tag:blogger.com,1999:blog-22176478269509669212024-03-07T20:35:16.630-08:00FMGE / MCI screening test , Preparation Tips, Imp Points & Questaion PapersHI FRIENDS there are no shortcuts. Competition is quite fierce these days and a casual approach to exam is not going to help. But if u plan properly and keep your cool during exam, there is no reason that you cant make it. I will try to give some tips. I hope some of you can benefit from it. All the views expressed here are my own and true and helpful to the best of my knowledge!!U will get hear FMGE / MCI screening test, Preparation Tips, Imp Points & Questaion PapersDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.comBlogger30125tag:blogger.com,1999:blog-2217647826950966921.post-78649357330643141542016-08-30T10:45:00.011-07:002016-08-30T11:07:44.653-07:00HOW TO CLEAR / PASS NEET PG / MCI SCREENING TEST / FMGE EXAMS <div dir="ltr" style="text-align: left;" trbidi="on">
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THERE ARE SPMR VERY IMPORTANT POINTS FOR EXAMS..</div>
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<span style="font-family: cambria, serif;"><u>1. Adrenal cortex layers and products</u></span><br />
<span style="font-family: cambria, serif;"><u>"Go Find Rex, Make Good Sex":</u></span><br />
<span style="font-family: cambria, serif;"><u>Layers:</u></span><br />
<span style="font-family: cambria, serif;"><u>Glomerulosa</u></span><br />
<span style="font-family: cambria, serif;"><u>Fasiculata</u></span><br />
<span style="font-family: cambria, serif;"><u>Reticulata</u></span><br />
<span style="font-family: cambria, serif;"><u>Respective products:</u></span><br />
<span style="font-family: cambria, serif;"><u>Mineralcorticoids</u></span><br />
<span style="font-family: cambria, serif;"><u>Glucocorticoids</u></span><br />
<span style="font-family: cambria, serif;"><u>Sex hormones (androgens)</u></span><br />
<span style="font-family: cambria, serif;"><u>Alternatively for layers: GFR</u></span><br />
<span style="font-family: cambria, serif;"><u>(Glomerular Filtration Rate, convenient since adrenal glands are atop kidney).</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>2. Adrenoceptors: vasomotor function of alpha vs. beta</u></span><br />
<span style="font-family: cambria, serif;"><u>ABCD:</u></span><br />
<span style="font-family: cambria, serif;"><u>Alpha = Constrict.</u></span><br />
<span style="font-family: cambria, serif;"><u>Beta = Dilate.</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>3. Amino Acids:The ten essential amino acids:</u></span><br />
<span style="font-family: cambria, serif;"><u>"PVT TIM HALL</u></span><br />
<span style="font-family: cambria, serif;"><u>Phenylalanine, Valine,Threonine,</u></span><br />
<span style="font-family: cambria, serif;"><u>Tryptophan Isoleucine, Methionine</u></span><br />
<span style="font-family: cambria, serif;"><u>Histidine, Arginine, Lysine, Leucine,</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>4. Antibiotics contraindicated during pregnancy MCAT:</u></span><br />
<span style="font-family: cambria, serif;"><u>Metronidazole</u></span><br />
<span style="font-family: cambria, serif;"><u>Chloramphenicol</u></span><br />
<span style="font-family: cambria, serif;"><u>Aminoglycoside</u></span><br />
<span style="font-family: cambria, serif;"><u>Tetracycline</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>5. ABC'S of the aortic arch!</u></span><br />
<span style="font-family: cambria, serif;"><u>Aortic arch gives off the Bracheiocephalic trunk,</u></span><br />
<span style="font-family: cambria, serif;"><u>the left Common Carotid, and the left</u></span><br />
<span style="font-family: cambria, serif;"><u>Subclavian artery</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>6. Asthma:</u></span><br />
<span style="font-family: cambria, serif;"><u>management of acute severe "O SHIT":</u></span><br />
<span style="font-family: cambria, serif;"><u>Oxygen (high dose: >60%)</u></span><br />
<span style="font-family: cambria, serif;"><u>Salbutamol (5mg via oxygen-driven nebuliser)</u></span><br />
<span style="font-family: cambria, serif;"><u>Hydrocortisone (or prednisolone)</u></span><br />
<span style="font-family: cambria, serif;"><u>Ipratropium bromide (if life threatening)</u></span><br />
<span style="font-family: cambria, serif;"><u>Theophylline (or preferably aminophylline-if life threatening)</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>7. B vitamin names</u></span><br />
<span style="font-family: cambria, serif;"><u>"Tu Ro Na Pyare Cutte":</u></span><br />
<span style="font-family: cambria, serif;"><u>• In increasing order: Thiamine (B1) Riboflavin (B2) Niacin (B3) Pyridoxine (B6) Cobalamin (B12)</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>8. Betablockers: cardioselective betablockers</u></span><br />
<span style="font-family: cambria, serif;"><u>"Betablockers Acting Exclusively At Myocardium"</u></span><br />
<span style="font-family: cambria, serif;"><u>• Cardioselective betablockers are:</u></span><br />
<span style="font-family: cambria, serif;"><u>· Betaxolol</u></span><br />
<span style="font-family: cambria, serif;"><u>· Acebutelol</u></span><br />
<span style="font-family: cambria, serif;"><u>· Esmolol</u></span><br />
<span style="font-family: cambria, serif;"><u>· Atenolol</u></span><br />
<span style="font-family: cambria, serif;"><u>· Metoprolol</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>9. Branches of the Brachial Plexus (In order from most lateral to most medial)</u></span><br />
<span style="font-family: cambria, serif;"><u>My Aunt Raped My Uncle</u></span><br />
<span style="font-family: cambria, serif;"><u>Musculocutaneous, Axillary, Radial, Median, Ulnar</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>10. Bronchopulmonary segments of right lung</u></span><br />
<span style="font-family: cambria, serif;"><u>"A PALM Seed Makes Another Little Palm":</u></span><br />
<span style="font-family: cambria, serif;"><u>• In order from superior to inferior:</u></span><br />
<span style="font-family: cambria, serif;"><u>1. Apical</u></span><br />
<span style="font-family: cambria, serif;"><u>2. Posterior</u></span><br />
<span style="font-family: cambria, serif;"><u>3. Anterior</u></span><br />
<span style="font-family: cambria, serif;"><u>4. Lateral</u></span><br />
<span style="font-family: cambria, serif;"><u>5. Medial</u></span><br />
<span style="font-family: cambria, serif;"><u>6. Superior</u></span><br />
<span style="font-family: cambria, serif;"><u>7. Medial basal</u></span><br />
<span style="font-family: cambria, serif;"><u>8. Anterior basal</u></span><br />
<span style="font-family: cambria, serif;"><u>9. Lateral basal</u></span><br />
<span style="font-family: cambria, serif;"><u>10. Posterior basal</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>11. Prolactin and oxytocin: functions</u></span><br />
<span style="font-family: cambria, serif;"><u>PROlactin stimulates the mammary glands to PROduce milk.</u></span><br />
<span style="font-family: cambria, serif;"><u>Oxytocin stimulates the mammary glands to Ooze (release) milk.</u></span><br />
<span style="font-family: cambria, serif;"><u>12. Radial n. innervates the BEST!!!!</u></span><br />
<span style="font-family: cambria, serif;"><u>Brachioradialis</u></span><br />
<span style="font-family: cambria, serif;"><u>Extensors</u></span><br />
<span style="font-family: cambria, serif;"><u>Supinator</u></span><br />
<span style="font-family: cambria, serif;"><u>Triceps</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>13. RNA viruses: negative stranded</u></span><br />
<span style="font-family: cambria, serif;"><u>"Always Bring Polymerase Or Fail Replication":</u></span><br />
<span style="font-family: cambria, serif;"><u>Arena</u></span><br />
<span style="font-family: cambria, serif;"><u>Bunya</u></span><br />
<span style="font-family: cambria, serif;"><u>Paramyxo</u></span><br />
<span style="font-family: cambria, serif;"><u>Orthomyxo</u></span><br />
<span style="font-family: cambria, serif;"><u>Filo</u></span><br />
<span style="font-family: cambria, serif;"><u>Rhabdo</u></span><br />
<span style="font-family: cambria, serif;"><u>• Note: Negative RNA viruses need there own polymerase.</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>14. WBC Count: "Never Let Mom Eat Beans" and "60, 30, 6, 3, 1"</u></span><br />
<span style="font-family: cambria, serif;"><u>Neutrophils 60%</u></span><br />
<span style="font-family: cambria, serif;"><u>Lymphocytes 30%</u></span><br />
<span style="font-family: cambria, serif;"><u>Monocytes 6%</u></span><br />
<span style="font-family: cambria, serif;"><u>Eosinophils 3%</u></span><br />
<span style="font-family: cambria, serif;"><u>Basophils 1:</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>15. Weights of children with age</u></span><br />
<span style="font-family: cambria, serif;"><u>Newborn 3 kg</u></span><br />
<span style="font-family: cambria, serif;"><u>6 mos 6 kg (2x birth wt at 6 mos)</u></span><br />
<span style="font-family: cambria, serif;"><u>1 yr 10 kg (3x birth wt at 1 yr)</u></span><br />
<span style="font-family: cambria, serif;"><u>3 yrs 15 kg (odd yrs, add 5 kg until 11 yrs)</u></span><br />
<span style="font-family: cambria, serif;"><u>5 yrs 20 kg</u></span><br />
<span style="font-family: cambria, serif;"><u>7 yrs 25 kg</u></span><br />
<span style="font-family: cambria, serif;"><u>9 yrs 30 kg</u></span><br />
<span style="font-family: cambria, serif;"><u>11 yrs 35 kg (add 10 kg thereafter)</u></span><br />
<span style="font-family: cambria, serif;"><u>13 yrs 45 kg</u></span><br />
<span style="font-family: cambria, serif;"><u>15 yrs 55 kg</u></span><br />
<span style="font-family: cambria, serif;"><u>17 yrs 65 kg</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>ABC'S of the aortic arch!</u></span><br />
<span style="font-family: cambria, serif;"><u>Aortic arch gives off the</u></span><br />
<span style="font-family: cambria, serif;"><u>Bracheiocephalic trunk,</u></span><br />
<span style="font-family: cambria, serif;"><u>left Common Carotid,</u></span><br />
<span style="font-family: cambria, serif;"><u>left Subclavian artery</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>Branches Of External Carotid Artery</u></span><br />
<span style="font-family: cambria, serif;"><u>Sneh Lta's Powdered Face Often Attracts Medical Students.</u></span><br />
<span style="font-family: cambria, serif;"><u>S= Superior Thyroid</u></span><br />
<span style="font-family: cambria, serif;"><u>L= Lingual</u></span><br />
<span style="font-family: cambria, serif;"><u>P= Posterior Auricular</u></span><br />
<span style="font-family: cambria, serif;"><u>F= Facial</u></span><br />
<span style="font-family: cambria, serif;"><u>O= Occipital</u></span><br />
<span style="font-family: cambria, serif;"><u>A= Ascending Pharyngeal</u></span><br />
<span style="font-family: cambria, serif;"><u>M= Maxillary</u></span><br />
<span style="font-family: cambria, serif;"><u>S= Superficial Temporal</u></span><br />
<span style="font-family: cambria, serif;"><u><br /></u></span>
<span style="font-family: cambria, serif;"><u>BRANCHES OF SUBCLAVIAN ARTERY ARE 5</u></span><br />
<span style="font-family: cambria, serif;"><u>VIT. C&D (Read as Vitamin C & D)</u></span><br />
<span style="font-family: cambria, serif;"><u>V = Vertebral artery</u></span><br />
<span style="font-family: cambria, serif;"><u>I = Internal Thoracic artery</u></span><br />
<span style="font-family: cambria, serif;"><u>T = Thyrocervical Trunk</u></span><br />
<span style="font-family: cambria, serif;"><u>C = Costocervical trunk ( from first br of left subclavian a. but arises from 2 branch of right side)</u></span><br />
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">D= Dorsal scapular artery (branch of third part)</u></span><br />
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;"><br /></u></span>
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;"><br /></u></span>
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Muscle Physiology</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Muscle form 40 to 50% of body mass.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•About 600 muscles are identified.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Classification of Muscles:</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Depending on striations: Striated(Skeletal & Cardiac) & Nonstriated(smooth)</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Depending on Control: voluntary(Skeletal) & Involuntary(Cardiac & smooth)</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Depending on situation: Skeletal, Cardiac & Smooth.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Muscle fiber or cell has a length b/w 1 – 4cm (Average 3cm) & diameter from 10 – 100microns.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•1 myofibril contains 1500 myosin filaments & 3000 actin filaments</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Sarcomere is the structural & functional unit of skeletal muscle.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Length – 2.5 to 3.2 mm.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Sarcomere lies b/w two ‘Z’ lines</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Each myofibril consists of alternate light (I or J band) & dark band (A or Q band).</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Each sarcomere consist of thin (Actin) & thick (myosin) filaments.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Myosin filament is present throughout the ‘A’ band.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">No movement of myosin during muscular contraction.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Actin filaments are formed by 3 types of proteins called actin, tropomyosin & troponin.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•The skeletal muscle is formed by 75% of water, 20% of proteins & 5%of organic substances.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Troponin: is formed by 3 subunits; Troponin I – attached to F actin; Troponin T – attached to tropomyosin; Troponin C – attached to calcium ions.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Following are the muscle proteins; Myosin; Actin; Tropomyosin; Troponin; Actinin; Titin; Desmin; Myogen & Myoglobulin.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•There is no movement in the myosin filament during muscle contraction.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Actin filaments slide over the myosin filament during muscle contraction.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Tropomyosin covers the active sites of actin.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Rheobase: this is the least possible, i.e. (minimum) strength (Voltage) of stimulus which can excite the tissue.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Chronaxie: it is the minimum time, at which a stimulus with double the rheobasic strength (voltage) can excite the tissue.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Chronaxie of skeletal muscle is shorter than that of cardiac and smooth muscles.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Cold lengthens chronaxie. whereas vagal stimulation shortens chronaxie.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Refractory period is the period at which the muscle does not show any response to a stimulus.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Skeletal muscles are purely aerobic & don’t have any fuel reserve.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•Dark, light bands & troponin are absent in smooth muscle.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•The study of electrical activity of the muscle is done by electromyography.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">•The muscle ruptures when it is stretched to about 3 times its equilibrium length.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Constrictions in oesophagus :</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">· at commencement 15 cm from incisor teeth.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">· at crossing over by aortic arch 22.5 cm from incisor teeth.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">· at crossing over by left principal bronchus 27.5 cm from incisor teeth.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">· at its point of piercing diaphragm 40 cm from incisor teeth.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Stomach :</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">· Cardiac orifice — Behind left 7th costal cartilage 1" from its junction with sternum.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">· Pyloric orifice — 1.2 cm (0.5") to the right of midline on transpyloric plane.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">· Capacity — at birth 30 ml; adults 1500 ml.</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Length of small intestine: 6 to7 metres</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Length of duodenum: 10” or 25 cm</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">1 st part: 5 cm</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">2nd part: 7.5 cm</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">3rd part: 10 cm</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">4th part: 2.5 cm</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Length of large gut: 1.5 metres</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Anal canal</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Hilum of kidney — Transpyloric plane (LI).</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Kidney:Length: 11 cm, Breadth : 6 cm, Antero-posterior diameter: 3 cm</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Length of Ureter : 25 cm</u></span></div>
<div style="font-weight: bold;">
<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Length of male urethra: 18-20 cm</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Spermatic cord : 9-10 cm</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Length of inguinal canal: 4 cm</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Testis: Length-4.5 cm, Breadth-2.5cm, Anteroposterior dr-3</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Ovary: Length -3 cm, Width-1.5 cm,Thickness-1 cm</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Uterus: Length-7.5 cm, Breadth-5 cm,Antero-posterior diameter-2.5 cm</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Weight :30 to 40 gms</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Uterine tubes: Length-10 cm</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Saphenous opening — Height 1.5 to 8 cm; Width 1 to 3 cm</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Femoral sheath — Length 3 to 4 cm.</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Femoral canal — Length 1.25 cm.</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">Tendo calcaneus — Length 15 cm.</u></span></div>
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<span style="font-family: "cambria" , serif;"><u style="font-weight: normal;">THANKS FOR READING MY BLOG &; BEST OF LUCK TO ALL ...</u></span></div>
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Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-16285657638727950902008-08-31T02:27:00.001-07:002016-08-30T10:24:50.585-07:00Basic books<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="color: #000066;">Basic books: -<br />All India Pevious years' solved papers by Mudit Khanna - AIIMS solved papers by Amit and Ashish - Tehalaka by Dr. Rajesh Prasad (it contains solved mcqs of anatomy, physiology, biochemistry and forensic medicine)...Must read book according to me - Sure Success By Ramgopal - Chauthary For PGI (not that useful for all india) </span><br />
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<span style="color: #000066;">These are the basic mcq books that should be done thoroughly. If u done with them, than you can do salgunan. In my opinion, this book is not necessary for all india. atleast i didnt read it Regardless of what i write here, you must follow your own plan according to your strengths and weaknesses. Spend more time on the subjects in which you are weak. This is the kkey to success. You have to identify which subjects made you suffer during your profs or during your previous attempt(s). Its always a good idea to finish them first. You can follow any order in doing subjects as u like. Try to finish all subjects atleast2-3 months beforte the main exam so that you can have adequate time to give the revisions. For each subject, you have to do the previous years' questions(AIIMS and All India), corresponding theory book and Ramgopal sure success. I also would recommend to keep Harrison alongside as a referance while doing any subject. It will always come handy. I also recommend you to take a small notebook and start taking notes of difficult to remember points, some important flow charts and tables. These come really handy for last day revision before the exam. You have to make sure that you don get too carried away with writing more and more as it will just waste your time and you may not be able to revise the whole things in one day before the exam. You ma do it subjectwise (if u have the patience)...or you can just write the points randomly (just like me). </span><br />
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<span style="color: #000066;"><strong>Anatomy:</strong> </span><br />
<span style="color: #000066;">This is the subject i never did all through my preparation! Indeed it seems too much for an effort to read through all volumes of chaurasiya and still not able to solve the mcqs. Recommended Books: Chaurasiya (all 3 volumes), Sure success by Ramgopal(big book), Tehalaka by Dr. Rajesh Prasad(for mcqs) if u ae short on time, i would suggest to read the anatomy pages from ramgopal's book and do mcqs from tehalaka...this way you should be able to answer more than half the questions from anatomy, which according to my opinion is quite good. you should concentrate on nerve injuries, nerve entrapment syndromes, muscles nerve supply and actions(especially upper limb), various type of joints(asked many times!), various fossa and there contents and cranial nerves. anyway one should not be spending too much of time on anatomy as itsa low yielding subject. </span><br />
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<span style="color: #000066;"><strong>Physiology:</strong></span><br />
<span style="color: #000066;"> Recommended books: Ganong (very good book), Guyton (only for referance), Tehalaka. Here tehalaka comes in very handy. if you read all the mcqs with explaination from this, you would be able to solve majority of the common questions from physiology. supplement it with ganong with selected reading with special emphasis on general physiology topics Biochemistry: Recommonded books: Harper, Tehalaka, lippincott (as an alternative) lot of people will say that lippincott is very good, but i never found it that good. I would recommend reading Harper. The newer editions of Harper have been progressively trimmed, so it should not take more that 10 days to read on the first go. Topics that should be stressed are genetics(obviously!), chapters at the beginning(like enzymes, amino acids and some general chapters), regarding metabolism, it would certainly help, if you take notes of some important points on a note book for quick revision before exam. It will certainly help.. Tehalaka is nice for revising the facts quickly </span><br />
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<span style="color: #000066;"><strong>Forensic Medicine:</strong> </span><br />
<span style="color: #000066;">Recommended books: Pareikh, Tehalaka, forensic SARP Here again Tehalaka comes in very handy. you can solve most of the mcqs from this book. Also forensic SARP is not bad at all for poisonings (especially do lead, mercuary, arsenic and others commonly asked). I would suggest you to make small notes of important features of common poisonings for quick revision later on. From Pareikh, do only selected reading. Always spend some time on ballistics...they need to be understood properly to solve the related mcqs. </span><br />
<span style="color: #000066;"><br /><strong>Pathology:</strong><br />Recommended books: Robbins(big) This is the only book thats needed...and of course, i am not including harrison, because i persume that you keep it alongside for referance while doning any subject. This in my opinion is the most important subject(even more than medicine, surgery). If u have good grasp of pathology, it would certainly go a long way to improve your chances in PG exams. I recommend you to read this book thoroughly with more emphasis on blood, GIT, kidney and general pathology...things that you can probably skip or do selectively are: CNS, Musculoskeletal system and other chapters towards the end of the book. I you have read this book during your prof, it would certainly help.</span><br />
<span style="color: #000066;"><br /><strong>Pharmacology:</strong> </span><br />
<span style="color: #000066;">Recommended books: Tripathi, Katzung (Referance), Goodman & Gilman (only for referance, not at all essential!), Tumors SARP Agian this is a very important and productive subject. In tripathi, more stress should be on ANS and CVS. Tumors SARP is also quite good...just to be read selectively</span><br />
<span style="color: #000066;"><br /><strong>Microbiology:</strong> </span><br />
<span style="color: #000066;">Recommended books: Ananthnarayan(very good book), jawetz(review), chatterjee(parsitology), SARP microbiology Jawetz (review, not the text book) i recommend for reading the immunology part. it will help you understand the basics of immunology in a very easy manner. For rest, Ananthnarayan is good enough...special emphasis should be on general microbiology. Virology can be done selectively like doing common ones like hepatitis, rabies, AIDS, rota virus, polio and from parts you see the questions...never forget to do general virology. Bacteriology has be done thoroughly in my view. For mycology, ananthnarayan is good. you may also look at SARP for mycology. For parasitology, although chatterjee is the recommended book but it consumes much of time..i would suggest just reading it from jawetz and doing mcqs. that should be enough for only 1-2 quesions are asked from parasitology. </span><br />
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<span style="color: #000066;"><strong>SPM:</strong> </span><br />
<span style="color: #000066;">Recommended books: Park (what else!), High yield biostats by tyagi or Mahajan SPM is the subject thats often said to decide matters. If prepared properly, it can be quite scoring subject as well ...as hardly anything is asked outside Park. Important topics are first 116 (or something like that) pages. I mean up to the chapter about screening. Learn all the concepts properly. this will help you solve more than half the mcqs of SPM. Diseases should be done selectively. Do the more important diseases like tuberculosis, polio, leprosy, rabies, AIDS, syphilis, respiratory infections, rickettsial diseases, dengue, yellow fever(who cares it doesn’t occur in India!), diptheria and as you see the questions. From the remaining chapters, you should do environment and health chapter, contraceptives, health and nutrition and disease control programmes, health goals and about the health workers and their population allocations....rest can be done selectively. Biostats you can do from high yield biostats. Its quite good. and you can do it in just one day. Nowadays some questions may even be out of that book. Ypu can also do Mahajan for biostats. Its better but consumes more time </span><br />
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<span style="color: #000066;"><strong>Eye:</strong> </span><br />
<span style="color: #000066;">Recommended books: Khurana, kaski (referance), parson(referance) Khurana will do for most of the questions. for some really hard questions, kanski comes in handy . important topics are... Cataracts, ocular injuries, uveitis, corneal ulcer, refractive errors, tumors(retinoblastoma, melanoma), retinitis pigmentosa, optic atrophy, papiloedema, chalazion. </span><br />
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<span style="color: #000066;"><strong>ENT:</strong> </span><br />
<span style="color: #000066;">Recommended books: Dhingra Nothing much to say. Dhingra will do for most of the questions. read selectively. more impotant topics acoustic neuroma, facial nerve course and palsy, otosclerosis, CSOM and its complications, layrngeal polps, nodules and cancer, DNS, sinusitis, epistaxis, abscess in reation to pharynx, tonsils. </span><br />
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<span style="color: #000066;"><strong>Paediatrics:</strong> </span><br />
<span style="color: #000066;">Recommended books: Ghai, Nelson(referance) Sometimes questions seem to be set from nelson and ghai seems to be insufficient. while thats true, but thats not a reason to read nelson. you cant gain much by reading nelson(its too huge a book). rather reading some selected topics may be useful. In Ghai, more stress should be on nenatology part, also CVS in quite good. also dont forget metabolic diseases and genetic diseases. Use nelson for refreance purpose as and when required. If u can spare some time, try to read the kidney part..that is cysts, dysplasias and vesicoureteric reflux. </span><br />
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<span style="color: #000066;"><strong>Gynae and Obs:</strong> </span><br />
<span style="color: #000066;">Recommended books: Shaw(Gynae) and Dutta(Obs.) Both very good books. in gynae, more stress should be on oncology, endometriosis, menstural disorders, infertility, fibroids. In Obs., do all the tables and flow charts. that makes it very easy to understand and most of the questions can be solved quite easily. And dont forget chapter of population dynamics and birth control. </span><br />
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<span style="color: #000066;"><strong>Surgery:</strong> </span><br />
<span style="color: #000066;">Recommended books: Bailey & Love, Sabiston pretest, Schwartz (reference) Bailey has to be done selectively according to the topics from which mcqs appear. More stress should be on GIT and genitourinary system. Schwartz can be useful for referance especially in GIT </span><br />
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<span style="color: #000066;"><strong>Medicine:</strong> </span><br />
<span style="color: #000066;">Recommended books: HARRISON or CMDT(depending upon what u have already read), Harrison pretest, Medicine self assessment guide by Amit Ashish Both books are good. Do the one that you have read during your profs. If u read Davidson during profs, i would suggest to do important topics from CMDT and less important topics from Davidson. As for Harrison, if u have read during your profs, it would certainly give you an edge. </span><br />
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<span style="color: #000066;">Some high yielding topics in Harrison are: CVS, Kidney(especially glomerulonephritis, renal failure), acid base imbalance, Hematology, Genetics, Viral Hepatitis. </span><br />
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<span style="color: #000066;">Important thing is not to get lost in reading medicine alone. Its huge subject and will never finish. So do selectively. Keep more stress on previous years' papers and the topics asked there. Medicine self assessment guide by Amit Ashish come handy for reading selectively from Harrison in retrograde manner </span><br />
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<span style="color: #000066;"><strong>Skin:</strong> </span><br />
<span style="color: #000066;">Harrison, Sure Success Ramgopal, Roxberg (referance) Harisson and previous years, mcqs will do for most of the questions. Do it from sure success(ramgopal) also. Roxberg has to be used for referance as and when needed. Anaesthesia: Sure Success Ramgopal, Lee(referance), Yadav Nothing much to say. Mainly concentrate on previous years, questions. Yadav is said to be very good. But personally I never read it. </span><br />
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<span style="color: #000066;"><strong>Ortho:</strong> </span><br />
<span style="color: #000066;">maheshwari This is the only book you should do. even though these days some questions are asked which have referances from PG level books. You are not expected to answer that. Remember you don’t need to score 100%. A score of around 65% actually will give you a very good rank </span><br />
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<span style="color: #000066;"><strong>Psychiatry:</strong> </span><br />
<span style="color: #000066;">Sure Success Ramgopal, Ahuja, High yield psychiatry. Concentrate on schezophrenia, mood disorders, substance abuse, sleep cycle and disorders, autistc disorder Radiology : No books needed here in my opinion. Just do previous years, mcqs and also do from Sure Success Ramgopal. </span><br />
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<span style="color: #000066;"><em>Time to spend on each subject: It depends upon how strong(or weak) you are in a particular subject. also you have to spend less time on subjects from which less questions area asked. anyway, i will try to give a rough idea...</em><br /><strong><span style="font-family: "times new roman";">Anatomy-3days(will mainly do questions from Tehalka)<br />Physio- 5 days Biochemistry-10days<br />Forensic- 2days Patho- 30days P<br />harma- 10days Micro- 10days Eye-7days<br />ENT- 5days<br />SPM- 20days<br />Gynae & Obs.- 20days<br />Medicine-30days<br />Surgery-20days Paeds- 7 days<br />SARP- 5 days<br />Ortho- 5days</span></strong>This roughly comes out to be a little more than 6months.<br />You may take some more or some less time depending upon your level of preparation. Its very important not to get stuck at one subject for too long.</span><span style="color: red; font-size: 180%;"><strong>Best of luck all of you my friends</strong></span></div>
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Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com5tag:blogger.com,1999:blog-2217647826950966921.post-74279875603102824702009-02-21T02:55:00.000-08:002009-02-22T04:46:19.049-08:00some factsCoronary artery disease is the single largest cause of morbidity amongst all diseases so much so that it has been classified as having reached pandemic proportions by none less than the WHO (World Health Organisation).<br /><a href="http://fmge.co.cc/">http://fmge.co.cc</a><br />Over 7,0000,000 Indians have heart related diseases<br />1 in 3 adults, both men and women, has some form of cardiovascular disease.<br />In 90% of adult victims of sudden cardiac death, two or more major coronary arteries are narrowed or blocked.<br /><a href="http://fmge.co.cc/">http://fmge.co.cc</a><br />Brain death and permanent death start to occur in just 4-6 minutes after someone experiences cardiac arrest.<br />It is in the early or initial stage that the heart disease is almost certainly treatable.<br />The heart and brain muscles are the ones which cannot be revived once dead.<br />The cardiac 64 CT scan provides 3D images of the heart so detailed that the heart disease can be detected at a very early stage.<br /><a href="http://fmge.co.cc/">http://fmge.co.cc</a><br /><br /><div class="post-body entry-content"> Mnemonics -Easy way to remember difficult things<br />Hai guys<br />here i am giving you some Mnemonics they are sub wise use them they really help<br />if you find them useful let me know pls<br /><br /><br />Anatomy Mnemonics<br />Bones of the Wrist<br />Some Lovers Try Positions That They Cannot Handle Branches of the Brachial Plexus (In order from most lateral to most medial)<br />My Aunt Raped My Uncle<br /><br />Musculocutaneous, Axillary, Radial, Median, Ulnar<br /><br />Slowly Lower Tilly's Pants To The Curly Hairs<br /><br />Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate<br /><br />Brachial Plexus<br />Randy Travis Drinks Cold Beers Robert Taylor Drinks Cold Beer<br /><br />Roots, Trunks, Divisions, Cords, Branches<br /><br />Branches of the Brachial Plexus (In order from most lateral to most medial)<br />My Aunt Raped My Uncle<br /><br />Musculocutaneous, Axillary, Radial, Median, Ulnar<br /><br />Extraocularmotor muscles<br />LR6 (SO4) LR6: Lateral rectus --> VI abductens<br />SO4: Superior Oblique --> IV Trochlear<br />All other extraocularmotor muscles are CN III<br /><br />Branches of the Facial Nerve<br />Ten Zebras Bought My Car<br /><br />Temporal, Zygomatic, Buccal, Masseteric, Cervical<br /><br />Innervation of phrenic nerve<br />c345 keeps the phrenic alive<br />c345 keep the diaphragm alive<br /><br /><br />Long thoracic nerve innervates serratus anterior<br />c5-6-7 raise your arms to heaven<br /><br /><br />Relationship of Thorasic duct to Esophagous and Azygous<br />The duck is between two gooses.<br />duck = thoracic duct 2 gooses = azyGOUS and esophaGOUS<br /><br /><br />Attachments of Pectoralis Major, Teres Major and Latissimus Drosi<br />A lady between tow majors.<br />Pectoralis major attaches to lateral lip of bicipital groove, the teres major attaches to medial lip of bicipital groove, and the latissimus dorsi attaches to the floor of bicipital groove. The "lati" is between two "majors."<br /><br /><br />Innervation of the Penis<br />Parasympathetic puts it up; sympathetic spurts it out.<br />Point Shoot Score<br />Parasympathetic, sympathetic, somatomotor<br /><br /><br />Lateral and Medial Pectoral Nerve<br />Lateral is less, medial is more.<br />Lateral pectoral nerves goes through pectoralis major while medial pn goes though both pectoral major and minor.<br /><br />Dentition: eruption times of permanent dentition<br />"Mama Is In Pain, Papa Can Make Medicine":<br />1st Molar: 6 years<br />1st Incisor: 7 years<br />2nd Incisor: 8 years<br />1st Premolar: 9 years<br />2nd Premolar: 10 years<br />Canine: 11 years<br />2nd Molar: 12 years<br />3rd Molar: 18-25 years<br /><br /><br />Layers of the epidermis<br />Grand son grate living Child.<br />Brent Spiner Gained Lieutenant Commander<br />Germinativum or Basale, Spinosum, Granulosum, Lucidum, Corneum<br /><br /><br /><br />Tarsal bones<br />"Tall Californian Navy Medcial Interns Lay Cuties":<br />• In order (right foot, superior to inferior, medial to lateral): Talus Calcanous Navicular Medial cuneiform Intermediate cuneiform Lateral cuneifrom Cuboid<br /><br />Bronchopulmonary segments of right lung<br />"A PALM Seed Makes Another Little Palm":<br />• In order from superior to inferior: Apical Posterior Anterior Lateral Medial Superior Medial basal Anterior basal Lateral basal Posterior basal<br /><br />Head & Neck<br />CRANIAL NERVES: I-Optic, II-Olfactory, III-Oculomotor, IV-Trochlear, V-Trigeminal, VI-Abducens, VII-Facial, VIII-Acoustic (Vestibulocochlear), IX-Glossophrayngeal, X-Vagus, XI-Spinal Accessory, XII-Hypoglossal<br />On Old Olympus Towering Tops, A Finn And German Viewed Some Hops (older and cleaner)<br />Oh Oh Oh To Touch And Feel A Girls Vagina And Hymen (newer and, well ...)<br /><br />Which cranial nerve is Sensory, Motor, or Both- Some Say Marry Money, But My Brother Says Big Breasts Matter More<br /><br />BRANCHES OF FACIAL NERVE: Temporal, Zygomatic, Buccal, Mandibular, Cervical<br />Ten Zebras Beat My Cock<br />Two Zulus buggered my cat –(for the sicker, amongst you!)<br /><br />You have I nose. You have II eyes. (I - Olfactory; II -- Optic)<br /><br />Exit of branches of trigeminal nerve from the skull S<br />Standing Room Only -<br />V1 -Superior orbital fissure, V2 -foramen Rotundum, V3 -foramen Ovale<br /><br /><br /><br />For the order of nerves that pass through the superior orbital fissure:<br />"Lazy French Tarts Lie Naked in Anticipation."<br />(Lacrimal, Frontal, Trochlear, Lateral, Nosociliary, Internal,<br />Abducens)<br /><br />2 Muscle of mastication- Lateral Lowers- lateral pterygoid is the one that opens the jaw<br />4 Muscles of Mastication MTPP( which could be read as "Empty Peepee") -masseter, temporal, lateral and medial pterygoids --<br /><br /><br />Arteries as they come off the external carotid:<br />Some Angry Lady Figured out PMS<br />Superior thyroid, Ascending pharyngeal, Lingual, Facial, Occipital, Post Auricular, Superficial temporal, Maxillary<br /><br />Innervation of Extraocular motor Muscles: LR6 SO4 3<br />LR6--Lateral rectus--> VI abductens<br />SO4--Superior Oblique--> IV Trochlear<br />3--The remaining 4 eyeball movers = III Oculomotor<br /><br />ABC'S of the aortic arch!<br />Aortic arch gives off the Bracheiocephalic trunk,<br />the left Common Carotid, and the left<br />Subclavian artery<br /><br />BRACHIAL PLEXUS: Roots, Trunks, Divisions, Cords, Branches<br />Robert Taylor Drinks Cold Beer.<br /><br />CERVICAL SPINAL NERVES:<br />c345 keeps the phrenic alive (innervation of phrenic nerve) c345 keep the diaphragm alive (innervation of diaphragm)<br />c5-6-7 raise your arms to heaven (nerve roots of long thoracic nerve innervate serratus anterior)<br /><br /><br />Cranial Bones<br />Annoying, aren't they?<br />The cranial bones are the PEST OF 6...<br /><br />Parietal, Ethmoid,Sphenoid,Temporal,Occipital,Frontal- 6 ? (6-the number of bones!)<br />( another one) Old People From Texas Eat Spiders.<br /><br /><br />LOCATION OF THORACIC DUCT: The duck is between two gooses (duck = thoracic duct) 2 gooses = azyGOUS and esophaGOUS<br /><br /><br />Cartilages of the Larynx - There are 4 cartilages in the larynx whose initial letters are TEAC (also the brandname of a home stereo).<br />Thyroid, Epiglottis, Arytenoid, Cricoid<br /><br /><br />Abdomen-Pelvis<br /><br />INNERVATION OF PENIS:<br />Parasympathetic puts it up; sympathetic spurts it out<br />Point , Shoot, Score! (erection, emmision ,ejaculation) Parasympathetic, Sympathetic , Somatomotor<br />"S2, 3, 4 keep the penis off the floor" Innervation of the penis by branches of the pudental nerve, derived from spinal cord levels S2-4<br /><br />Structures perforating the esophagus<br />"At T8 you see, perforates the IVC" (inferior Vena Cava)<br />the "EsoVagus" pierce T10 (esophagus, vagus nerve)<br />T12 - red, white and blue (aorta,thoracic duct,azygous vein)<br /><br />Femoral Sheath (lateral to medial) order of things in thigh -NAVEL<br />Nerve, Artery, Vein, Empty, Space, Lymphatics<br /><br />Radial n. innervates the BEST!!!!<br />Brachioradialis<br />Extensors<br />Supinator<br />Triceps<br /><br />Course of Ureters<br />Water runs under the bridge (uterine a. and ductus deferens)<br /><br />Carotid Sheath-- VAN<br />Internal Jugular Vein<br />Common carotid Artery<br />Vagus Nerve<br /><br />Dermatomes<br />C3 is a high turtleneck shirt<br />T4 is at the nipple<br />L1 is at the inguinal ligament (or L1 is IL -Inguinal ligament)<br />Randy Travis Drinks Cold Beer--Brachial plexus<br />Robert Taylor Drinks Cold Beer<br />Roots, Trunks, Divisions, Cords, Branches<br /><br />Bones of the wrist -Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium,<br />Trapezoid, Capitate, Hamate<br /><br />1. Slowly Lower Tilly's Pants To The Curly Hairs<br />2. Swifty Lower Tilly's Pants to try coitus here. (the risque version)<br />3.Scared Lovers Try Positions That They Can't Handle. (Classic version)<br /><br /><br />Pelvic Diaphragm<br />PICOLO(A) -Posterior to anterior<br />PIriformis<br />COccygeus<br />Levator Ani<br /><br /><br />Pelvic Splanchic-Parasympathetic<br />Sacral Splanchic-Sympathetic<br /><br /><br />Armies travel over bridges, the Navy travels under.<br />(Bridge is the ligament...reference to suprascapular artery and nerve.)<br /><br /><br />Pad, dab. Dorsal ABduct...Palmar ADduct...interosseous muscles of hand/foot.<br /><br /><br />Layers of the epidermis-Germinativum or Basale, Spinosum, Granulosum, Lucidum, Corneum<br /><br />Grandpa Shagging Grandma's Love Child.<br /><br />Limbic System- the 5 F’s- Feeding, Fighting, Feeling, Flight and making babiesing<br /><br /><br /><br />The 5 sphincters found in the Alimentary Canal are APE OIL:<br />Anal, Pyloric, Lower Esophogeal, Oddi, and Ileocecum.<br /><br /><br />The branches of the Axillary Artery are: Sally Thompson Loves Sex And Pot pie.<br />Superior Thoracic, Thoracoacromial, Lateral Thoracic, Subscapular, Anterior Circumflex Humeral, Posterior Circumflex Humeral, and Profunda Brachii.<br /><br /><br /><br />TIRE- four abdominal muscles -- transversus, internal oblique, rectus abdominus, and external oblique<br /><br />Anesthesia Mnemonics<br /><br /><br /><br />Spinal anesthesia agents<br />"Little Boys Prefer Toys":<br />Lidocaine<br />Bupivicaine<br />Procaine<br />Tetracaine<br /><br /><br /><br />Xylocaine: where not to use with epinephrine<br />"Nose, Hose, Fingers and Toes"<br />• Vasoconstrictive effects of xylocaine with epinephrine are helpful in providing hemostasis while suturing. However, may cause local ischemic necrosis in distal structures such as the digits, tip of nose, penis, ears.<br /><br /><br /><br />General anaesthesia: equipment check prior to inducing<br />MALES:<br />Masks<br />Airways<br />Laryngoscopes<br />Endotracheal tubes<br />Suction/ Stylette, bougie<br /><br /><br /><br />Endotracheal intubation: diagnosis of poor bilateral breath sounds after intubation<br />DOPE:<br />Displaced (usually right mainstem, pyreform fossa, etc.)<br />Obstruction (kinked or bitten tube, mucuous plug, etc.)<br />Pneumothorax (collapsed lung)<br />Esophagus<br /><br /><br /><br />Anesthesia machine/room check<br />MS MAID:<br />Monitors (EKG, SpO2, EtCO2, etc)<br />Suction<br />Machine check (according to ASA guidelines)<br />Airway equipment (ETT, laryngoscope, oral/nasal airway)<br />IV equipment<br />Drugs (emergency, inductions, NMBs, etc)<br /><br /><br /><br />Anesthesia: quick check<br />SOAP:<br />Suction<br />Oxygen<br />Airway<br />Pharmacology<br /><br /><br />Anesthetics equipment check<br />MISMADE:<br />Machine check<br />IV supplies<br />Suction<br />Monitors<br />Airways<br />Drugs<br />Equipment<br /><br /><br /><br />Failed intubation: causes<br />INTUBATION:<br />Infections of larynx<br />Neck mobility abnormalities<br />Teeth abnormalites (eg poor dentifom, loose and protuberant teeth)<br />Upper airway abnormalities, strictures, or swellings<br />Bullsneck deformities<br />Ankylosing spondylitis<br />Trauma/ TumourInexperienceOedema of upper airwayNarrowing of lower airway<br /><br /><br /><br />Respiratory complications of anaesthesia: patients at risk<br />COUPLES:<br />COPD<br />Obese<br />Upper abdominal surgery<br />Prolonged bed rest<br />Long surgery<br />Elderly<br />Smokers<br />Biochemistry Mnemonics<br /><br />Essential Amino Acids<br />PriVaTe TIM HALL<br />Phe, Val, Thr, Trp, Ile, Met, His, Arg, Leu, Lys<br /><br /><br />Urea Cycle<br />Ordinarily, Careless Crappers, Are Also Frivolous About Urination.<br />Ornithine, Carbamoyl, Citrulline, Arginosuccinate, Aspartate, Fumarate, Arginine, Urea.<br /><br /><br />Cell division<br />Prophase, metaphase, anaphase, telophase.<br />"People Meet And Talk."<br /><br /><br />In the Phasted State<br />Phosphorylate Phosphorylation cascade active when blood glucose low.<br />DNA expression into mature mRNA<br />Exons expressed, Introns in the trash.<br />Pyrimidines are CUT from purines.<br />Pyrimidines are Cytosine, Uracil, Thiamine and are one ring structures.<br />Purines are double ring structures.<br /><br />Amino Acids:The ten essential amino acids:<br />"These Ten Valuable Amino Acids Have Long Preserved Life In<br />Man."<br />(Threonine, Tryptophan, Valine, Arginine, Histidine, Lysine,<br />Phenylalanine, Leucine, Isoleucine, Methionine)<br /><br /><br /><br />GOAT FLAP- Eight hormones: Growth hormone, Oxytocin, Adenocorticotropin, Thyroid stimulating hormone, Follicle stimulating hormone, Leutinizing hormone (interstitial cell stimulating hormone in males), Anti-diruetic(Vasopressin), and Prolactin<br />(shhhh.... also Melatonin!)<br /> </div>Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com2tag:blogger.com,1999:blog-2217647826950966921.post-20119463031433669452009-01-16T07:51:00.000-08:002009-01-16T08:07:40.799-08:00Most Common's in medical science<a href="http://www.aippg.com/" target="_blank"></a>Most Common's in medical science<br />1° Tumor arising from bone in adults<br />· Multiple Myeloma<br />Adrenal Medullary Tumor – Adults<br />· Pheochromocytoma<br />Adrenal Medullary Tumor – Children<br />· Neuroblastoma<br />Bacterial Meningitis – adults<br />· Neisseria meningitidis<br />Bacterial Meningitis – elderly<br />· Strep pneumoniae<br />Bacterial Meningitis – newborns<br />· E. coli<br />Bacterial Meningitis – toddlers<br />· Hib<br />Bone Tumors<br />· Metasteses from Breast & Prostate<br />Brain Tumor – Child<br />· Medulloblastoma (cerebellum)<br />Brain Tumor –Adult<br />· Astrocytoma (including Glioblastoma Multiforme) then: mets, meningioma, Schwannoma<br />Breast Carcinoma<br />· Invasive Duct Carcinoma<br />Breast Mass<br />· Fibrocystic Change (Carcinoma is the most common is post-menopausal women)<br />Bug in Acute Endocarditis<br />· Staph aureus<br />Bug in debilitated, hospitalized pneumonia pt<br />· Klebsiella<br />Bug in Epiglottitis<br />· Hib<br />Bug in GI Tract<br />· Bacteroides (2nd – E. coli)<br />Bug in IV drug user bacteremia / pneumonia<br />· Staph aureus<br />Bug in PID<br />· N. Gonnorrhoeae<br />Bug in Subacute Endocarditis<br />· Strep Viridans<br />Cardiac 1° Tumor – Adults<br />· Myxoma “Ball Valve”<br />Cardiac 1° Tumor – Child<br />· Rhabdomyoma<br />Cardiac Tumor – Adults<br />· Metasteses<br />Cardiomyopathy<br />· Dilated (Congestive) Cardiomyopathy<br />Cause of 2° HTN<br />· Renal Disease<br />Cause of Addison’s<br />· Autoimmune (2nd – infection)<br />Cause of Congenital Adrenal Hyperplasia<br />· 21-Hydroxylase Deficiency (then, 11-)<br />Cause of Cushings<br />· Exogenous Steroid Therapy (then, 1° ­ ACTH, Adrenal Adenoma, Ectopic ACTH)<br />Cause of death in Alzheimer pts<br />· Pneumonia<br />Cause of death in Diabetics<br />· MI<br />Cause of Death in SLE pts.<br />· Lupus Nephropathy Type IV (Diffuse Proliferative)<br />Cause of Dementia<br />· Alzheimer’s<br />Cause of Dementia (2nd most common)<br />· Multi-Infarct Dementia<br />Cause of food poisoning<br />· Staph aureus<br />Cause of mental retardation<br />· Down’s<br />Cause of mental retardation (2nd most common)<br />· Fragile X<br />Cause of preventable blindness<br />· Chlamydia<br />Cause of Pulmonary HTN<br />· COPD<br />Cause of SIADH<br />· Small Cell Carcinoma of the Lung<br />Chromosomal disorder<br />· Down’s<br />Congenital cardiac anomaly<br />· VSD (membranous > muscular)<br />Congenital early cyanosis<br />· Tetralogy of Fallot<br />Coronary Artery thrombosis<br />· LAD<br />Demyelinating Disease<br />· Multiple Sclerosis<br />Dietary Deficiency<br />· Iron<br />Disseminated opportunistic infection in AIDS<br />· CMV (Pneumocystis carinii is most common overall)<br />Esophageal cancer<br />· SCCA<br />Fatal genetic defect in Caucasians<br />· Cystic Fibrosis<br />Female Tumor<br />· Leimyoma<br />Form of Amyloidosis<br />· Immunologic (Bence Jones protein in multiple myeloma is also called the Amyloid Light Chain)<br />Form of Tularemia<br />· Ulceroglandular<br />Gynecologic malignancy<br />· Endometrial Carcinoma<br />Heart Murmur<br />· Mitral Valve Prolapse<br />Heart Valve in bacterial endocarditis<br />· Mitral<br />Heart Valve in bacterial endocarditis in IV drug users<br />· Tricuspid<br />Heart Valve involved in Rheumatic Fever<br />· Mitral then Aortic<br />Hereditary Bleeding Disorder<br />· Von Willebrand’s Disease<br />Liver 1° Tumor<br />· Hepatoma<br />Liver Disease<br />· Alcoholic Liver Disease<br />Location of Adult brain tumors<br />· Above Tentorium<br />Location of Childhood brain tumors<br />· Below Tentorium<br />Lysosomal Storage Disease<br />· Gaucher’s<br />Motor Neuron Disease<br />· ALS<br />Neoplasm – Child<br />· Leukemia<br />Neoplasm – Child (2nd most common)<br />· Medulloblastoma of brain (cerebellum)<br />Nephrotic Syndrome<br />· Membranous Glomerulonephritis<br />Opportunistic infection in AIDS<br />· PCP<br />Ovarian Malignancy<br />· Serous Cystadenoma<br />Ovarian Tumor<br />· Hamartoma<br />Pancreatic Tumor<br />· Adeno (usually in the head)<br />Patient with ALL / CLL / AML / CML<br />· ALL - Child / CLL - Adult over 60 / AML - Adult over 60 / CML - Adult 35-50<br />Patient with Goodpasture’s<br />· Young male<br />Patient with Reiter’s<br />· Male<br />Pituitary Tumor<br />· Prolactinoma (2nd – Somatotropic “Acidophilic” Adenoma)<br />Primary Hyperparathyroidism<br />· Adenomas (followed by: hyperplasia, then carcinoma)<br />Pt. With Hodgkin’s<br />· Young Male (except Nodular Sclerosis type – Female)<br />Pt. With Minimal Change Disease<br />· Young Child<br />Secondary Hyperparathyroidism<br />· Hypocalcemia of Chronic Renal Failure<br />Sexually transmitted disease<br />· Chlamydia<br />Site of Diverticula<br />· Sigmoid Colon<br />Site of metastasis<br />· Regional Lymph Nodes<br />Site of metastasis (2nd most common)<br />· Liver<br />Sites of atherosclerosis<br />· Abdominal aorta > coronary > popliteal > carotid<br />Skin Cancer<br />· Basal Cell Carcinoma<br />Stomach cancer<br />· Adeno<br />Testicular Tumor<br />· Seminoma<br />Thyroid Cancer<br />· Papillary Carcinoma<br />Tracheoesophageal Fistula<br />· Lower esophagus joins trachea / upper esophagus – blind pouch<br />Tumor of Infancy<br />· Hemangioma<br />Type of Hodkin’s<br />· Mixed Cellularity (versus: lymphocytic predominance, lymphocytic depletion, nodular sclerosis)<br />Type of Non-Hodgkin’s<br />· Follicular, small cleaved<br />Vasculitis (of medium & small arteries)<br />· Temporal Arteritis<br />Viral Encephalitis<br />· HSVDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com1tag:blogger.com,1999:blog-2217647826950966921.post-52113881357975157472009-01-16T07:45:00.000-08:002009-01-16T07:49:07.664-08:00Characterstic Drug ToxicitiesCharacterstic Drug Toxicities<br />Agranulocytosis<br />· Clozapine<br />Aplastic Anemia<br />· Chloramphenicol · NSAIDs · Benzene<br />Atropine-like Side Effects<br />· Tricyclics<br />Cardiotoxicity<br />· Doxorubicin · Daunorubicin<br />Cartilage Damage in children<br />· Fluoroquinolones (Ciprofloxacin & Norfloxacin)<br />Cinchonism<br />· Quinidine<br />Coronary Steal Phenomenon<br />· Dipyridamole<br />Corneal micro deposits<br />· Amiodarone<br />Cough<br />· ACE Inhibitors<br />Diabetes Insipidus<br />· Lithium<br />Disulfiram-like effect<br />· Metronidazole · Sulfonylureas (1st generation)<br />Extrapyramidal Side Effects<br />· Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine)<br />Fanconi’s Syndrome<br />· Tetracycline<br />Fatal Hepatotoxicity (necrosis)<br />· Valproic Acid · Halothane · Acetaminophen<br />Gingival Hyperplasia<br />· Phenytoin<br />Gray Baby Syndrome<br />· Chloramphenicol<br />Gynecomastia<br />· Cimetidine · Azoles · Spironolactone · Digitalis · Estrogen & testosterone · INH & ethionamide · Clomiphine · Phenytoin · Reserpine & Methyldopa<br />Hand Foot Syndrome<br />· 5-Flurouracil (5-FU)<br />Hemolytic Anemia in G6PD-deficiency<br />· Sulfonamides · Isoniazid · Aspirin · Ibuprofen · Primaquine<br />Hemorrhagic Cystitis<br />· Cyclophosphamide · Ifosamide (Treat by Mesna & Acetylcysteine Bladder Wash)<br />Hepatitis<br />· Isoniazid<br />Hot Flashes, Flushing<br />· Niacin · Tamoxifen · Ca++ Channel Blockers<br />Hypertension: Postural<br />· Prazocin<br />Hypertension: Rebound<br />· Clonidine withdrawal<br />Increased intra cranial tension (­ ICT)<br />· Amiodarone · Hypervitaminosis A · OCP’s · Tetracycline · Quinolones <br />Induce CP450<br />· Barbiturates · Phenytoin · Carbamazepine · Rifampin<br />Inhibit CP450<br />· Cimetidine · Erythromycin · Ketoconazole · Isoniazid (INH) [remember CEKI]<br />Interstitial Nephritis<br />· Methicillin · NSAIDs (except Aspirin) · Furosemide · Sulfonamides<br />Milk Alkali Syndrome<br />· Calcium Carbonate (CaCo3)<br />Monday Disease<br />· Nitroglycerin Industrial exposure ® tolerance during week ® loss of tolerance during weekend ® headache, tach, dizziness upon re-exposure<br />Nephrotoxicity<br />· Cephaloridine · Gentamycin · Amphotericin<br />Orange Body Fluids<br />· Rifampin<br />Osteoporosis<br />· Heparin · Corticosteroids<br />Pancreatitis<br />· L-Asparginase · Glucocorticoids<br />Photosensitivity<br />· Lomefloxacin · Pefloxacin<br />Positive Coombs’ Test<br />· Methyldopa<br />Pulmonary Fibrosis<br />· Bleomycin · Amiodarone<br />Rabbit Syndrome (Perioral tremors)<br />· Phenothiazines<br />Red Man Syndrome<br />· Vancomycin (rapid IV)<br />Severe HTN with Tyramine<br />· MAOIs<br />SLE- Drug Induced[Anti Histone Antibody Characteristic of this]<br />· Chloropromazine · Hydralazine · Isoniazid · Methyldopa · Procainamide · Quinidine [ remember CHIMP -Q]<br />Tardive Dyskinesia<br />· Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine)<br />Tinnitus<br />· Aspirin · Quinidine<br />Torsades de Pontis<br />· TerfanadineDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com1tag:blogger.com,1999:blog-2217647826950966921.post-2888903476974023362009-01-16T07:31:00.000-08:002009-01-16T07:45:20.320-08:00LABORATORY TESTSa-1 FETOPROTEIN (ALPHA-I-FETOPROTEIN )<br />Elevated in:Hepatocellular carcinoma (usually values >1000 ng/ml), germinal neoplasms (testis, ovary, mediastinum, retroperitoneum), liver disease (alcoholic cirrhosis, acute hepatitis, chronic active hepatitis), fetal anencephaly, spina bifida----------------------------------------------------------------------------------------------------ACETONE (serum or plasma)<br />Elevated in:DKA, starvation, isopropanol Ingestion----------------------------------------------------------------------------------------------------ACID PHOSPHATASE (serum)<br />Elevated in:Carcinoma of prostate, other neoplasms (breast, bone), Paget's disease, osteogenesis imperfecta, malignant invasion of bone, Gaucher's disease, multiple myeloma, myeloproliferative disorders, benign prostatic hypertrophy, prostatic palpation or surgery, hyperparathyroidism, liver disease, chronic renal failure----------------------------------------------------------------------------------------------------ALANINE AMINOTRANSFERASE (ALT, SGPT)<br />Elevated in:Liver disease (hepatitis, cirrhosis, Reye's syndrome), hepatic congestion, infectious mononucleosis, Ml, myocarditis, severe muscle trauma, dermatomyositis/polymyositis, muscular dystrophy, drugs (antibiotics, narcotics, antihypertensive agents, heparin, labetalol, lovastatin, NSAIDs, amiodarone, chlorpromazine, phenytoin), malignancy, renal and pulmonary infarction, convulsions, eclampsia, shock liver----------------------------------------------------------------------------------------------------ALBUMIN (serum)<br />Elevated in:Dehydration<br />Decreased in:Liver disease, nephrotic syndrome, poor nutritional status, rapid IV hydration, protein-losing enteropathies (inflammatory bowel disease), severe bums, neoplasia, chronic inflammatory diseases, pregnancy, oral contraceptives, prolonged immobilization----------------------------------------------------------------------------------------------------ALDOLASE (serum)<br />Elevated in:Muscular dystrophy, rhabdomyolysis, dermatomyositis/polymyositis, trichinosis, acute hepatitis and other liver diseases, Ml, prostatic carcinoma, hemorrhagic pancreatitis, gangrene, delirium tremens<br />Decreased in:Loss of muscle mass, late stages of muscular dystrophy----------------------------------------------------------------------------------------------------ALKALINE PHOSPHATASE (serum)<br />Elevated in:Biliary obstruction, cirrhosis (particularly primary biliary cirrhosis), liver disease (hepatitis, infiltrative liver diseases, fatty metamorphosis), Paget's disease of bone, osteitis deformans, rickets, osteomalacia, hypervitaminosis D, hyperparathyroidism, hyperthyroidism, ulcerative colitis, bowel perforation, bone metastases, healing fractures, bone neoplasms, acromegaly, infectious mononucleosis, CMV infections, sepsis, pulmonary infarction, CHF, hypernephroma, leukemia, myelofibrosis, multiple myeloma, drugs (estrogens, albumin, erythromycin and other antibiotics, cholestasis-producing drugs [phenothiazines])<br />Decreased in:Hypothyroidism, pernicious anemia, hypophosphatemia, hypervitaminosis D, malnutrition----------------------------------------------------------------------------------------------------AMMONIA (serum)<br />Elevated in:Hepatic failure, hepatic encephalopathy, Reye's syndrome, portacaval shunt, drugs (diuretics, polymyxin B. methicillin)<br />Decreased in:Drugs (neomycin, lactulose, tetracycline), renal failure----------------------------------------------------------------------------------------------------AMYLASE (serum)<br />Elevated in:Acute pancreatitis, pancreatic neoplasm, abscess, pseudocyst, ascites, macroamylasemia, perforated peptic ulcer, intestinal obstraction, intestinal infarction, acute cholecyshtis, appendicitis, ruptured ectopic pregnancy, salivary gland inflammation, peritonitis, burns, diabetic ketoacidosis, renal insufficiency, drugs (morphine), carcinomatosis of lung, esophagus, ovary, acute ethanol ingestion<br />Decreased in:Advanced chronic pancreatitis, hepatic necrosis----------------------------------------------------------------------------------------------------ANGIOTENSIN CONVERTING ENZYME (ACE level)<br />Elevated in:Sarcoidosis, primary biliary cirrhosis, alcoholic liver disease, hyperthyroidism, hyperparathyroidism, diabetes mellitus, amyloidosis, multiple myeloma, lung disease (asbestosis, silicosis, berylliosis, allergic alveolitis, coccidioidomycosis), Gaucher's disease, leprosy----------------------------------------------------------------------------------------------------ANION GAP<br />Elevated in:Lactic acidosisKetoacidosis (DKA, alcoholic starvation)Uremia (chronic renal failure)Ingestion of toxins (paraldehyde, methanol, salicylates, ethylene glycol)<br />Decreased in:Hypoalbum nemia, severe hypermagnesem a, IgG myeloma, littaum toxicity, lab error (falsely Decreased sodium or overestimation of bicarbonate or chloride)----------------------------------------------------------------------------------------------------ANTI-DNA<br />Present in:SLE, chronic active hepatitis, infectious mononucleosis, biliary cirrhosis----------------------------------------------------------------------------------------------------ANTI-STREPTOLYSIN O TITER (STREPTOZYME, ASLO titer)<br />Elevated in:Streptococcal upper airway infection, acute rheumatic fever, acute glomerulonephritis, increased levels of B-lipoprotein<br />NOTE: A fourfold increase in titer between acute and convalescent specimens is diagnostic of streptococcal upper airway infection regardless of the initial titer.----------------------------------------------------------------------------------------------------ANTIMITOCHONDRIAL ANTIBODY<br />Elevated in:Primary biliary cirrhosis (85-95%), chronic active hepatitis (25%-30%) cryptogenic cirrhosis (25-30%)----------------------------------------------------------------------------------------------------ANTINUCLEAR ANTIBODY (ANA)<br />Positive test:SLE (more significant if titer >1: 160), drugs (phenytoin, ethosuximide, pnmudone, methyldopa, hydralazine, carbamazepine, penicillin, procainamide, chlorpromazine, griseofulvin, thiazides), chronic active hepatltis, age over 60 yr (particularly age over 80), rheumatoid arthritls, scleroderma, mixed connective tissue disease, necrotizing vasculitis, Sjogren's syndrome (SS), tuberculosis, pulmonary interstitial fibrosis----------------------------------------------------------------------------------------------------ANTITHROMBIN III<br />Decreased in:Hereditary deficiency of antithrombin III, DIC, pulmonary embolism, cirrhosis, thrombolytic therapy, chronic liver failure, post-surgery, third trimester of pregnancy, oral contraceptives, nephrotic syndrome, IV heparin >3 days, sepsis<br />Elevated in:Warfarin drugs, post-MI----------------------------------------------------------------------------------------------------ASPARTATE AMINOTRANSFERASE (AST, SGOT)<br />Elevated in:Liver disease (hepatitis, cirrhosis, Reye's syndrome), hepatic congestion, infectious mononucleosis, MI, myocarditis, severe muscle trauma, dermatomyositis/polymyositis, muscular dystrophy, drugs (antibiotics, narcotics, antihypertensive agents, heparin, labetalol, lovastatin, NSAIDs, phenytoin, amiodarone, chlorpromazine), malignancy, renal and pulmonary infarction, convulsions, eclampsia----------------------------------------------------------------------------------------------------BASOPHIL COUNT<br />Elevated in:Leukemia, inflammatory processes, polycythemia vera, Hodgkin's Iymphoma, hemolytic anemia, after splenectomy, myeloid metaplasia<br />Decreased in:Stress, hypersensitivity reaction, steroids, pregnancy, hyperthyroidism----------------------------------------------------------------------------------------------------BILIRUBIN, DIRECT (conjugated bilirubin)<br />Elevated in:Hepatocellular disease, biliary obstruction, drug-induced cholestasis, hereditary disorders (Dubin-Johnson syndrome, Rotor's syndrome)----------------------------------------------------------------------------------------------------BILIRUBIN, INDIRECT (unconjugated bilirubin)<br />Elevated in:Hemolysis, liver disease (hepatitis cirrhosis, neoplasm), hepatic congestion secondary to congestive heart failure, heredltary dlsorders (Gilbert's disease, Crigler-Najjar syndrome)----------------------------------------------------------------------------------------------------BILIRUBIN, TOTAL<br />Elevated in:Liver disease (hepatitis, cirrhosis, cholangitis, neoplasm, biliary obstruction, infectious mononucleosis), hereditary disorders (Gilbert's dsease, Dubin-Johnson syndrome), drugs (steroids, diphenylhydanton, phenothiazines, penicillin, erythromycin, clindamycin, captopril, amphotericin B. sulfonamides, azathioprine, isoniazid, 5-aminosalicylic acid, allopurinol, methyldopa, indomethacin, halothane, oral contracepuves, procainamide, tolbutamide, labetalol), hemolysis, pulmonary embolism or infarct, hepatic congestion secondary to CHF----------------------------------------------------------------------------------------------------BLEEDING TIME (modified Ivy method)<br />Elevated in:Thrombocytopenia, capillary wall abnormalities, platelet abnormalities (Bernard-Soulier, Glamzmann's), drugs (aspirin, warfarin, antinflammatory medications, streptokinase, urokinase, dextran, B lactam antibiotics, moxalactam), DIC, cirrhosis, uremia, myeloproliferative dlsorders, Von Willebrand's----------------------------------------------------------------------------------------------------C-REACTIVE PROTEIN<br />Elevated in:Rheumatoid arthritis, rheumatic fever, inflammatory bowel disease, bacterial infections, Ml, oral contraceptives, third trimester of pregnancy (acute phase reactant), inflammatory and neoplastic diseases----------------------------------------------------------------------------------------------------CALCITONIN (serum)<br />Elevated in:Medullary carcinoma of the thyroid (particularly if level >1500 pg/ml), carcinoma of the breast, APUDomas, carcinolds, renal failure, thyroiditis----------------------------------------------------------------------------------------------------CALCIUM (serum)<br />Increased in:-Hyperparathyroidism, primary (due to hyperplasia or adenoma of parathyroids) or secondary-Hyperparathyroidism due to parathormone-secreting cancer -Hematologic malignancies (e.g., myeloma, lymphoma, leukemia)-Excess vitamin D intake-Bone tumor (Metastatic carcinoma (10% of patients))-Acute osteoporosis (e.g., immobilization of young patients or in Paget's disease)-Milk-alkali (Burnett's) syndrome-Idiopathic hypercalcemia of infants-Infantile hypophosphatasia-Berylliosis-Hyperthyroidism (some patients)-Cushing's syndrome (some patients)-Addison's disease (some patients)-Myxedema (some patients)-Hyperproteinemia (Sarcoidosis, -Multiple myeloma (some patients))-Thiazide drugs-Artifactual (e.g., venous stasis during blood collection, use of cork-stoppered test tubes)<br />Decreased in:-Hypoparathyroidism (Surgical; Idiopathic; Pseudohypoparathyroidism)-Malabsorption of calcium and vitamin D (Obstructive jaundice)-Hypoalbuminemia (Cachexia, Nephrotic syndrome, Sprue, Celiac disease, Cystic fibrosis of pancreas)-Chronic renal disease with uremia and phosphate retention-Acute pancreatitis with extensive fat necrosis-Insufficient calcium, phosphorus, and vitamin D ingestion (Bone disease (osteomalacia, rickets); Starvation; Late pregnancy)<br />Total serum protein should always be known for proper interpretation of serum calcium levels.<br />----------------------------------------------------------------------------------------------------CARBOXYHEMOGLOBIN (CARBON MONOXIDE; CO)<br />Elevated in:Smoking, exposure to smoking, exposure to automobile exhaust fumes malfunctioning gas-burning appliances----------------------------------------------------------------------------------------------------CARCINOEMBRYONIC ANTIGEN (CEA)<br />Elevated in:Colorectal carcinomas, pancreatic carcmomas, and metastatic disease usually produce higher elevations (>20 ng/ml)<br />Carcinomas of the esophagus, stomach, small intestine, liver, breast ovary, lung and thyroid usually produce lesser elevations<br />Benign conditions (smoking, inflammatory bowel disease hypothyroidism, cirrhosis, pancreatitis, infections) usually produce ievels <10 ng/ml----------------------------------------------------------------------------------------------------CAROTENE (serum)<br />Elevated in:Carotenemia, chronic nephritis, diabetes mellitus, hypothyroidism, nephrotic syndrome<br />Decreased in:Fat malabsorption, steatorrhea, pancreatic insufficiency, lack of carotenoids in diet----------------------------------------------------------------------------------------------------CEREBROSPINAL FLUID (CSF)<br />----------------------------------------------------------------------------------------------------CERULOPLASMIN (serum)<br />Elevated in:Pregnancy, estrogens, oral contraceptives, neoplastic diseases (leukemias, Hodgkin's Iymphoma, carcinomas), inflammatory states, SLE, prirnary biliary cirrhosis, rheumatoid arthritis<br />Decreased in:Wilson's disease (values often <10 mg/dl), nephrotic syndrome, advanced liver disease, malabsorption, total parenteral nutrition, Menkes' syndrome----------------------------------------------------------------------------------------------------CHLORIDE (serum)<br />Elevated in:-Dehydration, excessive infusion of normal saline-Hyperparathyroidism, renal tubular disease, metabolic acidosis, prolonged diarrhea-Drugs (ammonium chloride administration, acetazolamide, boric acid, triamterene)<br />Decreased in:CHF, SIADH, Addison's disease, vomiting, gastric suction, salt-losing nephritis, continuous infusion of D5W, thiazide diuretic administration, diaphoresis, diarrhea, burns----------------------------------------------------------------------------------------------------CHOLESTEROL, TOTAL<br />Elevated in:Primary hypercholesterolemia, biliary obstruction, diabetes melhtus, nephrotic syndrome, hypothyroidism, primary biliary cirrhosis, high cholesterol diet, third trimester of pregnancy, Ml, drugs (steroids, phenothiazines, oral contraceptives)<br />Decreased in:Starvation, malabsorption, sideroblastic anemia, thalassemia, abetalipoproteinemia, hyperthyroidism, Cushing's syndrome, hepatic failure, multiple myeloma, polycythemia vera, chronic myelocytic leukemia, myeloid metaplasia, Waldenstrom's macroglobulinemia, myelofibrosis----------------------------------------------------------------------------------------------------CIRCULATING ANTICOAGULANT (lupus anticoagulant)<br />Detected in:SLE, drug-induced lupus, long-term phenothiazine therapy, multiple myeloma, ulcerative colhis, rheumatoid arthritis, postpartum, hemophilia, neoplasms, chronic inflammatory states----------------------------------------------------------------------------------------------------COLD AGGLUTININS TITER<br />Elevated in:Primary atypical pneumonia (mycoplasma pneumonia), infectious mononucleosis, CMV infection<br />Other: hepatic cirrhosis, acquired hemolytic anemia, frostbite, multiple myeloma, Iymphoma, malaria----------------------------------------------------------------------------------------------------COMPLEMENT (C3, C4)<br />C3 is increased in:Acute and chronic inflammation (slightly), obstructive jaundice<br />C3 is decreased in:Acute glomerulonephritis, systemic lupus erythromatosis<br />----------------------------------------------------------------------------------------------------COOMBS, DIRECT<br />Positive:Autoimmune hemolytic anemia, erythroblastosis fetalis, transfusion reactions, drugs (a-methyldopa, peniecllins, tetraeyeline, sulfonamides, levodopa, cephalosporins, quinidine, insulin)<br />False positive:May be seen with cold agglutinins----------------------------------------------------------------------------------------------------COOMBS, INDIRECT<br />Positive:Acquired hemolytic anemia, incompatible cross-matched blood, anti-Rh antibodies, drugs (methyldopa, mefenamic acid, levodopa)----------------------------------------------------------------------------------------------------COPPER (serum)<br />Increased in:-Anemias (Pernicious anemia, Megaloblastic anemia of pregnancy, Iron deficiency anemia, Aplastic anemia, Leukemia, acute and chronic, Infection, acute and chronic, Malignant lymphoma, Hemochromatosis)-Collagen diseases (including SLE, rheumatoid arthritis, acute rheumatic fever, glomerulonephritis)-Hypothyroidism-Hyperthyroidism-Frequently associated with increased C-reactive protein<br />Decreased in:-Nephrosis (ceruloplasmin lost in urine)-Wilson's disease-Acute leukemia in remission-Some iron deficiency anemias of childhood (that require copper as well as iron therapy)-Kwashiorkor<br />----------------------------------------------------------------------------------------------------CORTISOL (plasma)<br />Elevated in:-Ectopic ACTH production (i.e., oat cell carcinoma of lung), loss of normal diurnal variation, pregnancy, chronic renal failure-Iatrogenic, stress, adrenal or pituitary hyperplasia or adenomas<br />Decreased in:Primary adrenocortical insufficiency, anterior pituitary hypofunction, secondary adrenocortical insufficiency, adrenogenital syndromes----------------------------------------------------------------------------------------------------CREATINE KINASE (CK, CPK)<br />Elevated in:MI, myocarditis, rhabdomyolysis, myositis, crush injury/trauma, polymyositis, dermatomyositis, vigorous exercise, muscular dystrophy, myxedema, seizures, malignant hyperthermia syndrome, IM injections, CVA, pulmonary embolism and infarction, acute dissection of aorta<br />Decreased in:Steroids, decreased muscle mass, connective tissue disorders, alcoholic liver disease, metastatic neoplasms----------------------------------------------------------------------------------------------------CREATINE KINASE ISOENZYMES<br />CK-MBElevated in: Mi, myocarditis, pericarditis, muscular dystrophy, cardiac defibrillation, cardiac surgery, extensive rhabdomyolysis, strenuous exercise (marathon runners), mixed conmective tissue disease, cardiomyopathy, hypothermia<br />CK-MMElevated in: crush injury, seizures, malignant hyperthermia syndrome, rhabdomyolysis, myositis, polymyositis, dermatomyositis, vigorous exercise, muscular dystrophy, IM injections, acute dissection of aorta<br />CK-BBElevated in: CVA, subarachnoid hemorrhage, neoplasms (prostate, Gl tract, brain, ovary, breast, lung), severe shock, bowel infarction, hypothermia----------------------------------------------------------------------------------------------------CREATININE (serum)<br />Elevated in:Renal insufficiency (acute and chronic), Decreased renal perfusion (hypotension, dehydration, CHF), urinary tract infection, rhabdomyolysis, ketonemiaDrugs (antibiotics [aminoglycosides, cephalosporins], hydantoin, diuretics, methyldopa)<br />Falsely elevated in:DKA, administration of some cephalosporins (e.g., cefoxitin, cephalothin)<br />Decreased in:Decreased muscle mass (including amputees and older persons), pregnancy, prolonged debilitation----------------------------------------------------------------------------------------------------CREATININE CLEARANCE<br />Elevated in:Pregnancy, exercise<br />Decreased in:Renal insufficiency, drugs (cimetidine, procainanude, antibiotics, quinidine)----------------------------------------------------------------------------------------------------CRYOGLOBULINS (serum)<br />Present in:Collagen-vascular diseases, CLL, hemolytic anemias, multiple myeloma, Waldenstrom's macroglobulinemia, chronic active hepatitis, Hodgkin's disease----------------------------------------------------------------------------------------------------D-XYLOSE ABSORPTION<br />Decreased in:Malabsorption syndrome----------------------------------------------------------------------------------------------------EOSINOPHIL COUNT<br />Elevated in:Allergy, parasitic infestations (trichinosis, aspergillosis, hydatidosis), angmneurotic edema, drug reactions, warfarin sensitivity, collagen-vascular diseases, acute hypereosinophilic syndrome, eosinophilic nonallergic rhinitis, myeloproliferative disorders, Hodgkin's Iymphoma, radiation therapy, NHL, L-tryptophan ingestion----------------------------------------------------------------------------------------------------ERYTHROCYTE SEDIMENTATION RATE (Westergren)<br />Elevated in:Collagen-vascular diseases, infections, MI, neoplasms, inflammatory states (acute phase reactant)----------------------------------------------------------------------------------------------------EXTRACTABLE NUCLEAR ANTIGEN (ENA complex, anti-RNP antibody, anti-Sm, anti-Smith)<br />Present in:SLE, rheumatoid arthritis, Sjogren's syndrome, MCTD----------------------------------------------------------------------------------------------------FECAL FAT, QUANTITATIVE (72 hr collection)<br />Elevated in:Malabsorption syndrome----------------------------------------------------------------------------------------------------FERRITIN (serum)<br />Elevated in:Hyperthyroidism, inflammatory states, liver disease (ferritin elevated from necrotic hepatocytes), neoplasms (neuroblastomas, Iymphomas, leukemia, breast carcinoma), iron replacement therapy, hemochromatosis<br />Decreased in:Iron deficiency anemia----------------------------------------------------------------------------------------------------FIBRIN DEGRADATION PRODUCT (FDP)<br />Elevated in:DIC, primary fibrinolysis, pulmonary embolism, severe liver disease<br />NOTE: The presence of rheumatoid factor may cause falsely elevated FDP----------------------------------------------------------------------------------------------------FIBRINOGEN<br />Elevated in:Tissue inflammation/damage (acute-phase protein reactant), oral contraceptives, pregnancy, acute infection, MI<br />Decreased in:DIC, hereditary afibrinogenemia, liver disease, primary or secondary fibrinolysis, cachexia----------------------------------------------------------------------------------------------------FOLATE (FOLIC ACID)<br />Decreased in:Folic acid deficiency (inadequate intake, malabsorption), alcoholism, drugs (methotrexate, trimethoprim, phenytoin, oral contraceptives, azulfadine), vitamin B12 deficiency (defective red cell folate absorption)----------------------------------------------------------------------------------------------------FTA-ABS (serum)(FLUORESCENT TREPONEMAL ANTIBODY)<br />Reactive in:Syphilis, other treponemal diseases (yaws, pinta, bejel)----------------------------------------------------------------------------------------------------GASTRIN (serum)<br />Elevated in:Zollinger-Ellison syndrome (gastrinoma), pernicious anemia, hyperparathyroidism, retained gastric antrum, chronic renal failure, gastric ulcer, chronic atrophic gastritis, pyloric obstruction, malignant neoplasms of the stomach, H2 blockers, omeprazole----------------------------------------------------------------------------------------------------GLOMERULAR BASEMENT MEMBRANE ANTIBODY (ANTIGLOMERULAR BASEMENT ANTIBODY)<br />Present in:Goodpasture's syndrome----------------------------------------------------------------------------------------------------GLUCOSE-6-PHOSPHATE DEHYDROGENASE SCREEN (blood)<br />Abnormal:If a deficiency is detected, quantitation of G6PD is necessary; a G6PD screen may be falsely interpreted as abnormal----------------------------------------------------------------------------------------------------GLUCOSE TOLERANCE TEST<br />Elevated in:Glucose intolerance, diabetes mellitus, Cushing's syndrome, acromegaly, pheochromocytoma----------------------------------------------------------------------------------------------------GLUCOSE, FASTING<br />Elevated in:Diabetes mellitus, stress, infections, MI, CVA, Cushing's syndrome, acromegaly, acute pancreatitis, glucagonoma, hemocbromatosis, drugs (glucocorticoids, diuretics [thiazides, loop diuretics]), glucose intolerance----------------------------------------------------------------------------------------------------GLUCOSE, POSTPRANDIAL<br />Elevated in:Diabetes mellitus, glucose intolerance<br />Decreased in:Post-gastrointestinal resection, reactive hypoglycemia, hereditary fructose intolerance, galactosemia, leucine sensitivity----------------------------------------------------------------------------------------------------GLYCATED (GLYCOSYLATED) HEMOGLOBIN (HbA1c)<br />Elevated in:Uncontrolled diabetes mellitus (glycated hemoglobin levels reflect the level of glucose control over the preceding 120 days)<br />Decreased in:Hemolytic anemias, Decreased RBC survival, pregnancy, chronic blood loss, chronic renal failure, insulinoma----------------------------------------------------------------------------------------------------HAM TEST (acid serum test)<br />Positive in:Paroxysmal nocturnal hemoglobinuria (PNH)<br />False positive in:Hereditary or acquired spherocytosis, recent transfusion with aged RBC, aplastic anemia, myeloproliferative syndromes, leukemia, hereditary dyserythropoietic anemia type II (HEMPAS)----------------------------------------------------------------------------------------------------HAPTOGLOBIN (serum)<br />Elevated in:Inflammation (acute phase reactant), collagen-vascular diseases, infections (acute phase reactant), drugs (androgens)<br />Decreased in:Hemolysis (intravascular > extravascular), megaloblastic anemia, severe liver disease, large tissue hematomas, infectious mononucleosis, drugs (oral contraceptives)----------------------------------------------------------------------------------------------------HEMATOCRIT<br />Elevated in:Polycythemia vera, smoking, COPD, high altitudes, dehydration, hypovolemia<br />Decreased in:Blood loss (GI, GU), anemia, pregnancy----------------------------------------------------------------------------------------------------HEMOGLOBIN<br />Elevated in:Hemoconcentration, dehydration, polycythemia vera, COPD, high altitudes, false elevations (hyperlipemic plasma, WBC >50,000 mm3), stress<br />Decreased in:Hemorrhage (GI, GU), anemia----------------------------------------------------------------------------------------------------HEPATITIS A ANTIBODY<br />Present in:Viral hepatitis A, can be IgM or IgG (if IgM, acute hepatitis A; if IgG, previous infection with hepatitis A)----------------------------------------------------------------------------------------------------HEPATITIS B SURFACE ANTIGEN (HBsAg)<br />Detected in:Acute viral hepatitis Type B. Chronic hepatitis B----------------------------------------------------------------------------------------------------HIGH DENSITY LIPOPROTEIN (HDL) CHOLESTEROL<br />Increased:Use of gemfibrozil, nicotinic acid, estrogens, regular aerobic exercise, small (1 oz) daily alcohol intake<br />Decreased:Deficiency of apoproteins, liver disease, probucol ingestion, Tangier diseaseNOTE: A cholesterol/HDL ratio >4.5 is associated with increased risk of coronary artery disease.----------------------------------------------------------------------------------------------------IMMUNE COMPLEX ASSAY<br />Detected in:Collagen-vascular disorders, glomerulonephritis, neoplastic diseases, malaria, primary biliary cirrhosis, chronic acute hepatitis, bacterial endocarditis, vasculitis----------------------------------------------------------------------------------------------------IMMUNOGLOBULINS<br />Elevated in:-IgA: Iymphoproliferative disorders, Berger's nephropathy, chronic infections, autoimmune disorders, liver disease-IgE: allergic disorders, parasitic infections, immunological disorders IgE myeloma-IgG: chronic granulomatous infections, infectious diseases, inflammation, myeloma, liver disease-IgM: primary biliary cirrhosis, infectious diseases (brucellosis, malaria), Waldenstrom's macroglobulinemia, liver disease<br />Decreased in:-IgA: nephrotic syndrome, protein-losing enteropathy, congenital deficiency, Iymphocytic leukemia, ataxia-telengiectasia, chronic eosinopulmonary disease-IgE: hypogammaglobulinemia, neoplasm (breast, bronchial, cervical) ataxia, telengiectasia-IgG: congenital or acquired deficiency, Iymphocytic leukemia, phenytoin, methylprednisolone, nephrotic syndrome, protein-losing enteropathy-IgM: congenital deficiency, Iymphocytic leukemia, nephrotic syndrome----------------------------------------------------------------------------------------------------IRON-BINDING CAPACITY (TIBC)<br />Elevated in:Iron deficiency anemia, pregnancy, polycythemia<br />Decreased in:Anemia of chronic disease, hemochromatosis, chronic liver disease, hemolytic anemias, malnutrition (protein depletion)----------------------------------------------------------------------------------------------------LACTATE (blood)<br />Increased in:(Without signifigant acidosis): Muscular exercise, hyperbentilation, glucaon, glycogen storage disease, severe anemia, pyruvate infusion, HCO3 infusion, glucose and insulin infusion.<br />(With hypoxia and acidosis): Acute hemorrage, circulatory collapse, cyanotic heart disease, severe acute CHF, acute anoxemia, extracorpeal circulation, epinephrine<br />(Idiopathic): Mild uremia, infections (esp. pyelonephritis), septicemia, cirrhosis, acute pancreatitis (+/-), third trimester of pregnancy, severe vascular disease, leukemia, anemia, chronic alcoholism, subacute bacterial endocarditis, poliomyelitis----------------------------------------------------------------------------------------------------LACTATE DEHYDROGENASE (LDH)<br />Elevated in:Infarction of myocardium, lung, kidney<br />Diseases of cardiopulmonary system, liver, collagen, CNS<br />Hemolytic anemias, megaloblastic anemias, transfusions, seizures, muscle trauma, muscular dystrophy, acute pancreatitis hypotension shock, infectious mononucleosis, inflammation, neoplasia, intestinai obstruction, hypothyroidism----------------------------------------------------------------------------------------------------LACTATE DEHYDROGENASE ISOENZYMES<br />Abnormal values:LDH1 > LDH2: MI (can also be seen with hemolytic anemias, pernicious anemia, folate deficiency, renal infarct)<br />LDH5 > LDH4: liver disease (cirrhosis, hepatitis, hepatic congestion)----------------------------------------------------------------------------------------------------LEGIONELLA TITER<br />Positive in:Legionnaire's disease (presumptive: > 1:256 titer; definitive: fourfold titer increase to >1: 128)----------------------------------------------------------------------------------------------------LEUKOCYTE ALKALINE PHOSPHATASE (LAP SCORE)<br />Elevated in:Leukemoid reactions, neutrophilia secondary to infections (except in sickle cell crisisƒ€no significant increase in LAP score), Hodgkin's disease, polycythemia vera, hairy cell leukemia, aplastic anemia, Down's syndrome, myelofibrosis<br />Decreased in:Acute and chronic granulocytic leukemia, thrombocytopenic purpura, paroxysmal nocturnal hemoglobinuria (PNH), hypophosphatemia, collagen disorders----------------------------------------------------------------------------------------------------LIPASE<br />Elevated in:Acute pancreatitis, perforated peptic ulcer, carcinoma of pancreas (early stage), pancreatic duct obstruction----------------------------------------------------------------------------------------------------LOW DENSITY LIPOPROTEIN (LDL) CHOLESTEROL<br />Elevated in:Primary hyperlipoproteinemia, diet high in saturated fats, acute MI, hypothyroidism, primary biliary cirrhosis, nephrosis, driabetes mellitus<br />Decreased in:Abetalipoproteinemia, advanced liver disease, malabsorption, malnutrition----------------------------------------------------------------------------------------------------LYMPHOCYTES<br />Elevated in:Chronic infections, infectious mononucleosis and other viral infections, CLL, Hodgkin's disease, ulcerative colitis, hypoadrenalism, ITP<br />Decreased in:AIDS, ARC, bone marrow suppression from chemotherapeutic agents or chemotherapy, aplastic anemia, neoplasms, steroids, adrenocortical hyperfunction, neurologic disorders (multiple sclerosis, myasthenia gravis, Guillain-Barre syndrome)----------------------------------------------------------------------------------------------------MAGNESIUM (serum)<br />Increased in:-Renal failure-Diabetic coma before treatment-Hypothyroidism-Addison's disease and after adrenalectomy-Controlled diabetes mellitus in older patients-Administration of antacids containing magnesium<br />Decreased in:-GI disease showing malabsorption and abnormal loss of GI fluids (e.g., nontropical sprue, small bowel resection, biliary and intestinal fistulas, abdominal irradiation, prolonged aspiration of intestinal contents, celiac disease and other causes of steatorrhea)-Acute alcoholism and alcoholic cirrhosis-Insulin treatment oof diabetic coma-Hyperthyroidism-Aldosteronism-Hyperparathyroidism-Lytic tumors of bone-Diuretic drug therapy (e.g., ethacrynic acid, furosemide)-Some cases of renal disease (e.g., glomerulonephritis, pyeloneI phritis, renal tubular acidosis)-Acute pancreatitis-Excessive lactation-Idiopathic disorders<br />Magnesium deficiency may cause apparently unexplained hypocalcemia and hypokalemia; the patients may have neurologic and GI symptoms<br />----------------------------------------------------------------------------------------------------MEAN CORPUSCULAR VOLUME (MCV)<br />Elevated in:Vitamin B12 deficiency, folic acid deficiency, liver disease, alcohol abuse, reticulocytosis, hypothyroidism, marrow aplasia, myelofibrosis<br />Decreased in:Iron deficiency, thalassemia syndrome and other hemoglobinopathies, anemia of chronic disease, sideroblastic anemia, chronic renal failure, lead poisoning----------------------------------------------------------------------------------------------------MONOCYTE COUNT<br />Elevated in:Viral diseases, parasites, infections, neoplasms, inflammatory bowel disease, monocytic leukemia, Iymphomas, myeloma, sarcoidosis<br />Decreased in:Aplastic anemia, Iymphocytic leukemia, glucocorticoid administration----------------------------------------------------------------------------------------------------NEUTROPHIL COUNT<br />Elevated in:Acute bacterial infections, acute MI, stress, neoplasms, myelocytic leukemia<br />Decreased in:Viral infections, aplastic anemias, immunosuppressive drugs, radiation therapy to bone marrow, agranulocytosis, drugs (antibiotics, antithyroidals), Iymphocytic and monocytic leukemias----------------------------------------------------------------------------------------------------OSMOLALITY, SERUM<br />It can be estimated by the following formula:<br />2([Na] + [K]) + Glucose/18 + BUN/2.8<br />Elevated in:Dehydration, hypernatremia, diabetes insipidus, uremia, hyperglycemia, mannitol therapy, ingestlon of toxins (ethylene glycol, methanol ethanol)<br />Decreased in:SIADH, hyponatremia, overhydration----------------------------------------------------------------------------------------------------pH, BLOOD<br />Increased in:Metabolic alkalosis, respiratory alkalosis<br />Decreased in:Metabolic acidosis, repiratory acidosis----------------------------------------------------------------------------------------------------PARTIAL THROMBOPLASTIN TIME (PTT), ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT)<br />Elevated in:Heparin therapy, coagulation factor deficiency (I, II, V, VIII, IX, X, XI XII), liver disease, vitamin K deficiency, DIC, circulating anticoagulant, warfarin therapy, specific factor inhibition (PCN reaction, rheumatoid arthritis), thrombolytic therapy<br />NOTE: Useful to evaluate the intrinsic coagulaion system.----------------------------------------------------------------------------------------------------PHOSPHATASE, ALKALINE; see ALKALINE PHOSPHATASE PHOSPHORUS (serum)<br />Elevated in:Renal failure, dehydration, Addison's disease, myelogenous leukemia, hypervitaminosis D, hypoparathyroidism, pseudohypoparathyroidism, bone metastases, sarcoidosis, milk-alkali syndrome, immobilization, magnesium deficiency, transfusions, hemolysis<br />Decreased in:Starvation (e.g., alcoholics), DKA, TPN, continuous IV dextrose administration, vitamin D deficiency, hyperparathyroidism, pseudohyperparathyroidism, antacids containing aluminum hydroxide, insulin administration, nasogastric suctioning, vomiting, diuretics, steroids, gram-negative septicemia----------------------------------------------------------------------------------------------------PHOSPHORUS (serum)<br />Increased in:-Hypoparathyroidism (Idiopathic, Surgical, Pseudohypoparathyroidism)-Excess vitamin D intake-Secondary hyperparathyroidism (renal rickets)-Bone disease (Healing fractures, Multiple myeloma (some patients), Paget's disease (some patients), Osteolytic metastatic tumor in bone (some patients))-Addison's disease-Acromegaly-Childhood-Myelogenous leukemia-Acute yellow atrophy-High intestinal obstruction-Sarcoidosis (some patients)-Milk-alkali (Burnett's) syndrome (some patients)-Artifactual increase by hemolysis of blood<br />Decreased in-Alcoholism*-Diabetes mellitus*-Hyperalimentation*-Nutritional recovery syndrome* (rapid refeeding after prolonged starvation)-Alkalosis, respiratory (e.g., gram-negative bacteremia) or metabolic-Acute gout-Salicylate poisoning-Administration of glucose intravenously (e.g., recovery after severe burns, hyperalimentation)-Administration of anabolic steroids, androgens, epinephrine, glucagon, insulin-Acidosis (especially ketoacidosis)-Hyperparathyroidism-Renal tubular defects (e.g., Fanconi syndrome)-Hypokalemia-Hypomagnesemia-Administration of diuretics-Prolonged hypothermia (e.g., open heart surgery)-Malabsorption-Vitamin D deficiency and/or resistance, osteomalacia-Malnutrition, vomiting, diarrhea-Administration of phosphate-binding antacids*-Primary hypophosphatemia<br />*Indicates conditions associated with severe hypophosphatemia.<br />Mechanisms of hypophosphatemia are intracellular shift of phosphate, increased loss (via kidney or intestine), or decreased intestinal absorption; usually associated with prior phosphorus depletion. Often, more than one mechanism is operative.<br />----------------------------------------------------------------------------------------------------PLATELET COUNT<br />Elevated in:Neoplasms (GI tract), CML, polycythemia vera, myelofibrosis with myeloid metaplasia, infections, after splenectomy, postpartum, after hemorrhage, hemophilia, iron deficiency, pancreatitis, cirrhosis----------------------------------------------------------------------------------------------------POTASSIUM (serum)<br />Increased in:-Renal failure: (Acute with oliguria or anuria; Chronic end-stage with oliguria (glomerular filtration rate <3-5 ml/minute); Chronic nonoliguric associated with dehydration, obstruction, trauma, or excess potassium)-Decreased mineralocorticoid activity: (Addison's disease; Hypofunction of renin-angiotensin-aldosterone system; Pseudohypoaldosteronism; Aldosterone antagonist (e.g., spironolactone))-Increased supply of potassium: (Red blood cell hemolysis (transfusion reaction, hemolytic anemia); Excess dietary intake or rapid potassium infusion; Striated muscle (status epilepticus, periodic paralysis); Potassium-retaining drugs (e.g., triamterene); Fluid-electrolyte imbalance (e.g., dehydration, acidosis))-Laboratory artifacts (e.g., hemolysis during venipuncture, conditions associated with thrombocytosis, incomplete separation of serum and clot)<br />Decreased in:-Renal and adrenal conditions with metabolic alkalosis: (Administration of diuretics, Primary aidosteronism, Pseudoaldosteronism, Salt-losing nephropathy, Cushing's syndrome)-Renal conditions associated with metabolic acidosis: (Renal tubular acidosis, Diuretic phase of acute tubular necrosis, Chronic pyelonephritis, Diuresis following relief of urinary tract obstruction)-Gastrointestinal conditions: (Vomiting, gastric auctioning; Villous adenoma; Cancer of colon; Chronic laxative abuse; Zollinger-Ellison syndrome; Chronic diarrhea; Ureterosigmoidostomy)<br />----------------------------------------------------------------------------------------------------PROLACTIN<br />Elevated in:Prolactinomas (level >200 highly suggestive), drugs (phenothiazines, cimetidine, tricyclic antidepressants, metoclopramide, estrogens, antihypertensives [methyldopa], verapamil, haloperidol), postpartum, stress, hypoglycemia, hypothyroidism----------------------------------------------------------------------------------------------------PROTEIN (serum)<br />Elevated in:Dehydration, multiple myeloma, Waldenstrom's macroglobulinemia, sarcoidosis, collagen-vascular diseases<br />Decreased in:Malnutrition, low-protein diet, overhydration, malabsorption, pregnancy, severe bums, neoplasms, chronic diseases, cirrhosis, nephrosis----------------------------------------------------------------------------------------------------PROTEIN ELECTROPHORESIS (serum)<br />Elevated:-Albumin: dehydration-a-l: neoplastic diseases, inflammation-a-2: neoplasms, inflammation, infection, nephrotic syndrome-b: hypothyroidism, biliary cirrhosis, diabetes mellitus-y: see IMMUNOGLOBULINS<br />Decreased:-Albumin: malnutrition, chronic liver disease, malabsorption, nephrotic syndrome, burns, SLE-a-I: emphysema (a-l antitrypsin deficiency), nephrosis-a-2: hemolytic anemias (Decreased haptoglobin), severe hepatocellular damage-b: hypocholesterolemia, nephrosis-y: see IMMUNOGLOBULINS----------------------------------------------------------------------------------------------------PROTHROMBIN TIME (PT)<br />Elevated in:Liver disease, oral anticoagulants (Warfarin), heparin, factor deficiency (I, II, V, VII, X), DIC, vitamin K deficiency, afibrinogenemia, dysfibrinogenemia, drugs (salicylae, chloral hydrate, diphenylhydantoin, estrogens, antacids, phenylbutazone, quinidine, antibiotics, allopurinol, anabolic steroids)<br />Decreased in:Vitamin K supplementation, thrombophlebitis, drugs (gluthetimide, estrogens, griseofulvin, diphenhydramine)----------------------------------------------------------------------------------------------------PROTOPORPHYRIN (free erythrocyte)<br />Elevated in:Iron deficiency, lead poisoning, sideroblastic anemias, anemia of chronic disease, hemolytic anemias, erythropoietic protoporphyria----------------------------------------------------------------------------------------------------RED BLOOD CELL COUNT<br />Elevated in:Polycythemia vera, smokers, high altitude, cardiovascular disease, renal cell carcinoma and other erythropoietin-producing neoplasms, stress, hemoconcentration/dehydration<br />Decreased in:Anemias, hemolysis, chronic renal failure, hemorrhage, failure of marrow production----------------------------------------------------------------------------------------------------RED BLOOD CELL DISTRIBUTION WIDTH (RDW)<br />Normal RDW and...Elevated MCV: aplastic anemia, preleukemiaNormal MCV: normal, anemia of chronic disease, acute blood loss or hemolysis, CLL, CML, nonanemic enzymopathy or hemoglobinopathy<br />Decreased MCV: anemia of chronic disease, heterozygous thalassemia<br />Elevated RDW and...Elevated MCV: vitamin Bl2 deficiency, folate deficiency, immune hemolytic anemia, cold agglutinins, CLL with high count, liver disease<br />Normal MCV: early iron deficiency, early vitamin Bl2 deficiency, early folate deficiency, anemic globinopathy<br />Decreased MCV: iron deficiency, RBC fragmentation, Hb H. thalassemia intermedia----------------------------------------------------------------------------------------------------RED BLOOD CELL MASS (VOLUME)<br />Elevated in:Polycythemia vera, hypoxia (smokers, high altitude, cardiovascular disease), hemoglobinopathies with high 2B affinity, erythropoietin-producmg tumors (renal cell carcinoma)<br />Decreased in:Hemorrhage, chronic disease, failure of marrow production anemias, hemolysis----------------------------------------------------------------------------------------------------RETICULOCYTE COUNT<br />Elevated in:Hemolytic anemia (sickle cell crisis, thalassemia major, autoimmune hemolysls, hemorrhage, postanemia therapy (folic acid, ferrous sulfate, vitamin B12)<br />Decreased in:Aplastic anemia, marrow suppression (sepsis, chemotherapeutic agents radlation), hepatic cirrhosis, blood transfusion, anemias of disordered maturation (iron deficiency anemia, megaloblastic anemia, sideroblastlc anemua, anemna of chronic disease)----------------------------------------------------------------------------------------------------RHEUMATOID FACTOR<br />Present in titer >1:20:Rheumatoid arthritis, SLE, chronic inflammatory processes, old age, infection, liver disease----------------------------------------------------------------------------------------------------SMOOTH MUSCLE ANTIBODY (ANTI- SMOOTH MUSCLE ANTIBODY)<br />Present in:Chronic active hepatitis (>1:80), primary biliary cirrhosis (<1:80), infectious mononucleosis----------------------------------------------------------------------------------------------------SODIUM (serum)<br />Increased in:<br />Excess loss of water...-Conditions that cause loss via gastrointestinal tract (e.g., in vomiting), lung (hyperpnea), or skin (e.g., in excessive sweating)-Conditions that cause diuresis (Diabetes insipidus, Nephrogenic diabetes insipidus, Diabetes mellitus, Diuretic drugs, Diuretic phase of acute tubular necrosis, Diuresis following relief of urinary tract obstruction, Hypercalcemic nephropathy, Hypokalemic nephropathy)<br />Excess administration of sodium (iatrogenic), e.g., incorrect replacement following fluid loss.""Essential"" hypernatremia due to hypothalamic lesions<br />Decreased in (serum osmolality is decreased):<br />-Dilutional: (e.g., congestive heart failure, nephrosis, cirrhosis with ascites)-Sodium depletion: (Loss of body fluids (e.g., vomiting, diarrhea, excessive sweating) with incorrect or no therapeutic replacement, diuretic drugs (e.g., thiazides); Adrenocortical insufficiency; Salt-losing nephropathy; Inappropriate secretion of antidiuretic hormone)-Spurious (serum osmolality is normal or increased): (Hyperlipidemia; Hyperglycemia (serum sodium decreases 3 mEq/L for every increase of serum glucose of 100 mg/100 ml))<br />----------------------------------------------------------------------------------------------------SUCROSE HEMOLYSIS TEST (sugar water test)<br />Positive in:Paroxysmal nocturnal hemoglobinuria (PNH)<br />False positive: autoimmune hemolytic anemia, megaloblastic anemnasFalse negative: may occur with use of heparin or EDTA----------------------------------------------------------------------------------------------------T3 (TRIIODOTHYRONINE)<br />Decreased in:Starvation, trauma, surgery, may be an adaptive response to illness, drugs (PTU)----------------------------------------------------------------------------------------------------T3 RESIN UPTAKE (T3RU)<br />This test should be used only with a simultaneous measurement of serum T4 to exclude the possibility that an increased T4 is due to an increase in T4-binding globulin. Measurement of serum T-3 concentration should be done by radioimmunoassay for diagnosis of hyperthyroidism<br />Increased in:-Hyperthyroidism-Certain drugs (e.g., testosterone, androgens, anabolic steroids, prednisone, heparin, Dicumarol, salicylates, Butazolidin, penicillin, Dilantin)-Threatened abortion-Infants (up to about age 2 months)-Severe nephrosis-Metastatic neoplasms<br />Decreased in_-Hypothyroidism-Pregnancy (from about tenth week of pregnancy until up to 12th week postpartum)-Certain drugs (e.g., estrogens alone or in birth control pills, large amounts of iodine, propylthiouracil in hyperthyroidism)<br />Normal in:-Pregnancy with hyperthyroidism-Nontoxic goiter-Carcinoma of thyroid-Diabetes mellitus-Addison's disease-Anxiety-Certain drugs (mercurials, iodine)<br />Variable in:Liver disease<br />----------------------------------------------------------------------------------------------------T4, FREE (free thyroxine)<br />This determination gives corrected values in patients in whom the total thyroxine (T-4) is altered on account of changes in serum proteins or in binding sites. (Pregnancy; Drugs (e.g., androgens, estrogens, birth control pills, Dilantin); Altered levels of serum proteins (e.g., nephrosis))<br />This is the best single screening test for thyroid dysfunction. It is paralleled by the free thyroxine factor.<br />Increased in:-Hyperthyroidism-Hypothyroidism treated with thyroxine -Very ill euthyroid patients (frequently)<br />Decreased in:-Hypothyroidism-Hypothyroidism treated with triiodothyronine<br />----------------------------------------------------------------------------------------------------THROMBIN TIME (TT)<br />Elevated in:Thrombolytic and heparin therapy, DIC, hypofibrinogenemia, dysfibrinogenemia----------------------------------------------------------------------------------------------------THYROID STIMULATING HORMONE (TSH)<br />Elevated in:Hypothyroidism, drugs (haloperidol, chlorpromazme, metoclopramide, domperidone), TSH antibodies, pituitary resistance to thyroid hormone<br />Decreased in:Hyperthyroidism, acute medical illness, drugs (dopamine, corticosteroids, bromocriptine, levodopa, pyridoxine), hyponatremia, malnutrition<br />Normal in:Cushing's syndromeAcromegalyPregnancy at term<br />----------------------------------------------------------------------------------------------------THYROXINE-BINDING GLOBULIN (TBG)<br />Increased in:-Pregnancy-Excess TBG, genetic or idiopathic -Hypothyroidism (sorr-te patients)-Certain drugs (estrogens, birth control pills)-Gross iodine contamination-Acute intermittent porphyria<br />Decreased in:-Nephrosis and other causes of marked hypoproteinemia Deficiency of TBG, genetic or idiopathic-Certain drugs (androgenic and anabolic steroids)<br />An increase of TBG is associated with an increase in PBI, BEI, and T-4 by column and a decrease in T-3; converse association for decrease of TBG.----------------------------------------------------------------------------------------------------THYROXINE (T4)<br />Increased in:-Hyperthyroidism-Pregnancy-Certain drugs (estrogens, birth control pills, d-thyroxine, thyroid extract, TSH)<br />Decreased in:-Hypothyroidism-Hypoproteinemia-Certain drugs (phenytoin sodium [Dilantin], triiodothyronine, testosterone, ACTH, corticosteroids)<br />Not affected by:-Radiopaque substances for x-ray studies -Mercurial diuretics-Nonthyroidal iodine<br />----------------------------------------------------------------------------------------------------TRANSFERRIN<br />Elevated in:Iron deficiency anemia, oral contraceptive administration, viral hepatitis<br />Decreased in:Nephrotic syndrome, liver disease, hereditary deficiency, protein malnutrition, neoplasms, chronic inflammatory states, chronic illness thalassemia----------------------------------------------------------------------------------------------------TRIGLYCERIDES<br />Elevated in:Hyperlipoproteinemias (Types I, IIb, III, IV, V), hypothyroidism, pregnancy, estrogens, acute MI, pancreatitis, alcohol intake, nephrotic syndrome, diabetes mellitus, glycogen storage disease<br />Decreased in:Malnutrition, congenital abetalipoproteinemias, drugs (e.g., gemfibrozil, nicotinic acid, clofibrate) ----------------------------------------------------------------------------------------------------UREA NITROGEN (BUN)<br />Elevated in:-Drugs (aminoglycosides and other antibiotics, diuretics, lithium, corticosteroids), dehydration, gastrointestinal bleeding, -Decreased renal blood flow (shock, CHF, MI), renal disease (glomerulonephritis pyelonephritis, diabetic nephropathy), urinary tract obstruction (prostatic hypertrophy)<br />Decreased in:Liver disease, malnutrition, third trimester of pregnancy, overhydration----------------------------------------------------------------------------------------------------URIC ACID (serum)<br />Elevated in:Renal failure, gout, excessive cell Iysis (chemotherapeutic agents, radiation therapy, leukemia, Iymphoma, hemolytic anemia), hereditary enzyme deficiency (hypoxanthine-guanine-phosphoribosyl transferase) acidosis, myeloproliferative disorders, diet high in purines or protein drugs (diuretics, low doses of ASA, ethambutol, nicotinic acid), lead poisoning, hypothyroidism, Addison's disease, nephrogenic diabetes insipidus, active psoriasis, polycystic kidneys<br />Decreased in:Drugs (allopurinol, high doses of ASA, probenecid, warfarin, corticosteroid), deficiency of xanthine oxidase, SIADH, renal tubular deficits (Fanconi's syndrome), alcoholism, liver disease, diet deficient in protein or purines, Wilson's disease, hemochromatosis----------------------------------------------------------------------------------------------------URINE 5-HYDROXYINDOLE-ACETIC ACID (URINE 5-HIAA)<br />Elevated in:Carcinoid tumors, after ingestion of certain foods (bananas, plums, tomatoes, avocados, pineapples, eggplant, walnuts), drugs (MAO inhibitors, phenacetin, methyldopa, glycerol guaiacolate, acetaminophen,salicylates, phenothiazines, imipramine, methocarbamol, reserpine, metamphetamine)----------------------------------------------------------------------------------------------------URINE AMYLASE<br />Elevated in:Pancreatitis, carcinoma of the pancreas----------------------------------------------------------------------------------------------------URINE BILE (BILIRUBIN, URINE)<br />Abnormal:Urine bilirubin: Hepatitis (viral, toxic, drug-induced), biliary obstructionUrine urobilinogen: Hepatitis (viral, toxic, drug-induced), hemolytic jaundice, liver cell dysfunction (cirrhosis, infection, metastases)----------------------------------------------------------------------------------------------------URINE CALCIUM<br />Elevated in:Primary hyperparathyroidism, hypervitaminosis D, bone metastases multlple myeloma, increased calcium intake, steroids, prolonged immobilization, sarcoidosis, Paget's disease, idiopathic hypercalciuria renal tubular acidosis<br />Decreased in:Hypoparathyroidism, pseudohypoparathyroidism, vitamin D deficiency vitanun D-resistant rickets, diet low in calcium, drugs (thiazide diuretics, oral contraceptives), familial hypocalciuric hypercalcemia, renal osteodystrophy----------------------------------------------------------------------------------------------------URINE CATECHOLAMINES<br />Elevated in:Pheochromocytoma, neuroblastoma, severe stress----------------------------------------------------------------------------------------------------URINE CHLORIDE<br />Elevated in:Corticosteroids, Bartter's syndrome<br />Decreased in:Chloride depletion (vomiting, diuretics), colonic villous adenoma----------------------------------------------------------------------------------------------------URINE COPPER<br />Increased in:Wilson's disease----------------------------------------------------------------------------------------------------URINE CORTISOL, FREE<br />Elevated:Refer to CORTISOL (serum)----------------------------------------------------------------------------------------------------URINE CREATININE (24 hr)<br />NOTE: Useful test as an indicator of completeness of 24 hr urine collection.----------------------------------------------------------------------------------------------------URINE GLUCOSE (qualitative)<br />Present in:Diabetes mellitus, renal glycosuria (decreased renal threshold for glucose), glucose intolerance----------------------------------------------------------------------------------------------------URINE HEMOGLOBIN, FREE<br />Present in:Hemolysis (with saturation of serum haptoglobin binding capacity and renal threshold for tubular absorption of hemoglobin)----------------------------------------------------------------------------------------------------URINE HEMOSIDERIN<br />Present in:Paroxysmal noctumal hemoglobinuria (PNH), chronic hemolytic anemia, hemochromatosis----------------------------------------------------------------------------------------------------URINE INDICAN<br />Present in:Malabsorption secondary to intestinal bacterial overgrowth----------------------------------------------------------------------------------------------------URINE KETONES (semiquantitative)<br />Present in:DKA, alcoholic ketoacidosis, starvation, isopropanol ingestion----------------------------------------------------------------------------------------------------URINE METANEPHRINES<br />Elevated in:Pheochromocytoma, neuroblastoma, drugs (caffeine, phenothiazines, MAO inhibitors), stress----------------------------------------------------------------------------------------------------URINE MYOGLOBIN<br />Present in:Severe trauma, hyperthermia, polymyositis/demmatomyositis, carbon monoxide poisoning----------------------------------------------------------------------------------------------------URINE NITRITE<br />Present in:Urinary tract infections----------------------------------------------------------------------------------------------------URINE OCCULT BLOOD<br />Positive in:Trauma to urinary tract, renal disease (glomerulonephritis, pyelonephritis), renal or ureteral calculi, bladder lesions (carcinoma, cystitis), prostatitis, prostatic carcinoma, menstrual contamination, hematopoietic disorders (hemophilia, thrombocytopenia), anticoagulants, ASA----------------------------------------------------------------------------------------------------URINE OSMOLALITY<br />Elevated in:SIADH, dehydration, glycosuria, adrenal insufficiency, high-protein diet<br />Decreased in:Diabetes insipidus, excessive water intake, IV hydration with D5W acute renal insufficiency, glomerulonephritis----------------------------------------------------------------------------------------------------URINE pH<br />Elevated in:Bacteriuria, vegetarian diet, renal failure with inability to form ammonia, drugs (antibiotics, sodium bicarbonate, acetazolamide)<br />Decreased in:Acidosis (metabolic, respiratory), drugs (ammonium chloride, methenamine mandelate), diabetes mellitus, starvation, diarrhea----------------------------------------------------------------------------------------------------URINE POTASSIUM<br />Elevated in:Aldosteronism (primary, secondary), glucocorticoids, alkalosis, renal tubular acidosis, excessive dietary potassium intake<br />Decreased in:Acute renal failure, potassium-sparing diuretics, diarrhea, hypokalemia----------------------------------------------------------------------------------------------------URINE PROTEIN (quantitative)<br />Elevated in:Renal disease (glomerular, tubular, interstitial), CHF, hypertension, neoplasms of renal pelvis and bladder, multiple myeloma, Waldenstrom's macroglobulinemia----------------------------------------------------------------------------------------------------URINE SODIUM (quantitative)<br />Elevated in:Diuretic administration, high sodium intake, salt-losing nephritis, acutetubular necrosis, vomiting, CHF, hepatic failure. Addison's disease, SIADH, hypothyroidism----------------------------------------------------------------------------------------------------URINE SPECIFIC GRAVITY<br />Elevated in:Dehydration, excessive fluid losses (vomiting, diarrhea, fever) x-ray contrast media, diabetes mellitus, CHF, SIADH, adrenal insufficiency, Decreased fluid intake<br />Decreased in:Diabetes insipidus, renal disease (glomerulonephritis, pyelonephritis), excessive fluid intake or IV hydration----------------------------------------------------------------------------------------------------URINE VANILLYLMANDELIC ACID (VMA)<br />Elevated in:Pheochromocytoma, neuroblastoma, ganglioblastoma, drugs (isoproterenol, methocarbamol, levodopa, sulfonamides, chlorpromazine), severe stress, after ingestion of bananas, chocolate, vanilla, tea, coffee<br />Decreased in:Drugs (MAO inhibitors, reserpine, guanethidine, methyldopa)----------------------------------------------------------------------------------------------------VDRL<br />Positive test:Syphilis, other treponemal diseases (yaws, pinta, bejel)<br />NOTE: A false-positive test may be seen in patients with SLE and other autoimmune diseases, infectious mononucleosis, atypical pneumonia, malaria, leprosy.----------------------------------------------------------------------------------------------------VISCOSITY<br />Elevated in:Monoclonal gammopathies (Waldenstrom's macroglobulinemia, multiple myeloma), hyperfibrinogenemia, SLE, rheumatoid arthritis, polycythemia, leukemia----------------------------------------------------------------------------------------------------y-GLUTAMYL TRANSFERASE (GGT; GAMMA-GLUTAMYL TRANSFERASE )<br />Elevated in:Chronic alcoholic liver disease, neoplasms (hepatoma, metastatic disease to the liver, carcinoma of the pancreas), SLE, CHF, trauma, nephrotic syndrome, sepsis, cholestasis. drugs (phenytoin, barbiturates)Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com1tag:blogger.com,1999:blog-2217647826950966921.post-68551457799556253662009-01-16T06:51:00.000-08:002009-01-16T07:03:05.408-08:00GUIDE TO COMMON MEDICAL TESTS [lab tests]a-1 FETOPROTEIN (ALPHA-I-FETOPROTEIN )<br /><br />Elevated in:<br />Hepatocellular carcinoma (usually values >1000 ng/ml), germinal neoplasms (testis, ovary, mediastinum, retroperitoneum), liver disease (alcoholic cirrhosis, acute hepatitis, chronic active hepatitis), fetal anencephaly, spina bifida<br />----------------------------------------------------------------------------------------------------<br />ACETONE (serum or plasma)<br /><br />Elevated in:<br />DKA, starvation, isopropanol Ingestion<br />----------------------------------------------------------------------------------------------------<br />ACID PHOSPHATASE (serum)<br /><br />Elevated in:<br />Carcinoma of prostate, other neoplasms (breast, bone), Paget's disease, osteogenesis imperfecta, malignant invasion of bone, Gaucher's disease, multiple myeloma, myeloproliferative disorders, benign prostatic hypertrophy, prostatic palpation or surgery, hyperparathyroidism, liver disease, chronic renal failure<br />----------------------------------------------------------------------------------------------------<br />ALANINE AMINOTRANSFERASE (ALT, SGPT)<br /><br />Elevated in:<br />Liver disease (hepatitis, cirrhosis, Reye's syndrome), hepatic congestion, infectious mononucleosis, Ml, myocarditis, severe muscle trauma, dermatomyositis/polymyositis, muscular dystrophy, drugs (antibiotics, narcotics, antihypertensive agents, heparin, labetalol, lovastatin, NSAIDs, amiodarone, chlorpromazine, phenytoin), malignancy, renal and pulmonary infarction, convulsions, eclampsia, shock liver<br />----------------------------------------------------------------------------------------------------<br />ALBUMIN (serum)<br /><br />Elevated in:<br />Dehydration<br /><br />Decreased in:<br />Liver disease, nephrotic syndrome, poor nutritional status, rapid IV hydration, protein-losing enteropathies (inflammatory bowel disease), severe bums, neoplasia, chronic inflammatory diseases, pregnancy, oral contraceptives, prolonged immobilization<br />----------------------------------------------------------------------------------------------------<br />ALDOLASE (serum)<br /><br />Elevated in:<br />Muscular dystrophy, rhabdomyolysis, dermatomyositis/polymyositis, trichinosis, acute hepatitis and other liver diseases, Ml, prostatic carcinoma, hemorrhagic pancreatitis, gangrene, delirium tremens<br /><br />Decreased in:<br />Loss of muscle mass, late stages of muscular dystrophy<br />----------------------------------------------------------------------------------------------------<br />ALKALINE PHOSPHATASE (serum)<br /><br />Elevated in:<br />Biliary obstruction, cirrhosis (particularly primary biliary cirrhosis), liver disease (hepatitis, infiltrative liver diseases, fatty metamorphosis), Paget's disease of bone, osteitis deformans, rickets, osteomalacia, hypervitaminosis D, hyperparathyroidism, hyperthyroidism, ulcerative colitis, bowel perforation, bone metastases, healing fractures, bone neoplasms, acromegaly, infectious mononucleosis, CMV infections, sepsis, pulmonary infarction, CHF, hypernephroma, leukemia, myelofibrosis, multiple myeloma, drugs (estrogens, albumin, erythromycin and other antibiotics, cholestasis-producing drugs [phenothiazines])<br /><br />Decreased in:<br />Hypothyroidism, pernicious anemia, hypophosphatemia, hypervitaminosis D, malnutrition<br />----------------------------------------------------------------------------------------------------<br />AMMONIA (serum)<br /><br />Elevated in:<br />Hepatic failure, hepatic encephalopathy, Reye's syndrome, portacaval shunt, drugs (diuretics, polymyxin B. methicillin)<br /><br />Decreased in:<br />Drugs (neomycin, lactulose, tetracycline), renal failure<br />----------------------------------------------------------------------------------------------------<br />AMYLASE (serum)<br /><br />Elevated in:<br />Acute pancreatitis, pancreatic neoplasm, abscess, pseudocyst, ascites, macroamylasemia, perforated peptic ulcer, intestinal obstraction, intestinal infarction, acute cholecyshtis, appendicitis, ruptured ectopic pregnancy, salivary gland inflammation, peritonitis, burns, diabetic ketoacidosis, renal insufficiency, drugs (morphine), carcinomatosis of lung, esophagus, ovary, acute ethanol ingestion<br /><br />Decreased in:<br />Advanced chronic pancreatitis, hepatic necrosis<br />----------------------------------------------------------------------------------------------------<br />ANGIOTENSIN CONVERTING ENZYME (ACE level)<br /><br />Elevated in:<br />Sarcoidosis, primary biliary cirrhosis, alcoholic liver disease, hyperthyroidism, hyperparathyroidism, diabetes mellitus, amyloidosis, multiple myeloma, lung disease (asbestosis, silicosis, berylliosis, allergic alveolitis, coccidioidomycosis), Gaucher's disease, leprosy<br />----------------------------------------------------------------------------------------------------<br />ANION GAP<br /><br />Elevated in:<br />Lactic acidosis<br />Ketoacidosis (DKA, alcoholic starvation)<br />Uremia (chronic renal failure)<br />Ingestion of toxins (paraldehyde, methanol, salicylates, ethylene glycol)<br /><br />Decreased in:<br />Hypoalbum nemia, severe hypermagnesem a, IgG myeloma, littaum toxicity, lab error (falsely<br />Decreased sodium or overestimation of bicarbonate or chloride)<br />----------------------------------------------------------------------------------------------------<br />ANTI-DNA<br /><br />Present in:<br />SLE, chronic active hepatitis, infectious mononucleosis, biliary cirrhosis<br />----------------------------------------------------------------------------------------------------<br />ANTI-STREPTOLYSIN O TITER (STREPTOZYME, ASLO titer)<br /><br />Elevated in:<br />Streptococcal upper airway infection, acute rheumatic fever, acute glomerulonephritis, increased levels of B-lipoprotein<br /><br />NOTE: A fourfold increase in titer between acute and convalescent specimens is diagnostic of streptococcal upper airway infection regardless of the initial titer.<br />----------------------------------------------------------------------------------------------------<br />ANTIMITOCHONDRIAL ANTIBODY<br /><br />Elevated in:<br />Primary biliary cirrhosis (85-95%), chronic active hepatitis (25%-30%) cryptogenic cirrhosis (25-30%)<br />----------------------------------------------------------------------------------------------------<br />ANTINUCLEAR ANTIBODY (ANA)<br /><br />Positive test:<br />SLE (more significant if titer >1: 160), drugs (phenytoin, ethosuximide, pnmudone, methyldopa, hydralazine, carbamazepine, penicillin, procainamide, chlorpromazine, griseofulvin, thiazides), chronic active hepatltis, age over 60 yr (particularly age over 80), rheumatoid arthritls, scleroderma, mixed connective tissue disease, necrotizing vasculitis, Sjogren's syndrome (SS), tuberculosis, pulmonary interstitial fibrosis<br />----------------------------------------------------------------------------------------------------<br />ANTITHROMBIN III<br /><br />Decreased in:<br />Hereditary deficiency of antithrombin III, DIC, pulmonary embolism, cirrhosis, thrombolytic therapy, chronic liver failure, post-surgery, third trimester of pregnancy, oral contraceptives, nephrotic syndrome, IV heparin >3 days, sepsis<br /><br />Elevated in:<br />Warfarin drugs, post-MI<br />----------------------------------------------------------------------------------------------------<br />ASPARTATE AMINOTRANSFERASE (AST, SGOT)<br /><br />Elevated in:<br />Liver disease (hepatitis, cirrhosis, Reye's syndrome), hepatic congestion, infectious mononucleosis, MI, myocarditis, severe muscle trauma, dermatomyositis/polymyositis, muscular dystrophy, drugs (antibiotics, narcotics, antihypertensive agents, heparin, labetalol, lovastatin, NSAIDs, phenytoin, amiodarone, chlorpromazine), malignancy, renal and pulmonary infarction, convulsions, eclampsia<br />----------------------------------------------------------------------------------------------------<br />BASOPHIL COUNT<br /><br />Elevated in:<br />Leukemia, inflammatory processes, polycythemia vera, Hodgkin's Iymphoma, hemolytic anemia, after splenectomy, myeloid metaplasia<br /><br />Decreased in:<br />Stress, hypersensitivity reaction, steroids, pregnancy, hyperthyroidism<br />----------------------------------------------------------------------------------------------------<br />BILIRUBIN, DIRECT (conjugated bilirubin)<br /><br />Elevated in:<br />Hepatocellular disease, biliary obstruction, drug-induced cholestasis, hereditary disorders (Dubin-Johnson syndrome, Rotor's syndrome)<br />----------------------------------------------------------------------------------------------------<br />BILIRUBIN, INDIRECT (unconjugated bilirubin)<br /><br />Elevated in:<br />Hemolysis, liver disease (hepatitis cirrhosis, neoplasm), hepatic congestion secondary to congestive heart failure, heredltary dlsorders (Gilbert's disease, Crigler-Najjar syndrome)<br />----------------------------------------------------------------------------------------------------<br />BILIRUBIN, TOTAL<br /><br />Elevated in:<br />Liver disease (hepatitis, cirrhosis, cholangitis, neoplasm, biliary obstruction, infectious mononucleosis), hereditary disorders (Gilbert's dsease, Dubin-Johnson syndrome), drugs (steroids, diphenylhydanton, phenothiazines, penicillin, erythromycin, clindamycin, captopril, amphotericin B. sulfonamides, azathioprine, isoniazid, 5-aminosalicylic acid, allopurinol, methyldopa, indomethacin, halothane, oral contracepuves, procainamide, tolbutamide, labetalol), hemolysis, pulmonary embolism or infarct, hepatic congestion secondary to CHF<br />----------------------------------------------------------------------------------------------------<br />BLEEDING TIME (modified Ivy method)<br /><br />Elevated in:<br />Thrombocytopenia, capillary wall abnormalities, platelet abnormalities (Bernard-Soulier, Glamzmann's), drugs (aspirin, warfarin, antinflammatory medications, streptokinase, urokinase, dextran, B lactam antibiotics, moxalactam), DIC, cirrhosis, uremia, myeloproliferative dlsorders, Von Willebrand's<br />----------------------------------------------------------------------------------------------------<br />C-REACTIVE PROTEIN<br /><br />Elevated in:<br />Rheumatoid arthritis, rheumatic fever, inflammatory bowel disease, bacterial infections, Ml, oral contraceptives, third trimester of pregnancy (acute phase reactant), inflammatory and neoplastic diseases<br />----------------------------------------------------------------------------------------------------<br />CALCITONIN (serum)<br /><br />Elevated in:<br />Medullary carcinoma of the thyroid (particularly if level >1500 pg/ml), carcinoma of the breast, APUDomas, carcinolds, renal failure, thyroiditis<br />----------------------------------------------------------------------------------------------------<br />CALCIUM (serum)<br /><br />Increased in:<br />-Hyperparathyroidism, primary (due to hyperplasia or adenoma of parathyroids) or secondary<br />-Hyperparathyroidism due to parathormone-secreting cancer -Hematologic malignancies (e.g., myeloma, lymphoma, leukemia)<br />-Excess vitamin D intake<br />-Bone tumor (Metastatic carcinoma (10% of patients))<br />-Acute osteoporosis (e.g., immobilization of young patients or in Paget's disease)<br />-Milk-alkali (Burnett's) syndrome<br />-Idiopathic hypercalcemia of infants<br />-Infantile hypophosphatasia<br />-Berylliosis<br />-Hyperthyroidism (some patients)<br />-Cushing's syndrome (some patients)<br />-Addison's disease (some patients)<br />-Myxedema (some patients)<br />-Hyperproteinemia (Sarcoidosis, -Multiple myeloma (some patients))<br />-Thiazide drugs<br />-Artifactual (e.g., venous stasis during blood collection, use of cork-stoppered test tubes)<br /><br />Decreased in:<br />-Hypoparathyroidism (Surgical; Idiopathic; Pseudohypoparathyroidism)<br />-Malabsorption of calcium and vitamin D (Obstructive jaundice)<br />-Hypoalbuminemia (Cachexia, Nephrotic syndrome, Sprue, Celiac disease, Cystic fibrosis of pancreas)<br />-Chronic renal disease with uremia and phosphate retention<br />-Acute pancreatitis with extensive fat necrosis<br />-Insufficient calcium, phosphorus, and vitamin D ingestion (Bone disease (osteomalacia, rickets); Starvation; Late pregnancy)<br /><br />Total serum protein should always be known for proper interpretation of serum calcium levels.<br /><br />----------------------------------------------------------------------------------------------------<br />CARBOXYHEMOGLOBIN (CARBON MONOXIDE; CO)<br /><br />Elevated in:<br />Smoking, exposure to smoking, exposure to automobile exhaust fumes malfunctioning gas-burning appliances<br />----------------------------------------------------------------------------------------------------<br />CARCINOEMBRYONIC ANTIGEN (CEA)<br /><br />Elevated in:<br />Colorectal carcinomas, pancreatic carcmomas, and metastatic disease usually produce higher elevations (>20 ng/ml)<br /><br />Carcinomas of the esophagus, stomach, small intestine, liver, breast ovary, lung and thyroid usually produce lesser elevations<br /><br />Benign conditions (smoking, inflammatory bowel disease hypothyroidism, cirrhosis, pancreatitis, infections) usually produce ievels <10 ng/ml<br />----------------------------------------------------------------------------------------------------<br />CAROTENE (serum)<br /><br />Elevated in:<br />Carotenemia, chronic nephritis, diabetes mellitus, hypothyroidism, nephrotic syndrome<br /><br />Decreased in:<br />Fat malabsorption, steatorrhea, pancreatic insufficiency, lack of carotenoids in diet<br />----------------------------------------------------------------------------------------------------<br />CEREBROSPINAL FLUID (CSF)<br /><br />----------------------------------------------------------------------------------------------------<br />CERULOPLASMIN (serum)<br /><br />Elevated in:<br />Pregnancy, estrogens, oral contraceptives, neoplastic diseases (leukemias, Hodgkin's Iymphoma, carcinomas), inflammatory states, SLE, prirnary biliary cirrhosis, rheumatoid arthritis<br /><br />Decreased in:<br />Wilson's disease (values often <10 mg/dl), nephrotic syndrome, advanced liver disease, malabsorption, total parenteral nutrition, Menkes' syndrome<br />----------------------------------------------------------------------------------------------------<br />CHLORIDE (serum)<br /><br />Elevated in:<br />-Dehydration, excessive infusion of normal saline<br />-Hyperparathyroidism, renal tubular disease, metabolic acidosis, prolonged diarrhea<br />-Drugs (ammonium chloride administration, acetazolamide, boric acid, triamterene)<br /><br />Decreased in:<br />CHF, SIADH, Addison's disease, vomiting, gastric suction, salt-losing nephritis, continuous infusion of D5W, thiazide diuretic administration, diaphoresis, diarrhea, burns<br />----------------------------------------------------------------------------------------------------<br />CHOLESTEROL, TOTAL<br /><br />Elevated in:<br />Primary hypercholesterolemia, biliary obstruction, diabetes melhtus, nephrotic syndrome, hypothyroidism, primary biliary cirrhosis, high cholesterol diet, third trimester of pregnancy, Ml, drugs (steroids, phenothiazines, oral contraceptives)<br /><br />Decreased in:<br />Starvation, malabsorption, sideroblastic anemia, thalassemia, abetalipoproteinemia, hyperthyroidism, Cushing's syndrome, hepatic failure, multiple myeloma, polycythemia vera, chronic myelocytic leukemia, myeloid metaplasia, Waldenstrom's macroglobulinemia, myelofibrosis<br />----------------------------------------------------------------------------------------------------<br />CIRCULATING ANTICOAGULANT (lupus anticoagulant)<br /><br />Detected in:<br />SLE, drug-induced lupus, long-term phenothiazine therapy, multiple myeloma, ulcerative colhis, rheumatoid arthritis, postpartum, hemophilia, neoplasms, chronic inflammatory states<br />----------------------------------------------------------------------------------------------------<br />COLD AGGLUTININS TITER<br /><br />Elevated in:<br />Primary atypical pneumonia (mycoplasma pneumonia), infectious mononucleosis, CMV infection<br /><br />Other: hepatic cirrhosis, acquired hemolytic anemia, frostbite, multiple myeloma, Iymphoma, malaria<br />----------------------------------------------------------------------------------------------------<br />COMPLEMENT (C3, C4)<br /><br />C3 is increased in:<br />Acute and chronic inflammation (slightly), obstructive jaundice<br /><br />C3 is decreased in:<br />Acute glomerulonephritis, systemic lupus erythromatosis<br /><br />----------------------------------------------------------------------------------------------------<br />COOMBS, DIRECT<br /><br />Positive:<br />Autoimmune hemolytic anemia, erythroblastosis fetalis, transfusion reactions, drugs (a-methyldopa, peniecllins, tetraeyeline, sulfonamides, levodopa, cephalosporins, quinidine, insulin)<br /><br />False positive:<br />May be seen with cold agglutinins<br />----------------------------------------------------------------------------------------------------<br />COOMBS, INDIRECT<br /><br />Positive:<br />Acquired hemolytic anemia, incompatible cross-matched blood, anti-Rh antibodies, drugs (methyldopa, mefenamic acid, levodopa)<br />----------------------------------------------------------------------------------------------------<br />COPPER (serum)<br /><br />Increased in:<br />-Anemias (Pernicious anemia, Megaloblastic anemia of pregnancy, Iron deficiency anemia, Aplastic anemia, Leukemia, acute and chronic, Infection, acute and chronic, Malignant lymphoma, Hemochromatosis)<br />-Collagen diseases (including SLE, rheumatoid arthritis, acute rheumatic fever, glomerulonephritis)<br />-Hypothyroidism<br />-Hyperthyroidism<br />-Frequently associated with increased C-reactive protein<br /><br />Decreased in:<br />-Nephrosis (ceruloplasmin lost in urine)<br />-Wilson's disease<br />-Acute leukemia in remission<br />-Some iron deficiency anemias of childhood (that require copper as well as iron therapy)<br />-Kwashiorkor<br /><br />----------------------------------------------------------------------------------------------------<br />CORTISOL (plasma)<br /><br />Elevated in:<br />-Ectopic ACTH production (i.e., oat cell carcinoma of lung), loss of normal diurnal variation, pregnancy, chronic renal failure<br />-Iatrogenic, stress, adrenal or pituitary hyperplasia or adenomas<br /><br />Decreased in:<br />Primary adrenocortical insufficiency, anterior pituitary hypofunction, secondary adrenocortical insufficiency, adrenogenital syndromes<br />----------------------------------------------------------------------------------------------------<br />CREATINE KINASE (CK, CPK)<br /><br />Elevated in:<br />MI, myocarditis, rhabdomyolysis, myositis, crush injury/trauma, polymyositis, dermatomyositis, vigorous exercise, muscular dystrophy, myxedema, seizures, malignant hyperthermia syndrome, IM injections, CVA, pulmonary embolism and infarction, acute dissection of aorta<br /><br />Decreased in:<br />Steroids, decreased muscle mass, connective tissue disorders, alcoholic liver disease, metastatic neoplasms<br />----------------------------------------------------------------------------------------------------<br />CREATINE KINASE ISOENZYMES<br /><br />CK-MB<br />Elevated in: Mi, myocarditis, pericarditis, muscular dystrophy, cardiac defibrillation, cardiac surgery, extensive rhabdomyolysis, strenuous exercise (marathon runners), mixed conmective tissue disease, cardiomyopathy, hypothermia<br /><br />CK-MM<br />Elevated in: crush injury, seizures, malignant hyperthermia syndrome, rhabdomyolysis, myositis, polymyositis, dermatomyositis, vigorous exercise, muscular dystrophy, IM injections, acute dissection of aorta<br /><br />CK-BB<br />Elevated in: CVA, subarachnoid hemorrhage, neoplasms (prostate, Gl tract, brain, ovary, breast, lung), severe shock, bowel infarction, hypothermia<br />----------------------------------------------------------------------------------------------------<br />CREATININE (serum)<br /><br />Elevated in:<br />Renal insufficiency (acute and chronic),<br />Decreased renal perfusion (hypotension, dehydration, CHF), urinary tract infection, rhabdomyolysis, ketonemia<br />Drugs (antibiotics [aminoglycosides, cephalosporins], hydantoin, diuretics, methyldopa)<br /><br />Falsely elevated in:<br />DKA, administration of some cephalosporins (e.g., cefoxitin, cephalothin)<br /><br />Decreased in:<br />Decreased muscle mass (including amputees and older persons), pregnancy, prolonged debilitation<br />----------------------------------------------------------------------------------------------------<br />CREATININE CLEARANCE<br /><br />Elevated in:<br />Pregnancy, exercise<br /><br />Decreased in:<br />Renal insufficiency, drugs (cimetidine, procainanude, antibiotics, quinidine)<br />----------------------------------------------------------------------------------------------------<br />CRYOGLOBULINS (serum)<br /><br />Present in:<br />Collagen-vascular diseases, CLL, hemolytic anemias, multiple myeloma, Waldenstrom's macroglobulinemia, chronic active hepatitis, Hodgkin's disease<br />----------------------------------------------------------------------------------------------------<br />D-XYLOSE ABSORPTION<br /><br />Decreased in:<br />Malabsorption syndrome<br />----------------------------------------------------------------------------------------------------<br />EOSINOPHIL COUNT<br /><br />Elevated in:<br />Allergy, parasitic infestations (trichinosis, aspergillosis, hydatidosis), angmneurotic edema, drug reactions, warfarin sensitivity, collagen-vascular diseases, acute hypereosinophilic syndrome, eosinophilic nonallergic rhinitis, myeloproliferative disorders, Hodgkin's Iymphoma, radiation therapy, NHL, L-tryptophan ingestion<br />----------------------------------------------------------------------------------------------------<br />ERYTHROCYTE SEDIMENTATION RATE (Westergren)<br /><br />Elevated in:<br />Collagen-vascular diseases, infections, MI, neoplasms, inflammatory states (acute phase reactant)<br />----------------------------------------------------------------------------------------------------<br />EXTRACTABLE NUCLEAR ANTIGEN (ENA complex, anti-RNP antibody, anti-Sm, anti-Smith)<br /><br />Present in:<br />SLE, rheumatoid arthritis, Sjogren's syndrome, MCTD<br />----------------------------------------------------------------------------------------------------<br />FECAL FAT, QUANTITATIVE (72 hr collection)<br /><br />Elevated in:<br />Malabsorption syndrome<br />----------------------------------------------------------------------------------------------------<br />FERRITIN (serum)<br /><br />Elevated in:<br />Hyperthyroidism, inflammatory states, liver disease (ferritin elevated from necrotic hepatocytes), neoplasms (neuroblastomas, Iymphomas, leukemia, breast carcinoma), iron replacement therapy, hemochromatosis<br /><br />Decreased in:<br />Iron deficiency anemia<br />----------------------------------------------------------------------------------------------------<br />FIBRIN DEGRADATION PRODUCT (FDP)<br /><br />Elevated in:<br />DIC, primary fibrinolysis, pulmonary embolism, severe liver disease<br /><br />NOTE: The presence of rheumatoid factor may cause falsely elevated FDP<br />----------------------------------------------------------------------------------------------------<br />FIBRINOGEN<br /><br />Elevated in:<br />Tissue inflammation/damage (acute-phase protein reactant), oral contraceptives, pregnancy, acute infection, MI<br /><br />Decreased in:<br />DIC, hereditary afibrinogenemia, liver disease, primary or secondary fibrinolysis, cachexia<br />----------------------------------------------------------------------------------------------------<br />FOLATE (FOLIC ACID)<br /><br />Decreased in:<br />Folic acid deficiency (inadequate intake, malabsorption), alcoholism, drugs (methotrexate, trimethoprim, phenytoin, oral contraceptives, azulfadine), vitamin B12 deficiency (defective red cell folate absorption)<br />----------------------------------------------------------------------------------------------------<br />FTA-ABS (serum)(FLUORESCENT TREPONEMAL ANTIBODY)<br /><br />Reactive in:<br />Syphilis, other treponemal diseases (yaws, pinta, bejel)<br />----------------------------------------------------------------------------------------------------<br />GASTRIN (serum)<br /><br />Elevated in:<br />Zollinger-Ellison syndrome (gastrinoma), pernicious anemia, hyperparathyroidism, retained gastric antrum, chronic renal failure, gastric ulcer, chronic atrophic gastritis, pyloric obstruction, malignant neoplasms of the stomach, H2 blockers, omeprazole<br />----------------------------------------------------------------------------------------------------<br />GLOMERULAR BASEMENT MEMBRANE ANTIBODY (ANTIGLOMERULAR BASEMENT ANTIBODY)<br /><br />Present in:<br />Goodpasture's syndrome<br />----------------------------------------------------------------------------------------------------<br />GLUCOSE-6-PHOSPHATE DEHYDROGENASE SCREEN (blood)<br /><br />Abnormal:<br />If a deficiency is detected, quantitation of G6PD is necessary; a G6PD screen may be falsely interpreted as abnormal<br />----------------------------------------------------------------------------------------------------<br />GLUCOSE TOLERANCE TEST<br /><br />Elevated in:<br />Glucose intolerance, diabetes mellitus, Cushing's syndrome, acromegaly, pheochromocytoma<br />----------------------------------------------------------------------------------------------------<br />GLUCOSE, FASTING<br /><br />Elevated in:<br />Diabetes mellitus, stress, infections, MI, CVA, Cushing's syndrome, acromegaly, acute pancreatitis, glucagonoma, hemocbromatosis, drugs (glucocorticoids, diuretics [thiazides, loop diuretics]), glucose intolerance<br />----------------------------------------------------------------------------------------------------<br />GLUCOSE, POSTPRANDIAL<br /><br />Elevated in:<br />Diabetes mellitus, glucose intolerance<br /><br />Decreased in:<br />Post-gastrointestinal resection, reactive hypoglycemia, hereditary fructose intolerance, galactosemia, leucine sensitivity<br />----------------------------------------------------------------------------------------------------<br />GLYCATED (GLYCOSYLATED) HEMOGLOBIN (HbA1c)<br /><br />Elevated in:<br />Uncontrolled diabetes mellitus (glycated hemoglobin levels reflect the level of glucose control over the preceding 120 days)<br /><br />Decreased in:<br />Hemolytic anemias,<br />Decreased RBC survival, pregnancy, chronic blood loss, chronic renal failure, insulinoma<br />----------------------------------------------------------------------------------------------------<br />HAM TEST (acid serum test)<br /><br />Positive in:<br />Paroxysmal nocturnal hemoglobinuria (PNH)<br /><br />False positive in:<br />Hereditary or acquired spherocytosis, recent transfusion with aged RBC, aplastic anemia, myeloproliferative syndromes, leukemia, hereditary dyserythropoietic anemia type II (HEMPAS)<br />----------------------------------------------------------------------------------------------------<br />HAPTOGLOBIN (serum)<br /><br />Elevated in:<br />Inflammation (acute phase reactant), collagen-vascular diseases, infections (acute phase reactant), drugs (androgens)<br /><br />Decreased in:<br />Hemolysis (intravascular > extravascular), megaloblastic anemia, severe liver disease, large tissue hematomas, infectious mononucleosis, drugs (oral contraceptives)<br />----------------------------------------------------------------------------------------------------<br />HEMATOCRIT<br /><br />Elevated in:<br />Polycythemia vera, smoking, COPD, high altitudes, dehydration, hypovolemia<br /><br />Decreased in:<br />Blood loss (GI, GU), anemia, pregnancy<br />----------------------------------------------------------------------------------------------------<br />HEMOGLOBIN<br /><br />Elevated in:<br />Hemoconcentration, dehydration, polycythemia vera, COPD, high altitudes, false elevations (hyperlipemic plasma, WBC >50,000 mm3), stress<br /><br />Decreased in:<br />Hemorrhage (GI, GU), anemia<br />----------------------------------------------------------------------------------------------------<br />HEPATITIS A ANTIBODY<br /><br />Present in:<br />Viral hepatitis A, can be IgM or IgG (if IgM, acute hepatitis A; if IgG, previous infection with hepatitis A)<br />----------------------------------------------------------------------------------------------------<br />HEPATITIS B SURFACE ANTIGEN (HBsAg)<br /><br />Detected in:<br />Acute viral hepatitis Type B. Chronic hepatitis B<br />----------------------------------------------------------------------------------------------------<br />HIGH DENSITY LIPOPROTEIN (HDL) CHOLESTEROL<br /><br />Increased:<br />Use of gemfibrozil, nicotinic acid, estrogens, regular aerobic exercise, small (1 oz) daily alcohol intake<br /><br />Decreased:<br />Deficiency of apoproteins, liver disease, probucol ingestion, Tangier disease<br />NOTE: A cholesterol/HDL ratio >4.5 is associated with increased risk of coronary artery disease.<br />----------------------------------------------------------------------------------------------------<br />IMMUNE COMPLEX ASSAY<br /><br />Detected in:<br />Collagen-vascular disorders, glomerulonephritis, neoplastic diseases, malaria, primary biliary cirrhosis, chronic acute hepatitis, bacterial endocarditis, vasculitis<br />----------------------------------------------------------------------------------------------------<br />IMMUNOGLOBULINS<br /><br />Elevated in:<br />-IgA: Iymphoproliferative disorders, Berger's nephropathy, chronic infections, autoimmune disorders, liver disease<br />-IgE: allergic disorders, parasitic infections, immunological disorders IgE myeloma<br />-IgG: chronic granulomatous infections, infectious diseases, inflammation, myeloma, liver disease<br />-IgM: primary biliary cirrhosis, infectious diseases (brucellosis, malaria), Waldenstrom's macroglobulinemia, liver disease<br /><br />Decreased in:<br />-IgA: nephrotic syndrome, protein-losing enteropathy, congenital deficiency, Iymphocytic leukemia, ataxia-telengiectasia, chronic eosinopulmonary disease<br />-IgE: hypogammaglobulinemia, neoplasm (breast, bronchial, cervical) ataxia, telengiectasia<br />-IgG: congenital or acquired deficiency, Iymphocytic leukemia, phenytoin, methylprednisolone, nephrotic syndrome, protein-losing enteropathy<br />-IgM: congenital deficiency, Iymphocytic leukemia, nephrotic syndrome<br />----------------------------------------------------------------------------------------------------<br />IRON-BINDING CAPACITY (TIBC)<br /><br />Elevated in:<br />Iron deficiency anemia, pregnancy, polycythemia<br /><br />Decreased in:<br />Anemia of chronic disease, hemochromatosis, chronic liver disease, hemolytic anemias, malnutrition (protein depletion)<br />----------------------------------------------------------------------------------------------------<br />LACTATE (blood)<br /><br />Increased in:<br />(Without signifigant acidosis): Muscular exercise, hyperbentilation, glucaon, glycogen storage disease, severe anemia, pyruvate infusion, HCO3 infusion, glucose and insulin infusion.<br /><br />(With hypoxia and acidosis): Acute hemorrage, circulatory collapse, cyanotic heart disease, severe acute CHF, acute anoxemia, extracorpeal circulation, epinephrine<br /><br />(Idiopathic): Mild uremia, infections (esp. pyelonephritis), septicemia, cirrhosis, acute pancreatitis (+/-), third trimester of pregnancy, severe vascular disease, leukemia, anemia, chronic alcoholism, subacute bacterial endocarditis, poliomyelitis<br />----------------------------------------------------------------------------------------------------<br />LACTATE DEHYDROGENASE (LDH)<br /><br />Elevated in:<br />Infarction of myocardium, lung, kidney<br /><br />Diseases of cardiopulmonary system, liver, collagen, CNS<br /><br />Hemolytic anemias, megaloblastic anemias, transfusions, seizures, muscle trauma, muscular dystrophy, acute pancreatitis hypotension shock, infectious mononucleosis, inflammation, neoplasia, intestinai obstruction, hypothyroidism<br />----------------------------------------------------------------------------------------------------<br />LACTATE DEHYDROGENASE ISOENZYMES<br /><br />Abnormal values:<br />LDH1 > LDH2: MI (can also be seen with hemolytic anemias, pernicious anemia, folate deficiency, renal infarct)<br /><br />LDH5 > LDH4: liver disease (cirrhosis, hepatitis, hepatic congestion)<br />----------------------------------------------------------------------------------------------------<br />LEGIONELLA TITER<br /><br />Positive in:<br />Legionnaire's disease (presumptive: > 1:256 titer; definitive: fourfold titer increase to >1: 128)<br />----------------------------------------------------------------------------------------------------<br />LEUKOCYTE ALKALINE PHOSPHATASE (LAP SCORE)<br /><br />Elevated in:<br />Leukemoid reactions, neutrophilia secondary to infections (except in sickle cell crisisƒ€no significant increase in LAP score), Hodgkin's disease, polycythemia vera, hairy cell leukemia, aplastic anemia, Down's syndrome, myelofibrosis<br /><br />Decreased in:<br />Acute and chronic granulocytic leukemia, thrombocytopenic purpura, paroxysmal nocturnal hemoglobinuria (PNH), hypophosphatemia, collagen disorders<br />----------------------------------------------------------------------------------------------------<br />LIPASE<br /><br />Elevated in:<br />Acute pancreatitis, perforated peptic ulcer, carcinoma of pancreas (early stage), pancreatic duct obstruction<br />----------------------------------------------------------------------------------------------------<br />LOW DENSITY LIPOPROTEIN (LDL) CHOLESTEROL<br /><br />Elevated in:<br />Primary hyperlipoproteinemia, diet high in saturated fats, acute MI, hypothyroidism, primary biliary cirrhosis, nephrosis, driabetes mellitus<br /><br />Decreased in:<br />Abetalipoproteinemia, advanced liver disease, malabsorption, malnutrition<br />----------------------------------------------------------------------------------------------------<br />LYMPHOCYTES<br /><br />Elevated in:<br />Chronic infections, infectious mononucleosis and other viral infections, CLL, Hodgkin's disease, ulcerative colitis, hypoadrenalism, ITP<br /><br />Decreased in:<br />AIDS, ARC, bone marrow suppression from chemotherapeutic agents or chemotherapy, aplastic anemia, neoplasms, steroids, adrenocortical hyperfunction, neurologic disorders (multiple sclerosis, myasthenia gravis, Guillain-Barre syndrome)<br />----------------------------------------------------------------------------------------------------<br />MAGNESIUM (serum)<br /><br />Increased in:<br />-Renal failure<br />-Diabetic coma before treatment<br />-Hypothyroidism<br />-Addison's disease and after adrenalectomy<br />-Controlled diabetes mellitus in older patients<br />-Administration of antacids containing magnesium<br /><br />Decreased in:<br />-GI disease showing malabsorption and abnormal loss of GI fluids (e.g., nontropical sprue, small bowel resection, biliary and intestinal fistulas, abdominal irradiation, prolonged aspiration of intestinal contents, celiac disease and other causes of steatorrhea)<br />-Acute alcoholism and alcoholic cirrhosis<br />-Insulin treatment oof diabetic coma<br />-Hyperthyroidism<br />-Aldosteronism<br />-Hyperparathyroidism<br />-Lytic tumors of bone<br />-Diuretic drug therapy (e.g., ethacrynic acid, furosemide)<br />-Some cases of renal disease (e.g., glomerulonephritis, pyeloneI phritis, renal tubular acidosis)<br />-Acute pancreatitis<br />-Excessive lactation<br />-Idiopathic disorders<br /><br />Magnesium deficiency may cause apparently unexplained hypocalcemia and hypokalemia; the patients may have neurologic and GI symptoms<br /><br />----------------------------------------------------------------------------------------------------<br />MEAN CORPUSCULAR VOLUME (MCV)<br /><br />Elevated in:<br />Vitamin B12 deficiency, folic acid deficiency, liver disease, alcohol abuse, reticulocytosis, hypothyroidism, marrow aplasia, myelofibrosis<br /><br />Decreased in:<br />Iron deficiency, thalassemia syndrome and other hemoglobinopathies, anemia of chronic disease, sideroblastic anemia, chronic renal failure, lead poisoning<br />----------------------------------------------------------------------------------------------------<br />MONOCYTE COUNT<br /><br />Elevated in:<br />Viral diseases, parasites, infections, neoplasms, inflammatory bowel disease, monocytic leukemia, Iymphomas, myeloma, sarcoidosis<br /><br />Decreased in:<br />Aplastic anemia, Iymphocytic leukemia, glucocorticoid administration<br />----------------------------------------------------------------------------------------------------<br />NEUTROPHIL COUNT<br /><br />Elevated in:<br />Acute bacterial infections, acute MI, stress, neoplasms, myelocytic leukemia<br /><br />Decreased in:<br />Viral infections, aplastic anemias, immunosuppressive drugs, radiation therapy to bone marrow, agranulocytosis, drugs (antibiotics, antithyroidals), Iymphocytic and monocytic leukemias<br />----------------------------------------------------------------------------------------------------<br />OSMOLALITY, SERUM<br /><br />It can be estimated by the following formula:<br /><br />2([Na] + [K]) + Glucose/18 + BUN/2.8<br /><br />Elevated in:<br />Dehydration, hypernatremia, diabetes insipidus, uremia, hyperglycemia, mannitol therapy, ingestlon of toxins (ethylene glycol, methanol ethanol)<br /><br />Decreased in:<br />SIADH, hyponatremia, overhydration<br />----------------------------------------------------------------------------------------------------<br />pH, BLOOD<br /><br />Increased in:<br />Metabolic alkalosis, respiratory alkalosis<br /><br />Decreased in:<br />Metabolic acidosis, repiratory acidosis<br />----------------------------------------------------------------------------------------------------<br />PARTIAL THROMBOPLASTIN TIME (PTT), ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT)<br /><br />Elevated in:<br />Heparin therapy, coagulation factor deficiency (I, II, V, VIII, IX, X, XI XII), liver disease, vitamin K deficiency, DIC, circulating anticoagulant, warfarin therapy, specific factor inhibition (PCN reaction, rheumatoid arthritis), thrombolytic therapy<br /><br />NOTE: Useful to evaluate the intrinsic coagulaion system.<br />----------------------------------------------------------------------------------------------------<br />PHOSPHATASE, ALKALINE; see ALKALINE PHOSPHATASE PHOSPHORUS (serum)<br /><br />Elevated in:<br />Renal failure, dehydration, Addison's disease, myelogenous leukemia, hypervitaminosis D, hypoparathyroidism, pseudohypoparathyroidism, bone metastases, sarcoidosis, milk-alkali syndrome, immobilization, magnesium deficiency, transfusions, hemolysis<br /><br />Decreased in:<br />Starvation (e.g., alcoholics), DKA, TPN, continuous IV dextrose administration, vitamin D deficiency, hyperparathyroidism, pseudohyperparathyroidism, antacids containing aluminum hydroxide, insulin administration, nasogastric suctioning, vomiting, diuretics, steroids, gram-negative septicemia<br />----------------------------------------------------------------------------------------------------<br />PHOSPHORUS (serum)<br /><br />Increased in:<br />-Hypoparathyroidism (Idiopathic, Surgical, Pseudohypoparathyroidism)<br />-Excess vitamin D intake<br />-Secondary hyperparathyroidism (renal rickets)<br />-Bone disease (Healing fractures, Multiple myeloma (some patients), Paget's disease (some patients), Osteolytic metastatic tumor in bone (some patients))<br />-Addison's disease<br />-Acromegaly<br />-Childhood<br />-Myelogenous leukemia<br />-Acute yellow atrophy<br />-High intestinal obstruction<br />-Sarcoidosis (some patients)<br />-Milk-alkali (Burnett's) syndrome (some patients)<br />-Artifactual increase by hemolysis of blood<br /><br />Decreased in<br />-Alcoholism*<br />-Diabetes mellitus*<br />-Hyperalimentation*<br />-Nutritional recovery syndrome* (rapid refeeding after prolonged starvation)<br />-Alkalosis, respiratory (e.g., gram-negative bacteremia) or metabolic<br />-Acute gout<br />-Salicylate poisoning<br />-Administration of glucose intravenously (e.g., recovery after severe burns, hyperalimentation)<br />-Administration of anabolic steroids, androgens, epinephrine, glucagon, insulin<br />-Acidosis (especially ketoacidosis)<br />-Hyperparathyroidism<br />-Renal tubular defects (e.g., Fanconi syndrome)<br />-Hypokalemia<br />-Hypomagnesemia<br />-Administration of diuretics<br />-Prolonged hypothermia (e.g., open heart surgery)<br />-Malabsorption<br />-Vitamin D deficiency and/or resistance, osteomalacia<br />-Malnutrition, vomiting, diarrhea<br />-Administration of phosphate-binding antacids*<br />-Primary hypophosphatemia<br /><br />*Indicates conditions associated with severe hypophosphatemia.<br /><br />Mechanisms of hypophosphatemia are intracellular shift of phosphate, increased loss (via kidney or intestine), or decreased intestinal absorption; usually associated with prior phosphorus depletion. Often, more than one mechanism is operative.<br /><br />----------------------------------------------------------------------------------------------------<br />PLATELET COUNT<br /><br />Elevated in:<br />Neoplasms (GI tract), CML, polycythemia vera, myelofibrosis with myeloid metaplasia, infections, after splenectomy, postpartum, after hemorrhage, hemophilia, iron deficiency, pancreatitis, cirrhosis<br />----------------------------------------------------------------------------------------------------<br />POTASSIUM (serum)<br /><br />Increased in:<br />-Renal failure: (Acute with oliguria or anuria; Chronic end-stage with oliguria (glomerular filtration rate <3-5 ml/minute); Chronic nonoliguric associated with dehydration, obstruction, trauma, or excess potassium)<br />-Decreased mineralocorticoid activity: (Addison's disease; Hypofunction of renin-angiotensin-aldosterone system; Pseudohypoaldosteronism; Aldosterone antagonist (e.g., spironolactone))<br />-Increased supply of potassium: (Red blood cell hemolysis (transfusion reaction, hemolytic anemia); Excess dietary intake or rapid potassium infusion; Striated muscle (status epilepticus, periodic paralysis); Potassium-retaining drugs (e.g., triamterene); Fluid-electrolyte imbalance (e.g., dehydration, acidosis))<br />-Laboratory artifacts (e.g., hemolysis during venipuncture, conditions associated with thrombocytosis, incomplete separation of serum and clot)<br /><br />Decreased in:<br />-Renal and adrenal conditions with metabolic alkalosis: (Administration of diuretics, Primary aidosteronism, Pseudoaldosteronism, Salt-losing nephropathy, Cushing's syndrome)<br />-Renal conditions associated with metabolic acidosis: (Renal tubular acidosis, Diuretic phase of acute tubular necrosis, Chronic pyelonephritis, Diuresis following relief of urinary tract obstruction)<br />-Gastrointestinal conditions: (Vomiting, gastric auctioning; Villous adenoma; Cancer of colon; Chronic laxative abuse; Zollinger-Ellison syndrome; Chronic diarrhea; Ureterosigmoidostomy)<br /><br />----------------------------------------------------------------------------------------------------<br />PROLACTIN<br /><br />Elevated in:<br />Prolactinomas (level >200 highly suggestive), drugs (phenothiazines, cimetidine, tricyclic antidepressants, metoclopramide, estrogens, antihypertensives [methyldopa], verapamil, haloperidol), postpartum, stress, hypoglycemia, hypothyroidism<br />----------------------------------------------------------------------------------------------------<br />PROTEIN (serum)<br /><br />Elevated in:<br />Dehydration, multiple myeloma, Waldenstrom's macroglobulinemia, sarcoidosis, collagen-vascular diseases<br /><br />Decreased in:<br />Malnutrition, low-protein diet, overhydration, malabsorption, pregnancy, severe bums, neoplasms, chronic diseases, cirrhosis, nephrosis<br />----------------------------------------------------------------------------------------------------<br />PROTEIN ELECTROPHORESIS (serum)<br /><br />Elevated:<br />-Albumin: dehydration<br />-a-l: neoplastic diseases, inflammation<br />-a-2: neoplasms, inflammation, infection, nephrotic syndrome<br />-b: hypothyroidism, biliary cirrhosis, diabetes mellitus<br />-y: see IMMUNOGLOBULINS<br /><br />Decreased:<br />-Albumin: malnutrition, chronic liver disease, malabsorption, nephrotic syndrome, burns, SLE<br />-a-I: emphysema (a-l antitrypsin deficiency), nephrosis<br />-a-2: hemolytic anemias (<br />Decreased haptoglobin), severe hepatocellular damage<br />-b: hypocholesterolemia, nephrosis<br />-y: see IMMUNOGLOBULINS<br />----------------------------------------------------------------------------------------------------<br />PROTHROMBIN TIME (PT)<br /><br />Elevated in:<br />Liver disease, oral anticoagulants (Warfarin), heparin, factor deficiency (I, II, V, VII, X), DIC, vitamin K deficiency, afibrinogenemia, dysfibrinogenemia, drugs (salicylae, chloral hydrate, diphenylhydantoin, estrogens, antacids, phenylbutazone, quinidine, antibiotics, allopurinol, anabolic steroids)<br /><br />Decreased in:<br />Vitamin K supplementation, thrombophlebitis, drugs (gluthetimide, estrogens, griseofulvin, diphenhydramine)<br />----------------------------------------------------------------------------------------------------<br />PROTOPORPHYRIN (free erythrocyte)<br /><br />Elevated in:<br />Iron deficiency, lead poisoning, sideroblastic anemias, anemia of chronic disease, hemolytic anemias, erythropoietic protoporphyria<br />----------------------------------------------------------------------------------------------------<br />RED BLOOD CELL COUNT<br /><br />Elevated in:<br />Polycythemia vera, smokers, high altitude, cardiovascular disease, renal cell carcinoma and other erythropoietin-producing neoplasms, stress, hemoconcentration/dehydration<br /><br />Decreased in:<br />Anemias, hemolysis, chronic renal failure, hemorrhage, failure of marrow production<br />----------------------------------------------------------------------------------------------------<br />RED BLOOD CELL DISTRIBUTION WIDTH (RDW)<br /><br />Normal RDW and...<br />Elevated MCV: aplastic anemia, preleukemiaNormal MCV: normal, anemia of chronic disease, acute blood loss or hemolysis, CLL, CML, nonanemic enzymopathy or hemoglobinopathy<br /><br />Decreased MCV: anemia of chronic disease, heterozygous thalassemia<br /><br /><br />Elevated RDW and...<br />Elevated MCV: vitamin Bl2 deficiency, folate deficiency, immune hemolytic anemia, cold agglutinins, CLL with high count, liver disease<br /><br />Normal MCV: early iron deficiency, early vitamin Bl2 deficiency, early folate deficiency, anemic globinopathy<br /><br />Decreased MCV: iron deficiency, RBC fragmentation, Hb H. thalassemia intermedia<br />----------------------------------------------------------------------------------------------------<br />RED BLOOD CELL MASS (VOLUME)<br /><br />Elevated in:<br />Polycythemia vera, hypoxia (smokers, high altitude, cardiovascular disease), hemoglobinopathies with high 2B affinity, erythropoietin-producmg tumors (renal cell carcinoma)<br /><br />Decreased in:<br />Hemorrhage, chronic disease, failure of marrow production anemias, hemolysis<br />----------------------------------------------------------------------------------------------------<br />RETICULOCYTE COUNT<br /><br />Elevated in:<br />Hemolytic anemia (sickle cell crisis, thalassemia major, autoimmune hemolysls, hemorrhage, postanemia therapy (folic acid, ferrous sulfate, vitamin B12)<br /><br />Decreased in:<br />Aplastic anemia, marrow suppression (sepsis, chemotherapeutic agents radlation), hepatic cirrhosis, blood transfusion, anemias of disordered maturation (iron deficiency anemia, megaloblastic anemia, sideroblastlc anemua, anemna of chronic disease)<br />----------------------------------------------------------------------------------------------------<br />RHEUMATOID FACTOR<br /><br />Present in titer >1:20:<br />Rheumatoid arthritis, SLE, chronic inflammatory processes, old age, infection, liver disease<br />----------------------------------------------------------------------------------------------------<br />SMOOTH MUSCLE ANTIBODY (ANTI- SMOOTH MUSCLE ANTIBODY)<br /><br />Present in:<br />Chronic active hepatitis (>1:80), primary biliary cirrhosis (<1:80), infectious mononucleosis<br />----------------------------------------------------------------------------------------------------<br />SODIUM (serum)<br /><br />Increased in:<br /><br />Excess loss of water...<br />-Conditions that cause loss via gastrointestinal tract (e.g., in vomiting), lung (hyperpnea), or skin (e.g., in excessive sweating)<br />-Conditions that cause diuresis (Diabetes insipidus, Nephrogenic diabetes insipidus, Diabetes mellitus, Diuretic drugs, Diuretic phase of acute tubular necrosis, Diuresis following relief of urinary tract obstruction, Hypercalcemic nephropathy, Hypokalemic nephropathy)<br /><br />Excess administration of sodium (iatrogenic), e.g., incorrect replacement following fluid loss.<br />""Essential"" hypernatremia due to hypothalamic lesions<br /><br />Decreased in (serum osmolality is decreased):<br /><br />-Dilutional: (e.g., congestive heart failure, nephrosis, cirrhosis with ascites)<br />-Sodium depletion: (Loss of body fluids (e.g., vomiting, diarrhea, excessive sweating) with incorrect or no therapeutic replacement, diuretic drugs (e.g., thiazides); Adrenocortical insufficiency; Salt-losing nephropathy; Inappropriate secretion of antidiuretic hormone)<br />-Spurious (serum osmolality is normal or increased): (Hyperlipidemia; Hyperglycemia (serum sodium decreases 3 mEq/L for every increase of serum glucose of 100 mg/100 ml))<br /><br /><br />----------------------------------------------------------------------------------------------------<br />SUCROSE HEMOLYSIS TEST (sugar water test)<br /><br />Positive in:<br />Paroxysmal nocturnal hemoglobinuria (PNH)<br /><br />False positive: autoimmune hemolytic anemia, megaloblastic anemnas<br />False negative: may occur with use of heparin or EDTA<br />----------------------------------------------------------------------------------------------------<br />T3 (TRIIODOTHYRONINE)<br /><br />Decreased in:<br />Starvation, trauma, surgery, may be an adaptive response to illness, drugs (PTU)<br />----------------------------------------------------------------------------------------------------<br />T3 RESIN UPTAKE (T3RU)<br /><br />This test should be used only with a simultaneous measurement of serum T4 to exclude the possibility that an increased T4 is due to an increase in T4-binding globulin. Measurement of serum T-3 concentration should be done by radioimmunoassay for diagnosis of hyperthyroidism<br /><br />Increased in:<br />-Hyperthyroidism<br />-Certain drugs (e.g., testosterone, androgens, anabolic steroids, prednisone, heparin, Dicumarol, salicylates, Butazolidin, penicillin, Dilantin)<br />-Threatened abortion<br />-Infants (up to about age 2 months)<br />-Severe nephrosis<br />-Metastatic neoplasms<br /><br />Decreased in_<br />-Hypothyroidism<br />-Pregnancy (from about tenth week of pregnancy until up to 12th week postpartum)<br />-Certain drugs (e.g., estrogens alone or in birth control pills, large amounts of iodine, propylthiouracil in hyperthyroidism)<br /><br />Normal in:<br />-Pregnancy with hyperthyroidism<br />-Nontoxic goiter<br />-Carcinoma of thyroid<br />-Diabetes mellitus<br />-Addison's disease<br />-Anxiety<br />-Certain drugs (mercurials, iodine)<br /><br />Variable in:<br />Liver disease<br /><br />----------------------------------------------------------------------------------------------------<br />T4, FREE (free thyroxine)<br /><br />This determination gives corrected values in patients in whom the total thyroxine (T-4) is altered on account of changes in serum proteins or in binding sites. (Pregnancy; Drugs (e.g., androgens, estrogens, birth control pills, Dilantin); Altered levels of serum proteins (e.g., nephrosis))<br /><br />This is the best single screening test for thyroid dysfunction. It is paralleled by the free thyroxine factor.<br /><br />Increased in:<br />-Hyperthyroidism<br />-Hypothyroidism treated with thyroxine -Very ill euthyroid patients (frequently)<br /><br />Decreased in:<br />-Hypothyroidism<br />-Hypothyroidism treated with triiodothyronine<br /><br />----------------------------------------------------------------------------------------------------<br />THROMBIN TIME (TT)<br /><br />Elevated in:<br />Thrombolytic and heparin therapy, DIC, hypofibrinogenemia, dysfibrinogenemia<br />----------------------------------------------------------------------------------------------------<br />THYROID STIMULATING HORMONE (TSH)<br /><br />Elevated in:<br />Hypothyroidism, drugs (haloperidol, chlorpromazme, metoclopramide, domperidone), TSH antibodies, pituitary resistance to thyroid hormone<br /><br />Decreased in:<br />Hyperthyroidism, acute medical illness, drugs (dopamine, corticosteroids, bromocriptine, levodopa, pyridoxine), hyponatremia, malnutrition<br /><br />Normal in:<br />Cushing's syndrome<br />Acromegaly<br />Pregnancy at term<br /><br />----------------------------------------------------------------------------------------------------<br />THYROXINE-BINDING GLOBULIN (TBG)<br /><br />Increased in:<br />-Pregnancy<br />-Excess TBG, genetic or idiopathic -Hypothyroidism (sorr-te patients)<br />-Certain drugs (estrogens, birth control pills)<br />-Gross iodine contamination<br />-Acute intermittent porphyria<br /><br />Decreased in:<br />-Nephrosis and other causes of marked hypoproteinemia Deficiency of TBG, genetic or idiopathic<br />-Certain drugs (androgenic and anabolic steroids)<br /><br />An increase of TBG is associated with an increase in PBI, BEI, and T-4 by column and a decrease in T-3; converse association for decrease of TBG.<br />----------------------------------------------------------------------------------------------------<br />THYROXINE (T4)<br /><br />Increased in:<br />-Hyperthyroidism<br />-Pregnancy<br />-Certain drugs (estrogens, birth control pills, d-thyroxine, thyroid extract, TSH)<br /><br />Decreased in:<br />-Hypothyroidism<br />-Hypoproteinemia<br />-Certain drugs (phenytoin sodium [Dilantin], triiodothyronine, testosterone, ACTH, corticosteroids)<br /><br />Not affected by:<br />-Radiopaque substances for x-ray studies -Mercurial diuretics<br />-Nonthyroidal iodine<br /><br />----------------------------------------------------------------------------------------------------<br />TRANSFERRIN<br /><br />Elevated in:<br />Iron deficiency anemia, oral contraceptive administration, viral hepatitis<br /><br />Decreased in:<br />Nephrotic syndrome, liver disease, hereditary deficiency, protein malnutrition, neoplasms, chronic inflammatory states, chronic illness thalassemia<br />----------------------------------------------------------------------------------------------------<br />TRIGLYCERIDES<br /><br />Elevated in:<br />Hyperlipoproteinemias (Types I, IIb, III, IV, V), hypothyroidism, pregnancy, estrogens, acute MI, pancreatitis, alcohol intake, nephrotic syndrome, diabetes mellitus, glycogen storage disease<br /><br />Decreased in:<br />Malnutrition, congenital abetalipoproteinemias, drugs (e.g., gemfibrozil, nicotinic acid, clofibrate)<br />----------------------------------------------------------------------------------------------------<br />UREA NITROGEN (BUN)<br /><br />Elevated in:<br />-Drugs (aminoglycosides and other antibiotics, diuretics, lithium, corticosteroids), dehydration, gastrointestinal bleeding,<br />-Decreased renal blood flow (shock, CHF, MI), renal disease (glomerulonephritis pyelonephritis, diabetic nephropathy), urinary tract obstruction (prostatic hypertrophy)<br /><br />Decreased in:<br />Liver disease, malnutrition, third trimester of pregnancy, overhydration<br />----------------------------------------------------------------------------------------------------<br />URIC ACID (serum)<br /><br />Elevated in:<br />Renal failure, gout, excessive cell Iysis (chemotherapeutic agents, radiation therapy, leukemia, Iymphoma, hemolytic anemia), hereditary enzyme deficiency (hypoxanthine-guanine-phosphoribosyl transferase) acidosis, myeloproliferative disorders, diet high in purines or protein drugs (diuretics, low doses of ASA, ethambutol, nicotinic acid), lead poisoning, hypothyroidism, Addison's disease, nephrogenic diabetes insipidus, active psoriasis, polycystic kidneys<br /><br />Decreased in:<br />Drugs (allopurinol, high doses of ASA, probenecid, warfarin, corticosteroid), deficiency of xanthine oxidase, SIADH, renal tubular deficits (Fanconi's syndrome), alcoholism, liver disease, diet deficient in protein or purines, Wilson's disease, hemochromatosis<br />----------------------------------------------------------------------------------------------------<br />URINE 5-HYDROXYINDOLE-ACETIC ACID (URINE 5-HIAA)<br /><br />Elevated in:<br />Carcinoid tumors, after ingestion of certain foods (bananas, plums, tomatoes, avocados, pineapples, eggplant, walnuts), drugs (MAO inhibitors, phenacetin, methyldopa, glycerol guaiacolate, acetaminophen,salicylates, phenothiazines, imipramine, methocarbamol, reserpine, metamphetamine)<br />----------------------------------------------------------------------------------------------------<br />URINE AMYLASE<br /><br />Elevated in:<br />Pancreatitis, carcinoma of the pancreas<br />----------------------------------------------------------------------------------------------------<br />URINE BILE (BILIRUBIN, URINE)<br /><br />Abnormal:<br />Urine bilirubin: Hepatitis (viral, toxic, drug-induced), biliary obstruction<br />Urine urobilinogen: Hepatitis (viral, toxic, drug-induced), hemolytic jaundice, liver cell dysfunction (cirrhosis, infection, metastases)<br />----------------------------------------------------------------------------------------------------<br />URINE CALCIUM<br /><br />Elevated in:<br />Primary hyperparathyroidism, hypervitaminosis D, bone metastases multlple myeloma, increased calcium intake, steroids, prolonged immobilization, sarcoidosis, Paget's disease, idiopathic hypercalciuria renal tubular acidosis<br /><br />Decreased in:<br />Hypoparathyroidism, pseudohypoparathyroidism, vitamin D deficiency vitanun D-resistant rickets, diet low in calcium, drugs (thiazide diuretics, oral contraceptives), familial hypocalciuric hypercalcemia, renal osteodystrophy<br />----------------------------------------------------------------------------------------------------<br />URINE CATECHOLAMINES<br /><br />Elevated in:<br />Pheochromocytoma, neuroblastoma, severe stress<br />----------------------------------------------------------------------------------------------------<br />URINE CHLORIDE<br /><br />Elevated in:<br />Corticosteroids, Bartter's syndrome<br /><br />Decreased in:<br />Chloride depletion (vomiting, diuretics), colonic villous adenoma<br />----------------------------------------------------------------------------------------------------<br />URINE COPPER<br /><br />Increased in:<br />Wilson's disease<br />----------------------------------------------------------------------------------------------------<br />URINE CORTISOL, FREE<br /><br />Elevated:<br />Refer to CORTISOL (serum)<br />----------------------------------------------------------------------------------------------------<br />URINE CREATININE (24 hr)<br /><br />NOTE: Useful test as an indicator of completeness of 24 hr urine collection.<br />----------------------------------------------------------------------------------------------------<br />URINE GLUCOSE (qualitative)<br /><br />Present in:<br />Diabetes mellitus, renal glycosuria (decreased renal threshold for glucose), glucose intolerance<br />----------------------------------------------------------------------------------------------------<br />URINE HEMOGLOBIN, FREE<br /><br />Present in:<br />Hemolysis (with saturation of serum haptoglobin binding capacity and renal threshold for tubular absorption of hemoglobin)<br />----------------------------------------------------------------------------------------------------<br />URINE HEMOSIDERIN<br /><br />Present in:<br />Paroxysmal noctumal hemoglobinuria (PNH), chronic hemolytic anemia, hemochromatosis<br />----------------------------------------------------------------------------------------------------<br />URINE INDICAN<br /><br />Present in:<br />Malabsorption secondary to intestinal bacterial overgrowth<br />----------------------------------------------------------------------------------------------------<br />URINE KETONES (semiquantitative)<br /><br />Present in:<br />DKA, alcoholic ketoacidosis, starvation, isopropanol ingestion<br />----------------------------------------------------------------------------------------------------<br />URINE METANEPHRINES<br /><br />Elevated in:<br />Pheochromocytoma, neuroblastoma, drugs (caffeine, phenothiazines, MAO inhibitors), stress<br />----------------------------------------------------------------------------------------------------<br />URINE MYOGLOBIN<br /><br />Present in:<br />Severe trauma, hyperthermia, polymyositis/demmatomyositis, carbon monoxide poisoning<br />----------------------------------------------------------------------------------------------------<br />URINE NITRITE<br /><br />Present in:<br />Urinary tract infections<br />----------------------------------------------------------------------------------------------------<br />URINE OCCULT BLOOD<br /><br />Positive in:<br />Trauma to urinary tract, renal disease (glomerulonephritis, pyelonephritis), renal or ureteral calculi, bladder lesions (carcinoma, cystitis), prostatitis, prostatic carcinoma, menstrual contamination, hematopoietic disorders (hemophilia, thrombocytopenia), anticoagulants, ASA<br />----------------------------------------------------------------------------------------------------<br />URINE OSMOLALITY<br /><br />Elevated in:<br />SIADH, dehydration, glycosuria, adrenal insufficiency, high-protein diet<br /><br />Decreased in:<br />Diabetes insipidus, excessive water intake, IV hydration with D5W acute renal insufficiency, glomerulonephritis<br />----------------------------------------------------------------------------------------------------<br />URINE pH<br /><br />Elevated in:<br />Bacteriuria, vegetarian diet, renal failure with inability to form ammonia, drugs (antibiotics, sodium bicarbonate, acetazolamide)<br /><br />Decreased in:<br />Acidosis (metabolic, respiratory), drugs (ammonium chloride, methenamine mandelate), diabetes mellitus, starvation, diarrhea<br />----------------------------------------------------------------------------------------------------<br />URINE POTASSIUM<br /><br />Elevated in:<br />Aldosteronism (primary, secondary), glucocorticoids, alkalosis, renal tubular acidosis, excessive dietary potassium intake<br /><br />Decreased in:<br />Acute renal failure, potassium-sparing diuretics, diarrhea, hypokalemia<br />----------------------------------------------------------------------------------------------------<br />URINE PROTEIN (quantitative)<br /><br />Elevated in:<br />Renal disease (glomerular, tubular, interstitial), CHF, hypertension, neoplasms of renal pelvis and bladder, multiple myeloma, Waldenstrom's macroglobulinemia<br />----------------------------------------------------------------------------------------------------<br />URINE SODIUM (quantitative)<br /><br />Elevated in:<br />Diuretic administration, high sodium intake, salt-losing nephritis, acutetubular necrosis, vomiting, CHF, hepatic failure. Addison's disease, SIADH, hypothyroidism<br />----------------------------------------------------------------------------------------------------<br />URINE SPECIFIC GRAVITY<br /><br />Elevated in:<br />Dehydration, excessive fluid losses (vomiting, diarrhea, fever) x-ray contrast media, diabetes mellitus, CHF, SIADH, adrenal insufficiency,<br />Decreased fluid intake<br /><br />Decreased in:<br />Diabetes insipidus, renal disease (glomerulonephritis, pyelonephritis), excessive fluid intake or IV hydration<br />----------------------------------------------------------------------------------------------------<br />URINE VANILLYLMANDELIC ACID (VMA)<br /><br />Elevated in:<br />Pheochromocytoma, neuroblastoma, ganglioblastoma, drugs (isoproterenol, methocarbamol, levodopa, sulfonamides, chlorpromazine), severe stress, after ingestion of bananas, chocolate, vanilla, tea, coffee<br /><br />Decreased in:<br />Drugs (MAO inhibitors, reserpine, guanethidine, methyldopa)<br />----------------------------------------------------------------------------------------------------<br />VDRL<br /><br />Positive test:<br />Syphilis, other treponemal diseases (yaws, pinta, bejel)<br /><br />NOTE: A false-positive test may be seen in patients with SLE and other autoimmune diseases, infectious mononucleosis, atypical pneumonia, malaria, leprosy.<br />----------------------------------------------------------------------------------------------------<br />VISCOSITY<br /><br />Elevated in:<br />Monoclonal gammopathies (Waldenstrom's macroglobulinemia, multiple myeloma), hyperfibrinogenemia, SLE, rheumatoid arthritis, polycythemia, leukemia<br />----------------------------------------------------------------------------------------------------<br />y-GLUTAMYL TRANSFERASE (GGT; GAMMA-GLUTAMYL TRANSFERASE )<br /><br />Elevated in:<br />Chronic alcoholic liver disease, neoplasms (hepatoma, metastatic disease to the liver, carcinoma of the pancreas), SLE, CHF, trauma, nephrotic syndrome, sepsis, cholestasis. drugs (phenytoin, barbiturates)Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-85975315887516015252008-12-18T19:21:00.000-08:002009-01-13T21:31:01.745-08:00TARGET FMGE 2009 / MCI SCREENING TEST MARCH 2009Mnemonics -Easy way to remember difficult things<br />Hai guys<br />here i am giving you some Mnemonics they are sub wise use them they really help<br />if you find them useful let me know pls<br /><br /><br />Anatomy Mnemonics<br />Bones of the Wrist<br />Some Lovers Try Positions That They Cannot Handle Branches of the Brachial Plexus (In order from most lateral to most medial)<br />My Aunt Raped My Uncle<br /><br />Musculocutaneous, Axillary, Radial, Median, Ulnar<br /><br />Slowly Lower Tilly's Pants To The Curly Hairs<br /><br />Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate<br /><br />Brachial Plexus<br />Randy Travis Drinks Cold Beers Robert Taylor Drinks Cold Beer<br /><br />Roots, Trunks, Divisions, Cords, Branches<br /><br />Branches of the Brachial Plexus (In order from most lateral to most medial)<br />My Aunt Raped My Uncle<br /><br />Musculocutaneous, Axillary, Radial, Median, Ulnar<br /><br />Extraocularmotor muscles<br />LR6 (SO4) LR6: Lateral rectus --> VI abductens<br />SO4: Superior Oblique --> IV Trochlear<br />All other extraocularmotor muscles are CN III<br /><br />Branches of the Facial Nerve<br />Ten Zebras Bought My Car<br /><br />Temporal, Zygomatic, Buccal, Masseteric, Cervical<br /><br />Innervation of phrenic nerve<br />c345 keeps the phrenic alive<br />c345 keep the diaphragm alive<br /><br /><br />Long thoracic nerve innervates serratus anterior<br />c5-6-7 raise your arms to heaven<br /><br /><br />Relationship of Thorasic duct to Esophagous and Azygous<br />The duck is between two gooses.<br />duck = thoracic duct 2 gooses = azyGOUS and esophaGOUS<br /><br /><br />Attachments of Pectoralis Major, Teres Major and Latissimus Drosi<br />A lady between tow majors.<br />Pectoralis major attaches to lateral lip of bicipital groove, the teres major attaches to medial lip of bicipital groove, and the latissimus dorsi attaches to the floor of bicipital groove. The "lati" is between two "majors."<br /><br /><br />Innervation of the Penis<br />Parasympathetic puts it up; sympathetic spurts it out.<br />Point Shoot Score<br />Parasympathetic, sympathetic, somatomotor<br /><br /><br />Lateral and Medial Pectoral Nerve<br />Lateral is less, medial is more.<br />Lateral pectoral nerves goes through pectoralis major while medial pn goes though both pectoral major and minor.<br /><br />Dentition: eruption times of permanent dentition<br />"Mama Is In Pain, Papa Can Make Medicine":<br />1st Molar: 6 years<br />1st Incisor: 7 years<br />2nd Incisor: 8 years<br />1st Premolar: 9 years<br />2nd Premolar: 10 years<br />Canine: 11 years<br />2nd Molar: 12 years<br />3rd Molar: 18-25 years<br /><br /><br />Layers of the epidermis<br />Grand son grate living Child.<br />Brent Spiner Gained Lieutenant Commander<br />Germinativum or Basale, Spinosum, Granulosum, Lucidum, Corneum<br /><br /><br /><br />Tarsal bones<br />"Tall Californian Navy Medcial Interns Lay Cuties":<br />• In order (right foot, superior to inferior, medial to lateral): Talus Calcanous Navicular Medial cuneiform Intermediate cuneiform Lateral cuneifrom Cuboid<br /><br />Bronchopulmonary segments of right lung<br />"A PALM Seed Makes Another Little Palm":<br />• In order from superior to inferior: Apical Posterior Anterior Lateral Medial Superior Medial basal Anterior basal Lateral basal Posterior basal<br /><br />Head & Neck<br />CRANIAL NERVES: I-Optic, II-Olfactory, III-Oculomotor, IV-Trochlear, V-Trigeminal, VI-Abducens, VII-Facial, VIII-Acoustic (Vestibulocochlear), IX-Glossophrayngeal, X-Vagus, XI-Spinal Accessory, XII-Hypoglossal<br />On Old Olympus Towering Tops, A Finn And German Viewed Some Hops (older and cleaner)<br />Oh Oh Oh To Touch And Feel A Girls Vagina And Hymen (newer and, well ...)<br /><br />Which cranial nerve is Sensory, Motor, or Both- Some Say Marry Money, But My Brother Says Big Breasts Matter More<br /><br />BRANCHES OF FACIAL NERVE: Temporal, Zygomatic, Buccal, Mandibular, Cervical<br />Ten Zebras Beat My Cock<br />Two Zulus buggered my cat –(for the sicker, amongst you!)<br /><br />You have I nose. You have II eyes. (I - Olfactory; II -- Optic)<br /><br />Exit of branches of trigeminal nerve from the skull S<br />Standing Room Only -<br />V1 -Superior orbital fissure, V2 -foramen Rotundum, V3 -foramen Ovale<br /><br /><br /><br />For the order of nerves that pass through the superior orbital fissure:<br />"Lazy French Tarts Lie Naked in Anticipation."<br />(Lacrimal, Frontal, Trochlear, Lateral, Nosociliary, Internal,<br />Abducens)<br /><br />2 Muscle of mastication- Lateral Lowers- lateral pterygoid is the one that opens the jaw<br />4 Muscles of Mastication MTPP( which could be read as "Empty Peepee") -masseter, temporal, lateral and medial pterygoids --<br /><br /><br />Arteries as they come off the external carotid:<br />Some Angry Lady Figured out PMS<br />Superior thyroid, Ascending pharyngeal, Lingual, Facial, Occipital, Post Auricular, Superficial temporal, Maxillary<br /><br />Innervation of Extraocular motor Muscles: LR6 SO4 3<br />LR6--Lateral rectus--> VI abductens<br />SO4--Superior Oblique--> IV Trochlear<br />3--The remaining 4 eyeball movers = III Oculomotor<br /><br />ABC'S of the aortic arch!<br />Aortic arch gives off the Bracheiocephalic trunk,<br />the left Common Carotid, and the left<br />Subclavian artery<br /><br />BRACHIAL PLEXUS: Roots, Trunks, Divisions, Cords, Branches<br />Robert Taylor Drinks Cold Beer.<br /><br />CERVICAL SPINAL NERVES:<br />c345 keeps the phrenic alive (innervation of phrenic nerve) c345 keep the diaphragm alive (innervation of diaphragm)<br />c5-6-7 raise your arms to heaven (nerve roots of long thoracic nerve innervate serratus anterior)<br /><br /><br />Cranial Bones<br />Annoying, aren't they?<br />The cranial bones are the PEST OF 6...<br /><br />Parietal, Ethmoid,Sphenoid,Temporal,Occipital,Frontal- 6 ? (6-the number of bones!)<br />( another one) Old People From Texas Eat Spiders.<br /><br /><br />LOCATION OF THORACIC DUCT: The duck is between two gooses (duck = thoracic duct) 2 gooses = azyGOUS and esophaGOUS<br /><br /><br />Cartilages of the Larynx - There are 4 cartilages in the larynx whose initial letters are TEAC (also the brandname of a home stereo).<br />Thyroid, Epiglottis, Arytenoid, Cricoid<br /><br /><br />Abdomen-Pelvis<br /><br />INNERVATION OF PENIS:<br />Parasympathetic puts it up; sympathetic spurts it out<br />Point , Shoot, Score! (erection, emmision ,ejaculation) Parasympathetic, Sympathetic , Somatomotor<br />"S2, 3, 4 keep the penis off the floor" Innervation of the penis by branches of the pudental nerve, derived from spinal cord levels S2-4<br /><br />Structures perforating the esophagus<br />"At T8 you see, perforates the IVC" (inferior Vena Cava)<br />the "EsoVagus" pierce T10 (esophagus, vagus nerve)<br />T12 - red, white and blue (aorta,thoracic duct,azygous vein)<br /><br />Femoral Sheath (lateral to medial) order of things in thigh -NAVEL<br />Nerve, Artery, Vein, Empty, Space, Lymphatics<br /><br />Radial n. innervates the BEST!!!!<br />Brachioradialis<br />Extensors<br />Supinator<br />Triceps<br /><br />Course of Ureters<br />Water runs under the bridge (uterine a. and ductus deferens)<br /><br />Carotid Sheath-- VAN<br />Internal Jugular Vein<br />Common carotid Artery<br />Vagus Nerve<br /><br />Dermatomes<br />C3 is a high turtleneck shirt<br />T4 is at the nipple<br />L1 is at the inguinal ligament (or L1 is IL -Inguinal ligament)<br />Randy Travis Drinks Cold Beer--Brachial plexus<br />Robert Taylor Drinks Cold Beer<br />Roots, Trunks, Divisions, Cords, Branches<br /><br />Bones of the wrist -Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium,<br />Trapezoid, Capitate, Hamate<br /><br />1. Slowly Lower Tilly's Pants To The Curly Hairs<br />2. Swifty Lower Tilly's Pants to try coitus here. (the risque version)<br />3.Scared Lovers Try Positions That They Can't Handle. (Classic version)<br /><br /><br />Pelvic Diaphragm<br />PICOLO(A) -Posterior to anterior<br />PIriformis<br />COccygeus<br />Levator Ani<br /><br /><br />Pelvic Splanchic-Parasympathetic<br />Sacral Splanchic-Sympathetic<br /><br /><br />Armies travel over bridges, the Navy travels under.<br />(Bridge is the ligament...reference to suprascapular artery and nerve.)<br /><br /><br />Pad, dab. Dorsal ABduct...Palmar ADduct...interosseous muscles of hand/foot.<br /><br /><br />Layers of the epidermis-Germinativum or Basale, Spinosum, Granulosum, Lucidum, Corneum<br /><br />Grandpa Shagging Grandma's Love Child.<br /><br />Limbic System- the 5 F’s- Feeding, Fighting, Feeling, Flight and making babiesing<br /><br /><br /><br />The 5 sphincters found in the Alimentary Canal are APE OIL:<br />Anal, Pyloric, Lower Esophogeal, Oddi, and Ileocecum.<br /><br /><br />The branches of the Axillary Artery are: Sally Thompson Loves Sex And Pot pie.<br />Superior Thoracic, Thoracoacromial, Lateral Thoracic, Subscapular, Anterior Circumflex Humeral, Posterior Circumflex Humeral, and Profunda Brachii.<br /><br /><br /><br />TIRE- four abdominal muscles -- transversus, internal oblique, rectus abdominus, and external oblique<br /><br />Anesthesia Mnemonics<br /><br /><br /><br />Spinal anesthesia agents<br />"Little Boys Prefer Toys":<br />Lidocaine<br />Bupivicaine<br />Procaine<br />Tetracaine<br /><br /><br /><br />Xylocaine: where not to use with epinephrine<br />"Nose, Hose, Fingers and Toes"<br />• Vasoconstrictive effects of xylocaine with epinephrine are helpful in providing hemostasis while suturing. However, may cause local ischemic necrosis in distal structures such as the digits, tip of nose, penis, ears.<br /><br /><br /><br />General anaesthesia: equipment check prior to inducing<br />MALES:<br />Masks<br />Airways<br />Laryngoscopes<br />Endotracheal tubes<br />Suction/ Stylette, bougie<br /><br /><br /><br />Endotracheal intubation: diagnosis of poor bilateral breath sounds after intubation<br />DOPE:<br />Displaced (usually right mainstem, pyreform fossa, etc.)<br />Obstruction (kinked or bitten tube, mucuous plug, etc.)<br />Pneumothorax (collapsed lung)<br />Esophagus<br /><br /><br /><br />Anesthesia machine/room check<br />MS MAID:<br />Monitors (EKG, SpO2, EtCO2, etc)<br />Suction<br />Machine check (according to ASA guidelines)<br />Airway equipment (ETT, laryngoscope, oral/nasal airway)<br />IV equipment<br />Drugs (emergency, inductions, NMBs, etc)<br /><br /><br /><br />Anesthesia: quick check<br />SOAP:<br />Suction<br />Oxygen<br />Airway<br />Pharmacology<br /><br /><br />Anesthetics equipment check<br />MISMADE:<br />Machine check<br />IV supplies<br />Suction<br />Monitors<br />Airways<br />Drugs<br />Equipment<br /><br /><br /><br />Failed intubation: causes<br />INTUBATION:<br />Infections of larynx<br />Neck mobility abnormalities<br />Teeth abnormalites (eg poor dentifom, loose and protuberant teeth)<br />Upper airway abnormalities, strictures, or swellings<br />Bullsneck deformities<br />Ankylosing spondylitis<br />Trauma/ TumourInexperienceOedema of upper airwayNarrowing of lower airway<br /><br /><br /><br />Respiratory complications of anaesthesia: patients at risk<br />COUPLES:<br />COPD<br />Obese<br />Upper abdominal surgery<br />Prolonged bed rest<br />Long surgery<br />Elderly<br />Smokers<br />Biochemistry Mnemonics<br /><br />Essential Amino Acids<br />PriVaTe TIM HALL<br />Phe, Val, Thr, Trp, Ile, Met, His, Arg, Leu, Lys<br /><br /><br />Urea Cycle<br />Ordinarily, Careless Crappers, Are Also Frivolous About Urination.<br />Ornithine, Carbamoyl, Citrulline, Arginosuccinate, Aspartate, Fumarate, Arginine, Urea.<br /><br /><br />Cell division<br />Prophase, metaphase, anaphase, telophase.<br />"People Meet And Talk."<br /><br /><br />In the Phasted State<br />Phosphorylate Phosphorylation cascade active when blood glucose low.<br />DNA expression into mature mRNA<br />Exons expressed, Introns in the trash.<br />Pyrimidines are CUT from purines.<br />Pyrimidines are Cytosine, Uracil, Thiamine and are one ring structures.<br />Purines are double ring structures.<br /><br />Amino Acids:The ten essential amino acids:<br />"These Ten Valuable Amino Acids Have Long Preserved Life In<br />Man."<br />(Threonine, Tryptophan, Valine, Arginine, Histidine, Lysine,<br />Phenylalanine, Leucine, Isoleucine, Methionine)<br /><br /><br /><br />GOAT FLAP- Eight hormones: Growth hormone, Oxytocin, Adenocorticotropin, Thyroid stimulating hormone, Follicle stimulating hormone, Leutinizing hormone (interstitial cell stimulating hormone in males), Anti-diruetic(Vasopressin), and Prolactin<br />(shhhh.... also Melatonin!)<br /> </span></span>Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com4tag:blogger.com,1999:blog-2217647826950966921.post-8303298854732877462008-12-18T19:01:00.000-08:002008-12-18T19:03:24.800-08:00fmge sep 2008Posted: Sat Oct 04, 2008 2:46 pm Post subject: Questions FMGE -2008(Part-1,11; Set-A) <br /><br />--------------------------------------------------------------------------------<br /><br />Questions FMGE -2008(Part-1,11; Set-A)<br /><br /><br />1) Trendelenberg test is positive due to…..?<br />2) Notochord exists as….?<br />3) Neuroglia….?<br />4) Hyaline Arteriosclerosis seen in …..?<br />5) Which Ig crosses through placenta …..?<br />6) M.C cardiac lesion seen in pregnancy ……?<br />7) M.C valve disease due to M.I ? (Sorry, I forgot the question. It was asked in similarly)<br /> Herd Immunity?<br />9) Koplik’s spots seen in ……?<br />10) A ? patient with hypertension & suffering from Thyroiditis, DOC ……?<br />11) Hypocalcemia is seen with the following?<br />12) Most common position of Uterus?<br />13) Shortest ø of pelvis is……?<br />14) Right base of the heart is formed by …..?<br />15) Right side Mid calvicle the lung ends at which rib?<br />16) Water supply in hilly areas?<br />17) Prophylaxis DOC for Meningitis?<br />1 Anaemia is seen with all except?<br />19) Dose of Folic acid during pregnancy? (prophylaxis dose)<br />20) Vitamin “A” dosage is given in….? (?. of doses.)<br />21) What is Apoptosis?<br />22) Extrinsic factor in blood coagulation? (PT/PTT)<br />23) Curschmann’s spirals are due to?<br />24) Bell’s palsy?<br />25) In Dialysis which toxicity is seen commonly?<br />26) TOC for Gastric ulcer?<br />27) Squamous non-keratinizing is seen in….? a) Tongue b) Trachea c) Oesophagus d) Vagina<br />2 Tumour marker CA-125 is related to pancreatic Ca &…….?<br />29) Bilaterally kidneys are shrunken in …….?<br />30) Poisoning due to ______________preserved are hair, Etc..etc….?<br />31) The hormone helps in milk secretion?<br />32) Most abundant ICF is …….?<br />33) Features like-Hypogonadism, Loss of Hair, Pigmentation of skin Etc..etc Deficiency due to?<br />34) Most common features of alcohol withdrawl?<br />35) Negri bodies are characteristic of ?<br />36) M.C opportunistic Infection in immuno compromised patient?<br />37) Mallory-weiss syndrome? (Mallory bodies seen with….?)<br />3 Sickness benefit under ESI Act is given for the following illness?<br />39) Glucose is reabsorbed at?<br />40) M.C pemphigus seen in India?<br /><br />41) India ia at which stage of Demographic?<br />42) Urinary incontinence in Older people is due to……?<br />43) Breast cancer is due to all, Except?<br />44) Black & white colour vision is due to ………?<br />45) Grey colour……? ( Extremely sorry I forgot what was asked ,{Ophthalmology Q} if any one can remember please ADD)<br />46) Kussmaul breathing is due to or seen in ………?<br />47) Cellulitis is caused by…….?<br />4 Auer rods are seen in ……?<br />49) Gynaecomastia is due to drugs……..?<br />50) In a new born Jaundice occurs on 3-5days;its not due to ……….?<br />51) Transmitted by faeco-orally, Except ?<br />52) ß-Thalassemia inherited as ……..?<br />53) Foreign body inhaled usually lodges in which lung?<br />54) Change in blood viscosity causes ………?<br />55) * Question regarding Dentition? “Eruption”<br />56) Food poisoning 4-6 hrs organism responsible ……..?<br />57) Dreaming is common in which type of sleep?<br />5 Second heart sound is due to ……..?<br />59) “SAFE” ; ‘S’-stands for ……..?<br />60) Long term status of blood sugar explained by …….? (Ans: HbA1c ; The way the question was formed is different, any way the matter is most Important.)<br />61) Hyperglycemic drugs reduces weight ………..?<br />62) Surfactant is formed from which type of cells?<br />63) Spleenectomy is helpful in ……..?<br />64) Incineration done for which of the following?<br />65) Anti-gliadin antibodies are seen in?<br />--------------------------------------------------------------------------------<br /><br />) The following are example of Apootosis Except-<br />a) Graft versus host disease<br />b) Menstrual cycle<br />c) Pathological atrophy following duct obstruction<br />d) Tumour necrosis<br /><br />2) The normal tensile strength of tissue at the site of wound is gained after:<br />a) 1 week of wound healing<br />b) 2 weeks of wound healing<br />c) 2 months of wound healing<br />d) 2 years of wound healing<br /><br />Ths best test for BEST Disrase <br /><br />--------------------------------------------------------------------------------<br /><br />Best disease is characterized by a striking accumulation of lipofuscin-like material in the macula that often results in an "egg-yolk-like" appearance. In addition, patients affected with Best's disease display an abnormal electrophysiologic sign known as a depressed Arden ratio. The electro-oculogram (EOG) is a measurement of the electric potential that normally exists across the retinal pigment epithelium. This potential normally doubles in response to bright light. However, in Best's disease, this increase does not exist. This test can be used to diagnose patients without classic macular lesions, as well as identifying patients that are unlikely to have the disease.<br /><br /><br />--------------------------------------------------------------------------------<br /><br />qs of sept 2008 paper<br /><br />21 trisomy asso. with<br />ALL<br />CLL<br />AML<br />CML<br /><br />2) esophagus length<br />40<br />25<br />15<br />30<br /><br />3)pre malignant cond. of esophagus<br />barrets<br /><br />4)length of external aud. canal cartilagenous part<br />8<br />16<br />24<br />12<br /><br />5)max. Na absorption at<br />PCT<br />DCT<br />LOH<br />CT<br /><br />6)SUNRAY apearance on x ray<br />osteoclastoma<br />osteoblastoma<br />osteosarcoma<br />chondroblastoma<br /><br />7)m\c tumor in spine<br />sec.<br />ewings sarcoma<br />oteosarcoma<br />m. myeloma<br /><br /> punched out lesion in skull<br />ewings sarcoma<br />m.myeloma<br />sec.<br />oteosarcoma<br />9)m\c reason for bradycardia in MI<br />septal MI<br />right vent. MI<br />left ventricular MI<br /><br />10) S1 split seen in<br />RBBB<br />?<br />?<br />?<br /><br />11)snow flake cat. (from prev.papers)<br /><br />12)after injury to one eye other aslo worsen<br />glucoma<br />cat.<br />sym. opthalmia<br />?<br /><br />13)qs from placenta abroptia ...bleeding per vagina tender and hard<br /><br />very few qs from Obs<br /><br />14) 60 year old man with left hydroceal + ???<br /><br />ans. nephroma<br /><br />15)lateral epicondyal fac.<br />non union<br />tardy ulnar nerve palsy<br />?<br />all<br /><br />16)m\c parasitic infection in AIDS<br />strongiloids<br /><br />17)toxin responsibel for TSS in femals<br />exo toxin<br /><br />! in stap. aures food poisoning diarrhea occur due 2<br />endotoxin<br />vagus<br />exotoxin<br />?<br /><br />19)pheochromocytoma diagnosis<br />24 hours urine metabolites VMA+ CA<br />MIBG<br />CT scan<br />surgery<br /><br />20) what we use for thyroid scan<br />I 131<br />--------------------------------------------------------------------------------<br /><br />Q)DRUG WHICH CAUSES REVERSIBLE GYNECOMASTIA<br />-CIMETEDINE<br />-OMEPRAZOLE<br />Q)DOC FOR PROPHYLAXIS OF MENINGOCOCCAL MENINGITIS--RIFAMPIN<br />Q)A PT WITH THROMBOCYTOPENIA.1ST IOC<br />*-BLEEDING TIME<br />-PLATELET COUNT<br />-PROTHROMBIN TIME<br />Q)MC CAUSE OF SOLITARY THYROID NODULE<br />-FOLLICULAR ADENOMA<br />Q)TUMOR MARKER4BOTH PANCREATIC &COLON CA<br />-CA125<br />-CA19<br />Q)A PT VID AN INFERIOR WALL MI IN SHOCK.REASON?<br />ANS-RIGHT VENTRICULAR INFARCTION<br />Q)ALL R FEATURES OF ATRIAL MYXOMA EXCEPT<br />-FEVER<br />-CLUBBING<br />-EMBOLI<br />*HYPERTENSION<br />Q)DOC IN SVT--ADENOSINE<br />Q)A FEMALE PT HAS CHEST PAIN (NON EXERTIONAL)<br />AUSCULTATION--MULTIPLE NON EJECTION ? ..IOC?<br />*ECHO<br />Q)A PT PESENTS WITH MI.EARLEST MARKER?<br />CK-MB<br />TROP-T<br />MYOGLOBIN<br />Q)STAPH AUREUS FOOD POISONING-CAUSE OF NAUSEA?<br />ANS--DIRECT VAGAL STIMULATION<br />Q)A Q ON WEGENERS GRANULOMATOSIS<br />Q)A PT ON TPN.WHAT COULD BE THE CAUSE OF MORTALITY IN THAT PT?<br />OPTIONS CANT RECALL,BUT I MARKED INFECTIONS DUE2CENTRAL LINE<br />Q)A Q ON APGAR SCORE<br />Q)A Q ON ARDS--DIAGNOSTIC CRITERIA<br /><br /><br />some more recalls!<br /><br />Q)A PT WITH BULBAR URETRAL RUPTURE.UR 1ST MN: WUD BE<br />--SUPRAPUBIC CYSTOSTOMY<br />--FOLEY'S<br />--CONSERVATIVE MN<br />--REFER2UROLOGIST<br /><br />Q)MJ MUSCLE FOR EYE INTORSION?<br /><br />Q)ERYTHRODERMA IS ASSOCIATED WID A/E<br />--LEPROMATOUS LEPROSY<br />--AIR BORNE DERMATITIS<br /><br />Q)DERMATITIS HERPETIFORMIS IS A/W<br />*ULCERATIVE COLITIS<br /><br />Q)MC TYPE OF PEMPHIGUS IN INDIA?<br />*P.VULGARIS<br /><br />Q)LA SAFE IN RF?<br />GALLAMINE<br /><br />Q)A PT WID MYASTHENIA GRAVIS IS RESISTANT2<br />--*DEPOLARISING MR<br />--NON DEPOLARISING MR<br />--BOTH<br />--NONE<br /><br />Q)A PSM Q 2FIND OUT RELATIVE RISK<br /><br />Q)ANOTHER PSM Q ON PANEL DISCUSSION..Q WAS AS2VAT WAS IT ABOUT<br /><br />Q)A Q ON SARCOIDOSIS(PATHO)<br /><br />Q)WHICH ANTIBODY HAS BEST4 CELIAC DISEASE(SENSITIVE &SPECIFIC)?<br />*ANTI ENDOMYSIAL AB<br /><br /><br />Q)BEST PROGNOSTIC FACTOR 4 A/C PANCREATITIS<br />-*S.LIPASE<br /><br />Q)A Q ON ZES--WHICH IS NOT TRUE<br />ONE OF THE OPTION READ--REDUCED BAO:MAO WHICH S D ANS<br /><br /><br />Q)AN OHA WHICH IS USED 2TREAT OBESITY<br />ANS WAS SUM BIGUANIDE GIVEN IN THE OPTIONS<br /><br />Q)ANOTHER Q ON DIAB DRUG<br />WHICH ONE DOES'NT CAUSE HYPOGLYCEMIA<br />(SORRY,CANT RECALL OPTIONS)<br /><br /><br /><br />BUT FRIENDS,,NEXT TIME DO READ A BIT ABOUT ORAL HYPOGLYCEMICS AS WELL AS SOME IMP BITS ABOUT ANTI-OBESITY DRUGS<br />(SEEMS NAT BOARD HAS LOST IT'S LONG LASTED LOVE 4 MALARIA,TB,N OTHER PARASITIC INFECTIONS!NOT A SINGLE Q WAS ASKED!!))<br /><br /><br />Q)DRUG USED4TREMORS IN HYPERTHYROIDISM?<br />--PROPRANOLOL<br /><br /><br />Q)AN EASY Q--WHICH CAUSES HYPOCALCEMIA?<br />ANS WAS CALCITONIN<br /><br />Q)A PT ON TPN FOR A WEEK DEVELOPS FEATURES((WHICH WAS SUGGESTIVE OF ZN DEFICIENCY))..DEFICIENCY OF VAT?<br /><br /><br />Q)A Q ON NEPHROTIC SYNDROME IN CHILDREN....<br /><br /><br />Q)HYALINE ARTERIOSCLEROSIS IS SEEN IN<br />*BENIGN HTN<br /><br />some more questions frm FMGE sept 2008<br /><br />1-ring shaped ulcers seen in?<br />2-neurotrophic keratitis-nerve involved<br />3-question on sympathetic ophthalmia<br />4-extra capsular cataract surgery-parts of lens which are excised?<br />5- SAFE strategy for trachoma-S stands for?<br />6-rubro iridis is not seen in?<br />7-questions on cost benefit and cost accounting in PSM<br />8-central tendancy seen in-(refer biostats PSM )<br />9-question on odds ratio<br />10-complication of measles virus -encephalomelyitis<br />some more-<br />NNN Media used for- Ans-leshmania donavani<br />Treatment of first degree testicular cancer<br />Fourniers (sorry for d spelling,I don remember exactly!) gangrene seen in- Ans scrotum<br />Treatment Regimen for hodkgins lymphoma<br />Shape of tracheal cartilage-ans-horse shoe shape<br />Comonest congenital anomaly of trachea<br />Erythoderma is not seen in-?<br />Commonest lupus in india-<br />Fate of notochord-?<br />Mysanthia gravis is not inhibited by-depolarizing agents,non depolarizing agents,both,?<br />Rarest form of opportunistic fungal infection seen in AIDS-<br />White line of frenkel seen in-ans Scurvy<br />Xray sign of rickets<br />Splenomegaly not seen in-?<br />The first clinical presentation of acoustic neuroma-ans-facial nerve involvement<br />Stones r seen most commonly in submandibular salivary gland<br />The calories required by one year old child<br />4-5 questions on Tracheostomy<br />Sunray sign on xray seen in-?osteosarcoma<br />Tardy ulnar palsy seen in-?<br />Rigor mortis is due to-?<br />Vitreous hemorrhage on autopsy seen in poisoning of-?<br />One question on [bleep]-Refer Forensic Medicin<br />Most specific method of diagnosis of kalazar<br /><br /><br />--------------------------------------------------------------------------------<br /><br />questions<br /><br />Q.a patient with tb had decrease SERUM level of Na and k....... and has hyperpigmentation of crease of hand??...<br />ans.. secondary hyperaldeosteroism.<br />Q.MC. CAUSE OF DEATH IN INDIA?<br />ANS. CORONAY HEART DISEASE.<br />Q.CXR AP VIEWON RIGHT SIDE OF CARDIAC SILHOUTE U CAN SEE ALL EXCEPT?<br />ANS. SUPERIOR VENA CAVA<br />Q.NORMAL TO INCREASE SIZE OF KIDNEY IS SEEN ALL EXCEPT?<br />ANS. *CHRONOC GN<br />DIABETIC NEPHROPATHY<br />AIDS REALTED NEPHROPATHY<br />PKD<br />Q.SPLEEN IS SUPPORT BY WHICH LIGAMNET FROM UPPER SIDE?<br />ANS. GASTROSPLENIC LIGAMENT.<br />Q.STAIN FOR AMLYDOSIS<br />ANS. CONGO RED<br />Q.AUER RODS ARE SEEN IN?<br />AN. AML<br />Q.WHICH TUMOR IS MC IN DOWN SYNDROME?\<br />ANS MAY BE RETINOBLASTOMA (PLZ MAKE SURE FROM BOOK)<br /><br />--------------------------------------------------------------------------------<br /><br />1.Trendelenburg's test<br /><br />Also known as:<br />Brodie-Trendelenburg test<br />Trendelenburg-Brodie test<br /><br />Associated persons:<br />Sir Benjamin Collins Brodie<br />Friedrich Trendelenburg<br /><br />Description:<br /><br />Test for varicose veins. Patient lies on his back and raises his leg to empty the veins. A tourniquet is applied just below the saphenous opening. The patient is then stood up and the tourniquet removed in 60 seconds. Normally the vein should fill from below within 35 seconds with the tourniquet in situ. Earlier filling indicates incompetence of a communicating vein. If on release the veins fill rapidly from above it is due to incompetent sapheno-femoral valves.<br /><br /><br />2. Trendelenburg's test<br /><br /><br />Trendelenburg's test is a test of the saphenous and other veins.[1]<br />It is named for Friedrich Trendelenburg.[2][3]<br />It should not be confused with Trendelenburg's sign, which involves the muscles of the hip.<br /><br /><br />Trendelenburg's sign:<br /><br /><br />Trendelenburg's sign is found in people with weak abductor muscles of the hip. It is named after the German surgeon Friedrich Trendelenburg.<br />The Trendelenburg sign is said to be positive if, when standing on one leg, the pelvis drops on the side opposite to the stance leg. The weakness is present on the side of the stance leg. The body is not able to maintain the center of gravity on the side of the stance leg. Normally, the body shifts the weight to the stance leg, allowing the shift of the center of gravity and consequently stabilizing or balancing the body. However, in this scenario, when the patient/person lifts the opposing leg, the shift is not created and the patient/person cannot maintain balance leading to instability.<br /><br />Essentially, Trendelenburg sign is caused by paralysis of the gluteus medius and minimus muscles.<br /><br />Paralysis may arise due to nerve damage, namely, the superior gluteal nerve<br />--------------------------------------------------------------------------------<br /><br />1.<br />Trendelenburg test is a standard clinical assessment of hip stability.<br /><br />A positive test indicates gluteus medius weaknessand is observed when weight is supported by the affected limband the pelvis on the healthy side falls instead of rises.<br /><br />This test was used in this study to compare the two approaches. Incases of minimal abductor weakness there may be a delayedpositive test. It is for this reason that an element of musclefatigue was taken into account by considering the pelvicposition at 30 seconds of single leg stance. Since gait analysisallows subtle differences to be detected compared to clinicalanalysis, it was hoped this test would be an effective measureto compare the two approaches<br /><br />-------------------------------------------------------------------------------------<br /><br />2.<br /><br />The notochord exists transiently during the life of most vertebrates.<br /><br />A notochord is the defining characteristic of members of the phylum Chordata, a large and diverse biological group which includes all animals with spines, or backbones, along with more primitive chordates. The notochord has very large cells which are densely arranged within a protective sheath. Chordates are divided into three subphyla, depending on what form their notochords take and when they appear. At any developmental stage, a notochord acts as a form of support for the animal that possesses it, giving animals the ability to do things such as walking upright.<br /><br />The most primitive group of chordates, urochordates, also called tunicates, only have a notochord in the larval stages of development. The animals in this group are pelagic, meaning that they are found in the world's oceans, and there are a number of representative species, most of whom are only known to biologists. These animals do provide an insight into the development of chordates, however, showing the notochord at an early stage of development.<br /><br />The next group of chordates, cephalochordates, also called lancelets, possess a notochord into adulthood, and also live in the ocean. The notochord runs all the way along the body, even up into the head, and the animals lack a protective layer of bone such as a spine. The notochord acts as an axial support, providing a strong core for the animal. The notochord is highly flexible, but not compressible, allowing the animal to move freely without damaging the notochord.<br /><br />In the highest class of chordates, the vertebrates, the notochord only exists when the animal is in an embryonic form. As the vertebrate develops, the notochord is first ensheathed in and then replaced by spinal vertebrae, protective cases of bone which cover the delicate spinal cord. The spinal column is able to support a much larger and more complex organism, and is much stronger than the notochord. This allowed early vertebrates to make the leap to the land and develop into well known species such as humans.<br /><br />In all chordates, the notochord exists in some form when the animal is in a larval or embryonic stage[/size]. The development of the notochord from there helps shape what sort of animal it will turn into, whether it be a sac like tunicate or a pure bred Norwegian Fjord horse. The development of the notochord represents a major advance in evolution, as it allowed animals to get much larger and more complex, a drastic departure from simpler orders of animals which existed previously.<br /><br />------------------------------------------------------------------------------------<br /><br />3. NeuroGLIA<br /><br />Glial cells, commonly called neuroglia or simply glia (Greek for "glue"), are non-neuronal cells that provide support and nutrition, maintain homeostasis, form myelin, and participate in signal transmission in the nervous system. In the human brain, glia are estimated to outnumber neurons by about 10 to 1.<br /><br />Glial cells provide support and protection for neurons, the other main type of cell in the nervous system. They are thus known as the "glue" of the nervous system. The four main functions of glial cells are to surround neurons and hold them in place, to supply nutrients and oxygen to neurons, to insulate one neuron from another, and to destroy pathogens and remove dead neurons. They also modulate neurotransmission.<br /><br /><br />The supportive tissue of the nervous system, including the network of branched cells in the central nervous system (astrocytes, microglia, and oligodendrocytes) and the supporting cells of the peripheral nervous system (Schwann cells and satellite cells). Also called glia, reticulum.<br />------------------------------------------------------------------------------<br /><br />4. Hyaline arteriolosclerosis:<br /><br />Hyaline arteriolosclerosis can be seen in patients with diabetes mellitus and with hypertension. Hyaline arteriolosclerosis are more common in diabetic sufferers.<br /><br /><br />5. M.C cardiac lesion seen in pregnancy --><br /><br />Mitral stenosis is the most common rheumatic valvular lesion seen in pregnancy due to its prevalence in young women.<br /><br /><br />6. M.C valve disease due to ----<br /><br />Mitral valve prolapse (MVP) : is the most common forms of valve disease, affecting 6 percent of all women. In this condition one or both of the valve leaflets is enlarged or floppy, preventing the valve from closing evenly. When the valve shuts, the leaflets bulge into the left atrium. You may have heard mitral valve prolapse referred to as click-murmur syndrome from the sound the valve makes when it closes.<br /><br />7. Herd Immunity:<br /><br />In immunology, herd immunity refers to a situation in which a high percentage of a population is immune to a disease, essentially stopping the disease in its tracks because it cannot find new hosts. You may also hear this concept referred to as “community immunity.” The threshold for herd immunity varies, depending on the disease, with more virulent agents requiring vaccination of a higher percentage of the population to crate the desired herd immunity. In addition to being used in disease prevention, community immunity is also utilized to fight ongoing outbreaks.<br /><br />Most vaccination policies are focused on creating herd immunity. Many countries require vaccinations in childhood, for example, protecting children from common diseases and ensuring that when these diseases enter the population, they cannot prey on children or adults, who have been previously vaccinated or exposed to the disease. The creation of herd immunity is especially important in crowded environments which facilitate the spread of disease, like schools.<br /><br />Immunologists try to prevent the outbreak of diseases by creating herd immunity, but they are not always successful. Sometimes a disease mutates or is entirely new, or a batch of vaccinations is faulty, or a large percentage of the population fails to get vaccinated, creating a situation in which an outbreak can occur, because much of the population is vulnerable. In the event of an outbreak of a major disease, agencies like the World Health Organization can dispatch teams within days to figure out the cause of the outbreak and develop a vaccine, in the hopes of creating herd immunity to halt the outbreak in its tracks.<br /><br />For some diseases, herd immunity thresholds are as low as 50%, especially when combined with good hygiene. In other instances, up to 90% of the population may need to be vaccinated to create the desired herd immunity. It is also extremely important to receive regular boosters, as some vaccines lose their efficacy over time, leaving people vulnerable to an outbreak. Herd immunity led to the eradication of smallpox, and it explains why diseases such as polio and diphtheria are rare in developed nations with established vaccination policies.<br /><br />The concept of herd immunity is often used to encourage reluctant parents to vaccinate their children. In addition to ensuring that their children are protected from fully preventable diseases, childhood vaccinations also benefit society at large by creating herd immunity. Likewise, adults may be reminded to receive boosters to help protect their communities.<br /><br />---------------------------------------<br />9. Koplik’s spots seen in ---<br /><br />Also known as: Filatov’s spots, Flindt’s spots Maculae Koplik.<br /><br />Associated persons:<br />Nil Feodorovich Filatov<br />Nikolaj Flindt<br />Henry Koplik<br /><br />Description:<br />Small, grain-of-sand sized, irregular, bright red spots with blue-white centres, occurring on the inside of the cheek (buccal mucosa). Seen only on measles (rubeolae) they are, by themselves, a diagnostic sign in measles. The spots usually occur briefly after the fever begins and a couple of days before the generalized rash appears. Not infrequently, the spots disappear as the eruption develops.<br /><br />--------------<br /><br />Koplik's spots are bluish-white spots seen on the mucous membranes of the mouth and are pathognomonic of measles.<br /><br />They often appear a few days before the rash arrives and can be a useful sign to look for in children known to be exposed to the measles virus.<br /><br />--------------<br /><br />10. A ? patient with hypertension & suffering from Thyroiditis, DOC --<br /><br />L-Thyroxine has long been the treatment drug of choice<br /><br />Goals of<br />therapy (Rx) To bring free T4 (L-thyroxine) and TSH levels into normal range and improve symptoms. 1st choice therapy L-thyroxine.<br /><br /><br />11. Hypocalcemia is seen with the following--><br /><br />Hypocalcemia can be seen in chronic renal insufficiency.<br /><br /><br />Hypocalcemia may be seen in a number of disorders affecting the synthesis or action of PTH or vitamin D or following sequestration of calcium into a functionally inaccessible compartment.<br /><br />Many of these represent chronic illnesses where hypocalcemic symptoms develop insidiously or where the complication of hypocalcemia is anticipated early and appropriate treatment initiated prior to acute decompensation.<br /><br /><br />Hypocalcemia occurs in the setting of acute systemic illness (eg, toxic shock syndrome), a finding that has been linked to elevated free fatty acids levels in this setting. It has also been associated with specific drugs, including antineoplastic agents such as doxorubicin and cytarabine and other agents such as ketoconazole, pentamidine, and foscarnet.<br /><br />12.Most common position of Uterus?<br />The most common position is for the long axis of the uterus to lie in approximately the same axis as the pelvis, that is, with the upper part tilted forward and the lower end, the cervix, inserted into the top of the vagina. There is therefore an angle between the uterus and the vagina, the long axis of which corresponds to the lower part of the pelvis.<br /><br />13. Shortest ø of pelvis is--><br />The interspinous diameter is the shortest in the pelvis.<br /><br />Obstetrical Pelvic Diameters<br />The shape and size of the bony pelvis are important factors determining the outcome of labour. The pelvic inlet is the entrance to the true pelvis. The plane of the pelvic inlet is almost circular in a normal female or gynaecoid pelvis with a slightly greater transverse than anterior-posterior diameter. The true diameter of the pelvic inlet is difficult to assess clinically. An estimate can be made from the diagonal conjugate diameter which is measured between the midpoint of the sacral promontory and the nearest point on the posterior surface of the pubic symphysis. This measure is about 1.5cm greater than the obstetrical conjugate diameter. In practice it is rarely possible to reach the promontory on clinical examination. The pelvic outlet is narrower than the pelvic inlet. The anterior-posterior diameter of the pelvic outlet is measured from the inferior border of the pubic symphysis to the sacrococcygeal joint, and is usually about 12.5cm. The transverse diameter of the pelvic outlet is measured between the ischial tuberosities and is usually about 10cm. The plane of least pelvic dimensions represents the narrowest part of the birth canal. The anteroposterior diameter extends from the inferior margin of the pubic symphysis posteriorly through a line which connects the ischial spines, the transverse diameter. Both diameters can be assessed clinically, and the interspinous diameter is the shortest in the pelvis.<br /><br />14. Right base of the heart is formed by ---><br /><br />The base of the heart is opposite to that of the apex is mainly formed by the left atria, but getting some contribution from the right atrium.<br /><br />15. Right side Mid calvicle the lung ends at which rib --10 Rib?<br /><br />The border of the right lung lies immediately inside the pleural margin from the cupola down to about the 6th costal cartilages.<br /><br />It then lies about two spaces above the pleural margin:<br />it crosses the 6th rib in the midclavicular line and the 8th rib in the midaxillary line, and reaches the vertebral column at the level of the 10th rib.<br /><br />16. Water supply in hilly areas---?<br /><br /><br />Developing springs as a source for rural water supply is ideally suited for the following situations: (a). The springs are perennial (at least discharge at the rate of 20 lpcd during peak summer) and of good water quality (to be tested for chemical and bacteriological) contamination); (b) Chance of polluting the catchment is minimum; (c) The beneficiary population lives within close proximity of the springs preferably in the down stream areas of the springs.<br /><br />In the era of decentralized planning, community mobilization, resource mobilization, cost sharing, community management, cost recovery and operation and maintenance plays a significant role in the water supply schemes. In 1989, the Pazhakulam Social Service Society (PASSS) has taken the initiative for the development of natural springs as alternative safe drinking water to the communities in the remote hilly areas of Southern Kerala. The main objective of the spring development programme was to demonstrate to the Government, Non-Governmental Organizations and the people of Kerala, that it is possible to design and develop alternate delivery of drinking water through private sector initiatives. The concept of rejuvenation of springs is an alternative mechanism to increase the coverage and accessibility of safe water supply in the remote areas. PASSS has taken the leadership in demonstrating the programme since 1991 and more than 1150 springs have already been developed with the active participation of the community. The salient features of the programme is as follows:<br /><br />Established water committees as the nucleus of community organization, participation and management of the programme; Capacity building and empowerment; Capital cost sharing mechanism has become mandatory;<br />Full O & M by water committees/community; Low cost participatory design; Panchayat institutions as a partner; Integration of water, sanitation and hygiene; Water quality monitoring; Community monitoring and follow up.<br /><br /><br />17. Prophylaxis DOC for Meningitis --><br /><br />Meningitis is an inflammation of the leptomeninges and underlying subarachnoid cerebrospinal fluid<br /><br /><br />Cephalexin/Cefazolin<br /><br /><br />PO/IV<br />Stable vs Staph penicillinase<br />Spectrum: MSSA, PSSP, most E. coli, and some Klebs<br />Can be dose thrice weekly in HD pts<br />[1.5 grams IV TIW]<br />DoC: surgical prophylaxis, bacterial peritonitis in CAPD pts [1 gm in the dwell bag]<br /><br />--------------------<br /><br />Ampicillin/Amoxicillin<br /><br /><br />Amp (IV, PO) Amox (PO)<br />Spectrum: PenG + H. flu and some E. coli<br />DoC: Listeria monocytogenes and<br />Enterococcus [Amp 2g IV q4h]<br /><br />Dental Prophylaxis<br />Amox 1 gram PO x 1 prior to appt.<br />Integral in H. pylori regimens<br />ADRs<br />Non-allergic rashes (9%) – esp. when associated with a viral illness (mononucleosis - EBV)<br />Amox better tolerated PO and better absorbed (Amp must be taken on empty stomach)<br />-----------------------------<br /><br />more qns from FMGE sept 08<br /><br />who discovered xrays?<br />roentgen<br /><br />which disease is X linked recessive?<br />Hemophlia<br /><br />most common cause of death in people older than 70 yrs?<br />cardiovascular disease, cancer,respiratory disease?<br /><br />in retinal detachment?? options were red colour, blue colour, green colour? i cant remember exactly.<br /><br />in which poisoning shud the vitrous humor be preserved?<br /><br />malignant pustule?<br />anthrax<br /><br />a qn from varicocele frm surgery, i cant remember..<br /><br /><br />frnds, there were over 20 questions frm Ophthalmology and Biochemistry and many from parasitology in Microbiology ..<br />few questions were simple and thats all we can recollect! there were many confusing questions too...<br />all da best for 2009....<br /><br /><br />--------------------------------------------------------------------------------<br /><br />Prophylaxis DOC for Meningitis?<br /><br /><br />PRESCRIPTIONS FOR PROPHYLAXIS OF MENINGITIS :<br />PROCEDURES FOR GGHB COMMUNITY PHARMACISTS<br /><br />· Identify a prescription for meningitis prophylaxis:<br /><br />Rifampicin 600mg (or 10mg/kg for children) twice daily for 2 days<br /><br />or<br /><br />Ciprofloxacin 500mg as a single dose (although not yet licensed for this purpose).<br /><br />Establish the patient’s eligibility for exemption from prescription charge.<br /><br />If not exempt via NHS, reassure the patient that a special GGHB exemption will apply.<br /><br />Dispense the prescription.<br /><br />Please do not collect the prescription charge.<br /><br />Please submit an invoice for the prescription charge on headed notepaper to myself at GGHB Headquarters, noting patient name and date.<br /><br />Submit the prescription in the non-exempt category to the PPD.<br /><br /><br />-------------------------------------------------<br /><br />PRESCRIPTIONS FOR PROPHYLAXIS OF MENINGOCOCCAL SEPTICAEMIA<br /><br />You will be aware of the increased incidence of meningitis in recent weeks. All cases are notified to the GGHB Public Health Department. Treatment of the individual case in an acute hospital is accompanied by management of the public health implications in primary care. Typically, specialists in Communicable Disease will identify close family and friends of the patient who may require prophylactic treatment. The treatment options currently are:<br /><br />Rifampicin 600mg (or 10mg/kg for children) twice daily for 2 days<br /><br />or<br /><br />Ciprofloxacin 500mg as a single dose (although not yet licensed for this purpose)<br /><br />The options for supply of these prescriptions are as follows:<br /><br />community administration programme (e.g. school, church)<br /><br />hospital supply<br /><br />supply through the local GEMS centre<br /><br />prescription on HBP forms by the Public Health Consultant on call<br /><br />prescription on GP10<br /><br />The last of these is frequently the preferred option. Treatment needs to be started quickly but not urgently and both drugs need to be used cautiously in combination with other therapies. Community pharmacists can reinforce these points.<br /><br />--------------------------------------------------------------------------------<br /><br />1 Anaemia is seen with all except?<br /><br />Anemia<br />Definition<br />If you have anemia, people may say you have tired blood. That's because anemia — a condition in which there aren't enough healthy red blood cells to carry adequate oxygen to your tissues — can make you feel tired.<br /><br />There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe.<br /><br />Anemia is a common blood disorder. Women and people with chronic diseases are at increased risk of the condition.<br /><br />If you suspect you have anemia, see your doctor. Anemia can be a sign of serious illnesses. Treatments for anemia range from taking supplements to undergoing medical procedures. You may be able to prevent some types of anemia by eating a healthy, varied diet.<br /><br />Symptoms<br />The main symptom of most types of anemia is fatigue. Other anemia symptoms include:<br /><br />•Weakness<br />•Pale skin<br />•A fast or irregular heartbeat<br />•Shortness of breath<br />•Chest pain<br />•Dizziness<br />•Cognitive problems<br />•Numbness or coldness in your extremities<br />•Headache<br />Initially, anemia can be so mild it goes unnoticed. But signs and symptoms increase as the condition worsens.<br /><br />Causes<br />Blood consists of both a liquid called plasma and cells. Floating within the plasma are three types of blood cells:<br /><br />•White blood cells. These blood cells fight infection.<br />•Platelets. These blood cells help your blood clot after a cut.<br />•Red blood cells (erythrocytes). These blood cells carry oxygen from your lungs, via your bloodstream, to your brain and the other organs and tissues. Your body needs a supply of oxygenated blood to function. Oxygenated blood helps give your body its energy and your skin a healthy glow.<br />Red blood cells contain hemoglobin — a red, iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body, and to carry carbon dioxide from other parts of the body to the lungs so that it can be exhaled.<br /><br />Most blood cells, including red blood cells, are produced regularly in your bone marrow — a red, spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, protein and vitamins from the foods you eat.<br /><br />Anemia is a state in which the number of red blood cells or the hemoglobin in them is below normal. When you're anemic, your body produces too few healthy red blood cells, loses too many of them or destroys them faster than they can be replaced. As a result, your blood is low on red blood cells to carry oxygen to your tissues — leaving you fatigued. Common types of anemia and their causes include:<br /><br />•Iron deficiency anemia. This most common form of anemia affects about one in five women, half of pregnant women and 3 percent of men in the United States. The cause is a shortage of the element iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells. The result is iron deficiency anemia.<br /><br />One way your body gets needed iron is when blood cells die — the iron in them is recycled and used to produce new blood cells. So, if you lose blood, you lose iron. Women with heavy periods who lose a lot of blood each month during menstruation are at risk of iron deficiency anemia. Slow, chronic blood loss from a source within the body — such as an ulcer, a colon polyp or even colon cancer — also can lead to iron loss and iron deficiency anemia.<br /><br />Your body also gets iron from the foods you eat. An iron-poor diet can lead to this anemia. In pregnant women, a growing fetus can deplete the mother's store of iron, leading to iron deficiency anemia.<br /><br />•Vitamin deficiency anemias. In addition to iron, your body needs folate and vitamin B-12 to produce sufficient numbers of healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. People who have an intestinal disorder that affects the absorption of nutrients are prone to this type of anemia. Some people are unable to absorb vitamin B-12 for a variety of reasons and develop vitamin B-12 deficiency anemia, which is sometimes called pernicious anemia. Vitamin deficiency anemias fall into a group of anemias called megaloblastic anemias, in which the bone marrow produces large, abnormal red blood cells.<br />•Anemia of chronic disease. Certain chronic diseases — such as cancer, rheumatoid arthritis, Crohn's disease and other chronic inflammatory diseases — can interfere with the production of red blood cells, resulting in chronic anemia. Kidney failure also can be a cause of anemia. The kidneys produce a hormone called erythropoietin, which stimulates your bone marrow to produce red blood cells. A shortage of erythropoietin, which can result from kidney failure or be a side effect of chemotherapy, can result in a shortage of red blood cells.<br />•Aplastic anemia. This is a life-threatening anemia caused by a decrease in the bone marrow's ability to produce all three types of blood cells — red blood cells, white blood cells and platelets. Many times, the cause of aplastic anemia is unknown, but it's believed to often be an autoimmune disease. Some factors that can be responsible for this type of anemia include chemotherapy, radiation therapy, environmental toxins, pregnancy and lupus.<br />•Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelodysplasia, a pre-leukemic condition, can cause anemia by affecting blood production in the bone marrow. The effects of these types of cancer and cancer-like disorders vary from a mild alteration in blood production to a complete, life-threatening shutdown of the blood-making process. Additionally, other cancers of the blood or bone marrow, such as multiple myeloma, myeloproliferative disorders and lymphoma, can cause anemia.<br />•Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases can cause increased red blood cell destruction. Autoimmune disorders can cause your body to produce antibodies to red blood cells, destroying them prematurely. Certain medications, such as some antibiotics used to treat infections, also can break down red blood cells. Hemolytic anemias may cause yellowing of the skin (jaundice) and an enlarged spleen.<br />•Sickle cell anemia. This inherited and sometimes serious anemia, which affects mainly people of African and Arabic descent, is caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular-shaped red blood cells die prematurely, resulting in a chronic shortage of red blood cells. Sickle-shaped red blood cells can also block blood flow through small blood vessels in the body, producing other, often painful, symptoms.<br />•Other anemias. There are several other, rarer forms of anemia, such as thalassemia and anemias caused by defective hemoglobin.<br />Sometimes, no cause of anemia can be identified.<br /><br />Risk factors<br />These factors place you at increased risk of anemia:<br /><br />•Poor diet. Anyone — young or old — whose diet is consistently low in iron and vitamins, especially folate, is at risk of anemia. Your body needs iron, protein and vitamins to produce sufficient numbers of red blood cells.<br />•Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in the small intestine — such as Crohn's disease and celiac disease — puts you at risk of anemia. Surgical removal of or surgery to the parts of the small intestine where nutrients are absorbed can lead to nutrient deficiencies and anemia.<br />•Menstruation. In general, women are at greater risk of iron deficiency anemia than are men. That's because women lose blood — and with it, iron — each month during menstruation.<br />•Pregnancy. Pregnant women are at an increased risk of iron deficiency anemia because their iron stores have to serve the increased blood volume of the mother as well as be a source of hemoglobin for the growing fetus.<br />•Chronic conditions. For example, if you have cancer, kidney or liver failure, or another chronic condition, you may be at risk of what's called anemia of chronic disease. These conditions can lead to a shortage of red blood cells. Slow, chronic blood loss from an ulcer or other source within the body can deplete your body's store of iron, leading to iron deficiency anemia.<br />•Family history. If your family has a history of an inherited anemia, you also may be at increased risk of the condition.<br />Certain infections, blood diseases and autoimmune disorders, exposure to toxic chemicals, and the use of some medications can affect red blood cell production and lead to anemia. Other people at risk of anemia are people with diabetes, people who are dependent on alcohol (alcohol interferes with the absorption of folic acid) and people who adhere to a strict vegetarian diet, who may not get enough iron or vitamin B-12 in their diet.<br /><br />When to seek medical advice<br />See your doctor if you're feeling fatigued for unexplained reasons, especially if you're at risk of anemia. Some anemias, such as iron deficiency anemia, are common. But don't assume that if you're tired, you must be anemic. Fatigue has many causes besides anemia.<br /><br />Some people learn that their hemoglobin is low, which indicates anemia, when they go to donate blood. Low hemoglobin may be a temporary problem remedied by eating more iron-rich foods or taking a multivitamin containing iron. However, it may also be a warning sign of blood loss in your body that may be causing you to be deficient in iron. If you're told that you can't donate blood because of low hemoglobin, ask your doctor if you should be concerned.<br /><br />If you have a family history of an inherited anemia, such as sickle cell anemia, talk to your doctor and possibly a genetic counselor about your risk and what risks you may pass on to your children.<br /><br />Tests and diagnosis<br />Doctors diagnose anemia with the help of a medical history, a physical exam and blood tests, including a complete blood count (CBC). This blood test measures levels of red blood cells and hemoglobin in your blood. Some of your blood may also be examined under a microscope to study the size, shape and color of your red blood cells, which may indicate a diagnosis. For example, in iron deficiency anemia, red blood cells are smaller and paler in color than normal. In vitamin deficiency anemias, red blood cells are enlarged and fewer in number.<br /><br />If you receive a diagnosis of anemia, your doctor may order additional tests to determine the underlying cause. For example, iron deficiency anemia can result from chronic bleeding of known or unknown ulcers, benign polyps in the colon, colon cancer, tumors, or kidney failure. Your doctor may test for these and other conditions that may underlie the anemia.<br /><br />Occasionally, it may be necessary to study a sample of your bone marrow to diagnose anemia.<br /><br />Complications<br />When anemia is severe enough, it may interfere with your ability to do everyday tasks. You may be too exhausted to work or play. Although anemia is often treatable, it may take several weeks to months for red blood cell levels to return to normal after treatment. Ask your doctor what to expect from treatment.<br /><br />If you've been diagnosed with anemia — it's often detected during routine blood tests — ask your doctor what treatment is necessary. Then be sure to follow through on treatment, even if you quickly start to feel better. Left unchecked, anemia can lead to a rapid or irregular heartbeat — an arrhythmia. Your heart must pump more blood to compensate for the lack of oxygen in the blood when you're anemic. This can even lead to congestive heart failure. Untreated pernicious anemia can lead to nerve damage and decreased mental function, as vitamin B-12 is important not only for healthy red blood cells but also for optimal nerve and brain function.<br /><br />Some inherited anemias, such as sickle cell anemia, can be serious and lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal.<br /><br />Treatments and drugs<br />Anemia treatment depends on the cause:<br /><br />•Iron deficiency anemia. This form of anemia is treated with iron supplements, which you may need to take for several months or longer. If the underlying cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and stopped. This may involve surgery.<br />•Vitamin deficiency anemias. Pernicious anemia is treated with injections — often lifetime injections — of vitamin B-12. Folic acid deficiency anemia is treated with folic acid supplements.<br />•Anemia of chronic disease. There's no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. Iron supplements and vitamins generally don't help this type of anemia. However, if symptoms become severe, a blood transfusion or injections of synthetic erythropoietin, a hormone normally produced by the kidneys, may help stimulate red blood cell production and ease fatigue.<br />•Aplastic anemia. Treatment for this serious anemia may include blood transfusions to boost levels of red blood cells. You may need a bone marrow transplant if your bone marrow is diseased and can't make healthy blood cells. You may need immune-suppressing medications to lessen your immune system's response and give the transplanted bone marrow a chance to start functioning again.<br />•Anemias associated with bone marrow disease. Treatment of these various diseases can range from simple medication to chemotherapy to bone marrow transplantation. Treatment of these types of anemia usually involves a consultation from a blood specialist (hematologist).<br />•Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating related infections and taking drugs that suppress your immune system, which may be attacking your red blood cells. Short courses of treatment with steroids or gamma globulin can help suppress your immune system's attack on your red blood cells. If the condition has caused an enlarged spleen, you may need to have your spleen removed. The spleen — a small organ below your rib cage on the left side — filters out and stores defective red blood cells. Certain hemolytic anemias can cause the spleen to become enlarged with damaged red blood cells.<br />•Sickle cell anemia. Treatment for this incurable anemia may include the administration of oxygen, pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent complications. Doctors also commonly use blood transfusions, folic acid supplements and antibiotics. A bone marrow transplant may be an effective treatment in some circumstances. A cancer drug called hydroxyurea (Droxia, Hydrea) also is used to treat sickle cell anemia in adults.<br />Prevention<br />Many types of anemia can't be prevented. However, you can help avoid iron deficiency anemia and vitamin deficiency anemias by eating a healthy, varied diet that includes foods rich in iron, folate and vitamin B-12.<br /><br />The best sources of iron are beef and other meats. Other foods rich in iron include beans, lentils, iron-fortified cereals, dark green leafy vegetables, dried fruit, nuts and seeds. Folate, and its synthetic form, folic acid, can be found in citrus juices and fruits, dark green leafy vegetables, legumes and fortified breakfast cereals. Vitamin B-12 is plentiful in meat and dairy products. Foods containing vitamin C, such as citrus fruits, help increase iron absorption.<br /><br />Eating plenty of iron-containing foods is particularly important for people who have high iron requirements, such as children — iron is needed during growth spurts — and pregnant and menstruating women. Adequate iron intake is also crucial for infants, strict vegetarians and long-distance runners.<br /><br />Doctors may prescribe iron supplements or multivitamins containing iron for people with high iron requirements. But iron supplements are appropriate only when you need more iron than a balanced diet can provide. Don't assume that if you're tired that you simply need to take iron supplements. Overloading your body with iron can be dangerous.<br /><br />--------------------------------------------------------------------------------<br /><br />Anaemia is a condition in which the haemoglobin concentration in the blood is below a defined level, resulting in a reduced oxygen-carrying capacity of red blood cells.<br /><br />About half of all cases of anaemia can be attributed to iron deficiency; other common causes include infections, such as malaria and schistosomiasis, and genetic factors, which result in thalassaemias and sickle-cell disease.<br /><br />In its severe form, anaemia is associated with fatigue, weakness, dizziness and drowsiness. Pregnant women and children are particularly vulnerable.<br /><br />--------------------------------------------------------------------------------<br /><br />19 ) Dose of Folic acid during pregnancy?<br /><br /><br />Taking 400 micrograms of synthetic folic acid daily from fortified foods and/or supplements has been suggested.<br /><br />The Recommended Dietary Allowance (RDA) for folate equivalents for pregnant women is 600-800 micrograms, twice the normal RDA of 400 micrograms for women who are not pregnant.<br /><br /><br />--------------------------------------------------------------------------------<br /><br />Prophylaxis vs Neural Tube Defects (NTD):<br /><br />The Society of Obstetricians and Gynaecologists of Canada , in its 1993 Policy Statement, recommended that all women of child bearing potential, whether planning pregnancy or not, should consider maintaining a folic acid intake of at least 0.4 mg daily, either in the diet or as a supplement.<br /><br />Pregnant women with no previous history of fetal NTD and no other predisposing factors are advised to maintain an intake of at least 0.4 mg daily until 10 to 12 weeks after last menstrual period.<br />--------------------------------------------------------------------------------<br /><br />20) Vitamin “A” dosage is given in….? (?. of doses.)<br /><br />The World Health Organization recommends single-large-dose vitamin A supplementation for postpartum women in areas of prevalent vitamin A deficiency; neonatal dosing is under consideration.<br /><br />It is safe to give fertile women, independentof their vitamin A status, as much as 10,000IU (3000 µg RE) daily at any time duringpregnancy.<br /><br /><br />21) What is Apoptosis?<br /><br />Apoptosis, by contrast, is a process in which cells play an active role in their own death (which is why apoptosis is often referred to as cell suicide).<br /><br />Apoptosis, or programmed cell death, is a normal component of the development and health of multicellular organisms. Cells die in response to a variety of stimuli and during apoptosis they do so in a controlled, regulated fashion.<br /><br />This makes apoptosis distinct from another form of cell death called necrosis in which uncontrolled cell death leads to lysis of cells, inflammatory responses and, potentially, to serious health problems.<br /><br /><br />22) Extrinsic factor in blood coagulation? (PT/PTT)<br /><br />PT, PTT, D-DIMER<br /><br />This panel of tests is used to evaluate the extrinsic coagulation system. They may also aid in screening for congenital deficiencies of factors II, V, VII, X as well as deficiencies of prothrombin dysfibrinogenemia, and afibrinogenemia. Levels of PT, PTT and D-dimmer, can determine heparin effect, warfarin anticoagulant therapy, liver failure, disseminated intravascular coagulation (DIC), vitamin K deficiency. This test includes the following: prothrombin time (PT) and partial thromboplastin time (PTT), and D-dimmer.<br /><br />Prothrombin time (PT)<br /><br />This test is used to evaluate the adequacy of the extrinsic system and common pathway in the clotting mechanism. Prothrombin time (PT) test provides a control for long-term anticoagulant therapy that usually involves the use of a coumarin derivative (eg, Coumadin®).This therapy attempts to impede thrombus formation without the threat of mortality from hemorrhage.<br /><br />Partial Thromboplastin Time<br /><br />This test is used to evaluate the intrinsic coagulation system. It is also used to monitor heparin therapy, to aid in detecting classical hemophilia A, Christmas disease, and detection of congenital deficiencies of factors II, V, VIII, IX, X, XI, and XII. PTT is used to screen for the presence of dysfibrinogenemia, disseminated intravascular coagulation, liver failure, congenital hypofibrinogenemia, vitamin K deficiency, congenital deficiency of Fitzgerald factor, congenital deficiency of prekallikrein, high molecular weight kininogen, and circulatory anticoagulant.<br /><br />D-DIMER<br /><br />This test is a very specific confirmatory test for disseminated intravascular coagulation (DIC). This test is also used for the detection of deep vein thrombosis (DVT) and to detect acute myocardial infarction and unstable angina. The Fragment D-dimmer assess both thrombin and plasmin activity.<br /><br /><br /><br />23) Curschmann’s spirals are due to?<br /><br />Curschmann's spirals have been observed in the sputum of patients affected by lung cancer, asthma, chronic bronchitis, or in asymptomatic smokers.<br /><br />Spirally twisted masses of mucus occurring in the sputum in bronchial asthma.<br /><br />Curschmann's spirals:<br /><br />coiled, basophilic plugs of mucus formed in the lower airways and found in sputum and tracheal washings; indicate chronic obstruction.<br /><br />Curschmann's Spirals refer to parts of the desquamated epithelium seen in biopsies from asthmatic patients. They are named after German physician Heinrich Curschmann (1846-1910). They are often seen in association with eosinophilic infiltration and Charcot-Leyden crystals.<br /><br />However, to date, their clinical significance and pathogenesis have not been completely explained.<br /><br /><br />24) Bell’s palsy?<br />WHAT IS BELL'S PALSY?<br />Bells palsy is a condition that causes the facial muscles to weaken or become paralyzed. It's caused by trauma to the 7th cranial nerve, and is not permanent.<br /><br />WHY IS IT CALLED BELL'S PALSY?<br />The condition is named for Sir Charles Bell, a Scottish surgeon who studied the nerve and its innervation of the facial muscles 200 years ago.<br /><br />HOW COMMON IS BELL'S PALSY?<br />Bells palsy is not as uncommon as is generally believed. Worldwide statistics set the frequency at approximately .02% of the population (with geographical variations). In human terms this is 1 of every 5000 people, and 40,000 Americans every year.<br /><br />IS BELL'S PALSY ALWAYS ON THE SAME SIDE?<br />The percentage of left or right side cases is approximately equal, and remains equal for recurrences.<br /><br />IS THERE ANY DIFFERENCE BECAUSE OF GENDER OR RACE?<br />The incidence of Bells palsy in males and females, as well as in the various races is also approximately equal. The chances of the condition being mild or severe, and the rate of recovery is also equal.<br /><br />WHAT CONDITIONS CAN INCREASE THE CHANCE OF HAVING BELL'S PALSY?<br />Older people are more likely to be afflicted, but children are not immune to it. Children tend to recover well. Diabetics are more than 4 times more likely to develop Bells palsy than the general population. The last trimester of pregnancy is considered to be a time of increased risk for Bell's palsy. Conditions that compromise the immune system such as HIV or sarcoidosis increase the odds of facial paralysis occurring and recurring.<br /><br />CAN BELL'S PALSY AFFECT BOTH SIDES OF THE FACE?<br />It is possible to have bilateral Bells palsy, but it's rare, accounting for less than 1% of cases. With bilateral facial palsy, it's important to rule out all other possible diagnoses with thorough diagnostic tests.<br /><br />CAN BELL'S PALSY AFFECT OTHER PARTS OF THE BODY?<br />Bells palsy should not cause any other part of the body to become paralyzed, weak or numb. If any other areas are affected Bell's palsy is not the cause of the symptoms, and further testing must be done.<br /><br />HOW DO THE SYMPTOMS OF BELL'S PALSY PROGRESS?<br />Very quickly. Most people either wake up to find they have Bells palsy, or have symptoms such as a dry eye or tingling around their lips that progress to classic Bell's palsy during that same day. Occasionally symptoms may take a few days to be recognizable as Bells palsy. The degree of paralysis should peak within several days of onset - never in longer than 2 weeks (3 weeks maximum for Ramsey Hunt syndrome). A warning sign may be neck pain, or pain in or behind the ear prior to palsy, but it is not usually recognized in first-time cases.<br /><br />IS BELL'S PALSY CONTAGIOUS?<br />No, it is not contagious. People with Bells palsy can return to work and resume normal activity as soon as they feel up to it.<br /><br />WHAT ABOUT RECOVERY FROM BELL'S PALSY?<br />Approximately 50% of Bells palsy patients will have essentially complete recoveries in a short time. Another 35% will have good recoveries in less than a year.<br /><br />Regardless of the trigger, Bell's palsy is best described as an event - trauma to the nerve. As with any other injury, healing follows. The quality and duration of recovery is dependent on the severity of the initial injury. If the nerve has suffered nothing more than a mild trauma, recovery can be very fast, taking several days to several weeks. An "average" recovery is likely to take between a few weeks and a few months. The nerve regenerates at a rate of approximately 1-2 millimeters per day, and can continue to regenerate for 18 months, probably even longer. Improvement of appearance can continue beyond that time frame.<br /><br />IS MUSCLE ATROPHY A CONCERN?<br />Not as a rule. It takes longer for the muscles to start to atrophy than it takes for most people to fully recover.<br /><br />IS BELL'S PALSY LIKELY TO HAPPEN AGAIN?<br />The possibility of recurrence had been thought to be as high as 10 - 20%. These figures have been lowered as more has been learned about conditions that are now diagnosed as other types of facial palsies. Estimates of the rate of recurrence still vary widely, from around 4 - 14%. Most recent reports hover at 5 - 9%. The average timespan between recurrences is 10 years.<br /><br /><br /><br />25) In Dialysis which toxicity is seen commonly?<br /><br />Aluminum toxicity<br /><br />Aluminum toxicity, prevalent among individuals with chronic renal failure, is associated with disabling osteomalacia, encephalopathy, and anemia.<br /><br />The control of aluminum intake has included standards to limit the amount of aluminum in the dialysis fluid in addition to the use of nonaluminum containing phosphate binders.<br /><br />Deferoxamine mesylate, a heavy metal chelating agent, is used to remove aluminum from the tissues of dialysis patients. Chelation therapy has resulted in improvements of clinical symptoms and bone histology. Ocular, auditory, and infectious adverse effects have occurred with the use of deferoxamine.<br /><br /><br />26) TOC for Gastric ulcer?<br /><br />For people with Helicobacter pylori infection, the main goal is to get rid of the bacteria that causes the infection.<br /><br />H2 receptor antagonist such as famotidine (Pepcid) or nizatidine (Axid) or a proton pump inhibitor such as omeprazole (Prilosec) or esomeprazole (Nexium) to suppress acid, combined with two antibiotics.<br /><br />Those who do not have an H. pylori infection may be prescribed ulcer-healing medications such as antacids, H2 receptor antagonists, or proton pump inhibitors. Long-term treatment may be needed.<br /><br />If the ulcer bleeds, endoscopy can control bleeding in most cases.<br /><br />Surgery may be recommended for persons who do not respond to medicines or endoscopy. Surgical procedures for gastric ulcers include:<br /><br />Vagotomy -- cuts the vagus nerve, which controls the stomach's production of gastric acid<br />Partial gastrectomy -- removes part of the stomach<br /><br />--------------------------------------------------------------------------------<br /><br />27) Squamous non-keratinizing is seen in….?<br /><br />Squamous nonkeratinizing<br /><br />Function: barrier, protection.<br />Location: wet surfaces: oral cavity, esophagus, and vagina.<br /><br />Origin: ectoderm<br />• cells of basal layer (stratum germinatinum, stratum basale)<br /><br />• cells of stratum spinosum<br /><br />• squamous cells<br /><br /><br />Stratified squamous keratinizing (epidermis)<br /><br />Function: barrier, protection.<br /><br />Location: dry surfaces: skin.<br /><br />Origin: ectoderm<br />• keratinocytes of stratum germinatinum (stratum basale)<br /><br />• keratinocytes of stratum spinosum<br /><br />• keratinocytes of stratum granulosum<br /><br />• keratinocytes of stratum lucidum<br /><br />• squames of keratin of stratum corneum<br /><br />• melanocytes<br /><br />Stratified cuboidal & columnar<br /><br />Function: barrier, conduit.<br /><br />Location: sweat gland, ducts of exocrine glands, anorectal junction.<br /><br />Origin: ectoderm<br /><br /><br />Transitional<br /><br />Function: barrier, distensible property.<br /><br />Location: renal calyces, ureters, bladder, urethra.<br /><br />Origin: mesodermDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com1tag:blogger.com,1999:blog-2217647826950966921.post-52135778676643360472008-12-18T10:06:00.000-08:002008-12-18T10:07:32.577-08:00fmge 2007diseases?<br />A. Trachoma<br /><br /><br /><br />Anatomy<br /><br />1.Muscle which helps to open E.tube while opening mouth(Tensor tympani, Tensor palate, _, All)<br /><br />2. The order of vessels in the Intercostal space from above to below(VAN, AVN, ANV)<br /><br />3. Branches of Int iliac artery except (Ovarian a., sup vesical, med rectal, inf rectal)<br /><br />4. Bipolar neuron is seen in ( parasympathetic ganglion, sympa ganglion, cochlear ganglion)<br /><br />5. Inversion & eversion of foot joints at- Subtalor joints<br /><br />6. No of lobes in liver as per COUINAUD’s classification- (3,4,6,8)<br /><br />7. Umbilical cord contains – 2 arteries & 1 vein<br /><br />8. Lig Arteriosum is derived from- Ductus arteriosus<br /><br />9. MI ligament preventing uterine prolapse-(cardinal, teres uteri, broad lig)<br /><br /><br /><br />Biochemistry<br /><br /><br /><br />10. Water soluble form of vit K(phyllaquinone, menaquinione, menadione, )<br /><br />11. Single oral dose for vit D prophylaxis(50000,100000,200000 U)<br /><br />12. Test for RNA detection-Northern blotting<br /><br />13 .SSA-Glutamate in 6th posn in B chain by valine<br /><br />14. Chitin is a polymer of-N acetyl glucosamine<br /><br />15. Watson’s DNA model is –Right handed anti parallel<br /><br />16. Wheat lacking in(lysine, leucine, threonine)<br /><br />17. No of ATP produced by complete metabolism of pyruvate(12,15,18,30)<br /><br />18. Final product of purine metabolism(uric acid, NH3+CO2)<br /><br />19. T4 is formed from- Tyrosine<br /><br />20. Daily required dose of Fe in an adult man(5,10,20,30)<br /><br />21. Nieman pick dise due to def of-Sphingomyelinase<br /><br />22. Saturated fatty acids max in(coconut oil, ground nut oil, palm oil)<br /><br />23. MI indicator of protein efficacy(biol value, net protein utln, chemical score, protein efficacy ratio)<br /><br />24. Dietary fibres rich in(polysaccharides, monosaccharides, non starch polysaccharides)<br /><br />25. Dietary % of energy from fat should be less than(10,20,30,40)<br /><br />26. Unconj bilirubinemia seen in all except(Dubin Johnson, Criggler najjar, Gilbert’s, Hemolytic anemia)<br /><br />27. Source of NH3 in brain - Glutamine<br /><br />28. BMR depends mainly on- body surface area<br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />Physiology<br /><br /><br /><br />29. Normal PH of blood- 7.36-7.44<br /><br />30. Longest life span for(lymphocytes, neutrophils, monocytes)<br /><br />31. Normal glomerular capillary pressure(15,25,35,45 mm Hg)<br /><br />32. Ion which is not interfered at loop of Henle(Na, K, Cl, urea)<br /><br />33. MC Hb in adult(Hb A1, HbA2, Hb F)<br /><br />34. Feacal mass mainly derived from(indigested food, undigested food, intestinal flora, intestinal secretions)<br /><br />35. Nicotinic receptors are seen in all except(adrenal medulla, NMJ, bronchial smooth muscle)<br /><br />36. Anterior Pituitary secretes (ADH, oxytocin, FSH, GnRH)<br /><br />37. Mucin acini cells characteristic all except(peripherally placed nucleus,distinct lumen,zymogen granules,transparent)<br /><br />38. In synaptic cleft max concn of( Na, K, Ca, protein anions)<br /><br />39. Charecteristic for smooth muscle cells(don’t require Ca, cant do recurrent contraction, cant do sustained contraction)<br /><br />40. All or none law is obeyed by (spike potential, post synaptic potential, )<br /><br />41. All carried through lat spino thalamic tract except(crude touch, pressure, pain, Temperature)<br /><br /><br /><br />Pathology<br /><br /><br /><br />42. Longitudinal ulcers seen in – Typhoid fever<br /><br />43. Amoebic ulcer is – flask shaped<br /><br />44. TB ulcer edges are- undermined<br /><br />45. Crescent shaped gametocytes seen in- Falciparum malaria<br /><br />46. HIV affects (CD4, CD8, CD4+double +ve, CD8+)<br /><br />47. Few RBCs,few neutrophils with some degraded fibrin in lungs seen in(grey hepatisation, red hepatisation, viral pneumonia)<br /><br />48. Brunner’s glands in –Deodenum<br /><br />49. Organ which undergoes involution- Thymus<br /><br />50. Minimal change GN, all are true except(absence of podocytes, normal glomerulus, poor response to steroids)<br /><br />51. Bence Johns Protein is – light chain monoclonal<br /><br />52. True about NK cells except(mediates type IV hypersensitivity, kill viruses, are large granular lymphocytes)<br /><br />53. MHC is important in pathogenesis of- ? auto immune diseases<br /><br />54. SLE is- Type III hypersensitivity<br /><br />55. Adult polycystic kidney disease is inherited – AD<br /><br />56. Which is not inherited XR(G6PD def, Duschene’s MD, Cystic fibrosis)<br /><br />57. Lung Ca with worst prognosis( small cell, adeno. Squamous cell)<br /><br />58. Ovarian tumours MC arises from (epithelium, germ cell, stroma)<br /><br />59. Cholera toxin acts on (ADP G1, ADP Gs, _,_,)<br /><br />60. FAMILIAL hypercholesterolemia due to- LDL receptor deficiency<br /><br />61. Exudative pleural effusion seen in all except(CCF, Ca, Pneumonia, Nephrotic syndrome)<br /><br />62. Most active form at tissue level(T3, T4, mono iod thyronin)<br /><br />63. Immediate response in acute inflammation except(granuloma formation, vasodilatation, neutrophil migration)<br /><br />64. Epitheloid granuloma consists mainly of(monocytes ¯ophages, T cells, B cells)<br /><br />65. Invasive Ca differs from Ca in situ by (basement membrane involvement, pleomorphism, _)<br /><br />66. Pleural effusion in vertical positon MC accumulates in (costo phrenic recess, oblique fissure, horizontal fissure)<br /><br /><br /><br />Microbiology<br /><br /><br /><br />67. Babesiosis in India MC transmitted by – Ticks<br /><br />68. Q-fever is caused by- Coxiella burnetti<br /><br />69. Lymes disease is caused by- Borrellia burdgofferi<br /><br />70. Megaloblastic anemia caused by – Diphyllobotrum latum<br /><br />71. Paragonismus westermani is commonly called – Lung fluke<br /><br />72. Toxic Shock Syndrome MC caused by- Staphylococci<br /><br />73. Sabin Feldman test used to Dx- TOXOPLASMOSIS<br /><br />74. Bedside rapid urease test is Dx of(Proteus, H.pylori)<br /><br />75. Staph.aureus is a normal inhabitant of(nose , SKIN ,throat)<br /><br />76. LRTI is MC caused by (streptococci,viruses,H.influenza, mycoplasma)<br /><br />77. VR media used for –V.cholera<br /><br />78. Which vaccine should not be kept in freezer- DPT<br /><br />79. Promastigote form of Leishmania seen in (NNN medium, spleen , Bone marrow, lymph node)<br /><br />80. All are dimorphic fungi except(Cryptococcus, histoplasma, paracoccidia, blastomycoses)<br /><br />81. Which is Gram +ve(fusobacterium, bacteroids, artonella, ar----lla)<br /><br /><br /><br />Pharmacology<br /><br /><br /><br />82. Anti TB drug causing gout- Pyrazinamide<br /><br />83. Prolactine is stimulated by(TRH, ACTH, GnRH, Dopamine)<br /><br />84. GH is inhibited by (Bromocriptine, glucose, exercise, sleep)<br /><br />85. In a patient with hepatitis which ATT is most safe( S+E, H+E, R+E, S+H)<br /><br />86. Prokinetic drug with no dopamine antagonism(metachlopramide, domperidone, mosapride, chlorpromazine)<br /><br />87. Warfarin acts by inhibiting – factors II, VII, IX, X<br /><br />88. Heparin induced thrombocytopenia.Tactics include all except( switch on to warfarin, cannot be substituted with LMWH, stop Heparin,_)<br /><br />89. Warfarin metabolism is inhibited by( Ketoconazole, Pheno, Rifampicin, chronic alchoholism)<br /><br />90. Disulfiram like rn is caused by all except(Griseofulvin, metronidazole, ciprofloxacin, erythromycin)<br /><br />91. Drug not interferes with antacid( Azithromycin, Tetracyclin, Norfloxacin,Ranitidine)<br /><br />92. All are B-lactam inhibitors except(Astreonam, Sulbactam, Tazactam, Clavulenic acid)<br /><br />93. Penicillin is(safe in pregnancy, is 6 amino penicill acid, all are not antipseudomonal)<br /><br />94. Not used as an antacid(NaHCO3, AlOH3, SiO2, MgSO4)<br /><br />95. DOC in LGV- Tetracycline<br /><br />96. Lactic acidosis in DM therapy caused by – Phenformin<br /><br />97. Pancreatitis is a S/E of( Didanosine, Zidovudine,Zalcitabine)<br /><br />98. B-blockers are used in all except( A-V block, angina, FAMILIAL TREMOR )<br /><br /><br /><br />Forensic Medicine<br /><br /><br /><br />99. Female can give consent for SEX if above (16, 12, 19, 21)<br /><br />100. Post marteum stiffening is called –Rigor mortis<br /><br />101. Most informative test in parental identification-( DNA finger print, HLA)<br /><br />102. Lesion with intact SKIN but internal Pathology - Contusion<br /><br /><br /><br />PSM<br /><br /><br /><br />103. Rural community health centre for(30000,60000,100000,200000) population<br /><br />104. Exclusive breast feeding is recommended by WHO upto( 6, 4, 3, 9 months)<br /><br />105. Patient made to walk early after Surgery , this is to- reduce disability<br /><br />106. Which is secondary prevention(Cx pap smear checking, vaccination , admitting disabled child in special schools)<br /><br />107. Temporary contraceptive method of choice in a 37 yr well educated woman- (Diaphragm, IUCD, mala N, mala D)<br /><br />108. Best protection from STD & Syphilis by – condom<br /><br />109. Method used to compare cost of 2 studies- cost accounting<br /><br />110. Survillance is_<br /><br />111. PQLI includes- IMR, Life expectancy at 1 year, literacy<br /><br />112. Test which detects TRUE NEGATIVE- Specificity<br /><br />113. Disease usually not seen in a country but brought from abroad is – EXOTIC<br /><br />114. Couple protection rate should be – 60%<br /><br />115. Ideal couples are( just married, men 20-40 women 16-45,)<br /><br />116. Fastest population growth in ( India, Kuwait, Pakistan, Srilanka)<br /><br />117. A new drug not prevents a disease but reduce death due to that disease then- PREVALENCE increases<br /><br />118. Socially attained behavior is( culture, custom, socialization_)<br /><br />119. The upper line in growth chart is( 50 , 60, 70, 80 th percentile)<br /><br />120. Who should be trained in a community for house to house surveys<br /><br />121. MI factor deciding results of a clinical trial( Effective randomization, 50% Rx with placebo & 50% with drugs, Inclusion of all age groups, 100% follow up)<br /><br /><br /><br /><br /><br /><br /><br /><br /><br />Ophthalmology<br /><br /><br /><br />122. Trachoma in ( 1, 2, 3, 5 million people all over world)<br /><br />123. MCC of vision loss in HIV( CMV retinitis, Toxoplasma, HIV retinitis)<br /><br />124. Dendritic ulcer seen in – HERPEZ<br /><br />125. Most serious complication after traumatic injury to one eye – SYMPATHETIC OPHTHALMIA<br /><br />126. ROSETTE shaped cataract in – TRAUMA<br /><br />127. Rx of choice in CAG ( surgical iridectomy, laser iridectomy, pilocarpine, trabeculectomy)<br /><br />128. Ideal site for IOL- Posterior capsule<br /><br />129. Laser used for IOL inpln- NdYAG<br /><br />130. Muscle 1st to be affected in Thyroid ophthalmopathy.- INF RECTUS<br /><br />131. Axial length of eye ball- 24 mm<br /><br />132. 1mm increase in axial length leads to increase the power by ( 1,2,3,4 D)<br /><br />133. Argyll Robertson pupil seen in – Neuro syphilis<br /><br />134. Light reflex is carried through( Ciliary nerve, V, VII, )<br /><br />135. Anterior Uveitis is MC assd with - HLA B 27<br /><br />136. Scleritis MC assd with – RA<br /><br />137. Interstitial keratitis MC seen in – Syphilis<br /><br />138. MCC of Vitreous H-gge (Eale’s dse, DM , HTN)<br /><br />139. Tractional RD is seen in (Vitreous loss after Surgery , DM retinopathy,_)<br /><br />140. White pupillary reflex is called – Leucocoria<br /><br />141. Dx test for corneal ulcer ( Flur.angiography, Alcian blue, Rose Bengal, methylene blue)<br /><br />142. In DIRECT ophthalmoscopy image is magnified by ( 15, 5,10, 20 times)<br /><br />143. Sup oblique muscle is supplied by - IV nerve<br /><br />144. MCC of cataract blindness- (Senile, congenital, traumatic)<br /><br />145. Max cones are seen in ( fovea centralis, macula lutea, blind spot)<br /><br /><br /><br />ENT<br /><br /><br /><br />146. Ext ear is not supplied by( GP nerve, Vagus, Great auricular nerve, Lesser occipital nerve)<br /><br />147. Tonsills innervated by ( GP, Vagus, Abduscens)<br /><br />148. Schwart’s sign is seen in – OTOSCLEROSIS<br /><br />149. Pure tone is ( single frequency, multiple F, mixed F, F above 4000 Hz)<br /><br />150. In BERA the IVth potential is from ( Cochlear ganglion, inf colliculus, MGB)<br /><br />151. Bullous myringitis is seen in ( Measles, mumps,Herpez,Mycoplasma)<br /><br />152. About Rhinoscleroma false is ( Cause subglottic stenosis, caused by Gm+, streptomycin useful in Rx, Mikkuliz cells & Russel bodies seen)<br /><br />153. Le-Forte’s # is the # of - MAXILLA<br /><br /><br /><br /><br /><br /><br /><br /><br /><br />ANAESTHESIOLOGY<br /><br /><br />154. Pin index of oxygen(5,15,25,35)<br /><br />155. Laughing gas is – Nitrous oxide<br /><br />156. Used for iv induction except (Bupivacaine, Thiopental Na, Ketamine, Etomidate)<br /><br /><br /><br />Dermatology<br /><br /><br /><br />157. Latest retinoid drug used in PSORIASIS - Adapalane<br /><br />158. Isomorphism not seen in (Lichen sclerosis, Lichen planus, Vitiligo, PSORIASIS )<br /><br />159. Alopecia,hyperpigmentation ,hypogonadism charecteristc for deficiency of --Zn<br /><br />160. Decreased no of melanocytes seen in(Pebaldism, albinism, )<br /><br /><br /><br />Radiology<br /><br /><br /><br />161. Element MC used in brachytherapy of Ca Cervix- CESIUM<br /><br />162. Filament in X-Ray made of- Strontium<br /><br />163. Most radiosensitive organ- Bone marrow<br /><br />164. Double Bubble sign in Barium meal seen in – Deodenal Atresia<br /><br />165. Best method to Dx Pathology in terminal part of CBD. (USG, ERCP, PTC, CEST)<br /><br />166. Investigation of choice in a person brought with traumatic paraplegia( MRI, CT, Myelography)<br /><br />Psychiatry<br /><br /><br /><br />167. DOC in OCD( Sertraline, alprazolam, chlorpromazine)<br /><br /><br /><br />orthopaedics<br /><br /><br /><br />168. Hill-Sachs lesion seen in – Reccurent dislocation of shoulder<br /><br />169. Nerve damaged in # of shaft of humerous- Radial nerve<br /><br />170. Bony ankylosis is caused by ( Septic arthritis, TB arthritis, Bechet’s dse, Psoriatic arthritis)<br /><br />171. MCP joints are MC affected in – RA<br /><br />172. 1st epiphysis to be ossified in elbow( Head of radius, Capitulum, Trochlea, Med condyle)<br /><br /><br /><br />Paediatrics<br /><br /><br /><br />173. MCC of death in TOF (bronchopneumonia, starvation, malabsorption)<br /><br />174. Boy c/o haemetemesis, mild splenomegaly,no hepatomegaly.Dx ( Non cirrhotic fibrosis, chirrosis, Budd-Chiari sy)<br /><br />175. Minimal fluid intake in an 8 kg boy should be ( 800, 700 ml, 1L)<br /><br />176. Enuresis is normal until(5, 4, 3 1/2, 2 1/2 years)<br /><br />177. Normal duration of physiologicl jaundice in a trm baby- 1 week<br /><br />178. Charecteristic for achild with acute post strepto coccal GN- raised ASO& fever& Leucocytosis<br /><br />Medicine<br /><br /><br /><br />179. Nephrocalcinosis seen in –Hyper PTH<br /><br />180. 45 year man c\o vomiting with food mass taken days before,foul smelling breath, occasional dysphagia to solid food. Dx(Zenkers diverticulum, Achalasia, diabetic gastroparesis, scleroderma)<br /><br />181. Severity of mitral stenosis is determined by (diastolic murmur duration, mid DMD, opening snap, intensity of S1)<br /><br />182. Severity of DM assessed by (HbA1C, KB level, RBS)<br /><br /><br /><br />183. Typhoid ulcer perforation in – 3rd week<br /><br />184. Normal anion gap acidosis seen in (cholera, DKA, Lactic acidosis)<br /><br />185. pH=7.28,PCO2=70,HCO3=36 Dx (resp acidosis with metabolic alkalosis, resp acidosis with metb acidosis)<br /><br />186. In thalassemia trait(increased HbF & HbA2, increased HbF & decreased HbA2)<br /><br />187. Tetany is not seen in (Verapamil, thyroid Surgery , hyperventilation, malabsorption)<br /><br />188. Down’s Sy is Dx by all except(decreased hcg, increased hcg, decreased AFP)<br /><br />189. 100% O2 not effective in (TOF, DILD, Eosinophilic pneumonia)<br /><br />190. Prophylaxis to a child with RHD should be given minimum till(at least 5 years after onset, life long, till 17 years)<br /><br />191. Carotid massage is effective in- PSVT<br /><br />192. Lung Ca MC assd with(Asbestosis, Silicosis)<br /><br />193. Not premalignant(Crohn’s dse, UC, Leukoplakia, Retinitis pigmentosa)<br /><br />194. Complications of DU except(Malignancy, perforation, bleed, obstruction)<br /><br />195. Not a cutaneous manifestation of TB( LUPUS pernio, LUPUS vulgaris, Erythema nodosum)<br /><br />196. MI in aetiology of CAD- LDL<br /><br />197. MCC of ICH- (HTN, Berry aneurysm)<br /><br />198. Hemodialysis is not effective in( Digoxin , salicylate, methanol, barbiturate poisoning)<br /><br />199. Microangiopathic hemolytic anemia seen in – (HUS, HTN, DM , All)<br /><br />200. Post exposure prophylaxis for HIV min for( 6 weeks, 4 weeks, 12 weeks, 8 weeks)<br /><br />201. Vomiting,diarrhea 6 hours after food intake- Staphylococci<br /><br />202. Patient c/o finger stiffness, dysphagia.Dx- Scleroderma<br /><br />203. Hepatorenal syndrome charc by all except( normal intrinsic kidney , low or no proteinuria;_)<br /><br />204. Best marker to assess prognosis after colon Surgery for Ca( CEA, Ca199, Ca125)<br /><br />205. Rx of steroid dependant asthma(long acting B2 agonist, leucotrine antagonist, theophylline, systemic steroid)<br /><br />206. Pretibial myxedema is seen in ( Thyrotoxicosis, myxedema, follicular Ca , Pappilary Ca thyroid)<br /><br />207. Zn def not see n in ( Burns, TB, Renal tubular dse, malabsorption)<br /><br />208. True about Pan coast Tr except(lower lobe Ca, MC adeno Ca)<br /><br />209. Charecteristic of MCTD are all of the following (?except) (CNS involvement, GN, Polyarthritis, Hypocomplimentemia )<br /><br />210. MC CNS involvement in HIV- Dementia<br /><br />211. a –wave in JVP indicates – Atrial systole<br /><br />212. Wide split fixed 2nd sound seen in – ASD<br /><br />213. Anti mitochondrial Ab seen typically in – PBC<br /><br />214. brain death is loss of(brain stem Fx, cortical Fx, spinal refex, corneal reflex)<br /><br />215. H-gge into R internal capsule of aR handed person causes(Aphasia, R hom hemianopia, hemianopsia)<br /><br />216. Spirochets can be identified by all of the follwg(?except) ( Dark field microscopy, Levaditi stain, Fontana stain, Gram stain)<br /><br />217. Dressler’s syn due to- auto immune<br /><br />218. Pinpoint pupil seen in all except(Imipramine, Chlorpromazine, _, None)<br /><br />219. Pt with jaundice and ARF. MI in history except( TCA Rx,<br /><br />sewage worker, Paracetamol poisoning, Drug abuse)<br /><br />220. 45 year man c/o back pain & joint pain. In X-Ray B/L Sacroileitis. Dx. (Ankyl spondylosis, Psoriatic arthritis, RA)<br /><br />221. Not a cause of Cor pulmonale( Mitral stenosis, intermittent PE, COPD, Kyphoscoliosis)<br /><br />222. FAMILIAL bullous dse is equivalent to(Halvey halvey syn, Darrier’s dse, Bullous pemphigus)<br /><br />223. MCC of hypovolemic shock- (H-gge, Gm-ve shock)<br /><br />224. Flapping TREMOR is seen in all except( Thyrotoxicosis, Uraemia, CO2 narkosis, Hepatic failure)<br /><br />225. In hemolytic anemia true except( increased haptoglobulin, BM hyperplasia, Reticulocytosis, increased unconj bilirubin)<br /><br />226. Morphine is given in – LVF<br /><br />227. MCA territory H-gge, not seen is( Aphasia, dysarthria, hemiparesis)<br /><br />228. MI factor determining myocardial O2 consumption ( heart rate, blood volume, cardiac output, myocardial fibre tension)<br /><br />229. Hypotonia seen in all except( anxiety, sleep, shock)<br /><br /><br /><br />Surgery<br /><br /><br /><br />230. Tinel’s sign is seen in (nerve regeneration, degeneration, both, none)<br /><br />231. Thrombophlebitis seen in ( Buerger’s dse, Reynauld’s dse, AV fistula)<br /><br />232. GERD is predisposed by( Smoking, Achalasia, Trunkal vagectomy, All)<br /><br />233. Not premalignant( Condyloma lata, Bowen’s dse, Balanopostitis)<br /><br />234. Uvula vesicae is caused by(ant lobe, post lobe, medial lobe of Prostate)<br /><br />235. In Carpel tunnel syndrome,the nerve involved is – Median Nerve<br /><br />236. MCC of hepatic abscess in India( amoebic absess, infected haematoma, ascending infection, secondary to cholelithiasis)<br /><br />237. Multiple lytic lesions in all bones of a child of 14 years. Dx( Histiocytosis X, Neuroblastoma, Osteosarcoma, 2ory from Wilm’s Tr)<br /><br />238. Dumbing syn is charec by all except(Hyperglycemia, numbness & giddiness)<br /><br />239. Not a complication of Crohn”s dse( Sclerosing cholangitis, granuloma, fistula, stricture)<br /><br />240. Hirshprung’s Dse MC involves (recto sigmoidal jn, Rectum, colon )<br /><br />241. Hirshprung’s Dse Dx by – Rectal Biopsy<br /><br />242. Thimble bladder is seen in - TB<br /><br />243. Mass 15 cm away from anal orifice .Rx( Colonoscopic removal, hartman’s operation, ant resection, abd-peroneal resection)<br /><br />244. Sister Joseph Nodules are seen at – Umbilicus<br /><br />245. Spigelian hernia is- hernia of arcuate line<br /><br />246. Pott’s puffy Tr is - OSTEOMYELITIS of skull bone<br /><br />247. Grey Turner sign in – Acute pancreatitis<br /><br />248. Acute pancreatitis cause all except(induce fat necrosis, hypercalcemia, increased amylase)<br /><br />249. Amylase is increased in all except( A/c appendicitis, A/c pancreatitis, duodenal perforation, intestinal obstrn)<br /><br />250. Rx of paralytic ileus include all except(Parasympathomimetics, NG aspiration, IVF, Electrolyte correction)<br /><br />251. Painful tender & non reducable sac through inguinal canal with absent cough reflex.Dx- Strangulation<br /><br />252. MC organ ruptured in blunt trauma of abdomen- spleen<br /><br />253. Bornhalm’s sign seen in – AV fistula<br /><br />254. Dse with least flow(Intravisceral fistula, visceral hemangioma, portal vein shunt)<br /><br />255. Stones are MC seen in which salivary gland- sub mandibular<br /><br />256. Major amount of unstimulated salivary secretion by(Parotids,submandibular, sublingual, small lingual glands)<br /><br />257. MC mode of spread to cervical LN in TB( Haematogenous, lymphogenic, contact)<br /><br />258. MC mode of spread of Gall Bladder Ca- (Transcoelomic, lymphogenic, hematogenic, Direct extension)<br /><br />259. Chronic cholecystitis is assd with all except( usually palpable, MC in women, Assd wiyh GB stones, Rokitansky cells)<br /><br />260. MC type of Basal cell Ca- Nodular<br /><br />261. LN involved in Breast Ca except( Pre tracheal, ant axillary, parasternal, supraclavicular)<br /><br />262. Sted collar abscess seen in (TB, Syphilis, Actinomycoses)<br /><br />263. Which cannot be considered as a solitary noduleof thyroid(adenoma, carcinoma, physiological goiter, cyst)<br /><br />264. In neck dissection above omohyoid we are removing(I,II,III level LN)<br /><br /><br /><br /><br /><br />Gynaecology<br /><br /><br /><br />265. Scaly lesions with frequent bleed around areola. Dx ( Paget’s dse, Ezcema, TB)<br /><br />266. Epithelium in vagina is – squamous<br /><br />267. Colposcopy used to visualize- Cervix<br /><br />268. MC site of ectopic pregnancy,-(ampulla, isthmus, interstitium)<br /><br />269. 43 year lady c/o prolonged and heavy bleed.O/E hyperplasia with no atypia. Rx(Estrogen, Estrogen+ progestogen, Progestron, Hysterectomy)<br /><br />270. In a patient soon after 3rd stage of labour placenta fully came out, but heavy bleed. Tactics; (Massage & oxytocin, IVF, Check for placenta in uterus, check for laceration of labia)<br /><br />271. Painless heavy bleed seen in ( Placenta previa, )<br /><br />272. Hydramnios is complicated by all except( Atonic H-ge, obstructed labour, uterine dysfunction, Placenta abruptio)<br /><br />273. Bacterial vaginosis causes(Pre term labour, abruption placenta, endometritis, Chorioamnionitis)<br /><br />274. Gold standard in Dx of PID( USG, Laparoscopy, Blood leucocyte count, Anti chlamydial Ab)<br /><br />275. LH:FSH ratio increased in – PCOD<br /><br />276. Ovulation coincides with – LH surge<br /><br />277. Exact no of weeks between LMP & EDD- (38, 39, 40 weeks)<br /><br />278. Bishop’s classification is used for-_<br /><br />279. Pregnant lady presnts with fulminant hepatitis. MCC( Hep A, B,C, D)<br /><br />280. Advantages of median episiotomy over mediolateral are all except(H-ge, Healing, pain, extension)<br /><br />281. Active tactics in labour according to –PARTOGRAM<br /><br />282. Investigations to be done in a girl presented with delayed puberty( USG pelvis, FSH, Karyotyping, All)<br /><br />283. Best prognostic factor in breast Ca( LN involvement, age, FAMILIAL history)<br /><br />284. MC presentation( LOA, ROA, LOP, ROP)<br /><br /><br /><br /><br /><br />285. Appropriate investigation of choice in Vesico-ureteric Reflux- MCU<br /><br />286. Not a complication of Pseudo pancreatic cyst(H-ge into cyst, Rupture, Malignancy)<br /><br />287. Pheno cause HEMOLYSIS in all of the follwg except (G6PD def, TB, Alcoholism)<br /><br />288. External ear infections are MC caused by (Pseudomonas, fungi, virus, actinomyces)<br /><br />289. Major site of storage of labile proteins ( liver , skel muscle, endocrine glands, exocrine glands)<br /><br />290. Virus causing Rabies in man is( Street virus, wild virus,--)Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-12224365902168667542008-12-18T09:38:00.000-08:002008-12-18T10:04:54.029-08:00fmge september 2005QUESTIONS SEPTEMBER 2005(part 1&2)<br />(the answers marked with question mark are not appropriate. if anyone gets the correct answer, please do the proper corrections)<br />1,Hydatid cyst is commonly found in<br />1, liver<br />2, lungs<br />3, kidney<br />(ans:liver )<br />2, Most common site of abscess formation due to Amoeba<br />1, liver<br />2, Lungs<br />3, kidney<br />(ans:liver )<br />3, Umblical cord has (repeated question in all previous papers)<br />1,2artery n 1 vein<br />2,2 vein n 1 art.<br />(Ans:2 artery n 1 vein)<br />4, Apoptosis<br />Programmed internal suicidal cell death<br />5, wheal and flare reaction is<br />1, Type 1 hyper sensitivity<br />2, Type 2 hyper sensitivity<br />3, Type 3 hyper sensitivity<br />4, Type 4 hyper sensitivity<br />(ans:Type 1 hyper sensitivity. All the anaphylactic reactions comes under type 1 hyper sensitivity)<br />6, Hypoglossal nerve is<br />1,6th nerve<br />2,7th nerve<br />3,12th nerve<br />4,9th nerve<br />(Ans:12th nerve)<br />7, Muscle in the inguinal canal is<br />1, Internal oblique<br />2, External oblique<br />3, Transverse<br />(ans:???transverse)<br />8, Total claw hand<br />1, ulnar and median nerve<br />2, ulnar nerve<br />3, median nerve<br />(ans:?ulnar and median nerve)<br />9,In Hansen’s disease the nerve affected is:<br />1, ulnar nerve<br />2, median nerve<br />3, radial nerve<br />(ans:ulnar nerve.Hansans disease is the other name for leprosy. the most common nerve affected in leprosy is ulna nerve.<br />Ref.Bailey and love. Pg37-41)<br />10, Complication of extra capsular FRACTURE of femur:<br />1, Non union<br />2, mal union<br />(ans:Non union Ref.SARP Surgery and orthopaedics pg.89)<br />11,eye ball moments controlled by all, EXCEPT:<br />1, optic nerve<br />2, abducens nerve<br />3, Trochlear nerve<br />4, oculomotor nerve<br />(ans:optic nerve.( Abducens 6th nerve moves the eye laterally,Trochlear nerve helps in moving the eye down and in,Oculomotor 3rd nerve helps for outward lateral gaze)<br />12, Lacrimal duct passes through, except:<br />1, Frontal<br />2, maxillary<br />3, zygomaticus<br />4, lacrimal<br />13, Right common carotid artery arises from:<br />1,Right axillary<br />2, Arcus aorta<br />3, Brachiocephalicus<br />(ans:Brachiocephalicus)<br />14, The first heart sound S1 is due to the:<br />1, AV closure<br />2, opening of aortic valve<br />3, closing of aortic valve<br />(ans:AV closure)<br />15, Rheumatic fever is associated with:<br />1, Mitral valve<br />2,Pulmonary valve<br />3,Tricuspid valve<br />4, Aortic valve<br />(ans:Mitral valve)<br />?15, Hernia Morgani passes through:<br />1,pleuro peritoneum<br />2,diaphragm<br />16, Gland of Burner is found in (Rpt in march 2005)<br />()ANS:Deudenum)<br />17, Length of Duodenum:<br />1,15<br />2,20<br />3,25<br />(ans:20-25cm, Ref. SARP BAP(biochem,Anatomy ,Physiology ) pg 77)<br />18, Tuberculosis commonly affects which part of the colon:<br />1, Transverse colon<br />2, Terminal colon<br />3, Jejunal colon<br />19, Unilateral breast findings with scaly SKIN around the nipple with intermittent bleeding (Rpt. In march 2005)<br />1, Pagets disease<br />2, Eczema<br />3,CA breast<br />(ans:Pagets disease)<br />20Simple Mastectomy includes:<br />1,Breast and axillary nodes<br />2,only breast<br />3, Breast +axillaries nodes+pectoralis major muscle<br />(ans:Only Breast, Simple Mastectomy- this means complete removal of the breast but the axilla is left undisturbed except for the region of the axillary tail which usually has attached to it a few nodes low in the anterior group. Ref.Bailey and love(20th edition) pg.733)<br />21, Continous Murmur is found in which arterial disease:<br />1,AV Fistula<br />2,Disecting aortic aneurysm<br />(ans: AV Fistula. Continuous machinery murmur is also found in Patent Ductus arteriosus PDA)<br />??22, which ion helps is potential:<br />1,Na+<br />2,K+<br />23,All of the following found in Horner’s syndrome, EXCEPT:<br />1,Ptosis<br />2,Meiosis<br />3, Hyperhydrosis<br />(ans:Hyperhydrosis, In Horners syndrome, unilateral Anhidrosis(ie,loss of sweating) is found)<br />24,Peau d’ Orange of Breast is due to:<br />1,Obstruction if lymph<br />2,Obstruction of ducts<br />3,Obstruction of arteries<br />4,Obstruction of Vein<br />(ans:Obstruction of Lymphatic vessels, Ref.Robbins Basic Pathology ,pg.354)<br />25,Reabsorption of Water is maximum in :<br />1,proximal tubules<br />2,Henles loop<br />3,collecting duct<br />(ans:Proximal tubules)<br />26,Carcinoid syndrome, ass. With except,<br />1,Diarhoea<br />2,Flushing<br />3,Acute appendicitis<br />4,cyanosis<br />(ans:?cyanosis)<br />27,Acute Pancreatitis associated with:<br />1,Alcoholic<br />2,Gall bladder stones<br />3,Elevated serum amalyse<br />4,All of the above<br />(ans:?all of the above)<br />28,Diagnosis of CA colon ,best indicated by:<br />1,colonoscopy<br />2,CT<br />3,Barium enema<br />4,x-ray<br />(ans:colonoscopy)<br />29,Radiation is less in:<br />1,CT<br />2,MRI<br />3,Fluroscopy<br />4,X-ray<br />(ans:MRI)<br />30,CA colon Marker:<br />(ans:CEA)<br />31,AFP(alpha feta protein ) is increased in:<br />1,Hepatic carcinoma<br />2,Renal carcinoma<br />(ans:Hepatic carcinoma)<br />??32,Ananencephaly is better diagnosed in which trimester:<br />1,1st trimester<br />2,2-3 trimester<br />33,Which of the following nerve is damaged by the FRACTURE of the shaft of the humerus:<br />1,Radial nerve<br />2,ulnar nerve<br />3,median nerve<br />(ans:Radial nerve)<br />??34,Inversion and Eversion is done by?<br />35,Supination is done by:<br />(ans:Radio ulnar joint)<br />36,FRACTURE of supracondylar of the femur affects which nerve:<br />1,sciatic nerve<br />2,poplitial nerve<br />37,Vein used in bypass Surgery :<br />1,Long saphenus vein<br />2,short saphenus vein<br />(ans:long saphenus vein)<br />?38,pulseless<br />(ans:Methionine)<br />39,Which is seen in RNA but not seen in DNA:<br />1,adenosine<br />2,Uracil<br />(ans:uracil)<br />40,Production of Uric acid is by:<br />1,Nucleic acid<br />2,Protein<br />(ans:??nucleic acid)<br />41,Hexose is not seen in:<br />1,Pentose<br />2,Glucose<br />3,Fructose<br />(ans:Pentose-5 ,and hexose is 8 )<br />42,Common complication of long bone FRACTURE :<br />1,Fat embolism<br />2,Pulmonary embolism<br />(ans:Fat embolism.It is the commenest complication of long bone fractures like, femur FRACTURE )<br />43,Definitive management for Tension pneumothorax is:<br />(ans:Thoracosynthesis)<br />44,Normal Fluid level in pericardium<br />1,100-150<br />2,50-100<br />3,150-200<br />45,polyhydroaminosis is increase in aminoitic fluid more than:<br />1,1000ml<br />2,2000ml<br />3,3000ml<br />46,HIV is associated with<br />1,Disseminated TB<br />2,Oesophageal candidiasis<br />3,MAI<br />4,all of the above<br />(ans:?all of the above)<br />47,Radiological findings of Ewings sarcoma(Rpt)<br />(ans:Onion Peel appearance)<br />48,Osteosarcoma affects:<br />1,Metaphysis<br />2,Diaphysis<br />3,Epiphysis<br />(ans:Metaphysis,Ref:SARP-Surgery and orthopaedics ,pg 51)<br />49& 50,,Pseudomembranous colitis is caused by:<br />(ans:Clostridium Difficle)<br />51,Diagnostic test for Enteric Fever:<br />1,WIDAL test<br />2,VDRL<br />(ans:WIDAL.Enteric fever is the other name for Typoid fever, and the the diagnostic tests include, (mneumonic:BASU,ie, 1st week,B-blood culture,2nd week,A-agglutination test which is called as WIDAL,3rd week S-Stool culture and 4th week,U-Urine culture)<br />52,Complement Fixation test is:<br />1,Coombs test<br />2,Waserman reaction<br />3,VDRL<br />4,WIDAL<br />53,Iron Deficiency anemia is commonly caused by (Rpt)<br />(ans:Hook worm )<br />54,Which is a pre-toxin:<br />1,E.coli<br />2,Cholera<br />3,SALMONELLA<br />4,Staph.aureus<br />55,Trauma to spleen is best diagnosed by:<br />1,USG<br />2,CT<br />(ans:?USG)<br />56,Post splenectomy causes:<br />1,Thrombocytosis<br />2,Thrombocytopenia<br />3,Thrombocytopenia and leucopenia<br />57,Radial nerve<br />1,c5,c6<br />2,C5,C6,T1<br />(ans:C5,C6.T1)<br />58,ST elevation is seen in:<br />1,Acute MI<br />2,Pericarditis<br />3,Prinze metals angina<br />4,all of the above<br />(ans:all of the above)<br />59,cholera vaccination is effective:<br />1,6 months<br />2,3 months<br />60,Hepatitis B vaccine should be given as:<br />1,0,1,6months<br />2,0,1,6 days<br />(ans:0,1,6 months)<br />61,BCG should be given:<br />(ans:Immediately after birth)<br />62,Cellular fragments od Rabies vaccine is given at:<br />1,Anterior Abdomen<br />2,Deltoid muscle<br />3,Medial part of thigh<br />63,BCG is diluted with:<br />1,NS<br />2,Distilled water<br />64,Vitamin A should be given at:<br />(ans:6-9months)<br />65,Cancroid is caused by:<br />(ans:H.Ducrei)<br />66,Swan Gann Catheter is used to measure:<br />(ans:PCWP-pulmonary capillary wedge pressure)<br />67,CVP denotes,pressure of:<br />1,Right atrium<br />2,Rt.Ventricle<br />3,Left atrium<br />4,Lt.Ventricle<br />(ans:Rt.atrium,?as the vena cava(sup. N inf.) ends in Right atrium, central venous pressure helps in determing the venous filling)<br />68,Tricuspid Incompetence:<br />1,a wave<br />2,Hepatic pulsation<br />(ans:hepatic pulsation, pulsatile liver is a feature in Tricuspid regurgitation)<br />69,In a patient with Diabetic nephropathy , the anti hypertensive commonly used is:<br />1,ACE inhibitors<br />2,Ca channel blockers<br />3,B-blockers<br />(ans:ACE inhibitors)<br />70,Microaneurysm is the most common complication of:<br />1,Diabetic Mellitus<br />2,Hypertension<br />(ans:Diabetic Mellitus)<br />71,Most common cause of blindness in India is:(Rpt. In March 2005)<br />(ans:Cataract)<br />72,Vitreous Hemorrage in Young patients is most commonly due to:<br />1,Diabetics mellitus<br />2,Retinal Detachment<br />3,Eales disease<br />(ans??Eales disease)<br />73,The lens used in astigmatism:<br />1,concave lens<br />2,convex lens<br />3,cylindrical lens<br />(ans:cylindrical lens)<br />74,seminoma is ca of:<br />(ans:testes)<br />75,Post.staphyloma:<br />1,myopia<br />2,hypermetropia<br />76,constriction of pupils:<br />1,only light reflex<br />2,light reflex and accommodation<br />3,refraction<br />(ans:??light reflex and accommodation)<br />77,??keratoconus<br />78,Inhaled forgeign body is seen in the:<br />1,Right apex<br />2,Right lower lobe<br />3,Left apex<br />4,Left lower lobe<br />(ans:?Right lower lobe)<br />79,Community acquired pneumonia:<br />1,pneumococci<br />2,streptococci<br />3,H.influenza<br />80,Placenta Praveica:<br />1,Painfull bleeding<br />2,severe abdominal pain<br />3,painless bleeding<br />4,all of the above<br />(ans:painless bleeding, only Placenta Abruptia has painfull abdominal pain with bleeding)<br />81,A pregnant lady in her first trimester,complaints with bleeding, on examination the OS is closed:<br />1,Inevitable abortion<br />2,Threatend abortion<br />(ans:Threatened abortion,since the OS is closed it should be threatened abortion, is the os is opned, it can be inevitable abortion)<br />82,A primigravida with hypertension, when should we induce labour:<br />1,35 week<br />2,37 week<br />3,40 week<br />4,39 week<br />(ans:?37 week)<br />83,Anti-D Rh is given for:<br />(Rh positive father, and Rh neg. mother)<br />84,for a lady in her pregnancy, to prevent Tetanus, who should be immunized:<br />1,Tetanus toxid to the mother<br />2,Tetanus toxid to the infant<br />3,immunoglobin to the mother<br />(ans:TT to the mother)<br />85,Treatment for ectopic pregnancy:<br />1,salpihigotomy<br />2,observation<br />3,D&C<br />86,Misoprostol is given, except<br />1,Missed abortion<br />2,To induce labour<br />3,menorrhagia<br />4,postpartum hemorrhage<br /><br />87,custodial rape is judged in<br />1,Judicial magistrate<br />2,district magistrate<br />(ans:judicial magistrate)<br />88,Anti-hypertensive contratindicated in pregnancy :<br />1,Hydralazine<br />2,Methyldopa<br />3,Enalapril<br />4,Amylodopine<br />(ans:?enalapril)<br />89,which is a pro-drug:<br />1,enalapril<br />2,clonidine<br />(ans:?enalapril)<br />90,pharmocodynamics deals with:<br />1,Mechanism of action<br />2,Excretion<br />91,Theurapatic index:<br />1,efficacy<br />92,Le fort FRACTURE (Rpt in march 2005):<br />1,Maxilla<br />2,Mandible<br />(ans:Maxilla)<br />93,Metabolic acidosis is seen in:<br />(ans:Diabetic ketaacidosis,(Mneumonics:LUKD,Lactic acidosis,Uremia-renal failure,Ketoacidosis,Drugs like acetozolemide,phenformin etc,..in all these conditions, metabolic ketacidosis is seen)<br />94,Breast feeding is contraindicated in:<br />1,Mastitis<br />2,HIV carrier<br />3,Open TB<br />95,Condoms are more preferred because, they have:<br />1,Reduced side effects<br />2,reduced failure rates<br />(ans:reduced side effects)<br />96,Natural method of contraception::<br />1,Rhythm method<br />2,coitus interruption<br />3,breast feeding<br />4,all of the above<br />(ans:all of the above)<br />97,Infant Mortality rate is:<br />(ans:1000 live births)<br />98,Maternal mortility rate calculated as::<br />1,42 days after delivery<br />2,immediately after delivery<br />(ans:??42 days after delivery)<br />99,Total fertility rate is:<br />1,reproductive age of the female at 15-44<br />100,Eligible couple (rep. march 2005)<br />Recently married couple where the female is of fertile age<br />101,Not a grevious injury:<br />1,contusion of breast<br />2,multiple scars of face<br />3,FRACTURE of femur<br />(ans:contusion of breast)<br />102,Drug indicated for hyperthyroidism during pregnancy:<br />1,prophyltiouracil<br />2,carbamazipine<br />(ans:propylthiuracil)<br />103,No. of parathyroid glands:<br />1,4<br />2,6<br />3,2<br />(ans:4)<br />104,Features of Graves disease,except:<br />1,most common in male<br />2,TREMOR<br />3,pretibial myxodema<br />(ans:most common in males, graves disease is most commonly found among females, TREMOR , pretibial myxodema are characteristic features of graves disease)<br />108,Hypercholestremia is commonly associated with:<br />1,hypothyroidism<br />2,diabeticsmelitus<br />109,All are features of hypothyroidism except,<br />1,lid retraction<br />2,myxedema<br />3,bradycardia<br />4,dry SKIN<br />(ans:lid retraction, it is seen in hyperthyroidism ,ie, as exopthalmus, when the patient has exophthalmus, there is lid retraction. Rest are features of hypothyroidism)<br />110,Virchos triad is seen in:<br />1,DVT<br />2,Hyper coagulity<br />3,Abdominal visceral malignancy<br />111,glasscow scale in death is:<br />1,0<br />2,3<br />3,5<br />(ans:3, patient is declared death when the GCS is 3)<br />112,panic attack is:<br />1,Acute anxiety<br />2,chronic anxiety<br />113,sucidal tendency is assoiciated with:<br />1,depression<br />2,schizophrenia<br />3,impulsive disorder<br />4,all of the above<br />(ans:?depression or ? all of the above)<br />114,short acting drug(or? Bezodiazephams)<br />1,diazepham<br />2,lorezepham<br />3,midasolam<br />(ans:?diazepham or ?midazolam. both are short acting drugs, if benzodiazepham is mentioned then diazepham will be more opt. lorezepham is a long acting benzodiazepham)<br />115,short acting anesthetic agent used for induction:<br />1,thiopental<br />2,ketamine<br />3,propofol<br />(ans:?propofol)<br />121,Hypnotic drug action is:<br />1,rapid elimination and slow distribution<br />2,slow elimination and rapid distribution<br />122,H+ ion is eliminated by<br />1,lungs<br />2,stomach<br />3,kidney<br />(ans: ?kidney )<br />123,First pass metabolism:<br />1,oral<br />2,sub cutaneus<br />3,sub lingual<br />4,rectal<br />(ans:??sublingual)<br />124,lassik content<br />1,xenon<br />2,excimer<br />3,yog<br /><br />(ans:?excimer)<br />125,A 40 yr old male,has a rash over the groin, with a scaly lesion on examination:<br />1,candidiasis<br />2,Malazi furfur<br />3,Trichophyton<br /><br />126,Most common nosocomial fungal infection:<br />1,candidiasis<br />2,aspergillosis<br />127,superficial inguinal lymph nodes drain from except:<br />1,testis<br />2,uterus<br />128,EBV(ebstein barr virus) except:<br />1,pancreas<br />2,burkitts lymphoma<br />3,glandular fever<br />(ans:?pancreas)<br />129,antiaggrent:<br />(ans:asprin)<br />130,anticoagulant is given in all conditions except:<br />1,pericarditis<br />2,DVT<br />3,pulmonary embolism<br />(ans:pericarditis)<br />131,OCP(oral contraceptive pills) is contraindicated in<br />(ans:hepatic failure)<br />132,Primary colours except:<br />1,green<br />2,red<br />3,white<br />(ans:white)<br />133,in colour blindness<br />(ans:?defect in 1 or more prime colours)<br />134,jovel bodies seen in<br />?<br />135,Most commin utero-vesicle fistula in India:<br />1,obstructed labour<br />2,pelvic Surgery<br />(ans:obstructed Surgery )<br />136,Treatment for zollinger elison syndrome:<br />1,omeprezole<br />2,cimitedine<br />(ans:omeprezol, proton inhibitors are best indicated )<br />137,2nd stage of labour:<br />1,increase in contraction<br />2,cervix dilatation<br />3,all of the above<br />(ans:?all of the above)<br />138,Heamolysis:<br />1,vit.E<br />2,vit.K<br />(ans:vit.E)<br />139,Free radicals:<br />(ans:vit.E, vit.E,A,C are anti-oxidants.)<br />140,Meckels diverticulitis is ass. With:<br />1,increased bleeding<br />2,ass/ diverticulitis<br />141,pharyngeal pouch?<br />142,Reflex nephropathy is diagnosed by (Rpt in march 2005)<br />(ans:MCU(micturating cysto urethrogram)<br />143,Heamocolpus is :<br />(ans:imperforate hymen)<br />144,Height doubles at:<br />(ans:4 years)<br />145,vitamin D deficiency is:<br />(ans:Rickets)<br />146,Enteric fever is caused by:<br />(ans: S.thyphi)<br />147,Tubercular focus at apex:<br />1,gommus<br />2,simsands<br />148,Nutritional essential in a child noted as<br />1,weight for age<br />2,height for age<br />3,arm circumference<br />149,Tyrosin becomes essential in<br />1,phenylketonuria<br />2,thyrosinosis<br />150, ,In intermittent porphyria what is the urine content:<br />1,uroporphyrin<br />2,porphobilinogens<br />(ans:porphobilinogens,Ref:Oxford handbook of Medicine ,pg 708<br />151,Essential amino acids are named so:<br />Because they are not produced in the body<br />152,Enzymes are:<br />1,protein<br />2,Lipid<br />(ans:protein)<br />153,Poluunsaturated fatty acids,Except:<br />1,olieic acid<br />2,arachinic acid<br />154,All are bad cholesterol except:<br />1,HDL<br />2,LDL<br />155,MI enzymes are:<br />1,Tropin<br />2,Myoglobulin<br />3,LDH<br />4,all of the above<br />(ans:all of the above)<br />156,UTI contains microbes:<br />1,>10^6<br />>10^10<br />157,Which immunoglobulin is present in the breast milk:<br />(ans:IgA)<br />158,IgM denotes:<br />(ans:primary reaction)<br />159,Investigation of choice for Acute pancreatitis:<br />1,CT<br />2,USG<br />3,Xray<br />(ans:??CT)<br />160,What is the major side effect of streptomycin:<br />(ans:Ototoxicity)<br />161,which is of Obstructed COPD:<br />1,Bronchial asthma<br />2,Chronic bronchitis<br />3,bronchoectasis<br />4,all of the above<br />162.apoprotein of cholesterol:<br />1,apoE<br />2,apo A1<br />3,apoA2<br />163,Pancreatic calcification is due to:<br />1,alcoholism<br />2,Cystic fibrosis<br />3,idiopathic<br />4,heriditory<br />164,cholesterol is:<br />1,b-caratone<br />165,Breast milk ejection is due to:<br />1,oxytoxin<br />2,prolactin<br />(ans:oxytoxin,pralactin helps in secretion of milk)<br />166,Weight of a child triples at:<br />(ans:1 year)<br />167,recurrent laryngeal nerve supplies except:<br />1,cricothyroid<br />168,Not a solitary nodule:<br />1,cyst<br />2,adenoma<br />169,Cryptococcus<br />1,pigeon droppings<br />170,endemic dropsy:<br />1,sanginosus<br />171 ,in Malaria falciparum:<br />1,ring shaped cresents seen<br />172,potassium sparing drug:<br />1,spironolactone<br />2,furesemide<br />(ans:spironolactone,all other diuretics causes hypokalemia when given,spironolactone spares pottasium)<br />173,carbohydrates,proteins and fat metabolism occurs in which cycle:<br />1,krebs cycle<br />2,coherts cycle<br />174,pulse biferns occurs in:<br />1,AR<br />2,AS n AR<br />3,HOCM<br />4,all of the above<br />(ans:?all of the above)<br />175,Obstructive jaundice is due to:<br />(ans:gall stones)<br />176,Difference between human milk and cows milk:<br />1,iron deficiency<br />177,Post partum hemorrhage in a spontaneous delivery is due to:<br />(ans:uterine atony)<br />178,in SHOCK:<br />1,hypotension<br />2,hypoperfusion to tissues<br />3,hypoxia<br />4,all of the above<br />(ans:all of the above)<br />?179,hepatitis E<br />180,what is the lung findings in HIV:<br />1,disseminated TB<br />2,LUPUS vulgaris<br />(ans:disseminated TB)<br />181,Pneumoperitonium is seen in:<br />1,PA erect view<br />2,abdominal xray<br />182,Wilson disease is due to :<br />(ans:copper)<br />183,which is a mast cell stabilizer:<br />(ans:sodium chromoglycate)<br />184,drinking water test is done in:<br />1,acute congestive glaucoma<br />2,acute glaucoma<br />3,chronic glaucoma<br />185,osmolity<br />1,serum potassium<br />2,serum sodium<br />(ans?:serum sodium)<br />186,plaque is caused by<br />1,flea<br />2,tics<br />3,mites<br />(ans:?flea)<br />187,HONK (hyper osmality non ketoacidosis) occurs in:<br />(ans:Diabetes mellitus)<br />188,Mid day meals:<br />1/3 calories +1/2 protein<br />189,heamorrage leads to:<br />(ans:hypovolemic shock)<br />190,Most common stranglulation occurs in:<br />(ans:femoral hernia)<br />191,cough impulse is not seen in:<br />(ans:strangulation)<br />192,Acute appendicitis:<br />1,fever >42<br />2,anorexia,Right hypochondrial pain,fever<br />(ans: anorexia,Right hypochondrial pain,fever)<br />?193,active potential:<br />K+<br />194,Least conduction fibres:<br />1,C- fibres<br />195,Reticulocytes are found in:<br />(ans:hemolytic anemia,when HEMOLYSIS occurs, much of immature reticulocytes are produced in bone marrow,Ref.check kapithans ped. Book)<br />196,Which drug is not given in anaphylactic shock:<br />1,adrenalin<br />2,steroids<br />3,antibiotics<br />4,antihistamine<br />(ans:antibiotics)<br />197,Ovulation occurs:<br />1,14 days prior to next menstruation<br />2,14 days after menstruation<br />3,on 14th day<br />(ans:14 days prior to next menstruation:)<br />198,Complication in Diabetics mellitus occurs after :<br />1,6 years<br />2,8 years<br />3,12 years<br />199,glove and stockings sensory loss occurs in:<br />1,syringomelia<br />2,pheripheral neuropathy<br />3,all of the above<br />(ans:all of the above)<br />200,causative of sore throat:<br />1,Strep.pyogens<br />2,staphylococcus<br />(ans:strep. Pyogens, it is the causative for infective endocarditis)<br />?201,sup. Thyroid occurs frm:<br />1,4th branchial arch<br />202,DNA:<br />1,deoxyribose sugar<br />203,Mycobacterium grows in:<br />1,LG medium<br />204,Effective sterilization:<br />1,steam under pressure<br />2,hot water<br />205,?pasturation of milk determined by:<br />??methylene blue<br />206,Sharp instrument should be disposed in:<br />1,red bag<br />2,blue bag<br />(ans:?red bag)<br />207,term vaccine was named by:<br />1,Louis Pasteur<br />2,Jenner<br />208,Absence of sperms:<br />1,oligospermia<br />2,Azzospermia<br />(ans:azzospermia)<br />209,Duputryens contracture affects:<br />1,little finger<br />2,ring finger<br />3,middle finger<br />(ans:little finger)<br />210,GB (gullian barr syndrome) characteristic:<br />(ans:loss of limb reflex)<br />211,Co2 is carried in the plasma in the form of :<br />1,bicarbonate<br />2,carbonic acid<br />(ans:?bicarbonate)<br />212,glucose in ORS is used:<br />(ans:for the absorption of Na+)<br />213,disease caused by cotton:<br />(ans:bysinosis)<br />214,aniline dyes causes:<br />1,bladder Ca<br />2,renal ca<br />3,hepatic ca<br />(ans:bladder ca)<br />215,non alcoholic hepatitis,except:<br />1,Mallory hyaline fibrosis<br />2,steatis<br />216,COPD –all except,<br />1,RVF(right vent. Failure)<br />2,polycythemia<br />3,LVF(left vent. Failure)<br />(ans:?LVF)<br />217,Most common feature of essential hypertension:<br />1,headache<br />2,visual fortification<br />(ans:headache)<br />218,LVH is caused by:<br />(ans:essential hypertension, hypertension causes left vent. Strain)<br />219,Vagina is lined by:<br />1,Squamous cell epithelium<br />2,columnar cells<br />(ans:squamous cell)<br />220,Nitrates indicates:<br />(ans:,recent pollution)<br />221,first line prevention of epidemics:<br />1,confirmation of diagnosis<br />2,isolation<br />3,mass immunization<br />222,pin point pupils are seen in, except<br />1,datura<br />2,opiods<br />3,organophosphates<br />4,cerebello pontine hemarroge<br />(ans:datura(ectasy)<br />223,glomular filtration rate increases in:<br />1,hypertension<br />2,bowmen capsules pressure<br />3,increased osmotic pressure<br />224,hemorrhagic cystitis is caused by:<br />(ans:cyclophosphamide)<br />225,allopurinol:<br />1,inhibits the synthesis of uric acid<br />226,Gerotas fasia covering:<br />1,kidney<br />2,femur<br />227,gentamycin is not given orally because<br />228,which drug effects both bacterial and anerobic infections:<br />1,sparfloxcillin<br />2,pefloxacillin<br />3,norfloxacillin<br />4,ciprofloxcillin<br />229,Dark ground microscopy:<br />1,refracted light<br />2,polarized light<br />230,retained placenta causes<br />1,prolonged bleeding<br />2,sepsis<br />3,placental polyp<br />4,all of the above<br />(ans:all of the above)<br />231,exercise to increase the muscle strength:<br />1,isotonic<br />2,isometric<br />3,aerobic isotonic<br />232,Southern blot test:<br />1,DNA<br />2,RNA<br />3,PCR<br />(ans:DNA, northern blot test is for RNA, Western blot for HIV)<br />233,niacin is synthesized<br />1,tryptophan<br />234,Iron storage is:<br />1,transferring<br />234,In vitro fertilization:<br />1,artifical insemination<br />235,spinal cord ends at:<br />1,L2<br />2,S1<br />3,L1<br />4,S2<br />(ans:L2)<br />236,estrogen deficiency leads to:<br />1,osteoporosis<br />2,dysmenorrhea<br />(ans:osteoporosis, most of the post menopausal women get osteoporosis, because of estrogen def.)<br />237,curlings ulcer:<br />1,deudonal ulcers in burns<br />238,humoral cells are<br />1,B cells<br />2,NK cells<br />3,T cells<br />239,in leprosy<br />1,SKIN histocytes<br />2,swann cells<br />3,all of the above<br />240,bile secretion stimulation all, except:<br />1,vagus<br />?241,semicircular canal<br />242,cardiac output is determined by, except<br />1,stroke volume<br />2,cardiac contractility<br />3,cardiac rate<br />4,body surface area<br />(ans?:body surface area)<br />243,vessels to meninges:<br />1,external carotid<br />2,internal carotid<br />3,vertrebral<br />4,basilar<br />244,Artery supplied to sup. Temporal brain :<br />1,middle cerebral art.<br />245,epiphyseal plate FRACTURE is classified by<br />1,harris<br />246,?directly acting drugs except:<br />?dopamin<br />247,pharmocodynamics and pharmacokinetics:<br />1,nitrates<br />2,amiodarone<br />3,verapamil<br />4,hydralazine<br />248,maternal mortality<br />? 1 lakh<br />249,pneumatocoel is caused by<br />(ans: staph. Aureus)Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-61396613093544873392008-12-18T09:26:00.000-08:002008-12-18T09:36:51.613-08:00fmge 2005ALL INDIA<br />PAPER 2005<br />SOLVED<br />QUESTIONS AND ANSWERS<br /><br />ANATOMY<br />Q 1. The carpal tunnel contains all of the following important structures except:<br />A. Median nerve.<br />B. Flexor pollicis longus.<br />C. Flexor carpi radialis.<br />D. Flexor digitorum superficialis.<br />Ans. C<br />Q 2. The femoral ring is bounded by the following structures except:<br />A. Femoral vein.<br />B. Inguinal ligament.<br />C. Femoral artery.<br />D. Lacunar ligament.<br />Ans. C<br />Q 3. All of the following statements regarding vas deferens are true except:<br />A. The terminal part is dilated to form ampulla.<br />B. It crosses ureter in the region of ischial spine.<br />C. It passes lateral to inferior epigastric artery at deep inguinal ring.<br />D. It is separated from the base of bladder by the peritoneum.<br />Ans. D<br />Q 4. The following statements concerning chorda tympani nerve are true except that it:<br />A. Carries secretomotor fibers to slubmandibular gland.<br />B. Joins lingual nerve in infratemporal fossa<br />C. Is a branch of facial nerve.<br />D. Contains postganglionic parasympathetic fibers.<br />Ans. D<br />Q 5. The type of joint between the sacrum and coccyx is a:<br />A. Symphysis<br />B. Syostosis<br />C. Synchondrosis<br />D. Syndesmosis<br />Ans. A<br />Q 6. The prostatic urethra is characterized by all of the following geatures, except that it:<br />A. Is the widest and most dilatable part.<br />B. Presents a concavity posteriorly.<br />C. Lies closer to anterior surface of prostate.<br />D. Receives prostatic ductules along its posterior wall.<br />Ans. B<br /><br />Q 7. The following group of lymph nodes receives lymphatics from the uterus except;<br />A. External iliac.<br />B. Internal iliac.<br />C. Superficial inguinal.<br />D. Deep inguinal<br />Ans. D<br />Q 8. All of the following physiological processes occur during the growth at the epiphyseal plate except;<br />A. Proliferation and hypertrophy.<br />B. Calcification and ossification.<br />C. Vasculogenesis and erosion.<br />D. Replacement of red bone marrow with yellow marrow.<br />Ans. D<br />Q 9. Benign prostatic hypertrophy results in obstruction of the urinary tract. The specific condition is associated with enlargement of the:<br />A. Entire prostate gland.<br />B. Lateral lobes.<br />C. Median lobe.<br />D. Posterior lobes.<br />Ans. C<br />Q 10. In an adult male, on per rectal examination, the following structures can be felt anteriorly except:<br />A. Internal iliac lymph nodes.<br />B. Bulb of the penis.<br />C. Prostate.<br />D. Seminal vesicle when enlarged.<br />Ans. A<br />Q 11. While doing thoracocentesis, it is advisable to introduce needle along:<br />A. Upper border of the rib.<br />B. Lower border of the rib.<br />C. In the center of the intercostals space.<br />D. In anterior part of intercostals space.<br />Ans. A<br />Q 12. All of the following are branches of the external carotid artery except:<br />A. Superior thyroid artery.<br />B. Anterior ethmoidal artery.<br />C. Occipital artery.<br />D. Posterior auricular artery.<br />Ans. B<br /><br />Q 13. Barr body is found in the following phase of the cell cycle:<br />A. Interphase.<br />B. Metaplase.<br />C. G1 phase.<br />D. Telophase.<br />Ans. A<br />PHYSIOLOGY<br />Q 14. The type of hemoglobin that has least affinity for 2,3-diphosphoglycerate (2,3-DPG) or (2,3-BPG) is:<br />A. Hg A.<br />B. Hg F.<br />C. Hg B.<br />D. Hg A2.<br />Ans. B<br />Q 15. Cellular and flagellar movement is carried out by all of the following except:<br />A. Intermediate filaments.<br />B. Actin.<br />C. Tubulin.<br />D. Myosin.<br />Ans. D<br />Q 16. Heme is converted to bilirubin mainly in:<br />A. Kidney.<br />B. Liver<br />C. Spleen<br />D. Bone marrow.<br />Ans. C<br />Q 17. Normal CSF glucose level in a normoglycemic adult is:<br />A. 20-40 mg/dl<br />B. 40-70 mg/dl<br />C. 70-90 mg/dl<br />D. 90-110 mg/dl.<br />Ans. B<br />Q 18. Which one of the following molecules is used for cell signaling?<br />A. CO2<br />B. O2<br />C. NO<br />D. N2<br />Ans. C<br />Q 19. Osteoclasts are inhibited by:<br />A. Parathyroid hormone.<br />B. Calcitonin.<br />C. 1,25-dihydroxycholecalciferol.<br />D. Tumor necrosis factor.<br />Ans. B<br />Q 20. CO2 is primarily transported in the arterial blood as:<br />A. Dissolved CO2.<br />B. Carbonic acid<br />C. Carbamino-hemoglobin<br />D. Bicarbonate.<br />Ans. D<br />Q 21. Both vitamin K and C are involved in:<br />A. The synthesis of clotting factors.<br />B. Post translational modifications.<br />C. Antioxidant mechanisms.<br />D. The microsomal hydroxylation reactions.<br />Ans. B<br />Q 22. The main site of bicarbonate reabsorption is:<br />A. Proximal convoluted tubule.<br />B. Distal convoluted tubule.<br />C. Cortical collecting duct.<br />D. Medullary collecting duct.<br />Ans. A<br />Q 23. The membrane protein, clathrin is involved in:<br />A. Cell motility.<br />B. Receptor-mediated endocytosis.<br />C. Exocytosis.<br />D. Cell shape.<br />Ans. B<br />Q 24. The parvocellular pathway from lateral geniculate nucleus to visual cortex is most sensitive for the stimulus of:<br />A. Color contrast.<br />B. Luminance contrast.<br />C. Temporal grequency.<br />D. Saccadic eye movements.<br />Ans. A<br />Q 25. The fibers from the contralateral nasal hemiretina project to the following layers of the lateral geniculate nucleus:<br />A. Layers 2, 3 & 5.<br />B. Layers 1, 2 & 6.<br />C. Layers 1, 4 & 6.<br />D. Layers 4, 5 & 6.<br />Ans. C<br />Q 26. All endothelial cells produce thrombomodulin except those found in:<br />A. Hepatic circulation<br />B. Cutaneous circulation<br />C. Cerebral microcirculation.<br />D. Renal circulation.<br />Ans. C<br />Q 27. SA node acts as a pacemaker of the heart because of the fact that it:<br />A. Is capable of generating impulses spontaneously.<br />B. Has rich sympathetic innervations.<br />C. Has poor cholinergic innervations.<br />D. Generates impulses at the highest rate.<br />Ans. D<br />Q 28. The first physiological response to high environmental temperature is:<br />A. Sweating<br />B. Vasodilatation.<br />C. Decrease heat production.<br />D. Non-shivering thermogenesis.<br />Ans. B<br />Q 29. All of the following factors normally increase the length of the ventricular cardiac muscle fibres except:<br />A. Increased venous tone.<br />B. Increased total blood volume.<br />C. Increased negative intrathoracic pressure.<br />D. Lying-to-standing change in posture.<br />Ans. D<br />Q 30. The vasodilatation produced by carbon dioxide is maximum in one of the following:<br />A. Kidney.<br />B. Brain.<br />C. Liver.<br />D. Heart.<br />Ans. B<br />Q 31. Which one of the following statements regarding water reabsorption in the tubules?<br />A. The bulk of water reabsorption occurs secondary to Na+ reabsorption.<br />B. Majority of facultative reabsorption occurs in proximal tubule.<br />C. Obligatory reabsorption is ADH dependent.<br />D. 20% of water is always reabsorbed irrespective of water balance.<br />Ans. A<br />Q 32. Urinary concentrating ability of the kidney is increased by:<br />A. ECF volume contraction.<br />B. Increase in RBF.<br />C. Reduction of medullary hyperosmolarity.<br />D. Increase in CFR.<br />Ans. A<br />Q 33. Distribution of blood flow is mainly regulated by the:<br />A. Arteries.<br />B. Arterioles.<br />C. Capillaries.<br />D. Venules.<br />Ans. B<br />Q 34. In which of the following a reduction in arterial oxygen tension occurs?<br />A. Anaemia.<br />B. CO poisoning.<br />C. Moderate exercise.<br />D. Hypoventilation.<br />Ans. D<br />Q 35. With which one of the following lower motor neuron lesions are associated?<br />A. Flaccid paralysis.<br />B. Hyperactive stretch reflex.<br />C. Spasticity.<br />D. Muscular incorrdination.<br />Ans. A<br />Q 36. Which of the following statements can be regarded as primary action of inhibin?<br />A. It inhibits secretion of prolactin.<br />B. It stimulates synthesis of estradiol.<br />C. It stimulates secretion of TSH.<br />D. It inhibits secretion of FSH.<br />Ans. D<br />BIOCHEMISTRY<br />Q 37. The predominant isozyme of LDH in cardiac muscle is:<br />A. LD-1<br />B. LD-2<br />C. LD-3<br />D. LD-5<br />Ans. A<br />Q 38. All of the following hormones have cell surface receptors except:<br />A. Adrenalin<br />B. Growth hormone.<br />C. Insulin<br />D. Thyroxine.<br />Ans. D<br />Q 39. Fluoride, used in the collection of blood samples for glucose estimation, inbibits the enzyme:<br />A. Glucokinase.<br />B. Hexokinase.<br />C. Enolase.<br />D. Glucose-6-phosphatase.<br />Ans. C<br />Q 40. Enzymes that move a molecular group from one molecule to another are known as:<br />A. Ligases.<br />B. Oxido-reductases.<br />C. Transferases.<br />D. Dipeptidases.<br />Ans. C<br />Q 41. The amino acid residue having an imino side chain is:<br />A. Lysine.<br />B. Histidine.<br />C. Tyrosine.<br />D. Proline.<br />Ans. D<br />MICROBIOLOGY<br />Q 42. A woman with infertility receives an ovary transplant from her sister who is an identical twin. What type of graft it is?<br />A. Xenograft<br />B. Autograft<br />C. Allograft<br />D. Isograft.<br />Ans. D<br />Q 43. Virus mediated transfer of host DNA from one cell to another is known as:<br />A. Transduction.<br />B. Transformation.<br />C. Transcription.<br />D. Integration.<br />Ans. A<br />Q 44. In the small intestine, cholera toxin acts by:<br />A. ADP-ribosylation of the G regulatory protein.<br />B. Inhibition of adenyl cyclase.<br />C. Activation of GTPase.<br />D. Active absorption of NaCl.<br />Ans. A<br />Q 45. HIV can be detected and confirmed by:<br />A. Polymerase chain reaction (PCR)<br />B. Reverse transcriptase - PCR<br />C. Real time PCR<br />D. Mimic PCR.<br />Ans. B<br />Q 46. With reference to infections with Escherichia coli the following are true except:<br />A. Enteroaggregative E. coli is associated with pwesistent diarrhoea.<br />B. Enterohemorrhagic E.coli can cause haemolytic uraemic syndrome.<br />C. Enteroinvasive E. coli produces a disease similar to salmonellosis.<br />D. Enterotoxigenic E.coli is a common cause of travelers diarrhoea.<br />Ans. C<br />Q 47. The following statements are true regarding melioidosis except:<br />A. It is caused by Burkholderia mallei.<br />B. The agent is a grain negative aerobic bacteria.<br />C. Bipolar staining of the aetiological agent is seen with methylene blue stain.<br />D. The most common form of melioidosis is pulmonary infection.<br />Ans. A<br />Q 48. The following bacteria are most often associated with acute neonatal meningitis except:<br />A. Escherichia coli.<br />B. Streptococcus agalactiae.<br />C. Neisseria meningitidis.<br />D. Listeria monocytogenes.<br />Ans. C<br />Q 49. All of the following Vibrio sp. are halophilic, except:<br />A. V. cholerae.<br />B. V. parahaemolyticus.<br />C. V. alginolyticus.<br />D. V. fluvialis.<br />Ans. A<br />Q 50. All of the following organisms are known to survive intracellularly except:<br />A. Neisseria meningitides.<br />B. Salmonella typhi.<br />C. Streptococcus pyogenes.<br />D. Legionella pneumophila.<br />Ans. C<br />Q 51. The capsule of Cryptococus neoformans in a CSF sample is best seen by:<br />A. Grams stain.<br />B. India ink preparation.<br />C. Giemsa stain.<br />D. Methanamine-silver stain.<br />Ans. B<br />Q 52. Viruses can be isolated from clinical samples by cultivation in the following except:<br />A. Tissue culture.<br />B. Embryonated eggs.<br />C. Animals.<br />D. Chemicaly defined media.<br />Ans. D<br />Q 53. It is true regarding the normal microbial flora present on the skin and mucous membranes that:<br />A. It cannot be eradicated by antimicrobial agents.<br />B. It is absent in the stomach due to the acidic pH.<br />C. It establishes in the body only after the neonatal period.<br />D. The flora in the small bronchi is similar to that of the trachea.<br />Ans. A<br />Q 54. An army jawan posted in a remote forest area had fever and headache. His fever was 104°F and pulse was 70 per mibn. He had an erythematous lesion of about 1 cm on the leg surrounded by small vesicles, along with generalized lymphadenopathy at the time of presentation to the referral hospital. His blood sample was collected to perform serology for the diagnosis of Rickettsial disease. Which one of the following results in Weil-Felix reaction will be diagnostic in this clinical setting:<br />A. High OX-2.<br />B. High OX-19.<br />C. High OX-K.<br />D. High OX-19 and OX-2.<br />Ans. C<br />Q 55. Adenosine deaminase (enzyme) deficiency is associated with:<br />A. Severe combined immunodeficiency (SCID)<br />B. X-linked agammaglobulinemia.<br />C. Transient hypogammaglobulinemia of infancy.<br />D. Chronic granulomatous disease.<br />Ans. A<br />Q 56. Which of the following viral infections is transmitted by tick?<br />A. Japanese encephalitis.<br />B. Dengue fever.<br />C. Kyasanur forest disease (KFD).<br />D. Yellow fever.<br />Ans. C<br />Q 57. Atypical pneumonia can be caused by the following microbial agents except:<br />A. Mycoplasma pneumoniae.<br />B. Legionella pneumophila.<br />C. Human Corona virus.<br />D. Klebsiella pneumoniae.<br />Ans. D<br />Q 58. The serum concentration of which of the following human IgG subclass is maximum?<br />A. IgG1.<br />B. IgG2.<br />C. IgG3.<br />D. IgG4.<br />Ans. A<br />Q 59. Chlamydia trachomatis is associated with the following except:<br />A. Endemic trachoma.<br />B. Inclusion conjunctivitis.<br />C. Lymphogranuloma venereum.<br />D. Community acquired pneumonia.<br />Ans. D<br />Q 60. The following statements are true regarding Clostridium perfringens except:<br />A. It is commonest cause of gas gangrene.<br />B. It is normally present in human faeces.<br />C. The principal toxin of C.perfringens is the alpha toxin.<br />D. Gas gangrene producing strains of C.perfringens produce heat resistant spores.<br />Ans. D<br />Q 61. The most common organism amongst the following that causes acute meningitis in an AIDS patients is:<br />A. Streptococcus pneumoniae.<br />B. Streptococcus agalactiae.<br />C. Cryptococcus neoformans.<br />D. Listeria monocytogenes.<br />Ans. C<br />Q 62. A bacterial disease that has been associated with the 3 “Rs” i.e., rats, ricefields, and rainfall is:<br />A. Leptospirosis.<br />B. Plague.<br />C. Melioidosis.<br />D. Rodent-bite fever.<br />Ans. A<br />Q 63. A child was diagnosed to be suffering from diarrhoea due to Campylobacter jejuni. Which of the following will be the correct environmental conditions of incubation of the culture plates of the stool sample:<br />A. Temperature of 42°C and microaerophilic.<br />B. Temperature of 42°C and 10% carbon dioxide.<br />C. Temperature of 37°C and microaerophilic.<br />D. Temperature of 37°C and 10% carbon dioxide.<br />Ans. A<br />Q 64. Which one of the following statements is true regarding Chlamydia pneumoniae:<br />A. Fifteen serovars have been identified as human pathogens.<br />B. Mode of transmission is by the airborne bird excreta.<br />C. The cytoplasmic inclusions present in the sputum specimen are rich in glycogen.<br />D. The group specific antigen is responsible for the production of complement fixing antibodies.<br />Ans. D<br />Q 65. Type I hypersensitivity is mediated by which of the following immunoglobulins?<br />A. IgA.<br />B. IgG.<br />C. IgM.<br />D. IgE.<br />Ans. D<br />PATHOLOGY<br />Q 66. An example of a tumour suppressor gene is:<br />A. Myc.<br />B. Fos.<br />C. Ras.<br />D. Rb.<br />Ans. D<br />Q 67. The following is not a feature of malignant transformation by cultured cells:<br />A. Increased cell density.<br />B. Increased requirement for growth factors.<br />C. Alterations of cytoskeletal structures.<br />D. Loss of anchorage.<br />Ans. B<br />Q 68. A simple bacterial test for mutagenic carcinogens is:<br />A. Ames test.<br />B. Redox test.<br />C. Bacteriophage.<br />D. Gene splicing.<br />Ans. A<br />Q 69. The classification proposed by the International Lymphoma Study Group for non-Hodgkin’s lymphoma is known as:<br />A. Kiel classification.<br />B. REAL classification.<br />C. WHO classification.<br />D. Rappaport classification.<br />Ans. B<br />Q 70. All of the following features are seen in the viral pneumonia except:<br />A. Presence of interstitial inflammation.<br />B. Predominance of alveolar exudates.<br />C. Bronchiolitis.<br />D. Multinucleate giant cells in the bronchiolar wall.<br />Ans. B<br />Q 71. Aschoff’s nodules are seen in:<br />A. Subacute bacterial endocarditis.<br />B. Libman-Sacks endocarditis.<br />C. Rheumatic carditis.<br />D. Non-bacterial thrombotic endocarditis.<br />Ans. C<br />Q 72. Pulmonary surfactant is secreted by:<br />A. Type I pneumoncytes.<br />B. Type II pneumocytes.<br />C. Clara cells.<br />D. Bronchila epithelial cells.<br />Ans. B<br />Q 73. Which one of the following conditions commonly predisposes to colonic carcinoma?<br />A. Ulcerative colitis.<br />B. Crohn’s disease.<br />C. Diverticular disease.<br />D. Ischaemic colitis.<br />Ans. A<br />Q 74. Fibrinoid necrosis may be observed in all of the following except:<br />A. Malignant hypertension.<br />B. Polyarteritis nodosa.<br />C. Diabetic glomerulosclerosis.<br />D. Aschoff’s nodule.<br />Ans. C<br />Q 75. All of the following statements are true regarding reversible cell injury, except:<br />A. Formation of amorphous densities in the mitochondrial matrix.<br />B. Diminished generation of adenosine triphosphate (ATP)<br />C. Formation of blebs in the plasma membrane.<br />D. Detachment of ribosomes from the granular endoplasmic reticulum.<br />Ans. A<br />Q 76. Which of the following statements pertaining to leukemia is correct?<br />A. Blasts of acute myeloid leukemia are typically sudan black negative.<br />B. Blasts of acute lymphoblastic leukemia are typically myeloperoxidase positive.<br />C. Low leucocyte alkaline phosphatase score is characteristically seen in blastic phase of chronic myeloid leukemia.<br />D. Tartarate resistant acid phosphatase positivity is typically seen in hairy cell leukemiA.<br />Ans. D<br />Q 77. In which of the following conditions bilateral contracted kidneys are characteristically seen?<br />A. Amyloidosis.<br />B. Diabetes mellitus.<br />C. Rapidly progressive (crescentic) glomerulonephritis.<br />D. Benign nephrosclerosis.<br />Ans. D<br />Q 78. All of the following vascular changes are observed in acute inflammation, except:<br />A. Vasodilation.<br />B. Stasis of blood.<br />C. Increased vascular permeability.<br />D. Decreased hydrostatic pressure.<br />Ans. D<br />Q 79. The subtype of Hodgkin’s disease, which is histogenetically distinct from all the other subtypes, is:<br />A. Lymphocyte predominant.<br />B. Nodular sclerosis.<br />C. Mixed cellularity.<br />D. Lymphocyte depleted.<br />Ans. A<br />Q 80. In apoptosis, Apaf-1 is activated by release of which of the following substances from the mitochondria?<br />A. Bcl-2<br />B. Bax.<br />C. Bcl-XL<br />D. Cytochrome C.<br />Ans. D<br />Q 81. Which type of amyloidosis is caused by mutation of the transthyretin protein?<br />A. Familial Mediterranean fever.<br />B. Familial amyloidotic polyneuropathy.<br />C. Dialysis associated amyloidosis.<br />D. Prion protein associated amyloidosis.<br />Ans. B<br />Q 82. In familial Mediterranean fever, the gene encoding the following protein undergoes mutation:<br />A. Pyrin.<br />B. Perforin.<br />C. Atrial natriuretic factor.<br />D. Immunoglobulin light chain.<br />Ans. A<br />Q 83. Which of the following statements is not true?<br />A. Patinets with IgD myeloma may present with no evident M-spike on serum electrophoresis.<br />B. A diagnosis of plasma cell leukemia can be made if circulating peripheral blood plasmablasts comprise 14% of peripheral blood white cells in a patient with 109/L.´ 109/L and platelet count of 88 ´white blood cell count of 11<br />C. In smoldering myeloma plasma cells constitute 10-30% of total bone marrow cellularity.<br />D. In a patient with multiple myeloma, a monoclonal light chain may be detected in both serum and urine.<br />Ans. B<br />Q 84. In-situ DNA nick end labeling can quantitate:<br />A. Fraction of cells in apoptotic pathways.<br />B. Fraction of cells in S phase.<br />C. p53 gene product.<br />D. bcr/abl gene.<br />Ans. A<br />Q 85. Which one of the following stains is specific for amyloid?<br />A. Periodic acid Schiff (PAS)<br />B. Alzerian red.<br />C. Congo red.<br />D. Von-Kossa.<br />Ans. C<br />Q 86. Which one of the following diseases characteristically causes fatty change in liver?<br />A. Hepatitis B virus infection.<br />B. Wilson’s disease.<br />C. Hepatitis C virus infection.<br />D. Chronic alcoholism.<br />Ans. D<br />Q 87. A 48-year-old woman was admitted with a history of weakness for two months. On examination, cervical lymph nodes were found enlared and spleen was palpable 2 cm below the costal margin. Her hemoglobin was 10.5 g/dl, platelet count 237 x 109/L and total leukocyte count 40 x 109/L, which included 80% mature lymphoid cells with coarse clumped chromatin. Bone marrow revealed a nodular lymphoid infiltrate. The peripheral blood lumphoid cells were positive for CD19, CD5, CD20 and CD23 and were negative for CD79B and FMC-7.<br />The histopathological examination of the lymph node in this patient will most likely exhibit effeacement of lymph node architecture by:<br />A. A pseudofollicular pattern with proliferation centers.<br />B. A monomorphic lymphoid proliferation with a nodular pattern.<br />C. A predominantly follicular pattern.<br />D. A diffuse proliferation of medium to large lymphoid cells with high mitotic rate.<br />Ans. D<br />Q 88. Which one of the following is not a feature of liver histology in non cirrhotic portal fibrosis (NCPF).<br />A. Fibrosis in and around the portal tracts.<br />B. Thrombosis of the medium and small portal vein branches.<br />C. Non specific inflammatory cell infiltrates in the portal tracts.<br />D. Bridging fibrosis.<br />Ans. D<br />PHARMACOLOGY<br />Q 89. A highly ionized drug:<br />A. Is excreted mainly by the kidney.<br />B. Can cross the placental barrier easily.<br />C. Is well absorbed from the intestine.<br />D. Accumulates in the cellular lipids.<br />Ans. A<br />Q 90. Which one of the following drugs is ‘topoisomerase 1 inhibitor’?<br />A. Doxorubicin.<br />B. Irinotecan.<br />C. Etoposide.<br />D. Vincristine.<br />Ans. B<br />Q 91. The following drugs have significant drug interaction with digoxin, except:<br />A. Cholestyramine.<br />B. Thiazide diuretics.<br />C. Quinidine.<br />D. Amlodipine.<br />Ans. D<br />Q 92. One of the following is not true about nesiritide:<br />A. It is a brain natriuretic peptide analogue.<br />B. It is used in acutely decompensated heart failure.<br />C. It has significant oral absorption.<br />D. It has a short half-life.<br />Ans. C<br />Q 93. Antipsychotic drug-induced parkinsonism is treated by:<br />A. Anticholinergics.<br />B. Levodopa.<br />C. Selegiline.<br />D. Amantadine.<br />Ans. A<br />Q 94. Which one of the following is used in therapy of toxoplasmosis?<br />A. Artensenuate.<br />B. Thiacetazone.<br />C. Ciprofloxacin.<br />D. Pyrimethamine.<br />Ans. D<br />Q 95. The following statements regarding finasteride are true except:<br />A. It is used in the medical treatment of benign prostatic hypertrophy (BPH)<br />B. Impotence is well documented after its use.<br />C. It blocks the conversion of dihydrotestosterone to testosterone.<br />D. It is a 5-a reductase inhibitor.<br />Ans. C<br />Q 96. Eternacept acts by one of the following mechanisms:<br />A. By blocking tumor necorosis factor.<br />B. By blocking bradykinin synthesis.<br />C. By inhibiting cyclo-oxygenase-2.<br />D. By blocking lipoxygenase.<br />Ans. A<br />Q 97. In unconjugated hyperbilirubinemia, the risk of kernicterus increases with the use of:<br />A. Ceftriaxone.<br />B. Phenobarbitone.<br />C. Ampicillin.<br />D. Sulphonamide.<br />Ans. D<br />Q 98. All of the following are topically used sulphonamides except:<br />A. Sulphacetamide.<br />B. Sulphadiazine.<br />C. Silver sulphadiazine.<br />D. Mafenide.<br />Ans. B<br />Q 99. Oculogyric crisis is know to be produced by all of the following drugs except:<br />A. Trifluoperazine.<br />B. Atropine.<br />C. Perchlorperazine.<br />D. Perphenazine.<br />Ans. B<br />Q 100. Which of the following drugs is useful in prophylaxis of migraine?<br />A. Proproanolol.<br />B. Sumatriptan.<br />C. Domperidone.<br />D. Ergotamine.<br />Ans. A<br />Q 101. Inverse agonist of benzodiazepine receptor is:<br />A. Phenobarbitone.<br />B. Flumazenil.<br />C. Beta-Carboline.<br />D. Gabapentin.<br />Ans. C<br />Q 102. The group of antibiotics which possess additional anti-inflammatory and immunomodulatory activities is:<br />A. Tetracyclines.<br />B. Polypeptide antibiotics.<br />C. Fluoroquinolones.<br />D. Macrolides.<br />Ans. D<br />Q 103. With which of the following theophylline has an antagonistic interaction?<br />A. Histamine receptors.<br />B. Bradykinin receptors.<br />C. Adenosine receptors.<br />D. Imidazoline receptors.<br />Ans. C<br />Q 104. One of the following is not penicillinase susceptible:<br />A. Amoxicillin.<br />B. Penicillin G.<br />C. Piperacillin.<br />D. Cloxacillin.<br />Ans. D<br />Q 105. Which one of the following is best associated with lumefantrine?<br />A. Antimycobacterial.<br />B. Antifungal.<br />C. Antimalarial.<br />D. Antiamoebic.<br />Ans. C<br />Q 106. Which one of the following drugs increases gastro-intestinal motility?<br />A. Glycopyrrolate.<br />B. Atropine.<br />C. Neostigmine.<br />D. Fentanyl.<br />Ans. C<br />Q 107. Nevirapine is a:<br />A. Protease inhibitor.<br />B. Nucleoside reverse transcriptase inhibitor.<br />C. Non-nucleoside reverse transcriptase inhibitor.<br />D. Fusion inhibitor.<br />Ans. C<br />FORENSIC MEDICINE<br />Q 108. In a firearm injury, there is burning, blackening, toattooing around the wound, along with cherry red colour of the surrounding tissues and is cruciate in shape, the injury is:<br />A. Close shot entry.<br />B. Close contact exit.<br />C. Contact shot entry.<br />D. Distant shot entry.<br />Ans. C<br />Q 109. In methyl alcohol poisoning there is CNS depression cardiac depression and optic nerve atrophy. These effects are produced due to:<br />A. Formaldehyde and formic acid.<br />B. Acetaldehyde.<br />C. Pyridine.<br />D. Acetie acid.<br />Ans. A<br />Q 110. In chronic arsenic poisoning the following samples can be sent for laboratory examination except:<br />A. Nail clippings.<br />B. Hair samples.<br />C. Bone biopsy.<br />D. Blood sample.<br />Ans. D<br />Q 111. Which of the following statements is not correct regarding diatom?<br />A. Diatoms are aquatic unicellular plant.<br />B. Diatoms has an extracellular coat composed of magnesium.<br />C. Acid diagestion technique is used to extract diatoms.<br />D. Presence of diatoms in the femoral bone marrow is an indication of antemartem inhalation of water.<br />Ans. B<br />Q 112. In India, magistrate inquest is done in the following cases except:<br />A. Exhumation cases.<br />B. Dowry deaths within 5 years of marriage.<br />C. Murder cases.<br />D. Death of a person in police custody.<br />Ans. C<br />Q 113. At autopsy, the cyanide poisoning case will show the following features, except:<br />A. Characteristic bitter lemon smell.<br />B. Congested organs.<br />C. The skin may be pinkish or cherry red in colour.<br />D. Erosion and haemorrhages in oesophagus and stomach.<br />Ans. A<br />Q 114. The most reliable criteria in Gustafson’s method of identification is:<br />A. Cementum apposition.<br />B. Transparency of root.<br />C. Attrition.<br />D. Root resorption.<br />Ans. B<br />Q 115. The minimum age at which an individual is responsible for his criminal act is:<br />A. 7 years.<br />B. 12 years.<br />C. 16 years.<br />D. 21 years.<br />Ans. A<br />Q 116. The most reliable method of identification of an individual is:<br />A. Dactylography.<br />B. Scars.<br />C. Anthropometry.<br />D. Handwriting.<br />Ans. A<br />Q 117. The most common pattern of finger print is:<br />A. Arch.<br />B. Loop.<br />C. Whorl.<br />D. Composite.<br />Ans. B<br />PSM<br />Q 118. ‘Endemic disease’ means that a disease:<br />A. Occurs clearly in excess of normal expectancy.<br />B. Is constantly present in a given population group.<br />C. Exhibits seasonal pattern.<br />D. Is prevalent among animals.<br />Ans. B<br />Q 119. Which one of the following is a good index of the severity of an acute disease?<br />A. Cause specific death rate.<br />B. Case fatality rate.<br />C. Standardized mortality ratio.<br />D. Five year survival.<br />Ans. B<br />Q 120. Which one of the following statements about influence of smoking on risk of coronary heart disease (CHD) is not true?<br />A. Influence of smoking is independent of other risk factors for CHD.<br />B. Influence of smoking is only additive to other risk factors for CHD.<br />C. Influence of smoking is synergistic to other risk factors for CHD.<br />D. Influence of smoking is directly related to number of cigarettes smoked per day.<br />Ans. B<br />Q 121. Antibiotic treatment of choice for treating cholera in an adult is a single dose of:<br />A. Tetracycline.<br />B. Co-trimoxazole.<br />C. Doxycycline.<br />D. Furazolidone.<br />Ans. C<br />Q 122. All of the following statements are true about congenital rubella except:<br />A. It is diagnosed when the infant has IgM antibodies at birth.<br />B. It is diagnosed when IgG antibodies persist for more than 6 months.<br />C. Most common congenital defects are deafness, cardiac malformations and cataract.<br />D. Infection after 16 weeks of gestation results in major congenital defects.<br />Ans. D<br />Q 123. The recommended daily energy intake of an adult woman with heavy work is:<br />A. 1800.<br />B. 2100.<br />C. 2300.<br />D. 2900.<br />Ans. D<br />Q 124. All of the following methods are antilarval measures except:<br />A. Intermittent irrigation.<br />B. Paris green.<br />C. Gamusia affinis.<br />D. Malathion.<br />Ans. D<br />Q 125. All of the following are true about the herd immunity for infectious diseases except:<br />A. It refers to group protection beyond what is afforded by the protection of immunized individuals.<br />B. It is likely to be more for infections that do not have a sub-clinical phase.<br />C. It is affected by the presence and distribution of alternative animal hosts.<br />D. In the case of tetanus it does not protect the individual.<br />Ans. B<br />Q 126. The best indicator for monitoring the impact of iodine deficiency disorder control programme is:<br />A. Prevalence of goiter among school children.<br />B. Urinary iodine levels among pregnant women.<br />C. Neonatal hypothyroidism.<br />D. Iodine level in soil.<br />Ans. C<br />Q 127. What is the color-coding of bag in hospitals to dispose off human anatomical wastes such as body parts:<br />A. Yellow.<br />B. Black.<br />C. Red.<br />D. Blue.<br />Ans. A<br />Q 128. WHO defines adolescent age between:<br />A. 10-19 years of age.<br />B. 10-14 years of age.<br />C. 10-25 years of age.<br />D. 9-14 years of age.<br />Ans. A<br />Q 129. In a village having population of 1000, we found patients with certain disease. The results of a new diagnostic test on that disease are as follows.<br />Test result Disease<br />Present Absent<br />+ 180 400<br />– 20 400<br />What is the percent prevalence of disease?<br />A. 0.20<br />B. 2<br />C. 18<br />D. 20<br />Ans. D<br />Q 130. The following tests are used to check the efficiency of pasteurization of milk except:<br />A. Phosphatase test.<br />B. Standard plate count.<br />C. Coliform count.<br />D. Methylene blue reduction test.<br />Ans. D<br />Q 131. What will be the BMI of a male whose weight is 89 kg and height is 172 cm:<br />A. 27<br />B. 30<br />C. 33<br />D. 36<br />Ans. B<br />Q 132. The most common side effect of IUD insertion is:<br />A. Bleeding.<br />B. Pain.<br />C. Pelvic infection.<br />D. Ectopic pregnancy.<br />Ans. A<br />Q 133. For the treatment of case of class III dog bite, all of the following are correct except:<br />A. Give immunoglobulins for passive immunity.<br />B. Give ARV.<br />C. Immediately stitch wound under antibiotic coverage.<br />D. Immediately wash wound with soap and water.<br />Ans. C<br />Q 134. A 2-year-old female child was brought to a PHC with a history of cough and fever for 4 days with inability to drink for last 12 hours. On examination, the child was having weight of 5 kg and respiratory rate of 45/minute with fever. The child will be classified as suffering from:<br />A. Very severe disease.<br />B. Severe pneumonia.<br />C. Pneumonia.<br />D. No pneumonia.<br />Ans. A<br />Q 135. The information technology has revolutionized the world of medical sciences. In which of the following year the Information Technology Act was passed by the Government of India?<br />A. 1998.<br />B. 2000.<br />C. 2001.<br />D. 2003.<br />Ans. B<br />Q 136. Transplantation of Human Organs Act was passed by Government of India in:<br />A. 1996<br />B. 1993<br />C. 1998<br />D. 1994<br />Ans. D<br />Q 137. Which one of the following is not source of manager’s power?<br />A. Reward<br />B. Coercive<br />C. Legitimate.<br />D. Efferent.<br />Ans. D<br />Q 138. The standard normal distribution:<br />A. Is skewed to the left.<br />B. Has mean = 1.0<br />C. Has standard deviation = 0.0<br />D. Has variance = 1.0<br />Ans. D<br />Q 139. The PEFR of a group of 11 year old girls follow a normal distribution with mean 300 1/min and standard deviation 20 1/min:<br />A. About 95% of the girls have PEFR between 260 and 340 1/min.<br />B. The girls have healthy lungs.<br />C. About 5% of girls have PEFR below 260 1/min.<br />D. All the PEFR must be less than 340 l/min.<br />Ans. A<br />Q 140. The events A and B are mutually exclusive, so:<br />A. Prob (A or B) = Prob (A) + Prob (B).<br />B. Prob (A and B) = Prob (A). Prob (B).<br />C. Prob (A) = Prob (B).<br />D. Prob (A) + Prob (B) = 1.<br />Ans. D<br />Q 141. Total cholesterol level = a + b (calorie intake) + C (physical activity) + d (body mass index); is an example of:<br />A. Simple linear regression.<br />B. Simple curvilinear regression.<br />C. Multiple linear regression.<br />D. Multiple logistic regression.<br />Ans. C<br />Q 142. The Hb level in healthy woman has mean 13.5 g/dl and standard deviation 1.5 g/dl, what is the Z score for a woman with Hb level 15.0 g/dl:<br />A. 9.0<br />B. 10.0<br />C. 2.0<br />D. 1.0<br />Ans. D<br />Q 143. The diagnostic power of a test to correctly exclude the disease is reflected by:<br />A. Sensitivity<br />B. Specificity<br />C. Positive predictivity<br />D. Negative predictivity.<br />Ans. D<br />Q 144. Infant mortality does not include:<br />A. Early neonatal mortality.<br />B. Perinatal mortality.<br />C. Post neonatal mortality.<br />D. Late neonatal mortality.<br />Ans. B<br />Q 145. A cardiologist found a highly significant correlation coefficient (r=0.90, p=0.01) between the systolic blood pressure values and serum cholesterol values of the patients attending his clinic. Which of the following statements is a wrong interpretation of the correlation coefficient observed?<br />A. Since there is a high correlation, the magnitudes of both the measurements are likely to be close to each other.<br />B. A patient with a high level of systolic BP is also likely to have a high level of serum cholesterol.<br />C. A patient with a low level of systolic BP is also likely to have a low level of serum cholesterol.<br />D. About 80% of the variation in systolic blood pressure among his patients can be explained by their serum cholesterol values and vice a versa.<br />Ans. A<br />Q 146. The most common cancer affecting Indian urban women in Delhi, Mumbai and Chennai is:<br />A. Cervical cancer.<br />B. Ovarian cancer.<br />C. Breast cancer.<br />D. Uterine cancer.<br />Ans. C<br />MEDICINE<br />Q 147. The most common pathogens responsible for nosocomial pneumonias in the ICU are:<br />A. Gram positive organisms.<br />B. Gram negative organisms.<br />C. Mycoplasma.<br />D. Virus infections.<br />Ans. B<br />Q 148. The abnormal preoperative pulmonary function test in a patient with severe kyphoscoliosis includes:<br />A. Increased RV/TLC.<br />B. Reduced FEV1/FVC.<br />C. Reduced FEV25-75.<br />D. Increased FRC.<br />Ans. A<br />Q 149. Which one of the following drugs has been shown to offer protection from gastric aspiration syndrome in a patient with symptoms of reflux?<br />A. Ondansetron.<br />B. Metoclopramide.<br />C. Sodium citrate.<br />D. Atropine.<br />Ans. C<br />Q 150. Which one of the following is true of adrenal suppression due to steroid therapy?<br />A. It is not associated with atrophy of the adrenal glands.<br />B. It does not occur in patients receiving inhaled steroids.<br />C. It should be expected in anyone receiving > 5 mg, prednisolone daily.<br />D. Following cessation, the stress response normalizes after 8 weeks.<br />Ans. C<br />Q 151. A 30-year-old male patient presents with complaints of weakness in right upper and both lower limbs for last 4 months. He developed digital infarcts involving 2nd and 3rd fingers on right side and 5th finger on left lside. On examination, BP was 160/140 mmHg, all peripheral pulses were palpable and there was asymmetrical neuropathy. Investigations showed a Hb-12 gm, TLC-12000 cumm, platelets 4,30,000, ESR-49 mm. Urine examination showed proteinuria and RBC 10-15/ hpf with no casts. Which of the following is the most likely diagnosis?<br />A. Polyarteritis nodosa.<br />B. Systemic LUPUS erythematosus.<br />C. Wegener’s granulomatosis.<br />D. Mixed cryoglobulemia.<br />Ans. A<br />Q 152. Which of the following infestation leads to malabsorption?<br />A. Giardia lamblia.<br />B. Ascaris lumbricoides.<br />C. Necater americana.<br />D. Ancylostoma duodenale.<br />Ans. A<br />Q 153. All of the following can cause osteoporosis except:<br />A. Hyperparathyroidism.<br />B. Steroid use.<br />C. Fluorosis.<br />D. Thyrotoxicosis.<br />Ans. C<br />Q 154. Serum angiotensin converting enzyme may be raised in all of the following except:<br />A. Sarcoidosis.<br />B. Silicosis.<br />C. Berylliosis.<br />D. Bronchogenic carcinoma.<br />Ans. D<br />Q 155. Hypercalcemia associated with malignancy is most often mediated by:<br />A. Parathyroid hormone (PTH)<br />B. Parthyroid hormone related protein (PTHrP)<br />C. Interleukin-6 (IL-6)<br />D. Calcitonin.<br />Ans. B<br />Q 156. All of the following are the causes of relative polycythemia except:<br />A. Dehydration.<br />B. Dengue haemorrhagic fever.<br />C. Gaisbock syndrome.<br />D. High altitude.<br />Ans. D<br />Q 157. All of the following may cause ST segment elevation on EKG, except:<br />A. Early repolarization variant.<br />B. Constrictive pericarditis.<br />C. Ventricular aneurysm.<br />D. Prinzmetal angina.<br />Ans. B<br />Q 158. 5’-Nucleotidase activity is increased in:<br />A. Bone diseases.<br />B. Prostate cancer.<br />C. Chronic renal failure.<br />D. Cholestatic disorders.<br />Ans. D<br />Q 159. Bart’s hydrops fetalis is lethal because:<br />A. Hb Bart’s cannot bind oxygen.<br />-globin form insoluble precipitates.aB. The excess<br />C. Hb Bart’s cannot release oxygen to fetal tissues.<br />D. Microcytic red cells become trapped in the placenta.<br />Ans. C<br />Q 160. Cluster headache is characterized by all except:<br />A. Affects predominantly females.<br />B. Unilateral headache.<br />C. Onset typically in 20-50 years of life.<br />D. Associated with conjunctival congestion.<br />Ans. A<br />Q 161. The most sensitive test for the diagnosis of myasthenia gravis is:<br />A. Elevated serum ACh-receptor binding antibodies.<br />B. Repetitive nerve stimulation test.<br />C. Positive edrophonium test.<br />D. Measurement of jitter by single fibre electromyography.<br />Ans. A<br /><br />Q 162. Vitamin B12 deficiency can give rise to all of the following, except:<br />A. Myelopathy.<br />B. Optic atrophy.<br />C. Peripheral neuropathy.<br />D. Myopathy.<br />Ans. D<br />Q 163. EEG is usually abnormal in all of the following except:<br />A. Subacute sclerosing panencephalitis.<br />B. Locked-in state.<br />C. Creutzfoldt-Jackob disease.<br />D. Hepatic encephalopathy.<br />Ans. B<br />Q 164. All of the following are neurologic channelopathies except:<br />A. Hypokalemic periodic paralysis.<br />B. Episodic ataxia type 1.<br />C. FAMILIAL hemiplegic migraine.<br />D. Spinocerebellar ataxia 1.<br />Ans. D<br />Q 165. Which of the following is not a neuroparasite?<br />A. Taenia solium.<br />B. Acanthamoeba.<br />C. Naegleria.<br />D. Trichinella spiralis.<br />Ans. D<br />Q 166. A 50-year-old man, an alcoholic and a smoker presents with a 3 hour history of severe retrosternal chest pain and increasing shortness of breath. He started having this pain while eating, which was constant and radiated to the back and interscapular region. He was a known hypertensive. On examination, he was cold and clammy with a heart rate of 130/min, and a BP of 80/40 mm Hg. JVP was normal. All peripheral pulses were present and equal. Breath sounds were decreased at the left lung base and chest X-ray showed left pleural effusion.<br />Which one of the following is the most likely diagnosis?<br />A. Acute aortic dissection.<br />B. Acute myocardial infarction.<br />C. Rupture of the esophagus.<br />D. Acute pulmonary embolism.<br />Ans. A<br />Q 167. Which of the following is a cause of reversible dementia?<br />A. Subacute combined degeneration.<br />B. Picks disease.<br />C. Creutzfeld-Jakob disease.<br />D. Alzheimer’s disease.<br />Ans. A<br />Q 168. Palpable purpura could occur in the following conditions, except:<br />a. Thrombocytopenia.<br />B. Small-vessel vasculitis.<br />C. Disseminated gonococcal infection.<br />D. Acute meningococcemia.<br />Ans. A<br />Q 169. A 59-year-old man with severe myxomatous mitral regurgitation is asymptomatic, with a left ventricular ejection fraction of 45% and an end-systolic diameter index of 2.9 cm/m2. The most appropriate treatment is:<br />A. Mitral valve repair of replacement.<br />B. No treatment.<br />C. ACE inhibitor therapy.<br />D. Digoxin and diuretic therapy.<br />Ans. A<br />Q 170. The gold standard for the diagnosis of osteoporosis is:<br />A. Dual energy X-ray absorptimetry.<br />B. Single energy X-ray absorptiometry.<br />C. Ultrasound.<br />D. Quantiative computed tomography.<br />Ans. A<br />Q 171. All of the following CSF findings are present in tuberculous meningitis, except:<br />A. Raised protein levels.<br />B. Low chloride levels.<br />C. Cob web formation.<br />D. Raised sugar levels.<br />Ans. D<br />Q 172. Which one of the following serum levels would help in distinguishing an acute liver disease from chronic liver diseae?<br />A. Aminotransaminase.<br />B. Alkaline phosphatase.<br />C. Bilirubin.<br />D. Albumin.<br />Ans. D<br />Q 173. All of the following conditions are known to cause diabetes insipidus except:<br />A. Multiple sclerosis.<br />B. Head injury.<br />C. Histiocytosis.<br />D. Viral encephalitis.<br />Ans. A<br />Q 174. Paralysis of 3rd, 4th 6th nerves with involvement of ophthalmic division of 5th nerve, localizes the lesion to:<br />A. Cavernous sinus.<br />B. Apex of orbit.<br />C. Brainstem.<br />D. Base of skull.<br />Ans. A<br />Q 175. Which one of the following is the most common location of hypertensive bleed in the brain ?<br />A. Putamen/external capsule.<br />B. Pons.<br />C. Ventricles.<br />D. Lobar white matter.<br />Ans. A<br />Q 176. In which of the following diseases, the overall survival is increased by screening procedure?<br />A. Prostate cancer.<br />B. Lung cancer.<br />C. Colon cancer.<br />D. Ovarian cancer.<br />Ans. C<br />Paediatrics<br />Q 177. The protective effects of breast milk are known to be associated with:<br />A. IgM antibodies.<br />B. Lysozyme.<br />C. Mast cells.<br />D. IgA antibodies.<br />Ans. D<br />Q 178. Study the following carefully:<br /><br />Read the pedigree. Inheritance pattern of the disease in the family is:<br />A. Autosomal recessive type.<br />B. Autosomal dominant type.<br />C. X linked dominant type.<br />D. X linked recessive type.<br />Ans. D<br />Q 179. Diagnosis of beta thalassemia is established by:<br />A. NESTROFT test.<br />B. HbA1c estimation.<br />C. Hb electrophoresis.<br />D. Target cells in peripheral smear.<br />Ans. C<br />Q 180. Blood specimen for neonatal thyroid screening is obtained on:<br />A. Cord blood.<br />B. 24 hours after birth.<br />C. 48 hours after birth.<br />D. 72 hours after birth.<br />Ans. D<br />Q 181. A child with recurrent urinary tract infections is most likely to show:<br />A. Posterior urethral valves.<br />B. Vesicoureteric reflux.<br />C. Neurogenic bladder.<br />D. Renal and ureteric calculi.<br />Ans. B<br />Q 182. All of the following are true about manifestations of vitamin E deficiency, except:<br />A. Hemolytic anemia.<br />B. Posterior column abnormalities.<br />C. Cerebellar ataxia.<br />D. Autonomic dysfunction.<br />Ans. D<br />Q 183. Differential expression of same gene depending on parent of origin is referred to as:<br />A. Genomic imprinting.<br />B. Mosaicism.<br />C. Anticipation.<br />D. Non penetrance.<br />Ans. A<br />Q 184. The appropriate approach to a neonate presenting with vaginal bleeding on day 4 of life is:<br />A. Administration of vitamin K.<br />B. Investigation for bleeding disorder.<br />C. No specific therapy.<br />D. Administration of 10ml/kg of fresh frozen plasma over 4 hours.<br />Ans. C<br />Q 185. Which one of the following drugs is used for fetal therapy of congenital adrenal hyperplasia?<br />A. Hydrocortisone.<br />B. Prednisolone.<br />C. Fludrocortisone.<br />D. Dexamethasone.<br />Ans. D<br />Q 186. The coagulation profile in a 13-year-old girl with menorrhagia having von-Willebrands disease is:<br />A. Isolated prolonged PTT with a normal PT.<br />B. Isolated prolonged PT with a normal PTT.<br />C. Prolongation of both PT and PTT.<br />D. Prolongation of thrombin time.<br />Ans. A<br />Q 187. The chances of having an unaffected baby, when both parents have achondroplasia, are:<br />A. 0%<br />B. 25%<br />C. 50%<br />D. 100%<br />Ans. B<br />Q 188. All of the following therapies may be required in a 1 hour-old infant with severe birth asphyxia except:<br />A. Glucose<br />B. Dexamethasone.<br />C. Calcium gluconate.<br />D. Normal saline.<br />Ans. B<br />Q 189. The most common leukocytoclastic vasculitis affecting children is:<br />A. Takayasu disease.<br />B. Mucocutaneous lymph node syndrome (Kawasaki disease)<br />C. Henoch Schonlein purpura.<br />D. Polyarteritis nodosa.<br />Ans. C<br />Q 190. A four year old boy was admitted with a history of abdominal pain and fever for two months, maculopapular rash for ten days, and dry cough, dyspnea and wheezing for three days. On examination, liver and spleen were enlarged 4 cm and 3 cm respectively below the costal margins. His hemoglobin was 109/L, which´ 109/L and total leukocyte count 70 ´10.0 g/dl, platelet count 37 included 80% eosinophils. Bone marrow examination revealed a cellular marrow comprising 45% blasts and 34% eosinophils and eosinophilic precursors. The blasts stained negative for myeloperoxidase and non-specific esterase and were positive for CD19, CD10, CD22 and CD20.<br />Which one of the following statements in not true about this disease?<br />A. Eosinophils are not of the neoplastic clone.<br />B. t(5:14) rearrangement may be detected in blasts.<br />C. Peripheral blood wosinophilia may normalize with chemotherapy.<br />D. Inv (16) is often detected in the blasts and the eosinophils.<br />Ans. D<br />Q 191. kidney biopsy from a child with hemolytic uremic syndrome characteristically most likely presents features of:<br />A. Thrombotic microangiopathy.<br />B. Proliferative glomerulonephritis.<br />C. Focal segmental glomerulosclerosis.<br />D. Minimal change disease.<br />Ans. A<br />Q 192. One of the intestinal enzymes that is generally deficient in children following an attack of severe infectious enteritis is:<br />A. Lactase.<br />B. Trypsin.<br />C. Lipase.<br />D. Amylase.<br />Ans. A<br />Q 193. A new born presented with bloated abdomen shortly after birth with passing of less meconium. A full-thickness biopsy of the rectum was carried out. Which one of the following rectal biopsy findings is most likely to be present?<br />A. Fibrosis of submucosa.<br />B. Hyalinisation of the muscular coat.<br />C. Thickened muscularis propria.<br />D. Lack of ganglion cells.<br />Ans. D<br />Q 194. Eisenmenger syndrome is characterized by all except:<br />A. Return of left ventricle & right ventricle to normal size.<br />B. Pulmonary veins not distended.<br />C. Pruning of peripheral pulmonary arteries.<br />D. Dilatation of central pulmonary arteries.<br />Ans. A<br />Q 195. Which of the following is the most common renal cystic disease in infants is?<br />A. Polycystic kidnesy.<br />B. Simple renal cyst.<br />C. Unilateral renal dysplasia.<br />D. Calyceal cyst.<br />Ans. C<br />Q 196. The most common type of total anomalous pulmonary venous connection is:<br />A. Supracardiac<br />B. Infracardiac.<br />C. Mixed.<br />D. Cardiac.<br />Ans. A<br />Q 197. The most common cause of renal scarring in a 3 year old child is:<br />A. Trauma.<br />B. Tuberculosis.<br />C. Vesicoureteral reflux induced pyelonephritis.<br />D. Interstitial nephritis.<br />Ans. C<br />Q 198. Which one of the following is the common cause of congential hydrocephalus is?<br />A. Craniosynostosis.<br />B. Intra uterine meningitis.<br />C. Aqueductal stenosis.<br />D. Malformations of great Vein of Galen .<br />Ans. C<br />Q 199. In a child, non-functioning kidney is best diagnosed by:<br />A. Ultrasonography.<br />B. IVU.<br />C. DTPA renogram.<br />D. Creatinine clearance.<br />Ans. C<br />Q 200. The most common malignant neoplasm of infancy is:<br />A. Malignant teratoma.<br />B. Neuroblastoma.<br />C. Wilms’ tumor.<br />D. Hepatoblastoma.<br />Ans. B<br />Q 201. The most common presentation of a child with Wilms’ tumor is:<br />A. An asymptomatic abdominal mass.<br />B. Haematuria.<br />C. Hypertension.<br />D. Hemoptysis due to pulmonary secondary.<br />Ans. A<br />Psychiatry<br />Q 202. A 40-year-old male, with history of daily alcohol consumption for the last 7 years, is brought to the hospital emergency room with acute onset of seeing snakes all around him in the room, not recognizing family members, violent behavior and tremulousness for having missed the alcohol drink since 2 days, Examination reveals increased blood pressure, tremors, increased psychomotor activity, fearful affect, hallucinatory behavior, disorientation, impaired judgment and insight.<br />He is most likely to be suffering from:<br />A. Alcoholic hallucinosis.<br />B. Delirium tremens.<br />C. Wernicke encephalopathy.<br />D. Korsakoff’s psychosis.<br />Ans. B<br />Q 203. A 45-year-male with a history of alcohol dependence presents with confusion nystagmus and ataxia. Examination reveals 6th cranial nerve weakness. He is most likely to be suffering from:<br />A. Korsakoff’s psychosis.<br />B. Wernicke encephalopathy.<br />C. De Clerambault syndrome.<br />D. Delirium tremens.<br />Ans. B<br />Q 204. A 25-year-old female presents with 2 year history of repetitive, irresistible thoughts of contamination with dirt associated with repetitive hand washing. She reports these thoughts to be her own and distressing; but is not able to overcome them along with medications. She is most likely to benefit from which of the following therapies:<br />A. Exposure and response prevention.<br />B. Systematic desensitization.<br />C. Assertiveness training.<br />D. Sensate focusing.<br />Ans. A<br />Q 205. An 18 year old boy came to the Psychiatry OPD with a complaint of feeling changed from inside. He described himself as feeling strange as if he is different from his normal self. He was very tense and anxious yet could not point out the precise change in him. This phenomena is best called as:<br />A. Delusional mood.<br />B. Depersonalization.<br />C. Autochthonous delusion.<br />D. Over valued idea.<br />Ans. B<br />Q 206. The major difference between typical and atypical antipsychotics is that:<br />A. The latter cause minimal or no increase in prolactin.<br />B. The former cause tardive dyskinesia.<br />C. The former are available as parenteral preparations.<br />D. The latter cause substantial sedation.<br />Q 207. Dry mouth during antidepressant therapy is caused by blockade of:<br />A. Muscarininc acetylcholine receptors.<br />B. Serotonergic receptors.<br />C. Dopaminergic receptors.<br />D. GABA receptors.<br />Q 208. All of the following are hallucinogens, except:<br />A. LSD<br />B. Phenylcyclidine.<br />C. Mescaline.<br />D. Methylphendate.<br />Ans. D<br />Q 209. An 18 year old student complains of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches. The most appropriate clinical approach would be to:<br />A. Leave him as normal adolescent problem.<br />B. Rule out depression.<br />C. Rule out migraine.<br />D. Rule out an oppositional defiant disorder.<br />Ans. B<br />Q 210. Perseveration is:<br />A. Persistent and inappropriate repetition of the same thoughts.<br />B. When a patient feels very distressed about it.<br />C. Characteristic of schizophrenia.<br />D. Characteristic of obsessive compulsive disorder (OCD).<br />Ans. A<br />Q 211. One of the following usually differentiates hysterical symptoms from hypochondriacal symptoms:<br />A. Symptoms do not normally reflect understandable physiological or pathological mechanism.<br />B. Physical symptoms are prominent which are not explained by organic factors.<br />C. Personality traits are significant.<br />D. Symptoms run a chronic course.<br />Ans. A<br />Dermatology<br />Q 212. All of the following drugs are effective in the treatment of pityriasis versicolor except:<br />A. Selenium sulphide.<br />B. Ketoconazole.<br />C. Griseofulvin.<br />D. Clotrimazole.<br />Ans. C<br />Q 213. A 36-year-old factory worker developed itchy, annular scaly plaques in both groins. Application of a corticosteroid ointment led to temporary relief but the plaques continued to extend at the periphery. The most likely diagnosis is:<br />A. Erythema annulare centrifugum.<br />B. Granuloma annulare.<br />C. Annular lichen planus.<br />D. Tinea cruris.<br />Ans. D<br />Q 214. A 16-year-old boy presented with asymptomatic, multiple, erythematous, annular lesions with a callarette of scales at the periphery of the lesions present on the trunk. The most likely diagnosis is:<br />A. Pityriasis versicolor.<br />B. Pityriasis alba.<br />C. Pityriasis rosea.<br />D. Pityriasis rubra pilaris.<br />Ans. C<br />Q 215. The only definite indication for giving systemic corticosteroids in pustular PSORIASIS is:<br />A. Psoriatic enythroderma with pregnancy.<br />B. PSORIASIS in a patient with alcoholic cirrhosis.<br />C. Moderate arthritis.<br />D. Extensive lesions.<br />Ans. D<br />Q 216. A 40-year-old woman presents with a 2 year history of erythematous papulopustular lesions on the convexities of the face. There is a background of erythema and telangiectasia. The most likely diagnosis in the patient is:<br />A. Acne vulgaris.<br />B. Rosacea.<br />C. Systemic LUPUS erythematosus.<br />D. Polymorphic light eruption.<br />Ans. B<br />Q 217. An 8-year-old boy from Bihar presents with a 6 months history of an illdefined, hypopigmented slightly atrophic macule on the face. The most likely diagnosis is:<br />A. Pityriasis alba.<br />B. Indeterminate leprosy.<br />C. Morphoca.<br />D. Calcium deficiency.<br />Ans. B<br />Q 218. A 27-year-old sexually active male develops a vesiculobullous lesion on the glans soon after taking tablet paracetamol for fever. The lesion healed with hyperpigmentation. The most likely diagnosis is:<br />A. Behcet’s syndrome.<br />B. Herpes genitalis.<br />C. Fixed drug eruption.<br />D. Pemphigus vulgaris.<br />Ans. C<br />Surgery<br />Q 219. According to the Glasgow coma scale (GCS) a verbal score of 1 indicates:<br />A. No response.<br />B. Inappropriate words.<br />C. Incomprehensible sounds.<br />D. Disoriented response.<br />Ans. A<br />Q 220. Abbey-Estlander flap is used in the reconstruction of:<br />A. Buccal mucosa.<br />B. Lip.<br />C. Tongue.<br />D. Palate.<br />Ans. B<br />Q 221. In which one of the following perineural invasion in head and neck cancer is most commonly seen?<br />A. Adenocarcinoma.<br />B. Adenoid cystic carcinoma.<br />C. Basal cell Adenoma.<br />D. Squamous cell carcinoma.<br />Ans. B<br />Q 222. In which one of the following conditions the sialography is contraindicated?<br />A. Ductal calculus.<br />B. Chronic parotitis.<br />C. Acute parotitis.<br />D. Recurrrent sialadenitis.<br />Ans. C<br />Q 223. The most common site of leak in CSF rhinorrhoea is:<br />A. Sphenoid sinus.<br />B. Frontal sinus.<br />C. Cribriform plate.<br />D. Tegmen tympani.<br />Ans. C<br />Q 224. Which one of the following soft tissue sarcomas frequently metastasizes to lymph nodes?<br />A. Fibrosarcoma.<br />B. Osteosarcoma.<br />C. Embryonal rhabdomyosarcoma.<br />D. Alveolar soft part sarcoma.<br />Ans. C<br />Q 225. Lumbar sympathectomy is of value in the management of :<br />A. Intermittent claudication.<br />B. Distal ischaemia affecting the SKIN of the toes.<br />C. Arteriovenous fistula<br />D. Back pain.<br />Ans. B<br />Q 226. A blood stained discharge from the nipple indicates one of the following:<br />A. Breast abscess.<br />B. Fibroadenoma.<br />C. Duct papilloma.<br />D. Fat necrosis of breast.<br />Ans. C<br />Q 227. The earliest manifestation of increased intracranial pressure following head injury is:<br />A. Ipsilateral papillary dilatation.<br />B. Contralateral papillary dilatation.<br />C. Altered mental status.<br />D. Hemiparesis.<br />Ans. A<br />Q 228. In which of the following conditions splenectomy is not useful?<br />A. Hereditary spherocytosis.<br />B. Porphyria.<br />C. Thalassemia.<br />D. Sickle cell disease with large spleen .<br />Ans. None/B<br />Q 229. The following is ideal for the treatment with injection of sclerosing agents:<br />A. External hemorrhoids.<br />B. Internal hemorrhoids.<br />C. Prolapsed hemorrhoids.<br />D. Strangulated hemorrhoids.<br />Ans. B<br />Q 230. In which of the following locations, carcinoid tumor is most common?<br />A. Esophagus.<br />B. Stomach.<br />C. Small bowel.<br />D. Appendix.<br />Ans. C<br />Q 231. Pancreatitis, pituitary tumor and phaeochromocytoma may be associated with:<br />A. Medullary carcinoma of thyroid.<br />B. Papillary carcinoma of thyroid.<br />C. Anaplastic carcinoma of thyroid.<br />D. Follicular carcinoma of thyroid.<br />Ans. A<br />Q 232. Gardener’s syndrome is a rare herediatary disorder involving the colon. It is characterized by:<br />A. Polyposis colon, cancer thyroid, SKIN tumours.<br />B. Polyposis in jejunum, pituitary adenoma and SKIN tumours.<br />C. Polyposis colon, osteomas, epidermal inclusion cysts and fibrous tumorus in the SKIN .<br />D. Polyposis of gastrointestinal tract, cholangiocarcinoma and SKIN tumours.<br />Ans. C<br />Q 233. All of the following are true for patients of ulcerative colitis associated with primary sclerosing cholangitis (PSC), except:<br />A. They may develop biliary cirrhosis.<br />B. May have raised alkaline phosphatase.<br />C. Increased risk of hilar cholangiocarcinoma.<br />D. PSC reverts after a total colectomy.<br />Ans. D<br />Q 234. The most common complication seen in hiatus hernia is:<br />A. Oesophagitis.<br />B. Aspiration pneumonitis.<br />C. Volvulus.<br />D. Esophageal stricture.<br />Ans. A<br />Q 235. Patients of rectovaginal fistula should be initially treated with:<br />A. Colostomy.<br />B. Primary repair.<br />C. Colporrhaphy.<br />D. Anterior resection.<br />Ans. A<br />Q 236. Which of the following catheter materials is most suited for long-term use is?<br />A. Latex.<br />B. Silicone.<br />C. Rubber.<br />D. Polyurethane.<br />Ans. D<br />Q 237. Which of the following is the most troublesome source of bleeding during a radical retropubic prostatectomy?<br />A. Dorsal venous complex.<br />B. Inferior vesical pedicle.<br />C. Superior vesical pedicle.<br />D. Seminal vesicular artery.<br />Ans. A<br />Q 238. The most sensitive imaging modality for diagnosing ureteric stones in a patient with acute colic is:<br />A. X-ray KUB region.<br />B. Ultrasonogram.<br />C. Non contrast CT scan of the abdomen.<br />D. Contrast enhanced CT scan of the abdomen.<br />Ans. C<br />Q 239. Which one of the following is not used as a tumor marker in testicular tumors?<br />A. AFP.<br />B. LDH.<br />C. HCG.<br />D. CEA.<br />Ans. D<br />ORTHPAEDICS<br />Q 240. A young woman met with an accident and had mild quadriparesis. Her lateral X-ray cervical spine revealed C5-C6 FRACTURE dislocation. Which of the following is the best line of management?<br />A. Immediate anterior decompression.<br />B. Cervical traction followed by instrument fixation.<br />C. Hard cervical collar and bed rest cervical laminectomy.<br />D. Cervical laminectomy.<br />Ans. B<br />Q 241. Which one of the following is the investigation of choice for evaluation of suspected Perthes’ disease?<br />A. Plain X-ray.<br />B. Ultrasonography (US).<br />C. Computed tomography (CT).<br />D. Magnetic resonance imaging (MRI).<br />Ans. D<br />Q 242. Neuronal degeneration is seen in all of the following except:<br />A. Crush nerve injury.<br />B. Fetal development.<br />C. Senescence.<br />D. Neuropraxia.<br />Ans. D<br />Q 243. In Klippel-Feil syndrome, the patient has all of the following clinical features except:<br />A. Low hair line.<br />B. Bilateral neck webbing.<br />C. Bilateral shortness of sternomastoid muscles.<br />D. Gross limitations of neck movements.<br />Ans. C<br />Q 244. The most common sequelae of tuberculous spondylitis in an adolescent is:<br />A. Fibrous ankylosis.<br />B. Bony ankylosis.<br />C. Pathological dislocation.<br />D. Chronic OSTEOMYELITIS .<br />Ans. B<br />Q 245. In radionuclide imaging the most useful radio- pharmaceutical for skeletal imaging is:<br />A. Gallium 67 (67Ga).<br />B. Technetium-sulphur-colloid (99mTc-Sc).<br />C. Technetium-99m (99mTc).<br />D. Technetium-99m linked to methylene disphosphonate (99mTc-MDP).<br />Ans. D<br />Q 246. Heberden’s arthropathy affects:<br />A. Lumbar spine.<br />B. Symmetrically large joints.<br />C. Sacroiliac joints.<br />D. Distal interphalangeal joints.<br />Ans. D<br />Q 247. Subtrochanteric fractures of femur can be treated by all of the following methods except:<br />A. Skeletal traction on Thomas’ splint.<br />B. Smith Petersen nail.<br />C. Condylar blade plate.<br />D. Ender’s nail.<br />Ans. B<br />Q 248. All of the following are true about FRACTURE of the atlas vertebra, except:<br />A. Jefferson FRACTURE is the most common type.<br />B. Quadriplegia is seen in 80% cases.<br />C. Atlantooccipal fusion may sometimes be needed.<br />D. CT scans should be done for diagnosis.<br />Ans. D<br />Q 249. A 30-year-old man had road traffic accident and sustained FRACTURE of femur. Two days later he developed sudden breathlessness. The most probable cause can be:<br />A. Pneumonia.<br />B. Congestive heart failure.<br />C. Bronchial asthma.<br />D. Fat embolism.<br />Ans. D<br />Q 250. A 45-year-old was given steroids after renal transplant. After 2 years he had difficulty in walking and pain in both hips. Which one of the following is most likely cause?<br />A. Primary osteoarthritis.<br />B. Avascular necrosis.<br />C. Tuberculosis.<br />D. Aluminum toxicity.<br />Ans. B<br />Q 251. All of the following areas are commonly involved sites in pelvic FRACTURE except:<br />A. Pubic rami.<br />2. Alae of ileum.<br />3. Acetabula.<br />4. Ischial tuberosities.<br />Ans. D<br />Anaesthesia<br />Q 252. The laryngeal mask airway used for securing the airway of a patient in all of the following conditions except:<br />A. In a difficult intubation.<br />B. In a cardiopulmonary resuscitation.<br />C. In a child undergoing an elective/routine eye Surgery .<br />D. In a patient with a large tumor in the oral cavity.<br />Ans. D<br /><br /><br />Q 253. The following are used for treatment of postoperative nausea and vomiting following squint Surgery in children except:<br />A. Ketamine.<br />B. Ondansetron.<br />C. Propofol.<br />D. Dexamethasone.<br />Ans. A<br />Q 254. Which one of the following anaesthetic agents causes a rise in the intracranial pressure:<br />A. Sevoflurane.<br />B. Thiopentone sodium.<br />C. Lignocaine.<br />D. Propofol.<br />Ans. A<br />Q 255. The following modes of ventilation may be used for weaning off patients from mechanical ventilation except:<br />A. Controlled Mechanical ventilation (CMV).<br />B. Synchronized intermittent mandatory ventilation (SIMV).<br />C. Pressure support ventilation (PSV).<br />D. Assist-control ventilation (ACV).<br />Ans. A<br />Q 256. A lower segment caesarean section (LSCS) can be carried out under all the following techniques Anaesthesia except:<br />A. General Anaesthesia .<br />B. Spinal Anaesthesia .<br />C. Caudal Anaesthesia .<br />D. Combined spinal epidural.<br />Ans. C<br />Q 257. The most appropriate circuit for ventilating a spontaneonsly breathing infant during Anaesthesia is:<br />A. Jackson Rees modification of Ayres T piece.<br />B. Mapleson A or Magill’s circuit.<br />C. Mapleson C or Waters to and fro canister.<br />D. Bains circuit.<br />Ans. A<br />Q 258. All of the following are the disadvantages of anesthetic ether, except:<br />A. Induction is slow.<br />B. Irritant nature of ether increases salivary and bronchila secretions.<br />C. Cautery can not be used.<br />D. Affects blood pressure and is liable to produce arrhythmias.<br />Ans. D<br />Q 259. Which one of the following is the fastest acting inhalational agent?<br />A. Halothane.<br />B. Isoflurane.<br />C. Ether.<br />D. Sevoflurane.<br />Ans. D<br />Gynaecology AND OBSTETRICS<br />Q 260. Aspermia is the term used to describe:<br />A. Absence of semen.<br />B. Absence of sperm in ejaculate.<br />C. Absence of sperm motility.<br />D. Occurrence of abnormal sperm.<br />Ans. A<br />Q 261. Which of the following ultrasound marker is associated with greatest increased risk for trisomy 21 in fetus:<br />A. Echogenic foci in heart .<br />B. Hyperechogenic bowel.<br />C. Choroid plexus cysts.<br />D. Nuchal edema.<br />Ans. D<br />Q 262. The highest incidence of gestational trophoblastic disease is in:<br />A. Australia .<br />B. Asia.<br />C. North America.<br />D. Western Europe.<br />Ans. B<br />Q 263. The smallest diameter of the true pelvis is:<br />A. Interspinous diameter.<br />B. Diagonal conjugate.<br />C. True conjugate.<br />D. Intertuberous diameter.<br />Ans. A<br />Q 264. The most common pure germ cell tumor of the ovary is:<br />A. Choriocarcinoma.<br />B. Dysgerminoma.<br />C. Embryonal cell tumor.<br />D. Malignant teratoma.<br />Ans. B<br />Q 265. Infants of diabetic mother are likely to have the following cardiac anomaly:<br />A. Coarctation of aorta.<br />B. Fallot’s tetrology.<br />C. Ebstein’s anomaly.<br />D. Transposition of great arteries.<br />Ans. D<br />Q 266. Which one of the following is the ideal contraceptive for a patient with heart disease:<br />A. IUCD.<br />B. Depo-provera.<br />C. Diaphragm.<br />D. Oral contraceptive pills.<br />Ans. C<br />Q 267. The karyotype of a patient with androgen insensitivity syndrome is:<br />A. 46 XX.<br />B. 46 XY.<br />C. 47 XXY.<br />D. 45 XO.<br />Ans. B<br />Q 268. The following drug is not helpful in the treatment of ectopic pregnancy:<br />A. Methotrexate.<br />B. Misoprostol.<br />C. Actinomycin-D.<br />D. RU 486.<br />Ans. B<br />Q 269. The best period of gestation to carry out chorion villous biopsy for prenatal diagnosis is:<br />A. 8-10 weeks.<br />B. 10-12 weeks<br />C. 12-14 weeks.<br />D. 14-16 weeks.<br />Ans. B<br />Q 270. Which one of the follwing biochemical parameters is the most sensitive to detect open spina bifida?<br />A. Maternal serum alpha fetoprotein.<br />B. Amniotic fluid alpha fetoprotein.<br />C. Amniotic fluid acetyl cholinesterase.<br />D. Amniotic fluid glucohexaminase.<br />Ans. C<br />Q 271. Risk of preterm delivery is increased if cervical length is:<br />A. 2.5 cm.<br />B. 3.0 cm.<br />C. 3.5 cm.<br />D. 4.0 cm.<br />Ans. A<br />Q 272. All are the risk factors associated with macrosomia except:<br />A. Maternal obesity.<br />B. Prolonged pregnancy.<br />C. Previous large infant.<br />D. Short stature.<br />Ans. D<br />Q 273. Which of the following statements is incorrect in relation to pregnant women with epilepsy?<br />A. The rate of congenital malformation is increased in the offspring of women with epilepsy.<br />B. Seizure frequency increases in approximately 70% of women.<br />C. Breast feeding is safe with most anticonvulsants.<br />D. Folic acid supplementation may reduce the risk of neural tube defect.<br />Ans. B<br />Q 274. All are the causes of intrauterine growth retardation except:<br />A. Anemia.<br />B. Pregnancy induced hypertension.<br />C. Maternal heart disease.<br />D. Gestational diabetes.<br />Ans. D<br />Q 275. Misoprostal has been found to be effective in all of the following except:<br />A. Missed abortion.<br />B. Induction of labour.<br />C. Menorrhagia.<br />D. Prevention of post-partum hemorrhage (PPH).<br />Ans. C<br />Q 276. All of the following appear to decrease hot flushes in menopausal women except:<br />A. Androgens.<br />B. Raloxifene.<br />C. Isoflavones.<br />D. Tibolone.<br />Ans. B<br />Q 277. In a case of dysgerminoma of ovary one of the following tumor markers is likely to be raised:<br />A. Serum HCG.<br />B. Serum alphafetoprotein.<br />C. Serum lactic dehydrogenase.<br />D. Serum inhibin.<br />Ans. C<br />Q 278. Use of one of the following vaccination is absolutely contraindicated in pregnancy:<br />A. Hepatitis-B.<br />B. Cholera.<br />C. Rabies.<br />D. Yellow fever.<br />Ans. B/D<br />Q 279. The most common cause of secondary amenorrhoea in India is:<br />A. Endometrial tuberculosis.<br />B. Premature ovarian failure.<br />C. Polycystic ovarian syndrome.<br />D. Sheehan’s syndrome.<br />Ans. A<br />Ophthalmology<br />Q 280. In von Hippel-Lindau syndrome, the retinal vascular tumours are often associated with intracranial hemangioblastoma. Which one of the following regions is associated with such vascular abnormalities in this syndrome?<br />A. Optic radiation.<br />B. Optic tract.<br />C. Cerebellum.<br />D. Pulvinar.<br />Ans. C<br />Q 281. An 18 year old boy comes to the eye casualty with history of injury with a tennis ball. On examination there is no perforation but there is hyphaema. The most likely source of the blood is<br />A. Iris vessels.<br />B. Circulus iridis major.<br />C. Circulus iridis minor.<br />D. Short posterior ciliary vessels.<br />Ans. A<br />Q 282. A 25 year old male gives history of sudden painless loss of vision in one eye for the past 2 weeks. There is no history of trauma. On examination the anterior segment is normal but there is no fundal glow. Which one of the following is the most likely cause?<br />A. Vitreous haemorrhage.<br />B. Optic atrophy.<br />C. Developmental cataract.<br />D. Acute attack of angle closure glaucoma.<br />Ans. A<br />Q 283. The mother of a one and a half year old child gives history of a white reflex from one eye for the past 1 month. On computed tomography scan of the orbit there is calcification seen within the globe. The most likely diagnosis is:<br />A. Congenital cataract.<br />B. Retinoblastaoma.<br />C. Endophthalmitis.<br />D. Coats’ disease.<br />Ans. B<br />Q 284. Enlarged corneal nerves may be seen in all of the following except:<br />A. Keratoconus.<br />B. Herpes simplex keratitis.<br />C. Leprosy.<br />D. Neurofibromatosis.<br />Ans. B Q 285. Under the WHO ‘Vision 2020’ programme, the ‘SAFE’ strategy is adopted for which of the followingDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com1tag:blogger.com,1999:blog-2217647826950966921.post-66922033795781034802008-12-18T09:25:00.000-08:002008-12-18T09:26:30.757-08:00fmge 2004ALL INDIA<br />PAPER 2004<br />SOLVED<br />QUESTIONS AND ANSWERS<br /><br />Anatomy<br />Q 1. False statement regarding pudendal nerve is:<br />A. Both sensory and motor<br />B. Derived from S2,3,4 spinal nerve roots<br />C. Leaves pelvis through the lesser sciatic foramen<br />D. It is the only somatic nerve to innervate the pelvic organs<br />Ans. C<br />Q 2. Wrong statement regarding the coronary artery is:<br />A. Left coronary artery is present in anterior interventricular groove<br />B. Usually 3 obtuse marginal arteries arise from left coronary artery<br />C. Posterior interventricular artery arises from right coronary artery<br />D. Left atrial artery is a branch of left coronary artery<br />Ans. B<br />Q 3. All are true statements regarding inguinal canal except:<br />A. Roof is formed by conjoint tendon<br />B. Deep inguinal ring is formed by transversus abdominis<br />C. Superficial inguinal ring is formed by external oblique muscle<br />D. Internal oblique forms anterior and posterior wall<br />Ans. B<br />Q 4. Right gastroepiploic artery is a branch of:<br />A. Left gastric<br />B. Coeliac trunk<br />C. Splenic<br />D. Gastroduodenal<br />Ans. D<br />Q 5. In FRACTURE of middle cranial fossa, absence of tears is due to lesion in the:<br />A. Trigeminal ganglion<br />B. Ciliary ganglion<br />C. Lesser petrosal nerve<br />D. Greater petrosal nerve<br />Ans. D<br />Q 6. Motor supply to diaphragm is by:<br />A. Thoracodorsal nerve<br />B. Phrenic nerve<br />C. Intercostal nerves<br />D. Sympathetic nerves<br />Ans. B<br />Q 7. All of the following are supplied by facial nerve except:<br />A. Lacrimal gland<br />B. Submandibular gland<br />C. Nasal glands<br />D. Parotid gland<br />Ans. D<br />Q 8. In left coronary artery thrombosis, area most likely to be involved is:<br />A. Anterior wall of right ventricle<br />B. Anterior wall of left ventricle<br />C. Anterior wall of right atrium<br />D. Inferior surface of right ventricle<br />Ans. B<br />Physiology<br />Q 9. Tidal volume is calculated by:<br />A. Inspiratory capacity minus the inspiratory reserve volume<br />B. Total lung capacity minus the residual volume<br />C. Functional residual capacity minus residual volume<br />D. Vital capacity minus expiratory reserve volumes<br />Ans. A<br />Q 10. Surfactant production in lungs starts at:<br />A. 28 weeks<br />B. 32 weeks<br />C. 34 weeks<br />D. 36 weeks<br />Ans. A<br />Q 11. Initiation of nerve impulse occurs at the axon hillock because:<br />A. It has a lower threshold than the rest of the axon<br />B. It is unmyelinated<br />C. Neurotransmitter release occurs here<br />D. None of the above<br />Ans. A<br />Q 12. Albumin contributes the maximum to oncotic pressure because it has:<br />A. High molecular weight, low concentration<br />B. Low molecular weight, low concentration<br />C. High molecular weight, high concentration<br />D. Low molecular weight, high concentration<br />Ans. D<br /><br /><br />Q 13. After 5 days of fasting a man undergoes oral GTT, true is all except:<br />A. GH levels are increased<br />B. Increased glucose tolerance<br />C. Decreased insulin levels<br />D. Glucagon levels are increased<br />Ans. B<br />Q 14. Metalloproteins help in jaundice by the following mechanism:<br />A. Increased glucoronyl transferase activity<br />B. Inhibit heme oxygenase<br />C. Decrease RBC lysis<br />D. Increase Y and Z receptors<br />Ans. B<br />Q 15. Which protein prevents contraction by covering binding sites on actin and myosin:<br />A. Troponin<br />B. Calmodulin<br />C. Thymosin<br />D. Tropomyosin<br />Ans. D<br />Q 16. Which of the following is not correct regarding capillaries:<br />A. Greatest cross sectional area<br />B. Contain 25% of blood<br />C. Contains less blood than veins<br />D. Have single layer of cells bounding the lumen<br />Ans. B<br />Q 17. A 0.5 litre blood loss in 30 minutes will lead to:<br />A. Increase in HR, decrease in BP<br />B. Slight increase in HR, normal BP<br />C. Decrease in HR and BP<br />D. Prominent increase in HR<br />Ans. B<br />Q 18. Single most important factor in control of automatic contractility of heart is:<br />A. Myocardial wall thickness<br />B. Right atrial volume<br />C. SA node pacemaker potential<br />D. Sympathetic stimulation<br />Ans. D<br />Q 19. Which of the following is not mediated through negative FEEDBACK mechanism:<br />A. TSH release<br />B. GH formation<br />C. Thrombin formation<br />D. ACTH release<br />Ans. C<br />Q 20. Force generating proteins are:<br />A. Myosin and myoglobin<br />B. Dynein and kinesin<br />C. Calmodulin and G protein<br />D. Troponin<br />Ans. B<br />Q 21. Which is true about measurement of BP with sphygmomanometer versus intraarterial pressure measurements:<br />A. Less than intravascular pressure<br />B. More than intravascular pressure<br />C. Equal to intravascular pressure<br />D. Depends upon blood flow<br />Ans. B<br />Q 22. Secondary hyperparathyroidism due to vitamin D deficiency shows:<br />A. Hypocalcemia<br />B. Hypercalcemia<br />C. Hypophosphatemia<br />D. Hyperphosphatemia<br />Ans. C<br />Q 23. Maximum absorption of water takes place in:<br />A. Proximal convoluted tubule<br />B. Distal convoluted tubule<br />C. Collecting duct<br />D. Loop of Henle<br />Ans. A<br />Biochemistry<br />Q 24. Basic amino acids are:<br />A. Aspartate and glutamate<br />B. Serine and glycine<br />C. Lysine and arginine<br />D. None of the above<br />Ans. C<br />Q 25. Amino acid with dissociation constant closest to physiological pH is:<br />A. Serine<br />B. Histidine<br />C. Threonine<br />D. Proline<br />Ans. B<br />Q 26. Sources of the nitrogen in urea cycle are:<br />A. Aspartate and ammonia<br />B. glutamate and ammonia<br />C. Arginine and ammonia<br />D. Uric acid<br />Ans. A<br />Q 27. If urine sample darkens on standing: the most likely condition is:<br />A. Phenylketonuria<br />B. Alkaptonuria<br />C. Maple syrup disease<br />D. Tyrosinemia<br />Ans. B<br />Q 28. A baby presents with refusal to feed, SKIN lesions, seizures, ketosis organic acids in urine with normal ammonia; likely diagnosis is:<br />A. Propionic aciduria<br />B. Multiple carboxylase deficiency<br />C. Maple syrup urine disease<br />D. Urea cycle enzyme deficiency<br />Ans. B<br />Q 29. Force not acting in an enzyme substrate complex:<br />A. Electrostatic<br />B. Covalent<br />C. Van der Wall<br />D. Hydrogen<br />Ans. C<br />Q 30. Cellular oxidation is inhibited by:<br />A. Cyanide<br />B. Carbon dioxide<br />C. Chocolate<br />D. Carbonated beverages<br />Ans. A<br />Q 31. Triple bonds are found between which base pairs:<br />A. A-T<br />B. C-G<br />C. A-G<br />D. C-T<br />Ans. B<br />Q 32. Which of the following RNA has abnormal purine bases:<br />A. tRNA<br />B. mRNA<br />C. rRNA<br />D. 16SRNA<br />Ans. A<br />Q 33. False regarding gout is:<br />A. Due to increased metabolism of pyrimidines<br />B. Due to increased metabolism of purines<br />C. Uric acid levels may not be elevated<br />D. Has a predilection for the great toe<br />Ans. A<br />Q 34. All of the following statements are true regarding lipoproteins except:<br />A. VLDL transports endogenous lipids<br />B. LDL transports lipids to the tissues.<br />C. Increased blood cholesterol is associated with increased LDL receptors<br />D. Increased HDL is associated with decreased risk of coronary disease<br />Ans. C<br />Q 35. A destitute woman is admitted to the hospital with altered sensorium and dehydration; urine analysis shows mild proteinuria and no sugar; what other test would be desirable:<br />A. Fouchet<br />B. Rothera<br />C. Hays<br />D. Benedict’s<br />Ans. B<br />Q 36. Which of these fatty acids is found exclusively in breast milk:<br />A. Linolaete<br />B. Linolenic<br />C. Palmitic<br />D. d-hexanoic<br />Ans. A<br />Q 37. Blood is not a newtonian fluid because:<br />A. Viscosity does not changing with velocity<br />B. Viscosity changes with velocity<br />C. Density does not change with velocity<br />D. Density changes with velocity<br />Ans. B<br />Microbiology<br />Q 38. Regarding NK cells, false statement is:<br />A. It is activated by IL-2<br />B. Expresses CD 3 receptor<br />C. It is a variant of large lymphocyte<br />D. There is antibody induced proliferation of NK cells<br />Ans. D<br />Q 39. Adenosine deaminase deficiency is seen in the following:<br />A. Common variable immunodeficiency.<br />B. Severe combined immunodeficiency<br />C. Chronic granulomatous disease<br />D. Nezelof syndrome<br />Ans. B<br />Q 40. A beta hemolytic bacteria is resistant to vancomycin, shows growth in 6.5% NaCI, is non-bile sensitive. It is likely to be:<br />A. Strep. agalactiae<br />B. Strep. pneumoniae<br />C. Enterococcus<br />D. Strep. bovis<br />Ans. C<br />Q 41. False statement about the streptococcus is:<br />A. M protein is responsible for production of mucoid colonies<br />B. M protein is the major surface protein of group A streptococci<br />C. Mucoid colonies are virulent<br />D. Endotoxin causes rash of scarlet fever<br />Ans. A<br />Q 42. Toxin involved in the streptococcal toxic shock syndrome is:<br />A. Pyrogenic toxin<br />B. Erythrogenic toxin<br />C. Hemolysin<br />D. Neurotoxin<br />Ans. A<br />Q 43. A child presents with a white patch over the tonsils; diagnosis is best made by culture in:<br />A. Loeffler medium<br />B. LJ medium<br />C. Blood agar<br />D. Tellurite medium<br />Ans. A<br />Q 44. A patient with 14 days of fever is suspected of having typhoid. What investigation should be done:<br />A. Blood culture<br />B. Widal test<br />C. Stool culture<br />D. Urine culture<br />Ans. B<br />Q 45. All are true about EHEC except:<br />A. Sereny test is positive<br />B. Fails to ferment sorbitol<br />C. Causes HUS<br />D. Elaborates shiga like exotoxin<br />Ans. A<br />Q 46. An organism grown on agar shows green coloured colonies, likely organism is:<br />A. Staphylococcus<br />B. E. coli<br />C. Pseudomonas<br />D. Peptostreptococcus<br />Ans. C<br />Q 47. Congenital syphilis can be best diagnosed by:<br />A. IgM FTAbs<br />B. IgG FTAbs<br />C. VDRL<br />D. TPI<br />Ans. A<br />Q 48. All are features of Ureaplasma urealyticum except:<br />A. Non gonococcal urethritis<br />B. Salpingitis<br />C. Epididymitis<br />D. Bacterial vaginosis<br />Ans. D<br />Q 49. Regarding HIV infection, not true is:<br />A. p24 is used for early diagnosis<br />B. Lysis of infected CD 4 cells is seen<br />C. Dendritic cells do not support replication<br />D. Macrophage is a reservoir for the virus<br />Ans. C<br />Q 50. A pregnant woman from Bihar presents with hepatic encephalopathy. The likely diagnosis:<br />A. Hepatitis E<br />B. Hepatitis B<br />C. Sepsis<br />D. Acute fatty liver of pregnancy<br />Ans. A<br />Q 51. Virus causing hemorrhagic cystitis, diarrhea and conjunctivitis is:<br />A. RSV<br />B. Rhinovirus<br />C. Adenovirus<br />D. Rotavirus<br />Ans. C<br />Q 52. Cystine lactose enzyme deficient (CLED) medium is preferred over McConkey agar in UTI because:<br />A. Former prevents swarming of proteus<br />B. Is a selective medium<br />C. Prevents growth of pseudomonas<br />D. Promotes growth of candida<br />Ans. A<br />Q 53. In which stage of filariasis are microfilaria seen in peripheral blood:<br />A. Tropical eosinophilia<br />B. Early adenolymphangitis stage<br />C. Late adenolymphangitis stage<br />D. Elephantiasis<br />Ans. B<br />Q 54. Pancreatic CA is caused by:<br />A. Fasciola<br />B. Clonorchis<br />C. Paragonimus<br />D. None<br />Ans. B<br />Q 55. All of the following are true except:<br />A. E.coli is an aerobe and facultative anaerobe<br />B. Proteus forms uric acid stones<br />C. E. coli is motile by peritrichate flagella<br />D. Proteus causes deamination of phenylalanine to phenylpyruvic acid<br />Ans. B<br />Q 56. Consumption of uncooked pork is likely to cause which of the following helminthic disease:<br />A. Tinea saginata<br />B. Tinea solium<br />C. Hydatid cyst<br />D. Trichuris trichura<br />Ans. B<br />Pathology<br />Q 57. Enzyme that protects the brain from free radical injury is:<br />A. Myeloperoxidase<br />B. Superoxide dismutase<br />C. MAO<br />D. Hydroxylase<br />Ans. B<br />Q 58. Autoimmune haemolytic anemia is seen in:<br />A. ALL B. AML<br />C. CLL D. CML<br />Ans. C<br />Q 59. All of following are correct about thromboxane A2 except:<br />A. Low dose aspirin inhibits its synthesis<br />B. Causes vasoconstriction in blood vessels<br />C. Causes broncoconstriction<br />D. Secreted by WBC<br />Ans. D<br />Q 60. Which of the following complications is likely to result after several units of blood have been transfused:<br />A. Metabolic alkalosis<br />B. Metabolic acidosis<br />C. Respiratory alkalosis<br />D. Respiratory acidosis<br />Ans. A<br />Q 61. The mother has sickle cell disease and father is normal. Chances of children having sickle cell disease and sickle cell trait respectively are:<br />A. 0 and 100%<br />B. 25 and 25%<br />C. 50 and 50%<br />D. 10 and 50%<br />Ans. A<br />Q 62. Father has a blood group B, mother has AB; children are not likely to have the following blood group:<br />A. O<br />B. A<br />C. B<br />D. AB<br />Ans. A<br />Q 63. Protein involved in intercellular connections is:<br />A. Connexin<br />B. Integrin<br />C. Adhesin<br />D. None of the above<br />Ans. A<br /><br />Pharmacology<br />Q 64. All are reasons for reducing drug dosage in elderly except:<br />A. They are lean and their body mass is less<br />B. Have decreasing renal function with age<br />C. Have increased baroceptor sensitivity<br />D. Body water is decreased<br />Ans. C<br />Q 65. True statement regarding inverse agonists is:<br />A. Binds to receptor and causes intended action<br />B. Binds to receptor and causes opposite action<br />C. Binds to receptor and causes no action<br />D. Binds to receptor and causes submaximal action<br />Ans. B<br />Q 66. True statement regarding first order kinetics is:<br />A. Independent of plasma concentration<br />B. A constant proportion of plasma concentration is eliminated<br />C. T½ increases with dose<br />D. Clearance decreases with dose<br />Ans. B<br />Q 67. A diabetic female on INH and rifampicin for TB suffers DVT. She is started on warfarin. PT is not raised. Next step should be:<br />A. Long term heparin therapy<br />B. Replace warfarin with acecoumarin<br />C. Switch ethambutol for rifampin<br />D. Use LMW heparin<br />Ans. C<br />Q 68. Beta blocker that can be used in renal failure is:<br />A. Propranolol<br />B. Pindolol<br />C. Sotalol<br />D. Nadolol<br />Ans. A<br />Q 69. All of the following are correct about steroids except:<br />A. Inhibit the release of arachidonic acid from vessel wall through action of phospholipase A2<br />B. Bind plasma membrane receptors and following internalization influence nuclear changes<br />C. Inhibit vascular membrane permeability<br />D. Increase glucose synthesis, glycogen deposition in liver<br />Ans. B<br />Q 70. All of the following statements are true except:<br />A. PGs and leukotrienes are derived from arachidonic acid<br />B. COX I is an inducible enzyme<br />C. COX II is induced by cytokines at sites of inflammation.<br />D. Leukotrienes cause smooth muscle constriction<br />Ans. B<br />Q 71. Which of the following is a false statement:<br />A. IV noradrenaline increases systolic and diastolic BP and cause tachycardia<br />B. IV adrenaline increases systolic BP, no change or increase diastolic BP and causes tachycardia<br />C. IV isoproterenol causes increase in systolic BP, decreases diastolic BP and causes tachycardia<br />D. Dopamine improves renal function, increases cardiac output and systolic BP<br />Ans. A<br />Q 72. Digoxin is not indicated in:<br />A. Atrial flutter<br />B. Atrial fibrillation<br />C. High output failure<br />D. PSVT<br />Ans. C<br />Q 73. All of the following statements are true about theophylline except:<br />A. Increase in dose is required in cardiopulmonary disease<br />B. Increases cAMP<br />C. Increase in dose is required in smokers<br />D. Inhibits phosphodiesterase<br />Ans. A<br />Q 74. Mechanism of action of tetracycline is:<br />A. Binds to A site and inhibit attachment of t-RNA.<br />B. Inhibits peptidyl transferase<br />C. Causes misreading of mRNA<br />D. Causes termination of peptide chain elongation<br />Ans. A<br />Q 75. False statement about selegeline is:<br />A. It is a MAO-A inhibitor<br />B. Does not cause cheese reaction<br />C. Not useful in advanced cases of on-off phenomenon<br />D. It is used in parkinsonism<br />Ans. A<br />Q 76. A patient on phenytoin for treatment of seizures develops depression for which he is prescribed tricyclics. He now complains of lassitude and his Hb reads 8. Next step in managing this patient should be:<br />A. Chest X-ray<br />B. MCV should be estimated<br />C. GGT should be estimated<br />D. Bone marrow examination<br />Ans. B<br />Q 77. Which of the following drugs would be removed by dialysis?<br />A. Digoxin<br />B. Salicylates<br />C. Benzodiazepines<br />D. Organophosphates<br />Ans. B<br />Q 78. In low doses aspirin acts on:<br />A. Cyclooxygenase<br />B. Thromboxane A2<br />C. PGI2<br />D. Lipoxygenase<br />Ans. B<br />Q 79. True statement about ticlopidine is:<br />A. Directly interacts with platelet membrane<br />B. Onset of action is delayed<br />C. Inhibits platelet gp IIb/IIIa receptors<br />D. Has fibrinolytic activity<br />Ans. A<br />Q 80. All of the following statements about methotrexate are true except:<br />A. Folinic acid enhances the action of methotrexate<br />B. Methotrexate inhibit dehydrofolate reductase<br />C. Non proliferative cells are resistant to metho- trexate<br />D. Methotrexate is used in treatment of PSORIASIS<br />Ans. A<br />Q 81. Drug containing two sulfhydryl groups in a molecule:<br />A. BAL<br />B. EDTA<br />C. Pencillamine<br />D. Desferioxamine<br />Ans. A<br />Forensic Medicine<br />Q 82. Gettler’s test is done for death by:<br />A. Drowning B. Hanging<br />C. Bums D. Phophorus poisoning<br />Ans. A<br /><br />Q 83. Feature indicative of antimortem drowning is:<br />A. Cutis anserina<br />B. Rigor mortis<br />C. Washer woman’s feet<br />D. Grass and weeds grasped in the hand<br />Ans. D<br />Q 84. A boy has 20 permanent teeth and 8 temporary teeth. His age is likely to be:<br />A. 9 years<br />B. 10 years<br />C. 11 years<br />D. 12 years<br />Ans. C<br />Q 85. A patient has sensation of bugs crawling all over his body. This may be effect of:<br />A. Cocaine<br />B. Alcohol<br />C. Cannabis<br />D. Benzodiazepines<br />Ans. A<br />Q 86. A person comes in contact with other. This is called:<br />A. Locard principle<br />B. Quetlet’s rule<br />C. Petty’s principle<br />D. None of the above<br />Ans. A<br />Q 87. A patient of head injury, has no relatives and requires urgent cranial decompression; Doctor should:<br />A. Operate without formal consent<br />B. Take police consent<br />C. Wait for relatives to take consent<br />D. Take magistrate consent<br />Ans. A<br />Q 88. A boy attempts suicide. He is brought to a private doctor and he is successfully cured. Doctor should:<br />A. Inform police<br />B. Not required to inform police<br />C. Report to magistrate<br />D. Refer to a psychiatrist<br />Ans. B<br />PREVENTIVE AND SOCIAL Medicine<br />Q 89. All are true about DOTS except:<br />A. Continuation phase drugs are given in a multi- blister combipack<br />B. Medication is to be taken in presence of a health worker<br />C. Alternate day treatment<br />D. Improves compliance<br />Ans. C<br />Q 90. Basanti a 29 years aged female from Bihar presents with active tuberculosis. She delivers baby. All of the following are indicated except:<br />A. Administer INH to the baby<br />B. Withhold breastfeeding<br />C. Give ATT to mother for 2 years<br />D. Ask mother to ensure proper disposal of sputum<br />Ans. B<br />Q 91. Under the national TB programme, for a PHC to be called a PHC-R, requisite is:<br />A. Microscopy<br />B. Microscopy plus Radiology<br />C. Radiology<br />D. None of the above<br />Ans. B<br />Q 92. A person has received complete immunization against tetanus 10 years ago, now he presents with a clean wound without any lacerations from an injury sustained 3 hours ago. He should now be given:<br />A. Full course of tetanus toxoid<br />B. Single dose of tetanus toxoid<br />C. Human tetanus globulin<br />D. Human tetanus globulin and single dose of toxoid<br />Ans. B<br />Q 93. The false statement regarding tetanus is:<br />A. Five doses of immunisation provide life long immunity<br />B. TT affords no protection in the present injury<br />C. TIG is useful in lacerated wound<br />D. TT and Ig both may be given in suspected tetanus<br />Ans. A<br />Q 94. A certain community has 100 children out of whom 28 are immunised against measles. 2 of them acquired measles simultaneously. Subsequently 14 get measles. Assuming the efficacy of the vaccine to be 100%. What is the secondary attack rate?<br />A. 5%<br />B. 10%<br />C. 20%<br />D. 21.5%<br />Ans. C<br />Q 95. A community has a population of 10,000 and a birth rate of 36 per 1000. 5 maternal deaths were reported in the current year. The MMR is:<br />A. 14.5<br />B. 13.8<br />C. 20<br />D. 5<br />Ans. B<br />Q 96. 10 babies are born in a hospital on same day. All weigh 2.8 kg each. Calculate the standard deviation:<br />A. Zero<br />B. One<br />C. Minus one<br />D. 0.28<br />Ans. A<br />Q 97. Out of 11 births in a hospital, 5 babies weighed over 2.5 kg and 5 weighed less than 2.5 kg. What value does 2.5 represent:<br />A. Geometric average<br />B. Arithmetic average<br />C. Median<br />D. Mode<br />Ans. C<br />Q 98. A man weighing 68 kg, consumes 325 gm carbohydrate, 65 gm protein and 35 gms fat in his diet. The most applicable statement here is:<br />A. His total calorie intake is 3000 kcal<br />B. The proportion of proteins, fats and carbohydrates is correct and in accordance with a balanced diet<br />C. He has a negative nitrogen balance<br />D. 30% of his total energy intake is derived from fat<br />Ans. B<br />Q 99. A country has a population of 1000 million; birth rate is 23 and death rate is 6. In which phase of the demographic cycle does this country lie:<br />A. Early expanding<br />B. Late expanding<br />C. Plateau<br />D. Declining<br />Ans. B<br />Q 100. In a population of 10,000, beta carotene was given to 6000; it was not given to the remainder. 3 out of the first group got lung cancer while 2 out of the other 4000 also got lung cancer. The best conclusion is:<br />A. Beta carotene and lung cancer have no relation to one another<br />B. The p value is not significant<br />C. The study is not designed properly<br />D. Beta carotene is associated with lung cancer<br />Ans. A<br />Q 101. A subcentre in a hilly area caters to a population of:<br />A. 1000<br />B. 2000<br />C. 3000<br />D. 5000<br />Ans. C<br />Q 102. In a community, an increase in new cases denotes:<br />A. Increase in incidence rate<br />B. Increase in prevalence rate<br />C. Decrease in incidence rate<br />D. Decrease in prevalence rate<br />Ans. A<br />Q 103. More false positive cases on screening in a community signify that the disease has:<br />A. High prevalence<br />B. High sensitivity<br />C. Low prevalence<br />D. Low sensitivity<br />Ans. C<br />Q 104. The same screening test is applied to two communities X and Y; Y shows more false +ve cases as compared to X. The possibility is:<br />A. High sensitivity<br />B. High specificity<br />C. Y community has high prevalence<br />D. Y community has low prevalence<br />Ans. C<br />Q 105. ELISA is performed on a population with low prevalence of hepatitis B. What would be the result of performing double screening ELISA tests?<br />A. Increased sensitivity and positive predictive value<br />B. Increased sensitivity and negative predictive value<br />C. Increased specificity and positive predictive value<br />D. Increased specificity and negative predictive value<br />Ans. C<br />Q 106. While testing a hypolipidemic drug, serum lipid levels were tested both before and after its use. Which test is best suited for the statistical analysis of the result:<br />A. Paired t-test<br />B. Student’s test<br />C. Chi square test<br />D. None of the above<br />Ans. A<br />Q 107. Type 1 sampling error is classified as:<br />A. Alpha error<br />B. Beta error<br />C. Gamma error<br />D. Delta error<br />Ans. A<br />Q 108. Virulence of a disease is indicated by:<br />A. Proportional mortality rate<br />B. Specific mortality rate<br />C. Case fatality ratio<br />D. Amount of GDP spent on control of disease<br />Ans. C<br />Q 109. Which of the following diseases needs not to be screened for in workers to be employed in a dye industry in Gujarat ?<br />A. Anemia<br />B. Bronchial asthma<br />C. Bladder cancer<br />D. Precancerous lesion<br />Ans. A<br />Q 110. Best test to detect iron deficiency in community is:<br />A. Serum transferrin<br />B. Serum ferritin<br />C. Serum iron<br />D. Hemoglobin<br />Ans. B<br />Q 111. Which of the following is not a complete sterilization agent:<br />A. Glutaraldehyde<br />B. Absolute alcohol<br />C. Hydrogen peroxide<br />D. Sodium hypochlorite<br />Ans. B<br />Q 112. Seasonal trend is due to:<br />A. Vector variation<br />B. Environmental factors<br />C. Change in herd immunity<br />D. All of the above<br />Ans. B<br />Medicine<br />Q 113. False statement about type I respiratory failure is:<br />A. Decreased PaO2<br />B. Decreased PaCO2<br />C. Normal PaCO2<br />D. Normal A-a gradient<br />Ans. D<br />Q 114. A 60 years old man presents with nonproductive cough for 4 weeks. He has grade III clubbing, and a lesion in the apical lobe on X-ray. Most likely diagnosis here is:<br />A. Small cell CA<br />B. Non-small cell CA<br />C. Fungal infection<br />D. Tuberculosis<br />Ans. B<br />Q 115. A 60 years old man is suspected of having bronchogenic CA. TB has been ruled out in this patient. What should be the next investigation:<br />A. CT guided FNAC<br />B. Bronchoscopy and biopsy<br />C. Sputum cytology<br />D. X-ray chest<br />Ans. B<br />Q 116. A man presents with fever, weight loss and cough. Mantoux reads an induration of 17 × 19 mm; sputum cytology is negative for AFB. Most likely diagnosis is:<br />A. Pulmonary tuberculosis<br />B. Fungal infection<br />C. Viral infection<br />D. Pneumonia<br />Ans. A<br />Q 117. Pulmonary edema associated with normal PCWP is observed, which of these is not a cause:<br />A. High altitude<br />B. Cocaine overdose<br />C. Post cardiopulmonary bypass<br />D. Bilateral renal artery stenosis<br />Ans. D<br />Q 118. An ABG analysis shows: pH 7.2, raised pCO2, decreased HCO3. Diagnosis is:<br />A. Respiratory acidosis<br />B. Compensated metabolic acidosis<br />C. Respiratory and metabolic acidosis<br />D. Respiratory alkalosis<br />Ans. C<br />Q 119. ABG analysis of a patient on ventilator shows decreased pCO2, normal pO2, pH 7.5. Diagnosis is:<br />A. Respiratory acidosis<br />B. Metabolic alkalosis<br />C. Respiratory alkalosis<br />D. Metabolic acidosis<br />Ans. C<br />Q 120. In a patient of acute inferior wall MI. Best modality of treatment is:<br />A. IV fluids<br />B. Digoxin<br />C. Diuretics<br />D. Vasodilators<br />Ans. A<br />Q 121. A 26 years old asymptomatic woman is found to have arrhythmias and a systolic murmur associated with midsystolic ? . Which investigation would you use:<br />A. Electrophysiological testing<br />B. CT scan<br />C. Echocardiography<br />D. Angiography<br />Ans. C<br />Q 122. A patient complains of intermittent claudication, dizziness and headache. Most likely cardiac lesion is:<br />A. TOF<br />B. ASD<br />C. PDA<br />D. Coarctation of aorta<br />Ans. D<br />Q 123. All of the following are true about ASD except:<br />A. Right atrial hypertrophy<br />B. Left atrial hypertrophy<br />C. Right ventricular hypertrophy<br />D. Pulmonary hypertension<br />Ans. B<br />Q 124. Mitral valve vegetations do not usually embolise to:<br />A. Lung<br />B. liver<br />C. spleen<br />D. brain<br />Ans. A<br />Q 125. A woman has septic abortion done, vegetation on tricuspid valve is likely to go to:<br />A. Septic infarcts to lung<br />B. liver<br />C. spleen infarcts<br />D. Emboli to brain<br />Ans. A<br />Q 126. Kussmaul’s sign is not seen in:<br />A. Restrictive cardiomyopathy<br />B. Constrictive pericarditis<br />C. Cardiac tamponade<br />D. RV infarct<br />Ans. C<br />Q 127. A patient presents with engorged neck veins, BP 80/50 mmHg and pulse rate of 100/min following blunt trauma to the chest. Diagnosis is:<br />A. Pneumothorax<br />B. Right ventricular failure<br />C. Cardiac tamponade<br />D. Hemothorax<br />Ans. C<br />Q 128. Which of the following is not seen on hemoglobin electrophoresis in sickle cell anemia:<br />A. HbA<br />B. HbA2<br />C. HbF<br />D. HbS<br />Ans. A<br />Q 129. False statement regarding DIC is:<br />A. Thrombocytopenia<br />B. Decreased fibrinogen<br />C. Decreased PTT<br />D. Increased PT<br />Ans. C<br />Q 130. Thrombocytopenia occurs in all except:<br />A. Henoch Schonlein purpura<br />B. TTP<br />C. DIC<br />D. Leukemia<br />Ans. A<br />Q 131. A patient with an Hb of 6 g%, WBC count of 2000/cmm, has a normal different count except for having 6% blasts, platelets are reduced to 80,000/cmm; moderate splenomegaly is present. Possible diagnosis is:<br />A. Leukemia<br />B. Aplastic anemia<br />C. HEMOLYSIS<br />D. lTP<br />Ans. A<br />Q 132. A patient being investigated for anemia has a dry marrow tap; peripheral smear reveals tear drop cells. Most likely diagnosis is:<br />A. Leukemia<br />B. Lymphoma<br />C. Myelofibrosis<br />D. Polycythemia rubra vera<br />Ans. C<br />Q 133. Tumor associated with polycythemia vera is:<br />A. Sarcoma<br />B. Pituitary adenoma<br />C. Cerebellar haemangioblastoma<br />D. None of the above<br />Ans. C<br />Q 134. A young patient presents with jaundice. Total bilirubin is 21 mg%, direct is 9.6 mg%, alkaline phosphatase is 84 KA units. Diagnosis is:<br />A. Hemolytic jaundice<br />B. Viral hepatitis<br />C. Chronic active hepatitis<br />D. Obstructive jaundice<br />Ans. D<br />Q 135. A young male with gallbladder stones shows the following test results: serum bilirubin 2.5 mg%, Hb 6 g%, urine test positive for urobilinogen. Diagnosis is:<br />A. Hemolytic jaundice<br />B. Obstructive jaundice<br />C. Hepatocellular jaundice<br />D. Protoporphyria<br />Ans. A<br />Q 136. An 18 years old male presents with massive hematemesis. He has history of fever for the past 14 days for which he was managed with drugs. Moderate splenomegaly is present. Diagnosis is:<br />A. NSAID induced duodenal ulcer<br />B. Drug induced gastritis<br />C. Esophageal varices<br />D. None of the above<br />Ans. C<br />Q 137. Urinalysis shows RBC casts. Likely source is:<br />A. kidney<br />B. Ureter<br />C. Bladder<br />D. Urethra<br />Ans. A<br />Q 138. A young man develops gross hematuria 3 days after an attack of URTI. Most likely renal Pathology is:<br />A. Acute glomerulonephritis<br />B. Minimal change disease<br />C. IgA nephropathy<br />D. Membranous glomerulonephritis<br />Ans. C<br />Q 139. A patient’s CSF report reads as follows: sugar 40 mg%, protein 150 mg%, chloride 550 mg%; lymphocytosis present. The picture is suggestive of:<br />A. Fungal meningitis<br />B. Viral meningitis<br />C. TB meningitis<br />D. Leukemia<br />Ans. C<br />Q 140. Lacunar infarcts are caused by:<br />A. Lipohyalinosis of penetrating arteries<br />B. Middle carotid artery involvement<br />C. Emboli to anterior circulation<br />D. None of the above<br />Ans. A<br />Q 141. Dinesh, a 56 years aged man presents with complaints of slowness of movements, postural instability, tremors, rigidity and memory loss. Most likely diagnosis is:<br />A. Multi-infarct dementia<br />B. Alzheimer’s disease<br />C. Parkinsonism<br />D. None of the above<br />Ans. C<br />Q 142. All of the following may be seen in Wilson’s disease except:<br />A. Cerebellar ataxia<br />B. Peripheral neuropathy<br />C. Dysphagia<br />D. Chorea<br />Ans. B<br />Q 143. An elderly man presents with features of dementia, ataxia, difficulty in downward gaze and a history of frequent falls. Likely diagnosis is:<br />A. Parkinson disease<br />B. Progressive supranuclear gaze palsy<br />C. Alzheimer’s disease<br />D. None of the above.<br />Ans. B<br />Q 144. A chromosomal anomaly associated with Alzheimer’s dementia is:<br />A. Trisomy 18<br />B. Patau syndrome<br />C. Trisomy 21<br />D. Turner syndrome<br />Ans. C<br />Q 145. All are true about Huntington’s disease, except:<br />A. Chorea<br />B. Depression, apathy<br />C. Progressive dementia<br />D. Cog-wheel rigidity<br />Ans. D<br />Q 146. A 30-year-old male complains of loss of erection; he has low testosterone and high prolactin level in blood. What is the likely diagnosis:<br />A. Pituitary adenoma<br />B. Testicular failure<br />C. Craniopharyngioma<br />D. Cushing’s syndrome<br />Ans. A<br />Q 147. A patient meets with an accident with resultant transection of the pituitary stalk. What will not occur:<br />A. Diabetes mellitus<br />B. Diabetes insipidus<br />C. Hyperprolactinemia<br />D. Hypothyroidism<br />Ans. A<br />Q 148. A woman has bilateral headache that worsens with emotional stress. She has two children, both doing badly in school. Diagnosis is:<br />A. Migraine<br />B. Cluster headache<br />C. Tension headache<br />D. Trigeminal neuralgia<br />Ans. C<br />Q 149. A female aged 30 years, presents with episodic throbbing headache for past 4 years with nausea and vomiting. Most likely diagnosis is:<br />A. Migraine<br />B. Cluster headache<br />C. Angle closure glaucoma<br />D. Temporal arteritis<br />Ans. A<br />Q 150. A woman complains of headache associated with paresthesias of the right upper and lower limb. Most likely diagnosis is:<br />A. Trigeminal neuralgia<br />B. Glossopharyngeal neuralgia<br />C. Migraine<br />D. Cluster headache<br />Ans. C<br />Q 151. All of the following are features of MEN IIa, except:<br />A. Pituitary tumor<br />B. Pheochromocytoma<br />C. Medullary CA thyroid<br />D. Parathyroid adenoma<br />Ans. A<br />Q 152. A patient with Cushingoid features presents with hemoptysis. He shows no response to dexamethasone suppression test. Most likely diagnosis is:<br />A. Adrenal hyperplasia<br />B. Adrenal adenoma<br />C. CA lung with ectopic ACTH production<br />D. Pituitary microadenoma<br />Ans. C<br />Q 153. An obese patient presented in casualty in an unconscious state. His blood sugar measured 400 mg%, urine tested positive for sugar and ketones. Drug most useful in management is:<br />A. Glibenclamide<br />B. Troglitazone<br />C. Insulin<br />D. Chlorpropamide<br />Ans. C<br />Q 154. Which of the following is not associated with thymoma:<br />A. Red cell aplasia<br />B. Myasthenia gravis<br />C. Hypergammaglobulinemia<br />D. Compression of the superior mediastinum<br />Ans. C<br />Q 155. A young basketball player with height 188 cm and arm span 197 cm has a diastolic murmur best heard in second right intercostal space. Likely cause of murmur is:<br />A. AS<br />B. Coarctation of aorta<br />C. AR<br />D. MR<br />Ans. C<br />Q 156. A patient presents with arthritis, hyperpigmen- tation of SKIN and hypogonadism. Likely diagnosis is:<br />A. Hemochromatosis<br />B. Ectopic ACTH secreting tumor of lung<br />C. Wilson’s disease<br />D. Rheumatoid arthrits<br />Ans. A<br />Q 157. In myasthenia gravis, correct statement regarding thymectomy is:<br />A. Should be done in all cases<br />B. Should be done in cases with ocular involvement only<br />C. Not required if controlled by medical management<br />D. Should be done only in cases that are associated with thymoma<br />Ans. A<br />Q 158. Most common fungal infection in febrile neutropenia is:<br />A. Aspergillus niger<br />B. Candida<br />C. Mucormycosis<br />D. Aspergillus fumigatus<br />Ans. B<br />Q 159. The following group of tests should be done to optimise graft uptake in bone marrow transplant:<br />A. Blood grouping<br />B. HLA matching<br />C. Culture for infection<br />D. All of the above<br />Ans. B<br />Q 160. True statement about neurocysticercosis is:<br />A. Seizures due to neurocysticercosis are resistant to antiepileptic drugs<br />B. Albendazole is superior to praziquantel in the treatment of above condition<br />C. Common presentation is 6th cranial nerve palsy and hemiparesis<br />D. Steroids are used in the management of hydrocephalus<br />Ans. B<br />Q 161. All of the following are true regarding a patient with acid peptic disease except:<br />A. Misoprostol is the drug of choice in patients on NSAIDs<br />B. DU is preventable by the use of single night-time H2 blockers<br />C. Omeprazole may help ulcers refractory to H2 blockers<br />D. Misoprostol is DOC in pregnant patients<br />Ans. D<br />Q 162. A man presents with mass at duodenojejunal flexure invading renal papillae. Histopathology reports it as lymphoma. True statement is:<br />A. II E stage<br />B. III E stage<br />C. IV E stage<br />D. Staging cannot be done until bone marrow examination is performed<br />Ans. C<br />Q 163. A 45 years male presents with hypertension. He has sudden abnormal flinging movements in right upper and lower limbs. Most likely site of hemorrahge is:<br />A. Substantia nigra<br />B. Caudate nuclei<br />C. Pons<br />D. Subthalamic nuclei<br />Ans. D<br />Q 164. True about haemophilia A are all except:<br />A. PTT increased<br />B. PT increased<br />C. Clotting time is increased<br />D. Serum levels of factor VIII are decreased<br />Ans. B<br />Q 165. IPPV can cause:<br />A. Barotrauma<br />B. Pleural effusion<br />C. Increased venous return<br />D. None of the above<br />Ans. A<br />Q 166. Characteristic finding in CT in a TB is:<br />A. Exudate seen in basal cistern<br />B. Hydrocephalus is non communicating<br />C. Calcification commonly seen in cerebellum<br />D. Ventriculitis is a common finding<br />Ans. A<br /><br />Q 167. Vegetations on undersurface of AV valves are found in:<br />A. Acute rheumatic carditis<br />B. Limban Sack’s endocarditis<br />C. Non thrombotic bacterial endocarditis<br />D. Chronic rheumatic carditis<br />Ans. B<br />Q 168. Triage means:<br />A. Sorting out of cases on availability of medical resources and severity of patient’s condition<br />B. Patients are divided into 3 groups<br />C. Severely injured patients are attended first in military camps<br />D. None of the above<br />Ans. A<br />PEDIATRICS<br />Q 169. Which of the following is not true about atrial septal defect:<br />A. There is a defect in region of fossa ovalis<br />B. Blood flow from left atrium to right atrium<br />C. Increased blood flow through lungs lead to pulmonary plethora<br />D. There is splitting of first heart sound<br />Ans. D<br />Q 170. A neonate presents with jaundice and clay white stools. On liver biopsy giant cells are seen. Most likely diagnosis is:<br />A. Physiological jaundice<br />B. Neonatal hepatitis with extra biliary atresia<br />C. Neonatal hepatitis with physiological jaundice<br />D. Extra biliary atresia<br />Ans. B<br />Q 171. A newborn has dribbling after feeds. He has respiratory distress and froth at the mouth. Diagnosis is:<br />A. Tracheoesophageal fistula<br />B. Tetralogy of Fallot<br />C. Respiratory distress syndrome<br />D. None of the above<br />Ans. A<br />Q 172. Ramu, a 8-years-old boy presents with upper GI bleeding. On examination, he is found to have splenomegaly; there are no signs of ascites, or hepatomegaly; esophageal varices are found on UGIE. Most likely diagnosis is:<br />A. Budd Chiari syndrome<br />B. Non cirrhotic portal fibrosis<br />C. Cirrhosis<br />D. Veno-occlusive disease<br />Ans. B<br />Q 173. A 5-years-old child suffering from nephrotic syndrome is responding well to steroid therapy. What would be the most likely finding on light microscopy:<br />A. No finding<br />B. Basement membrane thickening<br />C. Hypercellular glomeruli<br />D. Fusion of foot processes<br />Ans. A<br />Q 174. Most common cause of urinary obstruction in a male infant is:<br />A. Anterior urethral valves<br />B. Posterior urethral valves<br />C. Stone<br />D. Stricture<br />Ans. B<br />Q 175. A 5-years-old child presents with a calculus of size 2 cm in the upper ureter. He also complains of haematuria. USG shows no further obstruction in the urinary tract. Treatment of choice for this patient would be:<br />A. Ureterolithotomy<br />B. Endoscopic removal<br />C. ESWL<br />D. Observation<br />Ans. C<br />Q 176. A patient presents with LVH and pulmonary complications. ECG shows left axis deviation. Most likely diagnosis is:<br />A. TOF<br />B. Tricuspid atresia<br />C. TAPVC<br />D. VSD<br />Ans. B<br />Q 177. Potts shunt is anastomosis of:<br />A. Right subclavian artery to right pulmonary artery<br />B. Descending aorta to left pulmonary artery<br />C. Left subclavian to left pulmonary artery<br />D. Ascending aorta to right pulmonary artery<br />Ans. B<br />Q 178. A neonate has recurrent attacks of abdominal pain, restless, irritability and diaphoresis on feeding. Cardiac auscultation reveals a nonspecific murmur. He is believed to be at risk for MI. Likely diagnosis is:<br />A. ASD<br />B. VSD<br />C. TOF<br />D. Anomalous coronary artery<br />Ans. D<br />Q 179. A child aged 2 years presents with nonspecific symptoms suggestive of anemia. On peripheral blood smear target cells are seen. He has hypochromic microcytic picture and Hb of 6 gm%. He also has ‘a positive family history’. Next investigation of choice is:<br />A. Hb electrophoresis<br />B. Coombs’ test<br />C. liver function tests<br />D. Osmotic fragility test<br />Ans. A<br />Q 180. Most common cause of meningitis in children between 6 months to 2 years of age is:<br />A. Pneumococcus<br />B. Staphylococcus<br />C. H. influenzae<br />D. E. coli<br />Ans. C<br />Q 181. A child presents with seborrheic dermatitis, lytic skull lesions, ear discharge and hepatosplenomegaly. Likely diagnosis is:<br />A. Leukemia<br />B. Lymphoma<br />C. Histiocytosis X<br />D. Multiple myeloma<br />Ans. C<br />Q 182. Which of the following is true regarding cretinism:<br />A. Short limbs compared to trunk<br />B. Proportionate shortening<br />C. Short limbs and short stature<br />D. Short limbs and long stature<br />Ans. C<br />Q 183. Manifestations of endemic cretinism include:<br />A. Deafness and facial nerve involvement<br />B. Blindness and hypothyroidism<br />C. Goitre and hypothyroidism<br />D. Multinodular goitre and mental retardation<br />Ans. A<br />Q 184. A 10 day old male pseudohermaphrodite child with 46 XY karyotype presents with BP of 110/80 mmHg. Most likely enzyme deficiency is:<br />A. 21 hydroxylase<br />B. 17 hydroxylase<br />C. 11 hydroxylase<br />D. 3-beta hydroxylase<br />Ans. B<br />Q 185. Treatment of Kawasaki disease in children is:<br />A. Oral steroids<br />B. IV steroids<br />C. IV Ig<br />D. Mycophenolate mefentil<br />Ans. C<br />Q 186. A neonate delivered at 32 weeks, is put on a ventilator. X-ray shows ‘white out lung’ and ABG reveals PO2 of 75. Ventilator settings are on, FIO2 of 70, and rate of 50/minute. Next step to be taken should be:<br />A. Increase rate to 60 per minute<br />B. Increase FIO2 to 80<br />C. Continue ventilation with the same settings<br />D. Weaning ventilator<br />Ans. C<br />Dermatology<br />Q 187. A man aged 50 years presents with, alopecia, boggy scalp swelling and easily pluckable hair. Next step in establishing the diagnosis would be:<br />A. KOH smear<br />B. Culture sensitivity<br />C. Biopsy<br />D. None of the above<br />Ans. A<br />Q 188. Most common organism causing tinea capitis is:<br />A. Trichophyton tonsurans<br />B. Microsporum<br />C. Epidermophyton<br />D. Candida albicans<br />Ans. A<br />Q 189. A young man aged 19 years develops a painless penile ulcer 9 days after sexual intercourse with a professional SEX worker. Most likely diagnosis is:<br />A. Chancroid<br />B. Herpes<br />C. Primary chancre<br />D. Traumatic ulcer<br />Ans. C<br />Q 190. An infant presents with itchy lesions over the groin and prepuce. All of the following are indicated in this patient except:<br />A. Bathe and apply scabicidal solution<br />B. Treatment should be extended to all family members<br />C. Dispose all clothes by burning<br />D. Start the patient on IV antibiotics<br />Ans. D<br />Q 191. A boy aged 8 years from Tamil Nadu presents with a white, non anesthetic, nonscaly, hypopigmented macule on his face. Most likely diagnosis is:<br />A. Pityriasis alba<br />B. Pityriasis versicolor<br />C. Indeterminate leprosy<br />D. Pure neuritic leprosy<br />Ans. C<br />Q 192. A 20 years old, male patient, from jaipur presents with an erythematous lesion on the cheek with central crusting. Most likely diagnosis is:<br />A. SLE<br />B. LUPUS vulgaris<br />C. Chillblains<br />D. Cutaneous leishmaniasis<br />Ans. D<br />Q 193. A 19 year old pregnant girl presents with light brown pigmentation over the malar eminences. Most likely diagnosis is:<br />A. Chloasma<br />B. SLE<br />C. Melasma<br />D. Melanoma<br />Ans. A<br />Q 194. A girl aged 19, presents with arthritis and a photosensitive rash on the cheek. Likely diagnosis is:<br />A. SLE<br />B. Chloasma<br />C. Stevens Johnson syndrome<br />D. Lyme’s disease<br />Ans. A<br />Psychiatry<br />Q 195. A patient with pneumonia for 5 days is admitted to the hospital. He suddenly ceases to recognize the doctor and staff, thinks that he is in jail and complains of scorpions attacking him. He is in altered sensorium. This condition is:<br />A. Acute delirium<br />B. Acute dementia<br />C. Acute schizophrenia<br />D. Acute paranoia<br />Ans. A<br />Q 196. A person missing from home, is found wandering purposefully. He is well groomed, and denies of having any amnesia. Most likely diagnosis is:<br />A. Dissociative fugue<br />B. Dissociative amnesia<br />C. Schizophrenia<br />D. Dementia<br />Ans. A<br />Q 197. Babu, a 40 years aged male complains of sudden onset palpitations and apprehension. He is sweating for the last 10 minutes and fears of impending death. Diagnosis is:<br />A. Hysteria<br />B. Cystic fibrosis<br />C. Panic attack<br />D. Generalized anxiety disorder<br />Ans. C<br />Q 198. A lady, while driving a car meets with an accident. She was admitted in an ICU for 6 months. After being discharged, she often gets up in night and feels terrified She is afraid to sit in a car again. The diagnosis is:<br />A. Panic disorder<br />B. Phobia<br />C. Conversion disorder<br />D. Post traumatic stress disorder<br />Ans. D<br />Q 199. A patient present with waxy flexibility, negativitism and rigidity. Diagnosis is:<br />A. Catatonic schizophrenia<br />B. Paranoid schizophrenia<br />C. Hebephrenic schizophrenia<br />D. Simple schizophrenia<br />Ans. A<br />Q 200. Chandu, age 32 presents with abdominal pain and vomiting. He also complains of some psychiatric symptoms and visual hallucinations. Most likely diagnosis is:<br />A. Intermittent porphyria<br />B. Hypothyroidism<br />C. Hyperthyroidism<br />D. Hysteria<br />Ans. A<br />Q 201. Basanti 27 years aged, female thinks her nose is ugly; her idea is fixed and not shared by anyone else. Whenever she goes out of home, she hides her face with a cloth. She visits a Surgeon. Next step would be:<br />A. Investigate and then operate<br />B. Refer to psychiatrist<br />C. Reassure the patient<br />D. Immediate operation<br />Ans. B<br />Surgery<br />Q 202. A male aged 60 years has foul breath. He regurgitates food that is eaten 3 days ago. Likely diagnosis is:<br />A. Zenker’s diverticulum<br />B. Meckel’s diverticulum<br />C. Scleroderma<br />D. Achalasia cardia<br />Ans. A<br />Q 203. Most common site for squamous cell carcinoma esophagus is:<br />A. Upper third<br />B. Middle third<br />C. Lower third<br />D. Gastro-esophageal junction.<br />Ans. B<br />Q 204. What is true regarding congenital hypertrophic pyloric stenosis:<br />A. More common in girls<br />B. Hypochloremic alkalosis<br />C. Heller’s myotomy is the procedure of choice.<br />D. Most often manifests at birth<br />Ans. B<br />Q 205. Patient presents with recurrent duodenal ulcer of 2.5 cm size. Procedure of choice is:<br />A. Truncal vagotomy and antrectomy<br />B. Truncal vagotomy and gastrojejunostomy<br />C. Highly selective vagotomy<br />D. Laparoscopic vagotomy and gastrojejunostomy<br />Ans. A<br />Q 206. All are features of hyperplastic tuberculosis of gastrointestinal tract except:<br />A. Presents with a mass in RIF<br />B. Barium meal shows pulled up caecum<br />C. Most common site is ileocecal junction<br />D. ATT is the treatment of choice<br />Ans. D<br />Q 207. A 56 year old woman has not passed stools for the last 14 days. X-ray shows no air/fluid levels. Probable diagnosis is:<br />A. Paralytic ileus<br />B. Aganglionosis of the colon<br />C. Intestinal pseudo-obstruction<br />D. Duodenal obstruction.<br />Ans. C<br />Q 208. A man aged 60 years has history of IHD and atherosclerosis. He presents with abdominal pain and maroon stools. Most likely diagnosis is:<br />A. Acute intestinal obstruction<br />B. Acute mesenteric ischemia<br />C. Peritonitis<br />D. Appendicitis<br />Ans. B<br />Q 209. True statement regarding ‘fistula in ano’ is:<br />A. Posterior fistulae have straight tracks<br />B. High fistulae can be operated with no fear of incontinence<br />C. High and low divisions are made in relation to the pelvic floor<br />D. Intersphincteric is the most common type<br />Ans. D<br />Q 210. In a 27 year old male most common cause of a colovesical fistula would be:<br />A. Crohn’s disease<br />B. Ulcerative colitis<br />C. TB<br />D. Cancer colon<br />Ans. A<br />Q 211. Following trauma, a patient presents with a drop of blood at the tip of urinary meatus. He complains of inability to pass urine. Next step should be:<br />A. IVP should be done<br />B. MCU should be done<br />C. Catheterize, drain bladder and remove the catheter thereafter<br />D. Catheterize, drain bladder and retain the catheter thereafter<br />Ans. D<br />Q 212. Chandu, a 45 years male shows calcification on the right side of his abdomen in an AP view. In lateral view the calcification is seen to overlie the spine. Most likely diagnosis is:<br />A. Gallstones<br />B. Calcified mesenteric nodes<br />C. Renal stones<br />D. Calcified rib<br />Ans. C<br />Q 213. CA prostate commonly metastasises to the vertebrae because:<br />A. Valveless communication exist with Batson’s prevertebral plexus<br />B. Via drainage to sacral lymph node<br />C. Of direct spread<br />D. None of above<br />Ans. A<br />Q 214. Following sexual intercourse, a person develops pain in the left testes that does not get relieved on elevation of scrotum. Diagnosis is:<br />A. Epididymo-orchitis<br />B. Torsion testis<br />C. Fournier’s gangrene<br />D. Tumor testes<br />Ans. B<br />Q 215. A testicular tumor in a man aged 60 years is most likely to be:<br />A. Germ cell tumor<br />B. Sertoli cell tumor<br />C. Teratocarcinoma<br />D. Lymphoma<br />Ans. D<br />Q 216. A patient presents with bilateral proptosis, heat intolerance and palpitations. Most unlikely diagnosis here would be:<br />A. Hashimoto’s thyroiditis<br />B. Thyroid adenoma<br />C. Diffuse thyroid igoitre<br />D. Reidel’s thyroiditis<br />Ans. D<br />Q 217. A patient with long standing multinodular goitre develops hoarseness of voice. Also, the swelling undergoes sudden increase in size. Likely diagnosis is:<br />A. Follicular CA<br />B. Papillary CA<br />C. Medullary CA<br />D. Anaplastic CA<br />Ans. A<br />Q 218. A patient presents with swelling in the neck following a thyroidectomy. What is the most likely resulting complication:<br />A. Respiratory obstruction<br />B. Recurrent laryngeal nerve palsy<br />C. Hypovolemia<br />D. Hypocalcemia<br />Ans. A<br />Q 219. A patient on the same evening following thyroidectomy presents with a swelling in the neck and difficulty in breathing. Next management would be:<br />A. Open sutures immediately<br />B. Intubate oro-tracheally<br />C. Wait and watch<br />D. Administer oxygen by mask<br />Ans. A<br />Q 220. Patient presents with neck swelling and respiratory distress few hours after a thyroidectomy Surgery . Next management would be:<br />A. Open immediately<br />B. Tracheostomy<br />C. Wait and watch<br />D. Oxygen by mask<br />Ans. A<br />Q 221. A patient undergoes thyroid Surgery , following which he develops perioral tingling. Blood Ca2+ is 8.9 mEq. Next step is:<br />A. Vitamin D orally<br />B. Oral Ca2+ and vitamin D<br />C. Intravenous calcium gluconate and serial monitoring<br />D. Wait for Ca2+ to decrease to < 7.0 before taking further action<br />Ans. C<br />Q 222. A case of blunt trauma is brought to the emergency in a state of shock. He is not responding to IV crystalloids. Next step in his management would be:<br />A. Immediate laparotomy<br />B. Blood transfusion<br />C. Albumin transfusion<br />D. Abdominal compression<br />Ans. A<br />Q 223. Babu is brought to the emergency as a case of road- traffic accident. He is hypotensive. Most likely ruptured organ is:<br />A. spleen<br />B. Mesentery<br />C. kidney<br />D. Rectum<br />Ans. A<br />Q 224. A patient is brought to the emergency as a case of head injury, following a head on collision road traffic accident. His BP is 90/60 mmHg. Tachycardia is present. Most likely diagnosis is:<br />A. EDH<br />B. SDH<br />C. Intracranial hemorrhage<br />D. Intra-abdominal bleed<br />Ans. D<br />Q 225. Ulcer that may develop in burn tissue is:<br />A. Marjolin’s<br />B. Rodent<br />C. Melanoma<br />D. Curling’s<br />Ans. A<br />Q 226. An elderly man presents with history of abdominal pain. He is found to have a fusiform dilatation of the descending aorta. Likely cause is:<br />A. Trauma<br />B. Atherosclerosis<br />C. Right ventricular failure<br />D. Syphilitic aortitis<br />Ans. B<br />Q 227. All of the following are correct regarding AV fistula except:<br />A. Arterialization of the veins<br />B. Proximal compression causes increase in heart rate<br />C. Overgrowth of a limb<br />D. Causes LV enlargement and LV failure<br />Ans. B<br />Q 228. All of the following are correct about axillary vein thrombosis except:<br />A. May be caused by a cervical rib<br />B. Treated with IV anticoagulant<br />C. Embolectomy is done in all cases<br />D. May occur following excessive exercise<br />Ans. C<br />Q 229. A 80 year old patient presents with a midline tumor of the lower jaw, involving the alveolar margin. He is edentulous. Treatment of choice is:<br />A. Hemimandibulectomy<br />B. Commando operation<br />C. Segmental mandiblectbmy<br />D. Marginal mandibulectomy<br />Ans. C<br />Q 230. Most common cause of unilateral parotid swelling in a 27 year old male is:<br />A. Warthin’s tumor<br />B. Pleomorphic adenoma<br />C. Adenocarcinoma<br />D. Haemangioma<br />Ans. B<br />Q 231. A 45 year old woman presents with a hard and mobile lump in the breast. Next investigation is:<br />A. FNAC<br />B. USG<br />C. Mammography<br />D. Excision biopsy<br />Ans. A<br />Q 232. A 45 years old man presents with progressive cervical lymph nodes enlargement since 3 month. Most diagnostic investigation is:<br />A. X-ray soft tissue<br />B. FNAC<br />C. Lymph node biopsy<br />D. None of the above<br />Ans. C<br />Q 233. All of the following are true about fibrolamellar carcinoma of the liver except:<br />A. Equal incidence in males and females<br />B. Better prognosis than HCC<br />C. AFP levels always greater than > 1000<br />D. Occur in younger individuals<br />Ans. C<br />Q 234. A child presents with an expansible swelling on medial side of the nose . Likely diagnosis is:<br />A. Teratoma<br />B. Meningocele<br />C. Dermoid cyst<br />D. Lipoma<br />Ans. B<br />orthopaedics<br />Q 235. Following anterior dislocation of the shoulder, a patient develops weakness of flexion at elbow and lack of sensation over the lateral aspect fore arm. Nerve injured is:<br />A. Radial nerve<br />B. Musculocutaneous nerve<br />C. Axillary nerve<br />D. Ulnar nerve<br />Ans. B<br />Q 236. Babloo a 10 years old boy presents with FRACTURE of humerus. X-ray reveals a lytic lesion at the upper end. Likely condition is:<br />A. Unicameral bone cyst<br />B. Osteosarcoma<br />C. Osteoclastoma<br />D. Aneurysmal bone cyst<br />Ans. A<br />Q 237. A patient sustained injury to the upper limb 3 years back. He now presents with valgus deformity in the elbow and paresthesias over the medial border of the hand. The injury is likely to have been:<br />A. Supracondylar FRACTURE humerus<br />B. Lateral condyle FRACTURE humerus<br />C. Medial condyle FRACTURE humerus<br />D. Posterior dislocation of the humerus<br />Ans. B<br />Q 238. A woman aged 60 years suffers a fall. Her lower limb is abducted and externally rotated. Likely diagnosis is:<br />A. Neck of femur FRACTURE<br />B. Intertrochanteric femur FRACTURE<br />C. Posterior dislocation of hip<br />D. Anterior dislocation of hip<br />Ans. D<br />Q 239. Triple arthrodesis involves:<br />A. Calcaneocuboid, talonavicular and talocalcaneal<br />B. Tibiotalar, calcaneocuboid and talonavicular<br />C. Ankle joint, calcaneocuboid and talonavicular<br />D. None of the above<br />Ans. A<br />Q 240. Babu a 19 years old male has a small circumscribed sclerotic swelling over diaphysis of femur. Likely diagnosis is:<br />A. Osteoclastoma<br />B. Osteosarcoma<br />C. Ewing’s sarcoma<br />D. Osteoid osteoma<br />Ans. D<br />Q 241. Most common site of osteogenic sarcoma is:<br />A. Femur, upper end<br />B. Femur, lower end<br />C. Tibia, upper end<br />D. Tibia, lower end<br />Ans. B<br />Q 242. Involvement of PIP joint, DIP joint and the carpometacarpal joint of base of thumb with sparing the wrist is seen in:<br />A. Rheumatoid arthritis<br />B. Osteoarthritis<br />C. Psoriatic arthritis<br />D. Pseudogout<br />Ans. B<br />Q 243. The pivot test is for:<br />A. Anterior cruciate ligament<br />B. Posterior cruciate ligament<br />C. Medial meniscus<br />D. Lateral meniscus<br />Ans. A<br />Q 244. Iliotibial band contracture following polio is likely to result in:<br />A. Extension at hip<br />B. Extension at knee<br />C. Flexion at hip and knee<br />D. Extension at hip and knee<br />Ans. C<br />Anaesthesia<br />Q 245. All of the following agents can be given for induction of Anaesthesia in children except:<br />A. Halothane<br />B. Servoflurane<br />C. Morphine<br />D. Nitrous oxide<br />Ans. C<br />Q 246. Anaesthetic agent of choice in renal failure is:<br />A. Methoxyflurane<br />B. Isoflurane<br />C. Enflurane<br />D. None of the above<br />Ans. B<br />Q 247. A man with alcoholic liver failure requires general Anaesthesia for Surgery . Anaesthetic agent of choice is:<br />A. Ether<br />B. Halothane<br />C. Methoxyflurane<br />D. Isoflurane<br />Ans. D<br />Q 248. All of the following are true except:<br />A. Halothane is good as an analgesic agent<br />B. Halothane sensitises the heart to action of catacholamines<br />C. Halothane relaxes brochi & is preferred as anaesthetics<br />D. Halothane may cause liver cell necrosis<br />Ans. A<br />Ophthalmology<br />Q 249. A patient has a miotic pupil, IOP= 25, normal anterior chamber, hazy cornea and a shallow anterior chamber in fellow eye . Diagnosis is:<br />A. Acute anterior uveitis<br />B. Acute angle closure glaucoma<br />C. Acute open angle glaucoma<br />D. Senile cataract<br />Ans. A<br />Q 250. A woman complains of coloured haloes around lights in the evening, with nausea and vomiting, IOP is normal. Diagnosis is:<br />A. Incipient stage, glaucoma open angle<br />B. Prodromal stage, closed angle glaucoma<br />C. Migraine<br />D. Raised ICT<br />Ans. B<br />Q 251. Babloo, a 5 years old child, presents with large cornea, lacrimation and photophobia. Diagnosis is:<br />A. Megalocornea<br />B. Congenital glaucoma<br />C. Congenital cataract<br />D. Anterior uveitis<br />Ans. B<br />Q 252. Herpes zoster ophthalmicus causes all except:<br />A. Nummular keratitis<br />B. Vitreal haemorrhage<br />C. Uveitis<br />D. Cranial nerve palsies<br />Ans. B<br />Q 253. Bilateral ptosis is not seen in:<br />A. Marfan’s syndrome<br />B. Myaesthenia gravis<br />C. Myotonic dystrophy<br />D. Kearns-Sayre syndrome<br />Ans. A<br />Q 254. eye is deviated laterally and downwards and patient is unable to look up or medially. Likely nerve involved is:<br />A. Trochlear<br />B. Trigeminal<br />C. Oculomotor<br />D. Abducent<br />Ans. C<br />Q 255. Left sided lateral gaze is affected in lesion of:<br />A. Right frontal lobe<br />B. Right occipital lobe<br />C. Left occipital lobe<br />D. Left frontal lobe<br />Ans. A<br />Q 256. An elderly male with heart disease presents with sudden loss of vision in one eye . Examination reveals cherry red spot. Diagnosis is:<br />A. Central retinal vein occlusion<br />B. Central retinal artery occlusion<br />C. Amaurosis fugax<br />D. Acute ischemic optic neuritis<br />Ans. B<br />Q 257. Which of following, is not a feature in diabetic retinopathy on fundus examination:<br />A. Microaneurysms<br />B. Retinal hemorrhages<br />C. Arteriolar dilatation<br />D. Neovascularisation<br />Ans. C<br />Q 258. Vitamin B12 deficiency is likely to cause:<br />A. Bitemporal hemianopia<br />B. Binasal hemianopia<br />C. Heteronymous hemianopia<br />D. Centrocecal scotoma<br />Ans. D<br />Q 259. All are true regarding optic neuritis except:<br />A. Decreased visual acuity<br />B. Decreased pupillary reflex<br />C. Abnormal electroretinogram<br />D. Abnormal visual evoked response retinogram<br />Ans. C<br />Q 260. Chalky white optic disc on fundus examination is seen in all except:<br />A. Syphilis<br />B. Leber’s hereditary optic neuropathy<br />C. Post papilledema optic neuritis<br />D. Traumatic injury to the optic nerve<br />Ans. D<br />ENT<br />Q 261. A 3 months old child presents with intermittent stridor. Most likely cause is:<br />A. Laryngotracheobronchitis<br />B. Laryngomalacia<br />C. Respiratory obstruction<br />D. Foreign body aspiration<br />Ans. B<br />Q 262. A patient presents with facial nerve palsy following head trauma with FRACTURE of the mastoid. Best intervention here is:<br />A. Immediate decompression<br />B. Wait and watch<br />C. Facial sling<br />D. Steroids<br />Ans. A<br />Q 263. A case of Bell’s palsy on steroids shows no improvement after 2 weeks. The next step in management should be:<br />A. Vasodilators and ACTH<br />B. Physiotherapy and electrical stimulation<br />C. Increase steroid dosage<br />D. Electrophysiological nerve testing<br />Ans. D<br />Q 264. Chandu a 15 years aged boy presents with unilateral nasal blockade, mass in the cheek and epistaxis. Likely diagnosis is:<br />A. Nasopharyngeal CA<br />B. Angiofibroma<br />C. Inverted papilloma<br />D. None of the above<br />Ans. B<br />Q 265. A 40 years old diabetic presents with blackish nasal discharge and a mass in the nose . Likely diagnosis is:<br />A. Mucormycosis<br />B. Actinomycosis<br />C. Rhinosporiodosis<br />D. Histoplasmosis<br />Ans. A<br />Q 266. Most radiosensitive tumour of the following is:<br />A. Supraglortic CA<br />B. CA glottis<br />C. CA nasopharynx<br />D. Subglottic CA<br />Ans. C<br />OBSTETRICS & Gynaecology<br />Q 267. Rokitansky Kuster Hauser syndrome is associated with:<br />A. Ovarian agenesis<br />B. Absent fallopian tube<br />C. Vaginal atresia<br />D. Bicornuate uterus<br />Ans. C<br />Q 268. A patient of 47 XXY karyotype presents with features of hypogonadism. The likely diagnosis is:<br />A. Turner syndrome<br />B. Klinefelter syndrome<br />C. Edward syndrome<br />D. Down syndrome<br />Ans. B<br />Q 269. A girl presents with primary amenorrhea, grade V thelarche, grade II pubarche, no axillary hair. The likely diagnosis is:<br />A. Testicular feminization<br />B. Mullerian agenesis<br />C. Turner syndrome<br />D. Gonadal dysgenesis<br />Ans. A<br />Q 270. A woman presents with amenorrhea of 6 weeks duration and lump in the right iliac fossa. Investigation of choice is:<br />A. USG abdomen<br />B. Laparoscopy<br />C. CT scan<br />D. Shielded X-ray<br />Ans. A<br />Q 271. A woman presents with amenorrhea of 2 months duration lower abdominal pain, facial pallor, fainting and shock. Diagnosis is:<br />A. Ruptured ovarian cyst<br />B. Ruptured ecotopic pregnancy<br />C. Threatened abortion<br />D. Septic abortion<br />Ans. B<br />Q 272. A young woman with six weeks amenorrhea presents with mass abdomen. USG shows empty uterus. Diagnosis is:<br />A. Ovarian cyst<br />B. Ectopic pregnancy<br />C. Complete abortion<br />D. None of the above<br />Ans. B<br />Q 273. A 30 years old female, presents to the emergency with complaint of sudden severe abdominal pain. An abdominal mass is palpable on examination. MoDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-83394586651389793182008-12-18T09:22:00.000-08:002008-12-18T09:24:53.767-08:00fmge 2003ALL INDIA<br />PAPER 2003<br />SOLVED<br />QUESTIONS AND ANSWERS<br /><br /><br /><br /><br /><br /><br /><br /><br /><br />ANATOMY<br />Q 1. The commonest variation in the arteries arising from the arch of aorta is:<br />A. Absence of brachiocephalic trunk.<br />B. Left vertebral artery arising from the arch.<br />C. Left common carotid artery arising from brachiocephalic trunk.<br />D. Presence of retroesophageal subclavian artery.<br />Ans. C<br />Q 2. The blood vessel related to the paraduodenal fossa is:<br />A. Gonadal vein<br />B. Superior mesenteric artery<br />C. Portal vein<br />D. Inferior mesenteric vein<br />Ans. D<br />Q 3. The nerve commonly damaged during McBurney’s incision is:<br />A. Subcostal<br />B. Iliohypogastric<br />C. 11th thoracic<br />D. 10th thoracic<br />Ans. B<br />Q 4. The lumbar region of the vertebral column permits all the following movements, except:<br />A. Flexion<br />B. Extension<br />C. Lateral flexion<br />D. Rotation<br />Ans. D<br />Q 5. All of the following are examples of traction epiphysis, except:<br />A. Mastoid process<br />B. Tubercles of humerus<br />C. Trochanter of femur<br />D. Condyles of tibia<br />Ans. D<br />Q 6. All of the following statements are true for metaphysis of bone, except:<br />A. It is the strongest part of the bone.<br />B. It is the most vascular part of bone.<br />C. Growth activity is maximized here.<br />D. It is the region favouring hematogenous spread of infection.<br />Ans. A<br /><br /><br />Q 7. All of the following features can be observed after the injury to axillary nerve, except:<br />A. Loss of rounded contour of shoulder.<br />B. Loss of sensation along lateral side of upper arm.<br />C. Loss of overhead abduction.<br />D. Atrophy of deltoid muscle.<br />Ans. C<br />Q 8. All of the following muscles are grouped together as ‘muscles of mastication’, except:<br />A. Buccinator<br />B. Masseter<br />C. Temporalis<br />D. Pterygoids<br />Ans. A<br />Q 9. Referred pain from ureteric colic is felt in the groin due to involvement of the following nerve:<br />A. Subcostal<br />B. Iliohypogastric<br />C. Ilioinguinal<br />D. Genitofemoral<br />Ans. D<br />Q 10. The right coronary artery supplies all of the following parts of the conducting system in the heart, except:<br />A. SA Node<br />B. AV Node<br />C. AV Bundle<br />D. Right bundle branch<br />Ans. D<br />Q 11. The cells belonging to the following type of epithelium are provided with extra reserve of cell membrane:<br />A. Transitional<br />B. Stratified squamous<br />C. Stratified cuboidal<br />D. Stratified columnar<br />Ans. A<br />Q 12. Injury to radial nerve in lower part of spiral groove:<br />A. Spares nerve supply to extensor carpi radialis longus<br />B. Results in paralysis of anconeus muscle<br />C. Leaves extension at elbow joint intact<br />D. Weakens pronation movement<br />Ans. C<br />Q 13. A 30 year old man came to the outpatient department because he had suddenly developed double vision. On examination it was found that his right eye, when at rest, was turned medially. The most likely anatomical structures involved are:<br />A. Medial rectus and superior division of oculomotor nerve<br />B. Inferior oblique and inferior division of oculomotor nerve<br />C. Lateral rectus and abducent nerve<br />D. Superior rectus and trochlear nerve<br />Ans. C<br />Q 14. In a patient with a tumour in superior mediastinum compressing the superior vena cava, all the following veins would serve as alternate pathways for the blood to return to the right atrium, except:<br />A. Lateral thoracic vein<br />B. Internal thoracic vein<br />C. Hemiazygos vein<br />D. Vertebral venous plexus<br />Ans. B<br />Q 15. The middle cardiac vein is located at the:<br />A. Anterior interventricular sulcus.<br />B. Posterior interventricular sulcus.<br />C. Posterior AV groove.<br />D. Anterior AV groove.<br />Ans. B<br />Q 16. Which of the following statements is true about the autonomic nervous system?<br />A. The sympathetic outflow from the CNS is through both the cranial nerves and the sympathetic chain.<br />B. The parasympathetic outflow from the CNS is through cranial nerves only.<br />C. The superior hypogastric plexus is located at the anterior aspect of the aortic bifurcation and fifth lumbar vertebra.<br />D. The superior hypogastric plexus contains sympathetic fibers only.<br />Ans. C<br />PHYSIOLOGY<br />Q 17. An increase in which of the following parameters will shift the O2 dissociation curve to the left:<br />A. Temperature<br />B. Partial pressure of CO2<br />C. 2,3 DPG concentration<br />D. Oxygen affinity of haemoglobin<br />Ans. D<br />Q 18. A lesion of ventrolateral part of spinal cord will lead to loss (below the level of lesion) of:<br />A. Pain sensation on the ipsilateral side<br />B. Proprioception on the contralateral side<br />C. Pain sensation on the contralateral side<br />D. Proprioception on the ipsilateral side<br />Ans. C<br />Q 19. Two students, Vineet and Kamlesh were asked to demonstrate in dogs the role of sinus nerve in hypovolemic shock.Vineet severed the sinus nerve when the mean blood pressure (MBP) was 85 mm Hg and Kamlesh cut the sinus nerve when the mean blood pressure was 60 mm Hg. On cutting the sinus nerve:<br />A. Vineet recorded an increase in MBP but Kamlesh recorded a decrease in MBP.<br />B. Vineet recorded a decrease in MBP but Kamlesh recorded an increase in MBP.<br />C. Both recorded an increase in MBP.<br />D. Both recorded a decrease in MBP.<br />Ans. A<br />Q 20. As a part of space-research program, a physiologist was asked to investigate the effect of flight-induced stress on blood pressure. Accordingly the blood pressure of the cosmonauts were to be measured twice: once before the take-off, and once after the spacecraft entered the designated orbit around the earth. For a proper comparison, the preflight blood pressure should be recorded in:<br />A. The lying down position.<br />B. The sitting position.<br />C. The standing position<br />D. Any position, as long as the post-flight recording is made in the same position.<br />Ans. A<br />Q 21. The renal plasma flow (RPF) of a patient was to be estimated through the measurement of Para Amino Hippuric acid (PAH) clearance. The technician observed the procedure correctly but due to an error in the weighing inadvertently used thrice the recommended dose of PAH. The RPF estimated is likely to be:<br />A. False-high<br />B. False-low<br />C. False-high or false-low depending on the GFR.<br />D. Correct and is unaffected by the PAG overdose.<br />Ans. B<br /><br /><br /><br /><br />Q 22. The EEG record shown below is normally recordable during which stage of sleep ?<br /><br />A. Stage I.<br />B. Stage II.<br />C. Stage III.<br />D. Stage IV.<br />Ans. B<br />Q 23. Figure below represents the pH of the digestive juice aspirated from the alimentary tract as a function of position along the alimentary tract during digestion of a meal:<br /><br />A. A typical value for Y2 is 9.0.<br />B. A typical value for Y3 is 10.0.<br />C. The segment C represents the pylorus.<br />D. The digestive enzymes active in segment A are inactivated in segment B.<br />Ans. D<br />Q 24. Which of the following statements is true for excitatory postsynaptic potentials (EPSP):<br />A. Are self propagating.<br />B. Show all or none response.<br />C. Are proportional to the amount of transmitter released by the presynaptic neuron.<br />D. Are inhibitory at presynaptic terminal.<br />Ans. C<br />Q 25. Synaptic conduction is mostly orthodromic because:<br />A. Dendrites cannot be depolarized.<br />B. Once repolarized, an area cannot be depolarized.<br />C. The strength of antidromic impulse is less.<br />D. Chemical mediator is located only in the presynaptic terminal.<br />Ans. D<br />Q 26. The cell junctions allowing exchange of cytoplasmic molecules between the two cells are called:<br />A. Gap junctions.<br />B. Tight junctions.<br />C. Anchoring junctions<br />D. Focal junctions.<br />Ans. A<br />BIOCHEMISTRY<br />Q 27. The main enzyme responsible for activation of xenobiotics is:<br />A. Cytochrome P-450<br />B. Glutathione S-transferase<br />C. NADPH cytochrome P-450-reductase<br />D. Glucoronyl transferase<br />Ans. A<br />Q 28. The primary defect which leads to sickle cell anemia is:<br />A. An abnormality in prophyrin part of hemo-globin.<br />-chain ofB. Replacement of glutamate by valine in HbA.<br />-chain of HbA.C. A nonsense mutation in the<br />D. Substitution of -chain of HbA.valine by glutanmate in the<br />Ans. B<br />Q 29. Decreased glycolytic activity impairs oxygen transport by hemoglobin due to:<br />A. Reduced energy production<br />B. Decreased production of 2,3-biphospho-glycerate<br />C. Reduced synthesis of hemoglobin<br />D. Low level of oxygen<br />Ans. B<br />Q 30. The primary role of chaperones is to help in:<br />A. Protein synthesis<br />B. Protein degradation<br />C. Protein denaturation<br />D. Protein folding<br />Ans. D<br />Q 31. The conversion of an optically pure isomer (enantiomer) into a mixture of equal amounts of both dextro and levo form is called as:<br />A. Polymerization<br />B. Stereoisomerization<br />C. Racemization<br />D. Fractionation<br />Ans. C<br />Q 32. The protein rich in basic amino acids, which functions in the packaging of DNA in chromosomes, is:<br />A. Histone<br />B. Collagen<br />C. Hyaluronic acid binding protein<br />D. Fibrinogen<br />Ans. A<br />Q 33. An enzyme involved in the catabolism of fructose to pyruvate in the liver is:<br />A. Glyceraldehyde-3-phosphate dehydrogenase<br />B. Phosphoglucomutase<br />C. Lactate dehydrogenase<br />D. Glucokinase<br />Ans. A<br />-oxidation of odd-chain fatty acids produces:Q 34.<br />A. Succinyl CoA<br />B. Propionyl CoA<br />C. Acetyl CoA<br />D. Malonyl CoA<br />Ans. B<br />Q 35. The buffering capacity of a buffer is maximum at pH equal to:<br />A. 0.5 pKa<br />B. pKa<br />C. pKa+1<br />D. 2pKa<br />Ans. B<br />Q 36. Which of the following is present intracellulary in muscle cells:<br />A. Insulin<br />B. Corticosteroid<br />C. Epinephrine<br />D. Glucagon<br />Ans. B<br />Q 37. Which of the following is not a post transcriptional modification of RNA?<br />A. Splicing<br />B. 5 capping<br />polyadenylationC. 3<br />D. Glycosylation<br />Ans. D<br />Q 38. Serum total lactate dehydrogenase level will NOT be raised in:<br />A. Muscle crush injury<br />B. Stroke<br />C. Myocardial infarction<br />D. Hemolysis<br />Ans. B<br />Q 39. Porphobilinogen in urine produces pink colour with:<br />A. Fouchet’s reagent.<br />B. Benedict’s reagent.<br />C. Sodium nitropruside.<br />D. Ehrlich’s aldehyde reagent.<br />Ans. D<br />Q 40. The collagen triple helix structure is not found in:<br />A. Cytoplasm.<br />B. Golgi apparatus.<br />C. Lumen of endoplasmic reticulum.<br />D. Intracellular vesicles.<br />Ans. A<br />MICROBIOLOGY AND PARASITALOGY<br />Q 41. An anxious mother brought her 4 year old daughter to the pediatrician. The girl was passing loose bulky stools for the past 20 days. This was often associated with pain in abdomen. The pediatrician ordered the stool examination which showed the following organisms. Identify the organism:<br />A. Entamoeba histolytica<br />B. Giardia lamblia<br />C. Cryptosporidium<br />D. E. coli<br /><br />Ans. B<br />Q 42. Heat labile instruments for use in surgical procedures can be best sterilized by:<br />A. Absolute alcohol<br />B. Ultra violet rays<br />C. Chlorine releasing compounds<br />D. Ethylene oxide gas<br />Ans. D<br />Q 43. Thirty-eight children consumed eatables procured from a picnic party. Twenty children developed abdominal cramps followed by vomiting and watery diarrhoea 6-10 hours after the party. The most likely etiology for the outbreak is:<br />A. Rotavirus infection<br />B. Entero-toxigenic E. coli infection<br />C. Staphylococcol toxin<br />D. Clostridium perfringens infection<br />Ans. C<br />Q 44. The following are true for Bordetella pertussis except:<br />A. It is a strict human pathogen.<br />B. It can be cultured from the patient during catarrhal stage.<br />C. It leads to invasion of the respiratory mucosa.<br />D. Infection can be prevented by a acellular vaccine.<br />Ans. C<br />Q 45. A chest physician performs bronchoscopy in the procedure room of the out patient department. To make the instrument safe for use in the next patient waiting outside, the most appropriate method to disinfect the endoscope is by:<br />A. 70% alcohol for 5 min.<br />B. 2% gluteraldelyde for 20 min.<br />C. 2% formaldehyde for 10 min.<br />D. 1% sodium hypochlorite for 15 min.<br />Ans. B<br />Q 46. Which of the following statements is true about rabies virus:<br />A. It is a double stranded RNA virus.<br />B. Contains a DNA-dependent RNA polymerase.<br />C. RNA has a negative polarity<br />D. Affects motor neurons.<br />Ans. C<br />Q 47. Which of the following statements is true about endemic typhus:<br />A. Is caused by R. rickettsii.<br />B. Is transmitted by the bite of fleas.<br />C. Has no mammalian reservoir.<br />D. Can be cultured in chemical defined culture medium.<br />Ans. B<br />Q 48. The organism most commonly causing genital filariasis in most parts of Bihar and eastern UP is:<br />A. Wuchereria bancrofti.<br />B. Brugia malayi.<br />C. Onchocerca volvulus.<br />D. Dirofilaria.<br />Ans. A<br />PATHOLOGY<br />Q 49. A married middle aged female gives history of repeated abortions for the past 5 years. The given below is conceptions prenatal karyogram.<br /><br />This karyogram suggests the following:<br />A. Klinfelter’s syndrome<br />B. Turner’s syndrome<br />C. Down’s syndrome<br />D. Patau’s syndrome<br />Ans. C<br />Q 50. An increased incidence of cholangiocarcinoma is seen in all of the following, except:<br />A. Hydatid cyst of liver<br />B. Polycystic disease of liver<br />C. Sclerosing cholangitis<br />D. Liver flukes<br />Ans. A<br />Q 51. Strong correlation with colorectal cancer is seen in:<br />A. Peutz-Jeghers polyp<br />B. Familial polyposis coli<br />C. Juvenile polyposis<br />D. Hyperplastic polyp<br />Ans. B<br />Q 52. Which of the following is the most common location of hypertensive hemorrhage?<br />A. Pons.<br />B. Thalamus.<br />C. Putamen/external capsule.<br />D. Subcortical white matter.<br />Ans. C<br />Q 53. A 63-year old man presented with massive splenomegaly, lymphadenopathy and a total leucocyte count of 17000 per mm3. The flowcytometry showed CD19 positive, CD5 positive, CD23 negative, monoclonal B-cells with bright kappa positivity comprising 80% of the peripheral blood lymphoid cells. The most likely diagnosis is:<br />A. Mantle cell lymphoma.<br />B. Splenic lymphoma with villous lymphocytes.<br />C. Follicular lymphoma.<br />D. Hairy cell leukemia.<br />Ans. A<br />Q 54. The HLA class III region genes are important elements in:<br />A. Transplant rejection phenomenon.<br />B. Governing susceptibility to autoimmune diseases.<br />C. Immune surveillance.<br />D. Antigen presentation and elimination.<br />Ans. C<br />Q 55. All the statements about lactoferrin are true, except:<br />A. It is present in secondary granules of neutrophil.<br />B. It is present in exocrine secretions of body.<br />C. It has great affinity for iron.<br />D. It transports iron for erythropoiesis.<br />Ans. D<br />Q 56. Which of the following procedures are used as routine technique for karyotyping using light microscopy?<br />A. C-banding B. G- banding<br />C. Q-banding D. Brd V-banding<br />Ans. B<br />Q 57. Restriction fragment length polymorphism is used for:<br />A. Analysis of chromosome structure.<br />B. DNA estimation.<br />C. Synthesis of nucleic acid.<br />D. Detecting proteins in a cell.<br />Ans. A<br />PHARMACOLOGY<br />Q 58. Granulocytopenia, gingival hyperplasia and facial hirsutism are all possible side effects of one of the following anticonvulsant drugs:<br />A. Phenytoin<br />B. Valproate<br />C. Carbamazepine<br />D. Phenobarbitone<br />Ans. A<br />Q 59. Bacitracin acts on:<br />A. Cell wall<br />B. Cell membrane<br />C. Nucleic acid<br />D. Ribosomes<br />Ans. A<br />Q 60. All of the following drugs act on cell membrane, except:<br />A. Nystatin<br />B. Griseofulvin<br />C. Amphotericin B<br />D. Polymixin B<br />Ans. B<br />Q 61. All of the following statements regarding bioavailability of a drug are true except:<br />A. It is the proportion (fraction) of unchanged drug that reaches the systemic circulation.<br />B. Bioavailability of an orally administered drug can be calculated by comparing ) after oral and intravenous (IV) administration.the area under curve (O-<br />C. Low oral bioavailability always and necessarily mean poor absorption.<br />D. Bioavailability can be determined from plasma concentration or urinary excretion data.<br />Ans. C<br />Q 62. The extent to which ionization of a drug takes place is dependent upon pKa of the drug and the pH of the solution in which the drug is dissolved. Which of the following statements is not correct:<br />A. pKa of a drug is the pH at which the drug is 50% ionized.<br />B. Small changes of pH near the pKa of a weak acidic drug will not affect its degree of ionization.<br />C. Knowledge of pKa of a drug is useful in predicting its behaviour in various body fluids.<br />D. Phenobarbitone with a pKa of 7.2 is largely ionized at acid pH and will be about 40% non-ionised in plasma.<br />Ans. B<br />Q 63. Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionisation of the drug in the stomach. Which of the following statement is not correct example:<br />A. Absorption of digoxin is delayed by the presence of food.<br />B. Concurrent food intake may severely reduce the rate of absorption of phenytoin.<br />C. Presence of food enhances the absorption of hydrochlorothiazide.<br />D. Antimalarial drug halofantrine is more extensively absorbed if taken with food.<br />Ans. B<br />Q 64. Bosentan is a:<br />A. Serotonin uptake inhibitor.<br />B. Endothelin receptor antagonist.<br />C. Leukotriene modifier.<br />D. Calcium sensitizer.<br />Ans. B<br />FORENSIC MEDICINE<br />Q 65. Mummification refers to:<br />A. Hardening of muscles after death<br />B. Colliquative putrification<br />C. Saponification of subcutaneous fat<br />D. Dessication of a dead body<br />Ans. D<br />Q 66. A patient has been allegedly bitten by cobra snake. The venom in such a bite would be:<br />A. Musculotoxic<br />B. Vasculotoxic<br />C. Cardiotoxic<br />D. Neurotoxic<br />Ans. D<br />Q 67. All the following are related to legal responsibility of an insane person except:<br />A. Mc Naughten’s rule<br />B. Durham’s rule<br />C. Curren’s rule<br />D. Rule of nine<br />Ans. D<br />Q 68. In a suspected case of death due to poisoning where cadaveric rigidity is lasting longer than usual, it may be a case of poisoning due to:<br />A. Lead<br />B. Arsenic<br />C. Mercury<br />D. Copper<br />Ans. B<br />Q 69. Blackening and tattooing of skin and clothing can be best demonstrated by:<br />A. Luminol spray.<br />B. Infrared photography.<br />C. Ultraviolet light.<br />D. Magnifying lens.<br />Ans. B<br />Q 70. Postmortem lividity is unlikely to develop in a case of:<br />A. Drowning in well.<br />B. Drowning in a fast flowing river.<br />C. Postmortem submersion.<br />D. Drowning in chlorinated swimming pool.<br />Ans. B<br />Q 71. The following situations are associated with rise of temperature after death except :<br />A. Burns.<br />B. Heat stroke.<br />C. Pontine hemorrhage.<br />D. Septicemia.<br />Ans. A<br />Q 72. In prenatal diagnostic technique Act 1994 which one of the following is not a ground for carrying out prenatal test ?<br />A. Pregnant women above 35 years of age.<br />B. History of two or more spontaneous abortion or fetal loss.<br />C. When fetal heart rate is 160 per min at fifth and 120 per min at ninth month.<br />D. History of exposure to potentially teratogenic drugs.<br />Ans. C<br />Q 73. Perjury means giving willful false evidence by a witness while under oath, the witness is liable to be prosecuted for perjury and the imprisonment may extend to seven years. This falls under which section of IPC?<br />A. 190 of Indian Penal Code.<br />B. 191 of Indian Penal Code.<br />C. 192 of Indian Penal Code<br />D. 193 of Indian Penal code.<br />Ans. D<br />Q 74. The most reliable criteria in Gustafson’s method of identification is:<br />A. Cementum apposition.<br />B. Transparency of root.<br />C. Attrition.<br />D. Root resorption.<br />Ans. B<br />PREVENTIVE AND SOCIAL MEDICINE<br />Q 75. The parameters of sensitivity and specificity are used for assessing:<br />A. Criterion validity<br />B. Construct validity<br />C. Discriminant validity<br />D. Content validity<br />Ans. A<br />Q 76. Chi-square test is used to measure the degree of:<br />A. Causal relationship between exposure and effect.<br />B. Association between two variables.<br />C. Correlation between two variables.<br />D. Agreement between two observations.<br />Ans. B<br />Q 77. Elements of primary health care include all of the following except:<br />A. Adequate supply of safe water and basic sanitation.<br />B. Providing essential drugs.<br />C. Sound referral system.<br />D. Health education.<br />Ans. C<br />Q 78. For the calculation of positive predictive value of a screening test, the denominator is comprised of:<br />A. True positive + False negative<br />B. False positive + True negative<br />C. True positive + False positive<br />D. True positive + True negative<br />Ans. C<br />Q 79. Elemental iron and folic acid contents of pediatric iron-folic acid tablets supplied under Rural Child Health (RCH) program are:<br />A. 20 mg iron & 100 micrograms folic acid.<br />B. 40 mg iron & 100 micrograms folic acid.<br />C. 40 mg iron & 50 micrograms folic acid.<br />D. 60 mg iron & 100 micrograms folic acid.<br />Ans. A<br />Q 80. In the management of leprosy, lepromin test is most useful for:<br />A. Herd immunity<br />B. Prognosis<br />C. Treatment<br />D. Epidemiological investigations<br />Ans. B<br />Q 81. A measure of location which divides the distribution in the ratio of 3:1 is:<br />A. Median<br />B. First quartile<br />C. Third quartile<br />D. Mode<br />Ans. C<br />Q 82. The following statements about meningococcal meningitis are true, except:<br />A. The source of infection is mainly clinical cases.<br />B. The disease is more common in dry and cold months of the year.<br />C. Chemoprophylaxis of close contacts of cases is recommended.<br />D. The vaccine is not effective in children below 2 years of age.<br />Ans. A<br /><br /><br />Q 83. The Protein Efficiency Ratio (PER) is defined as:<br />A. The gain in weight of young animals per unit weight of protein-consumed.<br />B. The product of digestibility coeffecient and biological value.<br />C. The percentage of protein absorbed into the blood.<br />D. The percentage of nitrogen absorbed from the protein absorbed from the diet.<br />Ans. A<br />Q 84. The Vitamin A supplement administered in "Prevention of nutritional blindness in children programme" contain:<br />A. 25,000 i.u./ml<br />B. 1 lakh i.u./ml<br />C. 3 lakh i.u./ml<br />D. 5 lakh i.u./ml<br />Ans. B<br />Q 85. A 5 year old boy passed 18 loose stools in last 24 hours and vomited twice in last 4 hours. He is irritable but drinking fluids. The optimal therapy for this child is:<br />A. Intravenous fluids<br />B. Oral rehydration therapy<br />C. Intravenous fluid initially for 4 hours followed by oral fluids.<br />D. Plain water add libitum.<br />Ans. B<br />Q 86. Study this formula carefully:<br /><br />This denotes:<br />A. Sensitivity.<br />B. Specificity.<br />C. Positive Predictive value.<br />D. Negative Predictive value.<br />Ans. A<br />Q 87. The ‘P’ value of a randomized controlled trial comparing operation A (new procedure) and operation B (Gold standard is 0.04). From this, we conclude that:<br />A. Type II error is small and we can accept the findings of the study.<br />B. The probability of false negative conclusion that operation A is better than operation B, when in truth it is not, is 4%.<br />C. The power of study to detect a difference between operation A and B is 96%.<br />D. The probability of a false positive conclusion that operation A is better than operation B, when in truth it is not, is 4%.<br />Ans. D<br /><br />Q 88. The commonest cause of low vision in India is:<br />A. Uncorrected refractive error<br />B. Cataract.<br />C. Glaucoma<br />D. Squint.<br />Ans. A<br />Q 89. Most important epidemiological tool used for assessing disability in children is:<br />A. Activities of Daily Living (ADL) scale.<br />B. Wing’s Handicaps, Behaviour and Skills (HBS) Schedule.<br />C. Binet and Simon IQ tests.<br />D. Physical Quality of Life Index (PQLI).<br />Ans. B<br />Q 90. Scope of family planning services include all of the following except:<br />A. Screening for cervical cancer.<br />B. Providing services for unmarried mothers.<br />C. Screening for HIV infection.<br />D. Providing adoption services.<br />Ans. C<br />Q 91. Class II exposure in animal bites includes the following:<br />A. Scratches without oozing of blood.<br />B. Licks on a fresh wound.<br />C. Scratch with oozing of blood on palm.<br />D. Bites from wild animals.<br />Ans. B<br />Q 92. Elemental iron and folic acid contents of iron and folic acid adult tablets supplied under the "National Programme for Anaemia Prophylaxis" are:<br />A. 60 mg of elemental iron and 250 microgram of folic acid.<br />B. 100 mg of elemental iron and 500 micrograms of folic acid.<br />C. 20 mg of elemental iron and 750 micrograms of folic acid.<br />D. 200 mg of elemental iron and 1000 micro-grams of folic acid.<br />Ans. B<br />Q 93. Denominator while calculating the secondary attack rate includes:<br />A. All the people living in next fifty houses.<br />B. All the close contacts.<br />C. All susceptibles amongst close contact.<br />D. All susceptibles in the whole village.<br />Ans. C<br />Q 94. The response which is graded by an observer on an agree or disagree continuum is based on:<br />A. Visual analog scale.<br />B. Guttman scale.<br />C. Likert scale.<br />D. Adjectival scale.<br />Ans. C<br />Q 95. For calculation of sample size for a prevalence study all of the following are necessary except:<br />A. Prevalence of disease in population.<br />B. Power of the study.<br />C. Significance level.<br />D. Desired precision.<br />Ans. D<br />Q 96. Leprosy is considered a public health problem if the prevalence of leprosy is more than:<br />A. 1 per 10,000<br />B. 2 per 10,000<br />C. 5 per 10,000<br />D. 10 per 10,000<br />Ans. A<br />Q 97. For controlling an outbreak of cholera, all of the following measures are recommended except:<br />A. Mass chemoprophylaxis.<br />B. Proper disposal of excreta.<br />C. Chlorination of water.<br />D. Early detection and management of cases.<br />Ans. A<br />Q 98. A child aged 24 months was brought to the Primary Health Centre with complaints of cough and fever for the past 2 days. On examination, the child weighed 11 kg., respiratory rate was 38 per minute, chest indrawing was present. The most appropriate line of management for this patient is?<br />A. Classify as pneumonia and refer urgently to secondary level hospital.<br />B. Classify as pneumonia, start antibiotics and advise to report after 2 days.<br />C. Classify as severe pneumonia, start antibiotics and refer urgently.<br />D. Classify as severe pneumonia and refer urgently.<br />Ans. C<br />MEDICINE<br />Q 99. The syndromic management of urethral discharge includes treatment of:<br />A. Neisseria gonorrhoeae and herpes genitalis.<br />B. Chlamydia trachomatis and herpes genitalis.<br />C. Neisseria gonorrhoeae and Chlamydia trachomatis.<br />D. Syphilis and chancroid.<br />Ans. C<br />Q 100. A 56 year old man presents in the casualty with severe chest pain and difficulty in breathing. His ECG was taken immediately. The above ECG suggest the following diagnosis:<br />A. Ventricular fibrillation<br />B. Acute pulmonary embolism<br />C. Second degree heart block<br />D. Atrial fibrillation<br /><br />Ans. B<br />Q 101. All of the following infections are often associated with acute intravascular hemolysis except:<br />A. Clostridium tetani<br />B. Bartonella bacilliformis<br />C. Plasmodium falciparum<br />D. Babesia microti<br />Ans. A<br />Q 102. All of the following are the electrocardiographic features of severe hyperkalemia except:<br />A. Peaked T waves<br />B. Presence of U waves<br />C. Sine wave pattern<br />D. Loss of P waves<br />Ans. B<br />Q 103. The correct sequence of cell cycle is:<br />A. G0 - G1 - S - G2 - M<br />B. G0 - G1 - G2 - S - M<br />C. G0 - M - G2 - S - G1<br />D. G0 - G1 - S - M - G2<br />Ans. A<br />Q 104. Commonest cause of sporadic encephalitis is:<br />A. Japanese B Virus<br />B. Herpes Simplex Virus<br />C. Human Immunodeficiency Virus<br />D. Rubeola Virus<br />Ans. B<br />Q 105. Raised serum level of lipoprotein - (a) is a predictor of:<br />A. Cirrhosis of liver<br />B. Rheumatic arthritis<br />C. Atherosclerosis<br />D. Cervical cancer<br />Ans. C<br />Q 106. Haemorrhage secondary to heparin administration can be best corrected by administration of:<br />A. Vitamin K<br />B. Whole blood<br />C. Protamine<br />D. Ascorbic acid<br />Ans. C<br />Q 107. Which one of the following conditions may lead to exudative pleural effusion:<br />A. Cirrhosis<br />B. Nephrotic syndrome<br />C. Congestive heart failure<br />D. Bronchogenic carcinoma<br />Ans. D<br />Q 108. A 60 year old man is diagnosed to be suffering from Legionnaire’s disease after he returns home from attending a convention. He could have acquired it:<br />A. From a person suffering from the infection while travelling in the aeroplane.<br />B. From a chronic carrier in the convention center.<br />C. From inhalation of the aerosol in the air-conditioned room at convention center.<br />D. By sharing an infected towel with a fellow delegate at the convention.<br />Ans. C<br />Q 109. In a post-operative intensive care unit, five patients developed post-operative wound infection on the same day. The best method to prevent cross infection occurring in other patients in the same ward is to:<br />A. Give antibiotics to all other patients in the ward.<br />B. Fumigate the ward.<br />C. Disinfect the ward with sodium hypochlorite.<br />D. Practice proper hand washing.<br />Ans. D<br />Q 110. The earliest immunoglobulin to be synthesized by the fetus is:<br />A. IgA<br />B. IgG<br />C. IgE<br />D. IgM<br />Ans. D<br />Q 111. The following are true regarding Lyme’s disease, except:<br />A. It is transmitted by Ixodes tick.<br />B. Erythema chronicum migrans may be a clinical feature.<br />C. Borrelia recurrentis is the aetiological agent.<br />D. Rodents act as natural hosts.<br />Ans. C<br />Q 112. A couple, with a family history of beta thalassemia major in a distant relative, has come for counselling. The husband has HbA2 of 4.8% and the wife has HbA2 of 2.3%. The risk of having a child with beta thalassemia major is:<br />A. 50%<br />B. 25%<br />C. 5%<br />D. 0%<br />Ans. D<br />Q 113. A 2 month old baby with acute icteric viral hepatitis like illness slips into encephalopathy after 48 hours. The mother is a known hepatitis B carrier. Mother’s hepatitis B virus serological profile is most likely to be:<br />A. HBsAg positive only<br />B. HBsAg and HBeAg positive<br />C. HBsAg and HBe antibody positive<br />D. HBV DNA positive<br />Ans. C<br />Q 114. A 7 year old girl from Bihar presented with three episodes of massive hematemesis and melena. There is no history of jaundice. On examination, she had a large spleen, non-palpable liver and mild ascites. Portal vein was not visualised on ultrasonography. Liver function tests were normal and endoscopy revealed esophageal varices. The most likely diagnosis is:<br />A. Kala azar with portal hypertension<br />B. Portal hypertension of unknown etiology<br />C. Chronic liver disease with portal hypertension<br />D. Portal hypertension due to extrahepatic obstruction.<br />Ans. D<br />Q 115. A 40 year old male had undergone splenectomy 20 years ago. Peripheral blood smear examination would show the presence of:<br />A. Dohle bodies<br />B. Hypersegmented neutrophils<br />C. Spherocytes<br />D. Howell-Jolly bodies<br />Ans. D<br />Q 116. Which of the heart valve is most likely to be involved by infective endocarditis following a septic abortion?<br />A. Aortic valve<br />B. Tricuspid valve<br />C. Pulmonary valve<br />D. Mitral valve<br />Ans. B<br />Q 117. Central nervous system manifestations in chronic renal failure are a result of all of the following, except:<br />A. Hyperosmolarity<br />B. Hypocalcemia<br />C. Acidosis<br />D. Hyponatremia<br />Ans. A<br />Q 118. Medullary carcinoma of the thyroid is associated with which of the following syndrome:<br />A. MEN I<br />B. MEN II<br />C. Fraumeni syndrome<br />D. Hashimoto’s syndrome<br />Ans. B<br />Q 119. Which of the following statements represent most correct interpretation from the ECG waveform given below:<br /><br />A. X-originated from an atrial ectopic focus.<br />B. X reset the cardiac rhythm.<br />C. Both heart sounds would have been present at X beat.<br />D. The path of spread of excitation was normal.<br />Ans. B<br />Q 120. A 60 year old male presented to the emergency with breathlessness, facial swelling and dilated veins on the chest wall. The most common cause is:<br />A. Thymoma.<br />B. Lung cancer.<br />C. Hodgkin’s lymphoma.<br />D. Superior vena caval obstruction.<br />Ans. B<br />Q 121. All of the following conditions may predispose to pulmonary embolism except:<br />A. Protein S deficiency.<br />B. Malignancy.<br />C. Obesity.<br />D. Progesterone therapy.<br />Ans. D<br />Q 122. An early systolic murmur may be caused by all of the following except:<br />A. Small ventricular septal defect.<br />B. Papillary muscle dysfunction.<br />C. Tricuspid regurgitation.<br />D. Aortic stenosis.<br />Ans. D<br />Q 123. Troponin-T is preferable to CPK-MB in the diagnosis of acute myocardial infarction (MI) in all of the following situations except:<br />A. Bedside diagnosis of MI.<br />B. Postoperatively (after CABG).<br />C. Reinfarction after 4 days.<br />D. Small infarcts.<br />Ans. C<br />Q 124. The most common cause of tricuspid regurgitation is secondary to:<br />A. Rheumatic heart disease.<br />B. Dilatation of right ventricle.<br />C. Coronary artery disease.<br />D. Endocarditis due to intravenous drug abuse.<br />Ans. B<br />Q 125. Absence seizures are characterized on EEG by:<br />A. 3 Hz spike & wave<br />B. 1-2 Hz spike & wave.<br />C. Generalized polyspikes.<br />D. Hypsarrythmia.<br />Ans. A<br />Q 126. All of the following are associated with low C3 levels except:<br />A. Post streptococcal glomerulonephritis.<br />B. Membrano-proliferative glomerulonephritis.<br />C. Goodpasture’s disease.<br />D. Systemic lupus erythematosus.<br />Ans. C<br />Q 127. Normal anion gap metabolic acidosis is caused by:<br />A. Cholera.<br />B. Starvation.<br />C. Ethylene glycol poisoning.<br />D. Lactic acidosis.<br />Ans. A<br />Q 128. Diagnostic features of allergic broncho-pulmonary aspergillosis (ABPA) include all of the following except:<br />A. Changing pulmonary infiltrates.<br />B. Peripheral eosinophilia.<br />C. Serum precipitins against Aspergillous fumigatus.<br />D. Occurrence in patients with old cavitary lesions.<br />Ans. D<br />Q 129. The syndrome of inappropriate antidiuretic hormone is characterized by the following:<br />A. Hyponatremia and urine sodium excretion > 20 mEq/l.<br />B. Hypernatremia and urine sodium excretion > 20 mEq/l.<br />C. Hyponatremia and hyperkalemia.<br />D. Hypernatremia and hypokalemia.<br />Ans. A<br />Q 130. All of the following heart sounds occur shortly after S2 except:<br />A. Opening snap.<br />B. Pericardial knock.<br />C. Ejection click.<br />D. Tumor plop.<br />Ans. C<br />Q 131. Pulmonary hypertension may occur in all of the following conditions except:<br />A. Toxic oil syndrome.<br />B. Progressive systemic sclerosis.<br />C. Sickle cell anaemia.<br />D. Argemone mexicana poisoning.<br />Ans. D<br />Q 132. Causes of metabolic alkalosis include all the following, except:<br />A. Mineralocorticoid deficiency.<br />B. Bartter’s syndrome.<br />C. Thiazide diuretic therapy.<br />D. Recurrent vomiting.<br />Ans. A<br />Q 133. The most frequent cause of recurrent genital ulceration in a sexually active male is:<br />A. Herpes genitalis.<br />B. Aphthous ulcer.<br />C. Syphilis.<br />D. Chancroid.<br />Ans. A<br />Q 134. The most effective drug against M. leprae is:<br />A. Dapsone.<br />B. Rifampicin.<br />C. Clofazimine.<br />D. Prothionamide.<br />Ans. B<br />Q 135. A 30-year old HIV positive patient presents with fever, dyspnoea and non-productive cough, patient is cyanosed. His chest X-ray reveals bilateral, symmetrical interstitial infiltrates. The most likely diagnosis is:<br />A. Tuberculosis.<br />B. Cryptococcosis.<br />C. Pneunocystis carinii pneumonia.<br />D. Toxoplasmosis.<br />Ans. C<br />Q 136. Extensive pleural thickening and calcification especially involving the diaphragmatic pleura are classical features of:<br />A. Coal worker’s pneumoconiosis.<br />B. Asbestosis.<br />C. Silicosis.<br />D. Siderosis.<br />Ans. B<br />Q 137. Commonest presentation of neurocysticercosis is:<br />A. Seizures.<br />B. Focal neurological deficits.<br />C. Dementia<br />D. Radiculopathy.<br />Ans. A<br />Q 138. A 55-year old man who has been on bed rest for the past 10 days, complains of breathlessness and chest pain. The chest X-ray is normal. The next investigation should be:<br />A. Lung ventilation-perfusion scan.<br />B. Pulmonary arteriography.<br />C. Pulmonary venous angiography.<br />D. Echocardiography.<br />Ans. B<br />Q 139. A 60-year old man with diabetes mellitus presents with painless, swollen right ankle joint. Radiograph of the ankle shows destroyed joint with large number of loose bodies. The most probable diagnosis is:<br />A. Charcot’s joint<br />B. Clutton’s joint<br />C. Osteoarthritis.<br />D. Rheumatoid arthritis.<br />Ans. A<br />Q 140. All of the following statements regarding the ECG in acute pericarditis are true except:<br />A. T wave inversion develop before ST elevations return to baseline.<br />B. Global ST segment elevation is seen in early pericarditis.<br />C. Sinus tachycardia is a common finding.<br />D. PR segment depression is present in majority of patients.<br />Ans. A<br />Q 141. Type IV hypersensitivity to Mycobacterium tuberculosis antigen may manifest as:<br />A. Iridocyclitis.<br />B. Polyarteritis nodosa.<br />C. Phlyctenular conjunctivitis.<br />D. Giant cell arteritis.<br />Ans. C<br />Q 142. The blood gas parameters: pH 7.58, pCO2 23 mmHg, PO2 300 mmHg and oxygen saturation 60% are most consistent with:<br />A. Carbon monoxide poisoning.<br />B. Ventilatory malfunction.<br />C. Voluntary hyperventilation.<br />D. Methyl alcohol poisoning.<br />Ans. A<br />Q 143. Most suitable radioisotope of iodine for treating hyperthyroidism is:<br />A. I123<br />B. I125<br />C. I131<br />D. I132<br />Ans. C<br />Q 144. In the presence of vasopressin the greatest fraction of filtered water is reabsorbed in which part of the nephron:<br />A. Proximal tubule.<br />B. Distal tubule.<br />C. Loope of Henle.<br />D. Collecting duct.<br />Ans. A<br />Q 145. All of the following statements are correct about potassium balance, except:<br />A. Most of potassium is intracellular.<br />B. Three quarter of the total body potassium is found in skeletal muscle.<br />C. Intracellular potassium is released into extra-cellular space in response to severe injury.<br />D. Acidosis leads to movement of potassium from extracellular to intracellular fluid compartment.<br />Ans. D<br />Q 146. Hypocalcemia is characterized by all of the following features except:<br />A. Numbness and tingling of circumoral region.<br />B. Hyperactive tendon reflexes.<br />C. Shortening of Q-T interval in ECG.<br />D. Carpopedal spasm.<br />Ans. C<br />Q 147. Which of the following is not true about Berger’s disease?<br />A. The pathologic changes are proliferation and usually confined to mesangial cells; usually focal and segmental.<br />B. Hematuria may be gross or microscopic.<br />C. On immunoflurorescence deposits contain both IgA and IgG.<br />D. Absence of associated proteinuria is pathognomonic.<br />Ans. D<br />Q 148. All of the following are risk factors for deep vein thrombosis (DVT) except:<br />A. Duration of surgery more than thirty minutes.<br />B. Obesity.<br />C. Age less than forty years.<br />D. Use of the oestrogen-progesterone contraceptive pills.<br />Ans. C<br />Q 149. A labourer involved with repair-work of sewers was admitted with fever, jaundice and renal failure. The most appropriate test to diagnose the infection in this patient is:<br />A. Weil Felix test.<br />B. Paul Bunnel test.<br />C. Microscopic agglutination test.<br />D. Micro immunofluorescence test.<br />Ans. C<br />Q 150. Memory T cells can be identified by using the following marker:<br />A. CD45 RA.<br />B. CD45 RB.<br />C. CD45 RC.<br />D. CD45 RO.<br />Ans. D<br />Q 151. All of the following statements about NK cells are true, except:<br />A. They are derived from large granular cells.<br />B. They comprise about 5% of human peripheral lymphoid cells.<br />C. They are MHC restricted cytotoxic cells.<br />D. They express IgG Fc receptors.<br />Ans. C<br />Q 152. Which of the following increases the susceptibility to coronary artery disease:<br />A. Type V hyperlipoproteinaemia.<br />B. Von Willebrandt’s disease.<br />C. Nephrotic syndrome.<br />D. Systemic lupus erythematosus.<br />Ans. D<br />Q 153. MHC class III genes encode:<br />A. Complement component C3.<br />B. Tumor necrosis factor.<br />C. Interleukin 2.<br />D. Beta 2 microglobulin.<br />Ans. B<br />Q 154. Gluten sensitive enteropathy is most strongly associated with:<br />A. HLA-DQ2.<br />B. HLA-DR4.<br />C. HLA-DQ3.<br />D. Blood group ‘B’.<br />Ans. A<br />Q 155. Most sensitive and specific test for diagnosis of iron deficiency is:<br />A. Serum iron levels.<br />B. Serum ferritin levels.<br />C. Serum transferrin receptor population.<br />D. Transferrin saturation.<br />Ans. B<br />Q 156. All of the following are poor prognostic factors for acute myeloid leukemias, except:<br />A. Age more than 60 years.<br />B. Leucocyte count more than 1,00,000/µl.<br />C. Secondary leukemias.<br />D. Presence of t(8;21).<br />Ans. D<br />Q 157. Leukoerythroblastic picture may be seen in all of the following, except:<br />A. Myelofibrosis.<br />B. Metastatic carcinoma.<br />C. Gaucher’s disease.<br />D. Thalassemia.<br />Ans. D<br />Q 158. Cardiac or central nervous system toxicity may result when standard lidocaine doses are administered to patients with circulatory failure. This may be due to the following reason:<br />A. Lidocaine concentration are initially higher in relatively well perfused tissues such as brain and heart.<br />B. Histamine receptors in brain and heart gets suddenly activated in circulatory failure.<br />C. There is a sudden out-bursts of release of adrenaline, noradrenaline and dopamine in brain and heart.<br />D. Lidocaine is converted into a toxic metabolite due to its longer stay in liver.<br />Ans. A<br />Q 159. All of the following are useful intravenous therapy for hypertensive emergencies, except:<br />A. Fenoldopam.<br />B. Urapidil.<br />C. Enalapril.<br />D. Nifedipine.<br />Ans. D<br />Q 160. Cardiac output measured by thermodilution technique is unreliable in all of the following situations except:<br />A. Ventricular septal defect.<br />B. Tricuspid regurgitation.<br />C. Low cardiac output.<br />D. Pulmonary regurgitation.<br />Ans. A<br />Q 161. Exercise testing is absolutely contraindi-cated in which one of the following:<br />A. One week following myocardial infarction.<br />B. Unstable angina.<br />C. Aortic stenosis.<br />D. Peripheral vascular disease.<br />Ans. B<br />Q 162. A nineteen year old female with short stature, wide spread nipples and primary amenorrhoea most likely has a karyotype of:<br />A. 47, XX+18.<br />B. 46, XXY.<br />C. 47, XXY.<br />D. 45 X.<br />Ans. D<br />Q 163. Osteomalacia is associated with:<br />A. Decrease in osteoid volume.<br />B. Decrease in osteoid surface.<br />C. Increase in osteoid maturation time.<br />D. Increase in mineral apposition rate.<br />Ans. C<br />Q 164. A 23-year old woman has experienced episodes of myalgias, pleural effusion, pericarditis and arthralgias without joint deformity over course of several years. The best laboratory screening test to diagnose her disease would be:<br />A. CD4 lymphocyte count.<br />B. Erythrocyte sedimentation rate.<br />C. Antinuclear antibody.<br />D. Assay for thyroid hormones.<br />Ans. C<br />Q 165. A 5-year old boy is detected to be HBsAg positive on two separate occasions during a screening program for hepatitis B. He is otherwise asymptomatic. Child was given 3 doses of recombinant hepatitis B vaccine at the age of one year. His mother was treated for chronic hepatitis B infection around the same time. The next relevant step for further investigating the child would be to:<br />A. Obtain HBe Ag and anti-HBe antibodies.<br />B. Obtain anti-HBs levels.<br />C. Repeat HBsAg.<br />D. Repeat another course of hepatitis B vaccine.<br />Ans. A<br />Q 166. Which of the following hepatitis viruses have significant perinatal transmission:<br />A. Hepatitis E virus.<br />B. Hepatitis C virus<br />C. Hepatitis B virus.<br />D. Hepatitis A virus.<br />Ans. C<br />Q 167. The diffusion capacity of lung (DLCO) is decreased in all of the following conditions except:<br />A. Interstitial lung disease.<br />B. Goodpasture’s syndrome.<br />C. Emphysema.<br />D. Primary pulmonary hypertension.<br />Ans. B<br />Q 168. Osler’s nodes are typically seen in which one of the following:<br />A. Chronic candida endocarditis.<br />B. Acute staphylococcal endocarditis.<br />C. Pseudomonas endocarditis.<br />D. Libman sack’s endocarditis.<br />Ans. B<br /><br />Q 169. Thiamine deficiency is known to occur in all of the following except:<br />A. Food Faddist.<br />B. Homocystinemia<br />C. Chronic alcoholic<br />D. Chronic heart failure patients on diuretics.<br />Ans. B<br />Q 170. Radiation exposure during infancy has been linked to which one of the following carcinoma:<br />A. Breast.<br />B. Melanoma.<br />C. Thyroid.<br />D. Lung.<br />Ans. C<br />Q 171. Recurrent ischemic events following thrombolysis has been pathophysiologically linked to which of the following factors:<br />A. Antibodies to thrombolytic agents.<br />B. Fibrinopeptide A.<br />C. Lipoprotein (a) [Lp(a)].<br />D. Triglycerides.<br />Ans. A<br />Q 172. Which of the following is pan-T lymphocyte marker?<br />A. CD2.<br />B. CD3.<br />C. CD19.<br />D. CD25<br />Ans. B<br />Q 173. Following are the features of corticospinal involvement except:<br />A. Cog-wheel rigidity.<br />B. Spasticity.<br />C. Plantar extensor response.<br />D. Exaggerated deep tendon reflexes.<br />Ans. A<br />Q 174. Positive feedback action of estrogen for inducting luteinizing hormone surge is associated with one of the following steroid hormone ratios in peripheral circulation:<br />A. High estrogen : low progesterone.<br />B. Low estrogen : high progesterone.<br />C. Low estrogen : low progestrone<br />D. High estrogen : high progesterone.<br />Ans. A<br />Q 175. A post-operative cardiac surgical patient developed sudden hypotension, raised central venous pressure, pulsus paradoxus at the 4th post operative hour. The most probable diagnosis is:<br />A. Excessive mediastinal bleeding.<br />B. Ventricular dysfunction.<br />C. Congestive cardiac failure.<br />D. Cardiac tamponade.<br />Ans. D<br />PEDIATRICS<br />Q 176. All of the following may occur in Noonan’s syndrome except:<br />A. Hypertrophic cardiomyopathy.<br />B. Cryptorchidism.<br />C. Infertility in females.<br />D. Autosomal dominant transmission.<br />Ans. C<br />Q 177. In an single visit, a 9-month old, unimmunized child can be given the following vaccination:<br />A. Only BCG.<br />B. BCG, DPT-1, OPV-1.<br />C. DPT-1, OPV-1, Measles.<br />D. BCG, DPT-1 OPV-1, Measles.<br />Ans. D<br />Q 178. An eight-year old boy had abdominal pain, fever with bloody diarrhea for 18 months. His height is 110 cms and weight is 14.5 kg. Stool culture was negative for known enteropathogens. The sigmoidoscopy was normal. During the same period, child had an episode of renal colic and passed urinary gravel. The mantoux test was 5 × 5 mm. The most probable diagnosis is:<br />A. Ulcerative colitis.<br />B. Crohn’s disease.<br />C. Intestinal tuberculosis.<br />D. Strongyloidosis.<br />Ans. B<br />Q 179. A 45-day old infant developed icterus and two days later symptoms and signs of acute liver failure appeared. Child was found to be positive for HBsAg. The mother was also HBs Ag carrier. The mother’s hepatitis B serological profile is likely to be:<br />A. HBsAg positive only.<br />B. HBsAg and HbeAg positivity.<br />C. HBsAg and anti-HBe antibody positivity.<br />D. Mother infected with mutant HBV.<br />Ans. B<br />Q 180. A 15-year old healthy boy with no major medical problem complaints that he breaks out with blocky areas of erythema that are pruritic over skin of his arm, leg and trunk every time within an hour of eating sea foods. The clinical features are suggestive of:<br />A. Localised immune-complex deposition.<br />B. Cell mediated hypersensitivity.<br />C. Localized anaphylaxis.<br />D. Release of complement C3b.<br />Ans. C<br />Q 181. A 2-month baby presents with history of jaundice, turmeric colored urine and pale stools since birth. Examination reveals liver span of 10 cms, firm in consistency and spleen of 3 cms. The most specific investigation for establishing the diagnosis would be:<br />A. Liver function tests.<br />B. Ultrasound abdomen.<br />C. Peroperative cholangiogram.<br />D. Liver biopsy.<br />Ans. D<br />Q 182. Transient myeloproliferative disorder of the newborn is seen in association with:<br />A. Turner syndrome.<br />B. Down syndrome.<br />C. Neurofibromatosis.<br />D. Ataxia telangiectasia.<br />Ans. B<br />Q 183. A 1-month old baby presents with frequent vomiting and failure to thrive. There are features of moderate dehydration. Blood sodium is 122 mEq/l and potassium is 6.1 mEq/l. The most likely diagnosis is:<br />A. Gitelman syndrome.<br />B. Bartter Syndrome<br />C. 21-hydroxylase deficiency.<br />hydroxylase deficiency.D. 11-<br />Ans. C<br />Q 184. A male child of 15 years, with a mental age of 9 years has an IQ of:<br />A. 50<br />B. 60<br />C. 70<br />D. 80<br />Ans. B<br /><br /><br />Q 185. The most appropriate drug used for chelation therapy in beta thalassemia major is:<br />A. Oral desferrioxamine.<br />B. Oral deferiprone.<br />C. Intramuscular EDTA.<br />D. Oral Succimer.<br />Ans. B<br />Q 186. Which endocrine disorder is associated with epiphyseal dysgenesis ?<br />A. Hypothyroidism.<br />B. Cushings syndrome.<br />C. Addison’s disease.<br />D. Hypoparathyroidism.<br />Ans. A<br />Q 187. An albino girl gets married to a normal boy. What are the chances of their having an affected child and what are the chances of their children being carriers?<br />A. None affected, all carriers.<br />B. All normal.<br />C. 50% carriers.<br />D. 50% affected, 50% carriers.<br />Ans. A<br />Q 188. Which one of the following statements is false with regard to Xanthogranulomatous pyelonephritis in children.<br />A. Often affects those younger than 8 years of age.<br />B. It affects the kidney focally more frequently than diffusely.<br />C. Boys are affected more frequently.<br />D. Clinical presentation in children is same as in adults.<br />Ans. D<br />Q 189. Which one of the following statements is false with regard to pyuria in children?<br />A. Presence of more than 5 WBC/hpf (high power field) for girls and more than 3 WBC/hpf for boys.<br />B. Infection can occur without pyuria.<br />C. Pyuria may be present without urinary tract infection.<br />D. Isolated pyuria is neither confirmatory nor diagnostic for urinary tract infection.<br />Ans. D<br />Q 190. Which one of the following is the most common cause of abdominal mass in neonates?<br />A. Neuroblastoma.<br />B. Wilm’s tumour.<br />C. Distended bladder.<br />D. Multicystic dysplastic kidneys.<br />Ans. D<br />DERMATOLOGY<br />Q 191. Acantholysis is characterstic of:<br />A. Pemphigus vulgaris<br />B. Pemphigoid<br />C. Erythema multiforme<br />D. Dermatitis herpetiformis<br />Ans. A<br />Q 192. A 5 year old boy has multiple asymptomatic oval and circular faintly hypopigmented macules with scaling on his face. The most probable clinical diagnosis is:<br />A. Pityriasis versicolor.<br />B. Indeterminate leprosy.<br />C. Pityriasis alba.<br />D. Acrofacial vitiligo.<br />Ans. C<br />Q 193. A 40-year old male developed persistent oral ulcers followed by multiple flaccid bullae on trunk and extremities. Direct examination of a skin biopsy immunofluorescence showed intercellular IgG deposits in the epidermis. The most probable diagnosis is:<br />A. Pemphigus vulgaris.<br />B. Bullous pemphigoid.<br />C. Bullous lupus erythematosus.<br />D. Epidermolysis bullosa acquisita.<br />Ans. A<br />Q 194. The test likely to help in diagnosis of a patient who presents with an itchy annular plaque on the face is:<br />A. Gram’s stain.<br />B. Potassium hydroxide mount.<br />C. Tissue smear.<br />D. Wood’s lamp examination.<br />Ans. B<br />Q 195. An eleven year old boy is having tinea capitis on his scalp. The most appropriate line of treatment is:<br />A. Oral griseofulvin therapy.<br />B. Topical griseofulvin therapy.<br />C. Shaving of the scalp.<br />D. Selenium sulphide shampoo.<br />Ans. A<br />Q 196. An 8 month old child presented with itchy, exudative lesions on the face, palms and soles. The sibling also have similar com-plaints. The treatment of choice in such a patient is:<br />A. Systemic ampicillin.<br />B. Topical betamethasone.<br />C. Systemic prednisolone.<br />D. Topical permethrin.<br />Ans. D<br />PSYCHIATRY<br />Q 197. Which of the following symbol represent adopted individuals:<br />A.<br />B.<br />C.<br />D.<br />Ans. D<br />Q 198. All of the following are features of hallucinations, except:<br />A. It is independent of the will of the observer.<br />B. Sensory organs are not involved.<br />C. It is as vivid as that in a true sense perception.<br />D. It occurs in the absence of a perceptual stimulus.<br />Ans. B<br />Q 199. Delirium tremens is characterized by confusion associated with:<br />A. Autonomic hyperactivity and tremors.<br />B. Features of intoxication due to alcohol.<br />C. Sixth nerve palsy.<br />D. Korsakoff psychosis.<br />Ans. A<br />Q 200. All of the following are impulse control disorders except:<br />A. Pyromania.<br />B. Trichotillomania.<br />C. Kleptomania.<br />D. Capgras’ syndrome.<br />Ans. D<br />Q 201. A 20-year old man has presented with increased alcohol consumption and sexual indulgence, irritability, lack of sleep and not feeling fatigued even on prolonged periods of activity. All these changes have been present for 3 weeks. The most likely diagnosis is:<br />A. Alcohol dependence.<br />B. Schizophrenia.<br />C. Mania.<br />D. Impulsive control disorder.<br />Ans. C<br />Q 202. An alcoholic is brought to the Emergency OPD with the complaint of irrelevant talking. He had stopped using alcohol three days back. On examination, he is found to be disoriented to time, place and person. He also has visual illusions and hallucinations. There is no history of head injury. The most likely diagnosis is:<br />A. Dementia praecox.<br />B. Derlirium tremens.<br />C. Schizophrenia.<br />D. Korsakoff’s psychosis.<br />Ans. B<br />Q 203. A 41-year old married female presented with headache for the last 6 months. She had several consultations. All her investigations were found to be within normal limits. She still insists that there is something wrong in her head and seeks another consultation. The most likely diagnosis is:<br />A. Phobia.<br />B. Psychogenic headache.<br />C. Hypochondriasis.<br />D. Depression.<br />Ans. C<br />Q 204. Behavior therapy to change maladaptive behaviors using response as reinforcer uses the principles of:<br />A. Classical conditioning.<br />B. Moneling.<br />C. Social learning.<br />D. Operant conditioning.<br />Ans. D<br />Q 205. A 15 year old boy feels that the dirt has hung onto him whenever he passes through the dirty street. This repetitive thought causes much distress and anxiety. He knows that there is actually no such thing after he has cleaned once but he is not satisfied and is compelled to think so. This has led to social withdrawal. He spends much of his time thinking about the dirt and contamination. This has affected his studies also. The most likely diagnosis is:<br />A. Obsessive compulsive disorder.<br />B. Conduct disorder.<br />C. Agoraphobia.<br />D. Adjustment disorder.<br />Ans. A<br />Q 206. A 50 year old man has presented with pain in back, lack of interest in recreational activities, low mood, lethargy, decreased sleep and appetite for two months. There was no history suggestive of delusions or hallucinations. He did not suffer from any chronic medical illness. There was no family history of psychiatric illness. Routine investigations including haemogram, renal function tests, liver functions tests, electrocardiogram did not reveal any abnormality. This patient should be treated with:<br />A. Haloperidol.<br />B. Sertraline.<br />C. Alprazolam.<br />D. Olanzapine.<br />Ans. B<br />GENERAL SURGERY<br />Q 207. A 70 year old male patient presented with history of chest pain and was diagnosed to have coronary artery disease. During routine evaluation, an ultrasound of the abdomen showed presence of gallbladder stones. There was no past history of biliary colic or jaundice. What is the best treatment advice for such a patient for his gallbladder stones:<br />A. Open cholecystectomy<br />B. Laparoscopic cholecystectomy<br />C. No surgery for gallbladder stones<br />D. ERCP and removal of gallbladder stones<br />Ans. C<br />Q 208. Early stage of trauma is characterized by:<br />A. Catabolism.<br />B. Anabolism.<br />C. Glycogenesis.<br />D. Gluconeogenesis.<br />Ans. A<br />Q 209. Bedsore is an example of:<br />A. Tropical ulcer<br />B. Trophic ulcer<br />C. Venous ulcer<br />D. Post thrombotic ulcer<br />Ans. B<br />Q 210. Marjolin’s ulcer is:<br />A. Malignant ulcer found on the scar of burn.<br />B. Malignant ulcer found on infected foot.<br />C. Trophic ulcer.<br />D. Meleney’s gangrene.<br />Ans. A<br />Q 211. If a patient with Raynaud’s disease immer-sed his hand in cold water, the hand will:<br />A. Become red.<br />B. Remain unchanged.<br />C. Turn white.<br />D. Become blue.<br />Ans. C<br />Q 212. The best treatment for cystic hygroma is:<br />A. Surgical excision.<br />B. Radiotherapy.<br />C. Sclerotherapy.<br />D. Chemotherapy.<br />Ans. A<br />Q 213. Which of the following is most suggestive of neonatal small bowel obstruction:<br />A. Generalised abdominal distension.<br />B. Failure to pass meconeum in the first 24 hours.<br />C. Bilious vomiting.<br />D. Refusal of feeds.<br />Ans. C<br />Q 214. What is most characteristic of congenital hypertrophic pyloric stenosis:<br />A. Affects the first born female child.<br />B. The pyloric tumour is best felt during feeding.<br />C. The patient is commonly marasmic.<br />D. Loss of appetite occurs early.<br />Ans. B<br />Q 215. Which of the following lasers is used for treatment of benign prostatic hyperplasia as well as urinary calculi?<br />A. CO2 laser<br />B. Excimer laser<br />C. Ho : YAG laser<br />D. Nd : YAG laser<br />Ans. C<br />Q 216. What is the most appropriate operation for a solitary nodule in one lobe of thyroid:<br />A. Lobectomy<br />B. Hemithyroidectomy.<br />C. Nodule removal.<br />D. Partial lobectomy with 1 cm margin around nodule.<br />Ans. B<br />Q 217. A posteriorly perforating ulcer in the pyloric antrum of the stomach is most likely to produce initial localized peritonitis or abscess formation in the following:<br />A. Omental bursa (lesser sac)<br />B. Greater sac<br />C. Right subphrenic space<br />D. Hepatorenal space (pouch of Morrison)<br />Ans. A<br />Q 218. A 65-year old male smoker presents with gross total painless hematuria. The most likely diagnosis is:<br />A. Carcinoma urinary bladder.<br />B. Benign prostatic hyperplasia.<br />C. Carcinoma prostate.<br />D. Cystolithiasis.<br />Ans. A<br />Q 219. A 10-mm calculus in the right lower ureter associated with proximal hydrouretero-nephrosis is best treated with:<br />A. Extracorporeal shockwave lithotripsy.<br />B. Antegrade percutaneous access.<br />C. Open ureterolithotomy.<br />D. Ureteroscopic retrieval.<br />Ans. D<br />Q 220. Semen analysis of a young man who presented with primary infertility revealed low volume, fructose negative ejaculate with azoospermia. Which of the following is the most useful imaging modality to evaluate the cause of his infertility ?<br />A. Colour duplex ultrasonography of the scrotum.<br />B. Transrectal ultrasonography.<br />C. Retrograde urethrography<br />D. Spermatic venography.<br />Ans. B<br />Q 221. A 70 year old patient with benign prostatic hyperplasia underwent transurethral resection of prostate under spinal anaesthesia. One hour later, he developed vomiting and altered sensorium. the most probable cause is:<br />A. Overdosage of spinal anaesthetic agent.<br />B. Rupture of bladder.<br />C. Hyperkalemia.<br />D. Water intoxication.<br />Ans. D<br />Q 222. A 50-year old male, working as a hotel cook, has four dependent family members. He has been diagnosed with an early stage squamous cell cancer of anal canal. He has more than 60% chances of cure. The best treatment option is:<br />A. Abdomino-perineal resection.<br />B. Combined surgery and radiotherapy.<br />C. Combined chemotherapy and radiotherapy.<br />D. Chemotherapy alone.<br />Ans. C<br />Q 223. The commonest cause of an obliterative stricture of the membranous urethra is:<br />A. Fall-astride injury.<br />B. Road-traffic accident with fracture pelvis and rupture urethra.<br />C. Prolonged catheterization.<br />D. Gonococcal infection<br />Ans. B<br />Q 224. Which of the following is an absolute indication for surgery in cases of benign prostatic hyperplasia:<br />A. Bilateral hydroureteronephrosis.<br />B. Nocturnal frequency.<br />C. Recurrent urinary tract infection.<br />D. Voiding bladder pressures >50 cm of water.<br />Ans. A<br />Q 225. A 27 year old man presents with a left testicular tumor with a 10 cm retroperitoneal lymph node mass. The treatment of choice is:<br />A. Radiotherapy.<br />B. Immunotherapy with interferon and inter-leukins.<br />C. Left high inguinal orchidectomy plus chemotherapy.<br />D. Chemotherapy alone.<br />Ans. C<br />Q 226. The best time for Surgery of hypospadias is:<br />A. 1-4 months of age.<br />B. 6-10 months of age.<br />C. 12-18 months of age.<br />D. 2-4 years of age.<br />Ans. B<br />Q 227. The Hunterian Ligature operation is performed for:<br />A. Varicose veins.<br />B. Arteriovenous fistulae.<br />C. Aneurysm.<br />D. Acute ischemia.<br />Ans. C<br />Q 228. Sympathectomy is indicated in all the following conditions except:<br />A. Ischaemic ulcers.<br />B. Intermittent claudication.<br />C. Anhidrosis.<br />D. Acrocyanosis.<br />Ans. C<br /><br />orthopaedics<br />Q 229. Commonest cause for neuralgic pain in foot is:<br />A. Compression of communication between medial and lateral plantar nerve.<br />B. Exaggeration of longitudinal arches.<br />C. Injury to deltoid ligament.<br />D. Shortening of plantar aponeurosis.<br />Ans. A<br />Q 230. In actinomycosis of the spine, the abscess usually erodes:<br />A. Intervertebral disc<br />B. Into the pleural cavity<br />C. Into the retroperitoneal space<br />D. Towards the SKIN<br />Ans. D<br />Q 231. A ten-year old girl presents with swelling of one knee joint. All of the following conditions can be considered in the differential diagnosis, except:<br />A. Tuberculosis<br />B. Juvenile rheumatoid arthritis<br />C. Haemophilia<br />D. Villonodular synovitis<br />Ans. C<br />Q 232. Avascular necrosis can be a possible sequelae of FRACTURE of all of the following bones, except:<br />A. Femur neck<br />B. Scaphoid<br />C. Talus<br />D. Calcaneum<br />Ans. D<br />Q 233. Sciatic nerve palsy may occur in the following injury:<br />A. Posterior dislocation of hip joint.<br />B. FRACTURE neck of femur.<br />C. Trochanteric FRACTURE .<br />D. Anterior dislocation of hip.<br />Ans. A<br />Q 234. A 30-year old male was brought to the casualty following a road traffic accident. His physical examination revealed that his right lower limb was short, internally rotated and flexed and adducted at the hip. The most likely diagnosis is:<br />A. FRACTURE neck of femur.<br />B. Trochanteric FRACTURE .<br />C. Central FRACTURE dislocation of hip.<br />D. Posterior dislocation of hip.<br />Ans. D<br />Q 235. Which one of the following tests will you adopt while examining a knee joint where you suspect an old tear of anterior cruciate ligament?<br />A. Posterior drawer test.<br />B. McMurray test.<br />C. Lachman test.<br />D. Pivot shift test.<br />Ans. C<br />Q 236. An eight-year old boy presents with back pain and mild fever. His plain X-ray of the dorsolumbar spine reveals a solitary collapsed dorsal vertebra with preserved disc spaces. There was no associated soft tissue shadow. The most likely diagnosis is:<br />A. Ewing’s sarcoma.<br />B. Tuberculosis.<br />C. Histiocytosis.<br />D. Metastasis.<br />Ans. C<br />Q 237. Kienbock’s disease is due to avascular necrosis of:<br />A. Femoral neck.<br />B. Medial cuneiform bone.<br />C. Lunate bone.<br />D. Scaphoid bone.<br />Ans. C<br />Q 238. Pseudoclaudication is due to compression of:<br />A. Femoral artery.<br />B. Femoral nerve.<br />C. Cauda Equina.<br />D. Popliteal artery.<br />Ans. C<br />Anaesthesia<br />Q 239. An anaesthetist orders a new attendent to bring the oxygen cylinder. He will ask the attendent to identify the correct cylinder by following color code:<br />A. Black cylinder with white shoulder.<br />B. Black cylinder with grey shoulder.<br />C. White cylinder with black shoulder.<br />D. Grey cylinder with white shoulder.<br />Ans. A<br />Q 240. During rapid sequence induction of Anaesthesia :<br />A. Sellick’s maneuver is not required.<br />B. Pre-oxygenation is mandatory.<br />C. Suxamethonium is contraindicated.<br />D. Patient is mechanically ventilated before endotracheal intubation.<br />Ans. B<br />Q 241. A 5 year old boy suffering from Duchenne muscular dystrophy has to undergo tendon lengthening procedure. The most appropriate anaesthetic would be:<br />A. Induction with intravenous thiopentone and N2O & halothane for maintenance.<br />B. Induction with intravenous propofol and N2O & oxygen for maintenance.<br />C. Induction with intravenous suxamethonium and N2O & halothane for maintenance.<br />D. Inhalation induction with inhalation halothane and N2O & oxygen for maintenance.<br />Ans. B<br />Q 242. A 25 year old male is undergoing incision and drainage of abscess under general Anaesthesia with spontaneous respiration. The most efficient anaesthetic circuit is:<br />A. Mapleson A<br />B. Mapleson B<br />C. Mapleson C<br />D. Mapleson D<br />Ans. A<br />Q 243. In all the following conditions neuraxial blockade is absolutely contraindicated, except:<br />A. Patient refusal.<br />B. Coagulopathy.<br />C. Severe hypovolemia.<br />D. Pre-existing neurological deficits.<br />Ans. D<br />Q 244. Interscalene approach to brachial plexus block does not provide surgical Anaesthesia in the area of distribution of which of the following nerve:<br />A. Musculocutaneous.<br />B. Ulnar.<br />C. Radial.<br />D. Median.<br />Ans. B<br />Q 245. At the end of a balanced Anaesthesia technique with non-depolarizing muscle relaxant, a patient recovered spontaneously from the effect of muscle relaxant without any reversal. Which is the most probable relaxant the patient had received?<br />A. Pancuronium<br />B. Gallamine<br />C. Atracuronium<br />D. Vecuronium<br />Ans. C<br />Q 246. A 64 year old hypertensive obese female was undergoing Surgery for FRACTURE femur under general Anaesthesia . Intra-operatively her end tidal carbon dioxide decreased to 20 from 40 mm Hg, followed by hypotension and oxygen saturation of 85%. What would be the most probable cause:<br />A. Fat embolism<br />B. Hypovolemia<br />C. Bronchospasm<br />D. Myocardial infarction<br />Ans. A<br />Q 247. One unit of fresh blood raises the Hb% concentration by:<br />A. 0.1 gm%<br />B. 1 gm%<br />C. 2 gm%<br />D. 2.2 gm%<br />Ans. B<br />Q 248. A 50 kg. man with severe metabolic acidosis has the following parameters: pH 7.05, pCO2 12 mmHg, pO2 108 mmHg, HCO3 5 mEq/L, base excess -30 mEq/L. The approximate quantity of sodium bicarbonate that he should receive in half hour is:<br />A. 250 mEq.<br />B. 350 mEq.<br />C. 500 mEq.<br />D. 750 mEq.<br />Ans. A<br />Q 249. The induction agent of choice in day care Anaesthesia is:<br />A. Sevoflurane.<br />B. Ketamine.<br />C. Propofol.<br />D. Methohexitone.<br />Ans. C<br />Q 250. A 38 year old man is posted for extraction of last molar tooth under general Anaesthesia as a day care case. He wishes to resume his work after 6 hours. Which one of the following induction agents is preferred:<br />A. Thiopentone sodium.<br />B. Ketamine.<br />C. Diazepam.<br />D. Propofol.<br />Ans. D<br />Q 251. During cardiopulmonary resuscitation, intravenous calcium gluconate is indicated under all of the following circumstances, except:<br />A. After 1 min. of arrest routinely.<br />B. Hypocalcemia.<br />C. Calcium channel blocker toxicity.<br />D. Electromechanical dissociation.<br />Ans. A<br />Q 252. Induction agent that may cause adrenal cortex suppression is:<br />A. Ketamine.<br />B. Etomidate.<br />C. Propofol.<br />D. Thiopentone.<br />Ans. B<br />OBSTETRICS AND Gynaecology<br />Q 253. A 40 year old lady delivered a full term baby. On examination of the baby, the neonatologist noted certain urogenital abnormality. He took the following picture. The most likely diagnosis is:<br />A. Urogenital sinus<br />B. Hypertrophied clitoris<br />C. Miocropenis<br />D. Vulval hematoma<br /><br />Ans. B<br />Q 54. A 55 year old lady presenting to out patient department (OPD) with postmenopausal bleeding for 3 months has a 1 × 1 cm nodule on the anterior lip of cervix. The most appropriate investigation to be done subsequently is:<br />A. Pap smear<br />B. Punch biopsy<br />C. Endocervical curettage<br />D. Colposcopy<br />Ans. B<br />Q 255. A hemodynamically stable nulliparous patient with ectopic pregnancy has adnexal mass of 2.5 × 3 cms and beta hCG titre of 1500 miu/ml. What modality of treatment is suitable for her:<br />A. Conservative management<br />B. Medical management<br />C. Laparoscopic Surgery<br />D. Laparotomy<br />Ans. B<br />Q 256. A case of gestational trophoblastic neoplasia belongs to high risk group if disease develop after:<br />A. Hydatidiform mole<br />B. Full term pregnancy<br />C. Spontaneous abortion<br />D. Ectopic pregnancy<br />Ans. BDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com1tag:blogger.com,1999:blog-2217647826950966921.post-36007827222930330832008-12-18T09:15:00.000-08:002008-12-18T09:21:21.376-08:00fmge paper 2002ALL INDIA<br />PAPER 2002<br />SOLVED<br />QUESTIONS AND ANSWERS<br /><br />Anatomy<br />Q 1. All the following are derivatives of the neural crest, except:<br />A. Melanocyte<br />B. Adrenal medulla<br />C. Sympathetic ganglia<br />D. Cauda equina<br />Ans. D<br />Q 2. Which of the following is true regarding gastrulation:<br />A. Establishes all the three germ layers<br />B. Occurs at the caudal end of the embryo prior to<br />its cephalic end<br />C. Involves the hypoblastic cells of inner cell mass<br />D. Usually occurs at 4 weeks<br />Ans. A<br />Q 3. All the following features are seen in neurons from dorsal root ganglia, except:<br />A. They have centrally located nuclei<br />B. They are derived from neural crest cells<br />C. They are multipolar<br />D. They contain lipofuscin granules<br />Ans. C<br />Q 4. Elastic cartilage is found in:<br />A. Auditory tube<br />B. Nasal septum<br />C. Articular cartilage<br />D. Costal cartilage<br />Ans. A<br />Q 5. The weight of the upper limb is transmitted to the axial skeleton by:<br />A. Coracoclavicular ligament<br />B. Coracoacromial ligament<br />C. Costoclavicular ligament<br />D. Coracohumeral ligament<br />Ans. A<br />Q 6. The superficial external pudendal artery is a branch of:<br />A. Femoral artery<br />B. External iliac artery<br />C. Internal iliac artery<br />D. Aorta<br />Ans. A<br /><br />Q 7. Diaphragmatic hernia can occur through all the following, except:<br />A. Esophageal opening<br />B. Costovertebral triangle<br />C. Costal and sternal attachment of diaphragm<br />D. Inferior vena cava opening<br />Ans. D<br />Q 8. Ureteric constriction is seen at all the following positions, except:<br />A. Ureteropelvic junction<br />B. Ureterovesicle junction<br />C. Crossing of iliac artery<br />D. Ischial spine<br />Ans. D<br />Q 9. All the following are true regarding blood supply to the kidney , except:<br />A. Stellate veins drain superficial zone<br />B. It is site of portosystemic anastomosis<br />C. The renal artery divides into five segmental arteries before entering the hilum<br />D. Its segmental arteries are end-arteries<br />Ans. B<br />Q 10. A patient with external hemorrhoids develops pain while passing stools. The nerve mediating this pain is:<br />A. Hypogastric nerve<br />B. Pudendal nerve<br />C. Splachnic visceral nerve<br />D. Sympathetic plexus<br />Ans. B<br />Q 11. Which of the following muscles is supplied by mandibular nerve:<br />A. Masseter<br />B. Buccinator<br />C. Tensor veli palati<br />D. Posterior belly of digastric<br />Ans. C<br />Q 12. The sensoy supply of the palate is through all of the following, except:<br />A. Facial nerve<br />B. Hypoglossal nerve<br />C. Glossopharyngeal nerve<br />D. Maxillary division of trigeminal nerve<br />Ans. B<br />Q 13. All of the following are features of large intestine, except:<br />A. Large intestine secretes acidic mucus which helps in formation of stools<br />B. It is a site of mucocutaneous junction<br />C. Its epithelium contains globlets cells in large numbers<br />D. Absorbs salt and water<br />Ans. A<br />Q 14. In flexion and abduction of shoulder all of the following structures are compressed except:<br />A. Subacromial bursa<br />B. Long head of biceps<br />C. Suprascapular nerve<br />D. Supraspinatus tendon<br />Ans. C<br />Physiology<br />Q 15. SI unit for measuring blood pressure is:<br />A. Torr<br />B. mrnHg<br />C. kPa<br />D. Bar<br />Ans. C<br />Q 16. Glucose mediated insulin release is mediated through:<br />A. ATP dependent K+ channels<br />B. cAMP<br />C. Carrier modulators<br />D. Receptor phosphorylation<br />Ans. A<br />Q 17. Sudden decrease in serum calcium is associated with:<br />A. Increased thyroxine and PTH secretion<br />B. Increased phosphate<br />C. Increased excitability of muscle and nerve<br />D. Cardiac conduction abnormalities<br />Ans. C<br />Q 18. Ablation of the ‘somatosensory area 1’ of the cerebral cortex leads to:<br />A. Total loss of pain sensation<br />B. Total loss of touch sensation<br />C. Loss of tactile localization but not of two point discrimination<br />D. Loss of tactile localization and two point discrimination<br />Ans. D<br />Q 19. Non shivering thermogenesis in adults is due to:<br />A. Thyroid hormone<br />B. Brown fat between the shoulders<br />C. Adrenaline from adrenal medulla<br />D. Muscle metabolism<br />Ans. C<br />Q 20. In metabolic acidosis, which of the following changes are seen:<br />A. Increased K+excretion<br />B. Decreased K+ excretion<br />C. Increased Na+ excretion<br />D. Increased Na+ reabsorption<br />Ans. B<br />Q 21. Tropomyosin:<br />A. Helps in the fusion of actin and myosin<br />B. Covers myosin and prevents attachments of actin and myosin<br />C. Slides over myosin<br />D. Causes Ca2+ release<br />Ans. B<br />Q 22. TRH stimulation testing is useful in diagnosis of disorders of following hormones:<br />A. Insulin<br />B. ACTH<br />C. Prolactin<br />D. PTH<br />Ans. C<br />Q 23. During muscular exercise all are seen except:<br />A. Increase in blood flow to muscles<br />B. Stroke volume increases<br />C. O2 dissociation curve shifts to left<br />D. O2 consumption increases<br />Ans. C<br />Biochemistry<br />Q 24. “All enzymes are not proteins.” This statement is justified by:<br />A. All enzymes do not follow the Michaelis Menten hypothesis<br />B. RNAs act as ribozymes<br />C. Antibodies take part in the catalysis of many reactions<br />D. Metals are involved in attachment to enzymes and catalysts<br />Ans. B<br />Q 25. Enzymes mediating transfer of one molecule to another are:<br />A. Transferases<br />B. Oxidases<br />C. Lysases<br />D. Peptidases<br />Ans. A<br />Q 26. In which of the following reactions is magnesium required:<br />A. Na+K+ ATPase<br />B. Dismutase<br />C. Phosphatase<br />D. Aldolase<br />Ans. A<br />Q 27. In oxidative phosphorylation, the ATP production and respiratory chain are linked by:<br />A. Chemical methods<br />B. Physical methods<br />C. Chemiosmotic methods<br />D. Conformational changes<br />Q Ans. C<br />Q 28. Thiamine level is best monitored by:<br />A. Transketolase level in RBC<br />B. Thiamine level in blood<br />C. G-6-PD activity<br />D. Reticulocytosis<br />Ans. A<br />Q 29. Vitamin B12 and folic acid supplementation in megaloblastic anemia leads to the improvement of anemia due to:<br />A. Increased DNA synthesis in bone marrow<br />B. Increased hemoglobin production<br />C. Erythroid hyperplasia<br />D. Increased iron absorption<br />Ans. A<br />Q 30. Nitric oxide synthase:<br />A. Is inhibited by Ca++<br />B. Catalyses a dioxygenase reaction<br />C. Accepts electrons from NADH<br />D. Requires NADH, FAD, FMN & heme iron<br />Ans. D<br />Q 31. Phenylalanine is the precursor of all the following, except:<br />A. Tyrosine<br />B. Epinephrine<br />C. Thyroxine<br />D. Melatonin<br />Ans. D<br />Q 32. In a well fed state, acetyl CoA obtained from diet is least used in the synthesis of:<br />A. Palmity CoA<br />B. Citrate<br />C. Acetoacetate<br />D. Oxalosuccinate<br />Ans. C<br />Q 33. Substrate level phosphorylation in citric acid cycle is seen in the conversion of:<br />-ketoglutarateaA. Acetoacetate to<br />B. Succinyl CoA to succinate<br />C. Fumarate to malate<br />D. Succinate to fumarate<br />Ans. B<br />Q 34. Apo B48 and apo B100 are expressed as two different apo-proteins because of difference in:<br />A. RNA editing<br />B. RNA splicing<br />C. Chromosomal loci<br />D. Apo-B gene<br />Ans. A<br />Q 35. All the following can be used to detect mutation, except:<br />A. Single strand conformational polymorphism<br />B. Ligase chain reaction<br />C. Polymerase chain reaction<br />D. DNA sequencing<br />Ans. B<br />Q 36. Which of the following is true regarding hydroxy ethyl starch:<br />A. It is an anesthetic agent<br />B. It is a plasma expander<br />C. It is a crystalloid<br />D. Used as a nutritional agent<br />Ans. B<br />Q 37. Elasticity of the corneal layer of SKIN is due to the presence of:<br />A. Histidine<br />B. Keratin<br />C. Lysine<br />D. Cysteine<br />Ans. B<br />Q 38. In dividing cells, spindle is formed by:<br />A. Ubiquitin<br />B. Tubulin<br />C. Laminin<br />D. Keratin<br />Ans. B<br /><br />Q 39. Entropy in a biological system is constant because:<br />A. It is an open system<br />B. It is a closed system<br />C. It is a governed by vitalism<br />D. Has exothermic-endothermic reactions<br />Ans. D<br />Q 40. Which of the following is true regarding a system which favours oscillatory responses:<br />A. Has proportional component<br />B. Has a greater gain<br />C. Has a lesser gain<br />D. Positive FEEDBACK system<br />Ans. D<br />Q 41. Highest binding of iron is seen with:<br />A. Transferrin<br />B. Ferritin<br />C. Haemoglobin<br />D. Ceruloplasmin<br />Ans. C<br />Pathology<br />Q 42. The epitheloid cell and multinucleated gaint cells of granulomatous inflammation are derived from:<br />A. Basophils<br />B. Eosinophils<br />C. CD4 T lymphocytes<br />D. Monocytes-macrophages<br />Ans. D<br />Q 43. The following host tissue responses can be seen in acute infection, except:<br />A. Exudation<br />B. Vasodilation<br />C. Margination<br />D. Granuloma formation<br />Ans. D<br />Q 44. The following feature is common to both cytotoxic T cells and NK cells:<br />A. Synthesize antibody<br />B. Require antibodies to be present for action<br />C. Effective against virus infected cells<br />D. Recognize antigen in association with HLA class II markers<br />Ans. C<br />Q 45. In the intra-epithelial region of the mucosa of intestine the predominant cell population is that of:<br />A. B cell<br />B. T cells<br />C. Plasma cells<br />D. Basophils<br />Ans. B<br />Q 46. In primary tuberculosis, all of the following may be seen except:<br />A. Cavitation<br />B. Caseation<br />C. Calcification<br />D. Langerhan giant cell<br />Ans. A<br />Q 47. A mylocardial infarct showing early granulation tissue has most likely occurred:<br />A. Less than 1 hours<br />B. Within 24 hours<br />C. Within 1 week<br />D. Within 1 month<br />Ans. D<br />Q 48. A 10 year old boy, died of acute rheumatic fever. All the following can be expected at autopsy except:<br />A. Ashoff nodules<br />B. Rupture of chordae tendinae<br />C. McCallum patch<br />D. Fibrinous pericarditis<br />Ans. B<br />Q 49. All of the following are seen in asbestosis except:<br />A. Diffuse alveolar damage<br />B. Calcified pleural plaques<br />C. Diffuse pulmonary interstitial fibrosis<br />D. Mesotheliomas<br />Ans. A<br />Q 50. Macrophages containing large quantities of undigested and partial digested bacteria in intestine are seen in:<br />A. Whipple’s disease<br />B. Amyloidosis<br />C. Immunoproliferative small instetinal disease<br />D. Vibrio cholerae infection<br />Ans. A<br /><br />Q 51. The histological features of celiac disease include all of the following, except:<br />A. Crypt hyperplasia<br />B. Increase in thickness of the mucosa<br />C. Increase in intraepithelial lymphocytes<br />D. Increase in inflammatory cells in lamina propria<br />Ans. B<br />Q 52. In a chronic alcoholic all the following may be seen in the liver except:<br />A. Fatty degeneration<br />B. Chronic hepatitis<br />C. Granuloma formation<br />D. Cholestatic hepatitis<br />Ans. C<br />Q 53. Crescent formation is characteristic of the following glomerular disease:<br />A. Minimal change disease<br />B. Rapidly progressive glomerulonephritis<br />C. Focal and segmental glomerulosclerosis<br />D. Rapidly non prgressive glomerulonephritis<br />Ans. B<br />Q 54. Necrotizing papillitis may be seen in all of the following conditions except:<br />A. Sickle cell disease<br />B. Tuberculous pyelonephritis<br />C. Diabetes mellitus<br />D. Analgesic nephropathy<br />Ans. B<br />Q 55. Disease or infarction of neurological tissue causes it to be replaced by:<br />A. Fluid<br />B. Neuroglia<br />C. Proliferation of adjacent nerve cells<br />D. Blood vessel<br />Ans. B<br />Q 56. Flat small vegetations in the cusps of both tricuspid and mitral valves are seen in:<br />A. Viral myocarditis<br />B. Libmann Sach’s endocarditis<br />C. Rheumatic carditis<br />D. Infective endocarditis<br />Ans. B<br />Microbiology<br />Q 57. Bacteria may acquire characteristics by all of the following except:<br />A. Taking up soluble DNA fragments across their cell wall from other species<br />B. Incorporating part of host DNA<br />C. Through bacteriophages<br />D. Through conjugation<br />Ans. B<br />Q 58. Neonatal thymectomy leads to:<br />A. Decreased size of germinal center<br />B. Decreased size of paracortical areas<br />C. Increased antibody production by B cells<br />D. mcreased bone marrow production of lymphocytes<br />Ans. B<br />Q 59. Staphylococcus aureus differs from Staphylococcus epidermidis by:<br />A. Is coagulase positive<br />B. Forms white colonies<br />C. A common cause of UTI<br />D. Causes endocarditis in drug addicts<br />Ans. A<br />Q 60. Positive Shick’s test indicates that person is:<br />A. Immune to diptheria<br />B. Hypersensitive to diptheria<br />C. Susceptible to diptheria<br />D. Carrier of diptheria<br />Ans. C<br />Q 61. In a patient with typhoid, diagnosis after 15 days of onset of fever is best done by:<br />A. Blood culture<br />B. Widal<br />C. Stool culture<br />D. Urine culture<br />Ans. B<br />Q 62. Which of the following is transmitted by rat urine?<br />A. Leptospira<br />B. Listeria<br />C. Legionella<br />D. Mycoplasma<br />Ans. A<br />Q 63. AII the following are true about Listeria except:<br />A. Transmitted by contaminated milk<br />B. Gram negative bacteria<br />C. Causes abortion in pregnancy<br />D. Causes meningitis in neonates<br />Ans. B<br />Q 64. Which of the following statement is true about Bacteroides:<br />A. It is gram positive bacilli<br />B. It is strictiy aerobic<br />C. It may cause peritonitis<br />D. Presence in stool culture indicates need for treatment<br />Ans. C<br />Q 65. Heat stable enterotoxin causing food poisoning is caused by all the following except:<br />A. Bacillus cereus<br />B. Yersinia enterocolitica<br />C. Staphylococcus<br />D. Clostridium perfringens<br />Ans. D<br />Q 66. HIV virus contains:<br />A. Single stranded DNA<br />B. Single stranded RNA<br />C. Double stranded DNA<br />D. Double stranded RNA<br />Ans. B<br />Q 67. Regarding HIV which of the following is not true:<br />A. It is a DNA retrovirus<br />B. Contains reverse transcriptase<br />C. May infect host CD4 cells other than T-lymphocytes<br />D. Causes a reduction in host CD4 cells at late stage of disease<br />Ans. A<br />Q 68. CMV retinitis in HIV occurs when the CD4 counts fall below:<br />A. 50<br />B. 100<br />C. 200<br />D. 150<br />Ans. A<br />Q 69. Epstein Barr virus causes all the following except:<br />A. Infectious mononucleosis<br />B. Measles<br />C. Nasopharyngeal carcinoma<br />D. Non Hodgkin’s lymphoma<br />Ans. B<br />Q 70. In a patient, corneal scraping reveals narrow angled septate hyphae. Which of the following is the likely etiologic agent:<br />A. Mucor<br />B. Aspergillus<br />C. Histoplasma<br />D. Candida<br />Ans. B<br />Q 71. Which of the following is true regarding globi in a patient with lepromatous leprosy:<br />A. Consists of lipid laden macrophages.<br />B. Consists of macrophages filled with AFB<br />C. Consists of neutrophils filled with bacteria<br />D. Consists of activated lymphocytes<br />Ans. B<br />Q 72. The following diagnostic tests are useful for corresponding purposes except:<br />A. Zeil-Neelson staining – Detection of mycobacteria<br />B. Immunoflorescence – Detection of influenza virus<br />C. Specific IgM antibodies – Immunity against rubella<br />D. Specific IgM antibodies – Detection of acute infection<br />Ans. C<br />Q 73. IL-1 produces:<br />A. T lymphocyte activation<br />B. Delayed wound healing<br />C. Increased pain perception<br />D. Decreased PMN release from bone marrow<br />Ans. A<br />Q 74. Microfilaria are seen in peripheral blood in which stage of filariasis:<br />A. Tropical eosinophilia<br />B. Early elephantiasis<br />C. Early adenolymphangitis stage<br />D. None of the above<br />Ans. C<br />Q 75. Confirmation of diagnosis of rota virus infection is by:<br />A. Antigen detection in stool by ELISA<br />B. Antibody titres in serum<br />C. Antigen detection by immunoflurescence<br />D. Antigen detection in serum by ELISA<br />Ans. A<br />Pharmacology<br />Q 76. Regarding efficacy and potency of a drug, all are true, except:<br />A. In a clinical setup, efficacy is more important than potency<br />B. In the log dose response curve, the height of the curve corresponds with efficacy<br />C. ED50 of the drug corresponds to efficacy<br />D. Drugs that produce a similar pharmacological effect can have different levels of efficacy<br />Ans. D<br />Q 77. All the following are selective beta blockers, except:<br />A. Atenolol<br />B. Esmolol<br />C. Bisprolol<br />D. Celiprolol<br />Ans. D<br />Q 78. All of the following factors increase the risk of aminoglycoside renal toxicity, except:<br />A. Elderly person<br />B. Dehydration<br />C. Simultaneous use with penicillin<br />D. Aminoglycoside administration in recent past<br />Ans. C<br />Q 79. In which of the following disorders is administration of barbiturates contraindicated in:<br />A. Anxiety disorders<br />B. Acute intermittent porphyria<br />C. Kemincterus<br />D. Refractive status epilepticus<br />Ans. B<br />Q 80. Mechanism of action tianeptin in the brain is:<br />A. Selective serotonin reuptake inhibition<br />B. Selective norepinephfine reuptake inhibition<br />C. Selective serotonin reuptake enchancer<br />D. Selective dopamine reuptake inhibition<br />Ans. C<br />Q 81. Proton pump inhibitors are most effective when they are given:<br />A. After meals<br />B. Shortly before meals<br />C. Along with H2 blockers<br />D. During prolonged fasting periods<br />Ans. B<br />Q 82. Which of the following is correctly matched:<br />A. Dimercaprol:Iron<br />B. Calcium di-sodium EDTA:Arsenic<br />C. Penicillamine:Copper<br />D. Desferrioxamine:Lead<br />Ans. C<br />Q 83. Digoxin is contraindicated in:<br />A. Supraventricular tachycardia<br />B. Atrial fibrillation<br />C. Congestive heart failure<br />D. Hypertrophic obstructive cardiomyopathy<br />Ans. D<br />Q 84. All the following drugs cause renal failure except:<br />A. Cephaloridine<br />B. Amphoterecin B<br />C. Cefoperazone<br />D. Gentamicin<br />Ans. C<br />Q 85. All of the following statements are true regarding losartan except:<br />A. It is a competitive angiotensin receptor antagonist<br />B. It has a long acting metabolite<br />C. Associated with negligible cough<br />D. Causes hyperuricemia<br />Q Ans. D<br />86. Gemcitabine is effective in:<br />A. Head and neck cancers<br />B. Pancreatic cancer<br />C. Small-cell lung cancer<br />D. Soft tissue sarcoma<br />Ans. B<br />Q 87. All of the following drugs can cross placenta except:<br />A. Phenytoin<br />B. Diazepam<br />C. Morphine<br />D. Heparin<br />Ans. D<br />Q 88. A highway truck driver has profuse rhinorrhea and sneezing. Which amongst the following durgs would you prescibe him?<br />A. Pheniramine<br />B. Promethazine<br />C. Dimerhydrinate<br />D. Cetrizine<br />Ans. D<br />Q 89. The mechanism of action of sodium nitroprusside is:<br />A. Increased cAMP<br />B. Increased guanylate cyclase<br />C. Calcium channel blockage<br />D. K+ channel opener<br />Ans. B<br />Q 90. All the following belong to the steroid receptor superfamily except:<br />A. Vitamin D3 receptor<br />B. Thyroid receptor<br />C. Retinoid receptor<br />D. Epinephrine receptor<br />Ans. D<br />Q 91. All of the following undergo hepatic metabolism before excretion except:<br />A. Phenytoin<br />B. Diazepam<br />C. Penicillin G<br />D. Cimetidine<br />Ans. C<br />Q 92. In a patient taking oral contraceptive, the chance of pregnancy increases after taking any of the following drugs except:<br />A. Phenytoin<br />B. Carbamazepine<br />C. Ampicillin<br />D. Cimetidine<br />Ans. D<br />Q 93. The primary mechanism of action of fluoride on topical application is:<br />A. Conversion of hydroxyapatite to fluoroapatite by replacing the –OH ions<br />B. Inhibition of plaque bacteria<br />C. Form a reservoir in saliva<br />D. Improvement in tooth morphology<br />Ans. A<br />Q 94. A 65 year old man was consuming opium for 20 years. He stops consumption suddenly and comes to casualty after 2 days. Which is likely to occur due to withdrawal:<br />A. Rhinorrhoea<br />B. Hypotension<br />C. Drowsiness<br />D. Miosis<br />Ans. A<br />Q 95. Which of the following causes hepatic granuloma?<br />A. Amiodarone<br />B. Alcohol<br />C. Cimetidine<br />D. Metronidazole<br />Ans. A<br />Q 96. Coronary steal commonly is seen with:<br />A. Atenolol<br />B. Diltiazem<br />C. Nitroglycerine<br />D. Dipyridamole<br />Ans. D<br />Q 97. A patient is taking ketoconazole for fungal infection develops cold for which he is prescribed terfenadine. Possible interaction between terfenadine and ketoconazole is:<br />A. Ketoconazole decreases metabolism of terfenadine<br />B. Terfenadine increases levels of ketoconazole<br />C. Ketoconazole decreases levels of terfenadine<br />D. No interaction<br />Ans. A<br />Forensic Medicine<br />Q 98. What would be the race of individual if skull bone having following feature – rounded nasal opening, horseshoe shaped palate, round orbit & cephalic index above 80:<br />A. Negro<br />B. Mongol<br />C. European<br />D. Aryans<br />Ans. B<br />Q 99. A sample to look for uric crystal (gouty tophus) would be submitted to the Pathology laboratory in:<br />A. Formalin<br />B. Distilled water<br />C. Alcohol<br />D. Normal saline<br />Ans. C<br />Q 100. Not a feature of brain death:<br />A. Complete apnea<br />B. Absent pupillary reflex<br />C. Absence of deep tendon reflex<br />D. heart rate unresponsive to atropine<br />Ans. C<br />Q 101. At autopsy, a body is found to have copious fine leathery froth in mouth & nostrils which increased on pressure over chest. Death was likely due to:<br />A. Epilepsy<br />B. Hanging<br />C. Drowning<br />D. Opium poisoning<br />Ans. C<br />Q 102. In fire arm injury, entery-wound blackening is due to:<br />A. Flame<br />B. Hot gases<br />C. Smoke<br />D. Deposition from bullet<br />Ans. D<br />Q 103. Tentative cut is a feature of:<br />A. Fall from the height<br />B. Homicidal assault<br />C. Accidental injury<br />D. Suicidal attempt<br />Ans. D<br />Q 104. Gastric lavage is indicated in all cases of acute poisoning ideally because of:<br />A. Fear of aspiration<br />B. Danger of cardiac arrest<br />C. Danger of respiratory arrest<br />D. Inadequat ventilation<br />Ans. A<br />Q 105. All of the following method used for detecting heavy metals, except:<br />A. Harrison & Gilroy test<br />B. Paraffin test<br />C. Neutron activation analysis<br />D. Atomic adsorption spectroscopy<br />Ans. B<br />Q 106. The sensation of creping, bugs over the body is a feature of poisoning due to:<br />A. Cocaine<br />B. Diazepam<br />C. Barbiturates<br />D. Brown sugar<br />Ans. A<br />Q 107. Which type of cattle poisoning occurs due to ingestion of linseed plant:<br />A. Aconite<br />B. Pilocarpine<br />C. Atropine<br />D. Hydro cyanic acid<br />Ans. D<br />Q 108. A 10 years old child present in casualty with snake bite since six hours. On examination no systemic signs are found & laboratory investigation are normal except localized swelling over the leg < 5 cm. Next step in management would be:<br />A. Incision & suction of local swelling<br />B. IV antivenom<br />C. Subcutaneous antivenom at local swelling<br />D. Observe the patient for progression of symptoms wait for antivenom therapy<br />Ans. D<br />Q 109. ‘Gold chloride’ test is done in poisoning with:<br />A. Heroin<br />B. Barbiturates<br />C. Cocaine<br />D. Heavy metals<br />Ans. C<br />PREVENTIVE AND SOCIAL Medicine<br />Q 110. Iron and folic acid supplementation forms:<br />A. Health promotion<br />B. Specific protection<br />C. Primordial prevention<br />D. Primary prevention<br />Ans. B<br />Q 111. The most important function of sentinel surveillance is:<br />A. To find the total amount of disease in a population<br />B. To plan effective control measures<br />C. To determine the trend of disease in a population<br />D. To notify disease<br />Ans. A<br />Q 112. Serial interval is:<br />A. Time gap between primary and secondary case<br />B. Time gap between index and primary case<br />C. Time taken for a person from infection to develop maximum infectivity<br />D. The time taken from infection till a person infects another person<br />Ans. A<br />Q 113. All the following are advantages of case control studies except:<br />A. Useful in rare disease<br />B. Relative risk can be calculated<br />C. Odds ratio can be calculated<br />D. Cost effective and inexpensive<br />Ans. B<br /><br /><br />Q 114. The association between coronary artery disease and smoking was found to be as follows:<br />CAD No CAD<br />Smokers 30 20<br />Non smokers 20 30<br />The Odds ratio can be estimated as:<br />A. 0.65<br />B. 0.85<br />C. 1.35<br />D. 2.25<br />Ans. D<br />Q 115. In a prospective study comprising 10,000 subjects, 6000 subjects were put on beta carotene and 4000 were not, 3 out of the first 6000 developed lung cancer and 2 out of the second 4000 developed lung cancer. What is the interpretation of the above results?<br />A. Beta carotene is protective in lung cancer<br />B. Beta carotene and lung cancer have no relation to each other<br />C. The study design is not sufficient to draw any meaningful conclusions<br />D. Beta carotene is carcinogenic<br />Ans. B<br />Q 116. About direct standardization all are true except:<br />A. Age specific death rates are not needed<br />B. A standard population is needed<br />C. Population should be comparable<br />D. Two propulations are compared<br />Ans. A<br />Q 117. Which vaccine is contraindicated in pregnancy?<br />A. Rubella<br />B. Diphtheria<br />C. Tetanus<br />D. Hepatitis B<br />Ans. A<br />Q 118. Which of the following statements is true regarding pertussis?<br />A. Neurological complication rate of DPT is 1 in 50000<br />B. Vaccine efficacy is more than 95%<br />C. Erythromycin is useful for prophylaxis<br />D. The degree of polymorphonuclear leukocytosis correlates with the severity of cough<br />Ans. C<br />Q 119. Drugs A & B are both used for treating a particular SKIN infection. After one standard application, drug A eradicates the infection in 95% of both adults and children. drug B eradicates the infection in 47% of adults & 90% of children. There are otherwise no significant pharmacological differences between the two drugs, and there are no significant side effects. However, the cost of drug A is twice that of drug B. Dr. Sunil, a general practitioner, always uses drug B for the first treatment, and resorts to drug A if the infection persists. Dr. Sudhir, another general practitioner, always uses drug A for adults and drug B for children. Ignoring indirect costs, which of the following statement is incorrect:<br />A. Drug A is more effective than B for treating children<br />B. Drug A is more cost-effective than drug B for treating children<br />C. Drug A is more cost-effective than drug B for treating adults<br />D. Dr. Sudhir’s regime achieves a higher level of cost-effectiveness than Dr. Sunil’s<br />Ans. B<br />Q 120. The infectivity of chicken pox lasts for:<br />A. Till the last scab falls off<br />B. 6 days after onset of rash<br />C. 3 days after onset of rash<br />D. Till the fever subsides<br />Ans. B<br />Q 121. Carriers are important in all the following except:<br />A. Polio<br />B. Typhoid<br />C. Measles<br />D. Diphtheria<br />Ans. C<br />Q 122. Acute flaccid paralysis is reported in a child aged:<br />A. 0-3 years<br />B. 0-5 years<br />C. 0-15 years<br />D. 0-25 years<br />Ans. C<br />Q 123. A 2-years-old boy, presented with cough, fever & difficulty in breathing. His RR 50/min. There was no chest indrawing. Auscultation of chest reveals bilateral crepitions. The most probable diagnosis is:<br />A. Very severe pneumonia<br />B. Severe pneumonia<br />C. Pneumonia<br />D. No pneumonia<br />Ans. C<br />Q 124. Active and passive immunity should be given together in all except:<br />A. Tetanus<br />B. Rabies<br />C. Measles<br />D. Hepatitis B<br />Ans. C<br />Q 125. Cereals and proteins are considered complemen- tary because:<br />A. Cereals are deficient in methionine<br />B. Cereals are deficient in methionine and pulse are deficient in lysine<br />C. Cereals are deficient in lysine and pulses are deficient in methionine<br />D. Cereal proteins contain non-essential amino-acids, while pulse proteins contain essential amino acids<br />Ans. C<br />Q 126. For a 60 kg Indian male, the minimum daily protein requirement has been calculated to be 40 g (mean) & standard deviation is 10. The recommended daily allowance of protein would be:<br />A. 60 g/day<br />B. 70 g/day<br />C. 40 g/day<br />D. 50 g/day<br />Ans. A<br />Q 127. A population study showed a mean glucose of 86 mg/ dL. In a sample of 100 showing normal curve distribution, what percentage of people have glocose above 86%?<br />A. 65 B. 50<br />C. 75 D. 60<br />Ans. B<br />Q 128. The best method to show the association between height and weight of children in a class is by:<br />A. Bar chart<br />B. Line diagram<br />C. Scatter diagram<br />D. Histogram<br />Ans. C<br />Q 129. The correlation between variables A and B in a study was found to be 1.1. This indicates:<br />A. Very strong correlation<br />B. Moderately strong correlation<br />C. Weak correlation<br />D. Computational mistake in calculating correlation<br />Ans. D<br />Q 130. The biological oxygen demand indicates:<br />A. Organic matter<br />B. Bacterial content<br />C. Anaerobic bacteria<br />D. Chemicals<br />Ans. A<br />Q 131. In a surveillance centre for hepatitis B, in a low prevalance area, the method for testing for hepatitis B was single ELISA. This policy was changed to double testing in series. This would result in the following 2 parameters of the test being affected:<br />A. Increased specificity and positive predictive value<br />B. Increased sensitivity and positive predictive value<br />C. Increased sensitivity and negative predictive value<br />D. Increased specificity and negative predictive value<br />Ans. A<br />Q 132. In a study, variation in cholesterol was seen before and after giving a drug. The test of significance would be:<br />A. Unpaired t test<br />B. Paired t test<br />C. Chi square test<br />D. Fisher test<br />Ans. B<br />Q 133. Ravi and Ashok stay in the same hostel of the same university. Ravi develops infection with group B meningococcus. After a few days Ashok develops infection due to group C meningococcus. All the following are true statements except:<br />A. Educate students about meningococcal trans- mission and take preventive measures<br />B. Chemotheraphylaxis to all against both group B and group C<br />C. Vaccine prophylaxis of contacts of Ravi<br />D. Vaccine prophylaxis of contacts of Ashok<br />Ans. C<br />Q 134. All of the following are common cause of post neonatal infant mortality in India, except:<br />A. Tetanus<br />B. Malnutrition<br />C. Diarrhoeal diseases<br />D. Acute respiratory infection<br />Ans. A<br />Q 135. True about ‘total fertility rate’ is:<br />A. Sensitive indicator of family planning achievement<br />B. Completed family size<br />C. Number of live births per 1000 married women in reproductive age group<br />D. Average number of girls born to a woman<br />Ans. B<br /><br />Q 136. ‘Silent epidemic’ of the century is:<br />A. Coronary artery disease<br />B. Chronic liver disease<br />C. Chronic obstructive lung disease<br />D. Alzheimer’s disease<br />Ans. D<br />Medicine<br />Q 137. The following condition is not associated with an increased anion-gap type of metabolic acidosis:<br />A. Shock<br />B. Ingestion of ante-freeze<br />C. Diabetic ketoacidosis<br />D. COPD<br />Ans. D<br />Q 138. Acute metabolic acidosis:<br />A. Has biphasic effect on K+ excretion<br />B. Does not effect K+ excretion significantly<br />C. Decreases urinary K+ excretion<br />D. Increases urinary K+ excretion<br />Ans. C<br />Q 139. Urinary anion gap an indication of excretion of:<br />A. Ketoacids<br />B. Na<br />C. H+ ion<br />D. K+ ion<br />Ans. B<br />Q 140. The most common mode of inheritance of congenital heart disease is:<br />A. Autosomal dominant<br />B. Autosomal recessive<br />C. SEX linked dominant<br />D. Multifactorial<br />Ans. D<br />Q 141. Which one of the following is an autosomal dominant disorder:<br />A. Cystic fibrosis<br />B. Hereditary spherocytosis<br />C. Sickle cell anemia<br />D. G-6-PD deficiency<br />Ans. B<br />Q 142. Which type diabetes is HLA associated:<br />A. Type I diabetes<br />B. Tyep II diabetes<br />C. Malnutrition related type disease<br />D. Pregnancy related type diabetes<br />Ans. A<br />Q 143. All of the following are sexually transmitted, except:<br />A. Candida albicans<br />B. Echionococcus<br />C. Molluscum contagiosum<br />D. Group B streptococcus<br />Ans. B<br />Q 144. All of the following infections may be transmitted via blood transfusion, except:<br />A. Parvo B19<br />B. Dengue virus<br />C. Cytomegalovirus<br />D. Hepatitis G virus<br />Ans. B<br />Q 145. Hypoglycemia is a recognized feature of all of the following conditions except:<br />A. Uremia<br />B. Acromegaly<br />C. Addison’s disease<br />D. Hepatocellular failure<br />Ans. B<br />Q 146. All of the following feature may be seen in thrombotic thrombocytopenic purpura, except:<br />A. Fever<br />B. HEMOLYSIS<br />C. Hypertension<br />D. Low platelet count<br />Ans. C<br />Q 147. The following laboratory determinants is abnormally prolonged in ITP:<br />A. APTT<br />B. Prothrombin time<br />C. Bleeding time<br />D. Clotting time<br />Ans. C<br />Q 148. PNH is associated with all of the following condition except:<br />A. Aplastic anemia<br />B. Increased LAP scores<br />C. Venous thrombosis<br />D. Iron deficiency anemia<br />Ans. B<br />Q 149. A 20 years adult presents with severe hypoplastic anemia. What is most effective treatment:<br />-interferonaA.<br />B. IL-2<br />C. ATG therapy<br />D. Bone marrow transplant<br />Ans. D<br />Q 150. Which of the following is not commonly seen in polycythemia vera?<br />A. Thrombosis<br />B. Hyperuricemia<br />C. Prone for acute leukemia<br />D. Spontaneous severe infection<br />Ans. D<br />Q 151. The following condition is not associated with an anti-phopholipid syndrome:<br />A. Venous thrombosis<br />B. Recurrent foetal loss<br />C. Thrombocytosis<br />D. Neurological manifestations<br />Ans. C<br />Q 152. Hypergastrinemia with hypochlorhydria is seen in:<br />A. Zollinger-Ellison syndrome<br />B. VIPoma<br />C. Pernicious anemia<br />D. Glucagonoma<br />Ans. C<br />Q 153. All of the following phases of the jugular venous pulse and their causes are correctly matched, except:<br />A. ‘c’wave – onset of atrial systole<br />B. ‘a-x’ descent – atrial relaxation<br />C. ‘v-y’ descent – emptying of blood from right atrium into right ventricle<br />D. ‘y-a’ ascent – filling of the right atrium from the vena cava<br />Ans. A<br />Q 154. Which of the following is the correct statement regarding findings in JVP:<br />A. Cannon wave: Complete heart block<br />B. Slow vy descent: Tricuspid regurgitation<br />C. Giant c wave: Tricuspid stenosis<br />D. Increased JVP with prominent pulsations:SVC obstruction<br />Ans. A<br />Q 155. While inseting a central venous catheter, a patient develops respiratory distress. The most likely cause is:<br />A. Hemothorax<br />B. Pneumothorax<br />C. Pleural effusion<br />D. Hypovolemia<br />Ans. B<br />Q 156. All of the following are clinical features of myxoma, except:<br />A. Fever<br />B. Clubbing<br />C. Hypertension<br />D. Embolic phenomenon<br />Ans. C<br />Q 157. Renal vein thrombosis is most commonly associated with:<br />A. Diabetic nephropathy<br />B. Membranous glomerulonephritis<br />C. Minimal change disease<br />D. Membranoproliferative glomerulonephritis<br />Ans. B<br />Q 158. Characteristic of Henoch-Schonlein purpura is:<br />A. Blood in stool<br />B. Thrombocytopenia<br />C. Intracranial hemorrhage<br />D. Susceptibility to infection<br />Ans. A<br />Q 159. Renal osteodystropy differs from nutritional and genetic forms of osesteomalacia in having:<br />A. Hypocalcaemia<br />B. Hypercalcemia<br />C. Hypophostaemia<br />D. Hyerphosphatema<br />Ans. D<br />Q 160. Medullary cystic disease of the kidney is best diagnosed by:<br />A. Ultrasound<br />B. Nuclear scan<br />C. Urography<br />D. Biopsy<br />Ans. D<br />Q 161. A patient with nephrotic syndrome on long- standing corticosteroid therapy may develop all the following except:<br />A. Hyperglycemia<br />B. Hypertophy of muscle<br />C. Neuropsychiatric symptoms<br />D. Suppression of the pituitary adrenal axis<br />Ans. B<br />Q 162. A 40 years old man presented with repeated episodes of bronchospasm and hemoptysis. Chest X-ray revealed perihilar bronchiectasis. The most likely diagnosis is:<br />A. Sarcoidosis<br />B. Idiopathic pulmonary fiborsis<br />C. Extrinsic allergic alveolitis<br />D. Bronchopulmonary aspergillosis<br />Ans. D<br />Q 163. Which of the following is characteristically not associated with the development of interstitial lung disease?<br />A. Coal dust<br />B. Sulfur dioxide<br />C. Thermophilic actenomycetes<br />D. Tobacco smoke<br />Ans. D<br />Q 164. A 35 years old man was found +ve for HBsAg and HBeAg, accidentally during screening of blood donation. On laboratory examination SGOT and SGPT are normal. What should you do next:<br />A. liver biopsy<br />B. Interferon therapy<br />C. Observation<br />D. HBV-DNA estimation<br />Ans. D<br />Q 165. A 25 years women presents with bloody diarrhea and is diagnosed as a case of ulcerative colitis. Which of the following condition is not associated:<br />A. Sclerosing cholengitis<br />B. Iritis<br />C. Ankylosing spondylitis<br />D. Pancreatitis<br />Ans. D<br />Q 166. Investigation of choice for invasive amebiasis is:<br />A. Indirect heamagglutination<br />B. ELISA<br />C. Counter immune electrophoresis<br />D. Microscopy<br />Ans. B<br />Q 167. A diabetic patient with BLOOD GLUCOSE of 600 mg/dL and Na 122 mEq/L was treated with insulin. After giving insulin the BLOOD GLUCOSE decreased to 100 mg/dL.What changes in blood Na level is expected?<br />A. Increase in Na+ level<br />B. Decrease in Na+ level<br />C. No change would be expected<br />D. Na+ would return to previous level spontaneously on correction of BLOOD GLUCOSE :<br />Ans. A<br />Q 168. A 20 years young man presents with exertional dyspnoea, headache, and giddiness. On examination, there is hypertension and L VR. X-ray picture shows notching of the anterior ends of the ribs. The most like diagnosis is:<br />A. Pheochromocytoma<br />B. Carcinoid syndrome<br />C. Coarctation of the aorta<br />D. Superior mediastinal syndrome<br />Ans. C<br />Q 169. Rheumatoid factor in rheumatoid arthritis is important because:<br />A. RA factor is associated with bad prognosis<br />B. Absent RA factor rules out the diagnosis of rheumatoid arthritis<br />C. It is very common in childhood-rheumatoid arthritis<br />D. It correlates with disease activity<br />Ans. A<br />Q 170. Conn’s syndrome is associated with all except:<br />A. Hypertension<br />B. Hypernatremia<br />C. Hypokalemia<br />D. Oedema<br />Ans. D<br />Q 171. The triad originally described by Zollinger-Ellison syndrome is characterized by:<br />A. Peptic ulceration, gastric hypersecretion, non beta cell tumour<br />B. Peptic ulceration, gastric hypersecretion, beta cell tumour<br />C. Peptic ulceration, achlorhydria, non beta cell tumour<br />D. Peptic ulceration, achlorhydria, beta cell tumour<br />Ans. A<br />Q 172. All of the following are features of pheochromocytoma except:<br />A. Hypertensive paraoxysm<br />B. Headache<br />C. Orhtostatic hypotension<br />D. Wheezing<br />Ans. D<br />Q 173. The treatment of choice in young patient suffering from aplastic anaemia is:<br />A. Danazol<br />B. G-CSF<br />C. Bone marrow transplantation<br />D. ATG<br />Ans. C<br />Q 174. Raised anion gap in blood is not seen in which of the following?<br />A. Renal failure<br />B. Antifreeze ingestion<br />C. Diabetic ketoacidosis<br />D. Chronic respiratory failure<br />Ans. D<br />PEDIATRICS<br />Q 175. A Down syndrome girl has 21/21 translocation and her father is carrier of balanced translocation. Risk of Down syndrome in next pregnancy is:<br />A. 100%<br />B. 0%<br />C. 50%<br />D. 25%<br />Ans. A<br />Q 176. The following signs would warrant further evaluation of developmental status in a healthy 12 weeks old infant:<br />A. Dose not vocalize<br />B. Dose not babble<br />C. Dose not raise head up to 90°<br />D. Dose not transfer a bright red ring from one hand to the other, even when the ring is directly placed in the hand of child<br />Ans. A<br />Q 177. A 2 years child weighing 6.7 kg presents in the casualty with history of vomiting & diarrhoea for last 2 days. On examination SKIN pinch over the anterior abdominal wall go quickly to its original position. Interpretation of SKIN pinch test in this child will be:<br />A. No dehydration<br />B. Some dehydration<br />C. Severe dehydration<br />D. SKIN pinch can not be evaluated in this child<br />Ans. D<br />Q 178. An infant presents with history of seizures & SKIN rashes. Investigations show metabolic acidosis and increased blood ketone levels. This child is likely to be suffering from:<br />A. Propionic aciduria<br />B. Urea cycle disorder<br />C. Phenylketonuria<br />D. Multiple carboxylase deficiency<br />Ans. D<br />Q 179. With reference to RDS, all of the following statements are true, except:<br />A. Usually occurs in infants born before 34 weeks of gestation<br />B. Is more common in babies born to diabetic mothers<br />C. Leads to cyanosis<br />D. Is treated by administering 100% oxygen<br />Ans. D<br />Q 180. Which of the following is not a common manifestation of congenital rubella:<br />A. Deafness<br />B. PDA<br />C. Aortic stenosis<br />D. Mental retardation<br />Ans. C<br />Q 181. An 8 years old boy presented with fever and bilateral cervical lymphadenopathy with prior history of sore throat. There was no hepatomegaly. The peripheral blood smear shows > 20% lymphoplasmacytoid cells. The most likely diagnosis is:<br />A. Influenza<br />B. Tuberculosis<br />C. Infectious mononucleosis<br />D. Acute lymphoblastic leukemia<br />Ans. C<br />Q 182. The most common genetic cause of liver disease in children is:<br />A. Haemochromatosis<br />antitrypsin deficiency1aB.<br />C. Cystic fibrosis<br />D. Glycogen storage disease<br />Ans. B<br />Q 183. Which of the following childhood tumors most frequently metastasizes to the bone:<br />A. Neuroblastoma<br />B. Ganglioneuroma<br />C. Wilms’ tumor<br />D. Ewing’s sarcoma<br />Ans. A<br />Q 184. A six months old girl is having recurrent UTI. Ultrasound abdomen shows bilateral hydronephrosis. MCU (micturating cystourethrogram) shows bilateral grade IV vesicoureteral reflux. The treatment of choice is:<br />A. Endoscopic injection of polyteflon at the ureteric orifices<br />B. Ureteric reimplantation<br />C. Bilateral ureterostomy<br />D. Prophylactic antibiotics<br />Ans. B<br />Q 185. The most common cause of ambiguous genitalia in a newborn is:<br />A. 21 hydroxylase deficiency<br />-hydroxylase deficiencybB. 11<br />C. -hydroxyalse deficiencya17<br />-hydroxysteroid deficiencybD. 3<br />Ans. A<br />Dermatology<br />Q 186. Multiple erythematous annular lesions with peripheral collarette of scales arranged predominantly over trunk are seen in:<br />A. Pityriasis versicolor<br />B. Pityriasis rubra<br />C. Pityriasis rosea<br />D. Pityriasis lichennoides<br />Ans. C<br />Q 187. All of the following are given for the treatment of pityriasis versicolor, except:<br />A. Ketoconazole<br />B. Griesofiilvin<br />C. Clotrimazole<br />D. Selenium sulphide<br />Ans. B<br />Q 188. A patient with PSORIASIS was started on systemic steroids. After stopping treatment, the patient developed generalized pustules all over the body. The cause is most likely to be:<br />A. Drug induced reaction<br />B. Pustular PSORIASIS<br />C. Bacterial infections<br />D. Septicemia<br />Ans. B<br />Q 189. Wickham’s striae are seen in:<br />A. Lichen niditus<br />B. Lichenoid eruption<br />C. Lichen striates<br />D. Lichen planus<br />Ans. D<br />Q 190. Griseofulvin is given for the treatment of fungal infection in finger nail dermatophytosis for:<br />A. 4 weeks<br />B. 6 weeks<br />C. 2 months<br />D. 3 months<br />Ans. D<br />Q 191. After 3 days of fever patient developed maculoerythematous rash that lasted for 48 hours. The most likely diagnosis is:<br />A. Fifth disease<br />B. Rubella<br />C. Measles<br />D. Roseola infantum<br />Ans. D<br />Q 192. Exfoliative dermatitis can be due to all the following diseases, except:<br />A. Drug hypersensitivity<br />B. Pityriasis rubra<br />C. Pityriasis rosea<br />D. PSORIASIS<br />Ans. C<br />Q 193. Genital elephantiasis is caused by:<br />A. Donovanosis<br />B. Congenital syphilis<br />C. Herpes genitalis<br />D. Lymphogranuloma venereum<br />Ans. D<br />Psychiatry<br />Q 194. All of the following are features of hallucination, except:<br />A. Depends on will of the observer<br />B. Occurs in inner subjective space<br />C. It is a vivid sensory perception<br />D. It occurs in absence of perceptual stimulus<br />Ans. A<br />Q 195. The following is suggestive of an organic cause of the behavioural symptoms:<br />A. Formal thought disorder<br />B. Auditory hallucinations<br />C. Delusion of fruit<br />D. Visual hallucinations<br />Ans. D<br />Q 196. Delusion is not present in:<br />A. Delirium<br />B. Mania<br />C. Depresion<br />D. Compulsive disorder<br />Ans. D<br />Q 197. An alcoholic is brought to the casualty, 3 days after he quit alcohol, with the complaint of irrelevant talking. On examination, he is found to be disoriented in time, place and person. He also has visual illusions and hallucinations. There is no history of head injury. The most probable diagnosis is:<br />A. Dementia praecox<br />B. Delirium tremens<br />C. Schizophrenia<br />D. Korsakoff psychosis<br />Ans. B<br />Q 198. Ram Lal, a 45 years old male came to the psychiatric OPD complaning of continuous, dull, non- progressive headache for the last 8 years. The patient has seen numerous neurologists in the belief that he has a brain tumor even though all his investigations have been normal. The patient insisted that he had a brain tumor and requested yet another workup. Psychiatric evaluation reveals disease conviction in the background of normal investigations. The most probable diagnosis is:<br />A. Hypochondriasis<br />B. Somatization disorer<br />C. Somatoform pain disorder<br />D. Conversion disorder<br />Ans. A<br />Q 199. A patient presented with short lasting episodic behavioural changes which include agitation & dream like state with thrashing movements of his limbs. He does not recall these episodes & has no apparant precipitating factor. The most likely diagnosis is:<br />A. Schizophrenia<br />B. Temporal lobe epilepsy<br />C. Panic episodes<br />D. Dissociative disorder<br />Ans. D<br />Q 200. A young lady presented with repeated episodes of overeating followed by purging after use of laxatives. She is probably suffering from:<br />A. Bulimia nervosa<br />B. Schizophrenia<br />C. Aorexia nervosa<br />D. Binge eating disorder<br />Ans. A<br />Q 201. An 11 years old boy is all the time so restless that the rest of the class is unable to concentrate. He is hardly ever in his seat and roams around the hall. He has difficulty in playing quietly. The most likely diagnosis is:<br />A. Attention-deficit hyperactivity disorder<br />B. Conduct disorder<br />C. Depressive disorder<br />D. Schizophrenia<br />Ans. A<br />Surgery<br />Q 202. A patient suddenly experienced pain radiating along the medial border of the dorsum of foot. Which of the following nerve is most likely to be accidently ligated:<br />A. Sural nerve<br />B. Saphenous nerve<br />C. Deep peroneal nerve<br />D. Genicular nerve<br />Ans. B<br />Q 203. In an adult patient with pleural effusion, the most appropriate site for pleurocentesis done by inserting a needle is in:<br />A. 5th intercostal space in midclavicular line<br />B. 7th intercostal space in midaxillary line<br />C. 2nd intercostal space adjacent to the sternum<br />D. 10th intercostal space adjacent to the vertebral column<br />Ans. B<br />Q 204. Measurements of intravascular pressure by a pulmonary artery catheter should be done:<br />A. At end expiration<br />B. At peak of inspiration<br />C. During mid inspiration<br />D. During mid expiration<br />Ans. A<br />Q 205. A 24 years old man falls on the ground when he is struck in the right temple by a baseball. While being driven to the hospital, he lapses into coma. He is unresponsive with the dilated right pupil when he reaches the emergency department. The most important step in initial management is:<br />A. Craniotomy<br />B. CT scan of the head<br />C. X-ray of the skull and cervical spine<br />D. Doppler ultrasound examination of the neck<br />Ans. A<br />Q 206. Kamla Rani, 75 years old woman, presents after 6 weeks with post myocardial infarction with mild CHF. There was past history of neck Surgery for parathyroid adenoma 5 years ago. EKG shows slow artrial fibrillation. Serum Ca2+ 13.0 mg/L and urinary Ca2+ is 300 g/24 h. On examination these is small mass in the paratracheal position behind the right clavicle. Appropriate management at this time is:<br />A. Repeat neck Surgery<br />B. Treatment with technetium -99<br />C. Observation and repeat serum Ca2+ in two months<br />D. Ultrasound-guided alcohol injection of the mass<br />Ans. D<br />Q 207. Not a feature of de Quervain’s disease:<br />A. Autoimmune in etiology<br />B. Raised ESR<br />C. Tends to regress spontaneously<br />D. Painful & associated with enlargement of thyroid<br />Ans. A<br />Q 208. A 35 years old woman has had recurrent episodes of headache and sweating. Her mother had renal calculi and died of thyroid cancer. Physical observations revealed a thyroid nodule and ipsilateral enlarged cervical lymph nodes. Before performing thyroid Surgery the woman’s physician should order:<br />A. Thyroid scan<br />B. Estimation of hydroxy indole acetic acid in urine<br />C. Estimation of urinary metanephrines, VMA and catecholamines<br />D. Estimation of TSH, and TRH levels in serum<br />Ans. C<br />Q 209. All of the following are associated with thyroid storm, except:<br />A. Surgery for thyroiditis<br />B. Surgery for thyrotoxicosis<br />C. Stressful illness in thyrotoxicosis<br />D. I131 therapy for thyrotoxicosis<br />Ans. A<br />Q 210. Needle biopsy of solitary thyroid nodule in a young woman with palpable cervical lymph nodes on the same sides demonstrates amyloid in stroma of lesion. Likely diagnosis is:<br />A. Medullary carcinoma thyroid<br />B. Follicular carcinoma thyroid<br />C. Thyroid adenoma<br />D. Multinodular goitre<br />Ans. A<br />Q 211. A 26 years old woman presents with a palpable thyroid nodule, and needle biopsy demonstrates amyloid in the stroma of the lesion. A cervical lymph node is palpable on the same side as the lesion. The preferred treatment should be:<br />A. Removal of the involved node, the isthmus,and the enlarged lymph node<br />B. Removal of the involved lobe, the isthmus, a portion of the opposite lobe, and the enlarged lymph node<br />C. Total thyroidectomy and modified neck dissection on the side of the enlarged lymph node<br />D. Total thyroidectomy and irradiation of the cervical lymph nodes<br />Ans. C<br />Q 212. The most common tumor of the salivary gland is:<br />A. Mucoepidermoid tumor<br />B. Warthin’s tumor<br />C. Acinic cell tumor<br />D. Pleomorphic adenoma<br />Ans. D<br />Q 213. The premalignant condition with the highest probability of progression to malignancy is:<br />A. Dysplasia<br />B. Hyperplasia<br />C. Leucoplakia<br />D. Erythroplakia<br />Ans. D<br />Q 214. An old man who is edentulous developed squamous cell CA in buccal mucosa that has infiltrated to the alveolus. Following is not indicated in treatment:<br />A. Radiotherapy<br />B. Segmental mandibulectomy<br />C. Marginal mandibulectomy involving removal of the outer table only<br />D. Marginal mandibulectomy involving removal of upper half of mandible<br />Ans. C<br />Q 215. Corkscrew esophagus is seen in which of the following condition?<br />A. Carcinoma esophagus<br />B. Scleroderma<br />C. Achalasia cardia<br />D. Diffuse esophagus spasm<br />Ans. D<br />Q 216. Treatment for achalasia associated with high rate of recurrence:<br />A. Pneumatic dilatation<br />B. Laparoscopic myotomy<br />C. Opefl surgical myotomy<br />D. Botulinum toxin<br />Ans. D<br />Q 217. Barrett’s esophagus is:<br />A. Lower esophagus lined by columnar epithelium<br />B. Upper esophagus lined by columnar epithelium<br />C. Lower esophagus lined by ciliated epithelium<br />D. Lower esophagus lined by pseudostratified epithelium<br />Ans. A<br />Q 218. The adenocarcinoma of esophagus developes in:<br />A. Barrett’s esophagus<br />B. Long standing achalasia<br />C. Corrosive stricture<br />D. Alcohol abuse<br />Ans. A<br />Q 219. The lowest recurrence of peptic ulcer is associated with:<br />A. Gastric resection<br />B. Vagotomy + drainage<br />C. Vagotomy + antrectomy<br />D. Highly selective vagotomy<br />Ans. C<br />Q 220. Risk factor for development of gastric CA:<br />A. Blood group O<br />B. Duodenal ulcer<br />C. Intestinal hyperplasia<br />D. Intestinal metaplasia type III<br />Ans. D<br />Q 221. In a case of hypertrophic pyloric stenosis, the metabolic disturbance is:<br />A. Respiratory alkalosis<br />B. Metabolic acidosis<br />C. Metabolic alkalosis with paradoxical aciduria<br />D. Metabolic alkalosis with alkaline urine<br />Ans. C<br />Q 222. All the following indicates early gastric cancer except:<br />A. Involvement of mucosa<br />B. Involvement of mucosa and submucosa<br />C. Involvement of mucosa, submucosa and muscularis<br />D. Involvement of mucosa, submucosa and adjacent lymph nodes<br />Ans. C<br />Q 223. In gastric outlet obstruction in a peptic ulcer patient, the site of obstruction is most likely to be:<br />A. Antrum<br />B. Duodenum<br />C. Pylorus<br />D. Pyloric canal<br />Ans. B<br />Q 224. Ramesh met an accident with a car and has been in ‘deep coma’ for the last 15 days. The most suitable route for the administration of protein and calories is by:<br />A. Jejunostomy tube feeding<br />B. Gastrostomy tube feeding<br />C. Nasogastric tube feeding<br />D. Central venous hyperalimentation<br />Ans. A<br />Q 225. A 10 months old infant present with acute intestinal obstruction. Contrast enema X-ray shows the intussusception. Likely cause is:<br />A. Peyer’s patch hypertrophy<br />B. Mekel’s diverticulum<br />C. Mucosal polyp<br />D. Duplication cyst<br />Ans. A<br />Q 226. After undergoing Surgery , for carcinoma of colon, a 44 year old patient developed single liver metastasis of 2 cm. What do you do next:<br />A. Resection<br />B. Chemo-radiation<br />C. Acetic acid injection<br />D. Radiofrequency ablation<br />Ans. A<br />Q 227. Ten days after a splenectomy for blunt abdominal trauma, a 23 years old man complains of upper abdominal and lower chest pain exacerbated by deep breathing. He is anorectic but ambulatory and otherwise making satisfactory progress. On physical examination, his temperature is 38.2°C(108°F) rectally, and he has decreased breath sounds at the left lung base. His abdominal wound appears to be healing well,. bowel sound are active and there are no peritoneal signs. Rectal examination is negative. The WBC count is 12,500 per mm3 with a shift to left. Chest X-ray shows plate like atelectasis of the left lung field. Abdominal X-rays show a nonspecific gas pattern in the bowel and an air-fluid level in the left upper quadrant. Serum amylase is 150 Somogyi units/ dl (normal 60 to 80). The most likely diagnosis is:<br />A. Subphrenic abscess<br />B. Pancreatitis<br />C. Pulmonary embolism<br />D. Subfascial wound infection<br />Ans. A<br />Q 228. Sentinel lymph node biopsy is an important part of the management of which of the following conditions?<br />A. Carcinoma prostate<br />B. Carcinoma breast<br />C. Carcinoma lung<br />D. Carcinoma nasopharynx<br />Ans. B<br />Q 229. A man who weighs 70 kg (154 pounds) is transfered to a burn center 4 weeks after sustaining a second and third-degree burn injury to 45% of his total body surface area. Prior to accident, the patients weight was 90 kg (198 pounds). The patient has not been given anything by mouth since the injury except for antacids because of previous ulcer history. On physical examination, the patient’s burn wounds are clean, but only minimal healing is evident and thick adherent eschar is present. The patient’s abdomen is soft and nondistended, and active bowel sounds are heard. His stools are trace-positive for blood, and he has a right inguinal hernia, which appears to be easily reducible. He has poor range of motion of all involved joints and has developed early axillary and popliteal fossae flexion contractures. In managing this patient at this stage of his injury, top priority must be given to correcting:<br />A. The presence of blood in stools by the increasing the dose of antacids and H1 receptor blocker<br />B. The open, poorly healing burn wounds treated by surgical excision and grafting<br />C. The inguinal hernia treated by surgical repair using local Anaesthesia<br />D. The nutritional status by oral supplementation or parenteral hyperalimentation<br />Ans. D<br />Q 230. A 14 years old girl sustains a steam bum measuring 6 by 7 inches over the ulnar aspect of her right forearm. Blisters develop over the entire area of the bum wound, and by the time the patient is seen 6 hours after the injury, some of the blisters have ruptured spontaneously. In addition to debridement of the necrotic epithelium, all the following therapeutic regiments might be considered appropriate for this patient except:<br />A. Application of silver sulfadiazine and daily washes, but no dressing<br />B. Application of polyvinylpyrrolidone foam, daily washes and a light occlusive dressing changed daily<br />C. Application of mafenide acetate cream, but no daily washes or dressing<br />D. Heterograft application with sutures to secure it in place and daily washes, but no dressing<br />Ans. D<br />Q 231. All of the following are the clinical features of thromboangitis obliterans except:<br />A. Raynaud’s phenomenon<br />B. Claudication of extremeties<br />C. Absence of popliteal pulse<br />D. Migratory superficial thrombophlebitis<br />Ans. C<br />Q 232. Rani, a 16 years old girl who has non-pitting edema of recent onset affecting her right leg but no other symptoms is referred for evaluation. True statements about this patient include:<br />A. Prophylactic antibiotics are indicated<br />B. A lymphagiongram will show hypoplasia of the lymphatics<br />C. Elastic stocking and diuretics will lead to a normal appearance of the limb<br />D. A variety of operations will ultimately lead to a normal appearance of the limb<br />Ans. B<br />Q 233. Kamla, a 59 years old woman, has a left femoral vein thrombosis during a pregnancy 30 year ago. The left greater saphenous vein had been stripped at age 21. She now presents with a large non healing ulceration over the medial left calf, which has continuously progressed despite bedrest, elevation, and use of a support stocking. Descending phlebography of the left leg demonstrates a patent deep venous system, with free flow of dye from the groin to foot. The first profunda femoris valve is competent. Appropriate management might include which of the following:<br />A. Division of the superficial femoral vein in the groin and transposition of its distal end onto the profunda femoris vein below the level of the competent profunda valve<br />B. Saphenous venous crossover graft with anastomosis of the end of the right saphenous vein onto the side of competent femoral vein<br />C. Ligated iliofemoral venous thrombectomy with creation of the temporary arteriovenous fistula<br />D. Subfascial ligation of perforating veins in the left<br />calf.<br />Ans. A<br />Q 234. On her third day of hospitalization, a 70 years old woman who is being treated with antibiotics for acute cholecystitis develops increased pain and tenderness in the right upper quadrant with a palpable mass. Her temperature rises to 40°C (104°F) her blood pressure falls to 80/60 mmHg. Hematemesis, and melena ensue and petechiae are noted. Laboratory studies reveal thrombocytopenia, prolonged prothrombin time, and a decreased fibrinogen level. The most important step in the correction of this patient’s coagulopathy is:<br />A. Exploratory laparotomy<br />B. Administration of heparin<br />-aminocaproic acideC. Administration of<br />D. Administration of fresh frozen plasma<br />Ans. A<br />Q 235. A 64 years old previously healthy man is admitted to a hospital because of a closed head injury and ruptured spleen following a road side automobile accident. During the first 4 days of hospitalization, following laparotomy and splenectomy, he receives 5% dextrose, 0.5% normal saline solution at a rate of 125 mL/h. Recorded daily fluid outputs include 450 to 600 mL of nasogastric drainage and 700 to 1000 mL of urine. The patient is somnolent but easily aroused until the morning of the 5th hospital day, when he is noted to be in deep coma. By the afternoon, he begins having seizures. The following laboratory data are obtained. Serum electrolytes (mEq/L): Na+ 130; K+ 1.9; CI– 96; HCO3– 19. Serum osmolality 260 mOsm/L. Urine electrolytes (mEq/L): Na+ 61; K+ 18. Which of the following statements about diagnosis or treatment of this patient’s condition is true:<br />A. Emergency carotid arteriogram is to be done<br />B. Secondary to metabolic acidosis there is hypokalemia<br />C. A small qantity of hypertonic saline should be given<br />D. IV infusion of 20 ml of 50% MgSO4 is given over a period of 4 hours<br />Ans. C<br />Q 236. All of the following statements about acute adrenal insufficiency are true except:<br />A. Hyperglycemia is usually present<br />B. Acute adrenal insufficiency usually is secondary to exogenous glucocorticoid administration<br />C. Acute adrenal insufficiency presents with weakness, vomiting, fever, and hypotension<br />D. Hyponatremia occurs because of impaired renal tubule sodium resorption<br />Ans. A<br />Q 237. All of the following are correct statements about radiological evaluation of a pateint with Cushing’s syndrome except:<br />A. MRI of the sella turcica will identify a pituitary cause for Cushing’s syndrome<br />B. Petrosal sinus sampling is the best way to distinguish a pituitary tumor from an ectopic ACTH producing tumor.<br />C. MRI of the adrenals may distinguish adrenal adenoma from carcinoma<br />D. Adrenal CT scan distinguishes adrenal cortical hyperplasia from an adrenal tumor<br />Ans. A<br />orthopaedics<br />Q 238. Carpel tunnel syndrome is due to compression of:<br />A. Radial nerve<br />B. Ulnar nerve<br />C. Palmar branch of the ulnar nerve<br />D. Median nerve<br />Ans. D<br />Q 239. Most common nerve involved in the FRACTURE of surgical neck of humerus is:<br />A. Median<br />B. Radial<br />C. Ulnar<br />D. Axillary<br />Ans. D<br />Q 240. All of the following are associated with supracondylar FRACTURE of humerus, except:<br />A. It is uncommon after 15 years of age<br />B. Extension type FRACTURE is more common than the flexion type<br />C. Cubitus varus deformity commonly results following malunion<br />D. Ulnar nerve is most commonly involved<br />Ans. D<br />Q 241. A 40 years old man, was admitted with FRACTURE shaft femur following a road traffic accident. On 2nd day he became disoriented. He was found to be tachypnoeic, and had conjunctival petechiae. Most likely diagnosis is:<br />A. Pulmonary embolism<br />B. Sepsis syndrome<br />C. Fat embolism<br />D. Haemothorax<br />Ans. C<br />Q 242. Kumar, a 31 years old motorcyclist sustained injury over his right hip joint. X-ray revealed a posterior dislocation of the right hip joint. The clinical attitude of the affected lower limb will be:<br />A. External rotation, extension & abduction<br />B. Internal rotation, flexion & adduction<br />C. Internal rotation, extension & abduction<br />D. External rotation, flexion & abduction<br />Ans. B<br />Q 243. Pappu, 7 years old young boy, had FRACTURE of lateral condyle of femur. He developed malunion as the FRACTURE was not reduced anatomically. Malunion will produce:<br />A. Genu valgum<br />B. Genu varum<br />C. Genu recurvatum<br />D. Dislocation of knee<br />Ans. A<br />Q 244. Patellar tendon bearing POP cast is indicated in the following FRACTURE :<br />A. Patella<br />B. Tibia<br />C. Medial malleolus<br />D. Femur<br />Ans. B<br />Q 245. Inversion injury at the ankle can cause all of the following except:<br />A. FRACTURE tip of lateral melleolus<br />B. FRACTURE base of the 5th metatarsal<br />C. Sprain of extensor digitorum brevis<br />D. FRACTURE of sustentaculam tali<br />Ans. C<br />Q 246. A previously healthy 45 years old laborer suddenly develops acute lower back pain with right-leg pain & weakness of dorsiflexion of the right great toe. Which of the following is true:<br />A. Immediate treatment should include analgesics, muscle relaxants & back strengthening exercises<br />B. The appearance of the foot drop indicates early surgical intervention<br />C. If the neurological signs resolve within 2 to 3 weeks but low back pain persists, the proper treatment would include fusion of affected lumbar vertebra<br />D. If the neurological signs fail to resolve within 1 week, lumbar laminectomy and excision of any herniated nucleus pulposus should be done<br />Ans. B<br />Q 247. Acute osteomylitis is most commonly caused by:<br />A. Staphylococcus aureus<br />B. Actinomyces bovis<br />C. Nocardia asteroides<br />D. Borrelia vincentii<br />Ans. A<br />Q 248. A 45 years male presented with an expansile lesion in the centre of femoral metaphysis. The lesion shows endosteal scalloping & punctuate calcifications. Most likely diagnosis is:<br />A. Osteosarcoma<br />B. Chondrosarcoma<br />C. Simple bone cyst<br />D. Fibrous dysplasia<br />Ans. B<br />Q 249. Raju, a 10 years old child, presents with predisposition to fractures, anemia, hepatosplenomegaly and a diffusely increased radiographic density of bones. The most likely diagnosis is:<br />A. Osteogenesis imperfecta<br />B. Pyenodysotosis<br />C. Myelofibrosis<br />D. Osteopetrosis<br />Ans. D<br />Q 250. Hari Vardhman, 9 years old child, presents with scoliosis, hairy tuft in the SKIN of back and neurological deficit. Plain X-rays reveal multiple vertebral anomalies & a vertical bony spur overlying lumbar spine on AP view. The most probable diagnosis is:<br />A. Dorsal dermal sinus<br />B. Diastometamyelia<br />C. Tight filum terminale<br />D. Caudal regresion syndrome<br />Ans. B<br />Q 251. In a patient with head injury, unexplained hypotension warrants evaluation of:<br />A. Upper cervical spine<br />B. Lower cervical spine<br />C. Thoracic spine<br />D. Lumbar spine<br />Ans. C<br />Q 252. Complete transection of the spinal cord at the C1 level produces all of the following effects except:<br />A. Hypotension<br />B. Limited respiratory effort<br />C. Anaesthesia below the level of the lesion<br />D. Areflexia below the level of the lesion<br />Ans. B<br />Anaesthesia<br />Q 253. The gas which produces systemic toxicity without causing local irritation is:<br />A. Ammonia<br />B. Carbon monoxide<br />C. Hydrocyanic acid<br />D. Sulfur dioxide<br />Ans. B<br />Q 254. In a patient with fixed respiratory obstruction helium is used along with oxygen instead of plain oxygen because:<br />A. It increases oxygenation<br />B. It decreases turbulence<br />C. It decreases the dead space<br />D. It provides analgesia<br />Ans. B<br />Q 255. Upper respiratory tract infection is a common problem in children. All the following anesthetic complications can occur in children with respiratory infections, except:<br />A. Bacteremia<br />B. Halothane granuloma<br />C. Increased mucosal bleeding<br />D. Laryngospasm<br />Ans. B<br />Ophthalmology<br />Q 256. In the normal human right eye , the peripheral field of vision is usually least:<br />A. On the left side (nasally)<br />B. In the downward direction<br />C. In the upward direction<br />D. On the right side (temporally)<br />Ans. C<br />Q 257. Tonography helps you to determine:<br />A. The rate of formation of aqueous<br />B. The facility of outflow of aqueous<br />C. The levels of intraocular presure at different times<br />D. The field changes<br />Ans. B<br />Q 258. Any spectral colour can be matched by a mixture of three monochromatic lights (red, green, blue) in different proportions. If a person needs more of one of the colour for matching than a normal person, then he has a colour anomaly. More red colour is needed in the case of:<br />A. Deuteranomaly<br />B. Tritanomaly<br />C. Protanomaly<br />D. Tritanomaly<br />Ans. C<br />Q 259. The colours best appreciated by the central cones of our foveo-macular area are:<br />A. Red and blue<br />B. Blue and green<br />C. Red and green<br />D. Blue and yellow<br />Ans. C<br />Q 260. Epiphora is:<br />A. Cerebrospinal fluid running from the nose after FRACTURE of anterior cranial fossa<br />B. An epiphenomenors of a cerebral tumor<br />C. An abnormal overflow of tears due to obstruction of lacrimal duct<br />D. Eversion of lower eyelid following injury<br />Ans. C<br />Q 261. A 35 years old hypermetrope is using 1.50 D sphere both eyes. Whenever his glasses slip downward on his nose he will feel that his near vision:<br />A. Becomes enlarged<br />B. Becomes distorted<br />C. Becomes decreased<br />D. Remains the same<br />Ans. A<br />Q 262. Occulomoter nerve palsy affects all of the following muscles, except:<br />A. Medial rectus<br />B. Inferior oblique<br />C. Lateral rectus<br />D. Levetor palpabrae superioris<br />Ans. C<br />Q 263. Kusum Lata presents with acute painful red eye and mildly dilated vertically oval pupil. Most likely diagnosis is:<br />A. Acute retrobulbar neuritis<br />B. Acute angle closure glaucoma<br />C. Acute anterior uveitis<br />D. Severe keratoconjunctivitis<br />Ans. B<br />Q 264. You have been referred a midle-aged patient to rule out open angle glaucoma. Which of the following findings will help in the diagnosis:<br />A. Cupping of the disc<br />B. Depth of anterior chamber<br />C. Visual acuity and refractive error<br />D. Angle of the anterior chamber<br />Ans. A<br />Q 265. In a case of hypertensive uveitis, most useful drug to reduce intraocular pressure is:<br />A. Pilocarpine<br />B. Latanoprost<br />C. Physostigmine<br />D. Dipivefrine<br />Ans. B<br />Q 266. A patient having glaucoma develops blepharoconjunctivitis after instilling some anti- glaucoma drug. Which of the following drug can be responsible for it:<br />A. Timolol<br />B. Latanoprost<br />C. Dipivefrine<br />D. Pilocarpine<br />Ans. C<br />Q 267. A 12 years old child complains of headache and decreased vision. On examination he has a visual acuity of 6/36 in the right eye and 6/6 in the left eye . On retinoscopy at 66 cm, the left eye showed correction of 1.5 D and the right eye of 5 D. The anterior chamber and fundus of<br />_________________Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com1tag:blogger.com,1999:blog-2217647826950966921.post-68255047315296768622008-09-05T21:58:00.001-07:002008-12-17T22:44:32.697-08:00FMGE/ MCI MARCH 2009<a href="http://www.fmge.co.cc/"></a><br /><div><span style="font-family:Times New Roman;font-size:130%;">THE MOST IMP POINTS FOR FMGE MARCH 2009 ( MCI SCREENING TEST MARCH 2009)</span><br /><a href="http://www.ziddu.com/download/2091101/AllIndiaPGpreparationTips.doc.html" target="_blank">AllIndiaPGpreparationTips.doc.html</a><br /><a href="http://www.ziddu.com/download/2091102/PSYCHIATRY.doc.html" target="_blank">PSYCHIATRY.doc.html</a><br /><a href="http://www.ziddu.com/download/2091080/HEMATOLOGY.doc.html" target="_blank">HEMATOLOGY.doc.html</a><br /><a href="http://www.ziddu.com/download/2091081/GYNECOLOGY.doc.html" target="_blank">GYNECOLOGY.doc.html</a><br /><a href="http://www.ziddu.com/download/2091082/INFECTIOUSDISEASES.doc.html" target="_blank">INFECTIOUSDISEASES.doc.html</a><br /><a href="http://www.ziddu.com/download/2091084/PSYCHIATRY.doc.html" target="_blank">PSYCHIATRY.doc.html</a><br /><a href="http://www.ziddu.com/download/2091056/PUBLICHEALTH.doc.html" target="_blank">PUBLICHEALTH.doc.html</a><br /><a href="http://www.ziddu.com/download/2091057/Surgery.doc.html" target="_blank">Surgery.doc.html</a><br /><a href="http://www.ziddu.com/download/2091058/POISONING.doc.html" target="_blank">POISONING.doc.html</a><br /><a href="http://www.ziddu.com/download/2091059/PEDIATRICS.doc.html" target="_blank">PEDIATRICS.doc.html</a><br /><a href="http://www.ziddu.com/download/2091060/BIOCHEMISTRY.doc.html" target="_blank">BIOCHEMISTRY.doc.html</a><br /><a href="http://www.ziddu.com/download/2090982/foransic.doc.html" target="_blank">foransic.doc.html</a><br /><a href="http://www.ziddu.com/download/2090984/CARDIOVASCULAR.doc.html" target="_blank">CARDIOVASCULAR.doc.html</a><br /><a href="http://www.ziddu.com/download/2090985/ENDOCRINOLOGY.doc.html" target="_blank">ENDOCRINOLOGY.doc.html</a><br /><a href="http://www.ziddu.com/download/%202090986/GENTOURINARY.doc.html">GENTOURINARY.doc.html</a><br /><a href="http://www.ziddu.com/download/2091083/DERMATOLOGY.doc.html" target="_blank">D</a>ERMATOLOGY.DOC.html<br /><br />Posted: Sat Oct 04, 2008 2:46 pm Post subject: Questions FMGE -2008(Part-1,11; Set-A)<br /><br />--------------------------------------------------------------------------------<br /><br />Questions FMGE -2008(Part-1,11; Set-A)<br /><br /><br />1) Trendelenberg test is positive due to…..?<br />2) Notochord exists as….?<br />3) Neuroglia….?<br />4) Hyaline Arteriosclerosis seen in …..?<br />5) Which Ig crosses through placenta …..?<br />6) M.C cardiac lesion seen in pregnancy ……?<br />7) M.C valve disease due to M.I ? (Sorry, I forgot the question. It was asked in similarly)<br />Herd Immunity?<br />9) Koplik’s spots seen in ……?<br />10) A ? patient with hypertension & suffering from Thyroiditis, DOC ……?<br />11) Hypocalcemia is seen with the following?<br />12) Most common position of Uterus?<br />13) Shortest ø of pelvis is……?<br />14) Right base of the heart is formed by …..?<br />15) Right side Mid calvicle the lung ends at which rib?<br />16) Water supply in hilly areas?<br />17) Prophylaxis DOC for Meningitis?<br />1 Anaemia is seen with all except?<br />19) Dose of Folic acid during pregnancy? (prophylaxis dose)<br />20) Vitamin “A” dosage is given in….? (?. of doses.)<br />21) What is Apoptosis?<br />22) Extrinsic factor in blood coagulation? (PT/PTT)<br />23) Curschmann’s spirals are due to?<br />24) Bell’s palsy?<br />25) In Dialysis which toxicity is seen commonly?<br />26) TOC for Gastric ulcer?<br />27) Squamous non-keratinizing is seen in….? a) Tongue b) Trachea c) Oesophagus d) Vagina<br />2 Tumour marker CA-125 is related to pancreatic Ca &…….?<br />29) Bilaterally kidneys are shrunken in …….?<br />30) Poisoning due to ______________preserved are hair, Etc..etc….?<br />31) The hormone helps in milk secretion?<br />32) Most abundant ICF is …….?<br />33) Features like-Hypogonadism, Loss of Hair, Pigmentation of skin Etc..etc Deficiency due to?<br />34) Most common features of alcohol withdrawl?<br />35) Negri bodies are characteristic of ?<br />36) M.C opportunistic Infection in immuno compromised patient?<br />37) Mallory-weiss syndrome? (Mallory bodies seen with….?)<br />3 Sickness benefit under ESI Act is given for the following illness?<br />39) Glucose is reabsorbed at?<br />40) M.C pemphigus seen in India?<br /><br />41) India ia at which stage of Demographic?<br />42) Urinary incontinence in Older people is due to……?<br />43) Breast cancer is due to all, Except?<br />44) Black & white colour vision is due to ………?<br />45) Grey colour……? ( Extremely sorry I forgot what was asked ,{Ophthalmology Q} if any one can remember please ADD)<br />46) Kussmaul breathing is due to or seen in ………?<br />47) Cellulitis is caused by…….?<br />4 Auer rods are seen in ……?<br />49) Gynaecomastia is due to drugs……..?<br />50) In a new born Jaundice occurs on 3-5days;its not due to ……….?<br />51) Transmitted by faeco-orally, Except ?<br />52) ß-Thalassemia inherited as ……..?<br />53) Foreign body inhaled usually lodges in which lung?<br />54) Change in blood viscosity causes ………?<br />55) * Question regarding Dentition? “Eruption”<br />56) Food poisoning 4-6 hrs organism responsible ……..?<br />57) Dreaming is common in which type of sleep?<br />5 Second heart sound is due to ……..?<br />59) “SAFE” ; ‘S’-stands for ……..?<br />60) Long term status of blood sugar explained by …….? (Ans: HbA1c ; The way the question was formed is different, any way the matter is most Important.)<br />61) Hyperglycemic drugs reduces weight ………..?<br />62) Surfactant is formed from which type of cells?<br />63) Spleenectomy is helpful in ……..?<br />64) Incineration done for which of the following?<br />65) Anti-gliadin antibodies are seen in?<br />--------------------------------------------------------------------------------<br /><br />) The following are example of Apootosis Except-<br />a) Graft versus host disease<br />b) Menstrual cycle<br />c) Pathological atrophy following duct obstruction<br />d) Tumour necrosis<br /><br />2) The normal tensile strength of tissue at the site of wound is gained after:<br />a) 1 week of wound healing<br />b) 2 weeks of wound healing<br />c) 2 months of wound healing<br />d) 2 years of wound healing<br /><br />Ths best test for BEST Disrase<br /><br />--------------------------------------------------------------------------------<br /><br />Best disease is characterized by a striking accumulation of lipofuscin-like material in the macula that often results in an "egg-yolk-like" appearance. In addition, patients affected with Best's disease display an abnormal electrophysiologic sign known as a depressed Arden ratio. The electro-oculogram (EOG) is a measurement of the electric potential that normally exists across the retinal pigment epithelium. This potential normally doubles in response to bright light. However, in Best's disease, this increase does not exist. This test can be used to diagnose patients without classic macular lesions, as well as identifying patients that are unlikely to have the disease.<br /><br /><br />--------------------------------------------------------------------------------<br /><br />qs of sept 2008 paper<br /><br />21 trisomy asso. with<br />ALL<br />CLL<br />AML<br />CML<br /><br />2) esophagus length<br />40<br />25<br />15<br />30<br /><br />3)pre malignant cond. of esophagus<br />barrets<br /><br />4)length of external aud. canal cartilagenous part<br />8<br />16<br />24<br />12<br /><br />5)max. Na absorption at<br />PCT<br />DCT<br />LOH<br />CT<br /><br />6)SUNRAY apearance on x ray<br />osteoclastoma<br />osteoblastoma<br />osteosarcoma<br />chondroblastoma<br /><br />7)m\c tumor in spine<br />sec.<br />ewings sarcoma<br />oteosarcoma<br />m. myeloma<br /><br />punched out lesion in skull<br />ewings sarcoma<br />m.myeloma<br />sec.<br />oteosarcoma<br />9)m\c reason for bradycardia in MI<br />septal MI<br />right vent. MI<br />left ventricular MI<br /><br />10) S1 split seen in<br />RBBB<br />?<br />?<br />?<br /><br />11)snow flake cat. (from prev.papers)<br /><br />12)after injury to one eye other aslo worsen<br />glucoma<br />cat.<br />sym. opthalmia<br />?<br /><br />13)qs from placenta abroptia ...bleeding per vagina tender and hard<br /><br />very few qs from Obs<br /><br />14) 60 year old man with left hydroceal + ???<br /><br />ans. nephroma<br /><br />15)lateral epicondyal fac.<br />non union<br />tardy ulnar nerve palsy<br />?<br />all<br /><br />16)m\c parasitic infection in AIDS<br />strongiloids<br /><br />17)toxin responsibel for TSS in femals<br />exo toxin<br /><br />! in stap. aures food poisoning diarrhea occur due 2<br />endotoxin<br />vagus<br />exotoxin<br />?<br /><br />19)pheochromocytoma diagnosis<br />24 hours urine metabolites VMA+ CA<br />MIBG<br />CT scan<br />surgery<br /><br />20) what we use for thyroid scan<br />I 131<br />--------------------------------------------------------------------------------<br /><br />Q)DRUG WHICH CAUSES REVERSIBLE GYNECOMASTIA<br />-CIMETEDINE<br />-OMEPRAZOLE<br />Q)DOC FOR PROPHYLAXIS OF MENINGOCOCCAL MENINGITIS--RIFAMPIN<br />Q)A PT WITH THROMBOCYTOPENIA.1ST IOC<br />*-BLEEDING TIME<br />-PLATELET COUNT<br />-PROTHROMBIN TIME<br />Q)MC CAUSE OF SOLITARY THYROID NODULE<br />-FOLLICULAR ADENOMA<br />Q)TUMOR MARKER4BOTH PANCREATIC &COLON CA<br />-CA125<br />-CA19<br />Q)A PT VID AN INFERIOR WALL MI IN SHOCK.REASON?<br />ANS-RIGHT VENTRICULAR INFARCTION<br />Q)ALL R FEATURES OF ATRIAL MYXOMA EXCEPT<br />-FEVER<br />-CLUBBING<br />-EMBOLI<br />*HYPERTENSION<br />Q)DOC IN SVT--ADENOSINE<br />Q)A FEMALE PT HAS CHEST PAIN (NON EXERTIONAL)<br />AUSCULTATION--MULTIPLE NON EJECTION ? ..IOC?<br />*ECHO<br />Q)A PT PESENTS WITH MI.EARLEST MARKER?<br />CK-MB<br />TROP-T<br />MYOGLOBIN<br />Q)STAPH AUREUS FOOD POISONING-CAUSE OF NAUSEA?<br />ANS--DIRECT VAGAL STIMULATION<br />Q)A Q ON WEGENERS GRANULOMATOSIS<br />Q)A PT ON TPN.WHAT COULD BE THE CAUSE OF MORTALITY IN THAT PT?<br />OPTIONS CANT RECALL,BUT I MARKED INFECTIONS DUE2CENTRAL LINE<br />Q)A Q ON APGAR SCORE<br />Q)A Q ON ARDS--DIAGNOSTIC CRITERIA<br /><br /><br />some more recalls!<br /><br />Q)A PT WITH BULBAR URETRAL RUPTURE.UR 1ST MN: WUD BE<br />--SUPRAPUBIC CYSTOSTOMY<br />--FOLEY'S<br />--CONSERVATIVE MN<br />--REFER2UROLOGIST<br /><br />Q)MJ MUSCLE FOR EYE INTORSION?<br /><br />Q)ERYTHRODERMA IS ASSOCIATED WID A/E<br />--LEPROMATOUS LEPROSY<br />--AIR BORNE DERMATITIS<br /><br />Q)DERMATITIS HERPETIFORMIS IS A/W<br />*ULCERATIVE COLITIS<br /><br />Q)MC TYPE OF PEMPHIGUS IN INDIA?<br />*P.VULGARIS<br /><br />Q)LA SAFE IN RF?<br />GALLAMINE<br /><br />Q)A PT WID MYASTHENIA GRAVIS IS RESISTANT2<br />--*DEPOLARISING MR<br />--NON DEPOLARISING MR<br />--BOTH<br />--NONE<br /><br />Q)A PSM Q 2FIND OUT RELATIVE RISK<br /><br />Q)ANOTHER PSM Q ON PANEL DISCUSSION..Q WAS AS2VAT WAS IT ABOUT<br /><br />Q)A Q ON SARCOIDOSIS(PATHO)<br /><br />Q)WHICH ANTIBODY HAS BEST4 CELIAC DISEASE(SENSITIVE &SPECIFIC)?<br />*ANTI ENDOMYSIAL AB<br /><br /><br />Q)BEST PROGNOSTIC FACTOR 4 A/C PANCREATITIS<br />-*S.LIPASE<br /><br />Q)A Q ON ZES--WHICH IS NOT TRUE<br />ONE OF THE OPTION READ--REDUCED BAO:MAO WHICH S D ANS<br /><br /><br />Q)AN OHA WHICH IS USED 2TREAT OBESITY<br />ANS WAS SUM BIGUANIDE GIVEN IN THE OPTIONS<br /><br />Q)ANOTHER Q ON DIAB DRUG<br />WHICH ONE DOES'NT CAUSE HYPOGLYCEMIA<br />(SORRY,CANT RECALL OPTIONS)<br /><br /><br /><br />BUT FRIENDS,,NEXT TIME DO READ A BIT ABOUT ORAL HYPOGLYCEMICS AS WELL AS SOME IMP BITS ABOUT ANTI-OBESITY DRUGS<br />(SEEMS NAT BOARD HAS LOST IT'S LONG LASTED LOVE 4 MALARIA,TB,N OTHER PARASITIC INFECTIONS!NOT A SINGLE Q WAS ASKED!!))<br /><br /><br />Q)DRUG USED4TREMORS IN HYPERTHYROIDISM?<br />--PROPRANOLOL<br /><br /><br />Q)AN EASY Q--WHICH CAUSES HYPOCALCEMIA?<br />ANS WAS CALCITONIN<br /><br />Q)A PT ON TPN FOR A WEEK DEVELOPS FEATURES((WHICH WAS SUGGESTIVE OF ZN DEFICIENCY))..DEFICIENCY OF VAT?<br /><br /><br />Q)A Q ON NEPHROTIC SYNDROME IN CHILDREN....<br /><br /><br />Q)HYALINE ARTERIOSCLEROSIS IS SEEN IN<br />*BENIGN HTN<br /><br />some more questions frm FMGE sept 2008<br /><br />1-ring shaped ulcers seen in?<br />2-neurotrophic keratitis-nerve involved<br />3-question on sympathetic ophthalmia<br />4-extra capsular cataract surgery-parts of lens which are excised?<br />5- SAFE strategy for trachoma-S stands for?<br />6-rubro iridis is not seen in?<br />7-questions on cost benefit and cost accounting in PSM<br />8-central tendancy seen in-(refer biostats PSM )<br />9-question on odds ratio<br />10-complication of measles virus -encephalomelyitis<br />some more-<br />NNN Media used for- Ans-leshmania donavani<br />Treatment of first degree testicular cancer<br />Fourniers (sorry for d spelling,I don remember exactly!) gangrene seen in- Ans scrotum<br />Treatment Regimen for hodkgins lymphoma<br />Shape of tracheal cartilage-ans-horse shoe shape<br />Comonest congenital anomaly of trachea<br />Erythoderma is not seen in-?<br />Commonest lupus in india-<br />Fate of notochord-?<br />Mysanthia gravis is not inhibited by-depolarizing agents,non depolarizing agents,both,?<br />Rarest form of opportunistic fungal infection seen in AIDS-<br />White line of frenkel seen in-ans Scurvy<br />Xray sign of rickets<br />Splenomegaly not seen in-?<br />The first clinical presentation of acoustic neuroma-ans-facial nerve involvement<br />Stones r seen most commonly in submandibular salivary gland<br />The calories required by one year old child<br />4-5 questions on Tracheostomy<br />Sunray sign on xray seen in-?osteosarcoma<br />Tardy ulnar palsy seen in-?<br />Rigor mortis is due to-?<br />Vitreous hemorrhage on autopsy seen in poisoning of-?<br />One question on [bleep]-Refer Forensic Medicin<br />Most specific method of diagnosis of kalazar<br /><br /><br />--------------------------------------------------------------------------------<br /><br />questions<br /><br />Q.a patient with tb had decrease SERUM level of Na and k....... and has hyperpigmentation of crease of hand??...<br />ans.. secondary hyperaldeosteroism.<br />Q.MC. CAUSE OF DEATH IN INDIA?<br />ANS. CORONAY HEART DISEASE.<br />Q.CXR AP VIEWON RIGHT SIDE OF CARDIAC SILHOUTE U CAN SEE ALL EXCEPT?<br />ANS. SUPERIOR VENA CAVA<br />Q.NORMAL TO INCREASE SIZE OF KIDNEY IS SEEN ALL EXCEPT?<br />ANS. *CHRONOC GN<br />DIABETIC NEPHROPATHY<br />AIDS REALTED NEPHROPATHY<br />PKD<br />Q.SPLEEN IS SUPPORT BY WHICH LIGAMNET FROM UPPER SIDE?<br />ANS. GASTROSPLENIC LIGAMENT.<br />Q.STAIN FOR AMLYDOSIS<br />ANS. CONGO RED<br />Q.AUER RODS ARE SEEN IN?<br />AN. AML<br />Q.WHICH TUMOR IS MC IN DOWN SYNDROME?\<br />ANS MAY BE RETINOBLASTOMA (PLZ MAKE SURE FROM BOOK)<br /><br />--------------------------------------------------------------------------------<br /><br />1.Trendelenburg's test<br /><br />Also known as:<br />Brodie-Trendelenburg test<br />Trendelenburg-Brodie test<br /><br />Associated persons:<br />Sir Benjamin Collins Brodie<br />Friedrich Trendelenburg<br /><br />Description:<br /><br />Test for varicose veins. Patient lies on his back and raises his leg to empty the veins. A tourniquet is applied just below the saphenous opening. The patient is then stood up and the tourniquet removed in 60 seconds. Normally the vein should fill from below within 35 seconds with the tourniquet in situ. Earlier filling indicates incompetence of a communicating vein. If on release the veins fill rapidly from above it is due to incompetent sapheno-femoral valves.<br /><br /><br />2. Trendelenburg's test<br /><br /><br />Trendelenburg's test is a test of the saphenous and other veins.[1]<br />It is named for Friedrich Trendelenburg.[2][3]<br />It should not be confused with Trendelenburg's sign, which involves the muscles of the hip.<br /><br /><br />Trendelenburg's sign:<br /><br /><br />Trendelenburg's sign is found in people with weak abductor muscles of the hip. It is named after the German surgeon Friedrich Trendelenburg.<br />The Trendelenburg sign is said to be positive if, when standing on one leg, the pelvis drops on the side opposite to the stance leg. The weakness is present on the side of the stance leg. The body is not able to maintain the center of gravity on the side of the stance leg. Normally, the body shifts the weight to the stance leg, allowing the shift of the center of gravity and consequently stabilizing or balancing the body. However, in this scenario, when the patient/person lifts the opposing leg, the shift is not created and the patient/person cannot maintain balance leading to instability.<br /><br />Essentially, Trendelenburg sign is caused by paralysis of the gluteus medius and minimus muscles.<br /><br />Paralysis may arise due to nerve damage, namely, the superior gluteal nerve<br />--------------------------------------------------------------------------------<br /><br />1.<br />Trendelenburg test is a standard clinical assessment of hip stability.<br /><br />A positive test indicates gluteus medius weaknessand is observed when weight is supported by the affected limband the pelvis on the healthy side falls instead of rises.<br /><br />This test was used in this study to compare the two approaches. Incases of minimal abductor weakness there may be a delayedpositive test. It is for this reason that an element of musclefatigue was taken into account by considering the pelvicposition at 30 seconds of single leg stance. Since gait analysisallows subtle differences to be detected compared to clinicalanalysis, it was hoped this test would be an effective measureto compare the two approaches<br /><br />-------------------------------------------------------------------------------------<br /><br />2.<br /><br />The notochord exists transiently during the life of most vertebrates.<br /><br />A notochord is the defining characteristic of members of the phylum Chordata, a large and diverse biological group which includes all animals with spines, or backbones, along with more primitive chordates. The notochord has very large cells which are densely arranged within a protective sheath. Chordates are divided into three subphyla, depending on what form their notochords take and when they appear. At any developmental stage, a notochord acts as a form of support for the animal that possesses it, giving animals the ability to do things such as walking upright.<br /><br />The most primitive group of chordates, urochordates, also called tunicates, only have a notochord in the larval stages of development. The animals in this group are pelagic, meaning that they are found in the world's oceans, and there are a number of representative species, most of whom are only known to biologists. These animals do provide an insight into the development of chordates, however, showing the notochord at an early stage of development.<br /><br />The next group of chordates, cephalochordates, also called lancelets, possess a notochord into adulthood, and also live in the ocean. The notochord runs all the way along the body, even up into the head, and the animals lack a protective layer of bone such as a spine. The notochord acts as an axial support, providing a strong core for the animal. The notochord is highly flexible, but not compressible, allowing the animal to move freely without damaging the notochord.<br /><br />In the highest class of chordates, the vertebrates, the notochord only exists when the animal is in an embryonic form. As the vertebrate develops, the notochord is first ensheathed in and then replaced by spinal vertebrae, protective cases of bone which cover the delicate spinal cord. The spinal column is able to support a much larger and more complex organism, and is much stronger than the notochord. This allowed early vertebrates to make the leap to the land and develop into well known species such as humans.<br /><br />In all chordates, the notochord exists in some form when the animal is in a larval or embryonic stage[/size]. The development of the notochord from there helps shape what sort of animal it will turn into, whether it be a sac like tunicate or a pure bred Norwegian Fjord horse. The development of the notochord represents a major advance in evolution, as it allowed animals to get much larger and more complex, a drastic departure from simpler orders of animals which existed previously.<br /><br />------------------------------------------------------------------------------------<br /><br />3. NeuroGLIA<br /><br />Glial cells, commonly called neuroglia or simply glia (Greek for "glue"), are non-neuronal cells that provide support and nutrition, maintain homeostasis, form myelin, and participate in signal transmission in the nervous system. In the human brain, glia are estimated to outnumber neurons by about 10 to 1.<br /><br />Glial cells provide support and protection for neurons, the other main type of cell in the nervous system. They are thus known as the "glue" of the nervous system. The four main functions of glial cells are to surround neurons and hold them in place, to supply nutrients and oxygen to neurons, to insulate one neuron from another, and to destroy pathogens and remove dead neurons. They also modulate neurotransmission.<br /><br /><br />The supportive tissue of the nervous system, including the network of branched cells in the central nervous system (astrocytes, microglia, and oligodendrocytes) and the supporting cells of the peripheral nervous system (Schwann cells and satellite cells). Also called glia, reticulum.<br />------------------------------------------------------------------------------<br /><br />4. Hyaline arteriolosclerosis:<br /><br />Hyaline arteriolosclerosis can be seen in patients with diabetes mellitus and with hypertension. Hyaline arteriolosclerosis are more common in diabetic sufferers.<br /><br /><br />5. M.C cardiac lesion seen in pregnancy --><br /><br />Mitral stenosis is the most common rheumatic valvular lesion seen in pregnancy due to its prevalence in young women.<br /><br /><br />6. M.C valve disease due to ----<br /><br />Mitral valve prolapse (MVP) : is the most common forms of valve disease, affecting 6 percent of all women. In this condition one or both of the valve leaflets is enlarged or floppy, preventing the valve from closing evenly. When the valve shuts, the leaflets bulge into the left atrium. You may have heard mitral valve prolapse referred to as click-murmur syndrome from the sound the valve makes when it closes.<br /><br />7. Herd Immunity:<br /><br />In immunology, herd immunity refers to a situation in which a high percentage of a population is immune to a disease, essentially stopping the disease in its tracks because it cannot find new hosts. You may also hear this concept referred to as “community immunity.” The threshold for herd immunity varies, depending on the disease, with more virulent agents requiring vaccination of a higher percentage of the population to crate the desired herd immunity. In addition to being used in disease prevention, community immunity is also utilized to fight ongoing outbreaks.<br /><br />Most vaccination policies are focused on creating herd immunity. Many countries require vaccinations in childhood, for example, protecting children from common diseases and ensuring that when these diseases enter the population, they cannot prey on children or adults, who have been previously vaccinated or exposed to the disease. The creation of herd immunity is especially important in crowded environments which facilitate the spread of disease, like schools.<br /><br />Immunologists try to prevent the outbreak of diseases by creating herd immunity, but they are not always successful. Sometimes a disease mutates or is entirely new, or a batch of vaccinations is faulty, or a large percentage of the population fails to get vaccinated, creating a situation in which an outbreak can occur, because much of the population is vulnerable. In the event of an outbreak of a major disease, agencies like the World Health Organization can dispatch teams within days to figure out the cause of the outbreak and develop a vaccine, in the hopes of creating herd immunity to halt the outbreak in its tracks.<br /><br />For some diseases, herd immunity thresholds are as low as 50%, especially when combined with good hygiene. In other instances, up to 90% of the population may need to be vaccinated to create the desired herd immunity. It is also extremely important to receive regular boosters, as some vaccines lose their efficacy over time, leaving people vulnerable to an outbreak. Herd immunity led to the eradication of smallpox, and it explains why diseases such as polio and diphtheria are rare in developed nations with established vaccination policies.<br /><br />The concept of herd immunity is often used to encourage reluctant parents to vaccinate their children. In addition to ensuring that their children are protected from fully preventable diseases, childhood vaccinations also benefit society at large by creating herd immunity. Likewise, adults may be reminded to receive boosters to help protect their communities.<br /><br />---------------------------------------<br />9. Koplik’s spots seen in ---<br /><br />Also known as: Filatov’s spots, Flindt’s spots Maculae Koplik.<br /><br />Associated persons:<br />Nil Feodorovich Filatov<br />Nikolaj Flindt<br />Henry Koplik<br /><br />Description:<br />Small, grain-of-sand sized, irregular, bright red spots with blue-white centres, occurring on the inside of the cheek (buccal mucosa). Seen only on measles (rubeolae) they are, by themselves, a diagnostic sign in measles. The spots usually occur briefly after the fever begins and a couple of days before the generalized rash appears. Not infrequently, the spots disappear as the eruption develops.<br /><br />--------------<br /><br />Koplik's spots are bluish-white spots seen on the mucous membranes of the mouth and are pathognomonic of measles.<br /><br />They often appear a few days before the rash arrives and can be a useful sign to look for in children known to be exposed to the measles virus.<br /><br />--------------<br /><br />10. A ? patient with hypertension & suffering from Thyroiditis, DOC --<br /><br />L-Thyroxine has long been the treatment drug of choice<br /><br />Goals of<br />therapy (Rx) To bring free T4 (L-thyroxine) and TSH levels into normal range and improve symptoms. 1st choice therapy L-thyroxine.<br /><br /><br />11. Hypocalcemia is seen with the following--><br /><br />Hypocalcemia can be seen in chronic renal insufficiency.<br /><br /><br />Hypocalcemia may be seen in a number of disorders affecting the synthesis or action of PTH or vitamin D or following sequestration of calcium into a functionally inaccessible compartment.<br /><br />Many of these represent chronic illnesses where hypocalcemic symptoms develop insidiously or where the complication of hypocalcemia is anticipated early and appropriate treatment initiated prior to acute decompensation.<br /><br /><br />Hypocalcemia occurs in the setting of acute systemic illness (eg, toxic shock syndrome), a finding that has been linked to elevated free fatty acids levels in this setting. It has also been associated with specific drugs, including antineoplastic agents such as doxorubicin and cytarabine and other agents such as ketoconazole, pentamidine, and foscarnet.<br /><br />12.Most common position of Uterus?<br />The most common position is for the long axis of the uterus to lie in approximately the same axis as the pelvis, that is, with the upper part tilted forward and the lower end, the cervix, inserted into the top of the vagina. There is therefore an angle between the uterus and the vagina, the long axis of which corresponds to the lower part of the pelvis.<br /><br />13. Shortest ø of pelvis is--><br />The interspinous diameter is the shortest in the pelvis.<br /><br />Obstetrical Pelvic Diameters<br />The shape and size of the bony pelvis are important factors determining the outcome of labour. The pelvic inlet is the entrance to the true pelvis. The plane of the pelvic inlet is almost circular in a normal female or gynaecoid pelvis with a slightly greater transverse than anterior-posterior diameter. The true diameter of the pelvic inlet is difficult to assess clinically. An estimate can be made from the diagonal conjugate diameter which is measured between the midpoint of the sacral promontory and the nearest point on the posterior surface of the pubic symphysis. This measure is about 1.5cm greater than the obstetrical conjugate diameter. In practice it is rarely possible to reach the promontory on clinical examination. The pelvic outlet is narrower than the pelvic inlet. The anterior-posterior diameter of the pelvic outlet is measured from the inferior border of the pubic symphysis to the sacrococcygeal joint, and is usually about 12.5cm. The transverse diameter of the pelvic outlet is measured between the ischial tuberosities and is usually about 10cm. The plane of least pelvic dimensions represents the narrowest part of the birth canal. The anteroposterior diameter extends from the inferior margin of the pubic symphysis posteriorly through a line which connects the ischial spines, the transverse diameter. Both diameters can be assessed clinically, and the interspinous diameter is the shortest in the pelvis.<br /><br />14. Right base of the heart is formed by ---><br /><br />The base of the heart is opposite to that of the apex is mainly formed by the left atria, but getting some contribution from the right atrium.<br /><br />15. Right side Mid calvicle the lung ends at which rib --10 Rib?<br /><br />The border of the right lung lies immediately inside the pleural margin from the cupola down to about the 6th costal cartilages.<br /><br />It then lies about two spaces above the pleural margin:<br />it crosses the 6th rib in the midclavicular line and the 8th rib in the midaxillary line, and reaches the vertebral column at the level of the 10th rib.<br /><br />16. Water supply in hilly areas---?<br /><br /><br />Developing springs as a source for rural water supply is ideally suited for the following situations: (a). The springs are perennial (at least discharge at the rate of 20 lpcd during peak summer) and of good water quality (to be tested for chemical and bacteriological) contamination); (b) Chance of polluting the catchment is minimum; (c) The beneficiary population lives within close proximity of the springs preferably in the down stream areas of the springs.<br /><br />In the era of decentralized planning, community mobilization, resource mobilization, cost sharing, community management, cost recovery and operation and maintenance plays a significant role in the water supply schemes. In 1989, the Pazhakulam Social Service Society (PASSS) has taken the initiative for the development of natural springs as alternative safe drinking water to the communities in the remote hilly areas of Southern Kerala. The main objective of the spring development programme was to demonstrate to the Government, Non-Governmental Organizations and the people of Kerala, that it is possible to design and develop alternate delivery of drinking water through private sector initiatives. The concept of rejuvenation of springs is an alternative mechanism to increase the coverage and accessibility of safe water supply in the remote areas. PASSS has taken the leadership in demonstrating the programme since 1991 and more than 1150 springs have already been developed with the active participation of the community. The salient features of the programme is as follows:<br /><br />Established water committees as the nucleus of community organization, participation and management of the programme; Capacity building and empowerment; Capital cost sharing mechanism has become mandatory;<br />Full O & M by water committees/community; Low cost participatory design; Panchayat institutions as a partner; Integration of water, sanitation and hygiene; Water quality monitoring; Community monitoring and follow up.<br /><br /><br />17. Prophylaxis DOC for Meningitis --><br /><br />Meningitis is an inflammation of the leptomeninges and underlying subarachnoid cerebrospinal fluid<br /><br /><br />Cephalexin/Cefazolin<br /><br /><br />PO/IV<br />Stable vs Staph penicillinase<br />Spectrum: MSSA, PSSP, most E. coli, and some Klebs<br />Can be dose thrice weekly in HD pts<br />[1.5 grams IV TIW]<br />DoC: surgical prophylaxis, bacterial peritonitis in CAPD pts [1 gm in the dwell bag]<br /><br />--------------------<br /><br />Ampicillin/Amoxicillin<br /><br /><br />Amp (IV, PO) Amox (PO)<br />Spectrum: PenG + H. flu and some E. coli<br />DoC: Listeria monocytogenes and<br />Enterococcus [Amp 2g IV q4h]<br /><br />Dental Prophylaxis<br />Amox 1 gram PO x 1 prior to appt.<br />Integral in H. pylori regimens<br />ADRs<br />Non-allergic rashes (9%) – esp. when associated with a viral illness (mononucleosis - EBV)<br />Amox better tolerated PO and better absorbed (Amp must be taken on empty stomach)<br />-----------------------------<br /><br />more qns from FMGE sept 08<br /><br />who discovered xrays?<br />roentgen<br /><br />which disease is X linked recessive?<br />Hemophlia<br /><br />most common cause of death in people older than 70 yrs?<br />cardiovascular disease, cancer,respiratory disease?<br /><br />in retinal detachment?? options were red colour, blue colour, green colour? i cant remember exactly.<br /><br />in which poisoning shud the vitrous humor be preserved?<br /><br />malignant pustule?<br />anthrax<br /><br />a qn from varicocele frm surgery, i cant remember..<br /><br /><br />frnds, there were over 20 questions frm Ophthalmology and Biochemistry and many from parasitology in Microbiology ..<br />few questions were simple and thats all we can recollect! there were many confusing questions too...<br />all da best for 2009....<br /><br /><br />--------------------------------------------------------------------------------<br /><br />Prophylaxis DOC for Meningitis?<br /><br /><br />PRESCRIPTIONS FOR PROPHYLAXIS OF MENINGITIS :<br />PROCEDURES FOR GGHB COMMUNITY PHARMACISTS<br /><br />· Identify a prescription for meningitis prophylaxis:<br /><br />Rifampicin 600mg (or 10mg/kg for children) twice daily for 2 days<br /><br />or<br /><br />Ciprofloxacin 500mg as a single dose (although not yet licensed for this purpose).<br /><br />Establish the patient’s eligibility for exemption from prescription charge.<br /><br />If not exempt via NHS, reassure the patient that a special GGHB exemption will apply.<br /><br />Dispense the prescription.<br /><br />Please do not collect the prescription charge.<br /><br />Please submit an invoice for the prescription charge on headed notepaper to myself at GGHB Headquarters, noting patient name and date.<br /><br />Submit the prescription in the non-exempt category to the PPD.<br /><br /><br />-------------------------------------------------<br /><br />PRESCRIPTIONS FOR PROPHYLAXIS OF MENINGOCOCCAL SEPTICAEMIA<br /><br />You will be aware of the increased incidence of meningitis in recent weeks. All cases are notified to the GGHB Public Health Department. Treatment of the individual case in an acute hospital is accompanied by management of the public health implications in primary care. Typically, specialists in Communicable Disease will identify close family and friends of the patient who may require prophylactic treatment. The treatment options currently are:<br /><br />Rifampicin 600mg (or 10mg/kg for children) twice daily for 2 days<br /><br />or<br /><br />Ciprofloxacin 500mg as a single dose (although not yet licensed for this purpose)<br /><br />The options for supply of these prescriptions are as follows:<br /><br />community administration programme (e.g. school, church)<br /><br />hospital supply<br /><br />supply through the local GEMS centre<br /><br />prescription on HBP forms by the Public Health Consultant on call<br /><br />prescription on GP10<br /><br />The last of these is frequently the preferred option. Treatment needs to be started quickly but not urgently and both drugs need to be used cautiously in combination with other therapies. Community pharmacists can reinforce these points.<br /><br />--------------------------------------------------------------------------------<br /><br />1 Anaemia is seen with all except?<br /><br />Anemia<br />Definition<br />If you have anemia, people may say you have tired blood. That's because anemia — a condition in which there aren't enough healthy red blood cells to carry adequate oxygen to your tissues — can make you feel tired.<br /><br />There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe.<br /><br />Anemia is a common blood disorder. Women and people with chronic diseases are at increased risk of the condition.<br /><br />If you suspect you have anemia, see your doctor. Anemia can be a sign of serious illnesses. Treatments for anemia range from taking supplements to undergoing medical procedures. You may be able to prevent some types of anemia by eating a healthy, varied diet.<br /><br />Symptoms<br />The main symptom of most types of anemia is fatigue. Other anemia symptoms include:<br /><br />•Weakness<br />•Pale skin<br />•A fast or irregular heartbeat<br />•Shortness of breath<br />•Chest pain<br />•Dizziness<br />•Cognitive problems<br />•Numbness or coldness in your extremities<br />•Headache<br />Initially, anemia can be so mild it goes unnoticed. But signs and symptoms increase as the condition worsens.<br /><br />Causes<br />Blood consists of both a liquid called plasma and cells. Floating within the plasma are three types of blood cells:<br /><br />•White blood cells. These blood cells fight infection.<br />•Platelets. These blood cells help your blood clot after a cut.<br />•Red blood cells (erythrocytes). These blood cells carry oxygen from your lungs, via your bloodstream, to your brain and the other organs and tissues. Your body needs a supply of oxygenated blood to function. Oxygenated blood helps give your body its energy and your skin a healthy glow.<br />Red blood cells contain hemoglobin — a red, iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body, and to carry carbon dioxide from other parts of the body to the lungs so that it can be exhaled.<br /><br />Most blood cells, including red blood cells, are produced regularly in your bone marrow — a red, spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, protein and vitamins from the foods you eat.<br /><br />Anemia is a state in which the number of red blood cells or the hemoglobin in them is below normal. When you're anemic, your body produces too few healthy red blood cells, loses too many of them or destroys them faster than they can be replaced. As a result, your blood is low on red blood cells to carry oxygen to your tissues — leaving you fatigued. Common types of anemia and their causes include:<br /><br />•Iron deficiency anemia. This most common form of anemia affects about one in five women, half of pregnant women and 3 percent of men in the United States. The cause is a shortage of the element iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells. The result is iron deficiency anemia.<br /><br />One way your body gets needed iron is when blood cells die — the iron in them is recycled and used to produce new blood cells. So, if you lose blood, you lose iron. Women with heavy periods who lose a lot of blood each month during menstruation are at risk of iron deficiency anemia. Slow, chronic blood loss from a source within the body — such as an ulcer, a colon polyp or even colon cancer — also can lead to iron loss and iron deficiency anemia.<br /><br />Your body also gets iron from the foods you eat. An iron-poor diet can lead to this anemia. In pregnant women, a growing fetus can deplete the mother's store of iron, leading to iron deficiency anemia.<br /><br />•Vitamin deficiency anemias. In addition to iron, your body needs folate and vitamin B-12 to produce sufficient numbers of healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. People who have an intestinal disorder that affects the absorption of nutrients are prone to this type of anemia. Some people are unable to absorb vitamin B-12 for a variety of reasons and develop vitamin B-12 deficiency anemia, which is sometimes called pernicious anemia. Vitamin deficiency anemias fall into a group of anemias called megaloblastic anemias, in which the bone marrow produces large, abnormal red blood cells.<br />•Anemia of chronic disease. Certain chronic diseases — such as cancer, rheumatoid arthritis, Crohn's disease and other chronic inflammatory diseases — can interfere with the production of red blood cells, resulting in chronic anemia. Kidney failure also can be a cause of anemia. The kidneys produce a hormone called erythropoietin, which stimulates your bone marrow to produce red blood cells. A shortage of erythropoietin, which can result from kidney failure or be a side effect of chemotherapy, can result in a shortage of red blood cells.<br />•Aplastic anemia. This is a life-threatening anemia caused by a decrease in the bone marrow's ability to produce all three types of blood cells — red blood cells, white blood cells and platelets. Many times, the cause of aplastic anemia is unknown, but it's believed to often be an autoimmune disease. Some factors that can be responsible for this type of anemia include chemotherapy, radiation therapy, environmental toxins, pregnancy and lupus.<br />•Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelodysplasia, a pre-leukemic condition, can cause anemia by affecting blood production in the bone marrow. The effects of these types of cancer and cancer-like disorders vary from a mild alteration in blood production to a complete, life-threatening shutdown of the blood-making process. Additionally, other cancers of the blood or bone marrow, such as multiple myeloma, myeloproliferative disorders and lymphoma, can cause anemia.<br />•Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases can cause increased red blood cell destruction. Autoimmune disorders can cause your body to produce antibodies to red blood cells, destroying them prematurely. Certain medications, such as some antibiotics used to treat infections, also can break down red blood cells. Hemolytic anemias may cause yellowing of the skin (jaundice) and an enlarged spleen.<br />•Sickle cell anemia. This inherited and sometimes serious anemia, which affects mainly people of African and Arabic descent, is caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular-shaped red blood cells die prematurely, resulting in a chronic shortage of red blood cells. Sickle-shaped red blood cells can also block blood flow through small blood vessels in the body, producing other, often painful, symptoms.<br />•Other anemias. There are several other, rarer forms of anemia, such as thalassemia and anemias caused by defective hemoglobin.<br />Sometimes, no cause of anemia can be identified.<br /><br />Risk factors<br />These factors place you at increased risk of anemia:<br /><br />•Poor diet. Anyone — young or old — whose diet is consistently low in iron and vitamins, especially folate, is at risk of anemia. Your body needs iron, protein and vitamins to produce sufficient numbers of red blood cells.<br />•Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in the small intestine — such as Crohn's disease and celiac disease — puts you at risk of anemia. Surgical removal of or surgery to the parts of the small intestine where nutrients are absorbed can lead to nutrient deficiencies and anemia.<br />•Menstruation. In general, women are at greater risk of iron deficiency anemia than are men. That's because women lose blood — and with it, iron — each month during menstruation.<br />•Pregnancy. Pregnant women are at an increased risk of iron deficiency anemia because their iron stores have to serve the increased blood volume of the mother as well as be a source of hemoglobin for the growing fetus.<br />•Chronic conditions. For example, if you have cancer, kidney or liver failure, or another chronic condition, you may be at risk of what's called anemia of chronic disease. These conditions can lead to a shortage of red blood cells. Slow, chronic blood loss from an ulcer or other source within the body can deplete your body's store of iron, leading to iron deficiency anemia.<br />•Family history. If your family has a history of an inherited anemia, you also may be at increased risk of the condition.<br />Certain infections, blood diseases and autoimmune disorders, exposure to toxic chemicals, and the use of some medications can affect red blood cell production and lead to anemia. Other people at risk of anemia are people with diabetes, people who are dependent on alcohol (alcohol interferes with the absorption of folic acid) and people who adhere to a strict vegetarian diet, who may not get enough iron or vitamin B-12 in their diet.<br /><br />When to seek medical advice<br />See your doctor if you're feeling fatigued for unexplained reasons, especially if you're at risk of anemia. Some anemias, such as iron deficiency anemia, are common. But don't assume that if you're tired, you must be anemic. Fatigue has many causes besides anemia.<br /><br />Some people learn that their hemoglobin is low, which indicates anemia, when they go to donate blood. Low hemoglobin may be a temporary problem remedied by eating more iron-rich foods or taking a multivitamin containing iron. However, it may also be a warning sign of blood loss in your body that may be causing you to be deficient in iron. If you're told that you can't donate blood because of low hemoglobin, ask your doctor if you should be concerned.<br /><br />If you have a family history of an inherited anemia, such as sickle cell anemia, talk to your doctor and possibly a genetic counselor about your risk and what risks you may pass on to your children.<br /><br />Tests and diagnosis<br />Doctors diagnose anemia with the help of a medical history, a physical exam and blood tests, including a complete blood count (CBC). This blood test measures levels of red blood cells and hemoglobin in your blood. Some of your blood may also be examined under a microscope to study the size, shape and color of your red blood cells, which may indicate a diagnosis. For example, in iron deficiency anemia, red blood cells are smaller and paler in color than normal. In vitamin deficiency anemias, red blood cells are enlarged and fewer in number.<br /><br />If you receive a diagnosis of anemia, your doctor may order additional tests to determine the underlying cause. For example, iron deficiency anemia can result from chronic bleeding of known or unknown ulcers, benign polyps in the colon, colon cancer, tumors, or kidney failure. Your doctor may test for these and other conditions that may underlie the anemia.<br /><br />Occasionally, it may be necessary to study a sample of your bone marrow to diagnose anemia.<br /><br />Complications<br />When anemia is severe enough, it may interfere with your ability to do everyday tasks. You may be too exhausted to work or play. Although anemia is often treatable, it may take several weeks to months for red blood cell levels to return to normal after treatment. Ask your doctor what to expect from treatment.<br /><br />If you've been diagnosed with anemia — it's often detected during routine blood tests — ask your doctor what treatment is necessary. Then be sure to follow through on treatment, even if you quickly start to feel better. Left unchecked, anemia can lead to a rapid or irregular heartbeat — an arrhythmia. Your heart must pump more blood to compensate for the lack of oxygen in the blood when you're anemic. This can even lead to congestive heart failure. Untreated pernicious anemia can lead to nerve damage and decreased mental function, as vitamin B-12 is important not only for healthy red blood cells but also for optimal nerve and brain function.<br /><br />Some inherited anemias, such as sickle cell anemia, can be serious and lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal.<br /><br />Treatments and drugs<br />Anemia treatment depends on the cause:<br /><br />•Iron deficiency anemia. This form of anemia is treated with iron supplements, which you may need to take for several months or longer. If the underlying cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and stopped. This may involve surgery.<br />•Vitamin deficiency anemias. Pernicious anemia is treated with injections — often lifetime injections — of vitamin B-12. Folic acid deficiency anemia is treated with folic acid supplements.<br />•Anemia of chronic disease. There's no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. Iron supplements and vitamins generally don't help this type of anemia. However, if symptoms become severe, a blood transfusion or injections of synthetic erythropoietin, a hormone normally produced by the kidneys, may help stimulate red blood cell production and ease fatigue.<br />•Aplastic anemia. Treatment for this serious anemia may include blood transfusions to boost levels of red blood cells. You may need a bone marrow transplant if your bone marrow is diseased and can't make healthy blood cells. You may need immune-suppressing medications to lessen your immune system's response and give the transplanted bone marrow a chance to start functioning again.<br />•Anemias associated with bone marrow disease. Treatment of these various diseases can range from simple medication to chemotherapy to bone marrow transplantation. Treatment of these types of anemia usually involves a consultation from a blood specialist (hematologist).<br />•Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating related infections and taking drugs that suppress your immune system, which may be attacking your red blood cells. Short courses of treatment with steroids or gamma globulin can help suppress your immune system's attack on your red blood cells. If the condition has caused an enlarged spleen, you may need to have your spleen removed. The spleen — a small organ below your rib cage on the left side — filters out and stores defective red blood cells. Certain hemolytic anemias can cause the spleen to become enlarged with damaged red blood cells.<br />•Sickle cell anemia. Treatment for this incurable anemia may include the administration of oxygen, pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent complications. Doctors also commonly use blood transfusions, folic acid supplements and antibiotics. A bone marrow transplant may be an effective treatment in some circumstances. A cancer drug called hydroxyurea (Droxia, Hydrea) also is used to treat sickle cell anemia in adults.<br />Prevention<br />Many types of anemia can't be prevented. However, you can help avoid iron deficiency anemia and vitamin deficiency anemias by eating a healthy, varied diet that includes foods rich in iron, folate and vitamin B-12.<br /><br />The best sources of iron are beef and other meats. Other foods rich in iron include beans, lentils, iron-fortified cereals, dark green leafy vegetables, dried fruit, nuts and seeds. Folate, and its synthetic form, folic acid, can be found in citrus juices and fruits, dark green leafy vegetables, legumes and fortified breakfast cereals. Vitamin B-12 is plentiful in meat and dairy products. Foods containing vitamin C, such as citrus fruits, help increase iron absorption.<br /><br />Eating plenty of iron-containing foods is particularly important for people who have high iron requirements, such as children — iron is needed during growth spurts — and pregnant and menstruating women. Adequate iron intake is also crucial for infants, strict vegetarians and long-distance runners.<br /><br />Doctors may prescribe iron supplements or multivitamins containing iron for people with high iron requirements. But iron supplements are appropriate only when you need more iron than a balanced diet can provide. Don't assume that if you're tired that you simply need to take iron supplements. Overloading your body with iron can be dangerous.<br /><br />--------------------------------------------------------------------------------<br /><br />Anaemia is a condition in which the haemoglobin concentration in the blood is below a defined level, resulting in a reduced oxygen-carrying capacity of red blood cells.<br /><br />About half of all cases of anaemia can be attributed to iron deficiency; other common causes include infections, such as malaria and schistosomiasis, and genetic factors, which result in thalassaemias and sickle-cell disease.<br /><br />In its severe form, anaemia is associated with fatigue, weakness, dizziness and drowsiness. Pregnant women and children are particularly vulnerable.<br /><br />--------------------------------------------------------------------------------<br /><br />19 ) Dose of Folic acid during pregnancy?<br /><br /><br />Taking 400 micrograms of synthetic folic acid daily from fortified foods and/or supplements has been suggested.<br /><br />The Recommended Dietary Allowance (RDA) for folate equivalents for pregnant women is 600-800 micrograms, twice the normal RDA of 400 micrograms for women who are not pregnant.<br /><br /><br />--------------------------------------------------------------------------------<br /><br />Prophylaxis vs Neural Tube Defects (NTD):<br /><br />The Society of Obstetricians and Gynaecologists of Canada , in its 1993 Policy Statement, recommended that all women of child bearing potential, whether planning pregnancy or not, should consider maintaining a folic acid intake of at least 0.4 mg daily, either in the diet or as a supplement.<br /><br />Pregnant women with no previous history of fetal NTD and no other predisposing factors are advised to maintain an intake of at least 0.4 mg daily until 10 to 12 weeks after last menstrual period.<br />--------------------------------------------------------------------------------<br /><br />20) Vitamin “A” dosage is given in….? (?. of doses.)<br /><br />The World Health Organization recommends single-large-dose vitamin A supplementation for postpartum women in areas of prevalent vitamin A deficiency; neonatal dosing is under consideration.<br /><br />It is safe to give fertile women, independentof their vitamin A status, as much as 10,000IU (3000 µg RE) daily at any time duringpregnancy.<br /><br /><br />21) What is Apoptosis?<br /><br />Apoptosis, by contrast, is a process in which cells play an active role in their own death (which is why apoptosis is often referred to as cell suicide).<br /><br />Apoptosis, or programmed cell death, is a normal component of the development and health of multicellular organisms. Cells die in response to a variety of stimuli and during apoptosis they do so in a controlled, regulated fashion.<br /><br />This makes apoptosis distinct from another form of cell death called necrosis in which uncontrolled cell death leads to lysis of cells, inflammatory responses and, potentially, to serious health problems.<br /><br /><br />22) Extrinsic factor in blood coagulation? (PT/PTT)<br /><br />PT, PTT, D-DIMER<br /><br />This panel of tests is used to evaluate the extrinsic coagulation system. They may also aid in screening for congenital deficiencies of factors II, V, VII, X as well as deficiencies of prothrombin dysfibrinogenemia, and afibrinogenemia. Levels of PT, PTT and D-dimmer, can determine heparin effect, warfarin anticoagulant therapy, liver failure, disseminated intravascular coagulation (DIC), vitamin K deficiency. This test includes the following: prothrombin time (PT) and partial thromboplastin time (PTT), and D-dimmer.<br /><br />Prothrombin time (PT)<br /><br />This test is used to evaluate the adequacy of the extrinsic system and common pathway in the clotting mechanism. Prothrombin time (PT) test provides a control for long-term anticoagulant therapy that usually involves the use of a coumarin derivative (eg, Coumadin®).This therapy attempts to impede thrombus formation without the threat of mortality from hemorrhage.<br /><br />Partial Thromboplastin Time<br /><br />This test is used to evaluate the intrinsic coagulation system. It is also used to monitor heparin therapy, to aid in detecting classical hemophilia A, Christmas disease, and detection of congenital deficiencies of factors II, V, VIII, IX, X, XI, and XII. PTT is used to screen for the presence of dysfibrinogenemia, disseminated intravascular coagulation, liver failure, congenital hypofibrinogenemia, vitamin K deficiency, congenital deficiency of Fitzgerald factor, congenital deficiency of prekallikrein, high molecular weight kininogen, and circulatory anticoagulant.<br /><br />D-DIMER<br /><br />This test is a very specific confirmatory test for disseminated intravascular coagulation (DIC). This test is also used for the detection of deep vein thrombosis (DVT) and to detect acute myocardial infarction and unstable angina. The Fragment D-dimmer assess both thrombin and plasmin activity.<br /><br /><br /><br />23) Curschmann’s spirals are due to?<br /><br />Curschmann's spirals have been observed in the sputum of patients affected by lung cancer, asthma, chronic bronchitis, or in asymptomatic smokers.<br /><br />Spirally twisted masses of mucus occurring in the sputum in bronchial asthma.<br /><br />Curschmann's spirals:<br /><br />coiled, basophilic plugs of mucus formed in the lower airways and found in sputum and tracheal washings; indicate chronic obstruction.<br /><br />Curschmann's Spirals refer to parts of the desquamated epithelium seen in biopsies from asthmatic patients. They are named after German physician Heinrich Curschmann (1846-1910). They are often seen in association with eosinophilic infiltration and Charcot-Leyden crystals.<br /><br />However, to date, their clinical significance and pathogenesis have not been completely explained.<br /><br /><br />24) Bell’s palsy?<br />WHAT IS BELL'S PALSY?<br />Bells palsy is a condition that causes the facial muscles to weaken or become paralyzed. It's caused by trauma to the 7th cranial nerve, and is not permanent.<br /><br />WHY IS IT CALLED BELL'S PALSY?<br />The condition is named for Sir Charles Bell, a Scottish surgeon who studied the nerve and its innervation of the facial muscles 200 years ago.<br /><br />HOW COMMON IS BELL'S PALSY?<br />Bells palsy is not as uncommon as is generally believed. Worldwide statistics set the frequency at approximately .02% of the population (with geographical variations). In human terms this is 1 of every 5000 people, and 40,000 Americans every year.<br /><br />IS BELL'S PALSY ALWAYS ON THE SAME SIDE?<br />The percentage of left or right side cases is approximately equal, and remains equal for recurrences.<br /><br />IS THERE ANY DIFFERENCE BECAUSE OF GENDER OR RACE?<br />The incidence of Bells palsy in males and females, as well as in the various races is also approximately equal. The chances of the condition being mild or severe, and the rate of recovery is also equal.<br /><br />WHAT CONDITIONS CAN INCREASE THE CHANCE OF HAVING BELL'S PALSY?<br />Older people are more likely to be afflicted, but children are not immune to it. Children tend to recover well. Diabetics are more than 4 times more likely to develop Bells palsy than the general population. The last trimester of pregnancy is considered to be a time of increased risk for Bell's palsy. Conditions that compromise the immune system such as HIV or sarcoidosis increase the odds of facial paralysis occurring and recurring.<br /><br />CAN BELL'S PALSY AFFECT BOTH SIDES OF THE FACE?<br />It is possible to have bilateral Bells palsy, but it's rare, accounting for less than 1% of cases. With bilateral facial palsy, it's important to rule out all other possible diagnoses with thorough diagnostic tests.<br /><br />CAN BELL'S PALSY AFFECT OTHER PARTS OF THE BODY?<br />Bells palsy should not cause any other part of the body to become paralyzed, weak or numb. If any other areas are affected Bell's palsy is not the cause of the symptoms, and further testing must be done.<br /><br />HOW DO THE SYMPTOMS OF BELL'S PALSY PROGRESS?<br />Very quickly. Most people either wake up to find they have Bells palsy, or have symptoms such as a dry eye or tingling around their lips that progress to classic Bell's palsy during that same day. Occasionally symptoms may take a few days to be recognizable as Bells palsy. The degree of paralysis should peak within several days of onset - never in longer than 2 weeks (3 weeks maximum for Ramsey Hunt syndrome). A warning sign may be neck pain, or pain in or behind the ear prior to palsy, but it is not usually recognized in first-time cases.<br /><br />IS BELL'S PALSY CONTAGIOUS?<br />No, it is not contagious. People with Bells palsy can return to work and resume normal activity as soon as they feel up to it.<br /><br />WHAT ABOUT RECOVERY FROM BELL'S PALSY?<br />Approximately 50% of Bells palsy patients will have essentially complete recoveries in a short time. Another 35% will have good recoveries in less than a year.<br /><br />Regardless of the trigger, Bell's palsy is best described as an event - trauma to the nerve. As with any other injury, healing follows. The quality and duration of recovery is dependent on the severity of the initial injury. If the nerve has suffered nothing more than a mild trauma, recovery can be very fast, taking several days to several weeks. An "average" recovery is likely to take between a few weeks and a few months. The nerve regenerates at a rate of approximately 1-2 millimeters per day, and can continue to regenerate for 18 months, probably even longer. Improvement of appearance can continue beyond that time frame.<br /><br />IS MUSCLE ATROPHY A CONCERN?<br />Not as a rule. It takes longer for the muscles to start to atrophy than it takes for most people to fully recover.<br /><br />IS BELL'S PALSY LIKELY TO HAPPEN AGAIN?<br />The possibility of recurrence had been thought to be as high as 10 - 20%. These figures have been lowered as more has been learned about conditions that are now diagnosed as other types of facial palsies. Estimates of the rate of recurrence still vary widely, from around 4 - 14%. Most recent reports hover at 5 - 9%. The average timespan between recurrences is 10 years.<br /><br /><br /><br />25) In Dialysis which toxicity is seen commonly?<br /><br />Aluminum toxicity<br /><br />Aluminum toxicity, prevalent among individuals with chronic renal failure, is associated with disabling osteomalacia, encephalopathy, and anemia.<br /><br />The control of aluminum intake has included standards to limit the amount of aluminum in the dialysis fluid in addition to the use of nonaluminum containing phosphate binders.<br /><br />Deferoxamine mesylate, a heavy metal chelating agent, is used to remove aluminum from the tissues of dialysis patients. Chelation therapy has resulted in improvements of clinical symptoms and bone histology. Ocular, auditory, and infectious adverse effects have occurred with the use of deferoxamine.<br /><br /><br />26) TOC for Gastric ulcer?<br /><br />For people with Helicobacter pylori infection, the main goal is to get rid of the bacteria that causes the infection.<br /><br />H2 receptor antagonist such as famotidine (Pepcid) or nizatidine (Axid) or a proton pump inhibitor such as omeprazole (Prilosec) or esomeprazole (Nexium) to suppress acid, combined with two antibiotics.<br /><br />Those who do not have an H. pylori infection may be prescribed ulcer-healing medications such as antacids, H2 receptor antagonists, or proton pump inhibitors. Long-term treatment may be needed.<br /><br />If the ulcer bleeds, endoscopy can control bleeding in most cases.<br /><br />Surgery may be recommended for persons who do not respond to medicines or endoscopy. Surgical procedures for gastric ulcers include:<br /><br />Vagotomy -- cuts the vagus nerve, which controls the stomach's production of gastric acid<br />Partial gastrectomy -- removes part of the stomach<br /><br />--------------------------------------------------------------------------------<br /><br />27) Squamous non-keratinizing is seen in….?<br /><br />Squamous nonkeratinizing<br /><br />Function: barrier, protection.<br />Location: wet surfaces: oral cavity, esophagus, and vagina.<br /><br />Origin: ectoderm<br />• cells of basal layer (stratum germinatinum, stratum basale)<br /><br />• cells of stratum spinosum<br /><br />• squamous cells<br /><br /><br />Stratified squamous keratinizing (epidermis)<br /><br />Function: barrier, protection.<br /><br />Location: dry surfaces: skin.<br /><br />Origin: ectoderm<br />• keratinocytes of stratum germinatinum (stratum basale)<br /><br />• keratinocytes of stratum spinosum<br /><br />• keratinocytes of stratum granulosum<br /><br />• keratinocytes of stratum lucidum<br /><br />• squames of keratin of stratum corneum<br /><br />• melanocytes<br /><br />Stratified cuboidal & columnar<br /><br />Function: barrier, conduit.<br /><br />Location: sweat gland, ducts of exocrine glands, anorectal junction.<br /><br />Origin: ectoderm<br /><br /><br />Transitional<br /><br />Function: barrier, distensible property.<br /><br />Location: renal calyces, ureters, bladder, urethra.<br /><br />Origin: mesoderm </div>Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-75683557252899237512008-08-31T02:01:00.001-07:002008-08-31T08:39:32.212-07:00SURGERY· SURGERY<br />· Hypotension not responsive to fluid administration is suggestive of ongoing blood loss and such patients with abdominal trauma need an immediate exploratory laparotomy.<br /><br />· Vital signs, hemodynamic stability, and need for blood transfusion are important determinant for surgical v/s non-surgical management of patient with splenic trauma.<br /><br />· Choledocholithiasis symptomatic of biliary colic and without any systemic toxicity is treated with analgesic and spasmolytics and elective surgery is done at a later date.<br /><br />· Tetanus prophylaxis depends upon whether the patient had his 3 doses or not. If yes, it depends upon when did he have it. For any wound, clean or minor, patients should be administered tetanus toxoid if the last dose was administered 5 years ago. However, if the patient has clean wound & he has previously received 3 or more doses, but received the last dose 10 years ago, then again he should receive the tetanus toxoid.<br /><br />· Transient submandibular gland swelling may occur during feeding due to partial obastruction of its duct and further evaluation is required if swelling is persistent or recurrent.<br /><br />· In a young individual who present with a fleshy immobile mass on his hard palate, the most likely Dx is torus palatinus. No medical or surgical therapy is required.<br /><br />· Technetium pertechnetate scintigraphy is the best diagnostic test for Meckel’s diverticulum.<br /><br />· Colonoscopy is difficult and rarely performed in settings of active bleeding. If the bleeding stops, however, it should be done.<br /><br />· Angiodysplasia may be seen as cherry-red spots that may be coagulated.<br /><br />· Labeled erythrocyte scintigraphy, although not a very precise study, could be helpful to define the site of bleeding.<br /><br />· The diaphragmatic rupture is more common on the left side, since the right side is protected by the liver. The leakage of intraabdominal contents into the chest causes compression of the lungs and mediastinal deviation. Elevation of the hemidiaphragn on the chest X-ray may be the only abnormal finding. Sometimes, there may be evidence of small bowel in the thoracic cavity.<br /><br />· Approximately 5-10% of unconscious patients who present to the ED as result of a motor vehicle accident or fall, have a major injury to the cervical spine. One third of injuries occur at the level of C2, and one half of the rest occur at the level of C6 or C7. Most fatal cervical spine injuries occur in upper cervical levels, either at craniocervical junction, C1 or C2.<br /><br />· It is important to rule out a fracture or dislocation of cervical spine as the first priority because of grave consequences of missing a cervical spine injury.<br /><br />· Cast immobilization is recommended in the tx of all non-displaced scaphoid fractures (fractures <>10<br />· ï‚• Neuromuscular scoliosis: secondary to neuromuscular disturbance or muscle disease.<br />· ï‚• Congenital scoliosis: secondary to structural bony deformities.<br /><br />· Highest detection rate of prostatic carcinoma in early stages---PSA+digital rectal examination<br /><br />· Kidney stones:<br />· ï‚• Oxalate stones: in a patient who undergoes bowel resection and then develops kidney stones, one should always suspect oxalate.<br />· ï‚• Cystine stones: rare and occurs as part of a rare inherited disorder of defective renal transport resulting in over-excretion of cystine. Sone formation begins in childhood and are a rare cause of staghorn calculi.<br />· ï‚• Uric acid stones: occur when urine is saturated with uric acid in the presence of an acidic urine and dehydration. Seen in gout, myeloproliferative disorders and diarrhea. Tx: fluid, alkalinization of urine, allopurinol.<br />· ï‚• Struvite stones: form in the collecting system and become infected with urea splitting organisms. Condicitons required for formation of struvite stones are presence of high urine pH, magnesium, ammonium and carbonate levels.<br />· ï‚• Calciu phosphate stones: associated with hypercalciuria (sarcoidosis, immobilization, Cushing’s syndrome, renal tubular acidosis.) std Tx: fluid, thiazide.(note Furosemide in CI).<br /><br />· Acute appendicitis: Rovsing’s sign +. Requires immediate surgery.<br /><br />· Acute appendicitis may be complicated by pelvic abscess that presents with lower abdominal pain, malaise, low-grade fever and tender pelvic mass on rectal examination. (most of the pelvic abscesses are due to perforation of appendix. Tx. Drainage of the abscess).<br /><br />· Laxatives should not be given in the setting of intestional obstruction.<br /><br />· Intestinal obstruction with metabolic acidosis and shock indicates serious disease and it requires laparotomy. (suggesting bowel ischemia or necrosis).<br /><br />· In case of simple mechanical obstruction, there would be metabolic alkalosis.<br /><br />· Patients who present more than 5 days after the onset of symptoms of appendicitis, and have localized right lower quadrant findings, should be treated with IV hydration, antibiotic and bowel rest. Antibiotics should cover enteric gram-negative organisms and anaerobes (cefotetan)<br /><br />· Cefotetan: has a good coverage of gram-negative organisms and anaerobes; therefore, this can be used as monotherapy in complicated appendicitis.<br /><br />· Erythromycin and vancomycin are effective against gram-positive organisms, they do not cover gram-negative organisms or anaerobes.<br /><br />· Persistent symptoms (e.g. mechanical symptoms) in patients with probable meniscal injury should be further evaluated by MRI or arthroscopy. Surgery (arthroscopic or open) is often necessary to correct the problem.<br /><br />· Boerhaave’s syndrome is esophageal perforation due to severe vomiting and it produces pneumomediastinum.<br /><br />· Saphenous vein cut down or percutaneous femoral vein catheterization are alternatives to have an intravenous access in trauma patients with collapsed veins.<br /><br />· Interosseous membrane cannulation is an alternative route in children <4>40 yo, one or more additional risk factors, minor/non-major surgery. The risk of DVT is 2-10%.<br />· ï‚• High risk: patients > 40 yo, additional risk factors, major operation (e.g. orthopedic procedures of the lower extremity). The risk of DVT in these patients is between 10-20%.<br /><br />· Bucket handle tear of medial meniscus is the MC meniscus injury at knee and leads to locking of the knee joint during terminal extension.<br /><br />· Lachman’s test is the most sensitive physical test for Dx of anterior cruciate ligament injury. (A popping or snapping sensation is commonly felt at the time of ACL injury, ACL prevents anterior gliding of the tibia under the femoral condyles). Patients complain of instability of the knee. Commonly associated with injury to medial meniscus and medial collateral ligament of the knee (terrible triad). Lachman’s test: is done with knee flexed at 20 degrees, and pulling the proximal tibia with one hand while stabilizing the femur with the other hand.<br /><br />· Anterior cruciate ligament: prevents anterior glinding of the tibia under the femoral condyles. Isolated injury is seen after hyperextension of the knee. A “popping or sanpping” sensation is commonly felt at the time of injury. Patients complain of instability of the knee (giving out, looseness etc.) It is commonly associated with injury to medial meniscus and medial collateral ligament of the knee. (terrible triad)<br /><br />· Osgood Schlatter disease: is an apopysitis of tibial tubercle seen in young teenager due to overuse. (swelling and marked tenderness over the tibial tubercle. Pain increases on contraction of quadriceps muscle.)<br /><br />· Slipped femoral capitis: is an emergency condition and should be promptly corrected with external screws. (Dx is made by a high degree of clinical suspicion in presence of limited range of hip movements. Loss of abduction and internal rotation are very characteristic and external rotation of thigh is seen when hip is flexed. Frog-leg lateral view X-ray of hip joint is the imaging technique of choice for Dx.)<br /><br />· Lateral collateral ligament injury: tackled while playing football, knee pain, swollen, direct palpation over the lateral aspect of the knee elicit pain. Anterior drawer and posterior drawer test, and Lachman test are all negative.<br /><br />· Anterior drawer test: is also used for Dx of ACL injury but is less sensitive. It is done in supine position with the knee flexed at 90 degrees and hips flexed at 45 degrees, while tibia is pulled forward over femur to note the degree of displacement.<br /><br />· Posterior drawer test: is used for Dx of posterior cruciate ligament injury. It is similar to anterior drawer test except that posterior pressure is exerted on tibia to note posterior displacement.<br /><br />· McMurray’s test: is used for Dx of meniscus injury. In case of meniscus injury a click is heard on forced flexion and rotation of the knee. (popping sound on passive flexion/extenstion of the joint)-specific for meniscal injury.<br /><br />· Valgus stress test: is used for Dx of medial collateral ligament injury in which case valgus stress leads to marked angulation of knee joint as compared to the normal knee.<br /><br />· The immediate management of splenic trauma caused by blunt abdominal injury depends on the patient’s hemodynamic status and response to IV fluids. If the patient is initially hemodynamically unstable but improves with fluid administration, the best next step is to obtain an abdominal CT scan. If the patient is initially hemodynamically unstable and is unresponsive to fluid administration, then emergent exploratory laparotomy is required.<br /><br />· Intermittent claudication is best treated with aspirin and an exercise program.<br /><br />· MRI is now the investigation of choice for ligamentous injuries of the knee with an accuracy rate of 95%. Surgery is rarely necessary for MCL tear.<br /><br />· Non-communicating hydrocele disappears spontaneously by 12 months of age and it is therefore managed expectantly.<br /><br />· CT scan of a diffuse axonal injury shows numerous minute punctuate hemorrhages with blurring of grey-white interface. It is the most significant cause of morbidity in patients with traumatic brain injuries.<br /><br />· A sternal fracture is very likely to be complicated by myocardial contusion, serial ECG is needed.<br /><br />· Paget’s disease of the nipple: Dx-mammogram and punch biopsy.<br /><br />· Tx. of Mitral stenosis: cardiovascular surgeons prefer to repair the patient’s own mitral valve, rather than replacing it. Stenosis is due to fusion at the commissures---commissurotomy can correct.<br /><br />· As a rule: internal hemorrhoids bleed but do not hurt, wherears external hemorrhoids hurt but do not bleed. (discomfort could be pain, or itchy)<br /><br />· Brain examinations:<br />· ï‚• CT scan is our best tool when intracranial bleeding is suspected.<br />· ï‚• MRI is our choice when brain tumor is suspected..<br />· ï‚• Duplex scanning is our choice if transient ischemic attack is suspected.<br /><br />· Fogarty balloon tipped catheters: an embolectomy used in treating embolic occlusion of the artery. Heparin etc anticoagulants are an adjunct to vascular procedures, but are not the primary Tx for a clot that has already traveled from the atrial appendage to the lower extremity. Anticoagulants cannot dissolve existing clots.<br /><br />· The urinary retention is extremely common in the immediate postoperative period after lower abdominal inguinal or perineal surgery. Tx: in and out bladder catheterization. (don’t use indwelling Foley catheter unless in and out fails twice to resolve the urinary retention.)<br /><br />· If a scaphoid fracture is suspected, even without a visible fracture on X-ray, it must be treated as if there was a fracture. (long arm cast)---fall on an outstretched hand. Pain with wrist movement, tenderness in the anatomical snuffbox. 10% go on to develop avascular necrosis due to tx error.<br /><br />· Spinal cord ischemia with lower spastic paraplegia is a rare complication of abdominal aneurism surgery.<br /><br />· Acute adrenal insufficiency is a potentially lethal postoperative complication. Preoperative steroid use is the main cause. A high index of suspicion is required. Commonly, they present with nausea, vomiting, abdominal pain, hypoglycemia, and hypotension.<br /><br />· Burns:<br />· ï‚• 1st degree: superficial burns, confined to the epidermis with minimal skin damage. The skin is mildly erythematous and pain is the chief complaint. (such as sunburn, heals without scaring.)<br />· ï‚• 2nd degree: partial thickness burns-involves the entire epidermis and various layers of the dermis. Skin is painful, red, edematous and blistered.<br />· ï‚• 3rd degree: full thickness burns-no dermal appendages remain, all epidermis and dermis is completely destroyed. (flame burn)<br /><br />· Patients have obvious signs of hemorrhagic shock (loss of about 25-30%, 1500 mL blood), can only occur with intraabdominal bleeding, intrathoracic bleeding, and fracture of femur, pelvic, extremities or bleeding in neck. USG and DPL are the procedure of choice to diagnose intra abdominal bleeding in an unstable trauma patient. (ultrasonogram, diagnostic peritoneal lavage).<br /><br />· In case of amputation injury, amputated parts should be retrieved and brought to the ED. The amputated part should be wrapped in a saline-moistened gauze sponge placed in a plastic bag. The plastic bag should be sealed and placed on ice.<br /><br />· Cirrhotic patients with ascites may develop spontaneous primary bacterial peritonitis, which gives a “mild picture of acute abdomen”, Dx: culture of the ascetic fluid.<br /><br />· Sigmoid volvulus, a common condition in elderly patients. The endoscopic instrument (proctosigmoidoscopy) can untwist the bowel from the inside, relieve the obstruction, and allow placement of a long rectal tube.<br /><br />· Nerves of the lower extremities:<br />· Femoral N.:innervated the muscles of the anterior compartment of the thigh, and is therefore responsible for knee extension and hip flexion. It provides sensation to the anterior thigh and medial leg via the saphenous branch.<br />· Tibial nerve: supplies the muscles of the posterior compartment of the thigh, posterior compartment of the leg, and plantar muscles of the foot. The tibial nerve provides sensation to the leg (except medial side) and plantar foot.<br />· The obturator nerve: innervated the medial compartment of the thigh (ie, gracilis adductor longus, adductor brevis, anterior portion of adductor magnus), and controls adduction of the thigh. It provides sensation over the medial thigh.<br />· The common peroneal nerve: gives rise to the superficial and deep peroneal nerves. These two nerves supply the muscle of the anterior and lateral leg. These nerves provide sensation to the anterolateral leg and dorsum of the foot.<br /><br />· Current Tx. to full thickness burn: immediate excistion, grafting<br /><br />· DDH:<br />· Ultrasound is the most sensitive investigation for DDH (developmental dysplasia of the hip) for infants less than 6 months of age.<br />· X-ray of hip is not useful in young infants, as the cartilage and epiphysis are not ossified.<br />· However, in older infants and children, plain radiography is the preferred modality of investigation.<br />· MRI of hip joint though sensitive is reserved for complicated cases<br />· CT though sensitive is not the first investigation of choice. It is particularly used for evaluating complicated dislocations and for postoperative evaluation of the hip.<br />· After rhinoplasty, if there is whistling noise during respiration, one should suspect nasal septal perforation.<br /><br />· Unless strangulation or perforation is suspected, bowel obstruction is treated conservatively with fluids, nasogastric suction and enemas.<br /><br />· Retrograde cystogram with post void film is the investigation of choice for patients with suspected bladder trauma.<br /><br />· Retrograde urethrogram should be the first step in management of suspected posterior urethral injury. (inability to void, trauma history, high riding prostate)<br /><br />· Anterior urethral injury due to injury to urethra anterior to the perineal memebrane. Anterior urethral injuries are most commonly due to blunt trauma to the perimeum (straddle injuries), and many have delayed manifestation.<br /><br />· Posterior urethra consists of the prostatic urethra and memebranous urethra. Posterior urethral injuries are most commonly associated with pelvic fracture. (presents with blood at meatus, high riding prostate, scrotal hematoma and inability to void in spite of sensation to void).<br /><br />· When suspecting a urethral injury, do a retrograde urethrogram, inject the dye directly into the urethra. Inserting a Foley catheter is absolutely contraindicated in suspected urethral injury, you may change a partial urethral disruption into a complete transaction.<br /><br />· Retrograde ejaculation occurs in up to 90% patients undergoing transurethral resection of the prostate (TURP).<br /><br />· TUIP (transurethral incision of the prostate) involves incision of the periurethral prostate without resection of any tissue. This procedure is minimally invasive and can be performed on an outpatient basis. It frequently results in symptomatic relief without the adverse effects of TRP.<br /><br />· The disease with the highest incidence of perioperative death or cardiac event is a recent myocardial infarction. (other causes: coronary disease, worsened or poor baseline exercise tolerance, recent infarction)<br /><br />· Postoperative period, patient has persistent difficulty swallowing solids and even more difficulty swallowing liquids. Any attempts to do so results in violent coughing ans aspiration.Lesion: ----------sensory fibers of the 9th (glossopharyngeal) nerve.<br /><br />· When a patient presents with a pulsatile abdominal mass and hypotension, a presumptive Dx of ruptured abdominal aortic aneurysm must be entertained and the patient should be taken straight to the operating room.<br /><br />· Aortic aneurysm rupture, best diagnostic exam: Spiral CT scan or MRI angiogram.<br /><br />· Ureteropelvic junction obstruction and profuse diuresis: a congenital narrowing at the ureteropelvic junction allows normal passage of urine at a normal flow rate, but the lumen can’t accomadate a suddenly increased flow rate. (remember, beer is a wonderful diuretic.)<br /><br />· Most common nontraumatic casue for SAH is: berry aneurysm in the anterior portion of the circle of Willis.<br /><br />· Any gunshot wound of the abdomen requires exploratory laparotomy. Any gunshot wound below the 4th intercostals space (level of nipple) is considered to involve the abdomen.<br /><br />· Subluxation of radial head is a common condition in preschool children and needs closed reduction by flexion and supination of forearm.<br /><br />· Small amount of intraperitoneal bleed that is not visible on abdominal ultrasound can be detected by diagnostic peritoneal lavage.<br /><br />· Consider bowel ischemia and infarction as an early complication of operation on the abdominal aorta.<br /><br />· Hallmark triad of urethral injury is:<br />· ï‚• Blood at urethral meatus<br />· ï‚• Inability to void<br />· ï‚• Distended bladder<br /><br />· For carcinoid tumors located at the tip of the appendix, appendectomy is sufficient Tx. Carcinoids do not have the tendency to spread and have a good prognosis. When carcinoid spreads to the liver, it may produce the carcinoid syndrome, which is characterized by flushing, diarrhea, cramping, and valvular heart lesions.<br /><br />· Rule out vascular injuries in case of penetrating wound near the site of important vessels. (arteriogram)<br /><br />· Monteggia fracture: an isolated fracture of proximal third of ulna, with anterior dislocation of radial head. May be associated with injury to radial nerve, so careful neurovascular examination at the time of evaluation is mandatory. Tx: open reduction and internal fixation in adults, closed reduction and casting are optimal for children.<br /><br />· Galeazzi fracture: an isolated radial shaft fracture, associated with disruption of distal radio ulnar joint also need open reduction and internal fixation.<br /><br />· Osteogenic sarcoma usually presents with painful swelling around the knee without any systemic signs and radiographic findings are osteolytic lesions with periosteal reaction.<br /><br />· Hyperventilation helps to prevent and treat intracranial hypertension by causing cerebral vasoconstriction and thus decresing cerebral blood flow. (goal: to have pCO2 in the range of 30-35 mmHg.)<br /><br />· Harvesting team’d evaluate any dying patient as a potential donor.<br /><br />· Typical history for fracture of the posterior lateral talar tubercle: standing on a chair and falls backward, a cracking sound -develop pain and swelling behind the ankle. Pain is exacerbated by plantar flexion and dorsiflexion of the hallus (big toe).Tx: with immobilization in a cast for 4-6 weeks. Dx: lateral x-ray film of the ankle.<br /><br />· After rectal surgery, patient experience impotence, cause?-erectile nerve damage.<br /><br />· In cirrhotic patient with hepaticencephalopathy, porto-systemic shunt may worsen the encephalopathy.<br /><br />· Patient with cirrhosis may have upper GI bleeding due to:<br />· ï‚• Erosive gastritis<br />· ï‚• Varices<br />· ï‚• PUD (peptic ulcer disease)<br />· ï‚• Mallory-Weiss tears.<br /><br />· In cases of bleeding esophageal varices, need for 5 or more units of blood transfusion in a period of 24 hours is considered an indication for surgery and transjugular intrahepatic portosystemic shunt is the best choice in emergency situations.<br /><br />· When clavicle injuries occur and a bruit is present, an anterial injury must be ruled out with an angiogram.<br /><br />· Atelectasis on chest X-ray can be confused with pneumonia and pleural effusion. However, it is more common after surgery in smoker and requires bronchoscopy to remove the mucus plug.<br /><br />· Fever on the first postoperative day is almost invariably from atelectasis, the Tx of which requires active participation and cooperation from the patient. If atelectasis does not resolve, it leads to the development of pneumonia, which can be identified in chest x-ray and confirmed with sputum cultures.<br /><br />· Sclerotherapy and surgery are indicated after first variceal bleeding, but not prophylactically. (sclerotherapy may have complications such as perforation, stenosis, and bleeding.)<br /><br />· Pelvic X-ray should be routinely done in all patients with trauma to screen for pelvic injury.<br /><br />· Fibrocystic disease: (mammary dysplasia) typically seen in women aged 20-40. It is characterized by painful breasts and recurrent formation of cysts.<br /><br />· Malrotation: 3 week old infant, protracted bilious vomiting. With double bubble sign with a little gas beyong is highly suggestive. Dx must be promptly confirmed by barium enema or contrast study from above. Tx: emergency surgery.<br /><br />· A patient must be left with at least 800mL in FEV1 to live a semi-decent life.<br /><br />· Even being left with at least 800 mL in FEV1, a patient with SCC in lung still needs to do a CT scan of the chest and upper abdomen to rule out lymph metastasis before a pneumonectomy can be done.<br /><br />· The best initial therapy for rhabdomyolysis is infusion of copious amounts of alkalinized saline to assist the kidneys in clearing the myoglobin from the blood. Alkalinizing the urine allows the renal tubules to retain the myoglobin and excrete it in the urine. (saline+bicarbonate)<br /><br />· Percutaneous lithotomy: used for large renal sontes located within the pelvicaliceal system. Smaller stones located in this position are best treated with ESWL.<br /><br />· Extracorporeal shock wave lithotripsy (ESWL): particularly effective on stones impacted in the distal ureter that have failed to pass spontaneously with conservative management.<br /><br />· Testicular torsion needs immediate de-torsion if the testis is to be saved. No time should be wasted doing further studies.<br /><br />· In patients sustaining trauma, there is a chance of bony cervical spine injury-lateral cervical spine x-ray can rule it out.<br /><br />· A COPD patient with a 1100 mL in FEV1, suffers from a SCC at the hilar. What to do? ---only radiation + chemotherapy. If surgery and have the bad lung removed, then only leave him 40% FEV1 (440 mL).<br /><br />· Expectant therapy is a rule for all patients with uncomplicated basilar skull fracture. Clinical signs of basilar skull fracture includes rhinorrhea, raccoon eyes (black eyes), and ecchymosis behind the ears and otorrhea. Patient’s head should be elevated and fluid intake should be restricted to 1200 mL/day. Patient should also be cautioned against the maneuvers that increase the intracranial pressure like blowing the nose.<br /><br />· Legg calve Perthes disease (avascular necrosis) is serious but self-limiting condition of young children characterized by avascular necrosis of femoral head. Can be painless. But hip pathology can present as referred knee pain. Also named: avascular necrosis of the capital femoral epiphysis.<br /><br />· The Tx of choice for isolated diaphyseal humeral fracture is by closed methods.<br /><br />· Scaphoid fracture: nonunion and avascular necrosis are common complications. The proximal third of the scaphoid is prone to avascular necrosis in fractures involving the wrist or proximal pole.<br /><br />· Gentle traction to attempt alignment of the fragments of a fractured long bone is important to prevent further vascular and neurological damage and it should be attempted immediately.<br /><br />· Nasopharyngeal cancer usually presents initially as a painless neck mass. (other symptoms: epistaxis, hearing loss, nasal blockage)<br /><br />· Warfarin treated patients should be given fresh frozen plasma instead of vitamin K when emergency surgical procedure is to be performed.<br /><br />· Intravenous pyelography is very useful for the Dx of renal stones.<br /><br />· Open fractures should not be closed primarily because of the associated increased risk of infection and subsequent osteomyelitis.<br /><br />· Rhabdomyolysis can occur with severe crush injuries and should be managed with IV fluids, osmotic diuretics and alkalinization of urine.<br /><br />· Hyperkalemia due to crush injuries needs IV calcium gluconate (acts as a membrane-stabilizing agent to balance against the imminent hyperkalemia-induced global depolarization of the myocardium.<br /><br />· Elderly patients with displaced femoral neck fractures should be treated with primary arthroplasty.<br /><br />· Tx of choic for intertrochanteric fracture: internal fixation with sliding screw and plate and early mobilization.<br /><br />· Patients treated with high-dose methylprednisolone within eight hours of spinal cord injury have significant and sustained neurological improvement, thus its use is warranted as the first priority after stabilizing the patient. *important Q.!!!*<br /><br />· 213. Garden classification for femoral neck fracture:<br />· ï‚• Type 1: valgus impaction of femoral head commonly seen with stress fracture<br />· ï‚• Type 2: complete but non-displaced femoral neck fracture.<br />· ï‚• Type 3: complete fracture with displacement <50%>50%<br /><br />· Delayed emergency from anesthesia is characterized by hypotension, which is evident by decreased in respiratory rate, HTN progressing to hypotension, tachycardia progressing to bradycardia, restlessness and pallor/cyanosis.<br /><br />· After blunt trauma to the chest, if an x-ray shows a deviated mediastinum with a mass in the left lower chest, one should suspect a diaphragmatic perforation.(Dx. barium swallow)<br /><br />· Patient with head injury can never have hemorrhagic shock due to intracranial bleeding.<br /><br />· Beck’s triad of hypotension, elevated JVP, and muffled heart sounds confirms the Dx of pericardial tamponade.<br /><br />· Volkmann’s ischemic contracture is the final sequel of compartment syndrome in which the dead muscle has been replaced with fibrous tissue. Tx: immediate fasciotomy.<br /><br />· Displaced anterior fat pad is a radiographic sign of supracondylar fracture, which may be complicated by Volkmann’s ischemic contracture.<br /><br />· Presence of brachial pulse on the fracture side can’t rule out the possibility of vascular compromise because of collateral flow.<br /><br />· Two locations in the body have the highest risk for development of the dreaded compartment syndrome: the forearm and the lower leg.<br /><br />· Hirschsprung’s disease in neonate presenting with obstruction: diverting ileostomy +appendectomy (for Dx. of the disease). Definite repair can be done when the child is older.<br /><br />· A known complication of ling-standing use of birth control pills is the development of hepatic adenomas that may rupture and bleed. (acute onset of abmominal pain, followed by a faint)<br /><br />· The MC site of ulnar nerve entrapment is the elbow where the ulnar nerve lies at the medial epicondylar groove. *extremely HY Q for USMLE* (decreased sensation over the 4th and 5th fingers of the hand and a weaker grip compared to the normal side.) Prolonged, inadvertent compression of the nerve by leaning on the elbows while working at a desk or table is the typical scenario.<br /><br />· APKD (adult onset polycystic kidney disease) diagnosed, you should order an MRA (magnetic resonance angiogram) of the brain to rule out berry aneurysms. (10%-20% incidence of this in APKD).<br /><br />· Virtually all solid testicular masses are malignant tumors. The best way to avoid dissemination is to open the inguinal canal, do a high ligation of the cord, and pull the testicle out.(radical inguinal orchiectomy)<br /><br />· Mixed connective tissue disease represents the over lapping symptoms of SLE, scleroderma and myositis. It is associated with autoantibody to ribonuclear protein.<br /><br />· The rule is that lymph nodes that progressively enlarge over several months are malignant.<br /><br />· Lymph nodes which are in the supraclavicular area, typically harbor metastasis from a primary tumor below the clavicles (i.e., not in the head and neck).<br /><br />· Inhalation injury is common in burns patients and may take several days to manifest. Diagnosis is best done with a bronchoscopy.<br /><br />· Body surface involved in burn injury is calculated with the rule of 9:<br />· ï‚• Each arm: 9%<br />· ï‚• Each lower extremity: 18%<br />· ï‚• Anteiror torso: 18%<br />· ï‚• Posterior torso: 18%<br />· ï‚• Face 9%<br />· ï‚• Perineum: 1%<br /><br />· Burns patients need 4 ml/kg/% of the body area involved of fluid in first 24 hours, half of which is given in the first 8 hours. Plus 2000 mL dextrose 5% in water.<br /><br />· Infection is the MCC of death in burns patients.<br /><br />· Burns:<br />· ï‚• Superficial and erythematous burns while painful do not require any special wound care (not even antibiotics)<br />· ï‚• Early excision therapy is indicated for extensive partial-thickness and full-thickness burns, as they do not heal spontaneously. Also, it allows for early skin grafting and lesser complications.<br />· ï‚• Prophylactic systemic antibiotic is not indicated in all the patients. However, topical antibiotics should be used for burn wound care.<br />· ï‚• The most commonly used topical anti bacterial agent: silver sulphadiazine. Mafenide sulphate is only used if deep penetration is required in case of wound with eschar. Mafenide sulfate is associated with severe pain and acidosis.<br />· ï‚• Eschar is dead rigid tissue formed in burns wounds. The eschar restricts outward expansion of the compartment as edema occurs in the injured extremity following the burns. As a result, interstitial pressure rised to the point that vascular flow is compromised. This can be relieved by performing an escharoctomy.<br />· ï‚• Tetanus prophylaxis should be considered in all the burns wound patients using std guidelines as burn wounds are prone to tetanus infection.<br />· Cholesteatoma is an epithelial cyst that contains desquamated keratin. Patients generally present with chronic ear discharge and granulation tissue that are unresponsive to antibiotic treatment. (This is not a tumor)<br /><br />· Carcinoids are most commonly found on the appendix; however, patients who present with carcinoid syndrome usually have carcinoids located in the small bowel.<br /><br />· Dog bite:<br />· ï‚• May result in rabies (fatal disease)<br />· ï‚• Post exposure prophylaxis: active and passive immunization.<br />· ï‚• Capture the dog, if fails to do so, the dog is assued to be rabid and post exposure prophylaxis is indicated.<br />· ï‚• If the dog is available and it does not show any features of rabies, observed it for the development of rabies (10 days). If it shows rabies, it is killed and its brain is examined to confirm the presence of rabies and post exposure prophylaxis is given when rabies in dog is confirmed by FA.(fluorescent antibody)Dr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-45346947609212526502008-08-31T02:12:00.001-07:002008-08-31T02:12:45.769-07:00PUBLIC HEALTHPUBLIC HEALTH<br />1. Levels of Prevention: 1o = actions to decr. incidence of health problems (prenatal care, immunizations)<br />2. 2o = interventions at early stage of disease to limit development (DM screen, PAP)<br />3. 3o = interventions to treat problem and prevent further morbidity & mortality<br /><br />4. Special Tests Complement & Complement disorders C3, C4, CH50<br />5. Rheumatiod - ANA, RF<br />6. Lupus - DNA, Anti Smith Antibody<br />7. Scleroderma - Scl-70, Anti Centromere<br />8. Sjogrens -SSA Anti Ro, Anti LA<br />9. Prostate = PSA, Pancreatic = CA 19-9,Ovarian=CA125; Breast = CA15-3 & CA27-29<br />10. Testiclar = BHCG, AFP, Thyroid = Calcitonin<br />11. 10 Biliary Cirrhosis = Anti mitochondrial antibody<br />12. Wilson's Disease = Ceroluplasmin Antibody<br />13. Liver = Alpha 1 antitrypsin<br />14. Thyroid - Antimicrosomal antibody, Thyroglobin antibody<br />15. Incidence # new cases / total population<br />16. Prevalence # cases at a given time / total pop at that time<br />17. Disease Frequency # people w/ disease / population at risk<br />18. Case Fatality # who die in a given period/ # people w/ disease<br /><br />19. Relative Risk Only from cohort study; a/a+b divided by c/c+d; >1 positive assoc, < association ="=""> disease if exposed /disease if not exposed<br /><br />20. Odds Ratio Only from case control; odds of getting if exposed / odds of getting if not exposed (ad/bc)<br /><br />21. Mortality Rate # people that die w/ in current population<br />22. Std Mortality Rate Adjusted according to age distribution<br />23. Attributable Risk exposed rate - unexposed rate<br />24. Sensitivity a/a+c; accurate diagnose ; incr. False +<br />25. Specificity d/b+d; Prob of neg test in those truly neg; incr. false neg<br />26. OMM<br />27. Fryettes Laws 1. Side bending then rotation in neutral position<br />1. Flexion or extension with rotation then side bending<br />2. Motion free in one direction is restricted in the other<br /><br />28. Ribs 1-5 pump handle, 6-10 bucket handle, 11-12 caliper; Elevated = expiration restricted Treat lower ribs 1st; Depressed = inhalation restriction, treat upper ribs 1st<br /><br />29. Flexion Test Standing = ilia sacral; Seated = sacroiliac; false neg = tight hamstrings on standing flexion; False positive = tight quads on standing flexion<br /><br />30. Sympathetic Innervations Head & Neck = T1-4; Lung T2-5 bilat; Heart T2-5 Left, Stomach T5-9 Left; Duodenum T10 rt; Gall Bladder T9 rt; Liver T5-9 Rt, Pancreas T6-9 bilat, Kidneys, Ovaries, Testes T10-L1 of respective side; Adrenals T10-11, Appendix T11-12 Rt, Bladder L3-4, Uterus L4-5, Rectum & Anus L4-5<br /><br />31. Parasympathetic Innervations Eyes=CN III; Nasal sinuses, Eustachian Tube=CN VII; Soft Palate, Salivary Glands=CN IX; Thyroid thru Transverse Colon=CN X (Vagus); Right Colon & Pelvis= Pelvic Splanchnic Nerves S2-4<br /><br />32. Somatic Dysfunction An altered or impaired function of related components of the somatic system<br />33. Qualities: Texture chg, asymmetry, decr. ROM, tenderness<br /><br />34. Treatment Types Direct = engages restricted barrier & pushes thru it, Force takes it from where it is to where it will not go<br />35. Indirect = Move away from the barrier, Leaves the structure in the position it was<br /><br />36. Direct Technique Used For: Subacute or chronic, no assoc osseous pathology post closure of epiphyseal plate, Short restrictors<br /><br />37. Indirect Technique Used For Acute, A lot of pain, a lot of restriction, non closure of epiphysis<br /><br />38. HVLA Contraindications<br />39. Direct, Passive Absolute = Weak bony structure, spinal cord, nerve compressions, Danger of vascular damage;<br />40. Relative: lax ligament, acute inflammation, pregnancy, Calcification of aorta, Recent MI, spondylosis, Ankylosin Spondylitis, Osteoporosis, Chronic Steroid use, Acute disk disease, Extreme scoliosis, Cauda Equina Syndrome, Adv. Degenerative disease, Severe DM, Hx or current malignancy, Agenesis Odontoid process, Vertigo<br /><br />41. Counter Strain<br />42. Passive Indirect Put joint into position of greatest comfort; Agonist-Antagonist pair; Strain due to rapid stretching followed by protective immediate shortening of agonist along with rapid shortening then lengthening of antagonist<br />43. Most comfort of pt (70%) Hold for 90 sec (120 secs for ribs) Reactions to Tx: generalized soreness, treat no more than 6 TP at a time, 3 days between Tx;<br /><br />44. Muscle Energy<br />45. (Active then passive, direct) Type I = Joint mobilization using direct muscle force<br />46. Type II = Muscle lengthening using postisometric relaxation, "Resetting the Gamma Gap or Synaptic Fatigue<br />47. Type III = Muscle lengthening using Reciprocal Inhibition<br />48. Type IV = Muscle relaxation using Crossed Extensor Reflex - Used w/ sever injury (flexor muscle on one extremity is contracted the flexor on opposite extremity relaxes & extensor contracts)<br /><br />49. Natural Body Rhythms Cardiac/Vascular, Ventilatory, Visceral, Cranial Rhythmic Impulse (CRI), Slow Undulating (Breath of life)<br /><br />50. Articular Mobility of Cranial Bones Newborn: Base is cartilage for stability, vault is membrane for accommodation Sphenoid motion - influences facial & frontal bones; Occipital Motion - influences temporals (mandible & hyoid) & parietals<br /><br />51. Motion of Sacrum between the Ilium Superior transverse axis, Located at S2, Only area of anterior convergence & posterior divergence of the SI joint<br /><br />52. Coordination of motion Inhalation = midline flex, paired ext rotate, sacral base post, SBS rises<br />53. Exhalation = midline extension, paired int. rotation, sacral base anterior SBS falls<br />54. Sacrum & Temporal follow movement of occiput; Facial bones follow motion of sphenoid<br /><br />55. Strain Patterns Torsion, Side bending rotation, Vertical Strain, Lateral Strain, Compression<br /><br />56. Naming Convention Vert unit, AP, side bending, rotation<br /><br />57. Type of Motion C0-C1 (OA) Type I; C1-C2 Rotation; C2-C7 Type II; C7-L5 Type I & II<br /><br />58. ACID BASE<br />59. pH acedemia < 7.35-7.45 < alkalemia<br />60. pCO2 Resp alkalosis < 35 - 45 < Resp acidosis<br />61. HCO3 Metabolic Acidosis < 22-26 < Metabolic alkalosis<br />62. Anion Gap = (NA) - [(Cl) + (HCO3)]<br />63. Primary disorder pCO2 or HCO3 altered same way as pHDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-11504233856508541532008-08-31T02:10:00.000-07:002008-08-31T02:11:26.477-07:00POISONING & ACCIDENTSPOISONING & ACCIDENTS<br />1. Burns 1st= only epidermis, red no blister; 2nd = hyperemic, blister; partial thickness; 3rd = full thickness, leathery no pain; 4th = electrical injuries, damage to nerves & bone; entry & exit burn; Fluid resc. If > 20% Parkland formula = 3-4 ml/kg LR x % burn RULE of 9's: head = 9; ant trunk= 18 post trunk = 18, each incr. ext = 9; each decr. ext = 18, Perineum = 1<br /><br />2. Common Poisons & Antidotes: Aspirin = Dialysis; Acetaminophen =N-acetylcystine; Digitalis = lidocaine; Methanol & Ethylene Glycol = Ethanol; CO = O2; Narcotics = Narcan, Naloxone; Iron = Deferoxamine; Cu, As, Pb = Penicillamine; Cyanide = Sodium nitrite, or sodium thiosulfate<br /><br />3. Types of Fx Open(compound); Simple(closed); Greenstick (incomplete, children usually); Spiral (twisting breakage); Comminuted (multi bone fragments)<br /><br />4. Vertebral Fx Most common cause of paraplegia & quadriplegia, Compression Fx seen in elderly due to osteoporosis & DJD<br /><br />5. Hip Fx Avascular necrosis of femoral head if blood flow is compromised; Tx: immobilization, bedrest, surgery; Prevention= safety & Ca supplement in women<br /><br />6. Skull Fx Signs of Fx: 1.Battle's Sign = discoloration over mastoid bone; 2. Blood draining from ears, 3. Bruising of orbit, CN palsies, CSF leakage from ears & nose<br /><br />7. Rib Fx Most common thoracic injury; usually 5-9, local pain worse w/ inspiration<br /><br />8. Colles Fx most common wrist fx; breakage & displacement of distal radius, Attempted to break fall on outstretched hand<br /><br />9. Elbow Fx <10 care =""> Volkman's Ischemic Contracture<br /><br />10. Pelvic Fx MVA, 30% blood volume can be lost; Tx as if shock victim<br /><br />11. Tibial Fx Compartment syndrome= bleeding into tight compartments=> blood supply compression=>muscle ischemia; 6 Ps = pain, pallor, pulselessness, puffiness, parathesia & paresis (weakness) or paralysis. Surgical opening of compartment<br /><br />12. Sprains Tx = RICE => Rest, Ice, Compression, Elevation<br /><br />13. Concussion transient loss of consciousness; Coup = bruising under site of injury; Contrecoup = bruising on side contralateral to injury<br /><br />14. Blunt Eye Trauma periorbital echymosis, hyphema (bleed into anterior chamber; edema; Blowout Fx = Fx of orbital bone; Aspirin & anticholinergics are contraindicated<br /><br />15. Blunt Ear Trauma Auricular Hematoma (cauliflower ear) Tx prompt drainage to prevent dissolution of cartilage<br /><br />16. Dog & Cat Bites Pasturella multocida; Tx tetanus & rabies if needed, antibiotics<br /><br />17. Snake Bite Splint affected area & transport; In US usually pit vipers<br /><br />18. Spider Bite Black Widow: Vomiting, abd pain, shock; Tx Calcium gluconate & methocarbamol; Local bite Tx not needed<br />19. Brown Recluse: bite becomes black scab w/ assoc fever, rash, vomiting & jaundice; DIC can occur; Tx: Dexamethasone, dapsone, colchcine & total excision of lesion<br /><br />20. Hypovolemic Shock Hemorrhage, Burns, Vomiting, Diarrhea; pale skin, JVD, incr. vasc resistance, incr. pulse Tx: rehydrate, transfusions,<br /><br />21. Septic Shock Infection, gangrene, necrosis,CV obstruction; pale/pink skin; flat neck veins, incr. pulse incr. or decr. vascular resistance Tx ventilation, Fluids, antibiotics<br /><br />22. Cardiogenic Shock Pale skin, flat neck veins, incr. pulse, incr. vascular resistance; Tx: medication for underlying problem, pacemaker,<br /><br />23. Neurogenic Shock Spinal cord injuries, drug OD; Pink skin, flat neck veins, normal => low pulse, low vascular resistance Tx: ventilation, fluids, drainageDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-65113999600842651502008-08-31T02:08:00.000-07:002008-08-31T02:10:42.289-07:00PEDIATRICSPSYCHIATRY<br />1. Axis Determination I = clinical psych disorders II personality disorders, III Coexisting medical conditions IV psychosocial stressors, V global assessment of functioning<br /><br />2. Schizophrenia Positive Sx: delusions, hallucinations, bizarre behavior; Negative Sx: alteration of affect, ambivalence, apathy, loosening of associations; males=females; industrial nations have incr. prevalence; Misalignment of cells in cortex; incr. ventricle size; decr. activity in frontal cortex on PET scan.<br />3. Disorganized: insidious, incoherent, inappropriate affect, social impaired<br />4. Catatonic: rigidity, posturing or excitement, negativism<br />5. Paranoid: highest functioning type, grandiose, jealous, persecution<br />6. Undifferentiated: not defined by other subtypes<br />7. Melerill = Retrograde ejaculation, Tx: Respiradol (Best side effect profile), Clozaril (agranulocytosis w/ weekly CBC) prescribed weekly,<br />8. Neurolyptic Malignant Syndrome = incr. temp, incr. CPK, rigidity<br /><br />9. Schizophrenifrom same sx as schizophrenia but have lasted for less than 6 months<br /><br />10. Schizoaffective mood disorder and separate psychotic sx. Must experience 2 weeks of psychotic sx w/o mood impairment for dx to be made; Antidepressants are 1st line tx<br /><br />11. Major Depression loss of interest in activities, sleep, wt, concentration, hopelessness, suicidal ideation, nihilism; Seasonal affective, Vegetative (non functioning can be terminal) Dysthymia(chronic low level); Reactive related to environment w/o severity id sx; Masked 1o depression denied or hidden by other sx<br />12. Depression & anxiety can occur together & can be treated w/ an antidepressent; Left anterior or rt posterior stroke => incr. possibility of depression; Tx: 1st Tricyclic (Imiprimine); SSRI = side effects; Trazadone=priapism Asendin (Amoxipine) = Extrapyramidal Symptoms<br /><br />13. BiPolar Bimodal peak 20's & 30'sCycling mood= highs w/ euphoria, hyperactive, pressured speech, flight of ideas, decr need for sleep, delusions, inflated self esteem, risks, poor judgement; Lows are major depressive episodes tx: lithium<br /><br />14. Panic Attacks Sudden, unprovoked onset of fear, impending doom, palpitations, SOB, chest pain, smothering, dizziness. May be associated w/ agoraphobia Tx: with SSRI's<br /><br />15. Phobias Persistent and irrational fear of a specific object or activity or situation. Tx like a phobia<br /><br />16. Obsessive Compulsive Persistent, unwanted thoughts, impulses or images<br />17. repetitive, purposeful intentional behaviors meant to decrease tension caused by the obsessive thoughts; genetic Tx: Anafranil (Tricyclic) Prozac & Luvox (SSRI)<br /><br />18. PTSD intrusive recollections, daydreams, nightmares, poor concentration, psychic numbing; Tx: don't treat w/ meds unless compulsion component<br />19. Studies: Buffalo Creek Disaster, Beverly Hills Nightclub<br /><br />20. Dissociative Disorder Amnesia = loss of memory, Fugue = assoc w/ physical flight, Identity Disorder = multiple ego states; Depersonalization = feelings of self estrangement or unreality<br /><br />21. Whirndingo Fear of becoming a cannibal<br /><br />22. Amok sudden unprovoked outburst of wild rage usually ending in homicide<br /><br />23. Coprolalia Feces & filth<br /><br />24. Koro penis is shrinking and may disappear<br /><br />25. Latah imitate words or actions to which they are exposed<br /><br />26. Piblotko Run around in snow naked<br /><br />27. White Out Syndrome lack of diverse stimuli in snow clad environment<br /><br />28. Narcolepsy REM sleep, sudden onset of daytime sleep and cataplexy; REM sleep is inappropriately present at beginning<br /><br />29. Personality Disorders Cluster A = Bizarre = Paranoid, Schizoid (no close relationships, restricted emotions) Schizotypical (schizoid + odd or distorted behavior or cognition)<br />30. Cluster B = Over emotional = Antisocial (Disregard for social norms) Borderline, Histrionic, Narcissistic (self centered)<br />31. Cluster C = Anxiety & Fear = avoidant, dependent, Obsessive compulsiveDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-41691327301524027752008-08-31T02:06:00.001-07:002008-08-31T02:08:08.803-07:00GYNECOLOGYGYNECOLOGY<br />1. Trichomonas Vaginitis Yellow green discharge, Strawberry patches, Motile flagellated, Tx: Metronidazole<br /><br />2. Gardenerella Vaginitis KOH whiff test = fish; Clue cells, most common symptomatic infection; Metronidazole<br /><br />3. Condyloma Acuminata Warts, HPV 6, 11, Not assoc w/ cervical cancer<br /><br />4. PID Cervical motion tenderness, Purulent discharge, assoc w/ ectopic pregnancy & infertility; Leukocytosis, neutrophilia, incr. ESR<br /><br />5. Candida cottage cheese, red vulva; Pseudohypahe & spores on wet mount, DM, antibiotics, OC, pregnancy<br /><br />6. UTI E coli, Dysuria, frequency, urgency; Tx: TMP-SMX, Bactrim, Septra<br /><br />7. Toxic Shock Syndrome Staph aureus exotoxin, rash, high fever, hypotensive shock<br /><br />8. Chancroid H. Ducreyi, tropical & sub tropical climates, gram neg; Tx Emycin or Ceftriaxne<br /><br />9. Chlamydia Trachomatis Intracellular, columnar epithelium, mucopurulent, Immunofluoresent discharge, Tx: Doxycycline (Emycine if pregnant)<br /><br />10. Herpes Genitalis HSV II clear sores , multinucleated giant cells w/ intracell inclusions; Tzanck smear<br /><br />11. Molluscum Contagiosum umbilicated nodule, remove & cauterize<br /><br />12. Endometriosis Ectopic endometrium tissue, Dysmenorrhea, Dyspareunia, infertility<br /><br />13. Paget's Disease of Breast Intraductal Ca in main excretory ducts; crusting erosion of nipples w/ or w/o discharge<br /><br />14. Polycystic Ovarian Disease incr. LH, decr. or normal FSH; hirsutism, obesity, menstrual irregularities, infertility<br /><br />15. Menopause Avg age =51; incr. FSH & LH; Hot flashes, Atrophic vaginal epithelium<br /><br />16. Urinary Incontinence Stress = incr. intra abd pressure, leak small amts of urine; Kegel exercises, estrogen<br />17. Urge = detrussor instability; lg amts of urine leaked immediately after urge to void<br /><br />18. 1o Amenorrhea Absence age 16 w/ 2o sex development or absence by age 14 w/o 2o characteristics<br />19. Anatomic Abnormalities; Ovary Failure ( incr. FSH & LH, decr. estradiol) (XO, turners, no ovary); Pituitary = Prolactinoma presents w/ galactorrhea (Bromocriptine to Tx), Hypothalamic = decr. FSH & LH, (anorexia, incr. exercise, stress); XY karotype<br /><br />20. 2o Amenorrhea Absence for 6 mos if prev normal; absence for 12 months if prev oligomenorrhea; r/o pregnancy; Galactorrhea = prolactinoma; Hirsutism = polycystic ovarian; Tx: 1st = progestin challenge (bleed w/ in 2 wks) if no bleed measure FSH levels<br /><br />21. 1o Dysmenorrhea correlates w/ 1st day of menses, cyclic, begins in adolescence, low back & abd pain, N/V/D, fatigue, HA<br /><br />22. 2o Dysmenorrhea acquired, Sx don't correlate w/ 1st day of cycle, Endometriosis most common cause<br /><br />23. Asherman's Syndrome intrauterine adhesions after D&C; destruction of endometrium => amenorrhea<br /><br />24. Fibroademoma Age 19 -29, stromal fibrosis; nontender, estrogen sensitive, regress w/ menopause<br /><br />25. Fibrocystic Breast Disease Age 29 - 39, may have green nipple discharge; tender w/ ovulation, regress w/ pregnancy,<br /><br />26. Breast Disease Age 39-49 malignant = intraductal Ca (bloody nipple discharge); Papillary #1 cause of nipple discharge; Sclerosing Adenitis<br /><br />27. Breast Ca Upper outer quadrant, Mets = bone, liver, lung, brain; Risks: Family Hx, menarche <> 35; late menopause, null parity, obesity, other breast, radiation, reserpine<br /><br />28. PAP Smear Atypia = inflamm, infection HPV (16 & 1 ; Mild Dysplasia = lowgrade epithelial lesion; Mod/Severe=high grade intraepithelial;<br /><br />29. Carcinoma in situ incr. nuclear/cytoplasm, dense chromatin, crowding, incr. mitosis; Koilocytes = HPV, pyknotic nucleus, perinuclear halo; Risks: early sex, multi partners, smoking, decr. social class, HPV; Culposcopy = white epithelium, mosiacism, punctation, atypical vessels<br /><br />30. Cervical CA 90% squamous cell; s/sx: Early = postcoital bleeding, intermenstral bleed, Late= backache, leg pain, edema, hematuria Tx: Ia=TAH, iB & IIA = rad hysto & pelvic lymph nodes, IIB -IVA = Radiation - Brachytherapy => Radium, Cesium<br /><br />31. Endometrium CA most common gyn malignancy; Risks: obesity, DM, HTN, anovulation, early menses, later menopause, nullparous, unopposed estrogen; Dx : abnormal menses, post menopausal bleeding; EMB, D&C; Histologic= grade 1-3 based on differentiation;<br />32. AdenoCA=70%; Adenocanthoma=benign squamous, best prog; adenosquamous= malig squam, poor prog; Papillary Serous = acts like ovarian CA, Clear Cell = poorest prog, older, DES, least common Tx; TAH/BSO, perioneal wash, pelvic & aortic nodes, Adjuvant Rad if + nodes, cervical +, > ½ myometrium, higrade<br /><br />33. Ovarian CA Abd./pelvic mass, ascites, early satiety, CA125, CEA, CA19-9, 75% w/ stage 3; Path types = Serous (psammoma bodies), Mucinous, Endometroid, Clear Cell (hobnail bodies) Brenner; Staging: 1A= 1 ovary, 1B = both ovaries; 1C= + wash, tumor rupture; IIA = fall tubes/uterus, IIB other pelvic structures, IIB + wash rupture w/ spread; IIIA gros in pelvis, micro to diaphragm or omentum, IIIB Intra abd <> 2cm, pelvic/aortic nodes, inguinal nodes; IV = distant spread, pleural effusion w/ malig cells, liver/spleen mets; Tx: debulk tumor surgery, Chemo = cisplatin/cytotoxin, taxol; Radiation (bowel obstruction);<br /><br />34. Teratomas immature (neuro epithelial); mature (dermoid)=95% of all teratomas, hemolytic anemia; LDH elev, CA125<br /><br />35. Dysgerminomas most common malignant, 15% bilateral, radiosensitive<br /><br />36. Endodermal Sinus Tumor Schiller Duvall Body, AFP<br /><br />37. Embryonal CA HCG, AFP, CA125<br /><br />38. Choriocarcinoma HCG<br /><br />39. Sexcord-Stromal Tuors Granulosa: 50% post menopause, incr. estrogen, Call-Exner bodies<br />40. Sertoli-Leydig: most often virilizing; Gonado Blastoma: gonadal dysgenesis<br /><br />41. Krukenburg Tumor: Ovarian mets from GI & breast; Signet ring cells<br /><br />42. Vulvar CA TNM staging, squamous cell, Vulvar pruritus; Pagets= adenoca of vulva, 20% assoc w/ breast, GI, cervical CA<br /><br />43. Gestational Trophoblastic - Benign: Complete Mole = 46 XX, paternal, no embryonic tissue; Incomplete = 69 XXY triploid, paternal, no fetal/ embryonic tissue<br />44. Malignant: Invasive= molar villi; Choriocarcinoma = no villi, any pregnancy; Placental Site = non molar gestations<br />45. S/Sx: size > dates, hyperemesis, hyperthyroid, large theca lutein cyst<br />46. F/U = CBC. Liver function, BUN, CR, TSH, HCG, US, CXR; TX = D&C<br />47. Weekly HCG' until 3 values that are non detectable then 1/mo x 1yr, BCP x 1 yr<br /><br />48. Ca in Pregnancy Melanoma = worsened by preg, can met to placenta or fetus<br />49. Breast CA = most common CA in pregnancy<br /><br />50. Chemotherapy Cyclophosphamide (Cytoxan) = ovarian, hem, cystits, alopecia, decr. bone marrow, N/V<br />51. Cisplatinum = ovaian, renal toxic, ototoxic, bone marrow ß, N/V<br />52. Adrimycin (Doxyrubicin)= endomet, ovarian; cardiotoxic (heart failure)<br />53. Bleomycin= cervical, germ cell, Pulmonary fibrosis<br />54. Vincristine= cervical germ cell; neurotoxic<br />55. Methotrexate = GTN, germ cell, hepatic & renal toxic, decr. bone marrow<br /><br />OBSTETRICS<br />56. Hydantiform Mole Preeclampsia 1st TM, Very high Beta HCG, Snowstorm on US<br /><br />57. Ectopic Pregnancy Beta HCG rises slowly, Amenorrhea, spotting, pain, Empty gestational sac on ultrasound, Ampulla of fallopian tube is most common site<br /><br />58. Gestational Age Nagel's = Add 7 days to FDLMP subtract 3 months; fundal ht in cm after 13 weeks<br /><br />59. Amniocentesis Adv maternal age, abn AFP - incr. Spina bifida, decr. Down's, detect lung maturity, early 2nd trimester<br /><br />60. CVS Adv. Maternal age, late 1st trimester<br /><br />61. Non stress Test > 2 fetal movements accompanied by incr. FHR of 15 bpm for at least 15 sec w/ in 20 min period<br /><br />62. Contraction Stress Test Negative = 3 contractions in 10 min, lasting 40 sec w/o late decelerations<br />63. Positive = consistent & late decelerations<br /><br />64. Biophysical Profile Nonstress test, fetal breathing, movement, adeq, amniotic fluid, limb extension<br /><br />65. Fetal HR normal 120-160, Brady = mild 100-120, < tachy =" mild"> 180<br /><br />66. Decelerations Early = shape is mirror of contraction, head compression<br />67. Variable = shape varies, cord compression<br />68. Late = starts as contraction peaks, recovery after contraction is terminated, uteroplacental insufficiency<br /><br />69. Placental Previa Partial - partially over os; Complete= covers OS, Marginal = at edge of OS, Complete Previa is indication for C section<br /><br />70. Placental Abruption Premature separation of a normally implanted placenta, vag bleed, uterine tenderness, back pain, hypertonic uterus, fetal distress<br /><br />71. Preeclampsia HTN w/ proteinuria & edema after 20 wks gestation<br /><br />72. Eclampsia Preeclampsia + seizures<br /><br />73. Gestational Diabetes 1 hr > 140 then do 3 hr; 3hr test = fast > 120, 1 hr > 190; 2 hr > 165, 3 hr > 145; Macrosomia, RSD, Cong abnormalities<br /><br />74. Types of Pelvises Gynecoid = round inlet, nonprominent spines, wide subpubic angle<br />75. Anthropoid = heart shaped inlet, decr. transverse and incr. AP diameters, decr. subpubic angle<br />76. Android= triangular inlet, decr. subpubic angle, prominent spines<br />77. Platypoid= incr. transverse and decr. AP diameters<br /><br />78. Leopold's Maneuvers fundal palpation, sides of uterus from feet of mother, lower part of uterus, sides of uterus from head of mother<br /><br />79. Stages of Labor 1. Onset contract => full dilation 2. Full dilation to delivery of head 3. Delivery of fetus to delivery of placenta 4. Delivery of placenta to 1 hr later<br /><br />80. Cardinal Movements Engagement, descent, flexion, int rotation, extension, ext rotation, expulsion<br /><br />81. Post Partum Hemorrhage Uterine Atony (most common); Placental Accreta: Accreta = superficial invasion into myometrium, Increta = deeper, Percreta = invasion to serosa of uterus; Undiagnosed lacerations, Coag defect; Retained placental fragments<br /><br />82. Apgar Scoring Heart Rate, Resp. Effort, Muscle Tone, Reflex Irritability, Color<br /><br />83. Shoulder Dystocia Maternal obesity, diabetes mellitus, postterm pregnancy<br /><br />84. Cesarean Section Indications Health of mom or baby endangered by labor, Dystocia precludes vag delivery, Emergent situation, Herpes, Prev C section if contributing factor still exists, Malpresentation of fetus<br /><br />85. Premature Rupture of Membranes Pooling of fluid in vagina, + nitrazine test, + ferning test, risk of endometritis<br /><br />86. Polyhydraminos Duodenal Atresia, Tracheoesophageal fistula, Anencephaly<br /><br />87. Oligohydraminos Renal Agenesis, Pulmonary hypoplasiaDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com1tag:blogger.com,1999:blog-2217647826950966921.post-79161013842865448622008-08-31T02:04:00.000-07:002008-08-31T02:06:09.084-07:00NEUROLOGYNEUROLOGY<br />1. Blindness visual acuity 20/400 with best possible correction<br /><br />2. Open Angle Glaucoma Increased intraocular pressure, gradual, bilateral vision loss => tunnel vision, elderly, diabetics, African Americans, familial; halos around lights, cuping of ocular disc, Beta Adrenergic blockers to treat; decr. amt aqueous humor produces<br /><br />3. Closed Angle Glaucoma Rapid rise in pressure due to blockage of aqueous drainage in the eye; Severe pain, blurred vision, halos, Nausea, Abd pain; Reddened eye, upper lid edema, steamy cornea, dilated non-reactive pupil; mannitol, oral glycerin or carbonic anhydrase in acute attack, Beta adrenergic blockers for prevention<br /><br />4. Diabetic Retinopathy Black spots, "cobwebs", flashing lights; cotton wool spots (infarct of vessel wall) neovascularization, hard yellow exudates<br /><br />5. Cataracts Painless clouding of lens; Age most common cause, Assoc. W/ smoking & alcohol; Absent red reflex.<br /><br />6. Senile Macular Degeneration Main cause of vision loss in the elderly; Atrophic degeneration or Leakage of Retinal Vessels , gradual loss of VA, Decr central vision, hemorrhagic or pigmented regions in the macula; Neovascular Membranes (Bruch's membrane)<br /><br />7. Conjunctivitis Acute inflammation, Adenovirus, a lot of discharge, no blurring, purulent if bacteria<br /><br />8. Uveitis Inflammation of the uveal tract (iris, ciliary body & choriod layer), haziness, floating spots; Photophobia & redness = iridocyclitis; "salt & pepper fundus = syphillis<br /><br />9. Central Retinal Occlusion sudden painless loss of sight in one eye, Pale fundus, cherry red spot fovea & boxcar appearance of veins<br /><br />10. Central Vein Occlusion unilateral loss of sight that is more gradual, Swelling of optic disc, cotton wool spots & tortuous dilated veins<br /><br />11. Retinoblastoma Childhood malignancy of immature retina, associated with other malignancies later in life, "white reflex or "cat's eye.<br /><br />12. Hearing Loss Rinne's Test: hold against mastoid process then adjacent to pinna, norm = pinna louder, if not maybe conductive loss; Weber Test: Midline of forehead, unilateral conductive loss = louder in affected ear; unilateral sensorineural = louder in unaffected ear<br /><br />13. Presbycusis normal loss of hearing associated with age, sensorineural<br /><br />14. Mastoiditis Usually following otitis media, Redness & swelling w/ fever & pain; X ray = destroyed mastoid air cells & fluid in the air pockets, IV antibiotics<br /><br />15. Meniere's Disease Severe vertigo w/ N/V, hearing loss, tinnitus worse during attack of vertigo<br /><br />16. Acoustic Neuroma Vestibular Schwannoma; tumor of CN VIII; Hearing loss, dizziness, tinnitus;<br /><br />17. Migraine 2x women : men; Age of onset 10 - 30; gone by age 50; family Hx; stress, bright lights, menstruation, fatigue, tyramine, monosodium glutamate, nitrites; Aura prior to onset; visual, scintillating scotomas (small areas of visual loss) , dull throbbing, unilateral; N/V, photo & sound sensitivity;<br /><br />18. Cluster Headache Men age 20-50; alcohol & vasodilators; severe, nonthrobbing, unilateral, recur same time each day for weeks, Horners syndrome & periorbital pain; Tx: ergot & lidocaine<br /><br />19. Tension Headache cause unknown, most common type; bilateral, occipital, constant; muscles tight<br /><br />20. Tumor Associated Headaches progressive, increasing, dull, nonthrobbing, worse w/ postural chgs, exertion. Disrupt sleep, assoc w/ N/V<br /><br />21. Trigeminal Neuralgia Tic douloureux; severe, "lightening" pain in V1 & V2 distribution of CN V; Trigger Pts<br />22. Tx: carbamazepine & phenytoin; Surgical decompression of CN V<br /><br />23. Partial Seizures Simple = focal sx, conscious, Jacksonian = simple muscle twitch that spreads progressively; 2o generalization = simple becomes grand mal; Complex Partial = automatism, olfactory hallucinations, fear, deja vu, loss of contact w/ environment; postictal confussion<br /><br />24. Generalized Seizures Absence = petit mal; brief, freq. Loss of consciousness w/o loss of muscle tone, rapid eye blinks, no aura, no postictal<br />25. Grand Mal= tonic clonic, preceded by GI upset or mood chg; tonic - 30 sec, clonic 1-5 min w/ alternating relax & contract of muscles, unconscious, then confussion & postictal<br /><br />26. Status Epilepticus continuous seizures w/o regained consciousness, grand mal progress or withdrawal of anticonvulsants; Complications = high fever, circulatory collapse, brain damage; Diazapam until controlled, Treat potential causes (glucose, thiamine, narcan)<br /><br />27. TIA sudden, brief, emboli or arterial stenosis, Risks: obesity, smoking, DM, hyperlipidemia, Carotid artery= unilateral, contralateral hemiparesis & parathesia w/ ipsilateral blindness; Aphasia if dominant hemisphere involved, Vertebrobasillar = brainstem dysfunction => vertigo, confusion, blindness, diplopia, weakness, parathesia of extremities<br /><br />28. Aneurysm localized vessel dilation, Berry Aneurysm = circle of Willis assoc w/ polycystic kidney disease & coarction of aorta<br /><br />29. Subarachnoid Hemorrhage between pia & arachoid; usually rupture of a cerebral artery aneurysm or AV malformation; Worst HA, syncope, nuchal rigidity, vomiting, nonfocal abnormalities, decr consciousness, CT first if neg then lumbar puncture mandatory.<br /><br />30. Intracerebral Hemorrhage Chronic HTN or local thrombus 2o to ischemia; Supratentorial: transtentorial herniation, w/ brainstem compression & midbrain bleeding, hemiparesis; Cerebellar : acute hydrocephalus due to CFS flow blockage; Acute onset HA w/ progressive neurological chgs.<br /><br />31. Stroke Middle Cerebral: most often, contralateral limb weakness, sensory loss, homonymous hemianopsia, dominant hemisphere = aphasia, nondominant = sensory neglect & apraxia<br />32. Posterior Cerebral: contralateral homonymous hemianopsia & sensory loss, thalamic pain, hemiballistic movement disorder<br />33. Vertebrobasilar artery: fatal, unilateral occlusion = ipsilateral CN abnormalities, contralateral weakness; Complete occlusion = opthalmoplegia, defective pupil constriction, bilateral weakness, paralysis, decreased consciousness, dysphagia & dysarthria; completed = neuro stable; Evolution = progressive signs over 1-2 days<br />34. CT positive 48 - 72 hrs after onset.<br /><br />35. Cavernous Sinus Thrombosis CN palsies, fever, exophthalmos, papilledema, HA, decr. consciousness, occasional seizures; IV antibiotics immediately<br /><br />36. Acute Subdural Hematoma rapid bleed between arachnoid & dural layers; Tearing of bridging veins, Sx slower to progress, Signs of transtentorial herniation w/ deepening coma, progression from decorticate to decerebrate posture, mid position or fixed & dilated pupils, spastic hemiplegia w/ incr. DTR. LP is contraindicated because may lead to herniation<br /><br />37. Chronic Subdural Hematoma Delayed formation of a subdural clot, Sx weeks after head injury, Elderly & alcoholics; Progressive daily HA, fluctuating consciousness & mild hemeparesis<br /><br />38. Epidural Hematoma Between dura & skull, less common than subdural, injury to arteries (middle meningeal); Rapid brain compression, permanent neurological problems or death; Brief lucid period after head injury; progressive neuro signs<br /><br />39. Concussion Injury due to blunt trauma; short loss of consciousness w/ intact brainstem function; post traumatic confussion syndrome w/ transient retrograde or anterograde amnesia; HA, vertigo, mild cognitive dysfunction<br /><br />40. Toxic Vestibulopathies Alcohol: positional vertigo & nystagmus w/ in 2 hrs of ingestion<br />41. Aminoglycosides: ototoxic, vertigo, N/V ataxia, sx last 1-2 wks after ending tx<br />42. Salicylates: reversible vertigo, tinnitus, sensorineural hearing loss<br />43. Quinine & Quinidine: cinchonism (color vision defects, tinnitus, hearing loss, vertigo, flushed skin, N/V, abd pain & sweating<br />44. Cisplatin: ototoxic, reversible vertigo, tinnitus, hearing loss, sensory neuropathy<br /><br />45. Toxic Neuropathies Lead: multi motor neuropathy; acute encephalopathy in children<br />46. Organophosphates: delayed motor neuropathies, cholinergic crisis<br />47. Arsenic and Thallium: acute onset symetrical sensorimotor polyneuropathy<br />48. Isoniazid: Reversible sensory polyneuropathy reversible w/ concurrent pyridoxine Gold: symetrical polyneuropathy<br /><br />49. Bacterial Meningitis 1st month life = group B strep & E. coli; Older kids = H. flu; Adults = S. pneumonia<br />50. N. meningiditis at any age = 50% have petechial rash<br />51. Brudzinski sign = neck flexion when supine causes involuntary hip & knee flexion<br />52. Kernig's Sign: extension of knee in pt w/ flexed hip is painful<br />53. CSF: decr. glucose, incr. neutrophils, incr. protein, incr. opening pressure; Tx: ampicillin & cefotaxime = infants; 3rd generation cephlosporin in kids > 3mos and adults<br /><br />54. Aseptic Meningitis nonbacterial meningeal irritation; CSF = incr. lymphocytes, normal glucose, neg gram stain & bacterial cultures, mild incr. protein, normal opening pressure; supportive Tx<br /><br />55. Fungal/TB Meningitis CSF: incr. lymphocytes, decr. glucose, incr. protein, incr. opening pressure; AIDS = cryptococcal meningitis<br /><br />56. Encephalitis Inflammation of brain tissue; Viral etiology = CSF lymphocytes, normal glucose & negative bacterial cultures; Acylcovir x10 days<br /><br />57. Reye's Syndrome follows viral infection; fatty infiltrate of organs; Usually kids; Salicylates can induce<br />58. Sudden onset of encephalopathy, severe vomiting, & liver dysfunction; liver biopsy w/ fatty infiltrates confirms Dx.<br /><br />59. Neurosyphillis Argyll Robertson Pupil (small, reacts to light but not accommodation); Psych disorders, Tabes Dorsalis; Tx: Procaine Penn G x 21 days; Examine CSF q 3-6 months until normal x 2 yrs.<br /><br />60. Rabies Dogs worldwide; wild animals in US, Sx: malaise, fever, restlessness 1st. Sx progress to extreme excitement w/ painful laryngeal & pharyngeal spasms, Tx: Passive IG and active vaccine<br /><br />61. Polio Fecal-oral; aseptic meningitis, paralysis w/o loss of sensation; Asymmetric paralysis during a febrile illness suggests it; Tx is palliative; OPV for all except immunocompromised who get IPV<br /><br />62. Primary Neoplasms Glioblastoma Multiforme: most common in adults, high mortality; Meningioma: most common benign tumor in adults; Cerebellar Astrocytoma & Medulloblastoma: most common in kids<br /><br />63. Huntington's Disease Autosomal dominant, Age 30-50; subtle dementia, irritability, antisocial, chorea, death 10-15 yrs after onset, atrophy of caudate nucleus & cerebral cortex, Tx D2-receptor antagonists (haloperidol)<br /><br />64. Parkinsonism Idiopathic - loss of dopaminergic cells in substantia nigra; Pin rolling temor, masklike facies, lack of arm swing when walking, cogwheel rigidity, difficulty initiating movement, small shuffling steps w/ increasing speed (festinating gait). Tx: Levadopa (dopamine precursor), Amantadine, bromocriptine (dopaminergic agonists), Benzotropine (anticholinergic)<br /><br />65. ALS<br />66. (Lou Gehrig's Disease) Progressive loss of anterior horn cell function; Initially = LMN dysfuntion w/ hand & foot weakness & atrophy; asymmetric progression, No sensory abnormalities; Later= UMN dysfunction w/ muscle spasticity, incr. DTR, extensor plantar reflexes<br /><br />67. Tay Sachs Disease Autosomal recessive; Eastern Europe jews & french Canadians; Absence of Hexosaminidase A, can't metabolizes lipid gangliosides, build up in brain; Progressive dev. delay, paralysis, blindness, dementia; death by age 4<br /><br />68. Multiple Sclerosis Progressive demyelinating, women>men; Peak onset 20 - 40; Gradual & variable CNS sx suggest dx; CSF = mild incr. proteins, mild lymphocytes , oligoclonal bands, MRI = multi plaques in white matter<br /><br />69. Guillain-Barre Syndrome polyneuropathy after mild viral illness, inoculation or surgery; Most common acquired demyelinating disorder; progressive bilateral weakness of legs, proximal weakness, abnormal DTR, instability of temp & BP; CSF = incr. protein w/ normal pressure, glucose & cell numbers; Plasmaphresis speeds recovery; Corticosteroids are contraindicated<br /><br />70. Cerebral Palsy CNS damage before age 5; Risks: Prematurity, IUGR, inutero complcations, neonatal jaundice, birth trauma, asphyxia, spastic syndrome, incr. DTR, incr. tone, weakness, toe walking, scissors gait<br /><br />71. Myasthenia Gravis autoimmune, antibodies against acetylcholine receptors at neuromuscular junctions, incr. women, age 20 - 40; Ptosis, diplopia, dysarthria, enhanced muscle fatigue, thymoma on chest x-ray; Tx exogenous anticholinesterase (edrophonium or neostigmine); Thymectomy in pts < 60; steroids or azathioprine if unresponsive to tx<br /><br />72. Muscular Dystrophy Duchenne most common type; X linked recessive, mutation in dystrophin gene; CK incr. before onset of sx; By age 5 toe walking, waddling gait, can't run; Prox legs 1st then prox arms; Pseudohypertrophy of calves = fat infiltrates in muscles;<br /><br />73. Coma dysfunction both cerebral hemispheres or RAS; Acute onset = subarachnoid hemorrhage or brainstem infarct; progressive min-> hours = Intracerebral hemorrhage; days => weeks = chronic subdural hematoma, tumor or abscess; No laterialization following delirium = metabolic; Pupil size: dilated nonreactive = at or below midbrain, pinpoint = pontine; opiod OD, Constriction intact w or w/o extraoccular impairment = metabolic; Localizing response to pain = superficial coma; Decorticate (flex @ elbow, ext leg) = thalamic lesion of compression; Decerebrate (elbow & leg extension) = midbrain; No response to pain = pontine or medullary<br /><br />74. Gait Abnormality Cerebellar lesions = truncal ataxia, broad based, unsteady, irregular; can't turn<br />75. Corticospinal = affected leg circumducts as it steps forward, scissors if bilateral<br />76. Extrapyramidal = festinating gait, flexed posture, small rapid steps, no arm swing<br />77. Motor System = Footdrop - anterior tibial; Calf muscle - can't toe walk; Pelvic muscle - waddling gait.<br /><br />78. Arnold Chiari Syndrome Cong. Protrusion of medulla thru foramen magnum; unusual sensory & motor chgs, Onset ~ 40<br /><br />79. Cold Calorics Test vestibular system, Slow deviation toward ear w/ cold water = brainstem intact, fast nystagmus away = contralateral cortex intact; COWS = cold opposite Warm same for fast componentDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com1tag:blogger.com,1999:blog-2217647826950966921.post-31616618474835020082008-08-31T01:54:00.001-07:002008-08-31T02:00:57.184-07:00DERMATOLOGYDERMATOLOGY<br />1. Seborrheic Dermatitis Red skin with greasy scales, worse in winter & when under stress, Se or Tar soap<br /><br />2. Psoriasis HLA-B27, Similiar sx to RA but w/ neg RF, Silvery scaled plaques w/ sharp demarcations, Pitted fingernails<br /><br />3. Pilonidal Cyst Hair lined tract in sacral area = "Jeep Seat"<br /><br />4. Actinic Keratoses Firm, yellow scale, Due to sun exposure, can lead to squamous cell CA<br /><br />5. Skin CA Basal Cell > Squamous; Basal Cell = pearly papule w/ dilated blood vessels and central depression; Squamous Cell: Red papule w/ crusted surface, later nodular and ulcerated, rarely mets; Assoc w/ sun exposure<br /><br />6. Malignant Melanoma Change in size, shape or color of a mole, Usually superficial spreading, Mets incr. as invasion goes deeper than 0.76 mm; itchy & ulcerated<br /><br />7. Contact Dermatitis 1o = irritant contact - direct injury, all w/ contact affected, Occurs w/ 1st exposure<br />8. Allergic = type IV hypersensitivity, T cell medicated, Never 1st exposure<br /><br />9. Carbuncle Abscess of skin caused by several boils coming together<br /><br />10. Dermatopytoses TINEA CORPORIS: ring worm of body (round lesion w/ raised borders, spreads peripherally w/ central clearing) TINEA CRURIS: Jock Itch; TINEA PEDIS: Athletes Foot; TINEA UNGUIUM : Toenails; TINEA CAPITIS: ring worm of scalp;<br /><br />11. NEVI PIGMENTED: (Benign) sun exposed areas in children & adolescents<br />12. DYSPLASTIC: 2-12 mm, more irregular, unexposed areas, Multiple dysplastic Nevi = familial incr. risk of melanoma<br /><br />13. Hemangiomas NEVUS FLAMMEUS: Port wine stain - flat, purple, does not fade<br />14. CAPILLARY: strawberry mark, raised, bright red, regress spontaneously by age 5<br />15. CAVERNOUS: Raised red or purple, enlarged vascular spaces<br /><br />16. MUSCULOSKELETAL & CONNECTIVE TISSUE<br />17. Osteoarthritis incr. morning stiffness, bone spurs, osteophytes, DIP = heberdon's nodes, PIP = Bouchard's nodes, also affects hips, knees, spine<br /><br />18. Rheumatoid Arthritis Symmetric, PIP & MCP joints NOT DIP, Subcutaneous nodules, 70% +RF<br /><br />19. Gout Affects big toe (Podagra), pinna of ear; Negatively birefringent crystals; Sodium urate; Colchicine or NASIDS for acute attacks<br /><br />20. Pseudo Gout Calcium pyrophosphate dihydrate; Knee most affected; Positively birefringent<br /><br />21. Phocomelia Hands & feet attached to trunk, Thalidomide<br /><br />22. Slipped Capital Femoral Epiphysis Overweight Teens; stiffness=>weakness=>pain radiating down anteromed thigh to knee, ext rot of leg; avascular necrosis<br /><br />23. Lyme Disease Borrelia burgdorfi, Ixodes tick, arthralgias, Rash w/ central clearing = erythema chronicum migrans, CNS chgs 1 month after exposure<br /><br />24. Osteoporosis decr. mass of bone; hip & wrist fx most common; decr. estrogen, Ca & Phos normal; Risk factors = post menopause, Caucasian, Asian, smoking, alcohol, corticosteroids, Cushings, hyperparathyroid, hyperthyroid; Etidronate - inhibits osteoclast activity, used for men & women who can't take estrogen<br /><br />25. Systemic Lupus Erythematosus Malar (butterfly) rash, arthralgias (raynauds), ANA sensitive; Anti dsDNA specific; Neuro = HA, psychosis, seizures, aseptic meningitis; Check for hemolytic anemia w/ Coombs; Renal = incr. BUN incr. Cr, + protein = immune complex glomerulonephritis<br /><br />26. Polymyositis & Dermatomyositis inflammation of skeletal muscles; violet discoloration of eyelids (heliotrope rash), elevated muscle enzymes (CPK, SGOT, SGPT, LDH) symetric proximal muscle weakness; hips & shoulders 1st<br /><br />27. Ankylosing Spondylitis "Bamboo shoots" = vertebral squaring w/ bony outgrowths, paraspinal lig. Calcifications on xray; sacroiliac involvement is diagnostic; HLA-B27; incr. ESR<br /><br />28. Shoulder Hand Syndrome Pain, stiffness, swelling in hand and shoulder; Occurs 1 month after MI or other acute disease<br /><br />29. Bone Mets from Primary breast, lung, prostate, kidney, thyroid<br /><br />30. Paget's Disease Osteolytic => osteoblastic; Frontal "bosing" (enlarged skull with rounded forehead) bow legs and shortened spine; incr. alk phos, Ca & phosphorus levels normal; "Cotton Wool" appearance on skull xray; high output cardiac failure<br /><br />31. Congenital Hip Femoral head partially or completely dislocated from acetabulum; BARLOWS: dislocates hip when abducted and decr. pressure; ORTOLANI'S: reduces dislocation by abduction and flexion<br /><br />32. Osteochondritis Inflammation of bone & cartilage; Osgood Schlaters - teens, tibial tubercle, pain& swelling at the insertion of the patellar tendon<br /><br />33. Osteomyelitis Bone infection; Local or hemtogenous spread; Prepuberty infection is in metaphysis; Salmonella - sicklers; S. aureus; pseudomonas; incr. ESR; incr. WBC; Radionucleotide bone scan w/ in 72 hrs; 4-6 wks organism specific antibiotics<br /><br />34. Septic Arthritis S, aureus = most common; N. Gon most common sexually active; synovial fluid = incr. WBC and + culture; Ceftriaxone NG infection; Nafcillin for others<br /><br />35. Degenerative Disk Nucleus Pulposa herniates post or postlat.; Lumbosacral = sciatics = L3L4; + pain on straight leg raise;<br /><br />36. CaudaEquina Syndrome Lg midline post. Hemorrhage compressing C.E. Urinary and bowel incontinence; bilateral leg weakness<br /><br />37. Polymyalgia Rheumatica older women; assoc w/ temporal arteritis; Morning stiffness; swelling 1-2 joints; no weakness; incr. ESR; neg. Rheum factor; steroid response immediate<br /><br />38. Fibromyalgia "Trigger Points" reduce pain, IBS, depression, anxiety<br /><br />39. Osteosarcoma teenage boys, distal femur & proximal tibia; mets to lungs<br /><br />40. Eosinophillic Granuloma 20-40; granuloma w/ histiocytes, eosinophilic infiltrate & fibrosis; multifocal = poor prognosisDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0tag:blogger.com,1999:blog-2217647826950966921.post-74508168958959708542008-08-31T01:54:00.000-07:002008-08-31T01:55:09.240-07:00HEMATOLOGY & ONCOLOGYHEMATOLOGY & ONCOLOGY<br /><br /><br />i. Microcytic Anemia MCV < 80; IRON DEFICIENCY = decr. ferritin; CHRONIC DISEASE decr. Fe, decr. Transferrin, incr. Ferritin; LEAD POISONING; THALASSEMIA<br /><br />ii. Normocytic Anemia MCV 80 - 100; Hemolysis, Chronic disease, Bone marrow suppression (drugs, leukemia) (aplastic)<br /><br />iii. Macrocytic Anemia MCV > 100; FOLATE DEF. = most common cause, decr. folate normal B12;<br />iv. B12 DEFICIENCY: B12 absorbed when linked with IF from parietal cells, neuro sx,<br /><br />v. Alpha Thalassemia Acanthocytes (rounded projections from cells); Poikilocytosis (variable size); target cells, Very low MCV but mild anemia, Hemoglobin H = a chain missing; Asians, Dx by Hb electrophoresis,<br /><br />vi. Beta Thalassemia Peripheral Smear = basophillic stippling, nucleated RBC, anisocytosis (chgs in size) Mediterranean & African heritage; Minor = heterozygous, Major = homozygous<br /><br />vii. Sickle Cell Anemia sickled cells, decr. Hct & incr. reticulocyte count, electrophoresis HbS + HbA neg. Salmonella osteomyelitis, S. pneumonia sepsis.<br /><br />viii. Hemophilia X linked factor VIII (A) or IX (B) deficiency; Prolonged PTT, Joint & soft tissue bleeding; Tx cryoprecipitate & FFP<br /><br />ix. Von Willebrand's Disease autosomal dominant deficiency of VIII & vWF, epistaxis, menorrhagia, bruising, increased PTT & bleeding time<br /><br />x. Eosinophilia Allergic Drug Reaction; NAACP = neoplasm, asthma/allergies, Addison's disease, connective tissue disorders, parasites<br /><br />xi. Thrombotic Thrombocytopenic Pupura adults > kids, women > men; platelets consumed in clotting reactions, Fluctuating neurologic defects, decr. platelets, decr. HCT, incr. retic count, incr. incr. incr. LDH, acute onset not autoimmune<br /><br />xii. Idiopathic Thrombocytopenic Pupura kids > adults, autoimmune destruction of platelets, Purpurea & Petechia , Platelets<10000, Epistaxis, menorrhagia<br /><br />xiii. Hemolytic Uremic Syndrome Usually caused by E. coli toxin, RBC fragments on smear, RBC destruction => acute renal failure, 2o thrombocytopenia, abd pain & diarrhea after a flu or URI prodrome; platelets derc, LDH greatly increased<br /><br />xiv. Hodgkin's Lymphoma Painless cervical lymphadenopathy, Reed Sternberg cells (multinucleated reticular cells), 80% survival<br /><br />xv. Burkitt's Lymphoma B cell lymphoma, Associated with Epstein-Barr virus, children & young adults<br /><br />xvi. Hereditary Spherocytosis dominant deficit in RBC membrane proteins, damaged cells get trapped in spleen. Spherical RBC & reticulocytosis on smear. Coombs neg.<br /><br />xvii. G-6-PDase Deficiency X linked hemoglobin accumulates in RBC (Heinz bodies) hemolysis occurs after ingestion of oxidant<br /><br />xviii. Agranulocytosis neutrophils = decr production or incr destruction<br /><br />xix. DIC wide spread activation of coagulation cascade. decr. platelets, fragmented RBC, incr. PT & PTT ; decr. fibrinogen, Pregnancy, malignancy, infections, massive trauma<br /><br />xx. Acute Lymphocytic Leukemia 80% childhood leukemia, peak age 3 - 7; usually B cell origin; incr. lymphoblasts, few other cells on bone marrow biopsy<br /><br />xxi. Acute Myelocytic Leukemia affects myeloid cells (N,B,E,erythrocytes, megakarocytes) adults > kids; DIC possible, gram neg and fungal infections, Auer Rods (red staining intracellular inclusions.<br /><br />xxii. Chronic Myelocytic Leukemia Philadelphia Chromosome (acquired translocation chromosome 9 & 22), tumor cells are more mature, Dx in middle aged, WBC > 150000; incr. uric acid, incr. B12 (B12 carrier protein produced by WBC); leukocyte alkaline phos decr or absent, RBC normal<br />xxiii. Blast crisis transforms it to acute leukemia<br /><br />xxiv. Chronic Lymphocytic Leukemia Disorder of mature B cells (rarely T); B cells don't differentiate into plasma cells, men > women; usually > 50; No Blast Crisis<br /><br />xxv. Hairy Cell Leukemia B cell transformed into tumor cell with fine hair like projections; pancytopenia, red pulp of spleen infiltrated<br /><br />xxvi. Multiple Myeloma Plasma cell proliferation and monoclonal IG; men = women; peak 50 - 60, 1 - 3 year survival; xrays show osteolytic bone lesions, Increased urine protein (Bence Jones)<br /><br />xxvii. Waldenstrom's Macroglobulinemia single B cell line = monoclonal IM over production; decr. RBC with normal WBC & platelets; Rouleau Formation = RBC pile up forming cylinders<br /><br />xxviii. Mycosis Fungoides Clonal proliferation of CD4 T cells; infiltrates dermis & epidermis, thickened & nodular skin lesions<br /><br />xxix. Polycythemia Vera overproduction of all 3 cell lines; RBC > 1,000,000, Hct > 60%; men & women peak age 60; Bone biopsy- hypercellular with absent Fe stores; R/O spurious polycythemia = incr. RBC due to dehydration; R/O 2o polycythemia = RBC mass incr. due to decr. oxygenation.<br /><br />xxx. Eaton Lambert 90% assoc w/ small cell CA, decr. presynaptic Ca release = proximal muscle weakness; hyporeflexia, dysautonomia, function incr. w/ stimulation; weakest in AM (opposite MG) Tx TubocurareDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com2tag:blogger.com,1999:blog-2217647826950966921.post-60368083940931076862008-08-31T01:53:00.001-07:002008-08-31T01:53:41.322-07:00INFECTIOUS DISEASES & IMMUNOLOGYINFECTIOUS DISEASES & IMMUNOLOGY<br />1. Fever most common cause immed post op = atelectasis; 3-5 days postop = infection; > 2 wks post op = PE or thrombophlebitis<br /><br />2. Fever of Unknown Origin > 100F for > 3 weeks despite active search for cause for > 1 week; need to get CBC w/diff, blood cultures; kids = usually infection; adults = infectious, neoplasm, autoimmune<br /><br />3. Inflamation Rubor, Tumor, Calor, Dolor<br /><br />4. Types of Immunity Active Acquired= direct exposure - infection or vaccination; Passive Acquired = temporary, serum Ab given (IG, breast milk)<br /><br />5. Bacteremia bacteria in blood but asymptomatic<br /><br />6. Septicemia bacteria in blood with symptoms<br /><br />7. Immunizations in Kids HEP B = mom + HbsAG = HBIG & 1st Hep B vaccine at birth<br />8. DTP = contraindications => progressive neuro disorder, Hx encephalopathy w/ in 7 days of previous dose; Pertussis not given if > 7 y/o or if currently have pertussis<br />9. H FLU = not in kids > 5<br />10. POLIO = IPV if immunocompromised<br />11. MMR = not effective before age 1; don't give if less than 3 months since transfussion or IG use; ok for HIV +; suppresses TB - give Tine(PPD) & MMR at same time or 4-6 weeks apart.<br /><br />12. Adult Immunizations TETANUS = booster q10y, No Hx immunization 2 td 1-2 mos apart then booster at 6-12 mos then on normal 10 y cycle<br />13. FLU = chronic resp problems, metabolic diseases, adults > 65; can cause false positive HIV test<br /><br />14. HIV/AIDS RNA retro, CD4 cells, Dx based on concurrent related diseases &/or CD4 , 200 cells/mm3; Flu-like illness, antibodies 1 - 6 months after infection<br /><br />15. AIDS related infections CMV, HSV, VZV, EBV, TB, mycoplasma avium-intracellular, candida coccidioides, histoplasmosis, cryptococcus, Pneumocystic carnii (protozoa) Toxoplasmosis, cryptosporidiosis, Giardiasis<br /><br />16. DeGeorge's Syndrome Thymic aplasia, Absent T cells, congenital heart disease, craniofacial abnormalities<br /><br />17. Wiskcott- Aldrich Syndrome X linked, no antibodies against encapsulated bacteria, eczema, decr. platelets,<br /><br />18. Chronic Granulamatous Disease Autosomal recessive, defect in phagocytic enzymes, recurrent bacterial & fungal infections<br /><br />19. Chediak-Higashi Syndrome Autosomal recessive, recurrent strep & staph infections<br /><br />20. Bruton's Disease x-liked, agammaglobulinemia, N B cells or antibodies<br /><br />21. Ataxia Telangectasia Auto recessive, lymphopenia & IgA deficiency; gait abnormal, telangiectasia<br /><br />22. Severe Combined Immunodeficiency Deficits of B & T cells, IgA deficiency, recurrent infections esp resp & GI, IG administration contraindicatedDr. VIKAShttp://www.blogger.com/profile/06929635397267021459noreply@blogger.com0