweating (Remember Datura poison). Usually symphathetic and parasymphathetic act in opposite direction. Why do they act in "Same" direction in Sweating.
    ANS.well it's bcoz sweating is mediated by sympathetic cholinergic fibers

    .which is not a feature of conus syndrome.........?
    1.begins at the level of lower 3 sacral n coccygeal segment
    2.absent knee and ankle jerk
    3.plantar flexor
    4.saddle anesthesia

    REFhttp://www.emedicine.com/neuro/topic667.htm
    Symptoms and Signs of Conus Medullaris and Cauda Equina Syndromes

    Conus Medullaris Syndrome Cauda Equina Syndrome
    Presentation Sudden and bilateral Gradual and unilateral
    Reflexes Knee jerks preserved but ankle jerks affected Both ankle and knee jerks affected

    Radicular pain Less severe More severe

    Low back pain More Less

    Sensory symptoms and signs Numbness tends to be more localized to perianal area; symmetrical and bilateral; sensory dissociation occurs Numbness tends to be more localized to saddle area; asymmetrical, may be unilateral; no sensory dissociation; loss of sensation in specific dermatomes in lower extremities with numbness and paresthesia; possible numbness in pubic area, including glans penis or clitoris

    Motor strength Typically symmetric, hyperreflexic distal paresis of lower limbs that is less marked; fasciculations may be present Asymmetric areflexic paraplegia that is more marked; fasciculations rare; atrophy more common
    Impotence Frequent Less frequent; erectile dysfunction that includes inability to have erection, inability to maintain erection, lack of sensation in pubic area (including glans penis or clitoris), and inability to ejaculate
    Sphincter dysfunction Urinary retention and atonic anal sphincter cause overflow urinary incontinence and fecal incontinence; tend to present early in course of disease Urinary retention; tends to present late in course of disease



    Physical: The symptoms described in History are associated with corresponding signs pointing to an LMN or UMN lesion. Refer to Images 1-2 for assistance in examining the patient and documenting examination findings. In addition to the signs listed below, signs of other possible causes should be sought (eg, examination of the peripheral pulses to rule out possible vascular cause or ischemia of the conus medullaris).

    Signs of cauda equina syndrome include the following:
    Muscle strength in the lower extremities is diminished. This may be specific to the involved nerve roots as listed below, with the lower lumbar and sacral roots more affected, leading to diminished strength in the glutei muscles, hamstring muscles (ie, semimembranosus, semitendinosus, biceps femoris), and the gastrocnemius and soleus muscles.
    Sensation is decreased to pinprick and light touch in a dermatomal pattern corresponding to the affected nerve roots. This includes saddle anesthesia (sometimes including the glans penis or clitoris) and decreased sensation in the lower extremities in the distribution of lumbar and sacral nerves. Vibration sense may also be affected. Sensation of the glans penis or clitoris should be examined.
    Muscle stretch reflexes may be absent or diminished in the corresponding nerve roots. Babinski reflex is diminished or absent.
    Bulbocavernosus reflexes may be absent or diminished. This should always be tested.
    Anal sphincter tone is patulous and should always be tested since it can define the completeness of the injury (with bulbocavernosus reflex); it is also useful in monitoring recovery from the injury.
    Urinary incontinence could also occur secondary to loss of urinary sphincter tone; this may also present initially as urinary retention secondary to a flaccid bladder.
    Muscle tone in the lower extremities is decreased, which is consistent with an LMN lesion.
    Signs of conus medullaris syndrome include the following:
    Patients may exhibit hypertonicity, especially if the lesion is isolated and primarily UMN.
    Signs are almost identical to those of the cauda equina syndrome, except that in conus medullaris syndrome signs are more likely to be bilateral; sacral segments occasionally show preserved bulbocavernosus reflexes and normal or increased anal sphincter tone; the muscle stretch reflex may be hyperreflexic, especially if the conus medullaris syndrome (ie, UMN lesion) is isolated; Babinski reflex may affect the extensors; and muscle tone might be increased (ie, spasticity).
    Other signs include papilledema (rare, occurs in lower spinal cord tumors), cutaneous abnormalities (eg, cutaneous angioma, pilonidal sinus that may be present in dermoid or epidermoid tumors), distended bladder due to areflexia, and other spinal abnormalities (noted on lower back examination) predisposing the patient to the syndrome.
    Muscle strength of the following muscles should be tested to determine the level of lesion:
    L2 - Hip flexors (iliopsoas)
    L3 - Knee extensors (quadriceps)
    L4 - Ankle dorsiflexors (tibialis anterior)

    L5 - Big toe extensors (extensor hallucis longus)

    S1 - Ankle plantar flexors (gastrocnemius/soleus)
  31. shacks

    shacks Guest

    Explanation to Conus medullaris syndrome. Discussed the options with our DM student. Saddle anesthesia is seen - True. Muscle spasm - Since a UMN lesion also seen - True.

    With regard to other two option - Loss of knee and ankle jerk , Flexor plantar response.
    Loss of both knee abd ankle jerk is seen only in cauda equina syndrome. Since L2-4 segment arises well above conus part of spinal cord , KNEE JERK is PRESENT in Conus medullaris syndrome.

    About the other option Flexor plantar response - It can be seen coz it is asymmetrical in Conus medullaris lesion. Only in Cauda equina syndrome, loss of knee jerk and ankle jerk are bilateral...
  32. shacks

    shacks Guest

    Q.which of the following is an organochlorine
    a. malathion
    b. parathion
    c. diazonin
    d. endrin

    ENDRIN

    malation, parathion, diazinon(tik 20) are organophosphates which are irreversible anti-cholinesterases


    Q.all are muscle sarcolemal protein except?

    1:perlecan
    2:dystrophin
    3:alpha dystroglycan
    4:sarcoglycan


    Answer for the muscle sarcolemmal protein is Perlecan. Ref: Ganong Figure 3-4
  33. kavish.

    kavish. Guest

    .100 A pregnant lady presents with a history of having a child with congenital adrenal hyperplasia. In case of this pregnancy, which is true?
    a. Give steroids after a chorionic villous sampling result
    b. Give steroids after knowing sex of the chid
    c. Give steroids just before labour
    d.give steroid after pregnancy is diagnosed

    Q.101. A patient develops osteosarcoma of the mandible after being treated for a retinoblastoma. Which of the following is false about the osteosarcoma?
    a. It follows radiation therapy
    b. It follows chemotherapy
    c. It is caused due to mutations of Rb gene
    d. It is caused due to mutations in p53 gene
  34. kavish.

    kavish. Guest

    Q.101. A patient develops osteosarcoma of the mandible after being treated for a retinoblastoma. Which of the following is false about the osteosarcoma?
    a. It follows radiation therapy
    b. It follows chemotherapy
    c. It is caused due to mutations of Rb gene
    d. It is caused due to mutations in p53 gene

    answer is p53 mutation

    see what oxford textbook of oncology says

    Osteosarcoma is the most frequent second malignancy complicating retinoblastoma.(8),(9) and (10) Estimates of the risk of developing this tumour in survivors of inherited retinoblastoma range between 150- and 400-fold. Most, but not all, of these tumours will develop within the field of previous therapeutic radiation and this along with exposure to alkylating agents are powerful causative cofactors.(11)
    Alterations of the retinoblastoma (Rb) gene and Rb protein expression have been widely described in tumours including osteosarcoma.(12),(13) There may be some adverse prognostic impact of such changes. As the Rb gene has such an important role in regulation of the cell cycle, studies of other components of this system are of interest.(14),(15)
  35. ayush.

    ayush. Guest

    regrading which of following is not canncer question ?

    see following lines from oxford textbook of oncology

    Fibromatosis is a term used to indicate a rare group of non-neoplastic lesions that tend to infiltrate the surrounding tissues and often recur after surgical excision, including mediastinal fibromatosis, solitary fibrous tumour of the mediastinum.


    Askin's tumour has been initially described as a malignant small cell tumour of the thoracopulmonary region in children and young adults.(35) There is a slight female preference, and tumours typically arise from the soft tissue of the chest wall or in the periphery of the lung. Askin's tumour does not disseminate as widely as neuroblastoma or Ewing's sarcoma but tends to recur locally. The management is as for Ewing's sarcoma
    so fibromatosis is nonneoplastic lesion and hence the answer
  36. shacks

    shacks Guest

    www.socialanxiety.factsforhealth.org/treatment/medication.asp

    "As of March 2003, the U.S. Food and Drug Administration (FDA) has approved three medications for the treatment of social anxiety disorder. Two of the medications, paroxetine (or Paxil) and sertraline (or Zoloft) are selective serotonin reuptake inhibitors (SSRIs). Paroxetine was the first medication to receive FDA approval for social anxiety disorder. Sertraline is the only medication that has approval for long-term treatment of generalized social anxiety disorder. The third medication approved for the treatment of generalized social anxiety disorder is venlafaxine (or Effexor) which is a serotonin-norepinephrine reuptake inhibitor (SNRI)"
  37. Heena.

    Heena. Guest

    45 yr female with gall stone 1.5 cm solitary ..(in question it was given that she was complaining pain and then subsided by the conservative treatment )

    a. cholecystectomy oinly if she develops biliary colic
    b. lap cholecystectomy immediately
    c. lap cholecystectomy even if she is asymptomatic after 2 months
    d. open cholecystectomy even if she is asymptomatic after 2 months

    answer is c. lap cholecystectomy even if she is asymptomatic after 2 months
    (answer & explanation submitted by bhavu279)

    maingot's abdominal operation 11th edition says :
    Experience with OC is vast and spans generations of surgeons.
    Traditionally, OC had been the standard treatment for all patients with symptomatic gallstone disease, regardless of whether the indication for intervention was recurring biliary colic, acute cholecystitis, or one of the complications of biliary stone disease. Although laparoscopic techniques have largely supplanted traditional methods of performing OC for most patients with chronic, uncomplicated cholecystitis and cholelithiasis, the open approach continues to be a safe and effective therapy for the treatment of complicated gallstone disease. The indications for LC are, and should be, the same as those for OC (Table 32–1). Patients generally have documented cholelithiasis and symptoms attributable to a diseased gallbladder. Biliary colic is typically a severe and episodic right upper abdominal or epigastric pain that often radiates to the back. Attacks frequently occur postprandially or awaken the patient from sleep. Once a patient begins to experience symptoms, there is a greater than 80% chance that she will continue to have symptoms. There is also a finite risk of disease related complications such as acute cholecystitis, gallstone pancreatitis and choledocholithiasis. Therefore, elective cholecystectomy is indicated after the first episode of typical biliary symptoms. so it clearly says that elective cholecystectomy is indicated even after first episode of biliary symptoms. and it clearly says elective and not emmergency. so best answer would be c. laproscopic cholecystectome after 2 month
  38. docvarun83

    docvarun83 Guest

    BEST treatment for Bartholin cyst is Marsupialisation
    BEST treatment for Bartholin abscess is Surgical excision. Simple incision and drainage should be avoided, since it does not address the drainage of mucus from a functioning gland - Danforth's Obstetrics and Gynecology , 9


    Wintrobe says "Cold agglutinin disease (CAD) is associated with IgM antibodies usually directed at the red cell I antigen. It occurs in adult patients, and may be primary or secondary to another disease process. Paroxysmal cold hemoglobinuria (PCH) is caused by the so-called Donath-Landsteiner antibody, an IgG hemolysin"

    "Unlike the IgG Donath-Landsteiner antibody of paroxysmal cold hemoglobinuria that fixes both complement C1 and C4 at cold temperatures, the IgM antibodies of cold agglutinin disease fix only C1 "
    th Ed, Chapter 32 - Pelvic Infections and Sexually Transmitted Diseases
  39. docvarun83

    docvarun83 Guest

    The pain associated with a stone in the ureter is usually caused by acute distention of the renal capsule, usually from inflammation or obstruction"
    - Campells Urology
  40. ayush.

    ayush. Guest

    regarding left atrial enlargement

    dahnert radiology reveiw clearly says

    right retrocardiac double density with inferomedial curvature (earliest sign)
    Left Atrial Enlargement
    Cause:
    acquired: mitral stenosis/regurgitation, LV failure, LA myxoma
    congenital: VSD, PDA, hypoplastic left heart
    LA enlarges in multiple directions
    PA CXR:
    right retrocardiac double density with inferomedial curvature (earliest sign)
    >7.0 (female)/7.5 (male) cm distance between midpoint of undersurface of left mainstem bronchus + right lateral LA shadow
    left retrocardiac double density
    >75° splaying of carina with horizontal orientation of distal left mainstem bronchus
    P.588

    enlarged left-convex left atrial appendage ± calcifications (in 90% due to rheumatic heart disease)
    LAT CXR:
    increased convexity of posterosuperior cardiac margin
    posterosuperior atrial convexity crosses vertical plane formed by tracheal midline + upper lobe bronchus
    posterior displacement of barium-filled esophagus
    posterior displacement of LUL bronch
  41. ayush.

    ayush. Guest

    Suprapubic aspiration (SPA) - the best technique (“gold standard”) of obtaining an
    uncontaminated urine sample and any growth from SPA specimen is significant. With
    the child in supine position; a thin needle is attached to a syringe is inserted vertically
    in the midline, 1 to 2 cm above the symphysis pubis. Urine is usually obtained at a
    depth of 2 to 3 cm. Usually done in infants less than a year but procedure also applicable in children up to 4 or 5 years of age.

    Good method --->Poor method
    • suprapubic aspirate
    • catheter specimen
    • mid stream specimen
    • clean catch
    • bag urine
  42. shacks.

    shacks. Guest

    regarding GVHD all are true excpet..
    a. common in lymphoma patients..
    b. common with blood components rather than with whole blood transusion..
    c.irradtion given to the substance tranfused to decrease its chacnes..
    d..???


    Transfusion Associated Graft-Versus-Host Disease (TA-GVHD)
    Transfusion associated graft-versus-host disease (TA-GVHD) is a rare but often fatal complication following a blood transfusion. TA-GVHD is an acute syndrome that occurs usually 2 to 30 days after a transfusion and can be characterized by fever, liver dysfunction, skin rash, diarrhea, and severe pancytopenia8.

    The incidence of TA-GVHD is currently unknown; however, some patients have been identified as being at increased risk: patients with congenital immunodeficiency syndromes, Hodgkin's disease, chronic lymphocytic leukemia, and recipients of blood donated by relatives23. It has been estimated that TA-GVHD occurs at a rate of approximately 0.1% to 1% among these high-risk patients. About 90% of patients with TA-GVHD eventually die as a result of the reaction8.

    TA-GVHD occurs when donors' lymphocytes are not recognized as foreigners by recipients' lymphocytes and therefore are not destroyed. Consequently, donor lymphocytes multiply and initiate an immune attack against the recipient's cells, resulting in TA-GVHD24-25.

    There is no effective treatment once TA-GVHD has occurred. Prevention of its occurrence among high-risk patients is critical to reducing TA-GVHD related fatalities. Gamma-irradiated blood components are highly recommended for use among high-risk recipients24.
  43. shacks.

    shacks. Guest

    Q.DOC FOR RESISTENT FALCIPARUM MALARIA?
    A)DOXYCYCLINE
    B)CHLOROQUINE
    C)?


    the choices were tetracycline, doxycycline , clindamycin and chloroquine.
    i guess answer is clindamycin, Harrison pg 1230
  44. tulio

    tulio Guest

    Digastric muscle a/e-
    a) omohyoid b) Sternocleidomastoid c) occipitofrontalis d) ligament of treitz

    Now on searching net i found that digastric muscles are one with two bellies. No doubt choices a & c have two bellies, but does sternocleidomastoid have two bellies. It has two heads rather. Ligament of treitz is made of skeletal muscle in upper part, elastic fibres in middle part & smooth muscle in lower part. So guuess answer should be sternocleidomastoid.

    Guys need your view & authentic reference for this.
  45. doc4u

    doc4u Guest

    about rt sided aortic arch i found a very interesting site... it will clear quite a few doubts...pls go through

    Loading Media... 9 3 ; 4 : -/- Diseases of the Great Vessels To ...File Format: Shockwave Flash

    it says
    PLATE 24
    if the pt has a mirror rt arch,then it will be asso:
    90% with tof
    6% with truncus arteriosus

    PLATE 25
    if the pt has this ds,then % will have rt mirror arch:
    truncus arteriosus 33%
    tof 25%

    PLATE 26
    MORE PT WITH A MIRROR IMAGE RT ARCH WILL HAVE TOF THAN ANY OTHER CHD

    MORE PT WITH TRUNCUS ARTERIOSUS WILL
    HAVE MIRROR IMAGE RT ARCH THAN ANY OTHER CONGENITAL HEART DS

    your views are awaited
    regards

    Post Options: Reply Add Forward Report New Email me when a reply is posted
  46. kayesha.

    kayesha. Guest

    Concurrent list includes all except?

    Concurrent list includes all except


    REF: Park's textbook of PSM ....18th edition page no 675

    CONCURRENT LIST

    "The functions listed under the concurrent list are the responsibility of both the Union and State governments The Centre and the states have simultaneous powers of legislation.The concurrent list includes

    1.Prevention of extension of communicable diseases from one unit to another.
    2.Prevention of adulteration of foodstuffs.
    3.Control of drugs and poisons.
    4.Vital statistics.
    5.Labour welfare
    6.Ports other than major.
    7.Economic and social planning
    8.Population control and family planning."

    One of the options said something like "Control of health professionals."
    Maybe that should be the answer.
    What were the exact options for this question??
    1.Communicable diseases
    2.Vital statistics
    3.Health professionals
    4.??? Population control???
  47. kayesha.

    kayesha. Guest

  48. FASFUR.

    FASFUR. Guest

    All of the following cells are found in lung except
    1.Clara cells
    2.Kulchitsky cell
    3.Langerhans cells
    4.Brush cells


    Ans.3.langerhans cell
    Explanation: Langerhans cell(3) the immature dendritic cells present in the skin,reaching lungs only in abnormal conditions like Histiocytosis.
    *Langerhans cells are abundant in the lymph nodes and are also evident in the gastro-intestinal epithelium.
    *Brush cells(4):lung bronchioles are lined by brush cells,having microvilli and are in association with the nerve terminals.
    *Kulchitsky cells(2) are the neuro-endocrine cells found in the lungs,secreting amines (APUD).
    *Clara cells(1) are the non-ciliated cuboidal (or columnar) cells in the lining of terminal & respiratory bronchioles, and secrete surfactant lipoproteins.
    References:
    Pg. no. 82,1057; Grays Anatomy ; 39th Ed.
  49. FASFUR.

    FASFUR. Guest

    The final common pathway for horizontal gaze is nucleus
    1.Abducent
    2.Occulomotor
    3.Trochlear/Hypoglossal
    4.Vestibular


    Ans. 1.Abducent
    Explanation: Subcortical centre for lateral/horizontal conjugate gaze lies in the abducent nucleus (pons), though some authors take it to be PPRF (para-median pontine reticular formation) and others nucleus prepositus hypoglossi.
    -This centre receives input from the contralateral frontal eyefield and moves ipsilateral lateral lateral rectus and contralateral medial rectus muscle via projections of MLF (medial longitudinal fasciculus).
    *PPRF lesion leads to inactivity of saccadic movements by lateral rectus & contralateral medial rectus.
    -There is loss of horizontal saccades directed towards the side of the lesion but pursuit & vergence movements are preserved.
    *One and a half syndrome: Unilateral abducent & bilateral MLF lesion. On attemted lateral gaze, the only muscle functional is the intact lateral rectus .
    *MLF connects the nuclei controlling eyeball muscles - (LR6 SO4)3 and mediates nystagmus & lateral conjugate gaze.
    -Its fibres originate in vestibular(4) nucleus & terminate in abducent, trochlear(3) and occulomotor(2) nuclei.
    -It coordinates eyeball movements with the head.
    References:
    Pg no. 131;the human nervous system by Barr (8th Ed.)
    Pg. no. 285,205;BRS neuroanatomy; 3rd edition
  50. FASFUR.

    FASFUR. Guest

    Nerve supplying the Skin lying above great saphenous vein
    1.Femoral /Saphenous
    2.Superficial peroneal
    3.Sural
    4.Tibial


    Ans. 1. Femoral /Saphenous
    Explanation: Great saphenous vein lies in the medial side of the leg and thigh.
    It is accompanied by Saphenous nerve all along, the nerve which supplies the medial aspect of leg and dorsum of foot till the ball of great toe.
    *Saphenous nerve itself is a branch of femoral nerve and can get damaged while venesection of great saphenous vein is carried out.
    *The skin over the medial thigh is mainly supplied by the medial cutaneous branch of femoral nerve.

    References:
    Pg. no. 47,48;BD Chaurasia-vol. 2 (4th Ed.)
    Pg. no. 584; Keith L Moore (5th Ed.)

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