Dentition (mnemonic)

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Eruption times of permanent dentition "Mama Is In Pain, Papa Can Make Medicine":
1st Molar: 6 years
1st Incisor: 7 years
2nd Incisor: 8 years
1st Premolar: 9 years
2nd Premolar: 10 years
Canine: 11 years
2nd Molar: 12 years
3rd Molar: 18-25 years

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Monday disease

"Monday disease" is related to which drug?
a)Spironolactone
b)Digoxin
c)Nitroglycerin
d)Hydrochlorothiazide

ANSWER:

Ans-C Monday disease is a toxicity that happens to those who are exposed to Nitroglycerin or isosorbide dinitrate industrially, like who work in construction or demolition industries, mix concrete, do plaster, ect.
During the week, Monday to Friday, they are exposed to the vasodilating action, so they build up a tolerance. If they are off on Saturday and Sunday the tolerance is lost. So when they go back to work on Monday the tachycardia, hypotension, flusing and headache return, but a tolerance is built up again by the next day.

Kveim test

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The Kveim test, Nickerson-Kveim or Kveim-Siltzbach test is a skin test used to detect sarcoidosis, where part of a spleen from a patient with known sarcoidosis is injected into the skin of a patient suspected to have the disease. If granulomas are found (4-6 weeks later), the test is positive. If the patient has been on treatment (e.g. glucocorticoids), the test may be false negative. The test is not commonly performed. There is a concern that certain infections, such as bovine spongiform encephalopathy, could be transferred through a Kveim test.

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Vagal nerve stimulation

Vagal nerve stimulation is used in the treatment of which of the following?
a. OCD
b. Schizophrenia
c. Depression
d. Seasonal affective disorder

ANSWER:

Ans: C
the cervical portion of the left vagus is stimulated in a pulsatile manner.

Spanish windlass (aiims nov 2010)

Spanish windlass is practiced in spain as a method of execution,it is a type of-
a) bansdola
b) garroting
c) hanging
d) mugging

ANSWER:

ans: B garroting

Tensor tympani (aiims nov 2010)

Tensor tympani nerve supply
a) trigeminal
b) facial
c) glassopharyngeal
d) vagus

ANSWER:

ans: A- 5th i.e trigeminal nerve

Axons from retina

Axons from Ipsilateral temporal hemiretina project to layers 2,3 and 5
&
Axons from Contralateral nasal hemiretina project to 1,4 and 6.

Alpha2 macroglobulin

increase in : Nephrotic , Diabet. Melitus. , Severe Burns
decrease in : COPD


it 
inactivates protinases and plasmin
and also inhibits thrombin 

Beta2 Microglobulin

Component of MHC I
present on nucleated cells


increased levels seen in  : Multiple Myeloma and Lymphoma

Late onset schizophrenia

Late onset schizophrenia, what is true? (AIIMS nov 2010)
a)age>45
b)age 20 to 30yrs
c)bad prognosis
d)olfactory hallucination

ANSWER:

answer: A- age>45

AIIMS nov 2010 PATHO

1.onion bulb appearance in a nerve biopsy is in
a) CIDP
b) leprosy
c) amyloidosis
d) diabetes

ANSWER:

ans: A- CIDP

2.Oligodendrocyte inclusion charecteristic of?
a) polio
b) JE
c) PML
d) alzheimer

ANSWER:

ans: C- PML-pprogressive multifocal leukoencephalopathy

3.Pale infarct seen in all except?
a) kidney
b) spleen
c) heart
d) lung

ANSWER:

ans: D- lung

4.Not a mediator of inflammation
a) INF
b) MPO
c) TNF
d) PG

ANSWER:

ans: B-MPO

5.Renal histopathology of wegener's granulomatosis?
a) focal necrotizing glomerulonephritis (answer)

AIIMS nov 2010 biochem

 1.Lactic acidosis is caused by which vitamin def
a) thiamine
b) riboflavin
c) niacin
d) pantothenic acid

ANSWER:

ans: A thiamine

2.What prevents ADP from leaving the mitochondria in exchange for ATP? 

a) oligomycin
b) rotenone
c) antimycin a
d) atractyloside

ANSWER:

ans:D atractyloside

3. Duchhene muscular dystrophy gene has a promoter site mutation, subsequent problem is? 

a) initiation of transcription is defective
b) capping of protein is defective 

c) tailing is defective
d) premature termination 

ANSWER:

ans:A initiation defective

Byler's disease

Progressive familial intrahepatic cholestasis (Byler's disease) ; an autosomal-recessive disorder caused by an error in conjugated bile salt metabolism, with early onset of loose, foul-smelling stools; jaundice; hepatosplenomegaly; and dwarfism.

The onset of the disease is usually before age 2, but patients have been diagnosed with PFIC even into adolescence.

Initial treatment is supportive, with the use of agents to treat cholestasis and pruritus, including the following:

• Ursodeoxycholic acid
• Cholestyramine
• Rifampin
• Naloxone, in refractory cases

Patients should be supplemented with fat soluble vitamins, and occasionally medium-chain triglycerides in order to improve growth.
When liver synthetic dysfunction is significant, patients should be listed for transplantation. Family members should be tested for PFIC mutations, in order to determine risk of transmission.


source: http://medical-dictionary.thefreedictionary.com/Byler's+disease
and http://en.wikipedia.org/wiki/Progressive_familial_intrahepatic_cholestasis

Ebstein's anomaly

Ebstein's anomaly is a congenital heart defect in which the opening of the tricuspid valve is displaced towards the apex of the right ventricle of the heart.


The annulus of the valve is still in the normal position. The valve leaflets, however, are to a varying degree, attached to the walls and septum of the right ventricle. There is subsequent 'atrialization' of a portion of the morphologic right ventricle (which is then contiguous with the right atrium). This causes the right atrium to be large and the anatomic right ventricle to be small in size.


There is an enlargement of the aorta which may cause an increased risk of abnormality in infants of women taking lithium during the first trimester of pregnancy (though some have questioned this) and in those with Wolff-Parkinson-White syndrome.

Pathological specimen and ultrasound image of a heart with Ebstein's anomaly. Abbreviations: RA: Right atrium; ARV: Atrialized right ventricle; FRV: Functional right ventricle; AL: Anterior leaflet; SL: Septal leaflet; LA: Left atrium; LV: Left ventricle; asterisk: grade II tethering of the tricuspid septal leaflet




 source: wikipedia

Trilogy of Fallot

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The Trilogy of Fallot is a congenital heart condition.

It consists of the following :

• pulmonary valve stenosis 
• right ventricular hypertrophy 
• atrial septal defect 

The first two of these are also found in the tetralogy of Fallot.

However, the tetralogy has a ventricular septal defect(VSD) instead of ASD, and it also involves an overriding aorta.

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Tetralogy of Fallot

Tetralogy of Fallot is a congenital heart defect which is classically understood to involve four anatomical abnormalities (although only three of them are always present). It is the most common cyanotic heart defect, and the most common cause of blue baby syndrome.

                           Diagram of a healthy heart and one suffering from tetralogy of Fallot



Tetralogy is:
1. Infundibular PS
2. RVH
3. Overriding Aorta (it over rides VSD)
4. Perimembranous VSD


Cause: because of improper rotation of Truncus Arteriosus over heart(bulbous cordis)
Can also be genetic: Mutation..Catch 22
                                  As a part of: a. Poland Syndrome
                                                      b. Goldenhar syndrome

C/f : 1. Central cyanosis
        2. Polycythemia
        3. Clubbing
        4. Iron defficiency
        5. Cynotic spells/squating episodes

Complications: 1. Brain abcess
                          2. Thromboembolic phenomenon

On Examination: 1.Single S2
                          2. Normal Size Heart

Chest X-ray : Boot shape heart (coer en sabot)

ECG : RVH and P-Pulmonale

T/t: For Cynotic spells: 1. Put in knee chest position
                                   2. Give O2
                                   3. Na Bicarbonate
                                   4. Morphine
                                   5. Increase systemic vascular resistance by Phenylephrine/Ketamine
                                   6. Decrease dynamic spasm by Propranolol.

Palliative shunt: MC is Blalock Tausig Shunt (Pulmonary artery to Subclavian artery)

Definitive Treatment: at 3-6 months age

CHF is rare in TOF but if TOF is associated with anaemia or myocarditis then there can be CHF with it.

TGA

Transposition of the great vessels (TGV) is a group of congenital heart defects (CHDs) involving an abnormal spatial arrangement of any of the primary blood vessels: superior and/or inferior vena cavae (SVC, IVC), pulmonary artery, pulmonary veins, and aorta. CHDs involving only the primary arteries (pulmonary artery and aorta) belong to a sub-group called transposition of the great arteries (TGA).



In a normal heart, oxygen-depleted blood is pumped from the right side of the heart, through the pulmonary artery, to the lungs where it is oxygenated. The oxygen-rich red blood then returns to the left heart, via the pulmonary veins, and is pumped through the aorta to the rest of the body, including the heart muscle itself.
Transposed vessels can present a large variety of atriovenous, ventriculoarterial and/or arteriovenous discordance. The effects may range from a change in blood pressure to an interruption in circulation, depending on the nature and degree of the misplacement and which vessels are involved.
Although "transposed" literally means "swapped", many types of TGV involve vessels that are in abnormal positions, while not actually being swapped with each other. The terms TGV and TGA are most commonly used in reference to dextro-TGA (d-TGA) – in which the arteries are in swapped positions; however, both terms are also commonly used, though to a slightly lesser extent, in reference to levo-TGA (l-TGA) – in which both the arteries and the ventricles are swapped; while other defects in this category are almost never referred to by either of these terms.


Source: wikipedia

X-ray showing characteristic finding in case of Transposition of the great vessels which is called egg on side sign.

Halothane metabolism

Halothane metabolism causes formation of all the following except which?:

a.	Bromide
b.	Chloride
c.	Iodine
d.	Trichloroacetic acid

ANSWER:

answer: C
There is no iodine in halothane, which has the chemical structure: CF3CHCLBr.

Munro's microabscess

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Munro's microabscess are intraepithelium abscesses and associated with psoriasis.
It is also associated with seborrheic dermatitis.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Itegrase inhibitor

Which of the following is the itegrase inhibitor approved for treatment of HIV
a. Raltigravir
b. Lopinavir
c. Tipranavir
d. Fosamprenavir

ANSWER:

Ans: A
this is a new drug approved for the treatment of advanced HIV in combination with other anti-HIV durgs

Autosomal dominant diseases

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Autosomal dominant diseases

A- Adult polycystic kidney disease

D- dystrophia myotonica (CTG repeat)
O- osteogenesis imperfecta, osler-weber-rendu disease
M- marfans syndrome , MEN
I-  intermittent porphyria
N- neurofibramatosis , Nail patella syndrome
A- achondroplasia
N- noonans syndrome
T- tuberous sclerosis

V-von willibrands disease/ von hippel lindau
&
3H---
H- Hypercholestrolemia
H- Huntingtons
H- hereditary spherocytosis

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SCID

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Severe combined immunodeficiency (SCID), or 
Bubble Boy Syndrome, (also known as 
"Alymphocytosis," 
"Glanzmann–Riniker syndrome," 
"Severe mixed immunodeficiency syndrome," and 
"Thymic alymphoplasia") 
is a genetic disorder in which both "arms" (B cells and T cells) of the adaptive immune system are crippled, due to a defect in one of several possible genes. SCID is a severe form of heritable immunodeficiency.





 source: http://en.wikipedia.org/wiki/Severe_combined_immunodeficiency

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Diffusion MRI

---

Diffusion MRI is a magnetic resonance imaging (MRI) technique that exploits characteristics of water diffusion. 

Diffusion weighted imaging (DWI) helps to image changes in the random motion (brownian) of water molecules.

There is inverse relation of water diffusion in ECF (extracellular) and ICF (intracellular). Cells having high NC ratio (nucleus-to-cytoplasm ratio) and high cellurarity tissues have large IC volume, therefore reduced EC volume which result in reduced diffusion of water molecules -- termed Restricted diffusion.

Restricted diffusion: increased signal intensity (hyperintensity) on DWI and low signal intensity (hypointense) on apparent diffusion coefficient (ADC) maps.

Points to remember for MCQs

Restricted diffusion is seen in :

1. Acute Infarct (because of Cytotoxic edema)
2. Epidermoid
3. Abcess
4. High cellularity tumors

Mimic:
T2 shine through: Hyperintense on both DWI and ADC, is not Restricted diffusion.

---

References:
1. Haaga JR, Boll D. CT and MRI of the whole body. Mosby. (2009) ISBN:0323053750. Read it at Google Books - Find it at Amazon

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DICOM

Digital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format. The National Electrical Manufacturers Association (NEMA) holds the copyright to this standard. It was developed by the DICOM Standards Committee, whose members are also partly members of NEMA.



^{source: http://en.wikipedia.org/wiki/Digital_Imaging_and_Communications_in_Medicine}

Ques on rinne's and fistula test

Q.38 yr old male presented with suspected diagnosis of supurative labrynthitis. Positive rinne and fistula test were recorded. Pt refused treatment and returned 2 wk later with complains of deafness in affected ear. O/e fistula test was negative. Rinne test when repeated will be
A true positive
B false positive
C true negative
D false negative

ANSWER:

answer: D
initially the suppurative labrynthitis caused SN deafness so rinne's +ve.
2wks later due to condition progressing to dead ear , the rinne's will come false negative i.e the a bone conduction response will come from the opposite ear instead.
Also in dead ear fistula test comes negative.

Hcg

Appears in urine of a pregnant women 8-11 days after conception or within 6 wks from LMP

It reaches maximum at 10wks=70days
then it declines and after 12wks its presence in urine is not reliable sign.

Ossification in fetus

Q.Ossification in fetus starts in
a.First week of intrauterine life
b.Third week of intrauterine life
c.Fifth week of intrauterine life
d.Fifth month of intrauterine life

ANSWER:

answer: C 5th week

Clutton's joints

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Clutton's joints is a term describing the finding of symmetrical joint swelling seen in patients with congenital syphilis. It most commonly affects the knees, presenting with synovitis and joint effusions (collections of fluid within the joint capsules) lasting up to a year. It has also been reported affecting the ankles, elbows, wrists and fingers. It is usually painless, although pain in the absence of trauma can occur in a few cases. There is usually no disability associated with the joint swelling, and recovery is usually complete. It occurs between 5 and 20 years of age in both sexes.

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MC joints affected in osteoarthritis

---

Based on x-ray evidence, the distal and proximal interphalangeal joints of the hand are most commonly affected by osteoarthritis, though they do not usually exhibit typical symptoms associated with the disease.

The hips and knees are the next most common sites of osteoarthritis and are almost always symptomatic.
The first metatarsal phalangeal and carpometacarpal joints also are common sites of osteoarthritis observed on x-ray but the shoulder, elbow, wrist, and metacarpophalangeal joints are rare sites of osteoarthritis unless related to injury or trauma.

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Info from , Read complete article at : http://osteoarthritis.about.com/od/osteoarthritis101/a/what_is_OA.htm

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Congenital diaphragmatic hernia (CDH)

Congenital diaphragmatic hernia (CDH) is a congenital malformation (birth defect) of the diaphragm. The most common type of CDH is a Bochdalek hernia; other types include Morgagni's hernia, diaphragm eventration and central tendon defects of the diaphragm. Malformation of the diaphragm allows the abdominal organs to push into the chest thereby impeding proper lung formation.
CDH is a life-threatening pathology in infants, and a major cause of death due to two complications: pulmonary hypoplasia and pulmonary hypertension.
Bochdalek hernia
The Bochdalek hernia, also known as a postero-lateral diaphragmatic hernia, is the most common manifestation of CDH, accounting for more than 95% of cases.In this instance the diaphragm abnormality is characterized by a hole in the postero-lateral corner of the diaphragm which allows passage of the abdominal viscera into the chest cavity. The majority of Bochdalek hernias (80-85%) occur on the left side of the diaphragm, a large proportion of the remaining cases occur on the right side, and a small fraction are bilateral i.e., left and right sided defects.
Morgagni's hernia
This rare anterior defect of the diaphragm is variably referred to as Morgagni’s, retrosternal, or parasternal hernia. Accounting for approximately 2% of all CDH cases, it is characterised by herniation through the foramina of Morgagni which are located immediately adjacent to the xiphoid process of the sternum.The majority of hernias occur on the right side of the body and are generally asymptomatic; However newborns may present with respiratory distress at birth similar to Bochdalek hernia. Additionally, recurrent chest infections and gastrointestinal symptoms have been reported in those with previously undiagnosed Morgagni's hernia. In asymptomatic individuals laparoscopic surgical repair is still recommended as they are at risk of a strangulated intestine.

Anti LKM antibodies

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LKM stands for liver kidney microsomal antibodies
Anti LKM 1 antibodies-----Chronic Hepatitis C , auto immune hepatitis type 2
Anti LKM 2 antibodies-----Drug induced hepatitis
Anti LKM 3 antibodies-----Chronic hepatitis D

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Ohngern’s

Ohngern’s classification is used for
a. Ca maxillary sinus
b. Ca nasopharynx
c. Ca oropharynx
d. Ca tongue

ANSWER:

Answer: A
a line from medial canthers to angle of mandible divides maxilla, used for staging of Ca maxillary sinus.

Therapy of toxoplasmosis

Q.Which of the following is used in the therapy of toxoplasmosis?
a. Artensenuate
b. Ciprofloxacin

c. Pyrimethamine
d. Thiacetazone  

ANSWER:

Answer: C
Toxoplasma gondii is an obligate intracellular parasite. It is one of the most common human parasites in the world. Combination of pyrimethamine and a sulfonamide is effective against acute toxoplasmosis in immunocompetent adults. These 2 drugs work synergistically against the tachyzoite form of T gondii. As an alternative to sulphonamides, clindamycin may be beneficial when used in combination with pyrimethamine.

Calcium dipicolinate

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Q.Calcium dipicolinate is found in

a. Aspergillus
b. Bacillus
c. Escherichia
d. Rickettsia

ANSWER:

Ans:B .. Dipicolinic acid is exclusively found in bacterial spores.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Liraglutide

---

Liraglutide is a long-acting glucagon-like peptide-1 (GLP-1) analog that has been developed for the treatment of type 2 diabetes.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Cell bodies

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Q.Cell bodies of serotonin releasing neurons are located in

A.Raphe nuclei
B.Locus ceruleus
C.Cingulate cortex
D.Basal forebrain

ANSWER:

Ans.A.Raphe nuclei

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

PROVENGE

---

Q. PROVENGE is a vaccine treatment for which of the following cancer

a. hepatoma
b. multiple myeloma
c. prostate cancer
d. hodgkin lymphoma

ANSWER:

answer: C
Provenge (generic name sipuleucel-T) is an immunotherapy for prostate cancer manufactured by Dendreon. It received U.S. Food and Drug Administration (FDA) approval for use in the treatment of advanced prostate cancer patients on April 29, 2010. It is the first FDA approved drug in its class.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Boiled lobster syndrome

---

Q.  “Boiled lobster syndrome” is seen in poisoning with:

a. Hydrochloric acid
b. Boric acid
c. Oxalic acid
d. Chromic acid

ANSWER:

Ans: B in boric acid poisoning, the major symptom is erythema, desquamation and exfoliation. The skin of the patient looks like a boiled lobster.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Adult size before birth

---

Q. Which of the following attains adult size before birth?

a. Ear Ossicles
b. Maxilla
c. Mastoid
d. Parietal bone

ANSWER:

Ans: A

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Ether demonstration

---

Q. Ether demonstration was done by morton in

a)1800

b)1846

c)1946

d)1956

ANSWER:

ans: 1846

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Thrombosis

---

Q.Which of the following does not predispose to thrombosis?
a. homocystinuria
b. Hypomagnesaemia
c. Paroxysmal nocturnal haemoglobinuria
d. Polycythaemia

ANSWER:

answer: B
The other three are associated with both arterial and venous thrombi.
Other important causes include antiphospholipid syndrome and oral contraceptive pill.
Important inherited conditions which lead to recurrent venous thromboses are
1.Factor 5 Leiden
2.Protein C
3.Protein S and
4.Antithrombin 3 deficiency.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Portal of entry of an Aspergillus

---

Q.What is the most probable portal of entry of an Aspergillus?

a. Blood
b. GIT
c. Lungs
d. Punture wound

ANSWER:

answer : C
Aspergillus species are ubiquitous in nature and large numbers of conidia or spores are dispersed in the air so that inhalation is inevitable.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Likelihood ratio

---

Likelihood ratio = sensitivity / 1-specificity

• Sensitivity is true positivity (req. more for screening tests)

• Specificity is true negativity (req. more for diagnostic tests)

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Remember *1000 and *100 (PSM)

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CDR , CBR , Incidence -------------------------------per 1000

and

CFR , Secondary Attack Rate , Prevalance------------per 100

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Disability means

---

Q. As per PDA act, all of the following are the disability except

a.Blindness
b.Deafness
c.Dumbness
d.Leprosy cured

ANSWER:

answer: C-Dumbness

"Disability" means-

(I) Blindness;

(ii) Low vision;

(iii) Leprosy-cured;

(iv) Hearing impairment;

(v) Loco motor disability;

(vi) Mental retardation;

(vii) Mental illness

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Phakomatoses (or "neurocutaneous syndromes")

---

 Phakomatoses / Phakomatosis (or "neurocutaneous syndromes") 

Conditions included are:

• Neurofibromatosis 
• Tuberous sclerosis
• Ataxia telangiectasia
• Sturge-Weber syndrome
• von Hippel-Lindau disease
• Incontinentia pigmenti
• Nevoid basal cell carcinoma syndrome

 Important points commonly asked in various examinations : 

 1. Neurofibromatosis -  inheritance AD

NF1 (Most common phakomatosis) = von Recklinghausen disease	NF2
Mutation - Chromosome 17 : Neurofibromin gene	Chromosome 22  : Merlin gene = schwannomin
Other MCQ points –(findings / associations) Cafe au lait spots Neurofibromas Optic nerve gliomas Lisch nodules (Iris hamartomas) Axillary or inguinal freckling Sphenoid wing dysplasia	Other MCQ points –(findings / associations) Schwannomas (Usually bilateral – 90% ) Meningiomas Ependymomas Mnemonic STEM where T is for TWO (NF2) About 70% of NF2 patients also have skin tumours.

 2. Tuberous sclerosis (Bourneville disease)  - inheritance AD

Triad :

• Mental retardation
• Epilepsy
• Adenoma sebaceum

Other MCQ points : (findings / associations)

• Ash leaf spots
• Shagreen patches (Connective tissue nevi , yellowish, over lumbar region) 
• Systemic hamartomas ( brain , retina , viscera )
• Subependymal giant cell astrocytoma. (near foramen of monro)

 3. Sturge-Weber syndrome (Encephalofacial angiomatosis) 

MCQ points : (findings / associations)

• Naevus flammeus (Port wine stain - on the forehead and upper eyelid of one side of the face )
• Hemangiomas - Choroidal , Meningeal
• Congenital glaucoma
• Epilepsy
• CT scan - Cortical atrophy , Tram track calcifications.

 4. von Hippel-Lindau disease  -inheritance AD

Gene mutation : Chromosome 3p25 (same gene is mutated in Sporadic RCC)

MCQ points : (findings / associations)

• Capillary hemangiomas of retina or optic nerve head
• Hemangioblastoma of cerebellum , spinal cord , medulla or pons.
• Tumours - renal carcinoma and phaeochromocytoma 
• Cysts - kidneys, liver, pancreas, epididymis, ovary and lungs 
• Polycythaemia

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Unfavorable position for a vaginal delivery

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Q.Most unfavorable position for a vaginal delivery is ?
A) Deep transverse arrest
B) Mentoanterior
C) Mentoposterior
D) Occipitoposterior

ANSWER:

Answer: C
mentoposterior position has no mech. of labour for vaginal delivery

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Congenital pyloric stenosis

---

Q.Which of the following does not occur with chronic pyloric stenosis 

A)Acid urine

B)alkaline urine

C)hypokalemia

D)hypochloremia.

ANSWER:

Answer: B
in pyloric stenosis there is paradoxical aciduria in alkalotic patient

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Tooth

---

Q. The last primary tooth to be replaced by a permanent tooth is usually ?

A) Maxillary canine

B) Mandibular canine

C) Maxillary first molar

D) Mandibular second molar

ANSWER:

answer: D
note that all the options in this ques mean deciduous/temporary/primary teeth
these are replaced as
1. 1st molar -------- by 1st premolar at 9-10 yrs
2. canines----------- by canines at 10-11 yrs
3. 2nd molar -------- by 2nd premolar at 11-13yrs
also there are no primary teeth after 11-13 yrs of age.....i.e all teeth then are permanent ones

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Intramedullary spinal cord lesions (important)

---

Q. Intramedullary spinal cord lesions are characterised by all except

a.Early bladder involvement

b.Dissociated sensory deficits

c.Sacral sparing

d.Root pains

ANSWER:

answer: D--root pain...seen in extramedullary
explanation
intramedullary lesions like astrocytoma and ependymoma will not disturb the roots,
1.also these interfere with the crossing fibers of lat. spiothalmic tract and so will lead to loss of pain and temperature but the posterior column remains intact---thus Dissociated sensory deficits...
2.early bladder involvement is cuz the bladder contorl fibers are from intermidiate or lateral horn which again is in close proximity to intramedullary lesion
3.sacral sparing is cuz the sacral fibers are placed laterally in spinothalmic tracts...so these are affected by lesions from outside(extramedullary)
:--extramedullary lesions press the cord from outside so they will also disturb roots leading to root pain

 

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Intrapleural pressure negative

---

Q. Why is intrapleural pressure negative?

a) alveolar pressure negative

b) surfactant is equally distributed

c) lymphatic drainage

d) upper airway ring cartilage

ANSWER:

Ans: C
Causes of negativity of Intrapleural pressure
Lymphatic system drains the pleural fluid, generating a negative intra pleural pressure (- 2 mm Hg)
Elasticity of lungs causes them to assume smallest possible size. But opposing force – elasticity of the chest wall pulls the thorax outward to enlarge the lungs.

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