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The right atrium chronic overload is indicated by a P wave of more than:
|
Ans. a. 2.5 mm (Ref: Harrison 19/e p1453, 18/e p1832; Marc Gertsch's The ECG; A Two-Step Approach to Diagnosis';Ch-4)The right atrium chronic overload is indicated by a P wave of more than 2.5 mm."Normal atrial depolarization vector is oriented downward and towards the subject's left, reflecting the spread of depolarization from the sinus node to the right and then the left atrial myocardium. This vector points toward the positive pole of lead II and toward the negative pole of lead aVR. Normal P wave is less than 2.5 mm in lead II. If it is more than 2.5 mm, this indicate right atrial overload."- Harrison 19/e p1453, 18/e p1832Right Atrial Enlargement (P Pulmonale): Peaked, tall and narrow P waves in leads II, III and aVF in lung disease are called 'P pulmonale'. The presence of P pulmonale is taken as P wave of more than 2.5 mm in leads, II, III and aVF. Though many factors such as verticalization of the heart, increased residual volume and impaired lung function have been reported to be correlated with these changes in the P wave, right atrial overload (right atrial enlargement or increased right atrial pressure or both) is still thought to be responsible for P pulmonale in lung disease."- Maeda S, Katsura H. Chida K. Imai T. Kuboki K. Watanabe C, Kida K. Ohkawa S, Matsushita S, Ueda K and Kuramoto K. Lack of correlation between P pulmonale and right atrial overload in chronic obstructive airways disease. Br Heart J. 1991; 65:132-6."Right Atrial Enlargement (P Pulmonale): As the activation of the right atrium begins earlier than that of the left atrium, an increase of the right atrial (RA) vector does not prolong the P duration. P pulmonale is characterized by tall and sometimes pointed P waves in leads II, aVF and III. The amplitude of the P waves is 2.5 mm in at least one of these leads. In the opposite 'lead aVL, the P wave is completely negative. The P wave may be higher than normal and pointed in leads V1/V2 rarely in the other precordial leads."- Marc Gertsch's 'The ECG: A Two-Step Approach to Diagnosis';- Ch-4
|
Medicine
|
C.V.S.
|
2.5 mm
|
Marbling is noticed by
|
Ans. (c) 36 hours.
|
Medicine
|
Miscellaneous
|
36 hours
|
The weight of the child at 3 years is usually times the birth weight –
| null |
Pediatrics
| null |
5
|
Sensory innervation of larynx as far as the vocal
folds is by _________ nerve
| null |
Anatomy
| null |
Internal laryngeal
|
Chlamydia causes all the following diseases except?
|
Ans. is 'd' i.e., Parotitis
|
Microbiology
| null |
Parotitis
|
Wedging in the interproximal areas in case of recession is called
| null |
Dental
| null |
Piggy back
|
Exposure to darkness leads to increased melatonin secretion. It is brought about by:
|
Ans. is 'b' i.e. increasing the serotonin N-acetyl transferase Ref Ganong 21st/e p 468, 20th/e p448First let's see the synthesis of melatonin from serotoninSerotonin| N. Acetyl transferase + Acetyl CoA N-Acetyl serotonin|Hydroxy indole - 0 methyl transferase + S-Adenosylmethionine Melatonin (N-acetyl-5-methoxytryptamine)Regulation of Melatonin SecretionIn humans and all other species studied to date, melatonin synthesis and secretion are increased during the dark period of the day and maintained at a low level during the day-light hours.The remarkable diurnal variation in secretion is brought about by training of the hypothalamus to the light-dark cycle via retino-hypothalamic nervesThe hypothalamus in turn cause norepinephrine secretion by the postganglionic sympathetic nerves (nervi conarii) that innervate the pineal glandThe norepinephrine acts via b adrenergic receptors in the pineal gland to increase intracellular cAMP, and the cAMP in turn produced a marked increase in N-acetyltransferase activity. This results in increased melatonin synthesis and secretionExposure to darkness|Retino hypothalamic fibres| supra chiasmatic nuclei in hypothalamus|Preganglionic sympathetic neurons in spinal cord| postganglionic sympatheticnerves (nervi conarii) arising in superior cervical ganglion|| norepinephrine secretion in pineal gland|| intracellular cAMP ||N-Acetyltransferase activity|| Hydroxyindole - O methyl transferase activity|| Melatonin
|
Physiology
|
Special Senses: Vision and its Elements
|
Increasing the serotonin N-acetyl transferase.
|
Slow onset of action is seen with?
|
TYPE ONSET (MIN/HR) PEAK (HR) DURATION RAPID ACTING Aspa 5-15 min 0.5-1.5 3-4 Lispro 5-15 0.5-1.5 3-4 SHO ACTING Human regular 30-60 2-3 4-6 Intermediate Lente 2-4 hr 6-12 18-26 NPH 2-4 4-12 18-26 LONG ACTING Determir 1-4 5-24 20-24 Glargine 1-4 5-24 20-24 Ultralente 4-8 10-30 Over 36
|
Medicine
|
Diabetes Mellitus
|
Glargine
|
Busulfan toxicity does not include -
|
Ans. is 'b' i.e., Toxic carditis o Adverse effects of busulfan --> Myelosuppression, hyperuricemia, pulmonary fibrosis, sterility, impotence, amenorrhea, addison's disease like syndrome (asthenia and hypotension). o High dose causes veno-occlusive disease of liver, seizures, hemorrhagic cystitis, alopecia, cataract. About option 'a' - In addison's disease there is hyperpigmentation (Busulfan causes addison's disease like syndrome).
|
Pharmacology
| null |
Toxic carditis
|
Which of the following is primordial prevention -
|
Ans. is 'a' Level of prevention Examples o Primordial prevention o Discouragement from adapting a harmful lifestyle, e.g. smoking o Primary prevention o Immunization (vaccination) o Chemoprophylaxis o Nutritional supplementation programmes o Chlorination of water o Using a mosquito net o Health education o Secondary prevention o Screening test o Case finding programmes o Early diagnosis & treatment o Tertiary prevention o Disability limitation # Resting the affected limb in neutral position in PRPP to prevent deformity o Rehabilitation # Estabilishing schools for blind # Provision of aids for crippled # Reconstructive surgery in leprosy # Muscle re-education and graded exercise in neurological disorder like polio # Changing profession for a more suitable one
|
Social & Preventive Medicine
|
Concept of Control
|
Avoiding nicotine
|
A 52-year-old, nonsmoking man complains of pain and paresthesias in his right hand, paicularly at night. Examination reveals a diminished radial pulse when he abducts his arm when his head is turned to either side. A bruit is audible over the upper right anterior chest. His neurologic examination is unremarkable. You suspect the patient has
|
The patient has a thoracic outlet syndrome (TOS), which is an abnormal compression of the aeries, veins, or nerves in the neck. TOS is more common in adults than in children, and may occur in either sex. The compression may be caused by a cervical rib, the scalenus anticus muscle, or positional changes. The diagnosis is confirmed with an aeriogram. Nerve conduction studies do not distinguish TOS from cervical disc disease, since the nerves are also involved in TOS.
|
Surgery
| null |
A cervical rib
|
Which of the following carriers received source of infection from other carriers is called -
|
<p> Incubatory carriers They are potential patients. Since then incubation period of cholera is sho(1-5 days) ,incubatory carriage is of sho duration. Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:230 <\p>
|
Social & Preventive Medicine
|
Communicable diseases
|
Incubatory carrier
|
Very low bih weight babies are
|
Low bih weight (LBW) neonate- A neonate weighing less than 2500g at bih irrespective of the gestational age. Very low bihweight (VLBW) neonate- A neonate weighing leas than 1500g at bih irrespective of the gestational age. Extremely low bih weight (ELBW) neonate- A neonate weighing leas than 1000g at bih irrespective of the gestational age. Reference : page 125 Ghai Essential Pediatrics 8th edition
|
Pediatrics
|
New born infants
|
< 1500 gm of bih weight
|
Causative factor acne are following except:
|
Acne is a chronic inflammatory disease of the pilosebaceous units, skin structures consisting of a hair follicle and its associated sebaceous gland Major factors are involved in the pathogenesis: - Hormonal factors (| androgens, Insulin resistance, Insulin growth factor-1(IGF-1) - | IL-1a activity - | Lenoleic acid - Increased sebum production k/a Seborrhea, - Hypercornification of the pilosebaceous duct, - Abnormality of the microbial flora especially colonization of the duct with Cutibacterium acnes. - The activity of bacteria (C.acnes) within the comedones releases free fatty acids from sebum, causes inflammation within the cyst, and results in rupture of the cyst.
|
Dental
|
Acne and chemical peeling
|
Oily food
|
Osiander's sign is positive in?
|
The pelvic changes are diverse and appear at different periods during pregnancy. There is increased pulsation, felt through the lateral fornices at 8th week called Osiander's sign. Similar pulsation is also felt in acute pelvic inflammatory disease. Ref: Textbook of Obstetrics D.C.Dutta 6th Ed Page 65.
|
Gynaecology & Obstetrics
| null |
First trimester of pregnancy
|
Dohlman's operation is related to -
| null |
ENT
| null |
Zenker's diverticulum
|
Comment on the diagnosis of this patient with hypokalemic periodic paralysis.
|
Ans. (c) Grave's disease.* Thyrotoxicosis is sometimes associated with a form of hypokalemic periodic paralysis; this disorder is particularly common in Asian males with thyrotoxicosis.* Lid retraction, causing a staring appearance, can occur in any form of thyrotoxicosis and is the result of sympathetic overactivity.* However, Graves' disease is associated with specific eye signs that comprise Graves' ophthalmopathy* Many scoring systems have been used to gauge the extent and activity of the orbital changes in Graves' disease. The "NO SPECS" scheme is an acronym derived from the following eye changes:0 = No signs or symptoms1 = Only signs (lid retraction or lag), no symptoms2 = Soft-tissue involvement (periorbital edema)3 = Proptosis (>22 mm)4 = Extraocular-muscle involvement (diplopia)5 = Corneal involvement6 = Sight loss
|
Ophthalmology
|
Adverse Ocular Effects of Systemic Drugs
|
Grave's disease
|
A 60-year-old man has his left forearm amputated because he has invasive rhabdomyosarcoma. The pathologist notes calcification in the wall of the radial aery, which otherwise appears unremarkable. Which of the following is the appropriate diagnosis?
|
Monckeberg medial sclerosis is characterized by calcification of the media of large and medium-sized aeries of older persons who are not otherwise affected by atherosclerosis . On gross examination, the involved aeries are hard and dilated. These aerial changes are usually asymptomatic. None of the other choices display calcification.
|
Pathology
|
Systemic Pathology
|
Monckeberg medial sclerosis
|
Mineral essential for Hb synthesis
| null |
Physiology
| null |
Copper
|
LA causing cutaneous vasoconstriction:
| null |
Surgery
| null |
Ropivacaine.
|
All of the following statements are true about tumour markers except
| null |
Surgery
| null |
confirmation of cancer
|
Platelet count is decreased in all of the following condition except:
|
Answer is A (H. S. Purpura) The mechanism of ecchymosis or purpura in Henoch Schonlein is vasculitis. There is no thrombocytopenia. All other options are known causes of thrombocytopenia.
|
Medicine
| null |
H. S. Purpura
|
Ehlers Danlos syndrome is?
|
Ehler-Danlos syndrome is classified into 8 types and more than 5 types show autosomal dominant transmission.
|
Pathology
| null |
Autosomal Dominant
|
drugs with high plasma protein binding are
|
plasma protein binding causes restriction of drugs in the vascular compament and thus lower volume of distribution
|
Anatomy
|
General anatomy
|
lower volumes of distribution
|
Which of the following agents are useful in the medical treatment of variceal bleeding?
| null |
Pharmacology
| null |
Octreotide
|
In beta-oxidation of fatty acids, carnitine is required for
|
Transport of long-chain fatty acid to mitochondria' inner layer
|
Biochemistry
| null |
Transport of long chain fatty acid to mitochondrial inner layer
|
Most common cause of pneumonia in children less than 2 years is ?
|
Respiratory syncytial virus is the most impoant cause of pneumonia in children less than 2 years of age.At other ages ,influenza, parainfluenza, adeno virus are common. Bacteria causing pneumonia are klebsiella, S.pneumonia, E.coli, H.influenza, staphylococci, Atypical organisms like Mycoplasma and Pneumocystis carinii. Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:352,7th edition
|
Pediatrics
|
Respiratory system
|
RSV
|
Which of the following binds antiapoptotic proteins
| null |
Pathology
| null |
Bax
|
A school going boy was noted with vacant stare several times a day. There was no history of fever, seizures and neurological deterioration. What is the diagnosis -
|
Ans. is 'b' i.e., Absence seizures o Absence seizure is characterized by a few seconds of impairment of conciousness without loss of postural control. There is associated eye blinking or staring which may occur as clustered events.
|
Pediatrics
| null |
Absence seizures
|
Multiple brain abscesses are characteristic of
|
(C) Hematogenous # Metastatic abscesses are commonly located in the parietal, frontal, or temporal lobes, and multiple brain abscesses are usually the result of metastatic spread from remote primary foci, accounting for 6% to 22% of cases.> Most common cause of brain abscesses was haematogenous spread, accounting for 26% of the episodes.
|
Medicine
|
Miscellaneous
|
Hematogenous
|
Mechanically, the strongest phase in amalgam restoration is
| null |
Dental
| null |
The original gamma phase (Ag3Sn)
|
Indications for ECT are :
|
B i.e. Depression with sucidal tendency
|
Psychiatry
| null |
Depression with suicidal tendency
|
Metacarpophalangeal joints are most commonly affected in: March 2005
|
Ans. C: Rheumatoid Ahritis RA is characterized by diffuse cailage loss and erosion of bone and cailage. It stas in the synol membrane, with the initial processes of edema, neovascularization, and hyperplasia of the synol lining. Proliferation of synoviocytes and macrophages causes thickening of the synol lining and, together with lymphocytes, plasma cells, and mast cells, develops into pannus. Pannus is a sheet of invasive cellular tissue that is continuous with the synol lining. As a result of the higher propoion of synoviocytes and macrophages, pannus causes erosion of bone and cailage at the margin of joints. In the hands, the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and thumb interphalangeal (IP) joints are most frequently involved. The distal interphalangeal (DIP) joints are involved only in the presence of a coexisting MCP or PIP disease. Tenosynovitis of the flexor tendons causes a reduction in finger flexion and grip strength. Nodular thickening in the tendon sheath may also produce a trigger finger. In osteoahritis and psoriatic ahritis, DIP is commonly involved.
|
Surgery
| null |
Rheumatoid ahritis
|
Factors responsible for the development of multidrug resistant pneumonia are all, EXCEPT:
|
Factors responsible for the development of multidrug resistant pneumonia are Widespread use of potent oral antibiotics Earlier transfer of patients out of acute-care hospitals to their homes or various lower-acuity facilities Increased use of outpatient IV antibiotic therapy General aging of the population More extensive immunomodulatory therapies Ref: Harrison, E-18, P-2130.
|
Medicine
| null |
Underlying lung cancer
|
All aggravates myastheia gravis,except ?
|
Ans. is 'a' i.e., Azathioprine o Tetracycline, aminoglycoside and quinidine can aggravate mysthenia gravis.
|
Pharmacology
| null |
Azathioprine
|
Genetic anticipation is characteristic of:
|
Genetic Anticipation refers to the progressive increase in severity of an illness as it manifests in its transmission from parent to child, occurring in a more severe form and at an earlier age with succeeding generations. It is more commonly seen in trinucleotide repeat disorders. Classical examples are Huntington's Disease - CAG Myotonic Dystrophy - CTG Dyskeratosis congenita - TTAGGG (telomere repeat sequence) Fragile X syndrome - CGG Crohn's disease Behcet's disease Ref: Genetic Instabilities and Neurological Diseases, Second Edition, edited by Robe D. Wells, Tetsuo Ashizawa, 2nd Edition, Page 56.
|
Medicine
| null |
Myotonic dystrophy
|
All the following are examples of diseases causing Aplastic anemia except :
|
Answer is D (Cold haemoglobinuria) Paroxysmal Cold Hemoglobinuria is a form of immune mediated hemolytic anemia and is not a form of aplastic anemia. Pregnancy, PNH and hepatitis have all been mentioned as causes of Aplastic anemia. Classification Of Aplastic Anemia And Cytopenias : Acquired Aplastic Anemia Inherited Aplastic Anemia Radiation Drugs and chemicals Regular effects Idiosyncratic reactions Viruses Epstein-Barr virus (infectious mononucleosis) Hepatitis (non-A, non-B, non-C hepatitis) Parvovirus B19 (transient aplastic crisis. PRCA) HIV-1 (AIDS) Immune diseases Eosinophilic fasciitis Hypoi-immunophilic globulinemia Thymoma/thymic carcinoma Graft-versus-host disease in Immunodeficiency Paroxysmal nocturnal hemoglobinuria Pregnancy Idiopathic Fanconi's anemia Dyskeratosis congenita Shwachman-Diamond syndrome Reticular dysgenesis Amegakaryocytic thrombocytopenia Familial aplastic anemias Preleukemia (monosomy 7, etc.) Nonhematologic syndrome (Down's Dubowitz, Seckel)
|
Medicine
| null |
Cold hemoglobinuria
|
Commonest ligament injured in ankle injury:
|
ANKLE LIGAMENT INJURY The most common mode of ankle injury is inversion of plantar flexed foot. Commonest ligament injured- Anterior talofibular ligament
|
Orthopaedics
|
Ohopaedics Q Bank
|
Anterior talofibular ligament
|
An 8-month old child presented with itchy, exudative lesions on the face, palms and soles. The siblings also have similar complaints. Which of the following is the treatment of choice?
|
The child in the question is showing features of scabies cause by Sarcoptes scabei. The treatment of choice in scabies is 5% permethrin cream. In adults, it is applied from the neck down and washed off after 8-14 hours. In children younger than 5 years of age and the elderly, it should be applied to the entire skin surface except the eyes. Other treatment options includes 1% gamma benzene hexachloride, Ivermectin, 25% Benzyl benzoate and Topical crotominton 10%. Ref: CURRENT Diagnosis and Treatment of Sexually Transmitted Diseases, Chapter 30.
|
Skin
| null |
Topical permethrin
|
All are true about Carvedilol except
|
Carvedilol blocks both β1 & β2 receptors and hence it is a non selective β - blocker.
|
Pharmacology
| null |
It is a cardioselective β - blocker
|
Lateral ventricle is connected to third ventricle by ?
|
Ans. is 'a' i.e., Foramen of Monro
|
Anatomy
| null |
Foramen of Monro
|
Reinforced anchorage. Example is
| null |
Dental
| null |
Inclined plane
|
The drug that can cause hirsutism is
|
Ans: a (Minoxidil)Ref: katzung 9 ed., Pg. 247Topical minoxidil is used for treating androgenic alopecia. The mechanism of action of minoxidil on hair follicles is unknownDrugs causing hirsutism- Minoxidil- Phenytoin- Cyclosporine- Diazoxide- Androgens- Oral contraceptives - containing progesterone- Penicillamine- Heavy metals- Acetazolamide
|
Pharmacology
|
Adverse Drug Effect
|
Minoxidil
|
What is the ideal site to make a burr hole in a patient of head injury with rapidly deteriorating sensorium & progressive dilatation of pupil with no localizing sign?
|
Burr hole surgery should be done by taking into consideration side of pupillary dilatation 1. One sided pupillary dilatation: Burr hole on that side 2. Both sided pupillary dilatation: Burr hole on the side of first dilated pupil/ side with obvious external trauma. 3. No localizing sign: Burr hole on the side of dominant hemisphere i.e left temporal.
|
Surgery
|
Trauma
|
Left temporal region
|
Most common muscle to be congenitally absent -
|
Congenital absence of Pectoralis major is the most common.
|
Anatomy
| null |
Pectoralis major
|
A 25-year-old woman complains of low-grade fever, fatigue, and persistent rash over her nose and upper chest. She also notes pain in her knees and elbows. A skin biopsy shows dermal inflammation and granular deposits of IgG and C3 complement along the basement membrane at the epidermal/dermal junction. Urinalysis reveals microscopic hematuria and proteinuria. The ANA is positive. The development of thromboembolic complications (e.g., deep venous thrombosis) in this patient is commonly associated with elevated serum levels of antibodies to which of the following antigens?
|
1/3rd of patients with SLE possess elevated concentrations of anti-phospholipid antibodies. It predisposes these patients to thromboembolic complications (stroke, pulmonary embolism, deep venous thrombosis, and poal vein thrombosis). The clinical course of SLE is highly variable and typically exhibits exacerbations and remissions. The overall 10-year survival rate approaches 90%(Because of early detection & management). -Antibodies against clotting factors (choice C) or fibrinolytic enzymes (choice D) are not involved in the clotting tendency associated with SLE. Diagnosis: Systemic lupus erythematosus
|
Pathology
|
Immunity disorders
|
Phospholipids
|
All of the following vascular changes are observ ed in acute inflammation, except-
|
Ans. is 'd' i.e., Decreased hydrostatic pressureInflammationVascular changesCellular changeso Vasoconstrictiono Vasodilatationo Increased permeability'o Chemotaxis, phagocytosiso Increased hydrostatis pressureo Marginationo Rollingo Adhesion
|
Pathology
|
Acute Inflammation - Overview and Morphologic Patterns
|
Decreased hydrostatic pressure
|
"Target lesions" are characteristically seen in?
|
Iris or target lesions = Erythema multiformie Bulla spread sign and Nikolsky's sign = Pemphigus vulgaris. Auspitz sign = Plaque Psoriasis. Darrier's sign = Uicaria pigmentosa. White dermographism = Atopic dermatitis. Dimple sign = Dermatofibroma Target lesions - Central erythema surrounded by area of clearing and another rim of erythema
|
Dental
|
Blistering disorders
|
Erythema multiforme
|
Quadrate lobe of liver is present between
|
Quadrate lobe of liver is present between groove for ligamentum tetes and gallbladder
|
Anatomy
|
G.I.T
|
Groove for ligamentum tetes and gall
|
A first year psychiatric resident is interviewing a patient in psychiatry ward. On asking any question, patient starts giving long details and to the point that listener may get bored, but eventually patient answers the question. Which of the following abnormality the resident could find in this patient?
|
Ans. D. CircumstantialityCircumstantiality is indirect speech that is delayed in reaching the point but eventually gets there. Circumstantiality is characterized by an overinclusion of details. Verbigeration is a meaningless repetition of specific words or phrases. Blocking is an abrupt interruption in the train of thinking before a thought or idea is finished. After a brief pause, the person indicates no recall of what was being said or what was going to be said. It is also known as thought deprivation. Tangentiality is the inability to have a goal-directed association of thoughts. The patient never gets from the desired point to the desired goal. Word salad is an incoherent mixture of words and phrases.
|
Psychiatry
|
Miscellaneous
|
Circumstantiality
|
Most common cause of epidural abscess -
|
Ans. is 'a' i.e., Staphylococcuso Therefore spinal epidural abscess is much more common than the intracranial epidural abscess.# Spinal epidural abscess is more common by a factor of nine to one.Causes of epidural abscess
|
Medicine
|
Bacteriology
|
Staphylococcus
|
Feed forward control system is employed during the regulation of
|
Ans. (c) Temperature(Ref: UMP, 4th ed/RL Bijlani p.12)There is a control system in our body when no stimulus is required but still the system ANTICIPATES and makes corrective changes. Such a system is called Feed forward or Anticipatory or Adaptive ControlExamples of feed forward controlTemperature control - Thermoregulatory responses are initiated by hypothalamus BEFORE the changes in environmental temperature have succeeded in changing the body's core body temperatureCephalic phase of gastric secretion- Just thinking about food increases gastric acid productionThinking about exercise itself increases heart rate & respiratory rateRole of cerebellum in motor coordination
|
Physiology
|
General
|
Temperature
|
Tzank smear in a case of pemphigus vulgaris shows
|
Tzanck smear is a very simple and rapid technique. For viral infections, samples should be taken from a fresh vesicle.The vesicle should be unroofed or the crust removed, and the base scraped with a scalpel or the edge of a spatula. The material is transferred to a glass slide.In the case of blistering disorders, the intact roof of a blister is opened along one side, folded back and the floor gently scraped. The material thus obtained is smeared onto a microscopic slide, allowed to air dry, and stained with Giemsa stain. Pemphigus vulgaris: It reveals multiple acantholytic cells (Tzanck cells). A typical Tzanck cell is a large round keratinocyte with a hyperophic nucleus, hazy or absent nucleoli, and abundant basophilic cytoplasm. The basophilic staining is deeper peripherally on the cell membrane ("mourning edged" cells) due to the cytoplasm's tendency to get condensed at the periphery, leading to a perinuclear halo. Herpes simplex, varicella, herpes zoster: multinucleated syncytial giant cells contain multiple nuclei Molluscum contagiosum: basophilic intracytoplasmic molluscum bodies (Henderson-Patterson bodies), the largest known inclusion bodies (30-35 m). Vaccinia, orf, milker's nodules and variola:[ eosinophilic cytoplasmic inclusion called a "Guarnieri body", Leishmaniasis:Cytology is very useful in detecting Leishman-Donovan (LD) bodies in early, untreated patients of leishmaniasis. LD bodies appear as light-blue, ellipsoid bodies IADVL Textbook of dermatology page 1099
|
Dental
|
Autoimmune skin disorders
|
Acantholytic cells
|
Digoxin toxicity is increased by all except -
|
Ans. is 'b' i.e., Hyperkalemia Digitalis toxicity is a2gravated by o Hypokalemia o Hypomagnesemia o Renal insufficiency o Hypercalcemia o Advanced age o Hypoxia o Acute myocardial infarction o Thyrotoxicosis o Mvxoedema o Acute Myocarditis
|
Pharmacology
| null |
Hyperkalemia
|
The electrical potential difference necessary for a single ion to be at equilibrium across a membrane is best described by the:
|
Ans. D. Nernst equationa. The Nernst equation calculates the membrane potential that develops when a single ion is distributed at equilibrium across a membrane.b. The Goldman equation gives the value of the membrane potential when all permeable ions are accounted for.c. The van't Hoff equation calculates the osmotic pressure of a solution.d. Fick's law refers to the diffusional movement of solute. The permeability coefficient accounts for several factors that determine the ease with which a solute can cross a membrane
|
Physiology
|
General
|
Nernst equation
|
The most common type of Rhabdomyosarcoma is
|
Rhabdomyosarcoma, the most common soft-tissue sarcoma of childhood and adolescence, usually appears before age 20. It may arise in any anatomic location, but most occur in the head and neck or genitourinary tract, where there is little if any skeletal muscle as a normal constituent. Rhabdomyosarcoma is histologically sub classified into embryonal, alveolar, and pleomorphic variants. The rhabdomyoblast—the diagnostic cell in all types—contains eccentric eosinophilic granular cytoplasm rich in thick and thin filaments. Rhabdomyoblasts may be round or elongate; the latter are known as tadpole or strap cells, and may contain cross-striations visible by light microscopy.
Embryonal rhabdomyosarcoma is the most common type, accounting for 60% of rhabdomyosarcomas. It includes the sarcoma botryoides as well as spindle cell and anaplasticvariants. The tumor occurs in children younger than 10 years of age and typically arises in the nasal cavity, orbit, middle ear, prostate, and paratesticular region. This variant of rhabdomyosarcoma commonly has parental isodisomy of chromosome 11p15.5, which leads to overexpression of the imprinted IGFII gene. The sarcoma botryoides subtype develops in the walls of hollow, mucosal-lined structures, such as the nasopharynx, common bile duct, bladder, and vagina. Where the tumors abut the mucosa of an organ, they form a submucosal zone of hypercellularity called the cambium layer.
|
Unknown
| null |
Embryonal
|
Sympathomimietic causing increase in mean blood pressure, heart rate and cardiac output on intravenous infusion is-
|
Ans. is 'a' i.e., Adrenaline Comparative effects oflntravenous Infusion ofadrenaline, noradrenaline and Isoprenallne AdrNAIso1. Heart rate||||2 Cardiac output|| ||3. BP-Svstolic||nbv|||Diastolic||||||Mean||||4. Blood flow Skin and mm|| Sk, muscle||||Kidney-|| Liver|| |Coronary|||5. Bronchial muscle|| ||6. Intestinal muscle||||7. Blood sugar||||
|
Pharmacology
|
Adrenergic System
|
Adrenaline
|
What is Hinge fracture?
|
Hinge fracture also called motorcyclist fracture, fracture lines passes across the middle cranial fossa, separating the skull base into 2 halves.
|
Forensic Medicine
| null |
Basilas fracture
|
Hysterectomy when done through broad ligament causes injury to?
|
ANSWER: (B) UreterREF: Shaw's 13th ed p. 14, Danforth 10th ed page 456, COGT 2009 ed chapter 48, The 5-Minute Obstetrics and Gynecology Consult edited by Paula J. Adams Hillard page 582Ureter lies in the pararectal space in the medial leaf of broad ligament in pelvis, hence when dissecting through it during hysterectomy, its liable to get injured."During vaginal hysterectomy, the ureter can be traumatized at its entry point at the trigone""Uterine artery ligation consists of placing a no. 1 absorbable suture 2 to 3 cm medial to the uterine vessels through the myometrium and then through an avascular space in the broad ligament. To avoid injury to the ureter, it is important not to go too far lateral in the avascular space"Urinary injuries during hysterectomy:Urinary injuries during laparoscopy have a similar rate to open procedures (0.02-1.7%). Bladder injuries are more common than ureteral injuries and are recognized more frequently intraoperatively, About two-thirds of urinary injuries occur during laparoscopic-assisted vaginal hysterectomy.The most common sites of ureter injury during gynaecological surgeries:Where the ureters enters the pelvis, near the pelvic brim, during ligation of ovarian vesselsWhere the ureter crosses medial to the bifurcation of the iliac vessels during pelvic lymph node dissection3. Where the ureter crosses under the uterine vessels at the level of the broad ligament during ligation of the uterine vessels during hysterectomy
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Gynaecology & Obstetrics
|
Operative Gynaecology
|
Ureter
|
The position of mucogingival line
| null |
Dental
| null |
Constant throughout the life
|
In which part of the oral cavity has thinnest mucous membrane:
|
Histologically mucosa of the floor of mouth is non-keratinized, thinnest and loosely adherent to the underlying structures. Loose attachment to the underlying tissue provide free mobility to the tongue.
|
Dental
| null |
Floor of the mouth.
|
When a 'spontaneous perforation' of the esophagus occurs as a result of severe barotrauma while a person vomits against a closed glottis, what is the condition known as -
| null |
Surgery
| null |
Boerhaave syndrome
|
Which of the following sphingolipidoses has a characteristic presentation of exaggerated startle response
|
Refer the byte "Sphingolipidoses"
|
Biochemistry
| null |
Tay Sachs disease
|
All true about - cocaine except-
|
It is ester local anesthetics Cocaine was the first local Anesthetic to be used clinically. It is only natural local anesthetic. Koller introduced this in the field of ophthalmology. It is the only local anesthetic with vasoconstrictor action. It is sympathomimetic and inhibits metabolism of catecholamine.
|
Anaesthesia
|
Regional Anesthesia
|
It is amide local anesthetics
|
Average duration of 3rd stage of labor is:
|
Stage Definition- First: From the onset of TRUE labor to full dilation of cervix. Average duration: 12 hours in primigravida and 6 hours in multigravida. Second: From full dilation of cervix to bih of the baby. Median duration is approximately 50 minutes in primigravida and 20 minutes in multigravida. Third: From bih of the baby to delivery of the placenta. Average duration: 15 minutes in both primigravida and multigravida. Fouh: 1-hour observation period, following delivery of the placenta.
|
Gynaecology & Obstetrics
|
Labour - normal, abnormal, malposition, malpresentation and their management
|
15 minutes
|
Fetal cardiac activity can be detected earliest by USG at which age of Intrauterine life-
|
Fetal cardiac activity can be detected earliest by USG at 5-6-week age of intrauterine life.
|
Radiology
|
ULTRASOUND
|
5-6 week
|
Which of the following can occurs in ovary, rectum and appendix -
|
Ans. is 'd' Endometriosis (Ref. Shaws, 13/e, p 439 (12/e, p 370)).Endometriosis is widely dispersed. It occurs anywhere throughout the lower pelvis. The common sites are ovaries*, cul-de-sac including the uterosacral ligaments, peritoneum overlying the bladder, sigmoid colon, back of the uterus, intestinal coils and appendix.It can also be seen in umbilicus following operation* in laparotomy scars, in tubal stumps following sterilization.
|
Gynaecology & Obstetrics
|
Disorders in Menstruation
|
Endometriosis
|
The most useful incision in the operating room for patients with penetrating pericardium injury is:
|
The subxyphoid incision is useful for determining if there is blood in the pericardium and if there is an intracardiac injury; however, exposure is extremely limited, and definitive repair can rarely be performed through the incision. Left (or right) anterior thoracotomy is easily performed, especially in the emergency room, and gives adequate exposure to certain areas of the heart. However, each has significant limitations in exposure. Either may be extended across the thoracotomy into the other side of the chest, thus producing a bilateral anterior thoracotomy. Exposure is excellent through this incision, and most injuries can be satisfactorily repaired through this approach. Most cardiac operations today are performed through median sternotomy incisions. If the patient is in the operating room, this incision is easily performed and always provides excellent exposure for all areas of the heart.
|
Unknown
| null |
Median sternotomy.
|
All of the following are an example of Indicator media EXCEPT:
|
Ans. (d) Stuart mediaRef.: Microbiology by Ananthanarayan and Paniker 8th ed. / 40, 43INDICATOR MEDIA* It is also known as differential media which distinguishes one microorganism type from another growing on the same media.* This type of media is used for the detection of microorganisms and by molecular biologists to detect recombinant strains of bacteria.* Examples of differential media include:# Blood agar# Eosin methylene blue (EMB)# MacConkey (MCK)# mannitol salt agar (MSA)TRANSPORT MEDIAExamples of Transport Media Include* Thioglycolate broth for strict anaerobes* Stuart transport medium - a non-nutrient soft agar gel containing a reducing agent to prevent oxidation, and charcoal to neutralize* Certain bacterial inhibitors- for gonococci, and buffered glycerol saline for enteric bacilli.* Venkat-Ramakrishnan (VR) medium for V. cholerae.
|
Microbiology
|
Culture media and method
|
Stuart media
|
Most common malignant tumour in childhood
|
Leukemia is the most common malignancy of childhood.There are two main subtypes,the commoner acute lymohoblastic leukemia(ALL) & acute myeloid leukemia(AML).A small propoion may have chronic myeloid leukemia(CML) and juvenile myelomonocytic leukemia(JMML).ALL is the most common childhood malignancy accounting for one-fouh of all childhood cancers. Reference:Essential pediatrics-Ghai,8th edition,page no:599.
|
Pediatrics
|
Childhood tumors
|
Leukemia
|
A child with decreased levels of LH, FSH and Testosterone presents with delayed puberty. Which of the following is the most likely diagnosis –
|
Kallman's syndrome is an X-linked disorder characterized by a deficiency of GnRH with a resultant decrease in FSH and LH levels producing an isolated Hypogonadotrophic Hypogonadism Kallman's syndrome may be seen in both men and women but is more common in men. It is typically also associated with agenesis or hypoplasia of the olfactory bulb producing anosmia or hyposmia.
|
Pediatrics
| null |
Kallman's syndrome
|
Which is not a component of MELD score
|
Recently, the Child-Pugh system has been replaced by the Model for End-Stage Liver Disease (MELD) system for the latter purpose. The MELD score is a prospectively derived system designed to predict the prognosis of patients with liver disease and poal hypeension. This score is calculated from three noninvasive variables: the prothrombin time expressed as the international normalized ratio (INR), the serum bilirubin level, and the serum creatinine concentration.Ref: Harrison&;s Textbook of Internal Medicine; 19th edition; Chapter 357; Approach to the Patient with Liver Disease; Page no: 1993
|
Medicine
|
Nutrition
|
Albumin
|
Which of the following interventions is not recommended in active management of third stage of Labour?
|
Canadian pediatric society and Cochrane database UK, has recommended delayed clamping of the umbilical cord, as it reduce the need for blood transfusion in premature babies and also reduce the incidence of intraventricular hemorrhage. Ref: Clinical Gynaecological Endocrinology and Infeility By Speroff, 7th Edition, Page 1036; Medical Veritas : The Journal of Medical Truth By Gary S. Goldman, November 2005, Volume2, Page 497; Current Obstetrics and Gynecology By Gita Ganguly Mukherjee, Sudip Chakravay, Bhaskar Pal, et al, Jaypee Brothers, Medical Publishers, 2007, Page 168
|
Gynaecology & Obstetrics
| null |
Immediate Clamping, Cutting and Ligation of cord
|
Which of the following has highest malignant transformation rate:
| null |
Pathology
| null |
Proliferative Verrucous leukoplakia
|
Waxy flexibility and stereotype verbal and behavioural signs are seen in
|
Ans. c (Catatonic schizophrenia). (Ref. Psychiatry by Niraj Ahuja, 5th ed., 60, 254)Schizophrenia: Symptoms must be present at least 6 monthsSchizophreniform Disorder: > 1 month but < 6 months.FEATURES OF CATATONIC SCHIZOPHRENIA# Bizarre posturing# Rigidity# Echolalia, echopraxia# Mutism# Waxy flexibility# Ambitendancy (no goal directed actions)# Stupor# Negativism (motiveless resistance to all commands and doing opposite)# Other signs (mannerisms, stereotype verbal and behavioural automatic obedience, verbigeration)TYPES OF SCHIZOPHRENIA ***Schizophrenia Paranoid Type# MC Type of Schizophrenia# Older patients (Onset is in their late twenties or thirties)Best prognosis# Presenting Symptoms: Preoccupation with delusions and/or hallucinations, usually involving grandeur or persecution.Schizophrenia Disorganized Type# Presenting Symptoms: Disorganized speech and behavior. Flat or inappropriate affect. Marked regression to primitive disinhibited behavior (Bizarre Behavior). Severe thought disorder. Poor contact with reality# Risk Factors: These patients tend to be younger than 25Worst prognosis.Schizophrenia Catatonic Type# Presenting Symptoms: Psychomotor Disturbances, ranging from severe retardation to excitation. Extreme negativism. Peculiarities of voluntary movements. Mutism is very common.# Complications: Medical care may be necessary because of exhaustion, malnutrition, self- inflicted injury, or hyperpyrexia.Schizophrenia Residual Type# Presenting Symptoms: Absence of positive symptoms (delusions, hallucinations, disorganized speech/behavior & catatonic behavior).# Patients tend to have negative symptoms (Social Withdrawal, Flat Affect, Occupational Dysfunction).Schizophrenia Undifferentiated Type# Presenting Symptoms: Meet criteria for schizophrenia.# Do not meet criteria for other schizophrenia types.
|
Psychiatry
|
Schizophrenia
|
Catatonic schizophrenia
|
Most diffusible ion across the membrane is
|
The resting membrane potential is close to the Nernst potential for K+, the ion to which the membrane is most permeable. .
|
Physiology
|
General physiology
|
K+
|
A study of persons developing skin lesions following sun exposure is conducted. The lesions are not found on skin protected from ultraviolet light. Biopsies of involved skin show immunoglobulin G deposition along the dermal-epidermal junction, along with vacuolization of the basal layer and a perivascular lymphocytic infiltrate. No other organ involvement is present. Which of the following diseases do these patients most likely have?
|
The more benign discoid lupus involves just skin, unlike systemic lupus erythematosus, but is still a form of type III hypersensitivity with antigen-antibody complex deposition along the basement membrane of the epidermis. The other listed options are not associated with sun exposure. Bullous pemphigoid lesions occur at the dermal-epidermal junction from antibody deposition targeting type XVII collagen as a component of hemidesmosomes. Dermatitis herpetiformis associated with celiac disease has IgA antibodies deposited at tips of dermal papillae. Dysplastic nevi develop in relation to mutations in genes encoding for growth control proteins. A toxic epidermal necrolysis is a severe form of erythema multiforme mediated by cytotoxic CD8+ cells targeting epidermal basal cells. Early lesions of discoid lupus erythematosus appear as well-demarcated scaly purple macules or papules and later expand into discoid plaques. Microscopically there is basal vacuolar degeneration, areas of epidermal atrophy, acanthosis, keratotic follicular plugging, basement membrane thickening, and superficial and deep perivascular lymphocytic infiltrate.
|
Pathology
|
Skin
|
Discoid lupus erythematosus
|
What is the normal cardiothoracic ratio in children?
|
"The cardiac silhouette occupies 50-55% of the chest width. Cardiomegaly is present when the cardiothoracic (CT) ratio is more than 55%".The CTR is measured on a PA chest x-ray and is the ratio of maximal horizontal cardiac diameter to maximal horizontal thoracic diameter (inner edge of ribs/edge of pleura). A normal measurement should be <0.5(50%).(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2170)
|
Pediatrics
|
All India exam
|
50-55%
|
Which of the following fatty acid present in fish-oil is known for its cardio-protective function?
|
Eicosapentaenoic acid (EPA): o3 fatty acid Present in fish-oil Known for its cardio-protective action EPA inhibits the formation of thromboxanes (TX2) which are potent platelet aggregators. Hence, the intake of o3 fatty acids promotes platelet disaggregation.
|
Biochemistry
|
Lipoproteins
|
Eicosapentaenoic acid
|
Pain in left hypochondrium vomiting, diarrhea, malena, weight loss diagnosis
|
Answer- C. Zollinger Ellison syndromePeptic ulceration is the most common manifestation of Zollinger Ellison syndrome leading to left hypochondriac pain, vomlting and weight loss and ulcers refractory to medical therapy.A bleeding ulcer gives rise to malena.
|
Surgery
| null |
Zollinger Ellison syndrome
|
Taurodontism is seen in
| null |
Pathology
| null |
Klinefelter's syndrome
|
The Normal value of P02 in healthy man is :
|
C i.e. 80 mm HgFeatureAerial blood--Mixed Venous blood (at rest)FeatureAerial blood--Mixed Venous blood (at rest) 02 tension/P0295 +- 5 mmHg40 +- 2 mm Hg02 tension/P0295 +- 5 mmHg40 +- 2 mm Hg 02 Content19 m1/100 ml14 ml /100 ml02 Content19 m1/100 ml14 ml /100 ml % Saturation of Hb95% +- 2%75%% Saturation of Hb95% +- 2%75% 02Content = dissolved 02 in the plasma + 02 Contained in the Hb * Aerial blood pH --> 7.4 +- 0.02* Dead space Volume --> 2 ml/kg body wt
|
Physiology
| null |
80 mm Hg
|
What is the minimal occlusal thickness that will provide resistance to fracture of amalgam:
| null |
Dental
| null |
1.5 mm
|
In catatonic schizophrenia, all are seen except :
|
D. i.e. Flight of ideas
|
Psychiatry
| null |
Flight of ideas
|
All of the following are true about paranoid schizophrenia except -
|
Paranoid schizophrenia is the commonest type of schizophrenia in clinical practice. The onset is later (3rd - 4th decade). The core symptoms are delusions of persecution. Other types of delusions (grandeur, reference, control, infidelity, double) and hallucinations may also occur. There is minimal or no disturbance of affect, volition, speech, motor behavior, and personality.
|
Psychiatry
| null |
Rapid deterioration of personality
|
Wilm's Tumour is associated with all. Except -
|
Ans. is 'd' Polycystic kidney disease (Ref O.P. Ghai, 5/e, p 466; CPDT, 15/e, p 808, Nelson 17/e, 617, 1749 1750,1757)Important associated malformations: syndromes associated with wilm's tumor.Aniridia*Hemihypertrophy*GenitourinaryCryptorchidism*Hypospadias*Gonadal dysgenesis*Pseudohermaphroditism *Horseshoe kidney *Beckwith Wiedemann syndrome*Dr ash syndromeWAGR syndrome*Wilms tumourAniridiaAmbiguous genitaliaMental retardation
|
Pediatrics
|
Neoplasms of the Kidney
|
Polycystic kidney
|
Which of the following disorders is least likely associated with progression to lymphoma
|
Ans. is 'c' i.e., Severe combined immunodeficiency Choice Cancers associated Sjogren syndrome NHL mainly MALT-oma involving salivary glands>stomach Ataxia telengectasia Elevated incidence of cancers, approximately 100-fold in comparison to the general population. In children, more than 85% of neoplasm cases are acute lymphocytic leukemia or lymphoma. In adults with ataxia-telangiectaisa, solid tumors are more frequent Lynch-II syndrome Gastrointestinal cancer associated with endometrial/ovarian carcinoma. Early onset brain tumor and lymphoma also seen in children
|
Medicine
| null |
Severe combined immunodeficiency
|
A patient has multiple, pearly papules on the face. Biopsy shows a malignant tumor. Which of the following features would most likely be seen on microscopic examination?
|
The malignant skin tumor that forms "pearly papules" on sun-exposed skin is basal cell carcinoma. A characteristic feature of this tumor is palisading of the basal cell-like nuclei at the edge of clusters of cells penetrating into the dermis. Basal cell carcinomas almost never metastasize, but can be very locally destructive, and resection of large ones on the face may produce disfiguring scars. Viral cytoplasmic inclusions are a feature of the infectious lesion molluscum contagiosum. Keratin pearls are a feature of squamous cell carcinoma. Melanin and S-100 positivity with immunohistochemical stains are features of melanoma Ref: Robbins Basic Pathology, 8th Ed, page 852-855
|
Pathology
| null |
Palisading nuclei
|
The risk of recurrence of congenital hea disease is
|
The incidence of congenital hea disease in the normal population is 0.8%.The risk increases to 2-6% for a second child if the sibling is having congenital hea disease(recurrence) or if the parent is affected.When two 1st degree relatives have congenital hea disease, the risk for the subsequent child may reach 20-30%.VSD30-35%ASD(SECUNDUM)6-8%PDA6-8%TOF5-7%
|
Pediatrics
|
All India exam
|
2-6%
|
Shanti has been diagnosed to have brain tumor. You would prefer to give her betamethasone/dexamethasone over hydrocortisone as steroids to decrease her cerebral edema because:
| null |
Pharmacology
| null |
They do not cause Na+ and water retention
|
Which of the following occurs first with the use of d-tubocurare:
|
Any neuromuscular blocker when given intravenously goes to highly perfused organ like diaphragm and intercostal muscle first then facial muscle , then upper limb and last lower limb. Thus sequence of block - diaphragm and intercostal muscle - facial muscle - upper limb - lower limb
|
Anaesthesia
|
Neuromuscular Blocker
|
Diaphragmatic relaxation
|
Maximum conduction occurs in which fibres
|
SENSORY NERVE FIBERS
|
Physiology
| null |
A alpha fibers
|
Given technique is called as:
|
Crown-Down Technique
Numerous modifications of the original step-down technique have been introduced, including the description of the crown-down technique. The more typical step-down technique includes the use of a stainless steel K-file exploring the apical constriction and establishing working length.
In contrast, a crown-down technique relies more on coronal flaring and then determination of the working length later in the procedure.
The more typical crown-down, or double-flare technique consisted of an exploratory action with a small file, a crown-down portion with K-files of descending sizes, and an apical enlargement to size #40 or similar. The original technique included stepping back in 1-mm increments with ascending file sizes and frequent recapitulations with a small K-file and copious irrigation. It is further emphasized that significant wall contact should be avoided in the crown-down phase to reduce hydrostatic pressure and the possibility of blockage. Several studies demonstrated more centered preparations in teeth with curved root canals shaped with a modified double-flare technique and Flex-R files compared to shapes prepared with K-files and step-back technique.
A double-flare technique was also suggested for ProFile rotary instruments.
|
Dental
| null |
Crown down technique
|
Which electrolyte abnormality occurs after TRUP:
|
Ans. (b) HyponatremiaRef: Bailey 26th Edition, page 1349* Most common electrolyte abnormality during TURP is HYPONATREMIA due to water intoxication.
|
Surgery
|
Urethra & Penis
|
Hyponatremia
|
Maximum Flexion in thoracic veebrae occurs at -
|
Ans. is 'c' i.e.,Lower thoracicFlexion (forward flexion) and lateral flexion (bending) -> Maximum at lower thoracic.Rotation - Maximum at mid-thoracic.FlexionExtensionLateral flexionRotationUpper thoracic - 8-9.5deg7-9-5deg throughoutUpper thoracic 55-6degUpper thoracic - 12-16degMid-thoracic 10-11.5deg Mid thoracic -> 7.8-8degMid thoracic - 21.5-25degLower-thoracic: 12.5-13deg Lower thoracic - 12-13degLower thoracic - 8.5-12deg
|
Anatomy
| null |
Lower thoracic
|
The most frequent non-sporing anaerobic bacilli isolated from clinical specimens is
| null |
Microbiology
| null |
Bacteroides fragilis
|
Reid index is useful in-
|
Ref: Textbook of pathology (Harash mohan)6th edition, page no.478 Just as there is clinical definition, there is histologic definition of chronic bronchitis by increased Reid index. Reid index is the ratio between thickness of the submucosal mucus glands (i.e. hyperophy and hyperplasia) in the cailage-containing large airways to that of the total bronchial wall . The increase in thickness can be quantitatively assessed by micrometer lens. The bronchial epithelium may show squamous metaplasia and dysplasia. There is little chronic inflammatory cell infiltrate. The non-cailage containing small airways show goblet cell hyperplasia and intraluminal and peribronchial fibrosis.
|
Pathology
|
Respiratory system
|
Chronic bronchitis
|
An 18-year-old woman has eaten homemade preserves. Eighteen hours later, she develops diplopia, dysarthria, and dysphagia. Which of the following is the most likely causative organism?
|
The incubation period of C. botulinum toxin is 18-36 hours but ranges from a few hours to days. There are no sensory symptoms. Foodborne botulinum is associated primarily with home-canned food. Severe foodborne botulinum can produce diplopia, dysarthria, and dysphagia; weakness then can progress rapidly to involve the neck, arms, thorax, and legs. There is usually no fever. Nausea, vomiting, and abdominal pain can precede the paralysis or come afterward.
|
Medicine
|
Infection
|
Clostridium botulinum toxin
|
Anteversion of uterus is maintained by
|
(D) Round ligaments[?]POSITIONS OF UTERUS:Anteversion of uterus: Long axis of uterus is bent forward on long axis of vagina, In most women.Also, long axis of body of uterus is bent forward at level of internal as with long axis of cervix (anteflexion of uterus). Thus, in erect position and with bladder empty, uterus lies in an almost horizontal plane.Fundus and body of uterus are bent backward on vagina so that they lie in rectouterine pouch (pouch of Douglas). Uterus is therefore retroverted. If body of the uterus is, in addition, bent backward on cervix, it is also retroflexed.Angle of Anteflexion is 125degStructures assist in keeping the uterus in position:Sustainer structures: Urogenital diaphragm, Levator ani muscle, Perineal bodySuspensory Structures:Pubocervical ligament, Cardinal ligament (parametrium)Uterosacral ligamentRound ligament of UterusStructures assist in keeping the uterus in Antever- s ion-anteflexion:Cardinal ligament (parametrium):Supports Anteversion, the uterine angle between cervix & body.-Between Vagina & CervixRound Ligament of Uterus:Maintains Anteflexion of the uterus (a position where the fundus of the uterus leans ventrally).-During Pregnancy it gives support to the anteversion as well.Angle of Anteversion 90deg: Maintained by Round & uterosacral ligaments.It has even more significant role during pregnancy. When the uterus grows during pregnancy, the round ligaments can stretch causing pain.#. Position:!. Non pregnant uterus is within the pelvis.!. It is anteverted & anteflexed in position.!. Long axis of cervix is bent on long axis of vagina this is called Anteversion.!. Body of uterus is bent forwards over cervix at the isthmus and is known as Anteflexion.#. Pubocervical ligament:!. Attached Anteriorly to posterior aspect of body of pubis!. Passes to neck of bladder.!. Anterior fornix of vagina.!. Pubocervical ligaments help to maintain normal angle of 45deg between the vagina & horizontal.!. Decrease may cause a cystocoele.
|
Anatomy
|
Abdomen & Pelvis
|
Round ligaments
|
A 6-year-old child presents with black spots on sclera and ear. His urine sample was collected for examination (A). After 30 minutes of collection, the colour of urine sample had changed to (B). What is the most probable enzyme deficiency, child is suffering from?
|
Alkaptonuria * Autosomal recessive disorder due to deficiency of enzyme homogentisic acid oxidase. Clinical features Ochronosis ( Dark spot on sclera / ear cailage ) Ahritis Darkening of urine on standing ( oxidation of homogentisic Acid) High incidence of Hea disease ( mitral / aoic valvulitis / calcification )
|
Pediatrics
|
Disorders of Amino acid Metabolism
|
Homogentisic acid oxidase
|
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