QId: 240 Histology - Cardiovascular System

EO: Interstitial myocardial granulomas (aschoff bodies) are found in carditis due to ARF,
which develops after an untreated group A streptococcal pharyngeal infection. Aschoff
bodies contain plump macrophages with abundant cytoplasm and central, slender ribbons of
chromatin (Anitschkow or caterpillar cells).

QId: 301 Immunology - Pulmonary & Critical Care

MYcobacterium infection. bacteria engulfed in macrophages but keep surviving and

reproducing. macrophages still able to present them to naive TH cells.IL-12 from macros
induce TH to form Th1 which produce IFN-gamma. activated macrophages produce
TNF-alpha recruiting more monocytes and macrophages.these infiltrating cells cluster in a
circular fashion around remaining organisms.

QId: 546 Immunology - Renal, Urinary Systems & Electrolytes

preformed abs against graft ABO causes hyper acute graft rejection The transplanted organ
gets MOTTLED immediately after vessels anastomosis and intense inflammatory response is
seen within hours.Has been virtually eliminated because of ABO screening for match.

QId: 673 Immunology - Nervous System

Ataxia telengiectasia--> autosomal recessive, defect in DNA repair genes. The DNA of these
patients is hypersensitive to ionizing radiation. Manifestation include cerebellar ataxia,
occulocutaneous telengiectasias, repeated sinupulmonary infections and increased incidence
of malignancy.

Neurofibrillary tangles : ALzheimer's.

Loss of SN neurons: Parkinson.
Posterior column involvement : Vit B12 def + Syphilis.
Lewy Bodies: Parkinson.

QId: 771 Embryology - Endocrine, Diabetes & Metabolism

Pheochromocytoma:catechol producing tumor of adrenal medulla.

Medullary thyroid cancer: parafollicular C cells.
Both are derived from neural crest cells.
QId: 796 Immunology - Pulmonary & Critical Care

CD19,20,21 identify B-cell lineage. Precursor B cell lymphoblastic leukemia may sometimes
involve pleura or present as diffuse patchy pulmonary inflitrates. In such cases, bronch
lavage might contain CD22+ lymphocytes.
# lavage eosinophillia is present in eosinophilic pneumonia,tropical pulm eosinophialia.
IPF has inc neutrophils, bact pneumonia too.

QId: 871 Pathology - Nervous System

*Liquefactive necrosis is characterized by complete digestion and removal of necrotic tissue

with formation of cystic cavity.(+/- surrounded by gliosis).
Hypoxic CNS injury is often followed by LN. Abscess formation due to bacterial or fungal
infection is another example of it.

QId: 1134 Immunology - Hematology & Oncology

subcapsular sinuses are in direct contact with afferent lymph vessels. also connected to the
cortical sinuses that line the trabeculae and penetrate thru cortex and paracortex to reach he
medulla. from there, med sinuses drain into the efferent channnel.

QId: 1418 Biochemistry - Hematology & Oncology

DNA synthesis can occur only in 5'-3' direction.Okazaki fragments are short stretches of
newly synthesized DNA that are separated by RNA primers. THey are formed by
discontinuous synthesis of DNA on the lagging strand.

QId: 1649 Immunology - Infectious Diseases

humoral response with abs directed agains hemagglutinin are most imp for immunity against
influenza virus.prevents it's binding to cell membranes of host.

QId: 1805 Anatomy - Cardiovascular System

Pressure in the left renal vein may become elevated due to compression where the vein
crosses the aorta beneath the SMA.This "Nut Cracker effect" can cause hematuria and flank
pain.Pressure can also be elevated in the gonadal vein,leading to formation of varicocoele.
QId: 2016 Biochemistry - Endocrine, Diabetes & Metabolism

In contrast to ER, SER contains enzymes for steroid and phospholipid biosynthesis. All
steroid producing cells (adrenals,gonads,liver) have a well-developed SER.

other points:
>Dopamine is a powerful vasoactive and inotropic substance.Functions via G-protein coupled
receptor.
>ER membranes enclose a single cisternal space.
>ACTH stimulates the SER in the adrenal cortex to produce steroids.
>Progesterone works via type 1 nuclear receptor.Ov.lutein cells which produce progesteron
have abundant SER but the cells on which it acts (endometrial) do not.

QId: 8294 Anatomy - Cardiovascular System

Early systolic murmur best heard over the left lower sternal border that is accentuated by
inspiration is most likely due to tricuspid regurgitation.

Aortic valve: Second right intercoastal space at the right sternal border.
Pulmonic Valve: Second left intercoastal space at the left sternal border.
Tricuspid: Fourth left intercoastal space at the lower left sternal border.(right-sided
endocarditis)>staph aureus>IV drugs.
Mitral valve: Fifth intercoastal space, medial to the mid-clavicular line.

QId: 8332 Anatomy - Cardiovascular System

Heart:
Apex and left border: Left ventricle. (on frontal CXR)
Right lateral border: Right atrium and SVR.
Inferior border and sternal surface : Right ventricle
Posterior surface: Left Atrium---> enlargement of this can compress esophagus and cause
dysphagia.

QId: 8333 Anatomy - Cardiovascular System

The descending thoracic aorta lies posterior to the esophagus and left atrium.This position
allows clear visualization of descending aorta by TEE,allowing for the detection of
abnormalities such as dissection or aneurysm.
other points:
>Superior and inferior pulm veins leave lungs hila B/L and enter left atrium.The prox 2-3cms
contain cardiac Muscle within media and function as a sphincter during atrial systole.
>R and L brachiocephalic merge to form SVC behind 1st costal cartilage.Mediastinal
neoplasm can compress it-->SVC syndrome.
>Main pulmonary artery ascends anteriorly and to the left of the ascending aorta and is
directed toward the left shoulder.After the pulmonary artery bifurcates,, the right pulmonary
artery travels horizontally under the aortic arch posterior to the SVC and the left pulm artery
courses superiorly over the left main bonchus.

QId: 8557 Anatomy - Ophthalmology

*The pupillary Light reflex is assessed by shinning a light in an eye and observing the
response in that eye (direct) and the opposite eye (consensual). The optic nerve is responsible
for the afferent limb of pupillary reflex and the oculomotor for efferent limb.

QId: 11659 Anatomy - Rheumatology/Orthopedics & Sports

Patella fractures are most commonly due to direct impact to the anterior aspect of the
knee.Signs: Acutely swollen knee,focal patellar tenderness. inability to extend knee against
gravity, palpable gap in the extensor mechanism.

other points:
>patella also improves nourishment of distal femur articular cartilage.Quadriceps tendon
inserts at the superior pole of the patella and wraps distally around the patella to become
patellar tendon and inserts on the tibial tuberosity.
>bungee jump on landing position can cause patellar fracture too.

QId: 11663 Anatomy - Nervous System

Temporomandibular disorder can arise from the problems involving the TMJ,Muscles of
mastication and the nerves supplying the jaw.Because the mandibular division of the
trigeminal nerve supplies the middle ear and the muscles of mastication, TMD can present
with both otologic symtoms and jaw pain.
other points:
>Mandibular nerve supply: (sensrory) : TMJ,mandibuar teeth,floor of mouth,inside of
cheeks,anterior tongue,much of skin of lower part of face.
(Motor): M.O.M(m+L pterygoids,masseter,temporalis), muscles of floor of mouth i.e.
mylohyoid, tensor veli palatini,tensor tympani in the middle ear,
>maxillary nerve carries sensation from cheek,nares,upper lip and teeth,pharyngeal palate and
the maxillary sinuses.
8th nerve not related to TMD.

QId: 11741 Anatomy - Pulmonary & Critical Care

A chest tube for drainage of pleural effusion is placed through the skin and subcutaneous fat
into the 4th or 5th intercoastal space in the anterior or midaxillary line.The tube traverses
through the serratus anterior muscle,Intercoastal muscles and the parietal pleura.

QId: 11769 Anatomy - Nervous System

Sensation to suprapubic and gluteal region and motor function to the anterolateral abdominal
wall muscles is by illiohypogastric nerve.
it can get damaged during abdominal surgery (appendicectomy) and cause decreased
sensation and /or burning pain at the suprapubic region.

QId: 11778 Anatomy - Rheumatology/Orthopedics & Sports

Thoracic Outlet syndrome: compression of lower trunk of brachial pplexus in the scalene
triangle, the space bordered by the anterior and middle scalene muscles and the first
rib.Syptoms: upper extremeity numbness,tingling,weakness.

QId: 11783 Anatomy - Ear, Nose & Throat (ENT)

Epistaxis is commonly caused by the irritation of highly vascular mucosa at the anterior nasal
septum.It contais the keiselbach plexus.Anterior ethmoidal,sphenopalatine and superior labial
arteriess anastomose in the region.
other point:
>Direct compression of nasal alae,cautery (of surrounding area may stop bleeding.
>The superior meatus drains: Sphenoidal and posterior ethmoidal sinuses. Medial:
frontal,maxillary and anterior ethmoidal sinuses and is most common site of nasal
polyps.Inferior: drains nasolacrimal duct.
>Branches of sphenopalatine supply the posterolateral wall and posterior choanae.It's the
most likely source of posterior bleeds.Posterior is usually severe and connot be treated with
cautery.

QId: 12031 Anatomy - Nervous System

Neurological damage associated with vitamin B12 deficiency classically includes subacute
combined degeration of the dorsal columns (loss of position and vibration sensation,positive
romberg sign) and lateral corticospinal tracts (spastic paresis).