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    Dr. Paresh Koli
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    AIPGMEE 2007 Rapid Review cover

    Anatomy

    1. Primordial germ cell is derived from Ectoderm.

    2. Movement of supination and pronation occurs in superior radio-ulnar joint, middle radioulnar joint and inferior radio-ulnar joint.

    3. Posterior cruciate ligament prevents posterior dislocation of tibia.

    4. Structures that pass from thorax to abdomen behind diaphragm includes azygos vein, aorta and thoracic duct.

    5. Most common site of Morgagni hernia is right anterior.

    6. Left gonadal vein does not cross midline.

    7. Portosystemic shunt is not seen in spleen.

    8. Injury to the male urethra below the perineal membrane causes urine to accumulate in superficial perineal pouch.

    9. In trigone of bladder mucosa is smooth, it is lined by transitional epithelium and it is derived from absorbed part of mesonephric duct.

    10. Supports of uterus includes uterosacral ligament, Mackenrodt’s ligament and levator ani.

    11. Posterior communicating artery is a branch of internal carotid.

    12. Branches of cavernous segment of internal carotid artery includes cavernous branch, inferior hypophyseal artery and meningeal branch.

    13. Difference between typical cervical and thoracic vertebra is that later has a foramen transversarium.

    14. Cervical part of vertebral canal will show secondary curves with concavity backwards.

    Physiology

    1. Agranular endoplasmic reticulum is involved in synthesis of Lipids.

    2. Factor VII is present present in both serum and plasma.

    3. Site of RBC formation in 20 year old healthy male is flat bones.

    4. 4th heart sound ‘S4’ is heard during ventricular filling phase.

    5. Heart muscle acts as syncytium, has gap junctions and has branching.

    6. Broca’s area is concerned with word formation.

    7. Nucleus involved in Papez circuit is anterior nucleus of thalamus.

    8. Mechanism of hearing and memory includes changes in level of neurotransmitters, increase in protein synthesis and spatial reorganization of synapse.

    9. Processing of short term memory to long term memory is done in Hippocampus.

    10. Delta waves are seen in deep sleep.

    11. Toxic effects of high oxygen tension includes pulmonary edema, retinal damage and CNS excitation and convulsions.

    12. Decreasing workload and increasing duration of exercise are apt to increase work capacity at high altitude.

    13. Intestinal motility is increased by distension, acetylcholine and cholecystokinin.

    14. Renin. Erythropoietin and 1, 25 DHCC are secreted by kidneys.

    15. Difference in age of onset of puberty among male compared to women can be explained by increased inhibin levels.

    Biochemistry

    1. Oxygenases incorporates 1 or 2 atoms of oxygen and required for hydroxylation of steroids.

    2. Treatment of multiple carboxylase deficiency is Biotin.

    3. Basement membrane degeneration is mediated by Metalloproteinases.

    4. Pepsin is stable at acidic pH.

    5. Chondroitin sulfate in a proteoglycan, Proteoglycans are made up of sugar and amino acids and carry charge.

    6. Protein purification and separation can be done by Chromatography, centrifugation and electrophoresis.

    7. Study of multiplication o proteins in disease process is called Proteomics.

    8. Protein that precipitates on heating to 45 degree C and redissolved on boiling is Bence Jones protein.

    9. Northern blot test is used or separation of mRNA.

    10. In cytosolic eukaryotic gene expression capping helps in attachment of mRNA to 40S ribosome, EF2 shifts between GDP and GTP and releasing factor releases the polypeptide chain from the P site.

    11. CAP in Lac operon is an example of Positive regulator.

    12. C terminal end of androgen receptor is concerned with Ligand binding.

    13. Kreb’s cycle, fatty acid oxidation and electron transport chain occurs in mitochondria.

    14. HMP shunt occurs in cytosol, no ATP is produced in it and it is active in adipose tissue, liver and gonads.

    15. Within RBC, hypoxia stimulated glycolysis by stimulating release of all glycolytic enzymes from Band on RBC membrane.

    16. Dinitrophenol causes uncoupling of oxidation and phosphorylation.

    17. Triacylglycerols in adipose tissue is synthesized from Dihydroxyacetone phosphate, enzyme glycerol phosphate dehydrogenase plays an important role and phosphatidate is hydrolyzed.

    Pathology

    1. Earliest transient change following tissue injury will be Neutrophilia.

    2. Oxygen dependent killing is done through NADPH oxidase.

    3. Factor present in final common terminal complement pathway is C5.

    4. Immunoglobulin involved in type I hypersensitivity reaction is IgE.

    5. Arthus reaction is localized immune complex type of hypersensitivity reaction.

    6. Protein defects which can cause hereditary spherocytosis includes Ankyrin, palladin and anion transport protein.

    7. ALL L3 morphology is a malignancy arising from mature B cell lineage.

    8. Non-specific esterase is positive in M3, M4 and M5 categories of AML.

    9. Bone marrow in AL amyloidosis shows bone marrow plasmacytosis.

    10. In a diabetic patient who has undergone dialysis, aspiration done around knee joint would show a beta 2 microglobulin.

    11. Rectal biopsy is the best method to confirm amyloidosis.

    Microbiology

    1. Nutrient broth is a basal medium.

    2. Urine examination of young man with UTI shows pus cells but no organisms. Best method for culture would be McCoy culture.

    3. Component of innate immunity active against viral cells is NK cells.

    4. Culture from skin lesion of child showed gram positive cocci in chains and hemolytic colonies. Test which will best identify the organism is Bacitracin sensitivity.

    5. A patient in ICU on central line for a week is on ceftazidime and amikacin. After 7 days of antibiotics he develops a spike of fever and his blood culture is positive or gram positive cocci in chains which are catalase negative, vancomycin started but culture remained positive for same organism even after 10 days of therapy. Most likely organism is Enterococcus faecalis.

    6. Pustule shows gram positive cocci on smear, beta hemolysis on culture and is catalase negative. To identify organism is group A streptococci, Bacitracin sensitivity should be done.

    7. Vibrio cholerae is non halophilic, grows on simple media and man is only natural host but it cannot survive in extracellular environment.

    8. Vibrio cholerae by increasing cAMP.

    9. In V. cholerae O139, clinical manifestations are similar O1 el tor strain, 1st discovered in chennai and epidemiologically indistinguishable from O1 el tor strain.

    10. Elderly male patient presented with fever, chest pain and dry cough, sputum culture showed growth on Charcoal yeast medium. Organism is Legionella.

    11. Person working in an abattoir presented with papule on hand which turned into ulcer. Best help in diagnosis will be Trichrome methylene blue.

    12. Brucella is transmitter by through placenta of animals, aerosol transmission and eating uncooked food.

    13. Botulinum toxin affects neuromuscular junction, preganglionic junction and postganglionic nerves.

    14. Bacteroides fragilis is a frequent anaerobe isolated from clinical samples, is not uniformly sensitive to metronidazole and LPS formed by Bacteroides fragilis is structurally and functionally different from conventional endotoxins.

    15. Chlamydia trachomatis is biphasic, reticulate body divides by binary fission and inside cell it evades phagolysome.

    16. Chlamydia psittacosis is acquired from bird’s droppings, causes pneumonia and treatment is tetracycline.

    17. Rabies is identified by Negri bodies.

    Pharmacology

    1. Hyperglycemia, detrusor relaxation and relaxation of gut and bronchial muscles may be associated with Beta2 agonist treatment.

    2. Hyperglycemia, tachycardia and relaxation of uterine muscles may be associated with use of beta agonist in preterm labour.

    3. Carvedilol and Labetalol are nonselective beta blockers with additional actions.

    4. Clonidine increases parasympathetic outflow, decreases sympathetic outflow outflow by blocking central alpha receptor and used in hypertension.

    5. Finasteride is a 5 alpha reductase inhibitor.

    6. Apomorphine, Alprostadil and PGE1 analogues may be used in erectile dysfunction.

    7. Orlistat and Sibutramine are used in obesity.

    8. Montelukast is a leukotriene antagonist.

    9. PGE1 agonist is beneficial in NSAID induced gastric ulcer.

    10. Estrogen, glucocorticoids and Vitamin D have receptor.

    11. Short and rapid acting insulins includes Lispro, Aspart and Glulisine insulin.

    12. Octreotide suppresses growth hormone secretion, useful for variceal bleeding and in secretory diarrhea.

    13. Antiepileptic drugs includes Phenytoin, Topiramate and Carbamazepine.

    14. Antiepileptic drugs, Phenytoin, Valproate and Lamotrigine act via Na+ channel.

    15. Nesiritide is a Brain natriuretic peptide analogue.

    16. PT 26, control PT 13 seconds and sensitivity index 1.41 then INR is (26/13)^1.41.

    17. Ticlopidine and Clopidogrel is a prodrug.

    18. Heparin causes alopecia, is non-teratogenic and it releases lipoprotein lipase.

    19. GpIIb/IIIa antagonists includes Abciximab, Tirofiban and Eptifibatide.

    20. Cotrimoxazole, Ciprofloxacin and Vancomycin are useful in MRSA but not Cefaclor.

    21. Orange coloured urine is due to Rifampicin.

    22. Nevirapine belongs to NNRTI.

    23. Stavudine has maximum propensity to cause peripheral neuropathy.

    24. Tacrolimus inhibits calcineurin pathway.

    25. Steroids binds to cytosolic receptors and heat shock proteins.

    26. Sirolimus will block kinase in the IL2 receptor pathway.

    27. Alkylating agents includes Cyclophosphamide, Busulfan and Chlorambucil.

    28. Decitabine Acts by hypomethylation.

    29. L asparaginase causes hypercoagulability.

    30. Methotrexate is used in high doses in Osteosarcoma.

    31. Filgrastim is used in treatment of Neutropenia.

    Forensic Medicine

    1. Spalding sign is seen in Maceration.

    2. Burtonian line is seen with poisoning of Lead.

    3. Acrodynia is associated with Mercury.

    4. Mercury will affect PCT in kidney.

    5. Drug of choice in mushroom poisoning is Atropine.

    6. TIK 20, Malathion and Folidol are aryl phosphates.

    PSM

    1. Physical quality of life index (PQLI) includes infant mortality rate, life expectancy at age 1 and literacy rate.

    2. 85% of lung cancer among smokers was due to their smoking. This is an example of Attributed risk.

    3. Herd immunity is most commonly due to subclinical infection, can be acquired by immunization and spread of epidemic is influenced by it.

    4. DPT, BCG and OPV vaccines are included in EPI schedule but MMR is not.

    5. Chronic carrier state is seen in Diphtheria, Typhoid and Gonorrhea.

    6. Least common complication of measles is SSPE.

    7. Under eradication o congenital rubella syndrome program the 1st group for rubella vaccination is all nonpregnant women of age 15-34 years.

    8. Strategies for prevention of Neonatal tetanus includes 5 clean practices, 2 doses of TT to all pregnant women and immunizing all married women.

    9. WHO recommends Danish 1331 strain for vaccine production.

    10. Case finding in RNTCP is based on Sputum microscopy.

    11. Lepromin test is negative in most children in 1st 6 months of life, is an important aid to classify type of leprosy disease and BCG vaccination may convert lepra reaction from negative to positive.

    12. Trench fever, Relapsing fever and Epidemic typhus is transmitted by lice.

    13. Flea is a vector of endemic typhus.

    14. SAFE strategy includes antibiotics, facial hygiene and environmental modification.

    15. Causes of blindness in children in India includes malnutrition, ophthalmia neonatorum and glaucoma.

    16. BMI to classify obesity should be >=30.

    17. Impact and efficiency of iodine control program can be estimated by Neonatal thyroxine levels.

    18. Compared with cow’s milk, mother’s milk has more Lactose.

    19. Highest percentages of polyunsaturated fatty acids are present in Soya bean oil.

    20. Chlorine demand is measured by Horrock’s apparatus.

    21. Cytotoxic waste, anatomical waste and infectious waste can be incinerated.

    22. Direct standardization is used to compare mortality rates between two countries. This is done because of difference in Age distribution.

    23. Major purpose of randomization in clinical trials is to reduce selection bias in allocation of treatment.

    24. Cluster sampling is a rapid and simple method, the sample size may vary according to study design and is a type probability sample.

    25. If data is arranged as satisfied, very satisfied and dissatisfied, it is Ordinal data.

    26. For SLE 6 tests were carried out, out of which 4 tests have come positive and 2 are negative. To determine probability of SLE at this point, needed things are prior probability of SLE, sensitivity and specificity of each test.

    Medicine

    1. Increased TIBC, decreased serum ferritin are diagnostic of iron deficiency anemia.

    2. Normotensive with normal hemoglobin suffered massive blood loss. Findings would be increased MCV, thrombocytosis and reticulocytosis.

    3. Autoimmune hemolytic anemia is associated with malignancy of B cell lineage.

    4. Pancytopenia with cellular marrow is seen in PNH.

    5. Pancytopenia with hypercellular bone marrow is seen in PNH and Megaloblastic anemia.

    6. Bone marrow biopsy is an absolute indication in Hairy cell leukemia.

    7. In PML, retinoic acid is used in treatment, 15/17 translocation may be seen and associated with disseminated intravascular coagulation (DIC).

    8. 80 year old asymptomatic man with TLC 1 lakh with 80% lymphocytes and 20% PMCs. Most probable diagnosis is CLL.

    9. Mycosis fungoides is the most common form of cutaneous lymphoma, Pautrier’s microabscess and erythroderma seen and spreads to peripheral circulation.

    10. Erythropoietin is increased in hepatocellular carcinoma, renal cell carcinoma and cerebellar hemangioblastoma.

    11. Patient on Aspirin will show, prolonged PT, Prolonged APTT and Prolonged CT.

    12. In DIVC there is increased FDP, prolonged PT and reduced platelets.

    13. In Bernard soulier syndrome there is aggregation with collagen and ADP is normal, large platelets and thrombocytopenia.

    14. ESR, X-ray and bone marrow biopsy are useful investigations in Multiple myeloma and Bone scan is least useful.

    15. ECG findings in hypokalemia includes increased PR interval with ST depression.

    16. CCF is associated with increased in right atrial mean pressure, serum urea and serum norepinephrine.

    17. Person with MR and syncope presents with syncope, HR is 55. Most probable cause is Digitalis toxicity.

    18. Immediate treatment modality in a patient with acute anterior wall infarction and hypotension is angiography and primary angioplasty.

    19. 70-year-old man with pneumonia and septicemia goes into renal failure and BP of 70/50 mm Hg. Drug that could be used to maintain BP is norepinephrine.

    20. A patient presents with decreased vital capacity and total lung capacity. Most probable diagnosis is Sarcoidosis.

    21. Commonly used regimens against H. pylori includes Amoxicillin, Bismuth subcitrate and Omeprazole.

    22. Best method to detect presence of residual H. pylori infection in a patient who has been treated with drugs for it is Urea breath test.

    23. Patient with chronic small bowel diarrhea, duodenal biopsy showed villous atrophy. Anti endomysial antibodies and IgA TTG antibodies are positive. Treatment of choice is Gluten free diet.

    24. Test used to diagnose Dubin Johnson syndrome is Bromsulphalein test (BSP).

    25. Most common cause of nephrotic range proteinuria in adult is diabetes mellitus.

    26. 30-year-old with generalized edema, hypertension, subnephrotic proteinuria (<2 gm), microscopic hematuria, decreased serum complement levels and anti-hepatitis C antibodies positive. Most likely diagnosis is Membranoproliferative glomerulonephritis (MPGN).

    27. 60-year-old woman with generalized edema, skin ulceration, hypertension, subnephrotic proteinuria (<2 gm), microscopic hematuria, decreased serum complement levels and positive for anti-hepatitis C antibodies. Likely diagnosis in essential mixed cryoglobulinemia.

    28. Gastrinoma is most commonly seen in MEN I.

    29. PPI is treatment of choice for Zollinger Ellison syndrome (ZES).

    30. SIADH is associated with Vincristine.

    31. Hypophosphatemia is seen in resolving phases of diabetic keto acidosis, respiratory alkalosis/COPD and chronic alcoholism.

    32. C-ANCA positively indicated antibodies formed against Proteinase 3.

    33. Deposition of anti dsDNA antibodies in kidney, skin, choroid plexus and joints is seen in SLE.

    34. Best marker for drug induced lupus is Anti histone antibodies.

    35. Raynaud’s disease is more common in women, it is most common cause of Raynaud’s phenomenon and has good prognosis.

    36. Components of Kawasaki disease includes Pedal edema, Truncal rash and Pharyngeal congestion.

    37. Increased ICT is associated with abducens paralysis, headache and visual blurring.

    38. Pontine stroke is associated with bilateral pinpoint pupil, pyrexia and quadriparesis.

    39. Millard Gubler syndrome include 6th, 7th nerves palsy and contralateral hemiparesis.

    40. In Benedikt’s syndrome there is contralateral tremor, 3rd nerve palsy and involvement of penetrating branch of basilar artery.

    41. Components of Brown Sequard syndrome includes ipsilateral extensor plantar response, ipsilateral pyramidal tract involvement and contralateral spinothalamic tract involvement.

    42. Classical CSF finding seen in TBM includes increased protein, decreased sugar and increased lymphocytes.

    43. Organs that may be involved in Leprosy includes ovary, testes and eye.

    44. Treatment of severe ulnar neuritis is borderline tuberculosis leprosy is n MDR + steroid.

    Surgery

    1. Chronic burrowing ulcer is caused by Microaerophilic streptococci.

    2. Histological variant of thyroid neoplasm includes Follicular, Insular and Anaplastic.

    3. Lymphoma of thyroid is more common in women, is clinically confused with undifferentiated tumours and may present with respiratory distress and dysphagia.

    4. CEA is marker of Paget’s disease of mammary glands.

    5. Gynaecomastia is seen in liver disease, in it there may be estrogen/ testosterone imbalance and can be drug induced.

    6. Preferred incision for abdominal exploration in Blunt injury of abdomen is always midline incision.

    7. Gastric injury is mostly related to penetrating trauma, treatment is simple debridement and suturing and heals well and fast.

    8. Patient with traumatic injury to major abdominal vessels has been planned to explore suprarenal aorta, celiac axis, superior mesenteric artery and left renal artery. Recommended manoeuvre for exposure is Left medial visceral rotation.

    9. Premalignant polyps includes Juvenile polyposis syndrome, Familial polyposis syndrome and Peutz jegher syndrome.

    10. Hamartomatous polyp in Peutz Jeghers syndrome has least malignant potential.

    11. External hemorrhoids are painful and are located below dentate line.

    12. Treatment of choice for Pilonidal sinus is surgical excision of sinus tract.

    13. For elderly patient with single episode of gross haematuria, recommended investigations includes Cystoscopy, urine microscopy for malignant cells and intravenous pyelogram.

    14. 60-year-old smoker with h/o painless gross hematuria for 1 day. Most logical investigation would be Urine microscopy for malignant cytology.

    15. A patient with RTA 8 hours back, few drops of blood were noted at external urethral meatus and not passed urine and bladder is palpable per abdomen. Most probable diagnosis is Urethral injury.

    16. 50-year-old diabetic man with poor urinary stream, hesitancy, difficulty in micturition and failure to void completely. Most probable diagnosis is Autonomic neuropathy.

    17. 50-year-old diabetic man with poor urinary stream, increased frequency of micturition and hesitancy. Most likely diagnosis is BPH.

    18. 50-year-old man with family h/o prostate cancer has come for screening. Most sensitive screening test to pick up prostate cancer is DRE + PSA.

    19. Best prognostic factor or head injury is Glasgow coma scale.

    Obstetrics & Gynaecology

    1. Shape of a Nulliparous cervix is Circular.

    2. Fibrinoid uterus may present with pelvic mass, infertility and polymenorrhea.

    3. Most common gestational trophoblastic disease following hydatidiform mole is Invasive mole.

    4. Most common cause of postmenopausal bleeding in Indian woman is Ca cervix.

    5. Most common agent responsible for Ca cervix is HPV 16.

    6. Most common ovarian cys to undergo torsion is benign cystic teratoma.

    7. Non contraceptive benefits of OC pills may be seen in Ca endometrium, Rheumatoid arthritis and Endometriosis.

    8. Pregnancy rate of Lippes loop and Cu-T 200 are similar.

    9. IUD can be used for Emergency contraception within 5 days.

    10. Cu-T 308 A has life span of 10 years.

    11. Antihormonal substance used to induce ovulation is Clomiphene citrate.

    12. Most common site of female tubal sterilization is Isthmus.

    13. Aspiration of sperms from testes is done in TESA.

    14. Maximum cardiac output in pregnancy is seen in immediately postpartum period.

    15. Nuchal translucency at 14 weeks is suggestive of Downs’s syndrome (Trisomy 21).

    16. In a woman of 32 weeks pregnancy, injection Dexamethasone is given to prevent RDS.

    17. Bishops score includes Dilatation, Effacement and Station of presenting part.

    18. On transvaginal sonography (TVS) U shape of cervix indicates imminent preterm labour.

    19. Doppler finding of Reversal of diastolic flow in IUGR is associated with worst prognosis.

    20. External cephalic version (ECV) is contraindicated in PIH.

    21. Caudal regression syndrome is seen in babies of mothers having Gestational diabetes.

    22. Gestational diabetes can lead to large baby.

    23. Hypothyroidism in pregnancy is associated with recurrent abortions, PIH and prematurity.

    24. Antiepileptic not associated with congenital malformation when used in pregnancy is Phenobarbitone.

    25. Treatment of choice for ovarian cyst in a postpartum patient is immediate removal.

    26. Highest transmission of hepatitis B from mother to fetus occurs if the mother is infected during IIIrd trimester.

    Paediatrics

    1. Most probable age of baby who has recently developed mouthing but has not developed stranger anxiety, likes and dislikes for food is 5 months.

    2. 6-year-old child with IQ of 50 should be able to identify colours.

    3. Moro’s reflex disappears at 3 months.

    4. Symmetric tonic neck reflex is not present at birth.

    5. Most common cause of short stature is Constitutional.

    6. Height for age is the best indicator of long term nutrition status.

    7. Most common tumor in children is Leukemia.

    8. Syndromes associated with AML includes Down’s syndrome, Klinefelter’s syndrome and Patau syndrome.

    9. Good prognostic factors for childhood ALL includes hyperdiploid, female sex and t(12:21) translocation.

    10. Fever is a minor criteria for diagnosis of Rheumatic fever (RF) according to modified Jones criteria.

    11. Atrial septal defect (ASD) is a component of Pentalogy of Fallot.

    12. Cardiomyopathy is a feature of DMD, Friedreich’s ataxia and Pompe’s disease but not of Lowe’s syndrome.

    13. Zafirlukast is leukotriene receptor antagonist used in bronchial asthma.

    14. A child with 3 days h/o URTI presents with stridor which decreases on lying down position. Most probable diagnosis is Laryngotracheobronchitis.

    15. Newborn with congenital heart failure which is not improving on treatment, has bulging anterior fontanelles with a bruit on auscultation. On transfontanelle USG a hypoechoic midline mass is seen with dilated lateral ventricles. Most probable diagnosis is Vein of Galen malformation.

    16. Most common organism causing meningitis in a 1 year old child is Streptococcus pneumoniae.

    17. Jitteriness can be distinguished from seizures by sensitivity to stimulus, abnormality of gaze and autonomic disturbance.

    18. A child has Microcephaly, blue eyes, fair skin and mental retardation, ferric chloride test positive. Most likely diagnosis is Phenylketonuria (PKU).

    19. Darkening of urine on standing is associated with Alkaptonuria.

    20. Premature baby of 3 weeks was delivered. Baby developed bullous lesion on skin and x-ray shows periostitis. Next investigation should be VDRL for mother and baby.

    21. Child with drowsiness, decreased deep tendon reflexes, seizures, line on gums and constipation. Most appropriate drug that should be used in this child is EDTA.

    22. Cat eye syndrome is Partial trisomy 22.

    23. Autosomal dominant inheritance is seen in Marfan’s syndrome, Osteogenesis imperfecta and Ehlers Danlos syndrome.

    24. In autosomal recessive disorder, one parent is normal and other is carrier, child is also affected. Reason is Uniparental disomy.

    Orthopaedics

    1. Tube cast is applied in fractures around Knee.

    2. Short wave diathermy, ultrasound therapy and interferential therapy are deep heat therapy but Infrared therapy is not.

    3. Claw hand is caused by lesion involving ulnar nerve.

    4. Meralgia paresthetica is due to involvement of Lateral cutaneous nerve of thigh.

    5. Nerves involved in entrapment neuropathy include Median nerve, ulnar nerve and Lateral cutaneous nerve of thigh.

    6. Bohler’s angle is measured in fractures involving Calcaneum.

    7. Flexion is the most common force involved in fractures of the spine.

    8. Mechanism of violence in burst fracture of spine is compression violence.

    9. Osteoclastoma occurs in epiphysis.

    10. 15-year-old boy with mass in distal femur and x-ray showing features of Codman’s triangle and Sunray appearance. The diagnosis is Osteosarcoma.

    11. Investigations required in Osteosarcoma include MRI femur, CT chest and bone scan but Bone marrow biopsy is not required.

    12. Osteosarcoma is pulsatile tumor of bone.

    13. Alkaline phosphatase is marker of new bone formation.

    14. Laboratory investigation of choice for a patient with heterotopic ossification around knee-joint is Serum alkaline phosphatase.

    15. Quadriceps muscle undergoes wasting in osteoarthritis of knee.

    Ophthalmology

    1. Mucopolysaccharide hyaluronic acid is present in Vitreous humor.

    2. Vitamin C, Glutathione and Catalase handles oxidative damage in lens but VItamin A does not.

    3. Papilledema is extradural hematoma, stasis of axoplasmic flow is present and there is axonal swelling as well.

    4. Cherry red spots are seen in GM1 gangliosidosis, Niemann pick disease and multiple sulfatase deficiency.

    5. Lamina cribrosa is absent in Morning Glory syndrome.

    6. Best disease has Autosomal dominant inheritance.

    7. A child with unilateral proptosis which is compressible, increases on bending forward, non-pulsatile and has no thrill or bruit. MRI shows retro orbital mass with echogenic shadows. Most probable diagnosis is Orbital varix.

    ENT

    1. Rhinolalia Clausa is associated with Allergic rhinitis, adenoids and Nasal polyps.

    2. Rhinophyma is associated with hypertrophy of sebaceous glands.

    3. Common site for CSF Rhinorrhea is Petrous.

    4. CSF rhinorrhea is diagnosed by Beta 2 transferrin.

    5. In Acoustic neuroma 5th cranial nerve is involved earliest.

    6. Brown sign is seen in Glomus tumor.

    7. Facial nerve palsy associated with temporal bone fracture is common with Transverse fractures.

    Skin

    1. Pityriasis Rosea is self-limiting.

    2. Infant with erythematous lesions on cheek, extensor aspect of limbs. Mother has h/o bronchial asthma. Most probable diagnosis is Atopic dermatitis.

    3. Tuberculids is seen in Scrofuloderma.

    Anaesthesia

    1. Procaine is not an amide linked local anaesthetic.

    2. Young boy undergoes eye surgery under day care anaesthesia with succinylcholine and propofol and after 8 hours he starts walking and develops muscle pain. Most likely cause is Succinylcholine.

    3. Elderly male on ventilator has received atracurium infusion for 3 days. He now develops epileptic fits. Probable causes of this is Accumulation of Laudanosine.

    4. Remifentanil is not given intrathecally.

    5. Central Neural (spinal and epidural) anaesthesia is contraindicated in platelets <80,000, patient on oral anticoagulants and raised intracranial pressure but not in patient on aspirin.

    6. Verapamil, Esmolol and Procainamide are used in controlling heart rate intraoperatively.

    7. Non-ventilated preterm baby in incubator in under observation. Best way to monitor baby’s breathing and detect apnea is Impedance pulmonometry.

    Radiology

    1. Investigation of choice for a lesion of temporal bone is CT.

    2. CT brain of young unconscious male with external injuries showed no midline shift, basal cisterns compressed with multiple small haemorrhages. Most likely diagnosis is diffuse axonal injuries.

    3. 45-year-old female with progressive weakness and spasticity of lower limb with difficulty in micturition. CT scan shows an intradural mid dorsal midline enhancing lesion. Likely diagnosis is Meningioma.

    4. Basal ganglia calcification is seen in hypoparathyroidism, perinatal hypoxia and Fahr’s syndrome.

    5. Radiocontrast is contraindicated in renal failure, patient on metformin and dehydration.

    6. I 123 is used for RAIU.

    Psychiatry

    1. Delusion is a disorder of Thought.

    2. Conditions included in diagnosis of Bipolar disorder includes mania alone, mania and depression and mania and anxiety.

    3. Drug of choice for OCD is Fluoxetine.

    4. Most common symptom of alcohol withdrawal is Tremor.

    5. Naltrexone is used in a case of opioid dependence to prevent relapse.

    6. Most common substance of abuse in India is Cannabis.

    7. 3-year-old child with delayed speech and poor concentration has difficulty in communication and is not making any friends. Most likely diagnosis is Autism.

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