Recalls from 14th Jan-2007 all india exam -post here.

Discussion in 'NEET 2013 All india Exam' started by ,Dr.Vijay from mumbai, Jan 8, 2007.

  1. RAJU.

    RAJU. Guest

    WHICH IS INVOLVED IN ACTIVELY TRANSPORTINNG VIT C TO LENS?
    1.MYOINOSITOL
    2TAURINE
    3CHOLINE
    4Na K ATPASE
  2. Dr.Meena.

    Dr.Meena. Guest

    all are true abt benedicts syndrome excpet..
    1.cause rd nerve palsy
    2.inv of penetrating branches of basilar artery..
    3.inv of pons..
    4.contralateral hemiplegis
    ans is 3.inv of pons as it is a MIDBRAIN SYNDRME involves red nucleus

    all of the following cause hypophosphatemis except
    ans is ACUTE RENAL FAILURE

    treatment of postpartum ovarian cyst?pt with normal Hb...sudden massive bld loss....?component present both in serum n plasma?

    canca is ass with antibodies to
    1.proteinase 3
    2.myeloperoxidase
    3.lactoferrin
    4..??
    ans is PROTEINASE 3

    nota asite for portosystemic anstamosis
    ans is SPLEEN
    other options were
    1. liver{anastamosis occurs at bare are of liver}
    2.anorectal junction{foramtion of haemorrhoids}
    3. i think was gastroesophageal junctn {haemetemsis by VARICES}

    osteoarthitis quadriceps only
    burst fracture compresion
  3. Tina.

    Tina. Guest

    hi,
    all.i am a late joiner but we can hav bilateral help.i made a lot of silly repeat q mistakes.only god can rescue me.am vry depressed.
  4. Tina.

    Tina. Guest

    guys here are sme asnwers for u all
    polycythaemia caused by all excpet
    ans is pancreatic carcinoma
    2.in bishops score all included except
    effacement of cx
    dilatation of cx.
    sation of head
    interspinal dia.
    ans is iterspinal dia.
    3.all can be incenirated excpet
    ans is cyto toxic waste .. due to fear of cytotoxic fumes ,disposed of by burial
    dinitrophenol causes
    ans.. uncoupler of etc and oxidative phosphorylation

    ca cervix....16 is correct
    16 more common than 18

    child with urti presents with stridor which is decreased in lying down position
    a epiglotitis
    b laryngotracheobronchitis
    c laryngeal fb
    ans is b laryngotracheobronchitis


    for heterotropic calcification marker is .. alkaline phosphatase
  5. vipul.

    vipul. Guest

    which of these bears the maximum force generated during mastication
    a pterygomaillary
    b nasomaxillary
    c zygomaxillary

    hypokalemia---PR prolongation with ST depression. __ref:SCHAMROTH.


    proteoglycans all of this is true except
    a contain uronic acid
    b helps in maintaining the structure of tissues
    c contains less water
    d chondritin sulphate is an example


    Proteoglycans represent a special class of glycoproteins that are heavily glycosylated. They consist of a core protein with one or more covalently attached glycosaminoglycan chain(s). These glycosaminoglycan (GAG) chains are long, linear carbohydrate polymers that are negatively charged under physiological conditions, due to the occurrence of sulphate and uronic acid groups.

    Proteoglycans can be categorised depending upon the nature of their glycosaminoglycan chains. These chains may be:

    chondroitin sulfate and dermatan sulfate
    heparin and heparan sulfate
    keratan sulfate

    so the ans could be they contain less water..

    mc spinal injury due to flexion type injury __maheshwari page 144

    which of thes is a immuno histochemical marker for pagets disease of the breast ?
    a s100
    b hmb 45
    c synographin
    it is s-100


    in mrna which of this isnot true
    a capping helps in attachment of rna to 40s ribosome
    b in eukayocytes is regulated by gtp to gdp transformation
    c the first aa is methosine
    d synthesized from dna 3 -5'?
  6. Hans

    Hans Guest

    most common force involved in fracture spine is
    a flexion
    b extension
    c rotation
    d compression


    which of this part of vertebral canal will show concavity backwards in secondary curves
    a cervical
    b thoracic
    c sacral
    d cocyx

    which of this not true about vibrio
    a nonhalophilic
    b can be easly cultivated ans

    which of this is not true about vibrio o137
    a can cause disease in distingushable from vibrio 01
    b was first isolated in chennai
    c as o polysacharide capsule

    smoker associated wid 85% risk of developing carcinoma...
    whats the answer?

    which waves not used for deep tumours?
    infra red
    micro wave
    short wave
    ultra sonic


    which of this does not handle the free radicals in lens
    a vit a
    b vit c
    c vit e
    d catalase

    ans is vit a

    which of this investigation is helpful in heterophoric calcification
    a alkline posphatase
    b calcium
    c acid posphatase
    d posphorus

    s 4 --
    a can be heard by unaided ear
    b more then 20 hz
    c ventricular filling
    d ventricular ejection

    factor present in common complement pathway?
    C4
    C3
    C5
    Protein B
    complement in common pathways is C3B so answer is c3


    L3 form of leukemia is
    biphenotypic
    mature b cell
    L3 type of leukemia is buritt type ALL
    immature b cell

    dexamethasone given to preterm child to reduce
    hyaline memb disease

    lepromin test is not a diagnostic test

    chlorine demand of water estimated by horrock s apparatus.

    direct standardisatin depend on age distribution


    brown sequard synd,nt true
    c/l post column involvement
    c/l lateral column involvement

    a fibroid in a woman, does not occur
    infertility
    amenorrhoea

    primordial germ cells arise from
    endoderm
    ectoderm
    mesoderm

    venereal warts associated . with human papilloma virus
    16
    18

    a pt has h.pylori inf.drugs given.after that,h.pylori detected by
    rapid urease test
    urea breath test

    in conjugated hyperbilirubinemia,wich inv is best
    gamma ggt
    amino transferases

    bmi of obese?
    20
    30
    40
    50

    drug not given in obesity
  7. PREETI.

    PREETI. Guest

    SOME ONE PL. POST COMPLETE QUESTION PAPER WITH ANSWERS ,I AM A SECONDE TIMER , I AM GETTING DEPRESSED, HAD ATTEMPTED 270 QUSTIONS, I ALREADY FOUND 25 SILLY MISTAKES , AFTER CROSS CHECKING MY ANSWERS WITH MESSAGES POSTED BY VARIOUS AUTHORS OF THIS FORUM, MAY ALMIGHY HELP ME IN RESCUING FROM A FAILURE IN THIS EXAM .PREETI
  8. vipul.

    vipul. Guest

    mc secndary d/s casuing nephrotic syndrme
    diapetic nephropathy
    amyloidosis
    lupus

    2.hypophostameia seen in all excpet
    diabetic ketoacidosi
    arf

    3.basal ganglia calcification seen in all excpet
    wilson d/s
    for?? d/s
    hypoparathyroidism

    que was sperm aspiration for fertilisation.tesa mesa gift or??
    ?wats d ans.i hav marked tesa,pure guess no idea.but i excluded gift nd another--
    away frm invitro fertilisation,it talked abt sperm aspiration.sa may b sperm aspiration in tesa or mesa.

    all blunt trauma abdomen we usually put midline incision coz after arresting the primary bleeding we should check other organs to rule out bleeding from them.so we usuall put i .midline incision.

    drug causing siadh is vincristine.
    The drugs most commonly implicated in SIADH are:

    thiazide diuretics
    vincristine
    vinblastine
    cyclophosphamide, at high or low dose
    Others include:

    chlorpromamide
    carbamazepine
    phenothiazines
    tricyclic antidepressants
    clofibrate
    oxytocin
    vasopressin
    morphia
    barbiturates
    nicotine

    hep B transmision maximum in 3rd trimester....CONFIRMED


    which is not a deep heat therapy....a) short wave diathermy b) infrared c) USG

    2) which is used to monitor respiration in neonate (not intubated) a) capnography b) impedance pulmometry c) nasal temperature

    3) hormone not secreted by kidney a) renin b) angiotensin 1 c) 1 - 25 diOH cholecalc d) erythropoeitin
  9. vipul.

    vipul. Guest

    all are given in obesity except..
    1.orlistat
    2.sibutramine
    3.olestra
    4..??

    Symmetrical Tonic Neck Reflex (STNR)
    The STNR is present in normal development from circa 8 to 11 months of post-natal life and is a precursor to crawling on the hands and knees. If it remains present in an older child, it can affect:

    Integration of upper and lower portions of the body (for example, when swimming)
    Sitting posture (tendency to slump when sitting at a desk or a table)
    Poorly developed muscle tone
    Poor hand-eye co-ordination

    coagulopathy is caused by l-asparaginase

    brocas area
    word formation
    sensory vocab stimulation meet
  10. vipul.

    vipul. Guest

    something about in vitro fertilisatin.... TESA, MESA, ZIFT, GIFT


    investigation not required in osteosarcoma.....A) MRI femur B) bonemarrow bopsy C) CT D) X ray or bone scan


    spinal cord curve post concave ...cervical

    sperm aspiration
    tesa
    tubal ligation
    isthmus
    absolute indication
    megaloblastic anaemia

    investigation not useful in multiple myeloma
    ESR, alkaline phosphatase, Xray or Bone scan

    paget's disease of breast Is it CEA??

    High dose methotrexate ??osteosarcoma
  11. sanjay r

    sanjay r Guest

    1) tube cast?? applied in a fracture around a) shoulder b) hip c) pelvis
    2) 5 month old child can do a) creeping b) crawling c) pincer grasp d) mirror play
    3)drugs for erection problem.... a) phenylephrine
    4)cherry red spot seen in all except.....a) neiman b) krabbe c) multiple sulfatse defec d) type 2 glycogrn?
    5)bone marker all except ....a) alk phosphatse b) osteocalcin c) hydroxyproline d) procollagen peptide
    6)pt with anterolateral MI with shock , most appropriate action....a) primary angioplasty b) intraaortic ballon pump
    7)which is not neonatl reflex....a) rooting reflex b) assymetric neck reflex c) symmetric neck reflex d) crossed extensor reflex
    8)treatment of asthma in 1 yr old....a) inhaled short acting b agonists B) oral theophyline c) oral ketotifen d) dont know....but i think the missing option was the right one
    9)about kawasaki all except....a) vesicular trunkal rash b) purulent bulbar conjunctival congestion c) extremity edema
    10)short and rapidly acting insulin....A/E a) lispro b) aspart c) glargine d)
    11) hereiditaryu spherocytosis due to defeceincy of all except....a) ankyrin b) spectrin c) anion exchanger d) glcophorin 2
    12)acostic neuroma nerve commonly involved.... A) 5 B) 7 C) 10 D) 9 ( 8 th nerve was not in choice)
    13) facial nerve commonly involved in a) longitudinal petrous # b) transverse petrous #
    14) not a aryl phosphate a) TIK 20 b) malathion c) parathion d)
    15)shortterm memory to long term memory... A) amygdala b) hippocampus C) thalamus?
    16)which of the following not suscpetible to acid....a) trypsin b) chymotrypsin c) pepsin
    17) something about GIT motility
    18)for protein purification and analysis all r used except.... a) centrifugation b) densitometry c) electrophoresis d) chromatography
  12. Guest

    Guest Guest

    any guesses on the correct and for this question?

    Commonest childhood malignancy is
    1.Wilm's tumour
    2.Leukemia
    3.Lymphoma
    4.Neuroblastoma

    Most books mention "Leukemias and Lymphomas are commonest childhood malignancies". Any idea which amongst them is the single best ans.?
    amit
  13. cmpilation of all questions

    .Nuchal transluency...seen in
    downs syndrme

    2. first to be seen in development of child
    creeping
    crawling
    pincer grip

    3. all pass behind aorta except
    azygous vein
    aorta
    greater splanchnic nerve
    thoracic duct
    4.
    ca prostate in a person with family history of ca prostate is best detected by

    1 digital rectal exam
    2 p s a
    3 both of the above
    4.******

    5.
    lung disease with max reduction in rv and tlc
    1. sarcoid
    2. bronchiectasis
    3. asthma

    6.brown sign ANS glomus tumor

    7.pentalogy of fallot....TBM csf findings....rhinophyma

    8.the following r associated with AML except:

    turner's syndrome
    down's syndrome
    patau
    klienfelter syndrome

    9.Meralgia paresthetica
    a. Lat cut n of thigh
    b. Med cut n of thigh
    c. Genitofemoral n
    d.
    ans A

    10) Pituryriasis rosea is a
    a. chronic replapsing disease
    b. it is an auto immune disease
    c. caused by dermato phyte
    d. self resolving
    ans D

    11.delusion is a disorder of
    a. thought
    b. perception
    c. insight
    d. cognition
    ans D
    12.the drug of choice for obsessive compulsive disorder?
    a. olanzepin
    b. fluoxetin
    c. haloperidol
    d. thioridazine
    13.
    Supination and pronation are done at all joints except
    a. Superior radioulnar joint
    b. Inferior radioulnar
    c. Middle RUlnar joints
    d. Radio carpal joint
    ans radio carpal joint
    14. Typical cervical vertebra can be differentiated from thoracic vertebra by
    a. Foraman transversum
    b. Triangle vertebral canal
    c. Heavy vertebral body
    d. Superior facet on upper surface of body
    ans a)
    15. All of the following is posterior to diaphragm, except
    a. Aorta
    b. Azygous vein
    c. Thoracic duct
    d. Great splanchnic vein
    ans b)
    16. Morgagni hernia is
    a. Right anterior
    b. Left anterior
    c. Left posterior
    d. Right posterior
    ans a}
    17. Maralgia paraesthetica involves
    a. Medial cutaneous nerve
    b. Lateral cutaneous nerve of thigh
    c. Sciatic N
    d. Sural N
    18.
    Which of the following doesn't prevent prolapse of uterus
    a. Levator ani
    b. Uterosacral ligament
    c. Broad ligament
    d. Meckenrodts ligament same

    19.5Trgone of bladder, not true à
    a. Smooth mucosa
    b. Loosely attached to underlying muscle
    c. Transitional epithelium lines it
    d. It is a remant of mesonephric duct opening into post grogenital sinus
    ANS B

    20 . Brucellosis can be transmitted by all of the following modes, except:
    a. Contact with infected placenta
    b. Ingestion of raw vegetables from infected farms
    c. Person to person transmission
    d. Inhalation of infected dust or aerosol
    ans C

    21 Direct standardization is used to compare the mortality rates between two countries. This is done because of the difference in:
    a. Causes of death
    b. Numerators
    c. Age distributions
    d. Denominators
    ans C

    22. You have diagnosed a patient clinically as having SLE and ordered 6 tests. Out of which 4 tests have come positive and 2 are negative. To determine the probability of SLE at this point, you need to know:
    a. Prior probability of SLE; sensitivity and specificity of each test
    b. Incidence of SLE and predicitive value of each test
    c. Incidence and prevalence of SLE
    d. Relative risk of SLE in this patient
    ans A
    23.Posterior cruciate ligament true statement
    a. prevents posterior displacement of tibia
    b. Intra synovial
    c. Attaches to lateral femoral condyle
    ans a)
    24. hemodialysis amyloid
    ans beta 2 microglobulin
    25. Naltroxone is used in
    a. Opiod withdrawl symptoms
    b. Coma
    d. To prevent overdose
    26.Lice are not the vectors of
    a. Relapsing fever
    b. Q fever
    c. Trench fever
    d. Epidemic typhus

    ans B)

    27.A patient admitted to an ICU is on central venous line for the last one week; He is on ceftazidime and Amikacin. After 7 days of antibiotics he develops a spike of fever and his blood culture is positive for gram positive cocci in chains, which are catalase –ve. Following this, vancomycin was restarted but the culture remained positive for the same organism even after 2 weeks of therapy. The most likely organism causing infection is
    a. Staph aureus
    b. Viridans streptococci
    c. Enterococus fecalis
    d. Coagulase positive staphylococcus

    ans c)

    28.With reference to Bacteroides fragilis, the following statements are true, except:
    a. B. fragilis is the most frequent anaerobic isolated from clinical samples
    b. B. fragilis is not uniformly sensitive to Metronidazole
    c. The lipopolysaccharide formed by B fragilis is structurally and functionally different from conventional endotoxin
    d. Shock and disseminated intravascular coagulation are common
    29.Which is not premalignant
    a. Juvenile polyposis syndrome
    b. Juvenile polyp
    c. Puetz Zeghers Syndrome

    ans b)

    30. alpha hemolytic colonies sensitive to
    a oxacillin]
    b) optochin]
    c) bacitracin

    ans B)

    31.Which of the following is the most important prognostic indicator in head injury
    a. Age
    b. Glasgow Coma [no ads please]
    c. Bleeding on CT

    ans B)

    32 Hypothyroidism in pregnancy is not associated with:
    a. Preterm labour
    b. Prematurity
    c. PIH
    d. Hydroamnios

    ans d)

    33 Patient presents with loss of consciousess CT shows minimal spotty hemorrhages and full basal cisterns.
    a. Braon contusions
    b. Diffuse axonal injury
    c. Subdural Hematoma

    ans b)

    34) H pylori all are used except
    a. Amoxycilline
    b. oxytetracycline
    c. Metronidazole
    d. bismuth

    ans B)

    35 Which of the following act through  CAMP?
    a. V cholerae
    b.
    ans a)

    36 sternocleido mastoid tumour
    a) associated with breech
    b) spontaneous resolution
    c) 2/3rd ve palpable mass
    d) uncorrected cases phagiocephaly

    37) Direct standardization is used to compare the mortality rates between tow countries. This is done because of the differences in:
    a. Causes of death
    b. Numerators.
    c. Age of distributions.
    d. Denominators.

    ans c)
    38) You have diagnosed a patient clinically as having SLE and ordered 6 tests. Out of which 4 tests have come positive and 2 are negative. To determine the probability of SLE at this point, you need to know:
    a. Prior probability of SLE; sensitivity and specificity of each test.
    b. Incidence of SLE and predictive value of each test.
    c. Incidence and prevalence of SLE.
    d. Relative risk of SLE in this patient.

    ans a)

    39) leukotriene inhibitor
    a) zileuton
    b) zafirlukast

    ans B)

    40) which is leukotriene inhibitor

    a) montelukast
    41.Which is not premalignant
    a. Juvenile polyposis syndrome
    b. Juvenile polyp
    c. Puetz Zeghers Syndrome

    ans b)

    42 alpha hemolytic colonies sensitive to
    a oxacillin]
    b) optochin]
    c) bacitracin

    ans B)

    43 Which of the following is the most important prognostic indicator in head injury
    a. Age
    b. Glasgow Coma [no ads please]
    c. Bleeding on CT

    ans B)

    44 Hypothyroidism in pregnancy is not associated with:
    a. Preterm labour
    b. Prematurity
    c. PIH
    d. Hydroamnios

    ans d)

    45 Patient presents with loss of consciousess CT shows minimal spotty hemorrhages and full basal cisterns.
    a. Braon contusions
    b. Diffuse axonal injury
    c. Subdural Hematoma

    ans b)

    46. H pylori all are used except
    a. Amoxycilline
    b. oxytetracycline
    c. Metronidazole
    d. bismuth

    ans B)

    47. Which of the following act through  CAMP?
    a. V cholerae
    b.
    ans a)

    48. sternocleido mastoid tumour
    a) associated with breech
    b) spontaneous resolution
    c) 2/3rd ve palpable mass
    d) uncorrected cases phagiocephaly

    49. Direct standardization is used to compare the mortality rates between tow countries. This is done because of the differences in:
    a. Causes of death
    b. Numerators.
    c. Age of distributions.
    d. Denominators.

    ans c)
    50) You have diagnosed a patient clinically as having SLE and ordered 6 tests. Out of which 4 tests have come positive and 2 are negative. To determine the probability of SLE at this point, you need to know:
    a. Prior probability of SLE; sensitivity and specificity of each test.
    b. Incidence of SLE and predictive value of each test.
    c. Incidence and prevalence of SLE.
    d. Relative risk of SLE in this patient.

    ans a)
    51 ) brown’s sign
    a) glomus tumour
    b) acoustic neuroma
    c) otosclerosis

    ans a)

    52) drug induced lupus
    a) anti-histone ab

    ans A)

    53 ) a patient with antibodies to dna suffering from manifestations of kidney , liver, skin
    a) wegenerâ€s
    b) sle

    ans B)

    54 ) lung disease with max reduction in rv and tlc
    1. sarcoid
    2. bronchiectasis
    3. asthma
    4. cystic fibrosis

    ans probably cystic fibrosis please check it

    55) a female with complete villous atrophy n positive anti-endomysial antibodies

    a) do complete intestinal resection
    b) gluten free diet

    ans B)

    56) moro’s reflex disappears by
    a) 3 months
    b) 5 months
    C) 7 months
    Ans a) 3 months
    57 rubella rx targeted
    a) adolescents
    b) child bearing age
    ans a)

    58)reflex not present @ birth
    a) asymmetric neck reflex
    b) tonic neck reflex

    59) absence of lamina cribrosa is seen with
    a) coloboma of retina
    b)
    60) finasteride is an
    a) 5 alpha reductase inhibitor
    ans a)
    61) anti hormone used in infertility
    a) clompihene
    b) tamoxifene
    ans) a

    Filagrafin- used for
    a.Malaria
    b.Filaria
    c.neutropenia

    Morros reflex disappears at what age
    5 months
    3
    4
    7months

    Nevirapine-Non nulceoside reverse inhibitor

    Satisfied,very disatisfied-Ordinal data

    54 Question answer is Sarcoidosis i think

    Caudal regression-Gestational Diabetes

    Caudal analgesia-is contraindicated in
    a.plt count less tahn 80,000
    b.patient on aspirin
    c.pt on oral anticoagulants
    d.pt on iv heparin

    Nerve not involved in entrapment
    a.femoral
    b.Median
    c.ulnar
    d.

    Claw hand
    a.median nerve
    b.ulnar
    c.Radial


    persistent GTT evolves to
    a.choriocarcinoma

    Leprosy is affected least by
    a.ovary
    b.uterus

    People on aspirin
    increase Bt
    incrse pt

    Tuberculide is seen in
    a.Lupus vulgaris
    b.scrofilacium
    c.lupus scrofilecium
    Filagrafin- used for
    a.Malaria
    b.Filaria
    c.neutropenia

    Morros reflex disappears at what age
    5 months
    3
    4
    7months

    Nevirapine-Non nulceoside reverse inhibitor

    Satisfied,very disatisfied-Ordinal data

    54 Question answer is Sarcoidosis i think

    Caudal regression-Gestational Diabetes

    Caudal analgesia-is contraindicated in
    a.plt count less tahn 80,000
    b.patient on aspirin
    c.pt on oral anticoagulants
    d.pt on iv heparin

    Nerve not involved in entrapment
    a.femoral
    b.Median
    c.ulnar
    d.

    Claw hand
    a.median nerve
    b.ulnar
    c.Radial


    persistent GTT evolves to
    a.choriocarcinoma

    Leprosy is affected least by
    a.ovary
    b.uterus

    People on aspirin
    increase Bt
    incrse pt

    Tuberculide is seen in
    a.Lupus vulgaris
    b.scrofilacium
    c.lupus scrofilecium
    rhinolalia clausia not seen in
    a) allergic rhinitis
    b) palatal palsy
    c) adenoids
    ans B) as palatal palsy causes rhinolalia aperta
    63) not an alkylating agent
    a) cyclophosphamide
    b) 5fc
    c) busulfan
    ans B)
    64) universal immunization progamme doesn’t include
    a) tt
    b) mmr
    c) dt
    ans B) it includes only measles
    65) rabies
    a) guanerni bodies
    b) Bollinger
    c) negri
    ans) c
    66) burtonian line is seen in
    a) lead
    b) arsenic
    ans a)
    67) acrodynia
    a) mercury
    b) arsenic
    c) lead
    ans a) mercury seen in chronic mercury poisoning

    68) commonest site for csf leak
    a) frontal
    b) ethmoid
    c) sphenoid
    69) indicator for csf leak
    a) beta 2 tranferrin
    b) beta protein trace
    70) best inv for temporal bone #
    a) ct
    b) mri
    c) x_ray
    ans a) ct please check it
    71) posterior communicatind artery a branch of
    a) internal carotid
    b) external carotid
    ans a) ic
    72) which is not a feature of pontine stoke
    A ) quadriparesis
    B) pin point
    Ans a)
    73 delta waves found in
    a) wake
    b) deep sleep
    ans B)
    74) most common cause of meningitis in infant
    a) strept pneumonia
    b) h. influenzae
    ans b) h. influenzae
    75) non granular endo reticulum function
    a) lipid
    b) protein
    hmp shunt take place in
    a) cytosol
    b) mitochondria
    ans a)
    77) a 7 yr old boy with x-ray features of codman triangle and sunray appearance
    a) osteoclastoma
    b) osteosarcoma
    ansB)
    78 ) mc ovarian ca to undergo torsion
    a) benign cystic teratoma
    b) dysgerminoma
    ans A)
    79 gynaecomastia false statement
    a) subcutaneous mastectomy
    b) withdrawal of offending drugs
    c) liver failure
    ans A)
    80) leprosy doesn’t affect
    a) uterus
    b) ovary
    c) nerve
    ans b)
    81 ) claw hand nerve involved
    a) radial
    b) ulnar
    c) axillary
    d) median
    god
    82) nerve not involved in entrapment
    a) femoral
    b) median
    c) lateral cutaneous nerve
    83) calculate inr


    84) rhinopyma
    ans hyperplasia of the sebaceous glands
    85) pentalogy of fallot
    a) tetrat + pda
    b) tetralogy + asd
    ans b) confirmed
    86) marker for osteoblastic activity
    a) alkaline phosphatase
    Commonest alcohol withdrawal syndrome
    a.tremors
    b.diarhhea
    c.lacrimation

    Least complication of measels
    SSpe
    Diarhhea

    Merucury posioning affects
    pCt
    dt
    collecting ducts
    Loop of henle

    all are methylating drugs except
    a.5fu
    b.Busulphan
    c.Clorambucil

    Chemotherapy causing Siadh
    Vincristine
    cyclophospahamide

    herpcoagulable state not seen in
    liver cancer
    pancreatic cancer

    Port systemic shunt is not seen in
    liver
    spleen
    anorectum
    gastro esophgeal

    Acrodynia seen in
    arsenic
    mercury
    oxalate

    oxygen toxixity causes all except
    retinal blindness
    pulmonary edema
    less cerbral flow causes oxygen toxicty
    oxygen will cause convulsions

    when a person acsends
    decrese work load and increase excercise
    increase workload and decrease excercise
    decrease workload and inhaling oxygen

    all are autosomal dominant in except
    Fabrys
    huntington disease
    adult polycystic kidney disease


    Post communicating is a artery is a branch of
    a.Internal carotid
    b.external carotid
    c.middle cerebral

    all are seen in raised ICP except
    a.6th nerve palsy
    b.pappiledema
    c.blurring of vision
    d.headache

    30 year old women has Mitral regurgitation and AF comes in with syncope and regular pulse of 55 /min
    a.digoxin toxicity
    b.Cerbral infarct

    external cephalic version is C>I in
    a.anemia
    b.flexed breech
    c.PIH

    Autoimmune hemolytic anemia is always associated with
    histiocytosis

    immediate cell injuty
    neuropenia
    neutophilis
    monocytosis
    monocytopenia

    Cat eye seen in
    trisomy 13\
    trisomy18
    trisomy 21
    in a patient with cariogenic shock and antr wall infection. best treatment of choice

    the centre that converts short term memory to long term memory

    regarding inr

    prostaglandin that helps in protecting gi mucosa

    cherry red spot doesnot occur in..

    epidemic typhus caused by

    petrous bone fracture.. facial nerve..

    glomus tumor most commonly affected nerve

    hpylori infection drugs as per standard schedule.. except..

    which of the intestinal lesion not associated with malignancy.. familial polyp.. petz juegers juvenile polyposis syndrome juvenile polyp

    high dose methotrexate most commonly used in

    age of a child who cannot read a sentence can ride a bicycle... etc etc
    3 months 5 7 9 months

    rhinolalia clausa....

    pitryasis rosea
    all are seen in raised ict]
    A) blurring of vision
    b) abducent paresis
    c) paraparesis
    d) head ache
    ans c) paraparesis
    89)Cat eye seen in
    a) trisomy 13
    b) trisomy18
    C) partial trisomy 21
    In net answer is partial trisomy 22

    90) Tuberculide is seen in
    a.Lupus vulgaris
    b.scrofulsorum

    Ans
    91Nevirapine
    a)nucleoside RTi
    b)non-nucleoside RTi
    c)protease inhibitor

    ans b)
    92. patient is questioned and following interpretation is got]
    satisfied,very satisfied, dissatisfies, very much dissatisfied
    a) nominal
    b) ordinal
    c) ratio
    ans B) ordinal
    93. what is analytical test you use for the study in which …………answer is yes or no
    a) student-t
    b) chi square test
    c) paired-t test
    ans B) chi square
    if people find answers are wrong ……please inform
    94) Caudal analgesia-is contraindicated in
    a.plt count less tahn 80,000
    b.patient on aspirin
    c.pt on oral anticoagulants
    d.pt on iv heparin

    95 ) People on aspirin ve
    a) increase Bt
    b) increase pt

    96) all are autosomal dominant in except
    a) Fabrys
    B) huntington disease
    c) adult polycystic kidney disease
    ans ) fabry ( x-linked)

    97) Filagrafin- used for
    a.Malaria
    b.Filaria
    c.neutropenia]
    d) anaemia

    98) Commonest alcohol withdrawal syndrome
    a.tremors
    b.diarhhea
    c.lacrimation
    ans a ) tremors

    99) Least complication of measels
    a)SSpe
    b)Diarhhea
    c) pneumonia
    ans a) sspe

    100 ) Merucury posioning affects
    a) proximal convoluted tubule
    b) distal ^ ^
    c )collecting ducts
    d )Loop of henle
    ans a) proximal renal c t ( confirmed)

    101) Port systemic shunt is not seen in
    a)liver
    B)spleen
    c)anorectum
    d) gastro esophageal
    ans b) spleen
    ans ) fabry ( x-linked)

    102 ) inheritance curve
    mother >> the mutant gene to all children but father not transmittin
    a) mitochondrial
    b) ad
    c) ar
    d) x-linked
    ans a) mitochondrial

    103 ) ocp prevent all except
    1) ca endo
    b) ca breast
    c) rheumatoid
    ans b) ca breast

    104) bcg vaccine
    a) diluent used distilled n saline
    b) who recommends Danish 1331
    ans B)

    all are seen in raised ict]
    A) blurring of vision
    b) abducent paresis
    c) paraparesis
    d) head ache
    ans c) paraparesis
    89)Cat eye seen in
    a) trisomy 13
    b) trisomy18
    C) partial trisomy 21
    In net answer is partial trisomy 22

    90) Tuberculide is seen in
    a.Lupus vulgaris
    b.scrofulsorum

    Ans
    91Nevirapine
    a)nucleoside RTi
    b)non-nucleoside RTi
    c)protease inhibitor

    ans b)
    92. patient is questioned and following interpretation is got]
    satisfied,very satisfied, dissatisfies, very much dissatisfied
    a) nominal
    b) ordinal
    c) ratio
    ans B) ordinal
    93. what is analytical test you use for the study in which …………answer is yes or no
    a) student-t
    b) chi square test
    c) paired-t test
    ans B) chi square
    if people find answers are wrong ……please inform
    94) Caudal analgesia-is contraindicated in
    a.plt count less tahn 80,000
    b.patient on aspirin
    c.pt on oral anticoagulants
    d.pt on iv heparin

    95 ) People on aspirin ve
    a) increase Bt
    b) increase pt

    96) all are autosomal dominant in except
    a) Fabrys
    B) huntington disease
    c) adult polycystic kidney disease
    ans ) fabry ( x-linked)

    97) Filagrafin- used for
    a.Malaria
    b.Filaria
    c.neutropenia]
    d) anaemia

    98) Commonest alcohol withdrawal syndrome
    a.tremors
    b.diarhhea
    c.lacrimation
    ans a ) tremors

    99) Least complication of measels
    a)SSpe
    b)Diarhhea
    c) pneumonia
    ans a) sspe

    100 ) Merucury posioning affects
    a) proximal convoluted tubule
    b) distal ^ ^
    c )collecting ducts
    d )Loop of henle
    ans a) proximal renal c t ( confirmed)

    101) Port systemic shunt is not seen in
    a)liver
    B)spleen
    c)anorectum
    d) gastro esophageal
    ans b) spleen
    ans ) fabry ( x-linked)

    102 ) inheritance curve
    mother >> the mutant gene to all children but father not transmittin
    a) mitochondrial
    b) ad
    c) ar
    d) x-linked
    ans a) mitochondrial

    103 ) ocp prevent all except
    1) ca endo
    b) ca breast
    c) rheumatoid
    ans b) ca breast

    104) bcg vaccine
    a) diluent used distilled n saline
    b) who recommends Danish 1331
    ans B)


    INR calculations?,

    filgrastin used in rx of
    1.anaemia
    2. neutropenia

    ans b) neutropenia

    non specific esterase present in all except?
    M3
    M4
    M5
    M6

    Which of the following comprise pentalogy of Fallot?
    1. Terology with ASD
    2. Terology with TAPVC
    3. Terology with TGA
    4. Terology with splenomegay

    Answer is 1st one.. Damn sure abt dat..

    oxygen dependent killing done thru
    NADPHoxidase
    sod
    catalase
    glutathione peroxidase

    cardiomyopathy not seen in
    fredrich ataxia
    duchene dystrophy
    lowe synd

    there was a ques abt heart muscle
    acts as syncitium
    has multiple nuclei
    has gap junctions

    minor criteria for rheumatic fever
    a. rising aso titre
    b. throat culture
    c. fever
    d. -----
    Millard Gublar syndrome
    A syndrome of unilateral softening of the brain tissue arising from obstruction of the blood vessels of the pons, involving the sixth and seventh cranial nerves and fibres of the corticospinal tract, and associated with paralysis of the abducens and facial nerves and contralateral hemiplegia of the extremities. The muscles of the ipsilateral side of the face are paralysed, and the ophthalmologic characteristics are diplopia, internal strabismus, and loss of power to rotate eye outward.
    choices were 6th palasy
    7th palsy
    3.?
    4.? primordial germ cells arise from
    endoderm
    ectoderm
    mesoderm which waves not used for deep tumours?
    infra red
    micro wave
    short wave
    ultra sonic

    Deep heat causes a temperature rise from the conversion of energy into heat as it penetrates the tissues of the body where the energy is applied. Energy sources include (1) high-frequency currents (shortwave diathermy), (2) electromagnetic radiation (microwaves), and (3) ultrasound (high-frequency sound).
    _________________

    which of this does not handel the free radicals in lens
    a vit a
    b vit c
    c vit e
    d catalase
    .AML NOT ASSO WITH TURNERS__HARRY"16.
    2.EARLIEST IS MIRROR GAZING /PLAYING__IAMS PEADS.
    3.HCV---- EMC 80% are due to MPGN__harry.16
    4.1st reaction--NEUTROPHILIA.
    5.NSE -VE IN BOTH M3 and M6!!!!!
    6.BARTONIAN LINE -LEAD.
    which of this muscles r involved along with osteoarthritis knee
    a quadriceps only
    b hamstrings only
    c a+b
    d gastronemius

    proeoglycans all of this is true except
    a contain uronic acid
    b helps in maintaining the structure of tissues
    c contains less water
    d chondritin sulphate is an example

    NEUTROPHILIA.. was in told a lect at IAMS
    NO REF OTHER den this so i went with that.
    1.BROWNS SIGN--GLOMUS JUGULARE_DHINGRA
    2.BETA2 TRANSFERIN IN CSF RHINORHOEA__DHINGRA
    3.LAC OPERON..---NEGATIVE REGULATION???__LIPPINCOTS.BIOCHEM.
    4.FILGRAMOSTIN--NEUTROPENIA__CMDT06
    5.GLARGINE INSULIN IS LONG ACTING SO THATS THE EXP._HARRY_16

    most common force involved in fracture spine is
    a flexion
    b extension
    c rotation
    d compression


    which of this part of vertebral canal will show concavity backwards in secondary curves
    a cervical
    b thoracic
    c sacral
    d cocyx

    complement is C5b which immediately gives late c6c7c8c9
    __ref ROBBINS 7th page66.

    which of this not true about vibrio
    a nonhalophilic
    b can be easly cultivated
    c ?
    d ?

    which of this is not true about vibrio o137
    a can cause disease in distingushable from vibrio 01
    b was first isolated in chennai
    c as o polysacharide capsule

    hypokalemia---PR prolongation with ST depression. __ref:SCHAMROTH.

    Proteoglycans represent a special class of glycoproteins that are heavily glycosylated. They consist of a core protein with one or more covalently attached glycosaminoglycan chain(s). These glycosaminoglycan (GAG) chains are long, linear carbohydrate polymers that are negatively charged under physiological conditions, due to the occurrence of sulphate and uronic acid groups.

    Proteoglycans can be categorised depending upon the nature of their glycosaminoglycan chains. These chains may be:

    chondroitin sulfate and dermatan sulfate
    heparin and heparan sulfate
    keratan sulfate


    so the ans could be they contain less water..
    _________________

    MC SPINAL INJURY D/T--FLEXION TYPE INJURY__MAHESHWARI..PG144.

    which of this is a immunohistochemical marker for pagets disease of the brest ?
    a s100
    b hmb 45
    c synographin
    d ?

    common site for csf rhionorea is
    a ethmoid sinus
    b frontal sinus
    c petrous
    d ?
    in mrna which of this isnot true
    a capping helps in attachment of rna to 40s ribosome
    b in eukayocytes is regulated by gtp to gdp transformation
    c the first aa is methosine
    d synthesized from dna 3 -5'?

    which of this is a immunohistochemical marker for pagets disease of the brest ?
    a s100
    b hmb 45
    c synographin
    d ?


    it is s-100


    child with urti presents with stridor which is decreased in lying down position
    a epiglotitis
    b laryngotracheobronchitis
    c laryngeal fb



    commonest site for csf rhinorrhea CRIBRIFORM PLATE... then sphenoid sinus...

    which of the following does not acts through NA+ CHANNEl antiepileptic
    1.phenytoin.
    2.vaproic acid.
    3.vigabarin
    4.lamotrigine

    which of the following is not a epileptic
    1.phenobarbitone.
    2.carbamazepine
    3.phenytoin
    4.FLUNARIZINE
    ans flunarizine
    which of the following antiepileptics are contraindicatd in pregnancy EXCPET..
    1.phenobarbitone
    2.phenytoin
    3.carbamezapine
    4.valproic acid
    ans. phenobarbitone
    doc in pregnancy

    1.WHICH ISINVOLVED IN ACTIVELY TRANSPORTINNG VIT C TO LENS?
    1.MYOINOSITOL
    2TAURINE
    3CHOLINE
    4Na K ATPASE
  14. sania

    sania Guest

    biotin deficiency seen in
    multiple carboxylase deficiency.
    msud
    homocystenuria
    phenylketonuria
    ans multiple carboxylase deficiency

    blood flow waveform in uterine arteries during contraction which predict IUGR
    a- diastolic notch
    b- diastolic flow reversal
    c- low diastolic flow
    d- low systolic flow
    answer is C - low diastolic flow ie persistently high s/d ratio in uterines.

    for burrowing ucler option are
    microaerophlic streptococcus
    streptococus viridans
    strept. pyogenes
    peptostreptococci

    cat eye syndrme partial trisomy 22
    bohlers angle is useful for CALCANEUM
    RX NOT FOR mi VERAPAMIL
    MORGAGNIAN HERNIA IA RT ANTERIOR HEMIDIAPHRAGM
    HERD IMMUNITY ALL ARE TRUE EXCEP..
    herd immunity is constant

    oxygenasesall true except-
    incorporates 1atom of o2mol
    incorporates dthe whole molecule of o2
    required fr rx like hydroxilation

    Millard gubler synd is associated with.....5,6,9 or tenth cranial nerve
    Least toxic drug for epilepsy in pregnancy is...valproate,carbamazepine,barbiturate
    Cat eye is found in...........patau,edward or down syndrome
    autosomal recessive expresses itself despite of present single is know as...anticipation,uniparental

    there ws a ques on blood findings of DIC? i found two options wrong??
    1)increased fibrinogen
    2)decreasedPT
    other two options were right
  15. sania

    sania Guest

    . dubin johnson syndrome

    2. screening for prostate
    dre + psa

    3. kidney secretes all/exc
    renin,
    angiotensin
    eryhtropoietin
    1,25 oh chole calci

    4. tube cast
    shoulder

    5. chronic carrier all exc
    measles

    6. supination pronation

    7. theta waves seen in
    nrem
    rem
    deep sleep

    8. minor jones criteria
    fever
    previous rh fever

    9. which is not thyroid ca
    merkels

    10 men 1
    gastrinoma

    11 nuchal translucency
    down,s

    12. moro,s reflex disappears

    13. black color urine
    alkaptunaria

    14. biotin in
    common carboxylase defeiciency

    15. codmans + sunray
    osteosarcoma

    16 pulsatile tumor

    17 calculating inr

    18 difference betwen cervical n thorecic vertebra

    19 mode of injury to vertebra
    flex

    rotn

    20 delusion

    21 spalding sign

    22 age 6 yrs iq 50
    colour diff

    23 mc malignancy children
    leukemia

    24 congenital torticollis
    always due to breech extractn

    25 ext cephalic version c/i
    pih

    26 hypothyroidism not assoc
    hypertension

    27 siadh due to

    28 bartonian line

    29 child with flexural papules, itching
    atopic dermatitis

    30 vibrio chol o131

    31 finasteride
    alpha 1 reductase inhib

    32 nevirapine
    nnrti

    33 chlorine content
    horrocks app

    34 chl psittaci
    ngu

    35 mcc oy cell lines

    36 filgrastim
    neutropenia

    37 all are gp iib/iiia exc
    clopilet

    38 aspirin
    ^ bt

    39 awmi + cardiogenic shock
    prim ptca

    40 kawasaki disease

    41 short stature
    constituional

    42 browns sign
    glomus ?

    43 pityriasis rosacea

    44 raynauds disease
    good prognosis

    45 aml m3
    t 15 : 17

    46 all pass post to diaphragm
    aorta
    thoracic duct
    azygous

    47 cross lt to right all /exc
    lt gonadal

    48 supports of uterus all /exc
    broad lig

    49 mc cause of post menopausal bleeding
    ca endometrium
    ca cervix

    50 mercury poison
    loop of henle
    pct
    dct
    ct

    51 iron defi anemia
    ^ tibc, decr ferritin

    52 oa knee wasting
    quadriceps

    53 physiotherapy deep mode exc
    infra red lamp

    54 schwannoma
    vestibulo

    55 pqli all /exc
    per capita

    56 extended immunisn schedule
    tt
    dt mmr
    57 cmv group
    all reproductive age females

    58 hep b transmission
    1 trim
    2 trim
    3trim
    implantation

    59 epidural c/i
    platelet < 80,000
    asprin
    warfarin
    heparin

    60 injury to urethra below perinial line ?
    sup pouch

    61 30 yrs lady atrial fibrilln with ms/mr
    digoxin toxicioty
    stroke

    62 not used in controllin heart rate
    encanaide
    procainamide
    ?

    63 preg lady ovary cyst surgery
    6 weeks
    8 weeks
    immed

    64 hydatiform mole progress to
    chorioca
    invasive
    65 mycophenolate

    66 pregnancy used anti epileptic
    carbazamepine
    valproate
    67 culture on charcoal,60 yr old man icu pneumonia

    68 found in serum n plasma
    prothrombin


    69 patient satisfied
    dissatisfied
    variable ?


    70 sle 6 tests specif sensiv

    71 drug induced lupus
    anti histone ?

    72 dic
    ^ fdp 3 choice ? exc one

    73 complications of measles all exc
    sspe
    diarrhoea

    74 rhinolalia

    75 red eye
    nieman pick
    gm1 ganglio
    krabbe

    76 bohlers angle
    calcaneum?
    77 anti obesity drug all exc

    78 2nd curvature with concavity post
    sacral
    coccyg
    cervical

    79 z e synd
    ppi

    80 h pylori regimen
    oxytetra

    81 orange coloured urine
    rifampicin

    82 lepromin
    not diagnostic

    83 bt leprosy with nerve

    mdt vid steroids
    84 tubersulide

    scrofulderma
    85 children anesthesia butrophenol?

    86 glomerulonephritis vid hcv

    87 amyloidosis
    rectal biopsy

    88 tlc +vc reduced
    brocnhiectasis
    cystic fibrosis

    89 child asthma rx ?

    90 montelukast
    lt1 inhib

    91 old man DM bladder disturbances
    bph
    nerogenic ub

    92 trigone of ub

    93 claw hand

    ulnar
    94 mastication
    zygomaticomaxillary butress

    95 rhinophyma

    96 portosystemic anastam
    spleen
    liver
    anorectal
    ge jn

    97 bochhdalek hernia
    rt ant

    nerve compression
    femora;
    99 aut dominant
    fabry,s

    100 broca,s
    word formn
    comprehensoin

    leukotrine receptor inhibitor - monteleukast
  16. Jai.

    Jai. Guest

    Non malignant among these ?
    A. Juvenile polyp
    B. FAP
    C. Puetz Jeghers polyp ?

    Ans. Juvenile polyp
  17. prasad82

    prasad82 Guest

    what abt the q on antioxidant in lens ?

    shape of cervical os in preterm lobour/CERVICAL incompetence
    1)U
    2)Y ans
    3)T
    4)O
  18. prasad82

    prasad82 Guest

    k.d tripathi page no.573 in exp abt clopidogrel c the last line it is given that LIKE TICLOPIDINE IT IS A PRODRUG

    ticlopidine is the antiplatelet prodrug


    coagulopathy is caused by l-asparaginase
  19. prasad82

    prasad82 Guest

  20. prasad82

    prasad82 Guest

    SPERM RETRIEVAL FOR ASSISTED REPRODUCTIVE TECHNOLOGIES




    Sperm quality in obstructive and non-obstructive azoospermia

    In the normal male reproductive tract, sperm exiting the testis have minimal motility and limited egg fertilizing capacity. Sperm acquire the potential for improved motility and fertilizing ability during epididymal transit. So, in the unobstructed epididymis, sperm of optimal quality (as evaluated by percent motile cells) are found in the most distal epididymis. The obstructed epididymis shows the opposite pattern of sperm quality: optimal sperm quality in the proximal epididymis and very poor quality in the most distal segments. This finding of "inverted motility" is expected in the obstructed male reproductive tract since sperm production continues in the testis and reabsorption of those sperm is an active process in the most distal regions of the system. The most distal obstructed epididymis tends to contain dilated yellow tubules that are packed with macrophages reabsorbing old, degenerated sperm. Therefore, sperm retrieval should be performed from the proximal obstructed epididymis.

    In non-obstructive azoospermia (testicular failure) some sperm production is at least focally present within the testis, despite the fact that inadequate numbers of sperm are released from the testis to contribute to the ejaculate. A common observation for testicular sperm samples is that retrieved spermatozoa are immotile or have a sluggish twitching motion. After several hours of incubation in vitro, testicular sperm typically show some motility. The lack of initial motility does not necessarily reflect a lack of viability for testicular sperm, since these sperm have never acquired motility. Non-motile ejaculated sperm have acquired and lost motility, as sperm viability is lost, rendering the sperm useless for ICSI.

    Typical criteria for a poor prognosis of sperm production, including an elevated serum FSH level or decreased testicular volume, does not prospectively predict which patients can have sperm found with testicular sperm extraction (TESE). Even the histologic patterns on diagnostic testicular biopsy (Sertoli cell-only, maturation arrest, hypospermatogenesis) cannot definitively predict the chance of finding sperm with TESE. However, many centers require diagnostic biopsies prior to TESE procedures to rule out carcinoma-in-situ (intratubular germ cell neoplasia) that is present in up to 3% of men with NOA who are candidates for treatment with TESE-ICSI.

    The goals of sperm retrieval are a) to obtain the best quality sperm possible, b) to retrieve an adequate number of sperm for both immediate use and cryopreservation [where possible], c) to minimize damage to the reproductive tract so as not to jeopardize future attempts at sperm retrieval or testicular function. For men with NOA, sperm retrieval has most commonly been performed with an open extraction procedure that allows sampling of large volumes of testicular parenchyma, since the concentration of sperm is so low in the testis.

    For men with obstructive azoospermia, a variety of techniques for sperm retrieval have been successfully applied.



    Percutaneous techniques.

    (All pictures: Dr. Peter Schlegel, Cornell Medical Center, with permission)

    Percutaneous Epididymal Sperm Aspiration (PESA)


    PESA has been advocated as superior to open microsurgical approaches in that it can be performed without surgical scrotal exploration, it is repeated easily at low cost, and it does not require an operating microscope or expertise in microsurgery. The procedure can be performed under local or general anesthesia. The testis is stabilized and the epididymis is held between the surgeonís thumb and forefinger. A 21-gauge butterfly needle attached to a 20-ml syringe is inserted into the caput epididymis and withdrawn gently until fluid can be seen entering the butterfly needle tubing .The procedure is repeated until adequate numbers of sperm are retrieved. PESA yields very small amount of epididymal fluid and contamination with blood cells is frequent. For the 10-20% of attempts where sperm are not etrieved with PESA, open sperm retrieval or percutaneous testicular aspiration is possible.



    Percutaneous Testicular Sperm Aspiration


    The technique of Testicular Fine Needle Aspiration (TFNA) of the testis was initially described as a diagnostic procedure in azoospermic men. Subsequently, testicular fine needle aspiration or biopsy for the recovery of spermatozoa has been described. Percutaneous puncture and aspiration of the testis can be performed using a 21-23 gauge needle connected to a 20 cc syringe in a Menghini syringe holder .

    Systematic TFNA was used to localized areas of sperm production in the testis ( testicular mapping) in small number of patients with nonobstructive azoospermia as a guide for subsequent testicular sperm extractions.



    Percutaneous testicular biopsy


    Percutaneous testicular biopsy is a technique that combines the effectiveness of testicular sperm extraction (TESE) with the minimally invasive nature of TFNA to improve sperm yield with a procedure that is rapid and simple. A large core (14-gauge) biopsy gun with a short (1 cm) excursion can be used (Microvasive ASAP channel-cut biopsy system, Boston, Mass.) . As with TFNA, testis is stabilized between the thumb and index finger of one hand. The biopsy gun is directed diagonally along the longitudinal axis of the testis, entering on the anterior surface of the lower pole, aimed toward the rete testis. A biopsy is obtained by firing the biopsy gun with the tip firmly applied to the testis through the overlying skin.

    The limited published experience to date with TFNA makes critical evaluation of this technique difficult, although it is evident from our experience that 1) sperm retrieval is routinely possible with TFNA for men with obstructive azoospermia, 2) occasional hematoceles and hematomas are possible with this technique.

    The advantages of percutaneous aspiration techniques are that they can be performed with less anesthesia, without open scrotal exploration and its attendant postoperative discomfort, and without microsurgical expertise. The percutaneous techniques are easily repeatable as well as potentially less expensive than microsurgical techniques and do not require special microsurgical training. However, lower pregnancy rates have been published after percutaneous sperm retrieval (24%) compared to that achieved with microsurgical epididymal sperm aspiration (36-82%) with ICSI (24% vs. 36-56%). In addition, the inconsistent ability to retrieve adequate numbers and quality of sperm for cryopreservation with percutaneous approaches is a disadvantage relative to open sperm retrieval techniques.

    Although fine needle aspiration has been reported as a technique of sperm retrieval for NOA, men have not been adequately characterized with formal testicular biopsy before these procedures, and it is possible that some of the patients thought to have NOA were actually obstructed. Fine needle aspiration would be much more likely to retrieve sperm in men who are obstructed and may make results of treatment unevaluable unless diagnostic biopsies were performed.



    Open surgical sperm retrieval



    Microsurgical Epididymal Sperm Aspiration (MESA)




    Epididymal sperm retrieval was initially performed using open, microsurgical technique commonly referred to as microsurgical epididymal sperm aspiration (MESA). This technique offers the advantages of dissection of individual epididymal tubules under direct vision, meticulous hemostasis to minimize sperm contamination with blood cells and aspiration of multiple sites to retrieve large numbers of sperm with optimal quality to allow immediate sperm use for assisted reproduction as well as sperm cryopreservation. To avoid contamination of sperm by blood cells, a technique of micropuncture was developed. Individual tubules are cleanly punctured, as occurs during venipuncture for blood drawing. With gentle aspiration, epididymal fluid passes through the glass micropipet, through the silastic tubing and into a plastic tuberculin syringe. Typically only microliters of fluid need to be retrieved. Sperm in the epididymal fluid are highly concentrated (roughly 1x106 sperm/ml) so this technique provides far more than an adequate number of sperm. Since post-thaw sperm viability is related to pre-freeze quality, it is worthwhile to retrieve and cryopreserve sperm of optimal quality to avoid the need for additional sperm retrieval procedures.

    New Mini-micro-epididymal sperm aspiration (Nudell et al., 1998) is a combination of standard MESA and PESA procedures but uses a small incision that is well tolerated under local anesthesia. The procedure is performed with the spermatic cord block and sedation. A tunica vaginalis space entered via transverse 1-cm scrotal incision. A self-retaining eye-lid retractor is placed to create a ëwindowí into the tunica vaginalis space. The posteriorly located epididymis is rotated into view by gentle traction or placement of 7-0 Prolene traction suture into the epididymal tunic. Under the operating microscope the epididymal tunic is incised and individual tubule isolated. After careful hemostasis with bipolar cautery, epididymal tubule is incised tangentially with microscissors. Fluid is aspirated with a 24-gauge angiocath sheath attached to a 1.0-ml syringe. About 10 microliters of aspirated fluid is examined under 400X light microscope. Aspiration sites then progresses from cauda to caput in order to obtain best quality sperm. Epididymal tubule and tunic are closed with 10-0 and 9-0 nylon sutures respectively. Tunica vaginalis space is closed with 4-0 absorbable suture after irrigation with saline and local anesthetic without epinephrine. Skin edges are reapproximated with 4-0 absorbable suture. The procedure was effective in 95% of 26 cases.



    TEsticular Sperm Extraction (TESE)



    Testicular sperm retrieval is usually timed to coincide with oocyte retrieval during a planned IVF cycle for the female partner. Under local or general anesthesia, sperm retrieval is effected using an open testicular biopsy technique. Scrotal exploration performed and testis is delivered into the wound in order to avoid any injury to the epididymis. Direct identification of testicular blood vessels is achieved using optical magnification with an operating microscope. Blood supply to the testis travels in a serpingious fashion under the capsule (tunica vaginalis) of the testis. An avascular area close to midportion of medial, lateral or anterior surface of the testis is chosen, tunica albuginea incised with a 150 ultrasharp knife Retrieval of ample amounts of testicular parenchyma can be achieved with a single large incision in the tunica albuginea. The testicular parenchyma (approximately 500-mg) is excised with sharp, curved iris scissors and placed in HTF culture medium supplemented with 6% Plasmanate. Individual tubules are isolated by immediate initial dispersal of the specimen with 2 sterile glass slides. Additional mechanical dispersal performed by mincing of the tissue with a sterile scissors in the HTF medium and performing sequential passes of tissue suspension through a 24-gauge angiocatheter. Wet preparation of this suspension is immediately examined under the phase contrast microscope at 100x and 400x power. Sampling is continued until spermatozoa are found or it is felt to be unsafe to perform additional biopsies. The incised segment of tunica albuginea is closed. Biopsy of the contralateral testis is performed if no sperm have been found. Multiple incisional biopsies should be avoided during TESE to prevent devascularization of the testis from damage to the subtunical testicular blood supply. It is also important to remember that sperm production is marginal in men with NOA; local inflammation and recovery after TESE may adversely affect sperm production for up to 6 months. Therefore, at least 6 months should elapse between TESE procedures. Recently Dr. Peter Schlegel (Cornell University Medical Center) introduced new technique of microsurgical testicular sperm retrieval with isolation and retrieval of isolated seminiferous tubule.

    Results of sperm retrieval (TESE) - ICSI for men with NOA have two different components. The first is the ability to retrieve sperm from the testis, and the second is the pregnancy rate after ICSI using those sperm. The chance of retrieving sperm has ranged up to 90% for men with NOA in a small series and as low as 50% in larger series. Obviously, the more careful selection of men before retrieval will determine the likelihood of finding sperm with TESE. Devroey et al. initially reported that 12 out of 15 (80%) men had sperm retrieved with TESE (80%). The fertilization rate per injected oocyte was 48%, with an overall clinical pregnancy rate of 20% (3/15) per attempt at TESE. Subsequent results from Belgium suggest that the rate of sperm retrieval is closer to 50% per TESE procedure. Schlegel et al. reported that 10/16 (62%) of men with NOA had sperm extracted with TESE. The fertilization rate per injected oocyte was 58%, and 5/10 (50%) of those undergoing ICSI achieved a clinical pregnancy [5/16 overall; (31% per TESE attempt.)] as standard therapy.



    Results of Intracytoplasmic Sperm Injection (ICSI) with testicular and epididymal sperm in the treatment of Obstructive Azoospermia

    Authors Sperm retrieval technique Clinical pregnancy rates
    Palermo ( 1996) 14/17 ( 82%) MESA
    Schlegel(1995) 14/27 (48%) MESA
    Silber(1994) 8/17(47%) MESA
    Gil-Salom(1995) 4/15(27%) Testicular biopsy
    Craft(1995) 10/42(24%) PESA
    Belker(1996) 6/15 (40%) TFNA

    Cryopreservation of epididymal and testicular sperm

    Successful sperm cryopreservation allows the opportunity for multiple ICSI cycles without the need for additional sperm retrieval procedures. Since ICSI enables even severely impaired sperm to effect oocyte fertilization, as long as sperm are viable, cryopreserved sperm can achieve acceptable rates of fertilization and pregnancy when coupled with ICSI. Cryopreservation also allows the potential for temporal separation of sperm retrieval procedures from assisted reproductive techniques. This is a significant benefit for the center that performs only occasional sperm retrieval procedures. If the cryopreserved sperm are viable after thawing, then this approach does not compromise the chance for achieving a pregnancy. Unfortunately, up to 10-20% of frozen epididymal samples will not have adequate viability after thawing for use with ICSI.







    Selected Bibliography


    Levine LA., Lisek EW. Successful sperm retrieval by percutaneous epididymal and testicular sperm aspiration.n J Urol 1998;159:437-440
    Schlegel P., Palermo G., Alkani M., Adler A., Reing A., Cohen J., Tpzenwaks Z. Micropuncture retrieval of eoididymal sperm with in vitro fertilization: omportance of in vitro micromanipulation techniques. Urology 1995;46:238
    Craft I., Tsirigotis M., Bennett V., Taratnissi M., Khalifa Y et al. Percutaneous epididymal sperm aspiration and intracytoplasmic sperm injection in the management of infertility due to obstructive azoospermia. Fertil Steril 1995; 63:1038
    Bourne H., Watkins W., Speirs A., Baker H. Pregnancies after intracytoplasmic injection of sperm collected by fine needle biopsy of the testis. Fertil Steril 1995;64:433
    Girardi SK, Schlegel PN. Microsurgical epididymal sperm aspiration: review od thechniqes, preoperative considerations , and results. J Androl 1996;17:1-5
    Sheynkin YR, Schlegel PN. Sperm retrieval for assisted reproductive technologies. Contemporary OB/GYN 1997;42:123-129
    Nudell DM, Conaghan J., Pedersen RA., Givens CR.,Schriock ED., Turek PJ. The mini-micro-epididymal sperm aspiration for sperm retrieval: a study of urological outcomes. Hum.Reprod. 1998;13:12601265
    Tournaye H. Clasen K., Aytoz A., Nagy Z., Van Steirteghem A., Devroey P. Fine needle aspiration versus open biopsy for testicular sperm recovery: a controlled study in azoospermic patients with normal spermatogenesis. Hum Reprod 1998; 13:901-904
    Friedler S., Raziel A., Strassburger D., Soffer Y., Komarovsky D., Ron-El R. Testicular sperm retrieval by percutaneous fine needle sperm aspiration compared with testicular sperm extraction by open biopsy in men with non-obstructive azoospermia. Hum Repord 1997;12:1488-1493
    Kahraman S., Ozgur S., Alatas C et al. Fertility with testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermic men. Hum Reprod 1996;11:756-760

    .







    .
  21. prasad82

    prasad82 Guest

    test for dubin johnsons syndrome
    brom suphthalein
    hippuric acid

    ans bromsulphthalein

    abt osteosarcome it shd be BONE MARROW BIOPSy as bopsy is done of tumour not of BONE MARROW
  22. sat_rishi

    sat_rishi Guest

    Commonest childhood malignancy is
    a. Leukemia
    b. Neuroblastoma
    c. Lymphoma
    d. Wilm's tumour
    Ans. ? a or c

    . Chemotherapeutic agent causing SIADH
    a. Vincristine
    b. Cyclophosphamide
    c.
    Ans. a
    Which of the following anticancer drugs causes hyperviscocity syndrome?
    a. Vinblastine
    b. L-asparaginase
    c. 5FU
    Ans. b

    . Absence of lamina cribrosa occurs in
    a. Optic nerve hypoplasia
    b. Morning glory syndrome

    Ans. b


    Mechanism of cellular memory and learning includes all except:
    a)increase or decrease in neurotransmittor release as in habituation and sensitization
    b)increase in no of synapses as in increase in no of synaptic terminals,increase in dendrites
    c)recruitment of neurons, involvement of more neurons in a particular function as occurs in somatosensory area of the cortex
    d)allocation of specialised nerve cells as occurs in the hippocampus

    Leprosy affects all except:
    a. uterus
    b. ovary
    c. eyes
    d. nerves

    ans is uterus

    A 50 yr old man with family h/o ca prostate wants to do screening. the most sensitive test is:
    a. digital rectal examination
    b. serum PSA
    c Both a + b combined
    d. endorectal coil MRI with T1 and T2 weighted images

    Fetus with increased nuchal transluscency at 14 wks
    a. Down's syndrome
    b. esophageal atresia

    ans Down's

    Finasteride acts via:
    a. alpha blockade
    b. 5-alpha reductase
    c. selective alpha-1 blockade


    ans is b

    The shape of nulliparous cervix is
    a. circular
    b. longitudinal
    c. transverse
    d. fimbriated

    ans is a i think

    The shape of cervical canal suggesting preterm delivery(something like that)
    a. T shaped
    b. Y shaped
    c. U shaped
    d. O shaped

    ans is b

    which of the statements related to gastric injury is untrue:
    a. mostly related to penetrating trauma
    b. treatment is simple debridement and suturing
    c. blood in stomach always related to gastric injury
    d. heals well and fast

    c is answer

    Claw hand is caused by lesions of:
    a. Ulnar
    b. Median
    c. Axillary
    d. Radial

    And is a/b most prob a since median is low median

    Invg in multiple myeloma are all except:
    a. urine proteins
    b. Xray
    c. Bone marrow biopsy
    d. Bone scan

    Ans is ?c

    Cat eye syndrome
    a. Partial trisomy 21
    b. Partial trisomy 18
    c. Partial trisomy 13
    d. Partial trisomy 22

    Ans is d

    There was one Q on Millard Gubler syndrome don’t remember options

    One Q on external haemorrhoids

    One Q on Dubin Johnson syndr one option is GGT

    One Q on calculation of INR

    The conversion of short term memory to long term memory occurs in
    a.frontal cortex
    b.hippocampus
    c.amygdala
    d.

    ans is most prob b

    CSF picture in TBM:
    a. incr prot, incr sugars, incr lymphocytes
    b. incr prot, decr sugars, incr lymphocytes
    c. decr prot, incr sugars, incr lymphocytes
    d. decr prot, decr sugars, incr lymphocytes

    ans is b

    Findings in DIC:
    a.incr fibrinogen, incr antithrombinIII incr thrombin-antithrombin complexes
    b.incr FDP, decr PT, incr antithrombin III
    c.incr FDP, prolonged PT, incr thrombin-antithrombin complexes
    d.incr FDP, prolonged PT, reduced platelets



    Two Q on vibrio cholerae

    Which IUCD lasts for 10 yrs

    OCPs are useful in all except:
    a. endometriosis
    b. ca endometrium
    c. ca breast

    ans is c

    Fibroid causes all of the foll except:
    a. menstrual irregularities
    b. infertility
    c. abd mass
    d. amenorrhoea

    ans is d

    One Q was on stats 2x2 table

    One Q was on External Cephalic Version

    Centrineuraxial (spinal or epidural) Anaesthesia is contraindicated in:
    a. Platelets < 80,000
    b. Pt on aspirin
    c. Pt on oral anticoagulants
    d. Pt on iv Heparin

    Ans is ? d

    Pt in septicaemic shock which vasopressor
    a. epinephrine
    b. nor epinephrine
    c. phenylephrine
    d. ephedrine

    ans : ? b

    Which antiepileptic not contraind in pregnancy
    a. phenobarbitone
    b. phenytoin
    c. carbamazepine
    d. valproic acid

    ans is d / a

    One of the options of the absence of lamina cribrosa Q was coloboma of the retina

    Better prognostic factor in childhood leukaemia
    a. common ALL subtype
    b. pre-B ALL
    c. Hyperploidy

    There was one Q on a child undergoing surgical procedure anaesthetized with artacurium and propofol, wakes up with body pain 12 hrs later Cause of body pain:
    a. adverse effect of propofol
    b. something abt buildup of Laudanosine



    Trauma to the temporal bone with injury to VII nerve. which is true?
    a.Longitudinal #
    b. Transverse #
    c. always asso with CSF leak
    d. The paralysis of VII nerve is always complete

    ans b

    The anatomical str passing frm left to right all except:
    a. left brachiocephalic vein
    b. azygous vein
    c. lt gonadal vein
    d. lt renal vein

    ans is c

    Which of the following Diseases cause decr VC, decr TLC?
    a.sarcoidosis
    b.cystic fibrosis
    c.? bronchial asthma


    A young man with chronic small bowel diarrhoea duodenal biopsy shows IgA anti-human tissue transglutimase (TTG), and IgA anti-endomysial antibodies. which of the following is the next step?
    a. rectal biopsy
    b. a trial of gluten free diet
    c. colonoscopy

    ans is b


    meningitis in 1 yr old caused by
    H. influenzae

    there was a inheritance chart for disease options were:
    a. mitochondrial inheritance
    b. X linked dominant
    c. autosomal dominant
    d. autosomal recessive

    ans is a




    Which antiepileptic is not contraindicated in pregnancy ?
    A. Phenobarbitone
    B. Phenytoin
    C. Carbamazepine
    D. Valproic acid

    Ans. A/D


    . Patient in septicaemic shock which vassopressor ?
    A. Epinephrine
    B. Norepinephrine
    C. Phenylephrine
    D. Ephedrine

    Ans. ?B


    Centrineuraxial (spinal or epidural) Anaesthesia is contraindicated in ?
    A. Platelets < 80,000
    B. Patient on aspirin
    C. Patient on oral anticoagulants
    D. Patient on I.V. Heparin

    Ans. ?D

    . External cehpalic version ?


    . Statistitics 2 X 2 table ?


    . Fibriod causes all of the following except ?
    A. menstrual irregularities
    B. infertility
    C. abdominal mass
    D. amenorrhoea

    Ans. amenorrhoea

    OCPs are useful in all except ?
    A. Endometriosis
    B. Ca endometrium
    C. Ca breast

    Ans. Ca breast

    Which IUCD lasts for 10 years ?
    On Vibrio Cholerae ?


    Findings in DIC ?
    A. increased fibrinogen, increased antithrombin III, increased thrombin-antithrombin complexes
    B. increased FDP, decreased PT, increased antithrombin III
    C. increased FDP, prolonged PT, increased thrombin-antithrombin complexes
    D. increased FDP, prolonged PT, reduced platelets

    Ans. ?D

    . CSF picture in Tubercular meningitis ?
    A. increased protein, increased sugars, increased lymphocytes
    B. increased protein, decreased sugars, increased lymphocytes
    C. decreased protein, increased sugars, increased lymphocytes
    D. decreased protein, decreased sugars, increased lymphocytes

    Ans. increased protein, decreased sugars, increased lymphocytes


    . Conversion of short term memory to long term memory occurs in ?
    A. Frontal cortex
    B. Hippocampus
    C. Amygdala

    Ans. ?Hippocampus


    Calculation of INR ?


    Dubin Johnson syndrome ?
    A. GGT


    External haemorhoids ?


    Millard Gubler Syndrome ?
    Contributed by: dubspg

    Cat eye syndrome ?
    A. Partial trisomy 21
    B. Partial trisomy 18
    C. Partial trisomy 13
    D. Partial trisomy 22

    Ans. Partial trisomy 22


    . Investigations in multiple myeloma are all except ?
    A. Urine proteins
    B. Xray
    C. Bone marrow biopsy
    D. Bone scan

    Ans. ?C


    Which of the statements related to gastric injury is untrue ?
    A. mostly related to penetrating trauma
    B. treatment is simple debridement and suturing
    C. blood in stomach always related to gastric injury
    D. heals well and fast

    Ans. blood in stomach always related to gastric injury


    The shape of cerivcal canal suggesting preterm delivery (something like that) is ?
    A. T shaped
    B. Y shaped
    C. U shaped
    D. O shaped

    Ans.Y shaped


    The shape of nulliparous cervix is ?
    A. circular
    B. longitudinal
    C. transverse
    D. fimbriated

    Ans. circular


    . Finasteride acts via ?
    A. alpha blockade
    B. 5-alpha reductase
    C. selective alpha-1 blockade

    Ans. 5-alpha reductase


    Fetus with increased nuchal translucency at 14 wks ?
    A. Down's syndrome
    B. Esophageal atresia

    Ans. Down's syndrome


    A 50 year old man with family history of carcinoma prostate wants to do screening. The most sensitive test is ?
    A. Digital rectal examination
    B. Serum PSA
    C. Both A + B Combined
    D. Endorectal coil MRI with T1 and T2 weighed images



    Leprosy affects all except ?
    A. Uterus
    B. Ovary
    C. Eyes
    D. Nerves

    Ans. Uterus


    Mechanism of cellular memory and learning includes all except ?
    A. Increase or decrease in neurotransmittor release as in habituation and sensitization
    B. Increase in no of synapses as in increase in no of synaptic terminals,increase in dendrites
    C. Recruitment of neurons, involvement of more neurons in a particular function as occurs in somatosensory area of the cortex
    D. Allocation of specialised nerve cells as occurs in the hippocampus


    Commonest childhood malignancy is ?
    A. Leukemia
    B. Neuroblastoma
    C. Lymphoma
    D. Wilm's tumour

    Ans. A / C


    Chemotherapeutic agent causing SIADH ?
    A. Vincristine
    B. Cyclophosphamide

    Ans. Vincristine

    Which of the following anticancer drugs causes hyperviscocity syndrome ?
    A. Vinblastine
    B. L-asparaginase
    C. 5FU

    Ans. L-asparaginase


    Absence of lamina cribrosa occurs in ?
    A. Optic nerve hypoplasia
    B. Morning glory syndrome

    Ans. Morning glory syndrome

    What is Pentalogy of Fallot ?
    A. TOF with ASD

    Ans. TOF with ASD


    Which of the following retinal diseases is transmitted as Autosomal Dominant Trait ?
    A. Best Disease

    Ans. Best Disease


    . A child has TGA. The mother should be investigated for ?
    A. Maternal Gestational Diabetes
    B. Maternal PIH

    Ans. Maternal Gestational Diabetes
    Contributed by : Rabies

    . BCG vaccine ?
    A. DANISH 1331 STRAIN

    Ans. DANISH 1331 STRAIN

    NSE non specific esterase seen in ?
    A. AML3

    Ans. AML3
    Contributed by: Dr. Samta

    Papez circuit ?
    Contributed by: Dr. Samta

    Which condition shows absence of lamina cribrosa?


    Tranmission of hepatitis B is more during which trimester ?

    A child wit IQ 50 ?
    A. identifies colours
    B. Rides a bicycle



    . Nesiritide ?
    A. Brain natriuretic peptide

    Ans. Brain natriuretic peptide
    Contributed by: Dr. Samta

    Nevirapine ?
    A. NNRTI

    Ans. NNRTI


    Pronation supination doesnt take place at ?
    A. Middle radio ulnar joint

    Ans. Middle radioulnar joint


    Commonest cause of post menopausal bleed ?
    A. Ca endometrium

    Ans. Ca endometrium


    Chlamydia pssitacci does not cause ?
    A. Community acquired pneumonia

    Ans. Community acquired pneumonia


    Interleukin 1 inhibitor ?
    A. Zafirlukast n montelukast


    Where is filgrastim used ?
    A. Neutropenia

    Ans. Neutropenia
    Contributed by: Dewdrop

    Claw hand is caused by lesions of ?
    A. Ulnar nerve
    B. Median nerve
    C. Axillary nerve
    D. Radial nerve

    Ans. Ulnar nerve


    . Which tumor arises from the epiphysis ?
    A. Osteoclastoma

    Ans. Osteoclastoma

    Which amyloid is found in the kidney in patients who have been on dialysis ?
    A. b2 microglobulin

    Ans. b2 microglobulin

    Supination and pronation are done at all joints, except :

    (1) Superior radioulnar joint

    (2) Inferior radioulnar joint

    (3) Middle Radioulnar joint

    (4) Radiocarpal joint

    Ans. (4)

    Regarding trigone of bladder, not true is :

    (1) Smooth mucosa

    (2) Loosely attached to underlying muscle

    (3) Transitional epithelium lines it

    (4) It is a remenant of mesonephric duct opening into posterior urogenital sinus


    Typical cervical vertebra can be differentiated from thoracic vertebra by :

    (1) Foraman transversarium

    (2) Triangle vertebral canal

    (3) Heavy vertebral body

    (4) Superior facet on upper surface of body

    Ans. (1)






    Morgagnian Hernia passes through :

    (1) Posterior left part of diaphragm

    (2) Posterior right part of diaphragm

    (3) Anterior left part of diaphragm

    (4) Anterior right part of diaphragm

    Ans. (4)






    All of the following pass posterior to diaphragm from thorax to abdomen, except :

    (1) Aorta

    (2) Azygous vein

    (3) Thoracic duct

    (4) Great splanchnic vein

    Ans. (3)






    Regarding posterior cruciate ligament, true statement is :

    (1) Prevents posterior displacement of tibia

    (2) Intra synovial

    (3) Attaches to lateral femoral condyle

    (4) It tightens during extension of knee joint

    Ans. (1)




    The smooth endoplasmic reticulum helps in the metabolism of which of the following?

    (1) Vitamin

    (2) Protein

    (3) Carbohydrate

    (4) Lipid

    Ans. (4)



    Not true about mycosis fungoides is :

    (1) Most common cutaneous lymphoma

    (2) Pautrier’s abscess

    (3) Curable disease

    (4) Erythroderma present

    Ans. (3)




    A patient presented with cough with expectoration, sputum culture shows gram negative organisms from only charcoal extract agar, the organism is :

    (1) Listeria monocytogens

    (2) M. catarrhalis

    (3) Mallei / pseudomallei

    (4) Legionella
  23. sat_rishi

    sat_rishi Guest

    1. dubin johnson syndrome

    2. screening for prostate
    dre + psa

    3. kidney secretes all/exc
    renin,
    angiotensin
    eryhtropoietin
    1,25 oh chole calci

    4. tube cast
    shoulder

    5. chronic carrier all exc
    measles

    6. supination pronation

    7. theta waves seen in
    nrem
    rem
    deep sleep

    8. minor jones criteria
    fever
    previous rh fever

    9. which is not thyroid ca
    merkels

    10 men 1
    gastrinoma

    11 nuchal translucency
    down,s

    12. moro,s reflex disappears

    13. black color urine
    alkaptunaria

    14. biotin in
    common carboxylase defeiciency

    15. codmans + sunray
    osteosarcoma

    16 pulsatile tumor

    17 calculating inr

    18 difference betwen cervical n thorecic vertebra

    19 mode of injury to vertebra
    flexion

    Extension

    20 delusion

    21 spalding sign

    22 age 6 yrs iq 50
    colour diff

    23 mc malignancy children
    leukemia

    24 congenital torticollis
    always due to breech extractn

    25 ext cephalic version c/i
    pih

    26 hypothyroidism not assoc
    hypertension

    27 siadh due to

    28 bartonian line

    29 child with flexural papules, itching
    atopic dermatitis

    30 vibrio chol o131

    31 finasteride
    alpha 1 reductase inhib

    32 nevirapine
    nnrti

    33 chlorine content
    horrocks app

    34 chl psittaci
    ngu

    35 mcc oy cell lines

    36 filgrastim
    neutropenia

    37 all are gp iib/iiia exc
    clopilet

    38 aspirin
    ^ bt

    39 awmi + cardiogenic shock
    prim ptca

    40 kawasaki disease

    41 short stature
    constituional

    42 browns sign
    glomus ?

    43 pityriasis rosacea

    44 raynauds disease
    good prognosis

    45 aml m3
    t 15 : 17

    46 all pass post to diaphragm
    aorta
    thoracic duct
    azygous

    47 cross lt to right all /exc
    lt gonadal

    48 supports of uterus all /exc
    broad lig

    49 mc cause of post menopausal bleeding
    ca endometrium
    ca cervix

    50 mercury poison
    loop of henle
    pct
    dct
    ct

    51 iron defi anemia
    ^ tibc, decr ferritin

    52 oa knee wasting
    quadriceps

    53 physiotherapy deep mode exc
    infra red lamp

    54 schwannoma
    vestibulo

    55 pqli all /exc
    per capita

    56 extended immunisn schedule
    tt
    dt mmr
    57 cmv aim group
    all reproductive age females

    58 hep b transmission
    1 trim
    2 trim
    3trim
    implantation

    59 epidural c/i
    platelet < 80,000
    asprin
    warfarin
    heparin

    60 injury to urethra below perinial line ?
    sup pouch

    61 30 yrs lady atrial fibrilln with ms/mr
    digoxin toxicioty
    stroke

    62 not used in controllin heart rate
    encanaide
    procainamide
    ?

    63 preg lady ovary cyst surgery
    6 weeks
    8 weeks
    immed

    64 hydatiform mole progress to
    chorioca
    invasive
    65 mycophenolate

    66 pregnancy used anti epileptic
    carbazamepine
    valproate
    67 culture on charcoal,60 yr old man icu pneumonia

    68 found in serum n plasma
    prothrombin
    ii
    v
    vii

    69 patient satisfied
    dissatisfied
    variable ?


    70 sle 6 tests specif sensiv

    71 drug induced lupus
    anti histone ?

    72 dic
    ^ fdp 3 choice ? exc one

    73 complications of measles all exc
    sspe
    diarrhoea

    74 rhinolalia

    75 red eye
    nieman pick
    gm1 ganglio
    krabbe

    76 bohlers angle
    calcaneum?
    77 anti obesity drug all exc

    78 2nd curvature with concavity post
    sacral
    coccyg
    cervical

    79 z e synd
    ppi

    80 h pylori regimen
    oxytetra

    81 orange coloured urine
    rifampicin

    82 lepromin
    not diagnostic

    83 bt leprosy with nerve

    mdt vid steroids
    84 tubersulide

    scrofulderma
    85 children anesthesia butrophenol?

    86 glomerulonephritis vid hcv

    87 amyloidosis
    rectal biopsy

    88 tlc +vc reduced
    brocnhiectasis
    cystic fibrosis

    89 child asthma rx ?

    90 montelukast
    lt1 inhib

    91 old man DM bladder disturbances
    bph
    nerogenic ub

    92 trigone of ub

    93 claw hand

    ulnar
    94 mastication
    zygomaticomaxillary butress

    95 rhinophyma

    96 portosystemic anastam
    spleen
    liver
    anorectal
    ge jn

    97 bochhdalek hernia
    rt ant

    -- nerve compression


    Meralgia paresthetica involves :

    (1) Medial cutaneous nerve

    (2) Lateral cutaneous nerve of thigh

    (3) Sciatic nerve

    (4) Sural nerve

    Ans. (2)
  24. DEPRESSED

    DEPRESSED Guest

    THERE SHOULD BE ATLEAST ONE EPISODE OF MANIA FOR THE DIAGNOSIS OF BIPOLAR DISORDER.... SO 'ONLY DEPRESSION' CAN EASILY BE EXCLUDED.
  25. DEPRESSED

    DEPRESSED Guest

    Most Common drug of abuse in INDIA
    1)tobacco
    2)alcohol
    3)heroine
    4)cannabis
  26. anshu

    anshu Guest

    strain of Hpv associated with invasive cervical carcinoma.
    options:
    16
    18
    35
    42
  27. Rekha

    Rekha Guest

    ALL INDIA PRE PG 2007 EXAM SOME Q/A

    HI,
    we are POSTING answers of some of the recalled questions (which are memory based) if you remember more question please post . thanks.
    1. Cat eye syndrome is associated with :
    1. Partial trisomy 22
    2. Partial trisomy 21
    3. Partial trisomy 18
    4. Partial trisomy 13 ANS

    2) Facial Nerve injury by
    A. Transverse tympanic fracture ANS
    B. Vertical tympanic fracture

    3) Serotype of HPV associated with invasive carcinoma cervix:
    1. HPV 16 ANS
    2. HPV 18 ANS
    3. HPV 32
    4. HPV 36

    4) Technique of aspiration of sperm from testis used in ART:
    1. TESA ANS
    2. MESA
    3. GIFT
    4. ZIFT

    5) Isotope used in RIA
    1.I 131 ANS
    2. I 123
    3. I 125
    4. I 127

    6) Primordial germ cells are derived from:
    1. Ectoderm
    2. Mesoderm ANS
    3. Endoderm

    7) Dubin-Johnson syndrome:test used:
    1. transaminase
    2. Bromosulphathalein test
    3. Hippurate test
    4. Gamma glutamyl transferase ?ANS

    Spalding sign is seen in:
    1. Mummification
    2. Maceration ANS

    9)Acrodynia is seen in:
    1. Phenol poisoning
    2. Mercury poisoning ANS
    3. Arsenic poisoning
    4. Carbolic acid poisoning

    10)Mercury causes nephrotoxicity by involving:
    1. PCT ANS
    2. DCT
    3. Loop of Henle
    4. Collecting duct

    11) Burtonian line is seen in poisoning with:
    1.
    2.
    3.
    4. Lead ANS

    12) Lamina cribrosa is not formed in:
    1. Morning Glory syndrome ANS
    2. Nanophthalmia
    3. Colobama of retina
    4. Optic N. agenesis

    13)Transport of Ascorbic acid to lens is done by:
    1. Myoinositol ANS
    2. Choline
    3. Taurine
    4. Na-K ATPase

    14) Perinatal transmission of Hepatitis B is maximum when infection in mother occurs:
    1. at implantation
    2. 1st trimester
    3. 2nd trimester
    4. 3rd trimester ANS

    15)Not seen in raised ICT:
    1. Headache
    2. Visual blurring
    3. Abducens palsy
    4. Paraparesis ANS

    16. Best prognostic factor for head injury.
    A. Glasgow coma scale ANS
    B. Age
    C. Mode of injury
    D. CT

    17. Mycosis fungoides which is not true.
    A. It is the most common from of cutaneous lymphoma
    B. Pautriers microabcess
    C. Indolent course and easily amenable to treatment ANS
    D. Erythroderma seen and spreads to peripheral circulation

    18. A 6 year old child with IQ of 50. Which of the following can the child do.
    A. Identify colurs ANS
    B. Read a sentence
    C. Ride a bicycle
    D. Copy a triangle

    19. A newborn has congenital heart failure, not improving on treatment. He has bulging anterior fontanelles with a bruit on auscultation. On trans fontanelle USG a hypo echoeic midline mass is seen with dilated lateral venricles. Most probable diagnosis is.
    A. Vein of Galen malformation ANS
    B. Arachnoid cyst
    C. Medulloblastoma
    D. Encephalocele

    20. To expose the suprarenal aorta, to see celiac axis, Superior Mesentiric Artery, & left renal artery. How do you expose the abodominal viscera
    A. Craniocaudal approach
    B. Caudocranial approach
    C. Right medial rotation ANS
    D. Left medial rotation

    21. 45 year old female complains of progressive weakness and spasticity of the lower limb with difficulty during micturition CT scan shows an intrfadural mid dorsal midline enhancing lesion. The diagnosis is
    A. Meningioma ANS
    B. Intradural Lipoma
    C. Neuroeptihelial Cyst
    D. Dermoid Cyst

    22. 45 Yrs old male presents with 90/60 BP,PR-110 permin & history of vomiting 24 hrs back, a volume of 500ml of block Splenomegaly 5cm below lower costal margin. Most probable diagnosis.
    A. Duodenal ulcer
    B. Portal hypertension ANS
    C. Gastric ulcer
    D. Erosive gastritis

    23. Posterior cruciate ligament – true statement
    A. attached to the lateral femoral condyle
    B. Intral synovial
    C. Prevents posterior dislocation of tibia ANS
    D. Relaxed in full flexion

    24. Sternomastoid tumour is associated with all except
    A. Always associated with breech extraction ANS
    B. Spontaneous resolution in most
    C. 2/3rd have palpable neck mass at birth
    D. Uncorrected cases develop phagiocephaly

    25. Difference between typical cervical & thoracic vertebra
    A. Has a triangular body
    B. Has a formaen transversarium ANS
    C. Superior articular facet directed backwards & upwards
    D. Has a large vertebral body

    26. Most common site of Morgagni Hernia
    A. Left Anterior
    B. Right Posterior
    C. Right Anterior ANS
    D. Left Posterior

    27. Meralgia parasthetica is due to the involvement of :
    A. Medial cutaneous nerve of thigh
    B. Lateral cutaneous nerve of thigh ANS
    C. Sural nerve
    D. Femoral nerve

    28. Movements of pronation & supination occurs in al the following joints except.
    A. superior radio-ulnar joint
    B. Middle radio-ulnar joint
    C. Inferior radio-ulnar joint
    D. Radio-carpal joint ANS

    29. Structures that pass from thorax to abdomen behind the diaphragm are all except
    A. Azygos vein ANS
    B. Aorta
    C. Thoracic duct
    D. Greater splancnic nerve
    30. Supports of the uterus are all except
    A. Uterosacral lingament ANS
    B. Broad Ligament
    C. Mackenrodts’ ligament
    D. Levator ani

    31. All are ture about the trigoneof the urinary bladder except
    A. Mucosa is loosely associated to the underlying musculature ANS
    B. Mucosa is smooth
    C. It is lined by transitional epithelium
    D. It is erived from the absorbed part of the mesonephric duct

    32. Which bone tumor occur in epiphysis
    A. Osteoclastoma ANS
    B. Ewing’s sarcoma
    C. Chondromyxiod fibroma
    D. Osteosarcoma

    33. Hypothyroidism in pregnancy is least likely associated with,
    A. Recurrent abortions
    B. Polyhydramnios
    C. PIH
    D. Preterm labour ANS

    34. Premature bab y of 34 wks was delivered baby had bullous lesion on the;bodyX-ray shows periostitis. What is next investigation?
    A. VDRL for mother & baby ANS
    B. ELISA for HV
    C. PCR for TB
    D. Hepatitis surface antigen for mother

    35. Pityriasis rosea true is
    A. Self limiting ANS
    B. Chronic relapsing
    C. Life threatening infection
    D. Caused by dermatioophytes

    36. A 3 yr old child had eczematous dermatitis on extensor surfaces. His other has a history of brfonchial asthma. Diagnosis could be
    A. Atopic dermatitis ANS
    B. Contact drmititis
    C. Seborrhic dermatitis
    D. Infantile eczematous dermatitis

    37. The drug of choice for obsessive compulsive disorder
    A. Imipramine
    B. Fluoxetine ANS
    C. Choppromazine
    D. Benzodiazepine

    38. Naltrexone is used in opiod addiction because
    A. To treat withdraw symptoms
    B. To treat overdose of opiods
    C. Prevent relapse ANS
    D. Has addiction potential

    39. A 3 year old child developmental milestones normal with delayed speech, and Difficulty in Communication, concentration, not making friends
    A. Autism ANS
    B. ADHD
    C. Specific learning disability
    D. Mental retardation

    40. Delusion is a disorder of
    A. Thought ANS
    B. Perception
    C. Insight
    D. Cognition

    41. The following drug is not useful for MRSA,
    A. Cfaclor ANS
    B. Cotrimoxazole
    C. Ciprofloxacin
    D. Vancomycin

    42. One of the following is a prodrug,
    A. Enalapril ANS
    B. Neostigmine
    C. Esmolol
    D. Captopril
    43. With reference to bacteroides frangilis, the following statements are true except
    A. Bacteroides fragilis is the same frequent anaerobe isolated from clinical samples
    B. Bacteroides fragilis is not uniformly sensitive to mentronidazole
    C. The LPS formed by bacteoides fragilis is structurally and functionally different from the conventionala endotoxins
    D. Shock and DIC are common in bacteroides bacteremia ANS

    44. Which of the following bacterial act by increasing c-AMP,
    A. Vibrio cholera ANS
    B. Staphyloccus aereus
    C. E.coli, heat stable toxin
    D. Salmonella

    45. A patient in ICU is on central venous line for the past one week. He is on caftazidime and maikacin. After 7 days of antibiotics he develops a spike of fever and his blood culture is positive for gram positive cocci in chains, which are catalase negative. Following this vancomycin was started, but the culture remained positive, for the same organism even after 10 days of therapy. The most likely organism causing infection is.
    A. Staphylococcus aureus
    B. Viridans streptococci
    C. Enterococcus fecalis ANS
    D. Coagulase negative staphylococcus

    46. A child presents with infective skin lesions of the leg. Culture was done which showed gram positive cocci in chains which were hemolytic colonies. Which of the following tests will best indentify the organism.
    A. Bile solubility
    B. Optochin sensitivity
    C. Bacitracin sensitivity ANS
    D. Catalase positive

    47. A young male patient presented with UTI, on urine examination pus cells were found but no organisms. Which method would be best used for culture ?
    A. MC Coy cell line ANS
    B. Thayer Martin medium
    C. L.J. Medium
    D. Levinthal Medium

    48. Which one of the following is true.
    A. Agar has nutrient properties
    B. Chocolate medium is selective medium
    C. Addition of selective substances in a soild medium is called enrichment media
    D. Nutrient broth is basal medium ANS

    49. Which of the following is not transmitted by lice.
    A. Q fever ANS
    B. Trench fever
    C. Relapsing fever
    D. Epidemic typhus

    50. Chlamydia trachomatis false is.
    A. Elementary body is metabolically active ANS
    B. It is biphasic
    C. Reticulate body divdes by binary fission
    D. Inside the cell it evades phagolysosome

    51. A elderly male patient presented with fever, chest pain and dry cough, sputum cultured on charcoal yeast medium, the organism is.
    A. H. Influenza
    B. Moraxella cartarrhails
    C. Legionella ANS
    D. Burkholderia capacia

    52. A person working in an abattoir presented with pustule on hand, which turned into ulcer, which will best help in diagnosis.
    A. Trichrome Methylene Blue ANS
    B. Carbol Fuschin
    C. Acid Fast Stain
    D. Calcoflour White

    53. 1yr old child with bronchial asthama. Treatment is
    A. Inhaled B2 agonist ANS
    B. Oral Ketotifen
    C. Oral LT2 receptor antagonist
    D. Theophyllin

    54. Brucellosis cannot be caused by
    A. Infected placenta
    B. Intake of raw vegetables
    C. Person to person transmission ANS

    55. Max peripheral Neuropathy is caused by
    A. Zidovudine
    B. Stavudine ANS
    C. Lamivudine
    D. Didanosine

    56. All are alkyating agents except
    A. 5FU ANS
    B. Chlorambucil
    C. Melphalan
    D. Cyclophosphamide

    57. All are true about Mycoses Fungoides except
    A. It is indolent ANS
    B. M/c skin leukaemia

    58. Northern blot is used for analysis of
    A. Mrna expression ANS
    B. Dna ‘’
    C. Protein ‘’

    59. Differentiating feature between cervical and lumbar vertebra
    A. Broad body
    B. Transverse process has transverse foramina ANS
    C. Triangular spinal cord

    60. Claw hand is caused by
    A. Ulnar ANS
    B. Median
    C. Radial

    61. All are autosomal dominant except
    A. Marfans
    B. Fabrys ANS
    C. Huntington Chorea
    D. ADPKD

    62. BCYE is used
    A. Legionella ANS
    B. Strep

    63. True about media
    A. Enrichment media is solid
    B. Nutrient agar is a baseline media ANS

    64. Fe def anaemia is a/s with
    A. Increased TIBC, decreased Ferritin ANS
    B. Decreased ‘’ ‘’ ‘’
    C. ‘’ ‘’ increased ‘’

    65. m/c childhood tumor
    A. Neuroblastoma
    B. Wilm’s
    C. Leukaemia ANS

    66. a person with IQ of 50 can do the following
    A. Riding a bicycle ANS
    B. Read a sentence
    49. Pedigree chart for mitochondrial inheritance

    67. Autosomal recessive trait is seen in child inspite of normal parents due to
    A. Uniparental disomy
    B. Mosaicism ANS

    68. Child feels more comfortable in lying position
    A. Ac epiglottitis
    B. Croup
    C. Laryngomalacia ANS
  28. SHIVJYOTI

    SHIVJYOTI Guest

    PT WTH ORBITAL SWELLING ,INCREASE ON BENDIND FORWARD,BRUIT + ANS IS ORBITAL VARIX
    A.
    B.ORBITAL VARIX
    C.NEUROFIBROMATOSIS
    D?
  29. SHIVJYOTI

    SHIVJYOTI Guest

    SAFE SRATEGY OF TRACHOMA,ALL EXCEPT
    A.SCREENING
    B.ENVIRNMENTAL SANITATION
    CFACE WASHING
    D.ANTIBIOTIC
    ANS A
    S-SURGERY (LID)
  30. Dr. Sumer

    Dr. Sumer Guest

    Neuropeptide Y analogues was in question.. Neuropeptide antagonists are used in treament of obesity..

    Olestra is zero-fat oil that is used to cook for obese persons!!! So? is it a drug?


    Mechanism of cellular memory & learning include all except?

    a) increase & decrease in neurotransmitter release as in learning & habituation
    b) increase in no. of synapses, increase in no. of synaptic terminals, increase in no. of dendrites
    c) recruitment of neurons, involvement of more neurons in a particular function as in somatosensory area of cortex
    d) allocation of specialized nerve cells as occurs in hippocampus


    the reason for sex diffenrence in puberty in boys is dute to
    a. due to high levels of inhibin
    b.presence of realesable pool of FSH


    for h pylori eradication
    ans is UREASE BREATH TEST
    ref.. harrison u can read it
  31. Dr. Ajay.

    Dr. Ajay. Guest

    which is not a obesiy drug
    a.orlistat
    b.sibutramine.
    c.orlestra
    d.neuropeptide y analogue
    ans is C. ORLESTRA


    Degenaration of basement membrane...Options had oxidase,metalloproteinase.Is the answer,metalloproteinase?


    How does a person maintain anabolic state ....BY O2 innhalation -decreased exercise,by decreased workload and prolonged duration of less excercise,By decreased workload and no exercise.


    the answer of h.pylori eradication investigation following treatment is endoscopy guided antral biopsy.
  32. Dr. Ajay.

    Dr. Ajay. Guest

    burrowing ulcer caused by peptostreptococcus ,Burrowing ulcer is also known as Malaney's ulcer


    tube cast,also known as sleeve cast., is used to immobilize knee..


    for the Q. marker related wih pagets disease of nipple. ans. is CEA
  33. pg aspirant

    pg aspirant Guest

    botulinum toxin .... postganglionic the referenec in harrison page 842 ans is CNS doesnt involved



    regarding aspiration technique it is clearly mentioned in Gynae dutta that two that is TESE AND MESA areused,and which come as testicular sperm extrastion adnd microsurgical epididymal sperm aspiration and i am sure that option was TESA and not TESE WHICH IS TRUE...
  34. pg aspirant

    pg aspirant Guest

    hi
    some more questions
    1 enzymes not stable in acidic ph:
    trypsin ,
    chymotrypsin,
    pepsin,
    carboxypeptidase
    2. true about pilonidal sinus
    common in females
    congenital
    toc excision
    3. botulinum toxin acts on all sites except
    cns
    4.site of rbc formation in 20 yr old healthy male
    flat bones
    long bones
    5.neonatal tetnus
    6.all are nonselective b blockers with axn only on b receptors except
    labetalol
    betoxalol
    ans was labetalol with both a b blocking activity.
  35. Prasant

    Prasant Guest

    Hi! I attempted 280 in all.
    240 at first go...
    In general, I have tried in mocks and also while practicing at home, I get approx 80% right what I answer at first go... It includes repeats, topics repeated, or any thing wich I have even faintest ideas about...
    That brings to 192 right... Of the rest I usually get 40% right and 60% wrong....
    I left 20 questions which I had never ever heard of.
    so, 192 + 16 = 208 right, 72 wrongs, i.e, -18.
    this brings a net score of around 190.

    Is it good enough to be between 1000 and 2000?

    I am pretty reluctant to check answers coz it might spoil my motivation for state PG.
    But yes this formula has worked for me in Bhatia mocks, IAMS mocks, and while I solve a question paper the first time...
  36. dr.shashi

    dr.shashi Guest

    so many people r expectin more than 70 percent marks in this thread...sounds to good to b true....agreed lots of repeats..yet this kinda papers seems simple but is not actually...same opinion was for nov AIIMS ..ppl were thinkin of 63 as cut off...which went as 56..this time we may not come to know exact cut off..but i m sure it cannot b so high...
  37. Guest

    Guest Guest

    one thing for sure
    after AIIMS nov 2006
    every one came out predicting very high marks coz even in that exam there were a significant chunk of repeats ........ but things changed when the results were out.... coz candidates got tricked into answering too many q's thereby too many negatives

    for this type of paper i guess two steps....
    first getting atleast 90-95% repeats correct
    secondly from the remaining mcq's the deciding factor will be the number of negatives.....
  38. Dr.  Chawla

    Dr. Chawla Guest

    Filgastrim is used in?
    a.malaria
    b.fileria
    c.neutropenia
    d.amemia
    ans. C

    Blood cells are short-lived and continuously replaced. Process of blood cell formation =
    hemopoiesis. Site where blood cell formation takes place is hemopoietic organs. These
    organs include the spleen, lymph nodes and thymus and bone marrow. Will consider blood
    cell formation primarily in marrow.
    Marrow found in cavities of long bones, spongiosa of vertebral bodies, ribs, sternum, flat
    bones of cranium and pelvis. Marrow = blood cells, macrophages, adipose cells reticular cells
    and reticular fibers. Marrow content changes with age in relative concentration of cell types.
    At birth marrow is primarily concerned with red cell formation therefore is very red. At 4-5
    years of age, the number of blood forming cells decreases and adipose cell number increases.
    Therefore is a transformation between hemopoietically active red marrow to more inactive
    adipose tissue.
    In adults, red marrow persists only in the proximal ends of the humerous and femur, ribs
    sternum and iliac crest. Cells in the marrow are arranged in vascular sinuses lined by
    endothelium and supported by a reticular layer. Developed blood cells which pass into the
    circulation do not do so by separating the endothelial cells but instead fuse with the endothelial
    cell membrane and form a migration pore through which the cells pass.
    Blood cell formation - cells must be continuously replaced to maintain relatively constant
    number
    Adult hematopoietic tissues:
    Bone marrow - main tissue
    Lymphoid organs - most lymphocytes
    Embryonic and fetal life - different organs - different phases:
    • Early embryo - prehepatic phase. Blood islands of yolk sac form nucleated red cells
    • Fetus - hepatosplenothymic phase. Liver and spleen form red cells, granulocytes,
    platelets. Thymus forms lymphocytes
    • Later fetus through adult - medullolymphatic phase. Bone marrow forms all types of
    blood cells. Lymphoid organs forms lymphocytes
    • Liver and spleen can become active again in pathologic conditions = extramedullary
    hematopoiesis
    A. Bone Marrow
    Large organ 4-6% body weight
    In hollow cavities of bone (medullary or myeloid cavities)
    1. Yellow marrow is inactive not hematopoietic
    Found in long bones of appendicular skeleton mostly
    Contains almost all fat cells. Important for energy storage. Can become active if
    needed.
    2. Red marrow is active hematopoietic tissue.
    Found in sternum, pelvis, skull, vertebrae, ribs, clavicle. Proximal epiphyses of femur
    and humerus in young adults. In infants, all marrow is red - more and more becomes
    yellow with age until adult pattern is obtained. Two types interconvertible depending on
    need. Structure of red marrow cavity: Bounded by endosteum.
    a. Vascular compartment - blood vessels
    Nutrient arteries penetrate bone form arterioles (in marrow) form sinusoids which form
    central veins. Sinusoids - thin-walled, anastomose freely. Endothelium has basal
    lamina. Exchange - new cells enter blood directly through the endothelium stimulated
    by releasing factor. Cells do not enter blood through hole in sinusoid but instead fuse
    with sinusoidal membrane.
    b. Hematopoietic compartment - is located between vessels and
    endosteum
    1. Stroma - consists of hematopoietic cords and sinusoids. Is a supportive network - fixed cells
    and reticular fibers
    a. Reticular (adventitial) cells which are stellate, branched, large pale nucleus.
    Synthesize reticular fibers. Form meshwork - branches and fibers. Incompletely
    cover outside of venous sinusoids - regulate passage of cells from hematopoietic to
    vascular compartment. Can become fat cells
    b. Macrophages Some near sinusoids - engulf material within sinusoids. Some
    deeper in hematopoietic tissue - clean up defective cells, nuclei from RBCs, etc.
    c. Adipose cells
    d. Parenchyma - functional part - hematopoietic cells in all stages. Different cells
    lines often in fairly specific locations. Marrow smears - important clinically. Contain
    all types of stromal and parenchymal cells. May also contain cells associated with
    vessels or osteogenic cells from endosteum. Many cells are irregular or damaged.
    Sizes and colors of cells based on Wright’s-stained dried smears.
    B. Hematopoiesis
    One cell most likely gives rise to all blood cell types - pluripotential cell. Arise from a
    single stem cell type in bone marrow = pluriotential stem cell. These are called stem cells. If
    cells are able to differentiate into several different types of mature blood cells they are
    described as pluripotential hemopoietic stem cells. These cells gradually become directed
    along a particular path of differentiation to form a single cells type. Because these stem cells
    lack the form of any particular cell type are very difficult to identify. General consensus is that
    these cells resemble a lymphocyte with poorly condensed chromatin in the nucleus.
    Stem cells in turn differentiate into two basic cell lines. Myeloid cell and lymphoid cell lines.
    • Myeloid cells develop in the bone marrow.
    • Lymphoid cells migrate from bone marrow to lymph nodes, spleen and thymus early in
    development. Continue differentiation there.
    Approximate composition of marrow smear:
    60% Erythrocytic line
    20% Granulocytic line
    10% Lymphocytic line
    3 -7% Blasts
    2% Monocytic line
    Many intermediate


    regarding bone FORMATION MARKER AS IT WAS THE CORRECT QUESTION...
    THE ANSWER IS HYDROXYPROLINE as it is a marker of bone resorption and also the option was procollagen peptide.
    To confirm it see harry page2273 16th in table and it will settle the problem.
    about question on csf leakage as the option mentioned ethmoid sinus and not ethmoid bone and it is written that csf leak occurs due to fracture of posterior wall of frontal sinus ...
    offcourse cribri and ethmoid being the commonest cause but not mentioned in the options.
  39. Dr.  Naseem

    Dr. Naseem Guest

    There was a question on MI + CARDIOGENIC SHOCK FOR WHICH THE

    ANS IS PRIMARY ANGIOPLASTY ..IT MAY RAISE EYEBROWS BUT SEE HARRY PAGE 1453 UNDER ANGIOPLASTY.

    THERE WAS A QUESTION ABOUT traacylglycerol and about it the pick was it has glycerol kinase which was false as adipocytes are deficient in glycerol kinase.

    next about gi motility... and here ans being it is completely independent of stomach influence as the option is falls...
    iam sure some may ask about cck option but it is clearly mentioned inganong that cck inhibits stomach motility but stimulates motility of smallintestine and colon and by this conjecture how one can conclude that cck inhibits motility.

    Q-which is not an aryl phosphate OP?
    a)parathion
    b)malathion
    c)tik20
    d)folidol

    ans is malahion (it is an alkyl phosphate)- ref. Reddy

    Q)probably....... all the foll are non selective beta blockers with no additional action EXCEPT
    a)labetalol
    b)?carvedilol
    c)betaxolol

    is the ans betaxolol?......it is a selective beta1 blocker


    TRANSPOSITION OF GREAT VESSELS Question, should NOT be gestational diabetes as with it there are no congenital malformations ref any any any Obs book with proper reading of gestational diabetes. it should be a chromosomal abnormality with translocation, inversion. etc. sorry foradding to the confusion already prevailing.


    All are true about clonidine except..

    a) stimulates parasympathetic outflow
    b) causes dry mouth
    c) prazocin antagonizes its action
    d) ?

    ans for clonidine PRAZOSIN ANTAGONIZES ITS EFFECT
    reff.. kdt clonidine acts on a2 receptors while prazosin is a1 selective
    its effect beign blocked by YOHIMBINE
  40. mmudhol

    mmudhol Guest

    Pentalogy its still on debate!shouldnt hv asked dt que.

    At present dont hv evidence,wl intimate u guys as soon as possible.
    Also on beta blocker the question formation wasnt so correct..like nonselective beta blocker,which has pharmacological action only on Beta,except! Sounds strange to me,insted one would hv asked in diffrent way....


    moro's reflex diasappear by
    a)2 month
    b)3 month
    c)4 month
    d)6 month ans
    refrence for moro's
    mehrban singh 2nd ed p.no.84

    2) earliest mile stone to be achived
    a)crawling
    b)creeping
    c)mirror gazing ans
    d)standing

    REF:ghai p.no.44

    3)bohler's angle is used for # of
    a)calcaneum ans
    b)talus


    REF:maheswari p.no.140


    4)most common type of injury to spinal cord?
    a)flexionb ans b)extension
    c)compression

    REF:maheshwari p.144

    5)modality not having deep penetration
    a)micro wave
    b)ultra sonic
    c)short wave
    d)infra red ans

    REF:maheshwari p.66

    6)isotope used in radio isotope scanning?
    I-123 ans
    I-125
    I-127
    I-131

    REF:LB surgery p.779


    There is anatomic variation between the hearts of individuals with tetralogy of Fallot. The degree of right ventricular outflow tract obstruction varies between patients and is generally determines clinical symptoms and disease progression. Tetralogy of Fallot may present with other anatomical analomies, including:

    stenosis of the left pulmonary artery, in 40% of patients
    a bicuspid pulmonary valve, in 40% of patients
    right-sided aortic arch, in 25% of patients
    coronary artery anomalies, in 10% of patients
    an atrial septal defect, in which case the syndrome is sometimes called a pentalogy of Fallot an atrioventricular septal defect
    partially or totally anomalous pulmonary venous return
    forked ribs and scoliosis
    Tetralogy of fallot with pulmonary atresia or pseudotruncus arteriosus is a severe variant in which there is complete obstruction of the right ventricular outflow tract and absence of the pulmonary trunk. In these individuals, there is complete right to left shunting of blood. The lungs are perfused via extensive collaterals from the systemic arteries.

    7)test for eradication of h.pylori?
    a)rapid urease test
    b)urea breath test ans
    c)serology

    REF:harisson p.no.1775(fig 274-10)


    structure involved in conversion of shotr term to long term memory?

    a)hippocampus
    b)amygdala ans
    C)frontal lobe

    Memory modulation
    The amygdalae also are involved in the modulation of memory consolidation. Following any learning event, the long-term memory for the event is not instantaneously formed. Rather, information regarding the event is slowly assimilated into long-term storage over time, a process referred to as memory consolidation, until it reaches a relatively permanent state.

    During the consolidation period, the memory can be modulated. In particular, it appears that emotional arousal following the learning event influences the strength of the subsequent memory for that event. Greater emotional arousal following a learning event enhances a person's retention of that event. Experiments have shown [citation needed] that administration of stress hormones to individuals immediately after they learn something enhances their retention when they are tested two weeks later.

    The amygdalae, especially the basolateral nuclei, are involved in mediating the effects of emotional arousal on the strength of the memory for the event, as shown by many laboratories including that of James McGaugh. These laboratories have trained animals on a variety of learning tasks and found that drugs injected into the amygdala after training affect the animals' subsequent retention of the task. These tasks include basic Pavlovian tasks such as inhibitory avoidance, where a rat learns to associate a mild footshock with a particular compartment of an apparatus, and more complex tasks such as spatial or cued water maze, where a rat learns to swim to a platform to escape the water. If a drug that activates the amygdalae is injected into the amygdalae, the animals had better memory for the training in the task [1]. If a drug that inactivates the amygdalae is injected, the animals had impaired memory for the task.

    Despite the importance of the amygdalae in modulating memory consolidation, however, learning can occur without it, though such learning appears to be impaired, as in fear conditioning impairments following amygdalar damage (Killcross 1997)

    Evidence from work with humans indicates that the amygdala plays a similar role. Amygdala activity at the time of encoding information correlates with retention for that information. However, this correlation depends on the relative "emotionalness" of the information. More emotionally-arousing information increases amygdalar activity, and that activity correlates with retentio


    9)drug not used in eradication of h.pylori?
    amoxycilline
    oxytetracycline ans
    bismuth salts
    clarithromycin


    REF:harisson p.no.p.1794


    all are nonselective beta blockers without any additional action except
    carveidelol,

    betaxolol,

    carteolol, ans

    labetalol



    REF:kdt

    carviedelol & labetalol r alpha +b blocker,
    betaxolol is b1 selective


    bernard soulier syndrome is associated with all except-
    1)reduced plt size
    2)reduced plt count
    3)ristoceti...is normal ans
    4)ADP.. IS NORMAL


    REF:HARISSON


    There is extensive evidence indicating that the noradrenergic system of the amygdala, particularly the basolateral nucleus of the amygdala (BLA), is involved in memory consolidation. Infusions of norepinephrine or β-adrenoceptor agonists into the BLA enhance memory for inhibitory avoidance as well as water maze training. Other findings show that α1-adrenoceptor activation also enhances memory for inhibitory avoidance training through an interaction with β-adrenergic mechanisms. The central hypothesis guiding the research reviewed in this chapter is that stress hormones released during emotionally arousing experiences activate noradrenergic mechanisms in the BLA, resulting in enhanced memory for those events. Findings from experiments using rats have shown that the memory-modulatory effects of the adrenocortical stress hormones epinephrine and glucocorticoids are mediated by influences involving activation of β-adrenoceptors in the BLA. In addition, both behavioral and microdialysis studies have shown that the noradrenergic system of the BLA also mediates the influences of other neuromodulatory systems such as opioid peptidergic and GABAergic systems on memory storage. Other findings indicate that this stress hormone-induced activation of noradrenergic mechanisms in the BLA regulates explicit/declarative memory storage in other brain

    sterilisation commonly performed at which site of fallopian tube
    ampulla
    infundibullum
    isthmus
    cornua


    ampulla or isthmus?



    Pontine hemorrhage.

    This is a catastrophic event, typically a hypertensive bleed. It presents with of coma, quadriplegia, small reactive pupils and absent horizontal eye movements. In most quadriplegic patients a hematoma in the middle of the pons is centered at the junction of the tegmentum and basis pontis. Ocular bobbing is a less constant feature. Lateral tegmental hemorrhages present with 1 1/2 syndrome, small reactive pupils, limb ataxia of the cerebellar type, and contralateral hemisensory loss (Caplan and Goodwin, 1982). Those that survive may develop oculopalatal myoclonus. Diagnosis may be made via MRI or CT scan."

    got this from internet

    clearly mentions 3 of the options
    i.e. coma, quadriparesis, pinpoint pupils

    no mention of any vagal palsy
    so that cud be the ans out of exclusion


    pt in septicemic shock vasopressor used nor adrenaline..harrisons
    iucd lasting fr 10 years ..cuT 380 A
    pca branch of internal carotid



    13)Transport of Ascorbic acid to lens is done by:
    1. Myoinositol
    2. Choline
    3. Taurine
    4. Na-K ATPase

    Best prognostic factor for head injury.
    A. Glasgow coma scale ans
    B. Age
    C. Mode of injury
    D. CT

    Mycosis fungoides which is not true.
    A. It is the most common from of cutaneous lymphoma
    B. Pautriers microabcess
    C. Indolent course and easily amenable to treatment ans
    D. Erythroderma seen and spreads to peripheral circulation

    A 6 year old child with IQ of 50. Which of the following can the child do.
    A. Identify colurs ans
    B. Read a sentence
    C. Ride a bicycle
    D. Copy a triaangle



    A newborn has congenital heart failure, not improving on treatment. He has bulging anterior fontanelles with a bruit on auscultation. On trans fontanelle USG a hypo echoeic midline mass is seen with dilated lateral venricles. Most probable diagnosis is.
    A. Vein of Galen malformation ans
    B. Arachnoid cyst
    C. Medulloblastoma
    D. Encephalocele

    Posterior cruciate ligament – true statement
    A. attached to the lateral femoral condyle
    B. Intral synovial
    C. Prevents posterior dislocation of tibia ans
    D. Relaxed in full flexion

    Sternomastoid tumour is associated with al except
    A. Always associated with breech extraction ans
    B. Spontaneous resolution in most
    C. 2/3rd have palpable neck mass at birth
    D. Uncorrected cases develop phagiocephaly

    Difference between typical cervical & thoracic vertebra
    A. Has a triangular body
    B. Has a formaen transversarium ans
    C. Superior articular facet directed backwards & upwards ans
    D. Has a large vertebral body

    Most common site of Morgagni Hernia
    A. Left Anterior
    B. Right Posterior
    C. Right Anterior ans
    D. Left Posterior

    Meralgia parasthetica is due to the involvement of :
    A. Medial cutaneous nerve of thigh
    B. Lateral cutaneous nerve of thigh ans
    C. Sural nerve
    D. Femoral nerve

    Movements of pronation & supination occurs in al the following joints except.
    A. superior radio-ulnar joint
    B. Middle radio-ulnar joint
    C. Inferior radio-ulnar joint
    D. Radio-carpal joint ans

    Structures that pass from thorax to abdomen behind the diaphragm are all except
    A. Azygos vein
    B. Aorta
    C. Thoracic duct
    D. Greater splancnic nerve ans

    Supports of the uterus are all except
    A. Uterosacral lingament
    B. BroaD Ligament ans C. Mackenrodts’ ligament
    D. Levator ani

    All are ture about the trigone of the urinary bladder except
    A. Mucosa is loosely associated to the underlying musculature ans
    B. Mucosa is smooth
    C. It is lined by transitional epithelium
    D. It is erived from the absorbed part of the mesonephric duct

    Which bone tumor occur in epiphysis
    A. Osteoclastoma ans
    B. Ewing’s sarcoma C. Chondromyxiod fibroma
    D. Osteosarcoma

    Hypothyroidism in pregnancy is least likely associated with,
    A. Recurrent abortions
    B. Polyhydramnios ans
    C. PIH
    D. Preterm labour

    Premature bab y of 34 wks was delivered baby had [bleep] lesion on the;bodyX-ray shows periostitis. What is next investigation?
    A. VDRL for mother & baby ans
    B. ELISA for HV
    C. PCR for TB
    D. Hepatitis surface antigen for mother

    Pityriasis rosea true is
    A. Self limiting ans
    B. Chronic relapsing
    C. Life threatening infection
    D. Caused by dermatioophytes

    . A 3 yr old child had eczematous dermatitis on extensor surfaces. His other has a history of brfonchial asthma. Diagnosis could be
    A. Atopic dermatitis ans
    B. Contact drmititis
    C. Seborrhic dermatitis
    D. Infantile eczematous dermatitis

    The drug of choice for obsessive compulsive disorder
    A. Imipramine
    B. Fluoxetine ans
    C. Choppromazine
    D. Benzodiazepine

    DELUSION IS A DISORDER OF ;-
    1.THOUGHT. ans
    2.COGNITION


    Benedicts syndrome-all are true abt benedicts syndrome excpet..
    1.cause rd nerve palsy
    2.inv of penetrating branches of basilar artery..
    3.inv of pons. ans .
    4.contralateral hemiplegis

    ans is 3.inv of pons as it is a MIDBRAIN SYNDRME involves red nucleus


    acrodynia
    a) mercury
    b) arsenic
    c) lead

    A


    Port systemic shunt is not seen in
    liver
    spleen
    anorectum
    gastro esophageal

    B


    hereiditaryu spherocytosis due to defeceincy of all except....
    a) ankyrin
    b) spectrin
    c) anion exchanger
    d) glcophorin 2



    which of this is a immunohistochemical marker for pagets disease of the brest ?
    a s100
    b hmb 45
    c synographin



    which of this does not handel the free radicals in lens
    a vit a
    b vit c
    c vit e
    d catalase


    d?


    which of this investigation is helpful in heterophoric calcification
    a alkline posphatase
    b calcium
    c acid posphatase
    d posphorus



    with increasing altitude one shud
    1.inc ex dec wrk load
    2.in both
    3.dec both
    4.dec exc inc work load

    in mrna which of this is not true
    a capping helps in attachment of rna to 40s ribosome
    b in eukayocytes is regulated by gtp to gdp transformation
    c the first aa is methosine
    d synthesized from dna 3 -5'

    which is not ca thyroid ???
    insular
    merkel cell
    follicula
    anaplastic


    ans looks like merkel?



    Insular carcinoma of the thyroid - Original Article

    Abstract

    Thyroid surgeons are becoming increasingly more aware of a histologically distinct subset of thyroid carcinoma whose classification falls between well-differentiated and anaplastic carcinomas with respect to both cell differentiation and clinical behavior. This subtype of tumors has been categorized as poorly differentiated or insular carcinoma, based on its characteristic cell groupings. Although the differentiation of insular carcinoma from other thyroid carcinomas has important prognostic and therapeutic significance, relatively little about insular carcinoma has been published in the otolaryngology literature. In this article, we describe a new case of insular carcinoma and we discuss the findings of our review of the literature. We conclude that insular thyroid carcinoma warrants aggressive management with total thyroidectomy followed by radioactive iodine ablation of any remaining thyroid tissue.


    which neonatl reflex is not present at birth...a) rooting reflex b) assymetric neck reflex c) symmetric neck reflex d) crossed extensor reflex


    que. the most common muscle involved in knee osteoarthritis.....
    ans
    quadriceps (the large muscle on the front of the pages that helps raise and lower the leg) in most cases preceded the development of osteoarthritis.

    What reflexes should be present in a newborn?
    Reflexes are involuntary movements or actions. Some movements are spontaneous, occurring as part of the baby's usual activity. Others are responses to certain actions. Reflexes help identify normal brain and nerve activity. Some reflexes occur only in specific periods of development. The following are some of the normal reflexes seen in newborn babies:

    root reflex
    This reflex begins when the corner of the baby's mouth is stroked or touched. The baby will turn his/her head and open his/her mouth to follow and "root" in the direction of the stroking. This helps the baby find the breast or bottle to begin feeding.


    ^*&^* reflex
    Rooting helps the baby become ready to ^*&^*. When the roof of the baby's mouth is touched, the baby will begin to ^*&^*. This reflex does not begin until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. Premature babies may have a weak or immature cramming ability because of this. Babies also have a hand-to-mouth reflex that goes with rooting and cramming and may ^*&^* on fingers or hands.


    Moro reflex
    The Moro reflex is often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his/her head, extends out the arms and legs, cries, then pulls the arms and legs back in. A baby's own cry can startle him/her and begin this reflex. This reflex lasts about five to six months.


    tonic neck reflex
    When a baby's head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow. This is often called the "fencing" position. The tonic neck reflex lasts about six to seven months.


    grasp reflex
    Stroking the palm of a baby's hand causes the baby to close his/her fingers in a grasp. The grasp reflex lasts only a couple of months and is stronger in premature babies.


    Babinski reflex
    When the sole of the foot is firmly stroked, the big toe bends back toward the top of the foot and the other toes fan out. This is a normal reflex up to about 2 years of age.


    step reflex
    This reflex is also called the walking or dance reflex because a baby appears to take steps or dance when held upright with his/her feet touching a solid surface.

    Symmetrical Tonic Neck Reflex (STNR)
    The STNR is present in normal development from circa 8 to 11 months of post-natal life and is a precursor to crawling on the hands and knees. If it remains present in an older child, it can affect:

    Integration of upper and lower portions of the body (for example, when swimming)
    Sitting posture (tendency to slump when sitting at a desk or a table)
    Poorly developed muscle tone
    Poor hand-eye co-ordination


    burrowing ulcer ?

    microaerophlic streptococcus
    streptococus viridans
    strept. pyogenes
    peptostreptococci



    herediatry spherocytosis is due todeficiency of all except...
    answer.c) anion exchanger


    reference:-www.bbts.org.uk/PDFs/events/M.King%20S1600.pdf -



    Seizure & jitteriness can be differentiated on all except:
    a)Gaze
    b)Autonomic Disturbance
    c)Sensitivity to stimulus
    d)frequancy of seizures



    Jitteriness versus seizure

    Clinical Feature Jitteriness Seizure

    Abnormality of gaze or -- +

    eye movement

    Movements stimulus + --

    sensitive

    Predominant movement Tremor Clonic jerking

    Movements cease with passive

    flexion + --

    Autonomic changes -- +


    The type of cast will depend on the nature and location of the injury.

    - Full Cast – includes the foot and extends the length of the limb to just below the elbow or stifle.
    - Sleeve/Tube Cast – partial cast that generally covers only a portion of the limb but does not encase the foot
    (usually immobilizes the knee or hock).
    - Half Limb/Distal Limb Cast- extends from below the knee or hock down to include the foot.

    - Short Cast/Foot Cast – starts below the fetlock joint and covers the foot.



    Muscle weakness and osteoarthritis are commonly associated. One belief for this link is that arthritic pain discourages muscle activity so that eventually the muscles weaken and atrophy (wither) from disuse. Of interest is a study suggesting that weak muscle tissue in the quadriceps is responsible for osteoarthritis in the first place. (The quadriceps are four muscles that stretch down the thigh and attach to the knee; they are responsible for leg extension.) This weakness may be due to an abnormality in the muscles themselves or in the nerves that serve those muscles. In the study, strength tests revealed that people with osteoarthritis had muscle weakness in the quadriceps even if they had no pain. However, there were no differences in signs of disuse between the legs of arthritic and nonarthritic people.

    vibrio cholera o 139 al ltrue except
    a. similar to eltor vibrio
    b.found in chennai
    c.contains o1 polysaccharide ans
    4.?
    ans is contains o1 polysaccharide
    ref anantnaraan under epidemiology of cholera


    the question on BOTULISM...
    ans is CNS involvment
    reff harrr 16th edition page no 843 clearly statedd cns not tinvolved


    Mechanism of cellular memory and learning includes all except:
    a)increase or decrease in neurotransmittor release as in habituation and sensitization
    b)increase in no of synapses as in increase in no of synaptic terminals,increase in dendrites
    c)recruitment of neurons, involvement of more neurons in a particular function as occurs in somatosensory area of the cortex
    d)allocation of specialised nerve cells as occurs in the hippocampus


    paget's disease........................

    Immunohistochemistry allows definitive diagnosis of mammary PD.

    S-100 protein and homatropine methylbromide (HMB-45) (monoclonal antibody to melanoma cells) are positive in melanoma cells and differentiate melanoma from PD.

    CEA is positive in Paget cells and negative in keratinocytes, thus differentiating PD from Bowen disease.

    Benign Toker cells are negative for CEA and S-100 protein.
    Paget cells show negative staining by anti-S-100 protein, which serves as a differentiating feature from malignant melanoma in situ.


    Synergistic gangrene

    Chronic progressive bacterial gangrene is caused by the synergistic action of microaerophilic non-haemolytic streptococci, and aerobic haemolytic staphylococci (Fig. 6) 24. The incubation period is 7 to 14 days. Cellulitis is followed by gangrenous ulceration that is progressive unless treated. Radical excision of the ulcerated lesion and its gangrenous borders is imperative, along with administration of large system doses of penicillin. Burrowing ulcers are caused by a combination of microaerophilic streptococci and staphylococci (Meleney's ulcer). Such lesions have a characteristic metallic sheen, cause necrosis of large areas of skin, and may produce sinus tracts in the underlying tissue. These should be incised, drained, and treated with high doses of penicillin (10 million units every 6 h).



    Non-clostridial gangrenous cellulitis caused by B. melaninogenicus and anaerobic streptococci is typified by a progressive gangrenous infection of the skin and adjacent areolar and fascial tissues. Prompt incision and drainage, and administration of large doses of penicillin are necessary. Supportive treatment is imperative, since toxaemia with dehydration, fever, and prostration rapidly develops.



    Clostridial cellulitis is a serosanguineous, crepitant, septic process of subcutaneous, retroperitoneal, or other areolar tissue, caused principally by C. perfringens (also known as C. welchii). It differs from gas gangrene in that the infection does not involve muscle (Fig. 7) 25, but spreads rapidly via fascial planes. Extensive gangrene results from vascular thrombosis. Systemic effects are moderate if the infection is treated promptly with early surgical debridement and penicillin therapy.



    Clostridial myonecrosis (gas gangrene) is an anaerobic infection of muscle characterized by profound toxaemia, extensive local oedema, massive necrosis of tissue, and a variable degree of gas production (Fig. 8) 26. The causative organisms are the clostridia which abound in soil, dust, and the alimentary tract of most animals and which are usually saprophytic. C. perfringens, which is the most common cause, produces a variety of potent toxins, including hyaluronidase, collagenase, four different haemolysins, five necrotizing lecithinases, and six other necrotizing lethal toxins. All clostridia owe their pathogenicity to elaboration of such soluble exotoxins that destroy tissue and blood cells. Clostridia enter a wound, multiply in the presence of devitalized muscle, and use iron from myoglobin to produce necrotizing exotoxins. Disruption and fragmentation of normal muscle cells and capillaries result in further necrosis, haemorrhage, and oedema. There is no fibrin formation or polymorphonuclear leucocytic reaction. The affected muscles are at first red and friable, but progress to a purplish black, stringy, pulpy mass. The presence of gas is variable. The affected area swells and discharges a brownish, malodorous fluid. The overlying skin initially shows blotchy ecchymoses (marbling), then blackens, and finally sloughs.



    The diagnosis of gas gangrene is based on typical clinical findings, as well as on the presence of large Gram-positive rods in the wound fluid. Delay in diagnosis, even for just a few hours, greatly increases the mortality. Immediate removal of involved muscle groups is necessary: amputation is indicated if the remaining viable muscles are insufficient for useful function. High intravenous doses of penicillin and whole blood are given preoperatively and postoperatively. Multiple treatments with hyperbaric oxygen (oxygen at 3.03 kPa) may reduce the amount of debridement necessary and lower the mortality, but muscle resection should not be delayed in anticipation of hyperbaric therapy. Untreated gas gangrene is always fatal; the fatality rate in treated patients ranges from 25 to 40 per cent.

    central neuraxial blockade i s contraindicated in all exept
    1.platelets<80000
    2pt on aspirin
    3pt on warfarin
    4pt on iv heparin

    ans is "platelets <80000"
    if pltelets >50000,one can give central neuraxial bloc.
    ref ajay yadav



    Basal ganglia calcification may be seen as an incidental finding as in the index case. Majority of basal ganglia calcification is idiopathic in nature and disturbances of calcium metabolism are so rare that biochemical testing is performed only if indicated by other features. Other causes include metabolic diseases (hypothyroidism, pseudohypothyroidism), mitochondrial cytopathy, and infectious diseases such as cytomegalovirus, Epstein-Barr virus, toxoplasmosis, tuberculosis and acquired immunodeficiency syndrome. The calcification seen in infectious diseases is usually asymmetric and not restricted to basal ganglia. Basal ganglia calcification may be seen in familial condition (Fahr’s syndrome)


    Causes of basal ganglia calcification


    Idiopathic basal ganglia calcification
    Hypoparathyroidism Idiopathic (autoimmune) Congenital Post-thyroidectomy
    Pseudohypoparathyroidism
    Secondary hyperparathyroidism (in renal disease )
    Congenital infections (for example, toxoplasmosis )
    Mitochondrial cytopathies
    Fahr syndrome
    Cockayne syndrome
    Toxins Carbon monoxide Lead poisoning


    Cellular Classification

    Cell type is an important determinant of prognosis in thyroid cancer. There are 4 main varieties of thyroid cancer (although, for clinical management of the patient, thyroid cancer is generally divided into 2 categories: well differentiated or poorly differentiated):[1]

    Papillary carcinoma.
    Papillary/follicular carcinoma.
    Follicular carcinoma.
    Hürthle cell carcinoma.
    Medullary carcinoma.
    Anaplastic carcinoma.
    Small cell carcinoma.
    Giant cell carcinoma.
    Others.
    Lymphoma.
    Sarcoma.
    Carcinosarcoma


    CAUSES OF AML:-

    Genetics–Leukemia risk is increased 15-fold among children with Down's syndrome, which is a genetically linked chromosomal abnormality (usually an extra copy of chromosome 21). Three rare inherited disorders—Fanconi's anemia, Bloom's syndrome, and ataxia telangiectasia—also have an increased risk for leukemia.

    males are at increased risk for AML.


    pilonidal sinus:-

    A Pilonidal (Abscess, Cyst, Sinus, Dimple) is an abscess in the natal cleft (more commonly referred to as your gluteus crack) that tends to become infected and cause intense pain and drainage. Sometimes a Pilonidal contains hair and sometimes they don't.

    A few basic facts:

    FACT: The term "Pilonidal" technically means "nest of hairs". This is not always true and there are people who have Pilonidal abscesses that have no hair in them. Many doctors will tell you that all Pilonidals are caused by hair, this has not been proven to be the case. A Pilonidal cyst is basically an abscess of pus and hair beneath the outer skin - a boil gone very, very bad. Pilonidal abscess are prone to excruciatingly painful infections and they can expand (tunnel) .

    FACT: The term "Pilonidal Cyst" is actually incorrect. 99% of all Pilonidals are actually abscesses, not cysts. Use of the word "cyst" has caused a great deal of misinformation about treatments among doctors and patients alike. Pathologists and surgeons on rare occasions find the sac is lined with epidermis, made up of cells from skin, but only cells from the outer layer of skin. That outer layer, which we call epidermis, contains no follicles. Pathologists find epidermis lines the sac only in rare late cases where epidermis has crept into a long-standing abscess in an attempt to heal it. They never find a sac lined with intact skin and follicles, only an occasional sac lined with epidermis.

    FACT: While the terms Pilonidal Cyst and Pilonidal Sinus are frequently used interchangeably, they are not technically the same thing. A Pilonidal is an abscess; a pocket of pus and infection below the skin. A sinus is a cavity/passageway that links the abscess with your outer skin. Not everyone who has a Pilonidal abscess has a Pilonidal Sinus; the sinus (and there can be more than one) is a small dimple-like hole, usually below the actual abscess, which allows it to drain.

    FACT: Pilonidal abscesses usually occur at the top of the "natal cleft" (aka your crack). Their usual position is slightly to the left side, with sinus openings traditionally right along the midline (middle) of the cleft. Many people have cysts lower in the cleft or on both sides, it depends on the individual.

    FACT: The peak incidence of Pilonidal Disease is between 16 and 26 (however, older and younger happens regularly too). It affects males only slightly more than females. It is uncommon (but not unknown) in Asian and Black peoples. We have heard from people in their 50's having their first Pilonidal episode and from parents with children as young as 12.

    FACT: Many babies are born with a "Sacral Dimple", however, this is not the same as the Pilonidals discussed on this site. Some Sacral Dimples will become infected and turn into Pilonidal abscesses, but most are harmless blind tunnels.

    FACT: Pilonidals rarely go away on their own. Most require some form of surgical intervention, although there are cases of "disappearance" after a lancing or antibiotic treatment. Pilonidals can go dormant for years at a time, lulling their owner into a false sense of escape. Some people have flare-ups every month and some people only get one every few years.

    FACT: Pilonidal abscesses are medically related to a group of diseases known as Follicular Occlusion - meaning blocked hair follicles. At one time it was believed that Pilonidals were all congenital, however, current medical philosophy is that very few of these abscesses are congenital and most are acquired.

    FACT: There are 3 suspected primary causes of Pilonidal Disease and no true consensus among medical researchers that covers every case. Just like in life, there are exceptions to every rule.


    Hypothyroidism can affect pregnancy in several ways:

    It can cause infertility in women because it can prevent the production of eggs.

    A pregnant woman with hypothyroidism is at higher risk for miscarriage.

    Women with untreated hypothyroidism near the time of delivery are in danger of developing high blood pressure and premature delivery.

    Babies born to women with untreated hypothyroidism may not achieve their full intellectual potential




    Brown's sign (blanching of the mass with positive pressure pneumotoscopy) is often mentioned, but the frequency of this finding is not clear. Rarely, a friable or bleeding mass in the EAC may be the presenting sign with larger tumors. HTN, tachycardia, tremor, or complaints of vascular headaches should alert for the possibility of a functional tumor.


    central neuraxial blockade i s contraindicated in all exept

    ans is aspirin

    reference--
    Practical Procedures [Next Article][Issue Index][Home Page][Previous Article]
    Issue 13 (2001) Article 11: Page 1 of 4 Go to page: 1 2 3 4





    Epidural Anaesthesia
    Dr Leon Visser,
    Dept. of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan, USA
    * Introduction * Factors affecting epidural Anaesthesia
    * Indications * Physiological effects of epidural blockade
    * Contradictions * Epidural management and choice of drugs
    * Epidurals and Anticoagulants * Complications and side effects
    * Anatomy of the Epidural Space * Further Reading
    * Technique of Epidural Anaesthesia


    Introduction

    Epidural Anaesthesia is a central neuraxial block technique with many applications. The epidural space was first described by Corning in 1901, and Fidel Pages first used epidural Anaesthesia in humans in 1921. In 1945 Tuohy introduced the needle which is still most commonly used for epidural Anaesthesia . Improvements in equipment, drugs and technique have made it a popular and versatile anaesthetic technique, with applications in surgery, obstetrics and pain control. Both single injection and catheter techniques can be used. Its versatility means it can be used as an anaesthetic, as an analgesic adjuvant to general Anaesthesia , and for postoperative analgesia in procedures involving the lower limbs, perineum, pelvis, abdomen and thorax. [Top]0

    Indications

    General

    Epidural Anaesthesia can be used as sole anaesthetic for procedures involving the lower limbs, pelvis, perineum and lower abdomen. It is possible to perform upper abdominal and thoracic procedures under epidural Anaesthesia alone, but the height of block required, with its attendant side effects, make it difficult to avoid significant patient discomfort and risk. The advantage of epidural over spinal Anaesthesia is the ability to maintain continuous Anaesthesia after placement of an epidural catheter, thus making it suitable for procedures of long duration. This feature also enables the use of this technique into the postoperative period for analgesia, using lower concentrations of local anaesthetic drugs or in combination with different agents.

    Specific uses

    * Hip and knee surgery. Internal fixation of a fractured hip is associated with less blood loss when central neuraxial block is used. The rate of deep venous thrombosis is reduced in patients undergoing total hip and knee replacement, when epidural Anaesthesia is used.
    * Vascular reconstruction of the lower limbs. Epidural Anaesthesia improves distal blood flow in patients undergoing arterial reconstruction surgery.
    * Amputation. Patients given epidural Anaesthesia 48-72 hours prior to lower limb amputation may have a lower incidence of phantom limb pain following surgery, although this has not been substantiated.
    * Obstetrics. Epidural analgesia is indicated in obstetric patients in difficult or high-risk labour, e.g. breech, twin pregnancy, pre-eclampsia and prolonged labour. Furthermore, Caesarean section performed under central neuraxial block is associated with a lower maternal mortality owing to anaesthetic factors than under general anaesthetic.
    * Low concentration local anaesthetics, opioids, or combinations of both are effective in the control of postoperative pain in patients undergoing abdominal and thoracic procedures. Epidural analgesia has been shown to minimise the effects of surgery on cardiopulmonary reserve, i.e. diaphragmatic splinting and the inability to cough adequately, in patients with compromised respiratory function, such as those with chronic obstructive airway disease, morbid obesity and in the elderly. Epidural analgesia allows earlier mobilization, reduces the risk of deep venous thrombosis, and allows better cooperation with chest physiotherapy, preventing chest infections.
    * Thoracic trauma with rib or sternum fractures. Adequate analgesia in patients with thoracic trauma improves respiratory function by allowing the patient to breathe adequately, cough and cooperate with chest physiotherapy. [Top]

    Contraindications

    Absolute

    * Patient refusal
    * Coagulopathy. Insertion of an epidural needle or catheter into the epidural space may cause traumatic bleeding into the epidural space. Clotting abnormalities may lead to the development of a large haematoma leading to spinal cord compression.
    * Therapeutic anticoagulation. As above
    * Skin infection at injection site. Insertion of the epidural needle through an area of skin infection may introduce pathogenic bacteria into the epidural space, leading to serious complications such as meningitis or epidural abscess.
    * Raised intracranial pressure. Accidental dural puncture in a patient with raised ICP may lead to brainstem herniation (coning).
    * Hypovolaemia. The sympathetic blockade produced by epidurals, in combination with uncorrected hypovolaemia, may cause profound circulatory collapse.

    Relative

    * Uncooperative patients may be impossible to position correctly, and be unable to remain still enough to safely insert an epidural.
    * Pre-existing neurological disorders, such as multiple sclerosis, may be a contraindication, because any new neurological symptoms may be ascribed to the epidural.
    * Fixed cardiac output states. Probably relative rather than absolute. This includes aortic stenosis, hypertrophic obstructive cardiomyopathy (HOCM), mitral stenosis and complete heart block. Patients with these cardiovascular abnormalities are unable to increase their cardiac output in response to the peripheral vasodilatation caused by epidural blockade, and may develop profound circulatory collapse which is very difficult to treat.
    * Anatomical abnormalities of vertebral column may make the placement of an epidural technically impossible.
    * Prophylactic low dose heparin
    .

    Epidurals and anticoagulants




    * Full oral anticoagulation with warfarin or standard heparin (SH) are absolute contraindications to epidural blockade.
    * Partial anticoagulation with low molecular weight heparin (LMWH) or low dose warfarin (INR <1.5) are relative contraindications.
    * Minihep (low dose standard heparin (SH), 5,000units bd s/c is not associated with an increased risk of epidural haematoma. Wait for 4 hours after a dose before performing epidural. Minihep/SH should not be given until 1 hour following epidural injection. These guidelines also apply for removal of epidural catheters.
    * LMWH (<40mg enoxaparin and dalteparin): allow 12hr interval between LMWH administration and epidural; this also applies to removal of epidural catheters.
    * NSAID's (including aspirin) do not increase the risk of epidural haematoma.
    * Intraoperative anticoagulation using 5000units i/v heparin following epidural/spinal injection appears safe, but careful postoperative observations are recommended. Bloody tap or blood in epidural catheter is controversial. Some teams delay surgery for 12hr, others (if pre-op coagulation normal) delay i/v bolus of heparin for 1hour.
    * Fibrinolytic and thrombolytic drugs: avoid epidural block for 24 hrs, check clotting prior to insertion.
    * Thrombocytopaenia: epidurals are relatively contraindicated below platelet count of 100,000/mm3.
    * An epidural haematoma should be suspected in patients who complain of severe back pain a few hours/days following any central neuraxial block or with any prolonged or abnormal neurological deficit (including. sensory loss, paraesthesiae, muscle weakness and disturbance of bladder control and anal sphincter tone). A high index of suspicion is required, with early orthopaedic or neurosurgical referral for decompression of the haematoma. Even with early recognition, the morbidity of this condition is still very high. [Top]

    Anatomy of the epidural space
    The epidural space is that part of the vertebral canal not occupied by the dura mater and its contents. It is a potential space that lies between the dura and the periosteum lining the inside of the vertebral canal. It extends from the foramen magnum to the sacral hiatus. The anterior and posterior nerve roots in their dural covering pass across this potential space to unite in the intervertebral foramen to form segmental nerves. The anterior border consists of the posterior longitudinal ligament covering the vertebral bodies, and the intervertebral discs. Laterally, the epidural space is bordered by the periosteum of the vertebral pedicles, and the intervertebral foraminae. Posteriorly, the bordering stuctures are the periosteum of the anterior surface of the laminae and articular processes and their connecting ligaments, the periosteum of the root of the spines, and the interlaminar spaces filled by the ligamentum flavum. The space contains venous plexuses and fatty tissue which is continuous with the fat in the paravertebral space.


    DRUG INDUCED LUPUS



    Drug-induced lupus occurs after the use of certain prescribed drugs. The symptoms of drug-induced lupus are similar to systemic lupus. The drugs most commonly connected with drug-induced lupus are hydralazine (used to treat high blood pressure or hypertension) and procainamide (used to treat irregular heart rhythms). The percentage of individuals using these drugs who develop drug-induced lupus is extremely small, and the symptoms usually fade when the medications are discontinued


    RUBELLA VACCINATION


    Mass immunization of childbearing-age women was justified on the basis of epidemiological and serological data. Follow-up of vaccinated pregnant women revealed no cases of congenital rubella syndrome due to rubella vaccination. However, the observed rate of congenital infection supports the recommendation to avoid vaccinating pregnant women, and to avoid conception for up to 1 month following rubella vaccination. Brazil, epidemiological surveillance, pregnancy, rubella, vaccination.



    beta trace protein is a indicator of CSF leak........

    We conducted a prospective observational study among a cohort of 40 term parturients undergoing spinal Anaesthesia for elective Caesarean section, to determine the concentration of β-trace protein in cerebrospinal fluid (CSF) and serum. Serum and CSF samples, taken at the time of dural puncture, were assayed by nephelometry. The mean serum β-trace protein concentration was 0.39 mg.l1 and the mean CSF concentration was 27.9 mg.l1, giving a mean ratio of CSF to serum concentration of 76. This ratio is higher than that published for non-pregnant females and for males because of both a higher mean CSF and a lower mean serum β-trace protein concentration. The concentration correlated positively with both serum creatinine and gestational age. If these concentrations are used to estimate the normal range, we propose that the nephelometric measurement of β-trace protein might prove a useful diagnostic test for cerebrospinal fluid-cutaneous fistula in parturients


    raised ICPressure

    ....Raised intracranial pressure can produce specific as well as non specific signs and symptoms. Cushing triad of headache, papilloedema and vomiting is considered the classical presentation of raised intracranial pressure


    External Cephalic Version
    External cephalic version is viewed by many obstetricians with distaste. This procedure involves applying physical force to the maternal abdomen to turn the fetus into a cephalic presentation. There are few contraindications to the procedure. It should not be performed on any patient who already has another indication for cesarean delivery, such as placenta previa. Other contraindications include uterine anomalies, third-trimester bleeding, oligohydramnios, evidence of uteroplacental insufficiency, obvious cephalopelvic disproportion, significant uterine surgery, and a nuchal umbilical cord identified on sonography. The procedure is best performed after 36 weeks of gestation, because this minimizes the chances of the fetus returning to a breech presentation and, should complications arise, immediate delivery of a full-term infant can be accomplished.


    BIPOLAR DISORDER.....................

    Bipolar disorder affects approximately 3 million persons in the United States. It is characterized by unpredictable swings in mood from mania (or hypomania) to depression. Some patients suffer only from recurrent attacks of mania, which in its pure form is associated with increased psychomotor activity, excessive social extroversion, decreased need for sleep, impulsivity and impairment in judgment, and expansive, grandiose, and sometimes irritable mood. In severe mania, patients may experience delusions and paranoid thinking indistinguishable from that associated with schizophrenia. About half of all patients with bipolar disorder present with a mixture of psychomotor agitation and activation with dysphoria, anxiety, and irritability. It may be difficult to distinguish mixed mania from agitated depression. In some bipolar patients (bipolar II disorder), the full criteria for mania are lacking, and recurrent depressions are separated by periods of mild activation and increased energy (hypomania). In cyclothymic disorder, there are numerous hypomanic periods, usually of relatively short duration, alternating with clusters of depressive symptoms that fail to meet the criteria of major depression, either in severity or duration. The mood fluctuations are chronic and should be present for at least 2 years before the diagnosis is made.

    TABLE 16.6-36 -- Spectrum of Bipolar Disorders Compared with Unipolar Depression
    Bipolar I: At leat one manic episode
    Soft bipolar -[ Bipolar II: Recurrent depressions with hypomania and cyclothymic disorder
    Bipolar III: (pseudo-unipolar) Recurrent depressions without spontaneous hypomania but often with hyperthymic temperament and bipolar family history
    Unipolar depressions: No evidence for hypomania, cyclothymic disorder, hyperthymic disorder, or bipolar family history


    AUTISM...............

    ..DIAGNOSIS AND CLINICAL FEATURES
    The diagnosis of autistic disorder requires that a certain number of criteria in three symptom areas of social interaction, verbal and nonverbal communication and play, and repertoire of activities and interests be met. However, children meeting criteria for autistic disorder may appear very different from one another owing to differences in intellectual and language ability: Both the mute, aloof child and the one who asks grammatically perfect but inappropriately personal questions of strangers may be diagnosed with autistic disorder. The variability in phenomenology may lead to diagnostic errors, especially when children are at the extremes of intellectual functioning. In addition, certain behaviors characteristic of autism diminish with age, so that diagnoses made after childhood are not as reliable as those made in the preschool period, when many behaviors characteristic of autistic disorder are seen. The evaluation of autistic children requires a detailed prenatal and perinatal developmental, psychiatric, and medical history and a comprehensive medical examination that includes hearing, speech, and neurological evaluations. Neuropsychological testing, including I.Q. testing, should be performed. Because autism is believed to be a syndrome with multiple etiologies, it is important to rule out medical-genetic conditions that may underlie the disorder in a particular child.

    Age at onset
    Onset characteristically occurs before age 3 years and is marked by failure to develop language and failure to develop relatedness to parents--the most frequent reasons parents of autistic children contact health professionals. In addition, some parents fear that their child may be deaf, as the child may not respond when spoken to. Rarely, parents report that their child had normal social and language development but subsequently lost language and withdrew from social interaction


    Kawasaki Disease: Diagnostic Criteria

    I. Fever for >5 days (usually >102EF)

    II. At least four of five features

    A. Bilateral conjunctival injection (bulbar. non-purulent)

    B. Cervical adenitis (unilateral >1.5 cm diameter, non-fluctuant)

    C. Rash (truncal. perineal accentuation, polymorphous but non-vesicular)

    D. Inflamed oral mucosae (fissured lips, strawberry tongue)

    E. Hands and feet inflammation (periungual peeling around 14-21 days)

    III. No alternate diagnosis

    IV. Fever plus 3/5 criteria are diagnostic when coronary abnormalities are present


    ENZYME STABLE AT GASTRIC PH IS

    ...Pepsin, an acidic protease, is the principal proteolytic enzyme of vertebrate gastric juice.


    free radicals in lens


    The second line of defence against free radical damage is the presence of antioxidants. An antioxidant is a molecule stable enough to donate an electron to a rampaging free radical and neutralize it, thus reducing its capacity to damage. Some such antioxidants, including glutathione, ubiquinol and uric acid, are produced during normal metabolism in the body. Other lighter antioxidants are found in the diet. Although about 4000 antioxidants have been identified, the best known are vitamin E, vitamin C and the carotenoids. Many other non-nutrient food substances, generally phenolic or polyphenolic compounds, display antioxidant
    properties and, thus, may be important for health.




    deep heat therapy.............................

    Application of shortwave diathermy with capacitor plates or microwave radiation at a frequency of 2456 MHz can provide selective heat for deep subcutaneous tissue and superficial muscle.

    Shortwave diathermy with an induction coil applicator at 27 MHz can heat superficial muscle.

    Microwave diathermy at 915 MHz selectively heats muscle thoroughly.

    Ultrasound at a frequency of 0.8-1 MHz preferentially heats joints, ligaments, tendons, tendon sheaths, fibrous scars, nerve trunks, and myofascial interfaces. Ultrasound is especially useful for heating joints with a thick layer of overlying soft tissues that shortwave diathermy or microwave diathermy cannot penetrate.

    Shortwave diathermy with internal electrodes at 27 MHz can provide selective heat for pelvic organs in cases of chronic pelvic inflammatory disease or management of coccygeal muscle spasms (eg, of the urogenital diaphragm).



    dinitrophenol causes

    Dinitrophenol causes toxicity by the uncoupling of oxidative phosphorylation in the mitochondria of cells throughout the body. In man the classic syndrome consists of lassitude, malaise, headache, increased perspiration, thirst, and dyspnea which may progress to hyperpyrexia, profound weight loss, respiratory failure, and death. Because dinitrophenol compounds are widely used, it is likely that some patients with unexplained fever have unrecognized dinitrophenol poisoning. Prompt recognition of the clinical manifestations of toxicity is vital for appropriate therapy.


    The Bishops Score generally follows this scale:

    Score Dilatation Effacement Station Position Consistency

    0 closed 0 – 30% -3 posterior firm
    1 1-2 cm 40 -50% -2 mid-position moderately firm
    2 3-4 cm 60 -70% -1,0 anterior soft
    3 5+ cm 80+% +1,+2




    AMYLOIDOSIS - RECTAL BIOPSY

    Tissue biopsy is the de®nitive test for the diagnosis of amyloidosis. Rectal biopsy and. subcutaneous fat aspiration are simple procedures with high ...



    drugs used in obesity

    Sibutramine, the generic marketed as Meridia® in the U.S. and Reductil® abroad, is manufactured by Abbott Laboratories

    Orlistat, the generic marketed as Xenical®, which is manufactured by Roche Pharmaceuticals, is the only weight loss drug approved to alter the way the body responds to fat intake.

    Olestra was approved by the Food and Drug Administration for use as a food additive in 1996 and was initially used in potato chips under the WOW brand by Frito Lay

    Intracerebroventricular (ICV) administration of neuropeptide Y (NPY) has been shown to decrease energy expenditure, induce hypothermia, and stimulate food intake





    Q.when a person acsends
    decrese work load and increase excercise
    increase workload and decrease excercise
    decrease workload and inhaling oxygen



    REG NTCP STRATEGY:-


    1. Early detection and treatment thereby converting infectious cases to noninfectious and preventing noninfectious cases from becoming infectious with treatment.
    2. Diagnosis through radiology and sputum microscopy.
    3. Free Domiciliary treatment through Primary Health Care Services.
    4. Establishing District Tuberculosis Centre in every district.
    5. Extend coverage under Short Course Chemotherapy (SCC).
    6. Strengthen state TB training and Demonstration centres.

    Q.oxygen toxixity causes all except ?
    retinal blindness
    pulmonary edema
    l guess cerbral flow causes oxygen toxicty
    oxygen will cause convulsions


    OXYGEN TOXICITY


    . Pulmonary Oxygen Toxicity occurs when a person is exposed to high oxygen levels for over 16 hours in pressures of 0.5 bar or more. It occurs in progressive, overlapping phases. During the first phase, fluid floods into the tissues of the lung that are normally filled with air. Bleeding then occurs between the alveoli, destroying capillaries and epithelial cells. Tissues begin producing in an attempt to heal the area. This causes thickening and scarring of the lungs.
    Symptoms begin with a substernal irritation that becomes progressively worse and is accompanied by an increasingly uncontrollable cough. The patient may experience tracheal or bronchial burning, that worsens during inspiration. Lung damage is sometimes irreversible.

    Retinopathic oxygen toxicity causes damage to the retina.


    Signs and symptoms of CNS Oxygen Toxicity may be any of the following --- visual disturbances, ringing in the ears, nausea, muscular twitching, irritability, dizziness, and convulsions. It is important to note that these signs and symptoms do not proceed in any particular order i.e. convulsions and subsequently death by drowning, can occur without warning



    Northern Blot (NB), uses techniques similar to the Southern blot described above. Messenger-RNA from the specimen is separated by electrophoresis and blotted to a specifically modified paper support to result in covalent fixing of the mRNA in the electrophoretic positions. Radiolabeled single-stranded DNA fragments complementary to the specific mRNA being sought are then hybridized to the bound mRNA. If the specific mRNA is present, the radioactivity is detected by autoradiography. The derivation of this technique from the Southern blot used for the DNA detection has led to the common usage of the term "Northen blot" for the detection of specific mRNA.


    ASTHMA IN 1 YEAR OLD CHILD:-

    INHALED BRONCHODILATOR MEDICATIONS


    For children with mild asthma this is often the only medication they will need. Inhaled bronchodilators are highly effective, and they have also proven to be the bronchodilator medicine of choice for moderate and severe asthma when used with other medications


    ISOTOPE USED IN RIA................


    In radioimmunassay (RIA), a fixed concentration of labeled tracer antigen is incubated with a constant amount of antiserum such that the concentration of antigen binding sites on the antibody is limiting, for example, only 50% of the total tracer concentration may be bound by antibody. If unlabeled antigen is added to this system, there is competition between labeled tracer and unlabeled antigen for the limited and constant number of binding sites on the antibody, and thus the amount of tracer bound to antibody will decrease as the concentration of unlabeled antigen increases. This can be measured after separating antibody-bound from free tracer and counting either the bound fraction, the free fraction or both. A calibration or standard curve is set up with increasing amounts of known antigen, and from this curve the amount of antigen in the unknown samples can be calculated. Thus the four basic necessities for a radioimmunoassay system are an antiserum to the compound to be measured, the availability of a radioactively labeled form of the compound, a method whereby antibody-bound tracer can be separated from unbound tracer, and a standard unlabeled material

    The I125 used as radioactive labeled antigen in this lab emits gamma rays (photons). The solid sodium iodide crystals in the gamma counters are scintillators, which give off a flash of yellow light when they absorb gamma radiation.



    COW MILK VS BREAST MILK..........


    ** Human milk is not considered deficient in any nutrients, but is considered the standard for infant feeding.

    - HUMAN COW GOAT FORMULA DEFICIENCY
    Chromium - - - - -
    Selenium - - - - -
    Molybdenum - - - - -

    - HUMAN COW GOAT FORMULA DEFICIENCY
    Protein 1.0 3.3 3.6 2.0 C+G HI
    Carbohydrate 6.9 4.7 4.5 7.0 C+G LO
    Fat 4.4 3.3 4.1 1.1 Formula LO
    Water 87.5 88.0 87.0 80
    Calories (kcal) 70 61 69 60

    * To compare the milks on a per day basis, /100g values were multiplied by 8 (the average 0-6 month old infant consumes 800 grams of milk/day.

    It is important to note that the bioavailability of each vitamin or mineral may differ. The above numbers do not indicate bioavailability, but research has shown that the iron and B12 in breast milk are significantly more bioavailable than in formula or cow milk (this has not been studied for goat milk).


    Q. PROTEOGLYCANS:-
    Proteoglycans represent a special class of glycoproteins that are heavily glycosylated. They consist of a core protein with one or more covalently attached glycosaminoglycan chain(s). These glycosaminoglycan (GAG) chains are long, linear carbohydrate polymers that are negatively charged under physiological conditions, due to the occurrence of sulphate and uronic acid groups.


    Types
    Proteoglycans can be categorised depending upon the nature of their glycosaminoglycan chains. These chains may be:

    chondroitin sulfate and dermatan sulfate
    heparin and heparan sulfate
    keratan sulfate

    Function
    Proteoglycans are a major component of the animal extracellular matrix, the 'filler' substance existing between cells in an organism



    Q. CHERRY RED SPOTS...........

    The typical cherry red spot occurs in several of the neuronal lipid storage disorders – most characteristically in Tay Sach’s disease (virtually all cases) and in the Sandhoff variant. Other causes include GM2 gangliosidosis, metachromatic leukodystrophy, Niemann Pick disease, Farber’s disease, Goldberg’s Syndrome, Gaucher’s disease, Hurler’s Syndrome (mucopolysaccharidosis 1H), b-galactosidase deficiency (mucopoly-saccharidosis VII), Hallervorden Spatz Syndrome, Batten-Mayou-Vogt-Spielmeyer Syndrome and Spranger’s disease.

    Besides the metabolic neurodegenerative diseases, it may also develop as a result of retinal ischemia secondary to central retinal artery occlusion or orbital contusion. It should be appreciated that cherry red spot is not a disease condition in itself but an ophthalmoscopic evidence of a Pathology that may involve the peripheral layers of the retina and multiple systems of the human body.



    .mechanism of learning & memory..............


    Molecular and Synaptic Mechanisms of Memory

    Synapses are the connections between nerve cells, and they are also the major site of information exchange and storage in the brain. We now know that synapses can alter their effectiveness based on their activity, and that this phenomenon, known as synaptic plasticity, may be the fundamental basis of learning and memory.

    episodic memory (such as memory of personal emotions and associations with a particular place) might be stored in the hippocampus.


    *synapse: In general, nerve cells have a single long
    extension (the "axon") that propagates the electrical output (the
    action potential) of the cell. The term "synapse" refers to the
    junction between the terminal of a neuron's axon and another
    neuron. When studying the synapse, the first neuron is called the
    "presynaptic" neuron, and the second neuron is called the
    "postsynaptic" neuron.

    neurotransmitter substance: Neurotransmitters are
    chemical substances released at the terminals of nerve axons in
    response to the propagation of an impulse to the end of that
    axon. The neurotransmitter substance diffuses into the synapse,
    the junction between the presynaptic nerve ending and the
    postsynaptic neuron, and at the membrane of the postsynaptic
    neuron the transmitter substance interacts with a receptor.
    Depending on the type of receptor, the result may be an
    excitatory or an inhibitory effect on the postsynaptic nerve


    PERIPHERAL NEUROPATHY IS CAUSED BY
    The nucleoside reverse transcriptase inhibitors (NRTIs) didanosine (ddI), zalcitabine (ddC), and stavudine (d4T) have all been shown to cause a dose dependent peripheral neuropathy.







    cell.
  41. mmudhol

    mmudhol Guest

    hi,
    I dont think that the scoring in this exam will be very high because of so many repeats...coz i think that even though around 50 questions were from nov AIIMS it doesn`t mean that those who had read that paper will get all those questions right....also conversely those who have not read them will not get them right....most of the repeats were easy...anuone seeing them for the first time would have got them right...also the answers of repeated controversial questions are not very reliable. So even if u had written the answer which was given in the solved paper which were available it does not assure that they were right answers.
    I think the scoring will be as usual as the earlier all india pre pg exam. ...may be marginally higher ( the newer questions weren`t that easy), but not as higher as people have been predicting
  42. DR.ANIL

    DR.ANIL Guest

    SAHPE OF CERVIX ASSOCIATED WITH PRETERM LABOUR IS....U-SHAPE FUNNELING ON USG....NEAREST RIVAL V-SHAPED...... THERE IS NO Y-SHAPED FUNNELING
  43. DR.Ansari

    DR.Ansari Guest

    agranular endoplasmic reticulam associated with production of
    1.vitamins
    2.lipid ANS
    3.protines
    4.carbohydrates

    SAFE sratigy for TRACOMA includes all of the following except
    1.screening ANS
    2.antibiotics
    3.environmental modification
    .4.facial cleenliness


    ppapez circuit
    its HMT Clock
    h-hippocampus
    m-mamallary body
    t- thalamic tract
    c- cingulate gyrus

    true abt cluster sampling is
    1)sample size same as simple random sampling
    2)rapid method of sampling


    contraindications for radio contrast dye -all except
    a. obesity
    b.nephropathy
    c.high dose of dye used

    PT- test- 40 sec
    Control- 30 sec
    International sensitivity index- 1.4
    Calculate the INR
    a) 40x1.4/30
    b) (40/30)to the power 1.4
    c) (40/30)to the power 1/1.4
    d) 40/30

    person wid previously normal hb with sudden hge will hav all except
    reticulocytosis
    Hi pcv ans
    lo mcv
    thrombocytopenia--

    hormones affecting intranuclear translation except
    insulin ans
    thyroxine
    vit D

    contrast nephropathy risk factor all except
    .decreased volume
    .diabetes mellitus
    .obesity
    .hi contrast dose

    incidence of perpheral neuropathy:
    with stavudine 23%
    with didanosine 14%
    answer is stavudine refer net search in google it'l solve the query.


    The rationale for performing a Doppler study in the diagnosis of IUGR is that many cases of growth restriction are thought to be associated with small vessel disease in the fetoplacental or uteroplacental circulation. Numerous Doppler criteria have been proposed for diagnosing IUGR. These involve at least 3 of the following waveform indices:


    Systolic/diastolic (S/D) ratio

    Pulsatility index (PI)

    Resistive index (RI)

    Spectral waveform of the umbilical, uterine, and fetal internal carotid arteries and the fetal descending thoracic aorta

    Spectral waveform of the ductus venosus and inferior vena cava
    Abnormal findings on Doppler waveforms include the following:


    Highest uterine artery PI – lowest uterine artery PI greater than 1.1

    Persistence of protodiastolic notch, unilateral or bilateral, after 23 weeks is suggestive of IUGR or preeclampsia.

    RI greater than 0.55 with bilateral notches

    RI greater than 0.65 with a unilateral notch

    RI greater than 0.70 with or without notches

    RI greater than 90th percentile for a given gestational age regardless of notches
    An S/D ratio of greater than 3 after 30 weeks of gestation is abnormal.

    The reversal of flow in ductus venosus is suggestive of a fetus with severely compromised IUGR and reflects fetal metabolic acidemia.

    Umbilical blood flow

    Umbilical venous blood flow, both absolute flow (in mm/min) and corrected blood flow (in mL/min/kg) are reduced in IUGR. Presence of pulsations in umbilical vein waveform between 8 and 12 weeks is normal, and its persistence is abnormal. The presence of umbilical vein pulsations is associated with an increased risk of an adverse perinatal outcome


    Qn was:

    Study of gene expression is called...
    a> Genomics
    b> Proteonomics
    c> ...
    d> ...

    Ans> b-Proteonomics
    Ref Harrison p.367

    1.MC neuroectodermal tumor wd MEN1? ANS: somatostatinoma-45%(ref harrison's chart)
    2. imp***....AZYGOUS VEIN doesnt pass from thorax to abdomen...rather it passes FROM ABDOMEN TO THORAX
    3. MC type of spinal injury? ans: flexion
    4. 5-FU is not an alkylatong agent...its an antimetabolite.
    5.mc. ovarian tumor to go torsion? ans: in nonpregnant state..mucinous,,in pregneant state..teratoma
  44. DR. GOVIND

    DR. GOVIND Guest

    I THINK CUT OF WILL BE 63 % ,PAPER WAS LIKE STATE PG AND IN ALL STATE PG CUT OFF IS USALLY AROUND 65 %.AS PREVIOS 2 YR PAPER WAS AVERAGE EVEN THEN CUT OFF WENT 60%SO I THINK LITLE BIT LOWER RANK IF SOME HAS 66 % IT WILL BE AROUND 1500 DEPENDING UPON RESERVATION
  45. DR. Meena

    DR. Meena Guest

    Gastrinomas are the most common cause of symptomatic disease and are found in approximately 60% of patients with MEN 1. Compared to the sporadic form of gastrinomas in Zollinger-Ellison syndrome (ZES), tumors in MEN 1 are more often duodenal, small, and multicentric, thus diminishing the probability of surgical cure. The features predictive of poor prognosis include pancreatic location of lesions, metastases, ectopic Cushing syndrome, and height of gastrin levels. Development of gastrinomas is preceded by multifocal hyperplasia of the gastrin-producing cells. Long-standing MEN 1/ZES may lead to development of gastric carcinoid tumors that might be aggressive.

    The most common complications include facial nerve paralysis, hearing loss, and vertigo. The incidence of CN VII damage is higher with transverse fractures than with the longitudinal form (40% vs 20%), but the greater prevalence of longitudinal fractures means that these more often cause facial nerve paralysis (Swartz).
  46. Dr. Anmad

    Dr. Anmad Guest

    immediate response to tissue indjury

    ans:transient neutropenia

    reference:In humans, neutrophil production takes place in the bone marrow. The life cycle of a neutrophil can be divided into bone marrow, blood, and tissue phases.

    The myeloblast, promyelocyte, and myelocyte are capable of cell division and differentiation. These forms constitute the mitotic compartment.

    The more mature forms, ie, metamyelocyte, band, and polymorphonuclear cells, are incapable of cell division but do undergo cell maturation and differentiation. These cells constitute the maturation compartment. The cells from the maturation compartment flow into the blood and are distributed into either the circulating granulocyte pool (CGP) or the marginal granulocyte pool (MGP). The total blood granulocyte pool (TBGP) is the sum of the CGP and the MGP. Cells in these 2 pools are in constant equilibrium. Both pools are approximately equal in size.

    An estimate of the CGP size can be determined by multiplying the neutrophil count per mm3 of blood by the known circulating blood volume. The MGP consists of cells still within the vascular space, but they are adherent to the walls of small vessels, especially postcapillary venules.

    Brief exercise or an epinephrine injection can increase the CGP by approximately 50% for a brief period, but the TBGP remains unchanged. This is due to the release of cells from the marginal pool. This demargination involves disruption of the bond between the endothelium and leukocyte adhesion receptors, presumably modulated by cytokines.

    The response with endotoxin injection is one of initial transient neutropenia followed by a subsequent increase in the TBGP a few hours later. The initial neutropenia is from the shift of the CGP to the MGP. An outpouring of cells from the bone marrow follows, resulting in the increase of TBGP. NEUTROPHIL KINETICS IN PATIENTS WITH NEUTROPHILIA Section 7 of 9
    Author Information Introduction Subcellular Structure Of Neutrophils Neutrophil Development Neutrophil Function Neutrophil Kinetics Neutrophil Kinetics In Patients With Neutrophilia Causes Of Neutrophilia Bibliography




    Neutrophilia refers to a higher than normal number of neutrophils. Neutrophilia may result from a shift of cells from the marginal to the circulating pool (shift neutrophilia) without an increase in the TBGP or from a true increase in TBGP size (true neutrophilia).

    Shift neutrophilia is usually transient and may occur in association with vigorous exercise or epinephrine injection and usually lasts 20-30 minutes. It also is seen in seizures and paroxysmal tachycardia. No increase in nonsegmented forms occurs because no change occurs in the inflow of neutrophils from the marrow.

    True neutrophilia occurs in most cases of neutrophilia related to infections. The TBGP may be increased 5-6 times normal. During early infection, the neutrophil count may actually decrease briefly due to margination of cells from the blood. This is followed rapidly by egress of cells from the marrow, resulting in an increase in the TBGP and blood neutrophilia. If the demand of cells is high, a shift to the left in the differential count may occur. A left shift is characterized by the appearance of more immature neutrophil forms in the blood.

    During established infection, the neutrophil count remains elevated, with equal numbers in the marginal and the circulating pool. During the recovery phase, the flow of cells from the marrow decreases, with a resultant decrease in neutrophilia.
  47. Dr. Anmad

    Dr. Anmad Guest

    poor prognostic factor for aml

    ans:pre b all


    reference:

    Identification of significant risk factors in a patient helps in selecting the optimum treatment protocol for that patient, permitting a more or less aggressive approach as needed.

    Parameters:

    (1) age

    (2) initial white blood cell count

    (3) sex

    (4) race

    (5) cytogenetics

    (6) immunophenotype

    (7) FAB morphology

    (8) organomegaly

    (9) mediastinal mass

    (10) lymphadenopathy

    (11) hemoglobin

    (12) LDL

    (13) platelet count

    (14) serum immunoglobulins

    (15) rapidity of leukemic cytoreduction on induction therapy

    (16) response to initial course of induction chemotherapy



    Parameter
    Finding
    Prognosis

    age
    < 12 months
    very poor


    12-23 months
    poor (?)


    2 - 10 years
    good


    > 10 years
    poor

    initial white blood cell count
    > 200,000 per µL
    very poor


    > 50,000 per µL
    poor


    < 10,000
    good

    sex
    females
    good


    males
    poor

    race
    Blacks
    poor

    cytogenetics
    hyperdiploidy (> 50 chromosomes)
    good


    hypoploidy
    poor


    t (8;14)
    very poor (induction failure and early relapse)


    t (9;22) (Philadelphia chromosome)
    very poor (induction failure and early relapse)


    t (4;11)
    poor (induction failure and early relapse)


    dicentric translocation involving short arms of 9 and 12
    good


    t (1;19) and pre-B immunophenotype (not early pre-B)
    poor


    MLL gene rearrangement in infants
    very poor

    immunophenotype
    early pre-B cell (no cytoplasmic immunoglobulin)
    good


    pre-B cell (cytoplasmic immunoglobulin)
    poor


    mature B cell
    very poor


    T cell
    poor


    myeloid markers present
    poor

    FAB morphology
    L3
    poor


    L2
    poor


    L1
    good

    mediastinal mass
    present
    poor

    organomegaly
    hepatomegaly
    poor


    splenomegaly
    poor

    lymphadenopathy
    present
    poor

    hemoglobin level



    LDH



    platelet count



    serum immunoglobulins
    low IgM
    poor


    low IgG and/or IgA
    poor

    rapidity of leukemic cytoreduction on induction therapy
    residual leukemia on day 14 of induction therapy
    poor

    response to initial course of induction chemotherapy
    failure to achieve complete remission
    poor




    where:

    • The relationship between initial WBC count and prognosis is linear and continuous, with the prognosis inversely related to the count.

    • The worse prognosis in males is related to testicular relapse and the higher rate of T cell ALL.

    • The worse prognosis in Blacks is associated with an increased frequency of very high initial white blood cell counts, mediastinal mass, and L2 morphology.

    • Mediastinal mass, hepatomegaly, splenomegaly and lymphadenopathy reflect high initial tumor burden and correlation with the initial WBC count.

    • > 1,000 blasts per µL one week after preliminary treatment with glucocorticoids and intrathecal methotrexate is a poor prognostic finding
  48. Dr. Anmad

    Dr. Anmad Guest

    tuberculides are the skin eruptons seen due to cutaneosu tuberculosis like scrofuloderma
    most common tuberculide is LICHE NSCROFULACEUM
    reff DORLANDS MEDICAL DICTIONARY...

    recurrent eruptions of the skin usually characterized by spontaneous involution. Some believe tuberculids to occur as local hyperergic reactions to mycobacteria or their antigens that are spread hematogenously to the skin from foci of active tuberculosis, while others believe that the lesions are unrelated to tuberculosis. Considered to comprise erythema induratum, lichen scrofulosorum, and papulonecrotic tuberculid, and sometimes lupus miliaris disseminatus faciei.


    The rationale for performing a Doppler study in the diagnosis of IUGR is that many cases of growth restriction are thought to be associated with small vessel disease in the fetoplacental or uteroplacental circulation. Numerous Doppler criteria have been proposed for diagnosing IUGR. These involve at least 3 of the following waveform indices:


    Systolic/diastolic (S/D) ratio

    Pulsatility index (PI)

    Resistive index (RI)

    Spectral waveform of the umbilical, uterine, and fetal internal carotid arteries and the fetal descending thoracic aorta

    Spectral waveform of the ductus venosus and inferior vena cava
    Abnormal findings on Doppler waveforms include the following:


    Highest uterine artery PI – lowest uterine artery PI greater than 1.1

    Persistence of protodiastolic notch, unilateral or bilateral, after 23 weeks is suggestive of IUGR or preeclampsia.

    RI greater than 0.55 with bilateral notches

    RI greater than 0.65 with a unilateral notch

    RI greater than 0.70 with or without notches

    RI greater than 90th percentile for a given gestational age regardless of notches
    An S/D ratio of greater than 3 after 30 weeks of gestation is abnormal.

    The reversal of flow in ductus venosus is suggestive of a fetus with severely compromised IUGR and reflects fetal metabolic acidemia.

    Umbilical blood flow

    Umbilical venous blood flow, both absolute flow (in mm/min) and corrected blood flow (in mL/min/kg) are reduced in IUGR. Presence of pulsations in umbilical vein waveform between 8 and 12 weeks is normal, and its persistence is abnormal. The presence of umbilical vein pulsations is associated with an increased risk of an adverse perinatal outcome.
  49. Dr. Anmad

    Dr. Anmad Guest

    1. the side effect of heparin is all except...
    a.thrombocytopenia
    b.alopecia
    c.hypokalemia
    d.hypersensitivity

    (c) harrison’s16/e 261 t41-4

    2 The following is not a gpIIb/IIIa inhibiter
    a.dipyradamole
    b.abciximab
    c.eptifibatide
    d.tirofiban

    (A) harrison’s16/e 688;KDT4e/535

    3.SIADH is a side effect of
    a.5FU
    b.vincristine
    c.bleomycin
    d.gemcitabine

    (b) harrison’s16/e 477

    4..which is associated with DIC
    a.vincristine
    b.gemcitabine
    c.L-sparginase
    d.busulphan

    (c) harrison’s16/e 473

    methotrexate is used in rx of
    a.rhabdomyosarcoma
    b.osteosarcoma
    c.multiple myeloma

    (b) harrison’s16/e 561

    5. All are true about clonidine except..

    a) stimulates parasympathetic outflow
    b) causes dry mouth
    c) prazocin antagonizes its action
    d.alpha adrenergic agonist

    (a) KDT 4e/546 ch 36

    6..ANTI-PSEUDOMONAS ANTIBIOTIC
    a.CIPROFLOXACIN
    b.CEFACLOR
  50. Dr. Anmad

    Dr. Anmad Guest

    1..methotrexate is used in rx of
    a.rhabdomyosarcoma
    b.osteosarcoma
    c.multiple myeloma

    (b) harrison’s16/e 561

    2. All are true about clonidine except..

    a) stimulates parasympathetic outflow
    b) causes dry mouth
    c) prazocin antagonizes its action
    d.alpha adrenergic agonist

    (a) KDT 4e/546 ch 36

    3.ANTI-PSEUDOMONAS ANTIBIOTIC
    a.CIPROFLOXACIN
    b.CEFACLOR
    c.

    (A)harrison’s16e/894

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