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important topics
here r sum imp topics ««hope itz helpful
Physiology :
1. Exercise changes in body Physiology
2. CSF and Physiology
3. Nerve Physiology
4. Hybridoma technique
5. Kidney and Physiology
6. Endocrinology- Insulin ,steroid hormones, adrenaline, vitamine D, PTH, Calcitonin
7. Blood vessel Physiology
@ 

1. General
2. Antimicrobials
3. Immunosuppressors and modulators
4. Chemotherapuetic drugs
5. Xenobiotics
6. Neuroleptics
7. Dose reductions
8. Detrusor instability syndromes and drugs
9. Osteoporosis and drugs
10. Digoxin toxicity
11. MRSA
12. Antihistaminics
13. Antiarrhythmics

1 leukemias
2 hyperparathyriodism
3 acid base balance
4 paraneoplastic syndr
5 megaloblastic anemias
6 cns hemorrhage
7 tumors


1.Coarctation of aorta ± collaterals


2.Ulner nerve and Radial nerve ± supply in forearm and hand, applied Anatomy
3.Tongue ± development, muscle supply, nerve supply
4.Facial muscles namely masseter ,buccinator, digastric ,
5.Common carotid artery ,its branches-internal carotid artery and its branches
6.Renal angle and renal vein drainage
7.Cervical and thoracic vertebrae
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Healing and Management of Wounds, Accident ,Resuscitation and
Support, Infections, Immunology, Tumours, Cysts, Ulcers, Sinuses, Skin, Burns, Arterial disorders,
Venous disorders, Lymphatic disorders, Cranium, Eye and Orbit, Head and Neck , Thyroid gland
Thyroglossal tract , Parathyroid and adrenal glands, Breast, Thorax, Heart and Pericardium,
Oesophagus, Stomach and Duodenum, Liver, Spleen Gall bladder and Bile ducts Pancreas, Peritoneum,
Omentum, Mesentery and, Retroperitoneal space, Small and Large intestines, Intestinal obstruction,
Vermiform appendix, Rectum, Anus, Hernias, Umbilicus, Abdominal wall, Kidney and Ureters, Urinary
bladder, Prostate and Seminal vesicles, Urethra and Penis, Testes and Scrotum, Miscellaneous
   @
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Fractures and dislocations, Infections, Tumours, Chronic joint disorders, Congenital disorders, Disorders
of Growing skeleton , Muscle, Tendon and Fascia, Neurological disorders, Spine,, Vertebral column and
Spinal cord, Nerves, Miscellaneous


   
The Molecular and Cellular basis of disease, Diseases due to infection, Virus, Bacteria, Protozoa,
Helminthes, Chlamydia, Rickettsiae Spirochaetes, Fungus,
Arthropods, Cardiovascular system, Heart rate, Rhythm and Condition, Ischeamic heart disease,
Vascular disease, Heart valves, Congenital heart disease, Myocardium and Pericardium, Diseases of
Respiratory system, Chronic obstructive pulmonary disease, Infections, Tumours of lung and Bronchus,
Interstitial and Infiltrative lung disease, Pulmonary vascular disease, Larynx, Trachea, Pleura, Diaphragm
and chest wall, Disturbance in Water, Electrolyte and Acid Base disorders, Kidney and Urinary system,
Nutrition and Metabolic disorders,Diabetes Mellitus, Endocrine disease, Alimentary tract and Pancreas,
Liver and Billary system, Diseases of the Blood, Anemias, Leukaemias, Lymphoma, Myeloma and
Myeloprolif erative disorders, Bleeding disorders, venous thrombosis,Blood transfusion, Diseases of the
connective tissues, Joints and bones, Diseases of the Nervous system, Cerebrovascular disease,
Inflammatory Disease, Degenerative disease, Disease of the nerve and muscle, Infections of the nervous
system, Spine and spinal cord, Intra cranial mass lesions, Hydrocephalus, Poisoning, Miscellaneous.
    c
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Anatomy , Histology and Physiology , Gynaecological diagnosis, Malformations of female generative
organs, Sex and Intersexuality, Vulva, Vagina, STD, Tuberculosis of genital tract, Diseases of Urinary
system, The Pathology of conception,Birth control, Trophoblastic diseases, Ectopic gestation, Disorders
of Menstruation, Hormone therapy in Gynaecology , Inflammation of uterus, Prolapse, Displacements,
Fibromyomas of Uterus, Dysplasias and Carcinomma of Cervix, Carcinoma of the Endometrium,
Disorders of the Ovary, PID, Broad ligament, Fellopian tubes and Parametrium , Endometriosis and
Adenomyosis, Fundamentals of reproduction, The placenta and Fetal membranes, Fetus, Physiological
changes during Pregnancy, Endocrinology, Diagnosis of Pregnancy, The Fetus ± in Utero, Fetal skull and
Material pelvis, Antenatal care, Normal Labour, Normal Puerperium, Vomiting in Pregnancy, hypertensive
disorders inPregnancy, Haemorrhage in early Pregnancy ± Abortion, MTP, Multiple Pregnancy,
Polyhydramnics, Abnormalities of placenta and cord, Antepartum haemorrhage, Medical, Surgical and,
Gynaecological disorders Complicating pregnancy, Pre term labour, Premature ruptures of membranes,
Post maturity, Intra uterine death, Special cases, Contracted Pelvis Abnormal uterine action, Malposition,
Malpresentation, Cord Prolapse, Prolonged labour, obstructed labour, Dystocia, Complications of the third
stage of labour, Injuries to the birth canal, Low birth weight baby, Diseases of fetus and New born,
Miscellaneous
º INDIA
º2004
 
QUESTIONSº º 

Anatomy
Q 1. False statement regarding pudendal nerve is:
A. Both sensory and motor
B. Derived from S2,3,4 spinal nerve roots
C. Leaves pelvis through the lesser sciatic foramen
D. It is the only somatic nerve to innervate the pelvic organs
Ans. C
Q 2. Wrong statement regarding the coronary artery is:
A. Left coronary artery is present in anterior interventricular groove
B. Usually 3 obtuse marginal arteries arise from left coronary artery
C. Posterior interventricular artery arises from right coronary artery
D. Left atrial artery is a branch of left coronary artery
Ans. B
Q 3. All are true statements regarding inguinal canal except:
A. Roof is formed by conjoint tendon
B. Deep inguinal ring is formed by transversus abdominis
C. Superficial inguinal ring is formed by external oblique muscle
D. Internal oblique forms anterior and posterior wall
Ans. B
Q 4. Right gastroepiploic artery is a branch of:
A. Left gastric
B. Coeliac trunk
C. Splenic
D. Gastroduodenal
Ans. D
Q 5. In FRACTURE of middle cranial fossa, absence of tears is due to lesion in the:
A. Trigeminal ganglion
B. Ciliary ganglion
C. Lesser petrosal nerve
D. Greater petrosal nerve
Ans. D
Q 6. Motor supply to diaphragm is by:
A. Thoracodorsal nerve
B. Phrenic nerve
C. Intercostal nerves
D. Sympathetic nerves
Ans. B
Q 7. All of the following are supplied by facial nerve except:
A. Lacrimal gland
B. Submandibular gland
C. Nasal glands
D. Parotid gland
Ans. D
Q 8. In left coronary artery thrombosis, area most likely to be involved is:
A. Anterior wall of right ventricle
B. Anterior wall of left ventricle
C. Anterior wall of right atrium
D. Inferior surface of right ventricle
Ans. B
Physiology
Q 9. Tidal volume is calculated by:
A. Inspiratory capacity minus the inspiratory reserve volume
B. Total lung capacity minus the residual volume
C. Functional residual capacity minus residual volume
D. Vital capacity minus expiratory reserve volumes
Ans. A
Q 10. Surfactant production in lungs starts at:
A. 28 weeks
B. 32 weeks
C. 34 weeks
D. 36 weeks
Ans. A
Q 11. Initiation of nerve impulse occurs at the axon hillock because:
A. It has a lower threshold than the rest of the axon
B. It is unmyelinated
C. Neurotransmitter release occurs here
D. None of the above
Ans. A
Q 12. Albumin contributes the maximum to oncotic pressure because it has:
A. High molecular weight, low concentration
B. Low molecular weight, low concentration
C. High molecular weight, high concentration
D. Low molecular weight, high concentration
Ans. D
Q 13. After 5 days of fasting a man undergoes oral GTT, true is all except:
A. GH levels are increased
B. Increased glucose tolerance
C. Decreased insulin levels
D. Glucagon levels are increased
Ans. B
Q 14. Metalloproteins help in jaundice by the following mechanism:
A. Increased glucoronyl transferase activity
B. Inhibit heme oxygenase
C. Decrease RBC lysis
D. Increase Y and Z receptors
Ans. B
Q 15. Which protein prevents contraction by covering binding sites on actin and myosin:
A. Troponin
B. Calmodulin
C. Thymosin
D. Tropomyosin
Ans. D
Q 16. Which of the following is not correct regarding capillaries:
A. Greatest cross sectional area
B. Contain 25% of blood
C. Contains less blood than veins
D. Have single layer of cells bounding the lumen
Ans. B
Q 17. A 0.5 litre blood loss in 30 minutes will lead to:
A. Increase in HR, decrease in BP
B. Slight increase in HR, normal BP
C. Decrease in HR and BP
D. Prominent increase in HR
Ans. B
Q 18. Single most important factor in control of automatic contractility of heart is:
A. Myocardial wall thickness
B. Right atrial volume
C. SA node pacemaker potential
D. Sympathetic stimulation
Ans. D
Q 19. Which of the following is not mediated through negative FEEDBACK mechanism:
A. TSH release
B. GH formation
C. Thrombin formation
D. ACTH release
Ans. C
Q 20. Force generating proteins are:
A. Myosin and myoglobin
B. Dynein and kinesin
C. Calmodulin and G protein
D. Troponin
Ans. B
Q 21. Which is true about measurement of BP with sphygmomanometer versus intraarterial pressure
measurements:
A. Less than intravascular pressure
B. More than intravascular pressure
C. Equal to intravascular pressure
D. Depends upon blood flow
Ans. B
Q 22. Secondary hyperparathyroidism due to vitamin D deficiency shows:
A. Hypocalcemia
B. Hypercalcemia
C. Hypophosphatemia
D. Hyperphosphatemia
Ans. C
Q 23. Maximum absorption of water takes place in:
A. Proximal convoluted tubule
B. Distal convoluted tubule
C. Collecting duct
D. Loop of Henle
Ans. A
Biochemistry
Q 24. Basic amino acids are:
A. Aspartate and glutamate
B. Serine and glycine
C. Lysine and arginine
D. None of the above
Ans. C
Q 25. Amino acid with dissociation constant closest to physiological pH is:
A. Serine
B. Histidine
C. Threonine
D. Proline
Ans. B
Q 26. Sources of the nitrogen in urea cycle are:
A. Aspartate and ammonia
B. glutamate and ammonia
C. Arginine and ammonia
D. Uric acid
Ans. A
Q 27. If urine sample darkens on standing: the most likely condition is:
A. Phenylketonuria
B. Alkaptonuria
C. Maple syrup disease
D. Tyrosinemia
Ans. B
Q 28. A baby presents with refusal to feed, SKIN lesions, seizures, ketosis organic acids in urine with
normal ammonia; likely diagnosis is:
A. Propionic aciduria
B. Multiple carboxylase deficiency
C. Maple syrup urine disease
D. Urea cycle enzyme deficiency
Ans. B
Q 29. Force not acting in an enzyme substrate complex:
A. Electrostatic
B. Covalent
C. Van der Wall
D. Hydrogen
Ans. C
Q 30. Cellular oxidation is inhibited by:
A. Cyanide
B. Carbon dioxide
C. Chocolate
D. Carbonated beverages
Ans. A
Q 31. Triple bonds are found between which base pairs:
A. A-T
B. C-G
C. A-G
D. C-T
Ans. B
Q 32. Which of the following RNA has abnormal purine bases:
A. tRNA
B. mRNA
C. rRNA
D. 16SRNA
Ans. A
Q 33. False regarding gout is:
A. Due to increased metabolism of pyrimidines
B. Due to increased metabolism of purines
C. Uric acid levels may not be elevated
D. Has a predilection for the great toe
Ans. A
Q 34. All of the following statements are true regarding lipoproteins except:
A. VLDL transports endogenous lipids
B. LDL transports lipids to the tissues.
C. Increased blood cholesterol is associated with increased LDL receptors
D. Increased HDL is associated with decreased risk of coronary disease
Ans. C
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:
A. Fouchet
B. Rothera
C. Hays
D. Benedict¶s
Ans. B
Q 36. Which of these fatty acids is found exclusively in breast milk:
A. Linolaete
B. Linolenic
C. Palmitic
D. d-hexanoic
Ans. A
Q 37. Blood is not a newtonian fluid because:
A. Viscosity does not changing with velocity
B. Viscosity changes with velocity
C. Density does not change with velocity
D. Density changes with velocity
Ans. B
Microbiology
Q 38. Regarding NK cells, false statement is:
A. It is activated by IL-2
B. Expresses CD 3 receptor
C. It is a variant of large lymphocyte
D. There is antibody induced proliferation of NK cells
Ans. D
Q 39. Adenosine deaminase deficiency is seen in the following:
A. Common variable immunodeficiency.
B. Severe combined immunodeficiency
C. Chronic granulomatous disease
D. Nezelof syndrome
Ans. B
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:
A. Strep. agalactiae
B. Strep. pneumoniae
C. Enterococcus
D. Strep. bovis
Ans. C
Q 41. False statement about the streptococcus is:
A. M protein is responsible for production of mucoid colonies
B. M protein is the major surface protein of group A streptococci
C. Mucoid colonies are virulent
D. Endotoxin causes rash of scarlet fever
Ans. A
Q 42. Toxin involved in the streptococcal toxic shock syndrome is:
A. Pyrogenic toxin
B. Erythrogenic toxin
C. Hemolysin
D. Neurotoxin
Ans. A
Q 43. A child presents with a white patch over the tonsils; diagnosis is best made by culture in:
A. Loeffler medium
B. LJ medium
C. Blood agar
D. Tellurite medium
Ans. A
Q 44. A patient with 14 days of fever is suspected of having typhoid. What investigation should be done:
A. Blood culture
B. Widal test
C. Stool culture
D. Urine culture
Ans. B
Q 45. All are true about EHEC except:
A. Sereny test is positive
B. Fails to ferment sorbitol
C. Causes HUS
D. Elaborates shiga like exotoxin
Ans. A
Q 46. An organism grown on agar shows green coloured colonies, likely organism is:
A. Staphylococcus
B. E. coli
C. Pseudomonas
D. Peptostreptococcus
Ans. C
Q 47. Congenital syphilis can be best diagnosed by:
A. IgM FTAbs
B. IgG FTAbs
C. VDRL
D. TPI
Ans. A
Q 48. All are features of Ureaplasma urealyticum except:
A. Non gonococcal urethritis
B. Salpingitis
C. Epididymitis
D. Bacterial vaginosis
Ans. D
Q 49. Regarding HIV infection, not true is:
A. p24 is used for early diagnosis
B. Lysis of infected CD 4 cells is seen
C. Dendritic cells do not support replication
D. Macrophage is a reservoir for the virus
Ans. C
Q 50. A pregnant woman from Bihar presents with hepatic encephalopathy. The likely diagnosis:
A. Hepatitis E
B. Hepatitis B
C. Sepsis
D. Acute fatty liver of pregnancy
Ans. A
Q 51. Virus causing hemorrhagic cystitis, diarrhea and conjunctivitis is:
A. RSV
B. Rhinovirus
C. Adenovirus
D. Rotavirus
Ans. C
Q 52. Cystine lactose enzyme deficient (CLED) medium is preferred over McConkey agar in UTI
because:
A. Former prevents swarming of proteus
B. Is a selective medium
C. Prevents growth of pseudomonas
D. Promotes growth of candida
Ans. A
Q 53. In which stage of filariasis are microfilaria seen in peripheral blood:
A. Tropical eosinophilia
B. Early adenolymphangitis stage
C. Late adenolymphangitis stage
D. Elephantiasis
Ans. B
Q 54. Pancreatic CA is caused by:
A. Fasciola
B. Clonorchis
C. Paragonimus
D. None
Ans. B
Q 55. All of the following are true except:
A. E.coli is an aerobe and facultative anaerobe
B. Proteus forms uric acid stones
C. E. coli is motile by peritrichate flagella
D. Proteus causes deamination of phenylalanine to phenylpyruvic acid
Ans. B
Q 56. Consumption of uncooked pork is likely to cause which of the following helminthic disease:
A. Tinea saginata
B. Tinea solium
C. Hydatid cyst
D. Trichuris trichura
Ans. B
Pathology
Q 57. Enzyme that protects the brain from free radical injury is:
A. Myeloperoxidase
B. Superoxide dismutase
C. MAO
D. Hydroxylase
Ans. B
Q 58. Autoimmune haemolytic anemia is seen in:
A. ALL B. AML
C. CLL D. CML
Ans. C
Q 59. All of following are correct about thromboxane A2 except:
A. Low dose aspirin inhibits its synthesis
B. Causes vasoconstriction in blood vessels
C. Causes broncoconstriction
D. Secreted by WBC
Ans. D
Q 60. Which of the following complications is likely to result after several units of blood have
been transfused:
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis
Ans. A
Q 61. The mother has sickle cell disease and father is normal. Chances of children having
sickle cell disease and sicklecell trait respectively are:
A. 0 and 100%
B. 25 and 25%
C. 50 and 50%
D. 10 and 50%
Ans. A
Q 62. Father has a blood group B, mother has AB; children are not likely to have the
following blood group:
A. O
B. A
C. B
D. AB
Ans. A
Q 63. Protein involved in intercellular connections is:
A. Connexin
B. Integrin
C. Adhesin
D. None of the above
Ans. A
Pharmacology
Q 64. All are reasons for reducing drug dosage in elderly except:
A. They are lean and their body mass is less
B. Have decreasing renal function with age
C. Have increased baroceptor sensitivity
D. Body water is decreased
Ans. C
Q 65. True statement regarding inverse agonists is:
A. Binds to receptor and causes intended action
B. Binds to receptor and causes opposite action
C. Binds to receptor and causes no action
D. Binds to receptor and causes submaximal action
Ans. B
Q 66. True statement regarding first order kinetics is:
A. Independent of plasma concentration
B. A constant proportion of plasma concentration is eliminated
C. T½ increases with dose
D. Clearance decreases with dose
Ans. B
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:
A. Long term heparin therapy
B. Replace warfarin with acecoumarin
C. Switch ethambutol for rifampin
D. Use LMW heparin
Ans. C
Q 68. Beta blocker that can be used in renal failure is:
A. Propranolol
B. Pindolol
C. Sotalol
D. Nadolol
Ans. A
Q 69. All of the following are correct about steroids except:
A. Inhibit the release of arachidonic acid from vessel wall through action of phospholipase A2
B. Bind plasma membrane receptors and following internalization influence nuclear changes
C. Inhibit vascular membrane permeability
D. Increase glucose synthesis, glycogen deposition in liver
Ans. B
Q 70. All of the following statements are true except:
A. PGs and leukotrienes are derived from arachidonic acid
B. COX I is an inducible enzyme
C. COX II is induced by cytokines at sites of inflammation.
D. Leukotrienes cause smooth muscle constriction
Ans. B
Q 71. Which of the following is a false statement:
A. IV noradrenaline increases systolic and diastolic BP and cause tachycardia
B. IV adrenaline increases systolic BP, no change or increase diastolic BP and causes tachycardia
C. IV isoproterenol causes increase in systolic BP, decreases diastolic BP and causes tachycardia
D. Dopamine improves renal function, increases cardiac output and systolic BP
Ans. A
Q 72. Digoxin is not indicated in:
A. Atrial flutter
B. Atrial fibrillation
C. High output failure
D. PSVT
Ans. C
Q 73. All of the following statements are true about theophylline except:
A. Increase in dose is required in cardiopulmonary disease
B. Increases cAMP
C. Increase in dose is required in smokers
D. Inhibits phosphodiesterase
Ans. A
Q 74. Mechanism of action of tetracycline is:
A. Binds to A site and inhibit attachment of t-RNA.
B. Inhibits peptidyl transferase
C. Causes misreading of mRNA
D. Causes termination of peptide chain elongation
Ans. A
Q 75. False statement about selegeline is:
A. It is a MAO-A inhibitor
B. Does not cause cheese reaction
C. Not useful in advanced cases of on-off phenomenon
D. It is used in parkinsonism
Ans. A
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:
A. Chest X-ray
B. MCV should be estimated
C. GGT should be estimated
D. Bone marrow examination
Ans. B
Q 77. Which of the following drugs would be removed by dialysis?
A. Digoxin
B. Salicylates
C. Benzodiazepines
D. Organophosphates
Ans. B
Q 78. In low doses aspirin acts on:
A. Cyclooxygenase
B. Thromboxane A2
C. PGI2
D. Lipoxygenase
Ans. B
Q 79. True statement about ticlopidine is:
A. Directly interacts with platelet membrane
B. Onset of action is delayed
C. Inhibits platelet gp IIb/IIIa receptors
D. Has fibrinolytic activity
Ans. A
Q 80. All of the following statements about methotrexate are true except:
A. Folinic acid enhances the action of methotrexate
B. Methotrexate inhibit dehydrofolate reductase
C. Non proliferative cells are resistant to metho- trexate
D. Methotrexate is used in treatment of PSORIASIS
Ans. A
Q 81. Drug containing two sulfhydryl groups in a molecule:
A. BAL
B. EDTA
C. Pencillamine
D. Desferioxamine
Ans. A
Forensic Medicine
Q 82. Gettler¶s test is done for death by:
A. Drowning B. Hanging
C. Bums D. Phophorus poisoning
Ans. A
Q 83. Feature indicative of antimortem drowning is:
A. Cutis anserina
B. Rigor mortis
C. Washer woman¶s feet
D. Grass and weeds grasped in the hand
Ans. D
Q 84. A boy has 20 permanent teeth and 8 temporary teeth. His age is likely to be:
A. 9 years
B. 10 years
C. 11 years
D. 12 years
Ans. C
Q 85. A patient has sensation of bugs crawling all over his body. This may be effect of:
A. Cocaine
B. Alcohol
C. Cannabis
D. Benzodiazepines
Ans. A
Q 86. A person comes in contact with other. This is called:
A. Locard principle
B. Quetlet¶s rule
C. Petty¶s principle
D. None of the above
Ans. A
Q 87. A patient of head injury, has no relatives and requires urgent cranial decompression; Doctor should:
A. Operate without formal consent
B. Take police consent
C. Wait for relatives to take consent
D. Take magistrate consent
Ans. A
Q 88. A boy attempts suicide. He is brought to a private doctor and he is successfully
cured. Doctor should:
A. Inform police
B. Not required to inform police
C. Report to magistrate
D. Refer to a psychiatrist
Ans. B
PREVENTIVE AND SOCIAL Medicine
Q 89. All are true about DOTS except:
A. Continuation phase drugs are given in a multi- blister combipack
B. Medication is to be taken in presence of a health worker
C. Alternate day treatment
D. Improves compliance
Ans. C
Q 90. Basanti a 29 years aged female from Bihar presents with active tuberculosis. She delivers baby. All
of the following are indicated except:
A. Administer INH to the baby
B. Withhold breastfeeding
C. Give ATT to mother for 2 years
D. Ask mother to ensure proper disposal of sputum
Ans. B
Q 91. Under the national TB programme, for a PHC to be called a PHC-R, requisite is:
A. Microscopy
B. Microscopy plus Radiology
C. Radiology
D. None of the above
Ans. B
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:
A. Full course of tetanus toxoid
B. Single dose of tetanus toxoid
C. Human tetanus globulin
D. Human tetanus globulin and single dose of toxoid
Ans. B
Q 93. The false statement regarding tetanus is:
A. Five doses of immunisation provide life long immunity
B. TT affords no protection in the present injury
C. TIG is useful in lacerated wound
D. TT and Ig both may be given in suspected tetanus
Ans. A
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?
A. 5%
B. 10%
C. 20%
D. 21.5%
Ans. C
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:
A. 14.5
B. 13.8
C. 20
D. 5
Ans. B
Q 96. 10 babies are born in a hospital on same day. All weigh 2.8 kg each. Calculate
the standard deviation:
A. Zero
B. One
C. Minus one
D. 0.28
Ans. A
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:
A. Geometric average
B. Arithmetic average
C. Median
D. Mode
Ans. C
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:
A. His total calorie intake is 3000 kcal
B. The proportion of proteins, fats and carbohydrates is correct and in accordance with a balanced diet
C. He has a negative nitrogen balance
D. 30% of his total energy intake is derived from fat
Ans. B
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:
A. Early expanding
B. Late expanding
C. Plateau
D. Declining
Ans. B
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 firstgroup got lung cancer while 2 out of the other 4000 also got lung cancer. The best
conclusion is:
A. Beta carotene and lung cancer have no relation to one another
B. The p value is not significant
C. The study is not designed properly
D. Beta carotene is associated with lung cancer
Ans. A
Q 101. A subcentre in a hilly area caters to a population of:
A. 1000
B. 2000
C. 3000
D. 5000
Ans. C
Q 102. In a community, an increase in new cases denotes:
A. Increase in incidence rate
B. Increase in prevalence rate
C. Decrease in incidence rate
D. Decrease in prevalence rate
Ans. A
Q 103. More false positive cases on screening in a community signify that the disease has:
A. High prevalence
B. High sensitivity
C. Low prevalence
D. Low sensitivity
Ans. C
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:
A. High sensitivity
B. High specificity
C. Y community has high prevalence
D. Y community has low prevalence
Ans. C
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?
A. Increased sensitivity and positive predictive value
B. Increased sensitivity and negative predictive value
C. Increased specificity and positive predictive value
D. Increased specificity and negative predictive value
Ans. C
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:
A. Paired t-test
B. Student¶s test
C. Chi square test
D. None of the above
Ans. A
Q 107. Type 1 sampling error is classified as:
A. Alpha error
B. Beta error
C. Gamma error
D. Delta error
Ans. A
Q 108. Virulence of a disease is indicated by:
A. Proportional mortality rate
B. Specific mortality rate
C. Case fatality ratio
D. Amount of GDP spent on control of disease
Ans. C
Q 109. Which of the following diseases needs not to be screened for in workers to be employed in a dye
industry in Gujarat ?
A. Anemia
B. Bronchial asthma
C. Bladder cancer
D. Precancerous lesion
Ans. A
Q 110. Best test to detect iron deficiency in community is:
A. Serum transferrin
B. Serum ferritin
C. Serum iron
D. Hemoglobin
Ans. B
Q 111. Which of the following is not a complete sterilization agent:
A. Glutaraldehyde
B. Absolute alcohol
C. Hydrogen peroxide
D. Sodium hypochlorite
Ans. B
Q 112. Seasonal trend is due to:
A. Vector variation
B. Environmental factors
C. Change in herd immunity
D. All of the above
Ans. B
Medicine
Q 113. False statement about type I respiratory failure is:
A. Decreased PaO2
B. Decreased PaCO2
C. Normal PaCO2
D. Normal A-a gradient
Ans. D
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:
A. Small cell CA
B. Non-small cell CA
C. Fungal infection
D. Tuberculosis
Ans. B
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:
A. CT guided FNAC
B. Bronchoscopy and biopsy
C. Sputum cytology
D. X-ray chest
Ans. B
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:
A. Pulmonary tuberculosis
B. Fungal infection
C. Viral infection
D. Pneumonia
Ans. A
Q 117. Pulmonary edema associated with normal PCWP is observed, which of these is not a cause:
A. High altitude
B. Cocaine overdose
C. Post cardiopulmonary bypass
D. Bilateral renal artery stenosis
Ans. D
Q 118. An ABG analysis shows: pH 7.2, raised pCO2, decreased HCO3. Diagnosis is:
A. Respiratory acidosis
B. Compensated metabolic acidosis
C. Respiratory and metabolic acidosis
D. Respiratory alkalosis
Ans. C
Q 119. ABG analysis of a patient on ventilator shows decreased pCO2, normal pO2, pH 7.5. Diagnosis is:
A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Metabolic acidosis
Ans. C
Q 120. In a patient of acute inferior wall MI. Best modality of treatment is:
A. IV fluids
B. Digoxin
C. Diuretics
D. Vasodilators
Ans. A
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:
A. Electrophysiological testing
B. CT scan
C. Echocardiography
D. Angiography
Ans. C
Q 122. A patient complains of intermittent claudication, dizziness and headache. Most
likely cardiac lesion is:
A. TOF
B. ASD
C. PDA
D. Coarctation of aorta
Ans. D
Q 123. All of the following are true about ASD except:
A. Right atrial hypertrophy
B. Left atrial hypertrophy
C. Right ventricular hypertrophy
D. Pulmonary hypertension
Ans. B
Q 124. Mitral valve vegetations do not usually embolise to:
A. Lung
B. liver
C. spleen
D. brain
Ans. A
Q 125. A woman has septic abortion done, vegetation on tricuspid valve is likely to go to:
A. Septic infarcts to lung
B. liver
C. spleen infarcts
D. Emboli to brain
Ans. A
Q 126. Kussmaul¶s sign is not seen in:
A. Restrictive cardiomyopathy
B. Constrictive pericarditis
C. Cardiac tamponade
D. RV infarct
Ans. C
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:
A. Pneumothorax
B. Right ventricular failure
C. Cardiac tamponade
D. Hemothorax
Ans. C
Q 128. Which of the following is not seen on hemoglobin electrophoresis in sickle cell anemia:
A. HbA
B. HbA2
C. HbF
D. HbS
Ans. A
Q 129. False statement regarding DIC is:
A. Thrombocytopenia
B. Decreased fibrinogen
C. Decreased PTT
D. Increased PT
Ans. C
Q 130. Thrombocytopenia occurs in all except:
A. Henoch Schonlein purpura
B. TTP
C. DIC
D. Leukemia
Ans. A
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:
A. Leukemia
B. Aplastic anemia
C. HEMOLYSIS
D. lTP
Ans. A
Q 132. A patient being investigated for anemia has a dry marrow tap; peripheral smear reveals tear
drop cells. Most likelydiagnosis is:
A. Leukemia
B. Lymphoma
C. Myelofibrosis
D. Polycythemia rubra vera
Ans. C
Q 133. Tumor associated with polycythemia vera is:
A. Sarcoma
B. Pituitary adenoma
C. Cerebellar haemangioblastoma
D. None of the above
Ans. C
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:
A. Hemolytic jaundice
B. Viral hepatitis
C. Chronic active hepatitis
D. Obstructive jaundice
Ans. D
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:
A. Hemolytic jaundice
B. Obstructive jaundice
C. Hepatocellular jaundice
D. Protoporphyria
Ans. A
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:
A. NSAID induced duodenal ulcer
B. Drug induced gastritis
C. Esophageal varices
D. None of the above
Ans. C
Q 137. Urinalysis shows RBC casts. Likely source is:
A. kidney
B. Ureter
C. Bladder
D. Urethra
Ans. A
Q 138. A young man develops gross hematuria 3 days after an attack of URTI. Most likely
renal Pathology is:
A. Acute glomerulonephritis
B. Minimal change disease
C. IgA nephropathy
D. Membranous glomerulonephritis
Ans. C
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:
A. Fungal meningitis
B. Viral meningitis
C. TB meningitis
D. Leukemia
Ans. C
Q 140. Lacunar infarcts are caused by:
A. Lipohyalinosis of penetrating arteries
B. Middle carotid artery involvement
C. Emboli to anterior circulation
D. None of the above
Ans. A
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:
A. Multi-infarct dementia
B. Alzheimer¶s disease
C. Parkinsonism
D. None of the above
Ans. C
Q 142. All of the following may be seen in Wilson¶s disease except:
A. Cerebellar ataxia
B. Peripheral neuropathy
C. Dysphagia
D. Chorea
Ans. B
Q 143. An elderly man presents with features of dementia, ataxia, difficulty in downward gaze and
a history of frequentfalls. Likely diagnosis is:
A. Parkinson disease
B. Progressive supranuclear gaze palsy
C. Alzheimer¶s disease
D. None of the above.
Ans. B
Q 144. A chromosomal anomaly associated with Alzheimer¶s dementia is:
A. Trisomy 18
B. Patau syndrome
C. Trisomy 21
D. Turner syndrome
Ans. C
Q 145. All are true about Huntington¶s disease, except:
A. Chorea
B. Depression, apathy
C. Progressive dementia
D. Cog-wheel rigidity
Ans. D
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:
A. Pituitary adenoma
B. Testicular failure
C. Craniopharyngioma
D. Cushing¶s syndrome
Ans. A
Q 147. A patient meets with an accident with resultant transection of the pituitary stalk. What will not
occur:
A. Diabetes mellitus
B. Diabetes insipidus
C. Hyperprolactinemia
D. Hypothyroidism
Ans. A
Q 148. A woman has bilateral headache that worsens with emotional stress. She has two children, both
doing badly in school. Diagnosis is:
A. Migraine
B. Cluster headache
C. Tension headache
D. Trigeminal neuralgia
Ans. C
Q 149. A female aged 30 years, presents with episodic throbbing headache for past 4 years with nausea
and vomiting. Most likely diagnosis is:
A. Migraine
B. Cluster headache
C. Angle closure glaucoma
D. Temporal arteritis
Ans. A
Q 150. A woman complains of headache associated with paresthesias of the right upper and lower limb.
Most likelydiagnosis is:
A. Trigeminal neuralgia
B. Glossopharyngeal neuralgia
C. Migraine
D. Cluster headache
Ans. C
Q 151. All of the following are features of MEN IIa, except:
A. Pituitary tumor
B. Pheochromocytoma
C. Medullary CA thyroid
D. Parathyroid adenoma
Ans. A
Q 152. A patient with Cushingoid features presents with hemoptysis. He shows no response to
dexamethasone suppression test. Most likely diagnosis is:
A. Adrenal hyperplasia
B. Adrenal adenoma
C. CA lung with ectopic ACTH production
D. Pituitary microadenoma
Ans. C
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:
A. Glibenclamide
B. Troglitazone
C. Insulin
D. Chlorpropamide
Ans. C
Q 154. Which of the following is not associated with thymoma:
A. Red cell aplasia
B. Myasthenia gravis
C. Hypergammaglobulinemia
D. Compression of the superior mediastinum
Ans. C
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:
A. AS
B. Coarctation of aorta
C. AR
D. MR
Ans. C
Q 156. A patient presents with arthritis, hyperpigmen- tation of SKIN and hypogonadism.
Likely diagnosis is:
A. Hemochromatosis
B. Ectopic ACTH secreting tumor of lung
C. Wilson¶s disease
D. Rheumatoid arthrits
Ans. A
Q 157. In myasthenia gravis, correct statement regarding thymectomy is:
A. Should be done in all cases
B. Should be done in cases with ocular involvement only
C. Not required if controlled by medical management
D. Should be done only in cases that are associated with thymoma
Ans. A
Q 158. Most common fungal infection in febrile neutropenia is:
A. Aspergillus niger
B. Candida
C. Mucormycosis
D. Aspergillus fumigatus
Ans. B
Q 159. The following group of tests should be done to optimise graft uptake in bone marrow transplant:
A. Blood grouping
B. HLA matching
C. Culture for infection
D. All of the above
Ans. B
Q 160. True statement about neurocysticercosis is:
A. Seizures due to neurocysticercosis are resistant to antiepileptic drugs
B. Albendazole is superior to praziquantel in the treatment of above condition
C. Common presentation is 6th cranial nerve palsy and hemiparesis
D. Steroids are used in the management of hydrocephalus
Ans. B
Q 161. All of the following are true regarding a patient with acid peptic disease except:
A. Misoprostol is the drug of choice in patients on NSAIDs
B. DU is preventable by the use of single night-time H2 blockers
C. Omeprazole may help ulcers refractory to H2 blockers
D. Misoprostol is DOC in pregnant patients
Ans. D
Q 162. A man presents with mass at duodenojejunal flexure invading renal papillae. Histopathology
reports it as lymphoma. True statement is:
A. II E stage
B. III E stage
C. IV E stage
D. Staging cannot be done until bone marrow examination is performed
Ans. C
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:
A. Substantia nigra
B. Caudate nuclei
C. Pons
D. Subthalamic nuclei
Ans. D
Q 164. True about haemophilia A are all except:
A. PTT increased
B. PT increased
C. Clotting time is increased
D. Serum levels of factor VIII are decreased
Ans. B
Q 165. IPPV can cause:
A. Barotrauma
B. Pleural effusion
C. Increased venous return
D. None of the above
Ans. A
Q 166. Characteristic finding in CT in a TB is:
A. Exudate seen in basal cistern
B. Hydrocephalus is non communicating
C. Calcification commonly seen in cerebellum
D. Ventriculitis is a common finding
Ans. A
Q 167. Vegetations on undersurface of AV valves are found in:
A. Acute rheumatic carditis
B. Limban Sack¶s endocarditis
C. Non thrombotic bacterial endocarditis
D. Chronic rheumatic carditis
Ans. B
Q 168. Triage means:
A. Sorting out of cases on availability of medical resources and severity of patient¶s condition
B. Patients are divided into 3 groups
C. Severely injured patients are attended first in military camps
D. None of the above
Ans. A
PEDIATRICS
Q 169. Which of the following is not true about atrial septal defect:
A. There is a defect in region of fossa ovalis
B. Blood flow from left atrium to right atrium
C. Increased blood flow through lungs lead to pulmonary plethora
D. There is splitting of first heart sound
Ans. D
Q 170. A neonate presents with jaundice and clay white stools. On liver biopsy giant cells are seen. Most
likely diagnosisis:
A. Physiological jaundice
B. Neonatal hepatitis with extra biliary atresia
C. Neonatal hepatitis with physiological jaundice
D. Extra biliary atresia
Ans. B
Q 171. A newborn has dribbling after feeds. He has respiratory distress and froth at the
mouth. Diagnosis is:
A. Tracheoesophageal fistula
B. Tetralogy of Fallot
C. Respiratory distress syndrome
D. None of the above
Ans. A
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:
A. Budd Chiari syndrome
B. Non cirrhotic portal fibrosis
C. Cirrhosis
D. Veno-occlusive disease
Ans. B
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:
A. No finding
B. Basement membrane thickening
C. Hypercellular glomeruli
D. Fusion of foot processes
Ans. A
Q 174. Most common cause of urinary obstruction in a male infant is:
A. Anterior urethral valves
B. Posterior urethral valves
C. Stone
D. Stricture
Ans. B
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:
A. Ureterolithotomy
B. Endoscopic removal
C. ESWL
D. Observation
Ans. C
Q 176. A patient presents with LVH and pulmonary complications. ECG shows left axis deviation. Most
likely diagnosis is:
A. TOF
B. Tricuspid atresia
C. TAPVC
D. VSD
Ans. B
Q 177. Potts shunt is anastomosis of:
A. Right subclavian artery to right pulmonary artery
B. Descending aorta to left pulmonary artery
C. Left subclavian to left pulmonary artery
D. Ascending aorta to right pulmonary artery
Ans. B
Q 178. A neonate has recurrent attacks of abdominal pain, restless, irritability and diaphoresis on
feeding. Cardiacauscultation reveals a nonspecific murmur. He is believed to be at risk for MI.
Likely diagnosis is:
A. ASD
B. VSD
C. TOF
D. Anomalous coronary artery
Ans. D
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 µa positive family history¶. Next investigation of choice is:
A. Hb electrophoresis
B. Coombs¶ test
C. liver function tests
D. Osmotic fragility test
Ans. A
Q 180. Most common cause of meningitis in children between 6 months to 2 years of age is:
A. Pneumococcus
B. Staphylococcus
C. H. influenzae
D. E. coli
Ans. C
Q 181. A child presents with seborrheic dermatitis, lytic skull lesions, ear discharge and
hepatosplenomegaly. Likelydiagnosis is:
A. Leukemia
B. Lymphoma
C. Histiocytosis X
D. Multiple myeloma
Ans. C
Q 182. Which of the following is true regarding cretinism:
A. Short limbs compared to trunk
B. Proportionate shortening
C. Short limbs and short stature
D. Short limbs and long stature
Ans. C
Q 183. Manifestations of endemic cretinism include:
A. Deafness and facial nerve involvement
B. Blindness and hypothyroidism
C. Goitre and hypothyroidism
D. Multinodular goitre and mental retardation
Ans. A
Q 184. A 10 day old male pseudohermaphrodite child with 46 XY karyotype presents with BP of 110/80
mmHg. Most likelyenzyme deficiency is:
A. 21 hydroxylase
B. 17 hydroxylase
C. 11 hydroxylase
D. 3-beta hydroxylase
Ans. B
Q 185. Treatment of Kawasaki disease in children is:
A. Oral steroids
B. IV steroids
C. IV Ig
D. Mycophenolate mefentil
Ans. C
Q 186. A neonate delivered at 32 weeks, is put on a ventilator. X-ray shows µwhite 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:
A. Increase rate to 60 per minute
B. Increase FIO2 to 80
C. Continue ventilation with the same settings
D. Weaning ventilator
Ans. C
Dermatology
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:
A. KOH smear
B. Culture sensitivity
C. Biopsy
D. None of the above
Ans. A
Q 188. Most common organism causing tinea capitis is:
A. Trichophyton tonsurans
B. Microsporum
C. Epidermophyton
D. Candida albicans
Ans. A
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:
A. Chancroid
B. Herpes
C. Primary chancre
D. Traumatic ulcer
Ans. C
Q 190. An infant presents with itchy lesions over the groin and prepuce. All of the following are indicated
in this patient except:
A. Bathe and apply scabicidal solution
B. Treatment should be extended to all family members
C. Dispose all clothes by burning
D. Start the patient on IV antibiotics
Ans. D
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:
A. Pityriasis alba
B. Pityriasis versicolor
C. Indeterminate leprosy
D. Pure neuritic leprosy
Ans. C
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:
A. SLE
B. LUPUS vulgaris
C. Chillblains
D. Cutaneous leishmaniasis
Ans. D
Q 193. A 19 year old pregnant girl presents with light brown pigmentation over the malar eminences.
Most likelydiagnosis is:
A. Chloasma
B. SLE
C. Melasma
D. Melanoma
Ans. A
Q 194. A girl aged 19, presents with arthritis and a photosensitive rash on the cheek. Likely diagnosis is:
A. SLE
B. Chloasma
C. Stevens Johnson syndrome
D. Lyme¶s disease
Ans. A
Psychiatry
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:
A. Acute delirium
B. Acute dementia
C. Acute schizophrenia
D. Acute paranoia
Ans. A
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:
A. Dissociative fugue
B. Dissociative amnesia
C. Schizophrenia
D. Dementia
Ans. A
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:
A. Hysteria
B. Cystic fibrosis
C. Panic attack
D. Generalized anxiety disorder
Ans. C
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:
A. Panic disorder
B. Phobia
C. Conversion disorder
D. Post traumatic stress disorder
Ans. D
Q 199. A patient present with waxy flexibility, negativitism and rigidity. Diagnosis is:
A. Catatonic schizophrenia
B. Paranoid schizophrenia
C. Hebephrenic schizophrenia
D. Simple schizophrenia
Ans. A
Q 200. Chandu, age 32 presents with abdominal pain and vomiting. He also complains of some
psychiatric symptomsand visual hallucinations. Most likely diagnosis is:
A. Intermittent porphyria
B. Hypothyroidism
C. Hyperthyroidism
D. Hysteria
Ans. A
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:
A. Investigate and then operate
B. Refer to psychiatrist
C. Reassure the patient
D. Immediate operation
Ans. B
Surgery
Q 202. A male aged 60 years has foul breath. He regurgitates food that is eaten 3 days ago.
Likely diagnosis is:
A. Zenker¶s diverticulum
B. Meckel¶s diverticulum
C. Scleroderma
D. Achalasia cardia
Ans. A
Q 203. Most common site for squamous cell carcinoma esophagus is:
A. Upper third
B. Middle third
C. Lower third
D. Gastro-esophageal junction.
Ans. B
Q 204. What is true regarding congenital hypertrophic pyloric stenosis:
A. More common in girls
B. Hypochloremic alkalosis
C. Heller¶s myotomy is the procedure of choice.
D. Most often manifests at birth
Ans. B
Q 205. Patient presents with recurrent duodenal ulcer of 2.5 cm size. Procedure of choice is:
A. Truncal vagotomy and antrectomy
B. Truncal vagotomy and gastrojejunostomy
C. Highly selective vagotomy
D. Laparoscopic vagotomy and gastrojejunostomy
Ans. A
Q 206. All are features of hyperplastic tuberculosis of gastrointestinal tract except:
A. Presents with a mass in RIF
B. Barium meal shows pulled up caecum
C. Most common site is ileocecal junction
D. ATT is the treatment of choice
Ans. D
Q 207. A 56 year old woman has not passed stools for the last 14 days. X-ray shows no air/fluid levels.
Probablediagnosis is:
A. Paralytic ileus
B. Aganglionosis of the colon
C. Intestinal pseudo-obstruction
D. Duodenal obstruction.
Ans. C
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:
A. Acute intestinal obstruction
B. Acute mesenteric ischemia
C. Peritonitis
D. Appendicitis
Ans. B
Q 209. True statement regarding µfistula in ano¶ is:
A. Posterior fistulae have straight tracks
B. High fistulae can be operated with no fear of incontinence
C. High and low divisions are made in relation to the pelvic floor
D. Intersphincteric is the most common type
Ans. D
Q 210. In a 27 year old male most common cause of a colovesical fistula would be:
A. Crohn¶s disease
B. Ulcerative colitis
C. TB
D. Cancer colon
Ans. A
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:
A. IVP should be done
B. MCU should be done
C. Catheterize, drain bladder and remove the catheter thereafter
D. Catheterize, drain bladder and retain the catheter thereafter
Ans. D
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:
A. Gallstones
B. Calcified mesenteric nodes
C. Renal stones
D. Calcified rib
Ans. C
Q 213. CA prostate commonly metastasises to the vertebrae because:
A. Valveless communication exist with Batson¶s prevertebral plexus
B. Via drainage to sacral lymph node
C. Of direct spread
D. None of above
Ans. A
Q 214. Following sexual intercourse, a person develops pain in the left testes that does not get relieved
on elevation of scrotum. Diagnosis is:
A. Epididymo-orchitis
B. Torsion testis
C. Fournier¶s gangrene
D. Tumor testes
Ans. B
Q 215. A testicular tumor in a man aged 60 years is most likely to be:
A. Germ cell tumor
B. Sertoli cell tumor
C. Teratocarcinoma
D. Lymphoma
Ans. D
Q 216. A patient presents with bilateral proptosis, heat intolerance and palpitations. Most
unlikely diagnosis here would be:
A. Hashimoto¶s thyroiditis
B. Thyroid adenoma
C. Diffuse thyroid igoitre
D. Reidel¶s thyroiditis
Ans. D
Q 217. A patient with long standing multinodular goitre develops hoarseness of voice. Also, the swelling
undergoes sudden increase in size. Likely diagnosis is:
A. Follicular CA
B. Papillary CA
C. Medullary CA
D. Anaplastic CA
Ans. A
Q 218. A patient presents with swelling in the neck following a thyroidectomy. What is the most likely
resulting complication:
A. Respiratory obstruction
B. Recurrent laryngeal nerve palsy
C. Hypovolemia
D. Hypocalcemia
Ans. A
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:
A. Open sutures immediately
B. Intubate oro-tracheally
C. Wait and watch
D. Administer oxygen by mask
Ans. A
Q 220. Patient presents with neck swelling and respiratory distress few hours after a
thyroidectomy Surgery . Next management would be:
A. Open immediately
B. Tracheostomy
C. Wait and watch
D. Oxygen by mask
Ans. A
Q 221. A patient undergoes thyroid Surgery , following which he develops perioral tingling. Blood Ca2+ is
8.9 mEq. Next step is:
A. Vitamin D orally
B. Oral Ca2+ and vitamin D
C. Intravenous calcium gluconate and serial monitoring
D. Wait for Ca2+ to decrease to < 7.0 before taking further action
Ans. C
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:
A. Immediate laparotomy
B. Blood transfusion
C. Albumin transfusion
D. Abdominal compression
Ans. A
Q 223. Babu is brought to the emergency as a case of road- traffic accident. He is hypotensive. Most
likely ruptured organ is:
A. spleen
B. Mesentery
C. kidney
D. Rectum
Ans. A
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:
A. EDH
B. SDH
C. Intracranial hemorrhage
D. Intra-abdominal bleed
Ans. D
Q 225. Ulcer that may develop in burn tissue is:
A. Marjolin¶s
B. Rodent
C. Melanoma
D. Curling¶s
Ans. A
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:
A. Trauma
B. Atherosclerosis
C. Right ventricular failure
D. Syphilitic aortitis
Ans. B
Q 227. All of the following are correct regarding AV fistula except:
A. Arterialization of the veins
B. Proximal compression causes increase in heart rate
C. Overgrowth of a limb
D. Causes LV enlargement and LV failure
Ans. B
Q 228. All of the following are correct about axillary vein thrombosis except:
A. May be caused by a cervical rib
B. Treated with IV anticoagulant
C. Embolectomy is done in all cases
D. May occur following excessive exercise
Ans. C
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:
A. Hemimandibulectomy
B. Commando operation
C. Segmental mandiblectbmy
D. Marginal mandibulectomy
Ans. C
Q 230. Most common cause of unilateral parotid swelling in a 27 year old male is:
A. Warthin¶s tumor
B. Pleomorphic adenoma
C. Adenocarcinoma
D. Haemangioma
Ans. B
Q 231. A 45 year old woman presents with a hard and mobile lump in the breast. Next investigation is:
A. FNAC
B. USG
C. Mammography
D. Excision biopsy
Ans. A
Q 232. A 45 years old man presents with progressive cervical lymph nodes enlargement since 3 month.
Most diagnostic investigation is:
A. X-ray soft tissue
B. FNAC
C. Lymph node biopsy
D. None of the above
Ans. C
Q 233. All of the following are true about fibrolamellar carcinoma of the liver except:
A. Equal incidence in males and females
B. Better prognosis than HCC
C. AFP levels always greater than > 1000
D. Occur in younger individuals
Ans. C
Q 234. A child presents with an expansible swelling on medial side of the nose . Likely diagnosis is:
A. Teratoma
B. Meningocele
C. Dermoid cyst
D. Lipoma
Ans. B
orthopaedics
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:
A. Radial nerve
B. Musculocutaneous nerve
C. Axillary nerve
D. Ulnar nerve
Ans. B
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:
A. Unicameral bone cyst
B. Osteosarcoma
C. Osteoclastoma
D. Aneurysmal bone cyst
Ans. A
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:
A. Supracondylar FRACTURE humerus
B. Lateral condyle FRACTURE humerus
C. Medial condyle FRACTURE humerus
D. Posterior dislocation of the humerus
Ans. B
Q 238. A woman aged 60 years suffers a fall. Her lower limb is abducted and externally rotated.
Likely diagnosis is:
A. Neck of femur FRACTURE
B. Intertrochanteric femur FRACTURE
C. Posterior dislocation of hip
D. Anterior dislocation of hip
Ans. D
Q 239. Triple arthrodesis involves:
A. Calcaneocuboid, talonavicular and talocalcaneal
B. Tibiotalar, calcaneocuboid and talonavicular
C. Ankle joint, calcaneocuboid and talonavicular
D. None of the above
Ans. A
Q 240. Babu a 19 years old male has a small circumscribed sclerotic swelling over diaphysis of femur.
Likely diagnosisis:
A. Osteoclastoma
B. Osteosarcoma
C. Ewing¶s sarcoma
D. Osteoid osteoma
Ans. D
Q 241. Most common site of osteogenic sarcoma is:
A. Femur, upper end
B. Femur, lower end
C. Tibia, upper end
D. Tibia, lower end
Ans. B
Q 242. Involvement of PIP joint, DIP joint and the carpometacarpal joint of base of thumb with sparing the
wrist is seen in:
A. Rheumatoid arthritis
B. Osteoarthritis
C. Psoriatic arthritis
D. Pseudogout
Ans. B
Q 243. The pivot test is for:
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Medial meniscus
D. Lateral meniscus
Ans. A
Q 244. Iliotibial band contracture following polio is likely to result in:
A. Extension at hip
B. Extension at knee
C. Flexion at hip and knee
D. Extension at hip and knee
Ans. C
Anaesthesia
Q 245. All of the following agents can be given for induction of Anaesthesia in children except:
A. Halothane
B. Servoflurane
C. Morphine
D. Nitrous oxide
Ans. C
Q 246. Anaesthetic agent of choice in renal failure is:
A. Methoxyflurane
B. Isoflurane
C. Enflurane
D. None of the above
Ans. B
Q 247. A man with alcoholic liver failure requires general Anaesthesia for Surgery . Anaesthetic agent of
choice is:
A. Ether
B. Halothane
C. Methoxyflurane
D. Isoflurane
Ans. D
Q 248. All of the following are true except:
A. Halothane is good as an analgesic agent
B. Halothane sensitises the heart to action of catacholamines
C. Halothane relaxes brochi & is preferred as anaesthetics
D. Halothane may cause liver cell necrosis
Ans. A
Ophthalmology
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:
A. Acute anterior uveitis
B. Acute angle closure glaucoma
C. Acute open angle glaucoma
D. Senile cataract
Ans. A
Q 250. A woman complains of coloured haloes around lights in the evening, with nausea and vomiting,
IOP is normal.Diagnosis is:
A. Incipient stage, glaucoma open angle
B. Prodromal stage, closed angle glaucoma
C. Migraine
D. Raised ICT
Ans. B
Q 251. Babloo, a 5 years old child, presents with large cornea, lacrimation and photophobia. Diagnosis is:
A. Megalocornea
B. Congenital glaucoma
C. Congenital cataract
D. Anterior uveitis
Ans. B
Q 252. Herpes zoster ophthalmicus causes all except:
A. Nummular keratitis
B. Vitreal haemorrhage
C. Uveitis
D. Cranial nerve palsies
Ans. B
Q 253. Bilateral ptosis is not seen in:
A. Marfan¶s syndrome
B. Myaesthenia gravis
C. Myotonic dystrophy
D. Kearns-Sayre syndrome
Ans. A
Q 254. eye is deviated laterally and downwards and patient is unable to look up or medially. Likely nerve
involved is:
A. Trochlear
B. Trigeminal
C. Oculomotor
D. Abducent
Ans. C
Q 255. Left sided lateral gaze is affected in lesion of:
A. Right frontal lobe
B. Right occipital lobe
C. Left occipital lobe
D. Left frontal lobe
Ans. A
Q 256. An elderly male with heart disease presents with sudden loss of vision in one eye
. Examination reveals cherry red spot. Diagnosis is:
A. Central retinal vein occlusion
B. Central retinal artery occlusion
C. Amaurosis fugax
D. Acute ischemic optic neuritis
Ans. B
Q 257. Which of following, is not a feature in diabetic retinopathy on fundus examination:
A. Microaneurysms
B. Retinal hemorrhages
C. Arteriolar dilatation
D. Neovascularisation
Ans. C
Q 258. Vitamin B12 deficiency is likely to cause:
A. Bitemporal hemianopia
B. Binasal hemianopia
C. Heteronymous hemianopia
D. Centrocecal scotoma
Ans. D
Q 259. All are true regarding optic neuritis except:
A. Decreased visual acuity
B. Decreased pupillary reflex
C. Abnormal electroretinogram
D. Abnormal visual evoked response retinogram
Ans. C
Q 260. Chalky white optic disc on fundus examination is seen in all except:
A. Syphilis
B. Leber¶s hereditary optic neuropathy
C. Post papilledema optic neuritis
D. Traumatic injury to the optic nerve
Ans. D
ENT
Q 261. A 3 months old child presents with intermittent stridor. Most likely cause is:
A. Laryngotracheobronchitis
B. Laryngomalacia
C. Respiratory obstruction
D. Foreign body aspiration
Ans. B
Q 262. A patient presents with facial nerve palsy following head trauma with FRACTURE of the mastoid.
Best intervention here is:
A. Immediate decompression
B. Wait and watch
C. Facial sling
D. Steroids
Ans. A
Q 263. A case of Bell¶s palsy on steroids shows no improvement after 2 weeks. The next step in
management should be:
A. Vasodilators and ACTH
B. Physiotherapy and electrical stimulation
C. Increase steroid dosage
D. Electrophysiological nerve testing
Ans. D
Q 264. Chandu a 15 years aged boy presents with unilateral nasal blockade, mass in the cheek and
epistaxis. Likelydiagnosis is:
A. Nasopharyngeal CA
B. Angiofibroma
C. Inverted papilloma
D. None of the above
Ans. B
Q 265. A 40 years old diabetic presents with blackish nasal discharge and a mass in the nose .
Likely diagnosis is:
A. Mucormycosis
B. Actinomycosis
C. Rhinosporiodosis
D. Histoplasmosis
Ans. A
Q 266. Most radiosensitive tumour of the following is:
A. Supraglortic CA
B. CA glottis
C. CA nasopharynx
D. Subglottic CA
Ans. C
OBSTETRICS & Gynaecology
Q 267. Rokitansky Kuster Hauser syndrome is associated with:
A. Ovarian agenesis
B. Absent fallopian tube
C. Vaginal atresia
D. Bicornuate uterus
Ans. C
Q 268. A patient of 47 XXY karyotype presents with features of hypogonadism. The likely diagnosis is:
A. Turner syndrome
B. Klinefelter syndrome
C. Edward syndrome
D. Down syndrome
Ans. B
Q 269. A girl presents with primary amenorrhea, grade V thelarche, grade II pubarche, no axillary hair.
The likelydiagnosis is:
A. Testicular feminization
B. Mullerian agenesis
C. Turner syndrome
D. Gonadal dysgenesis
Ans. A
Q 270. A woman presents with amenorrhea of 6 weeks duration and lump in the right iliac fossa.
Investigation of choice is:
A. USG abdomen
B. Laparoscopy
C. CT scan
D. Shielded X-ray
Ans. A
Q 271. A woman presents with amenorrhea of 2 months duration lower abdominal pain, facial pallor,
fainting and shock.Diagnosis is:
A. Ruptured ovarian cyst
B. Ruptured ecotopic pregnancy
C. Threatened abortion
D. Septic abortion
Ans. B
Q 272. A young woman with six weeks amenorrhea presents with mass abdomen. USG shows empty
uterus. Diagnosisis:
A. Ovarian cyst
B. Ectopic pregnancy
C. Complete abortion
D. None of the above
Ans. B
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. Most likely diagnosis is:
A. Torsion of subserous fibroid
B. Torsion of ovarian cyst
C. Rupture of ectopic pregnancy
D. Rupture of ovarian cyst
Ans. B
Q 274. Basanti, a 28 years aged female with a history of 6 weeks of amenorrhea, presents with pain in
abdomen. USG shows fluid in pouch of Douglas. Aspiration yields dark colour blood that fails to clot. Most
probable diagnosis is:
A. Ruptured ovarian cyst
B. Ruptured ectopic pregnancy
C. Red degeneration of fibroid
D. Pelvic abscess
Ans. B
Q 275. A patient complains of post coital bleed. No growth is seen on per speculum examination. Next
step should be:
A. Colposcopic biopsy
B. Conization
C. Pap smear
D. Culdoscopy
Ans. A
Q 276. A 50 years old woman presents with post coital bleeding. A visible growth on cervix is detected on
per speculumexamination. Next investigation is:
A. Punch biopsy
B. Colposcopic biopsy
C. Pap smear
D. Cone biopsy
Ans. A
Q 277. Rekha, a 45 years woman, has negative pap smear with +ve endocervical curretage. Next step in
management will be:
A. Colposcopy
B. Vaginal hysterectomy
C. Conization
D. Wartheim¶s hysterectomy
Ans. D
Q 278. A case of carcinoma cervix is found in altered sensorium and is having hiccups. The likely cause
is:
A. Septicemia
B. Uremia
C. Raised ICT
D. Intestinal obstruction
Ans. B
Q 279. Bilateral ovarian cancer with capsule breached, ascites positive for malignant cells. Stage is:
A. I
B. II
C. III
D. IV
Ans. B
Q 280. The true regarding adenomyosis is:
A. More common in nullipara
B. Progestins are the agents of choice for medical management
C. Presents with menorrhagia, dysmenorrhoea, and an enlarged uterus
D. More common in young women
Ans. C
Q 281. In an infertile woman, endometrial biopsy reveals proliferative changes. Which hormone should be
preferred?
A. MDPA
B. Desogestrel
C. Norethisterone
D. None of the above
Ans. A
Q 282. A patient semen sample reveals: 15 million sperms/ml, 60 % normal morphology, 60% motile
sperms volume is 2 ml; no agglutination is seen. Diagnosis is:
A. Azoospermia
B. Aspermia
C. Oligospermia
D. Normospermia
Ans. C
Q 283. Primary peritonitis is more common in females because:
A. Ostia of fallopian tubes communicate with abdominal cavity
B. Peritoneum overlies the uterus
C. Rupture of functional ovarian cysts
D. None of the above.
Ans. A
Q 284. False statement regarding HCG is:
A. It is secreted by cytotrophoblasts
B. It acts on same receptor as LH does
C. It has luteotrophic action
D. It is a glycoprotein
Ans. A
Q 285. All of the following are false except:
A. Oxytocin sensitivity increased during delivery
B. Prostaglandins should be given during 2nd trimester
C. Ergot derivatives relax lower segment of uterus
D. Oxytocin is best for induction of labour in IUD
Ans. A
Q 286. Snow storm appearance on USG is seen in:
A. Hydatidiform mole
B. Ectopic pregnancy
C. Anencephaly
D. None of the above
Ans. A
Q 287. All of the following are indications for termination of pregnancy in APH patient except:
A. 37 weeks
B. IUD
C. Transverse lie
D. Continous bleeding
Ans. C
Q 288. A lady with 37 weeks pregnancy, presented with bleeding per vagina. Invetigation shows severe
degree of placenta previa. The treatment is:
A. Immediate CS
B. Blood transfusion
C. Conservative
D. Medical induction of labour
Ans. A
Q 289. A pregnant woman presents with red degeneration of fibroid. Management is:
A. Myomectomy
B. Conservative
C. Hysterectomy
D. Termination of pregnancy
Ans. B
Q 290. An ovarian cyst is detected in a pregnant woman. Management is:
A. Immediate removal by laprotomy
B. Wait and watch
C. Removal by laparotomy in second trimester
D. Remove at time of caesarean section
Ans. C
Q 291. Most useful investigation in the first trimester to identify risk of fetal malformation in a fetus of a
diabetic mother is:
A. Glycosylated Hb
B. Ultrasound
C. MS-AFP
D. Amniocentesis
Ans. A
Q 292. A pregnant diabetic on oral sulphonyl urea therapy is shifted to insulin. All of the followings are
true regarding this, except:
A. Oral hypoglycaemics cause PIH
B. Insulin does not cross placenta
C. Oral hypoglycaemics cross placenta and deplete fetal insulin
D. During pregnancy insulin requirement increases and cannot be met with sulphonylureas
Ans. A
Q 293. Condition associated with lack of a single pelvic ala is:
A. Robert¶s pelvis
B. Naegele¶s pelvis
C. Rachitic pelvis
D. Osteomalacia pelvis
Ans. B
Q 294. Consequence of maternal use of cocaine is:
A. Hydrops fetalis
B. Sacral agenesis
C. Cerebral infarction
D. Hypertrichosis
Ans. C
Q 295. DNA analysis of chorionic villus/amniocentesis is not likely to detect:
A. Tay Sachs¶ disease
B. Hemophilia A
C. Sickle cell disease
D. Duchenne muscular dystrophy
Ans. A
Q 296. A woman has had 2 previous anencephalic babies, risk of having a third one is:
A. 0%
B. 10%
C. 25%
D. 50%
Ans. B
Radiology
Q 297. A neonate presents with respiratory distress, contralateral mediastinal shift and multiple cystic
airfilled lesions in the chest. Most likely diagnosis is:
A. Congenital diaphragmatic hernia
B. Congenital lung cysts
C. Pneumonia
D. None of the above
Ans. A
Q 298. Ground glass appearance is not seen in:
A. Hyaline membrane disease
B. Pneumonia
C. Left to right shunt
D. Obstructive TAPVC
Ans. C
Q 299. Drug that is radioprotective:
A. Paclitaxel
B. Vincristine
C. Amifostine
D. Etoposide
Ans. C
Q 300. Most radiosensitive tumour of the following is:
A. CA kidney
B. CA colon
C. CA pancreas
D. CA cervix
Ans. D
_________________

 c@  
  

1. Right heart of the border is formed by ? ans. Svc ivc and right atrium remember NOT right ventricle.
2. Arch of aorta begins and ends at which level--- T2/T3/T4/T5 ans- T4
3. Glomus jugulare is present in ans. Carotid Body.
4. Which of the following is NOT the primary prevention for hypertension? Ans²Early diagnosis and
treatment( this is criteria for secondary prevention)
5. Treatment for pleomorphic adenoma? Ans--- Superficial Parotidectomy
6. Villous adenoma presents as ans²Hypokalemia
7. Which of the following is NOT a feature of Nephrotic syndrome ans--- Hematuria(seen in Nephritic
Syndrome)
8. Looser´s zone is present in Multiple myeloma/ Osteomalacia ans²Ostemalacia
9. Which element is present in Phosphofrucktokinase---- ans--- Magnesium
10. Lucid interval is present in ans--- Extradural hematoma
11. Which of the following is false about Wilm´s tumor A. presents before the age of 5 years B. mostly
presents as Abdominal Mass C. spreads mostly by Lymphatics ans--- C
12. Sudden hypocalcemia results in ans²Tetany
13. Subconjuctival hemorrhages are seen in ans²Pertussis( Donot remember other options)
14. Lacunar cells in which type of Hodgkins Lymphoma ans---Nodular Type
15. Basic pathology for renal rickets ans--- vitamin D malabsorption in intestinal cells
16. Antibodies diagnostic for SLE ans²anti ds DNA
17. Esotropia seen in ans²Uncrossed Diplopia
18. Grave´s Ophthalmopathy mostly presents as ans--- Proptosis
19. The most common cause of maternal mortality in india ans²heamorrhage
20. MMR is shown as ans²per lac LIVE BIRTHS
21. Early neonatal mortality doesNOT include ans--- Post neonatal mortality
22. Methionine are defecient in ans--- Pulses
23. Normal requirement of Iron during pregnancy? 2000/1500 not knowing the units as well as answer but
the options were like this.
24. Gower´s sign is seen in ans--- Duchhene Muscular Dystrophy
25. Tuberculosis in Pott´s disease involves what ans-- Spine
26. Munro micro abscesses and Auspitz sign are seen in ans--- Psoriasis
27. Wimberger´s sign seen in ans--- Scurvy ( Skin question)
28. cAMP is seen in Clostridium tetani/ Clostridium difficle/ Clostridium novyi/ and fourth option also was a
subtype of clostridium ans--- Clostridium perfringens
29. Technique used for RNA ans²Northern Blotting
30. Christmas disease is due to deficiency of ans²Defeciency of factor 9
31. Wincham´s striae is seen in Lichen planus/ Psoriasis ans²Lichen Planus
32. Day care anesathesia done by ans--- Propofol( NOT sure whether this question was in the exam or
not)
33. Substance used in Teletherapy Cesium/ Iridium ans--- Cesium
34. Material used for detection of bone metastasis ans²Tc99m
35. Which of the following does NOT present with hemoptysis Mitral stenosis/ Acute pulmonary oedema
ans²Acute pulmonary oedema
36. Malignant intraocular tumor of children Retinoblastoma/ Rhabdomyosarcoma ans--- Retinoblastoma
37. Which of the following is NOT seen in CRF? Ans²Hypophosphatemia
38. VDRL is what type of test ans²Slide flocculation test
39. Heterophile reaction is seen in ans²Weil Felix Reaction
40. Chalcosis is deposition of ans²Copper
41. Early feature of Diabetic Retinopathy ans²Microaneurysms
42. Which of the following is NOT a feature of Red Infarction Venous occlusion/ Occurs in organs having
dual circulation/ Occurs in solid organs ans--- Occurs in solid organs
43. Hirsutism is caused by ans------ Phenytoin
44. Gynacomastia is caused by ans--- ?
45. Which drug is NOT given in pregnancy ans²ACE Inhibitors
46. Arsenic poisoning mimics which disease Acute cholecystitis/ Acute gastroenteritis/?/? ans---? Check
from forensic book
47. Earliest immunoglobulin to be synthesized by foetus ans²IgM
48. Avascular necrosis occurs in ans²Talus( head of femur was not given) remember avascular necrosis
occurs in Femur, Scaphoid, Talus and Lunate
49. Workers working in Textile Industry suffer from ans²Bysinossis
50. ESI act does NOT cover Hotels/ Transpoters/ Railway/ Factory ans²Railway

51. PERT is a type of ans²Network output analysis


52. Which is the indicator of water pollution ans²E coli
53. Hallucinations NOT a feature ans²Always pathological
54. SINGLE drug treatment for trachoma( Read the question carefully) --- Tetracyclin/ Doxycycline/
Azithromycin ans²Doxycycline
55. Sinus NOT present at birth Sphenoidal/ Frontal/ Maxillary ans--?
56. Diagnosis of Interstitial lung disease done by ans²HRCT
57. Charecteristic of type2 respiratory failue ans²Low Pa oxygen and High Pa carbon dioxide
58. Mechanism of action of Cyanide ans--- Blocks Cytochrome enzyme P- 450
59. No Sweating occurs in ans--- Heat Stroke( Forensic Medicine)
60. Buerger´s disease involves ans---- Arteries, Veins and Nerves
61. Measure for Long term measurement Height for age/ Weight for age ans--- Height for age
62. Heller´s Operation is done in ans--- Achalasia Cardia
63. Psedomembranous colitis is caused by ans²Clostridium difficle
64. Folic acid is given during which trimester of pregnancy first/ second/ third/ puerperium ans--- First
65. Juvenile age is ?
66. Whats is Incidence Rate ans²It represents the no. of new cases in the community
67. Child age is 3 years he has how many teeths ans-- ?
68. NOT a part of Lochia rubra( Obs question) --- Blood cells/Decidua/ Platelets««. Ans---?
69. Which of the is NOT true about carbimazole ans--- Safely used in pregnancy(NOTE²Propylthiouracil
is used safely in pregnancy among anti thyroid drugs).
70. Adipocytes use which of following GLUT1/2/3/4 ans--- GLUT4
71. Which is feature of Irreversible cell injury ans--- Swelling of Mitochondria
72. Which is involved in transport in Mitochondria ans--- Carnitine
73. Least mode of transmission in HIV ans--- Sexual Intercourse(0.1-1.0 %)
74. According to census 2001 the urban population of india ans---27.4% ( SPM QUESTION)
75. Platelets are stored at what temperature ans--- 4 degree celsius
76. What area does palmar surface of hand represents in body surface are 1%/2%/3%/4% ans²1%
77. For shock patient best to check for administering fluid therapy ans--- Central Venous Pressure
78. Misoprostol is CONTRAINDICATED in not remembering options
79. Case related to Psychiatry ans²Hypochondriasis
80. Cellulitis is caused by Staph/ Streptococcus/ Klebsiella ans--- Streptococcus
81. Lobar pneumonia is caused by ans--- Streptococcus pnuemoniae
82. Codons are present in mRNA/ tRNA ans--- mRNA
83. Swine Flu caused in 2009 was due to H1N1/H5N1 ans²H1N1
84. Most common cancer WORLDWIDE Lung/ Breast/ Cervix/ Oral Cavity ans--- Lung Cancer
85. Drug of choice in PSVT Adenosine/ Verapamil ans²Adenosine(1st DOC and Verapamil is 2nd DOC)
86. First sign of Sexual maturity in BOYS Increase in height/ Increase in facial hairs/?/? ans--- Increase in
Facial hairs
87. Definition of Blindness ans--- Visual acuity less than 1/60 (Visual acuity less than 3/60 was NOT given
in options)
88. Question related to reflexes of Ambiguous Nucleus NOT seen is ans--- JAW REFLEX.
89. Beta2 adrenergic receptors does NOT act on which of the following ans--- Adipose Tissue
90. Which of the following diseases is NOT under WHO regulation Wild Poliomyelitis/SARS/Human
Influenza/ Cholera ans----- SARS
91. In which of the following interpretation is done in Results Achieved ans---- Cost Effectiveness
92. One question related to following are NOT feature of COST ACCOUNTING( SPM question)
93. First to appear in Anemia ans---- RETICULOCYTOSIS
94. First symptom of anemia Hypochromia/ Microcytic ans--- Microcytic
95. Teratogenic effects has NOT been seen with HIV/ Rubella/ CMV/ Varicella ans--- HIV
96. Nevirapine belongs to ans²NNRTI( Non Nucleoside Reverse Transcriptase Inhibitor).
97. Cherry red spot is seen in CRVO/ CRAO ans²CRAO
98 . Treatment of hypercholestremia Thiamine/Biotin/Pyridoxine/Vitamin B12 It was also some name of
vitamin ans-----Vitamin B12
99. Hartnup´s disease is due to deficiency of Phenyalanine/ Homogentisate ans------- Phenylalanine(
Tryptophan is produced from Phenylalanine).
100. Purine metabolism end product is ans---- Uric Acid

101. Defect seen in Vitiligo not remembering options


102. Flouride ions inhibit ans--- Enolase
103. Pneumatocele is caused by ans--- Staphylococcus
104. What is epiphora ans--- Abnormal flow of tears.
105. What is Peau de orange ( Surgery ques. From breast chapter) ans--- Occurs due to lymphatic
obstruction.
106. Earliest marker to rise in MI ans--- CPK-MB
107. In Dengue hemorrhagic fever, torniquest test is done for diagnosis presence of how many no. of
petechieas necessary 5/10/15/20 ans---20
108. Poliomyelitis is diagnosed by ans. Isolation of virus in stool
109. Wernicke"s disease is caused due to defeciency of ans. Vitamin B1
110. Traveller"s diarrohea is caused by ans. ETEC
111. Keratometer measures ans--- Curvature of cornea
112. Rape is defined under IPC375/376/377/378 ans---IPC375
113. Child of 2 years with mental age of 10years, what is his IQ 20%/ 30%/ 50%/ 70% ans²20%
114. Xanthine Oxidase requires Zinc/ Copper/ Iron/ Molybdenum ans--- Molybdenum
115. 8 sign in CXR seen in ans--- TAPVC
116. Allen´s test done for ans²Ulnar artery patency
117. Aspirin mechanism of action ans---- Irreversibly inhibits COX
118. Reversed cold chain used for AIIMS QUESTION not remembering the options as well as answer
119. Autosplenectomy seen in ans²Sickle Cell Anemia
120. Cobra venom is ans²Neurotoxic
121. ECG changes in Hyperkalemia ans--- Peaked T waves
122. LH surge time duration ans²24 hours
123. Most common site of Volvulus ans²Sigmoid Colon
124. HALDANE EFFECT ( Physio question)
125. Hepatitis E more common in ans--- Pregnancy
126. Most common lung cancer in non-smokers ans²Adenocarcinoma
127. Incubation period of Rabies depends on ans--- Depends on site of bite.
128. Content of Anatomical Snuff Box Anterior interosseous artery/ Posterior interosseous artery/ Radial
artery ans²Radial Artery
129. Anti TB drug being least Hepatotoxic Rifampicin/ Streptomycin ans--- Streptomycin
130. Which of the following does NOT have any cycloplegic and mydriatic effect ans²Pilocarpine
131. Cycloplegics are used for treatment of Angle closure glaucoma/ Closed angle glaucoma/ Iritis ans---
Iritis
132. Oschner-Sherren regimen used in Appendicular abscess/ Appendicular lump ans²Appendicular
Lump
133. Certificate of vaccination of Yellow Fever is valid for ___ years ans²10
134. Which of the following is NOT symptom of defeciency vitamin A Night blindness/ Xerophthalmia/
Follicular hyperkeratosis/ Polyneuropathy ans²Polyneuropathy
135. Safety muscle of Tongue Styloglossus/ Hyoglossus/ Genioglossus/ Palatoglossus ans²
Genioglossus
136. In visual pathway, ganglion cells are 1st order neuron/ 2nd order neuron ans--- 2nd order neuron
137. Mechanism of action of Telmisartan Blocks AT1 receptors/ Angiotensin 2 receptor antagonist ans----
Angiotensin 2 receptor antagonist
138. Predisposing factors for Carcinoma of penis are all except Pagets disease/ Phimosis/
Balanoposthitis/ Papilloma ans--- Papilloma
139. Fetal adrenals predominantly secrete Cortisone/ Aldosterone/ Testosterone/ Oestrogen ans----
Cortisone
140. Which muscle helps in opening Eustachian tube options were like Inferior turbinate/ Superior
turbinate/ Middle turbinate not remembering exact options but it was like this ans---- Inferior Turbinate
141. Which of the following is used in Teletherapy Cesium/ Iridium ans--- Cesium( Remember Iridium is
NOT used in teletherapy)
142. Calorie test activates what ans--- lateral NOT remembering exact otions but answer was this as it
was being asked from old papers of MCI
143. HCG during pregnancy doubles at ans--- 60-70 days
144. Most common donor for a transplant Mother/ Father/ Brother/ Identical twin ans--- Identical twin
145. Pschiatry case related to Acute Psychosis
146. Case on Medicine---- A woman has been Coronary artery disease when opened found gall stones.
Earlier mo history of pain and jaundice. Treatment--- ans--- ?
147. Metoprolol is preffered over Propanolol why? Has negative cholinergic action/ Has negative inotropic
action/ Doesnot blocks beta receptors/ Doesnot blocks alpha receptors ans---- Doesnot blocks alpha
receptors.
148. Benign prostatic hypertrophy is associated with Median lobe/ Posterior lobe/ Periurethral surface
ans²Median lobe ALL INDIA 2005 Q.4 MUDIT KHANNA
149. Cushing disease seen as a Paraneoplastic syndrome in ans---- Small cell lung carcinoma
150. Gastric lavage is contraindicated in ans--- Organophosphorus Poisoning

151. Illness criteria done by ans--- APACHE


152. Lower GI bleeding most common cause in india ans--- ?
153. Which of the following is NOT a feature of megaloblastic anemia Macro ovalocyte/ Megablastosis/
Heinz bodies/ ? ans---- Heinz Bodies
154. Most common symptom for Mountain sickness Headche/ Dizziness ans-- Headache
155. In nephrotic syndrome what infection is more common in children ans--- ?
156. What is Neurapraxia ans--- Defect in nerve conduction only
157. What are side effects of OCP except Thromboembolism/ Breast Carcinoma/ Ovarian tumor/ Liver
disease ans--- Ovarian Tumor( Remember OCP are NOT given In breast carcinoma BUT are used in
benign breast disease)
158. Sjogren´s syndrome all are true except Keratoconjuctivitis sicca/ Rheumatoid arthritis/ Xerostomia
ans--- Fourth option was the answer NOT remembering what was it
159. Peyer´s patches are present in Duodenum/ Jejunum/ Ileum ans---- Ileum
160. Features of Diffuse axonal injury options were related to hours of lost consciousness and some
some more also
161. Wood´s lamp is NOT used for there 2 options related to subtypes of tinea ONE of them was the
answer please confirm from book
162. Best method to prevent infection in a ward ans--- Proper hand washing
163. Features of Bacterial Vaginosis except Ph>4.5/ clue cells/ Increased lactobacillus ans--- Increased
lactobacillus
164. Which of the following DONOT inhibit bacterial cell wall synthesis Vancomycin/ Amikacin / Linezolid/
Aztreonam ans---- Amikacin
165. Which of the following has opsonins on its surface IgG/ IgM ans---- IgG
166. Free friable soft vegetations are seen in Infective endocartitis/ Libman sack´s endocartitis/
Rheumatic fever ans--- Rheumatic Fever
167. Triple arthrodesis doesNOT involve Calcaneocuboid/ Talanovicular/ Talocalcaneal/ Tibiotalar ans----
Tibiotalar
168. One question related to Housemaid´s Knee ( Ortho ques.)
169. Pemphigoid types all are autoimmune except ans--- ?
170. Side effects of glucocorticoids are all except Hyperkalemia/ Cataract/ Proximal myopathy ans----
Hyperkalema
171. Sudden loss of vision occurs in Diabetic Retinopathy reason ans---- Vitreous Hemorrhage
172. Tb bone disease spreads by Direct spread/ Blood/ Lymphatics/ All of the above ans--- All of the
above.
173. Sulfonyl urea drug mechanism of action are all except
174. Pulsus paradoxus is seen in ans--- Severe COPD
175. Rabies vaccine is prepared from which ans²Fixed Virus
176. Hyponatremia is seen in all except CCF/ Nephrotic syndrome ans--- Nephrotic Syndrome
177. Which of the following is true ans---- ICF is more than ECF ( Physio ques.)
178. Lens develop from ans--- Surface ectoderm
179. Chronic inflammation of Meiobian Gland is seen in External hordeolum/ Internal hordeolum/
Chalazion ans²Chalazion
180. Crew cut hair on end appearance on skull X ray seen in
Beta thalassemia/ Sickle cell anemia ans--- Beta thalassemia
181. Kussmaul´s sign is NOT seen in ans²Cardiac tamponade
182. Most common location of appendix ans--- Retrocaecal
183. HCG is secreted by Syncytiotrophoblast/ Cytotrophoblast ans--- Syncytiotrophoblast.
184. What is Rhinophyoma ans--- Hypertrophy of sebaceous glands.
185. Not a screening test for Carcinoma of breast FNAC/ Mammogram/ USG/ Self Examination ans----
FNAC
186. Drug NOT used in glaucoma Timolo/ Metoprolol/ Pilocarpine ans--- Metoprolol
187. Sweating occurs due to Cholinergic/ Anti- cholinergic Action ans--- Cholinergic Action
188. Menstrual regulation is done upto ans²42 days of Amenorrhea
189. NOT a feature of occulomotor palsy ans--- Proptosis
190. There was a question related to Triple glass test of urine done and in first glass test there is beaded
appearance seen What is diagnosis Cystitis/ Proastitis/ Urethritis ans²Urethritis
191. In a burn patient what type of fluid is given Normal Saline/ Ringer´s Lactate ans--- Ringer´s Lactate (
Learn this by heart very imp. and confusing question)
192. There was a question related to features seen in dengue hemorrhagic fever are all except NOT
remembering d options
193. Alzehemeir´s disease pathology Defeciency of cholinergic action/ Excess action of dopamine ans---
Excess action of dopamine
194. How is diagnosis of Vesicoureteral Reflux done ans--- Micturating cystourethrogram
195. Breast milk is produced from ans--- ?
196. Breast carcinoma most common type ans--- ?
197. Carrier state NOT seen in which infection Tetanus/ Ameobiasis/ Pertussis/ Diphtheria ans---- ?
198 . Investigation of choice in Cerebral calcification ans²CT Scan
199. Confirmatory test for Primary Syphilis VDRL/ TPI ans--- ?
200. Crescent air sign in CXR due to ans--- I marked ASPERGILLOSIS ( PLZ CONFIRM)

201. Furosemide mechanism of action in LVF ans²Inhibitor of NA-K-CL ion inhibitor ( Thiazide is inhibitor
of only NA- CL ions only NOT K ions).
202. Trendelenburg test is done in ans²Varicose Veins ( I donot remember the options otherwise it was
difficult to rule out)
203. Iron binding protein is Ferritin/ Apoferritin ans--- Apoferritin ( Plz confirm)
204. Contents of Ringer´s lactate are all except I donot remember exactly but it was something asked
about conc. Of NA K CL and one more.
205. There was one case of Leukemia
206. One more case for Aplastic anemia
207. Most common tumor in Oral area donot remember options as well as answer
208. One ortho question related to HOUSEMAID´S KNEE ( See Q. 168)
209. Melanoma of choroid spreads most commonly where Lungs/ Kidneys/ Adrenals ans-- ?
210. Submandibular gland is NOT supplied by which nerve ans--- ?
211. Mountain sickness prophylaxis ans--- ?
212. What is Xenograft ans--- Graft done from 1 species to other species.
213. Physiological jaundice is characterized by Appears in first 24 hours/ Peaks by some days/
Disappears by 3rd week of life ans--- Disappears by 3rd week of life
214. NOT a feature of Primary complex TB Apical cavity/ Ghon´s focus/ Lymphadenopathy ans--- Apical
cavity.
215. One question related to Radio immunoassay of HCG ans---- HCG detected as early as 8-9 days of
ovulation.
216. Radon226 spits into all except Alpha/ Beta/ Gamma/ X rays ans---- X Rays
217. Acetazolamide decreases IOP by what mechanism Decreases aqueous humor production/
Decreases vitreous volume ans--- Decreases vitreous volume ( Plz confirm)
218. Socially acquired behavior Acculturation/ Custom ( SPM question) ans--- Custom
219. Bezold abscess seen in ans--- Sternocleidomastoid Muscle



Study of the microscopic structure of the human organism co related with the development, function and
clinical significance.

It is derived from Greek term´ anatome´ meaning cutting apart.

 

It is the study of the formation and development of the embryo from the moment of its inception upto

the time when it is born as an infant.

Gonads: no: of chromosomes in an organism=23 pairs/46 no.

ƃ-----44 autosomes ±XY

Ƃ----44 autosomes - XX

Karyotyping : Classification of chromosomes based upon their differences that enable us to identify each
chromosome individually.

Spermatogenisis : The process of formation and development of spermatazoan .

Formed in the wall of the seminiferous tubules of testes.

Spermiogenesis (spermateleosis) : The process of transformation of a circular spermatid to a


spermatozoan.

Mature spermatozoan: Has a head, a neck middle piece and a principal piece or tail. Head is covered
with a cap called acrosome.

Length -50-60 microns

Golgi apparatus forms the acrosomic cap.

Nucleus forms head.

Mitochondrion forms the sheath of middle piece.

Proximal centriole comes to lie in the neck.


Distal centriole becomes ring shaped and forms the annulus.

Axial filament grows out from the centriole and is present in middle piece and tail.

Viability of spermatozoa =4 days.

: The shedding of ovum from the ovary.

Corpus luteum- It is an important structure derived after the rupture of ovarian follicle to shed the ovum.

It secretes hormone progesterone.

Viability of ovum =24 hrs

Menstrual cycle: Divided into 4 phases

1.Post menstrual phase

2.Proliferative

3.Secretory(premenstrual)

4.Menstrual

Follicular phase ---post menstrual + proliferate phase -~ Oestrogen

Luteal phase ± secretory +menstrual phase -~ progesterone

Size of Oocyte² 120u.

Approximate number of occytes at puberty²around 40,000.

Approximate number of ova liberated during reproductive period of female²around 300 to 400.

Time required for formation of spermatozoa from spermatogonium²64 days.

Fertilized ovum reaches uterine cavity²by 4 days.

Implantation of ovum (fertilized) occurs²about 7th day.

Primitive uteroplacental circulation begins²by end of 2nd week.

Number of somites in embryo ² 42 to 44.

Time of somite formation ² 21 to 30th day.

Organogenesis ² from 4th to 8th weeks.


Formation of primary ovary in a female takes place by 8th week

      

1.Persons with two X chromosomes are female; those with one x and one y are male.

2.Y chromosome bears a gene responsible for production of a testis determining factor.

3.Interstitial cells in testis produce testosterone .It forms a complex with certain receptor proteins which
attaches itself

to DNA. This causes the mesonephric duct to develop as in male.

4.Presence of dihydrotestosterone .

5.Sertoli cells produce mullerian inhibiting substance .This causes regression of paramesonephric ducts.

Genital swellings in male differentiate into scrotum whereas in a female, they form labia majora.

The mesonephric duct in a female develops into Gartner's duct.

The Mullerian ducts in male develop into appendix testes whereas in a female, they develop into uterus
and uterine tubes.

In female, the homologue of prostatic glands are paraurethral glands.


 


Differs from adult circulation in

a) Source of oxygenated blood is not the lung but the placenta.

b) Oxygenated blood from placenta comes to foetus through umbilical vein and joins the left branch of
portal vein.

Small portion passes through the substance of the liver to I V, but the greater part passes direct to I V
through the ductus venosus.

Changes at birth: 1) umbilical artery contracts.

2) Lumen of umbilical veins and ductus venosus occludes and this takes place a few minutes after birth.

3) Ductus arteriosus occludes by about 10 th day.

4) Pulmonary vessels increase in size.left atrial pressure rises than that of right atrium and leads to
closure of foramen ovale.

  
Umbilical artery - medial umbilical ligament

Left umbilical vein - ligament teres of the liver

Ductus venosus - Ligamentum venosum

Ductus arteriosus - Ligamentum arteriosum

c

Study of bones.

Bones are divided according to their

1)Position

Human skeleton -------axial} bones of skull, vertebral column, ribs, sternum, hyoid.

-------appendicular} bones of pectoral, pelvic girdle ,upper and lower limbs

2) Shape

Long bones: eg: Femur, tibia, humerus, ulna, radius, and fibula

Short long bones: eg: Metacarpals, metatarsals, phalanges

Short bones: eg: Carpals, tarsals

Flat bones: eg : Scapula , sternum, ribs, parietal and frontal.

Pneumatic bones : Maxillary ,sphenoid , ethmoid, mastoid part of temporal bone.

Irregular bones: eg: Vertebrae, skull bones

Sesamoid bone: eg: patella, pisciform, fabella

2)Structure

Compact bone =consisting of haversian system

Cancellous (spongy) bone = consisting of irregularly placed lamellae.

Diploic =consisting of inner and outer tables of compact bone with intervening porous layer.

3)Development

Ecto chondral bones: which develop in membrane (membranous)


Endochondral bones: which develop in cartilage. (cartilageneous)

Total no of bones ---206

Upper limbs-64

Lower limbs-62

Vertebrae-33

Skull - 29(14-facial bones

- 14- cranial bones , hyoid bone )

Sternum-1

Ribs- 12 pairs

Longest bone---femur

Smallest bone---stapes

Strongest part in human body- Enamel of teeth

Largest sesamoid bone --- Patella developing in quadriceps.

Microscopic unit of a bone: Haversian system (secondary osteone)



Process of gradual bone formation.

a)Ossification in membrane (direct)²easy process

Eg: clavicle, bones of face,vault of skull.

b)Ossification in cartilage (Indirect) ---gradual process.

Eg: bones of limbs, trunk.

Secondary cartilage bone: eg: neck of mandible, sternal end of clavicle.

Primary centres of ossification may be single or multiple ,appear before birth between 6th ± 8th week of
foetal life

except cuneiform ,navicular bones .

Secondary centres of ossification are multiple and appear after birth except lower end of femur.
Ossification of acetabulum is complete at 16-17 years

Growing ends of bones of upper limb²upper end of humerus & Lower end of radius and
ulna

Growing ends of bones of lower limbs ---- lower end of femur & Upper limbs of tibia and fibula

In long bones, growing ends fuse with shaft at 20 yrs and opposite ends at about 18 yrs.

In other bones it is between 20-25 yrs.

     

a) Pressure epiphyses - located at pressure points like joints

b) Traction epiphyses: subjected to traction by pull of muscles when located at the muscular attachment

c) Atavistic epiphyses: centre appearing in the part of bone which was orginally a separate bone in
evolution eg : Coracoid

process of scapula.

Hyaline cartilage has a tendency to get calcified in later years of life.

c   ²22 bones

Facial bones (14)-paired-nasal, maxillae, zygomatic, palantine, lachrymal, inferior nasal connchae.

Unpaired-mandible, vomer

Cranial bones (14)-paired- parietal, temporal, ear ossicles

Unpaired- frontal, ethmoid, sphenoid, occipital.

Carpal bones- 8 bones Lat TO medial (Proximal) Scaphoid, lunate, triquetral, pisiform

(Distal)²Trapezium, trapezoid, capitate, hamate.

Tarsal bones-7 bones (proximal) Talus, calcaneus

(distal) medial cuneiform, intermediate cuneiform, lateral cuneiform, cuboid.

Largest and strongest of tarsal bones²Calcaneus

@   4 pairs : Frontal, sphenoidal, ethmoidal, maxillary.

Largest of all air sinuses ---Maxillary sinus (Antrum of Highmore)


   

Anterior cranial fossa :

1.Foramen caecum: lies between the alae of crista galli of ethmoid and frontal crest. Transmits an
emissary vein.

Middle cranial fossa:

2.Optic canal (foramen): Transmits optic nerve, opthalmic artery.

3.Superior orbital fissure: Bounded by lesser wing above, greater wing below and body of sphenoid
medially.

Divided by three compartments by common tendinous ring.

 ±superior and inferior divisions of oculomotor, nasociliary nerve, abducent nerve, trochlear
nerve, frontal nerve,

lacrimal nerve, lachrimal artery, orbital branch of middle meningeal artery, superior ophthalmic
vein,recurrent meningeal

branch of lachrymal artery, inferior ophthalmic vein.

4.Foramen rotundum---transmits maxillary nerve.

5. Foramen ovale --- transmits mandibular nerve,accessory meningeal artery ,lesser superficial petrosal
nerve, emissary vein.

6. Foramen spinosum--- transmits middle meningeal artery, nervus spinosus

7. Foramen lacerum--- transmits Internal carotid artery.

8. Carotid canal---- transmits internal carotid artery with plexus, emissary veins, meningeal lymphatics.

Posterior cranial fossa:

9. Jugular foramen --- transmits 9th,, 10, 11th cranial nerves.

10. Foramen magnum---largest foramen in skull.

Divided into anterior small compartment: Apical ligament

Upper band of cruciate ligament

Condylar parts on sides.

Posterior large compartment: lower end of medulla oblongata, 2 anterior and one posterior spinal artery,
veins joining
venous plexus, lower part of tonsil of cerebellum, vertebral artery, sympathetic plexus, spinal root of
accessory nerve.

: 12 in number on each side.

True ribs²1-7th

False ribs--- 8-12th

Floating ribs --- 11-12th

Atypical ribs²1, 2, and 10.11, 12th.

    

Falx cerebri ± encloses superior sagittal sinus, inferior sagittal sinus, straight sinus

Tentorium cerebelli- encloses transverse sinuses, posterior petrosal sinuses.

Falx cerebelli²encloses occipital sinus

Diaphragma sellae²encloses anterior and posterior intercavernous sinuses.

    

1.Bregma: meeting of coronal and sagittal sutures.site of anterior fontanelle, closes at 11/2 yrs of age.

2 .Lambda: meeting of sagittal and lambdoid sutures .site of posterior fontanelle ,closes at 2-3 months of
age.

3. Nasion : meeting point of internasal and fronto nasal sutures.

4. Inion : centre of external occipital protruberance.

5. Pterion : area formed by meeting of frontal, squamous part of temporal ,parietal, greater wing of
sphenoid.deep to

this lies anterior branch of middle meningeal artery, middle meningeal vein ,stem of the lateral sulcus.

6. Asterion : point at the postero inferior angle of parietal bones.

 

Inferior aperture (outlet )of thorax.

Aortic opening²T12- transmits Aorta, thoracic duct, Azygos vein

Oesophageal opening²T10-transmits oesophagus, gastric nerves, oesophageal branches of left gastic


artery.

Venecaval opening --- T8 transmits inferior venecava, branches of right phrenic nerve.

c@
 
 c

Definition

CSF is a modified tissue fluid in the central nervous system. It is contained in the ventricular system of
brain and the

subarad space of brain and spinal cord. CSF replaces lymph in the CNS. It acts as a sensitive mirror
which reflects

diseases of the na system. Formation

1.The bulk of the CSF is formed by choroid plexuses of the lateral ventricules, and the lesser amounts by
the choroid plexus

the third and fourth ventricles. '

2.Possibly it is also formed by the capillaries on the surface of the brain and spinal cord.



CSF passes from the lateral ventricles to the third ventricle through foramina of Monro (interventricular
foramina). From

ventricle it passes to the fourth ventricle through cerebral aqueduct. From fourth ventricle the CSF
passes to the subarachnoid

around the brain and spinal cord through the foramen of Magendie and foramina of Luschka.

Absorption

1.CSF is absorbed chiefly by the arachnoid villi and granulations, and is thus drained to the cranial
venous sinuses.

2.It is also absorbed partly by the perineural lymphatics around I, II, VII and VIII cranial nerves

3.And also by the veins related to the spinal nerves.

Rate of Formation

200 cc/hour, 5000 cc/day.

Total Quantity About 150 cc. Pressure:60-150 mm of fluid (or water). Composition

Proteins 20-40 mg per 100 cc.


Sugar 50-75 mg per 100 cc.

Chlorides 720-750 mg per 100 cc.

Cells 0-5 per cubic mm

Functions

It is (a) protective, (b) nutritive, and (c) excretory to the CNS.

Applied Anatomy

1.CSF can be obtained by (a) lumbar puncture, (b) cisternal puncture, or (e) ventricular puncture. Lumbar
puncture is 1st

method of all and is commonly used. It is done in the interspace between third and fourth lumbar spines.

2.Biochemical analysis of the CSF is of diagnostic value, as the cases of meningitis and spinal tumours.

3.Drainage of CSF at regular intervals is of therapeutic value in meningitis. Certain intractable headaches
of unknown are

also known having been caused by a mere lumbar puncture with drainage of CSF.

4.Obstruction to the flow of CSF in the ventricular system of brain leads to hydrocephalus in children
.Spinal obstruction

leads to Froins syndrome.

  of parotid duct: 5 cm.

Length of submandibular duct: 5 cm.

Length of auditory tube: 36 mm.

Bony part: 12 mm.

Cartilagenous part: 24 mm

Length of external acoustic meatus(from bottom of choncha): 2.4 cm.

Bony part:16 mm.

Cartilagenous part:8 mm.

Transverse diameter of mid cavity

Opposite the centre of tympanic membrane: 2 mm.


Total number of cones in the  : 6.3 to 6.8 million.

Length of pharynx: 12 to 14 cm

Length of larynx

Length of vocal cords

Length of Trachea -

Pituitary gland: 13 x 8 mm.

Heart ² Measures 12 x 9 cm (5x3 or 3.5 inches)

Weight 300 g (males)

250 g (females)

Termination of oesophagus 11th Thoracic vertebra.

     :

· at commencement 15 cm from incisor teeth.

· at crossing over by aortic arch 22.5 cm from incisor teeth.

· at crossing over by left principal bronchus 27.5 cm from incisor teeth.

· at its point of piercing diaphragm 40 cm from incisor teeth.

c

· Cardiac orifice ² Behind left 7th costal cartilage 1" from its junction with sternum.

· Pyloric orifice ² 1.2 cm (0.5") to the right of midline on transpyloric plane.

· Capacity ² at birth 30 ml; adults 1500 ml.

Length of small intestine: 6 to7 metres

Length of duodenum: 10´ or 25 cm

1 st part: 5 cm

2nd part: 7.5 cm

3rd part: 10 cm
4th part: 2.5 cm

Length of large gut: 1.5 metres

Anal canal

Hilum of kidney ² Transpyloric plane (LI).

¢  :Length: 11 cm, Breadth : 6 cm, Antero-posterior diameter: 3 cm

Length of Ureter : 25 cm

Length of male urethra: 18-20 cm

Spermatic cord : 9-10 cm

Length of inguinal canal: 4 cm

Testis: Length-4.5 cm, Breadth-2.5cm, Anteroposterior dr-3

Ovary: Length -3 cm, Width-1.5 cm,Thickness-1 cm

 : Length-7.5 cm, Breadth-5 cm,Antero-posterior diameter-2.5 cm

Weight :30 to 40 gms

   : Length-10 cm

Saphenous opening ² Height 1.5 to 8 cm; Width 1 to 3 cm

Femoral sheath ² Length 3 to 4 cm.

Femoral canal ² Length 1.25 cm.

Tendo calcaneus ² Length 15 cm.

!      ² 30 gms.

Length of spinal cord ² 45 cm.

Filum terminale ² 20 cm.

Internum ²15 cm.

Externum ² 5 cm.

Commencement of spinal cord ² Cranial border of C1 vertebra (Atlas).

Termination of spinal cord -² lower border of LI or disc between LI & L2 vertebrae.


Cervical enlargement of spinal cord ² Circumference 39 mm. Extends from LI to SI spinal segments.

Lumbar enlargement of spinal cord ² Circumference 35 mm. Extends from LI to S3 spinal segments.

å          

Cervical vertebral spine corresponds to succeeding cord segment Eg : C6 spine to C7 segment.

Upper thoracic spine corresponds to two spinal segments lower Eg : T4 spine corresponds to T4 spinal
segments.

Lower thoracic spine corresponds to three spinal sements below Eg : T10 spine to LI spinal segment. T11
spine to

L3segment, T12 spine to SI segment.

New born child lower limit of spinal cord is at ² L3 vertebral upper border.

Length of medulla oblongata ² 3 cm.

Shortest segment of brain stem ² mid brain 2.cm.

Thalamus-Length ²- 4 cm.

Corpus callosum length 10 cm.

Specific gravity of C.S.F: 1007.

Pressure of CSF (in recumbent position):100 to 150 mm of H2O

Total volume of CSF in man: 140 ml; amount of CSF in Ventricles 25 ml.

Commencement of subclavian artery ² Behind sternoclavicular joint.

Termination of Subclavian artery ² Outer border of 1st rib.

Termination of Brachial artery ² Neck of radius.

  

Commencement ² T4 Vertebral lower border.

Termination ² T12 Vertebral body.

Abdominal Aorta commencement ² T12 Vertebral body.

   :Origin ² T12, Length ²1.25 cm.Superior mesenteric artery ² LI.
Inferior mesenteric artery ²L3.

Commencement of common iliac ²L4 vertebral body.

Bifurcation of common iliac²Sacroiliac joint

External iliac termination ²Mid-inguinal point.

Vertebral prominence ² C7.

Superior angle of scapula ²T2.

Upper border of manubrium sterni (suprasternal notch)²T2, T3 vertebral junction.

Spine of scapula ²T3

c   ²T4 & T5 (Disc between).

Inferior angle of scapula ² T7.

Xiphisternal joint ² T9.

Tonsil is derived from 2nd pouch

CSF to plasma glucose ratio is normally 0.6 to 0.8

Appearance of permanent kidney ² 5th week of Intrauterine period.

Invasion of primordial germ cells into developing gonad ² 5th week.

Appearance of neural plate (nervous system) ² 3rd week.

Development of eye ² between 4th and 7th weeks.

Appearance of limb buds ² beginning of 5th week.

    :

At deep inguinal ring² 7th month of intra uterine life.

In inguinal canal ² 8th month of intrauterine life.

At superficial inguinal ring ² 9th month of intrauterine life.

Haller's circle is found in the Pyloric orifice.

Marginal artery of Sudeck lies at 2.5-3.8 cm from colon.

Portal vein is about 8 cm long.


The maximum breadth of mesentry is in central part and is 8 inches

The lesser omentum is a fold of peritoneum extending from lesser curvature of stomach and first 2 cm of
duodenum to the liver.

Common carotid artery is derived from III aortic arch.

At full term, diameter of placenta is 6-8 inches.

  contains about 100-200 lymph nodes.

Between lowest sigmoid and sup. Rectal artery anastomosis is regarded as the critical point of Sudeck.

Mesentry is fan shaped fold of peritoneum.

Total area of placenta is 14 sq. m.

Oesophagus structure is related to both left and right lung.

Weight of parathyroid gland is 50 mg.

Length of caecum is 6 cm.

Sprain of ankle is most often due to abduction.

The superficial muscles of the back of leg are supplied by S1,2.

Thickness of suprarenal is 10 mm.

Duodenojejunal is largest duodenal recess.

Cisterna chyli is 5-7 cm long.

Ovary has     "

V pharyngeal arch disappears at the earliest.

Weight of prostate gland is 8 gm.

Longest part of duodenum is III.

Left dome of diaphragm corresponds to the lowest part of 5 rib.

Width of stomach is 10-12 cm.

Claustrum is situated between putamen and Insula

Third ventricles are derived from Diencephalon.


Thickness of spleen is 3-4 cm.

Middle one third of transverse colon is derived from midgut.

Placental membrane at its formation is 0.025 mm thick.

Syncytiotrophoblast is called plasmoditrophoplast.

Midbrain is Mesencephalon.

The left brachiocephalic vein is about 7.5 cm long.

Deep palmar arch is about 4 cm long.

Spine of scapula corresponds to 3rd thoracic spine.

Pereoneal tubercle if felt as a prominence about 2.0 cm below tip of lateral malleolus.

Hip joint lies 1.2 cm vertically below the middle third of inguinal ligament.

Pulmonary arteries are derived from å


  "

Ischial tuberosity is felt 5.0 cm away from the median plane.

Nelaton's line touches the centre of acetabulum, ishcial tube and Ant. sup. iliac spine.

Filum terminale is about 20 cm long which extends from conus medullaris to the back of the 1st coccygeal
vertebral segment

The duramater of spinal cord ends at S2 vertebral level.

# point is C4 C5.

Ureter is 50 cm long.

Distance between upper incisors and gastroesophageal junction is 40 cm.

The ratio of weight of liver and weight in an adult is 1: 40.

Oesophagus crosses the diaphragm at level of T10.

Developing gonad is identified as male or female by the end of 7th week.

The infant with pupillary membrane must have been product of pregnancy lasting less than 7 months.

Stillborn foetus with eyelids fused is of 3-7 months.

Length of a mature human spermatozoon is 50-60 microns.


Breast development in intrauterine life starts at 12 weeks.

Point situated 1 cm below sacral promontary representing CG of body is Weber's point.

The number of ossification centres in the hyoid bone is 6.

Great saphenous vein is exposed anterior to medial malleolus at 2.5 cm.

Ossification centres for all carpal bones is found by 5th year.

Xiphisternal junction is usually at the level of disc between      "

Length of ductus deferens is usually 45 cms.

Frontal eye field motor area is 8.

Nerve supplying submandibular gland is VII nerve.

Length of female urethra is 4 cm.

Root value of phrenic nerve is C^5.

Sacral canal's volume is 25-35 c.c.

Detrusor is supplied by Sj_4.

At midaxillary line, parietal pleura extend up to level of 10th rib.

The weight of the left healthy lung is 570 gm and that of right is 620 gm.

The SA node is by a branch of the right coronary artery in 65%.

The AV node is supplied by a branch of the right coronary artery in 80%.

·Upto 80% of liver resection can be tolerated by noncirrhotic individual.

·Liver has a high power of regeneration. Following resection of two third portion of liver, it regenerates in
about six month

·Hepatocytes drain about one litre of bile daily into bile canaliculi.

·Common bile duct (CBD) is about 10 cm long.

·Normal size of CBD is 6-10 mm.

·Normal pressure in portal vein is $% . of Hg.

·Average size of spleen is about 5x3x1 inch. Average weight is about 150 gm.
·Average size of kidney is been shaped, having weight about 150 gm.

·Blood flow through each Kidney is 1-2 litre per minute.

·Normal capacity of UB is about 250 ml. but can accommodate upto 500 ml of Urine.

·Prostate secretes 0.5-2 ml of fluid per day, which contains Acid Phosphatase, Prostate glandins,
Fibrinogen and Citric Acid.

·Length of large intestine is'1.5 m.

·Length of anal canal is 3.8 cm.

·Part of anal canal about 15 mm below anal valves is the transitional zone pectin.

·Bile duct is 7.5-10 cm long.

·Gall bladder has Capacity of 45 ml (range 30 to 50 ml) and length of 7.5 to 10 cm. \

·Ureter lies 2 cm lateral to cervix and Uterine artery crosses above and infront of ureter.

·Size of ovary is Length 3 cm, Width 1.5 cm, Thickness 1 cm.

·Vascular segments of     &"

·Number of lobules in foetal kidney is 12.

·Saphenous opening is a gap in fascia lata of thigh, situated 4 cm. below and lateral to pubic tubercle. Its
sharp edge is called falciform margin.

·Saphenous opening is covered by cribriform fascia.

·Inter alveolar septum²0.2 m thick (Arithmetic means thickness of barrier in human is 2.2 nun).

·Manubriosternal angle may be ossified after the age of 30 years.

·Cervical curve appears in intrauterine life and accentuaies by 3 or 4 months when the child hold up the
head.

·  appears at 12 to 18 months when the child begins to walk.

·Subpubic arch is more angular in males (50° to 60°), in females it is wide usualy 80° to 85°.

·Greater sciatic notch is wider in females ² 50.4° and in males is ² 74.4°.

·Sacral index in males 10.5% and in females 115%.

·In hip joint, extension beyond vertical is 10° to 20°.


·Extension of knee beyond vertical femoro-tibial axis is 5° -10° and flexion is 120° with extended hip joint.

·Passive rotation in knee is about 60° to 70° but conjuct rotation is only about 20°.

·In "Colles "fracture", there is a fracture of distal end of radius with displacement of lower fragment
backwards and upward. This occurs due to fall of outstretched hand. Resulting deformity is dinner fork
deformity.

·Anal canal is 38 mm long (upper - 15 mm, middle - 15 mm, lower - 8 mm)

·In hip, primary centres of ossification appear in the order of ilium (2nd month), ischium (4th month), and
pubis .

Main action of     is lateral rotation.

Foramen lacerum lies in between petrous part of temporal bone and sphenoid.

Parotid duct pierces the buccinator muscle.

Functional tissue of lungs is alveoli.

Carpal tunnel syndrom involves median nerve

Meckel's diverticulum arises from the antimesenteric border of ileum.

Auerback's plexus is located in oesophagus.

Brachialis is supplied by musculocutaneous as well as radial nerve.

Gluteus maximus is supplied by inferior gluteal nerve.

Trendelenburg sign may be positive in gluteal medius paralysis.

Elbow is a condyloid joint

Left testicular vein drains into left renal vein.

Flexor digitorum profundus has a dual nerve supply.

Anterior interosseus artery is a branch of   "

Purkinje cells in cerebellum are input cells.

The most fixed part of the GIT is duodenum.

The glands of Brunner are seen in duodenum.

Spinal part of accessory nerve supplies sternocleidomastoid muscle.


T-s free border of lesser omentum contains hepatic artery, portal vein and bile duct.

Lateral rectus is supplied by VI cranial nerve.

Dentate nucleus is a part of cerebellum.

Lamina cribrosa is modification of sclera.

Automatic bladder is seen in lesions of higher centres whereas lesions at lower centres lead to autonomic
bladder.

  is occupied by the coronary sinus.

Siren or vena cava is formed by brachiocephalic veins.

The base of heart, formed by atria, lies opposite the 5th-9th thoracic vertebrae.

All the tongue muscles are supplied by hypoglossal nerve except palatoglossus muscle which is supplied
by pharyngeal plexus of nerves

·Tympanic membrane is derived from ecto, meso and entoderm.

·Edochondral ossification is seen in scapula.

·Melanoblasts are derived from neural crest cells.

·Human placenta is haemochorial.

·Commonest part of aorta ruptured in trauma is junction of thoracic and abdominal aorta.

·The only pharyngeal muscle innervated by the glossopharyngeal nerve is stylopharyngeus.

·Radial bursa encloses the tendon of flexor pollicis longus.

·Choroid fissure of the eye permits the entry of hyaloid artery.

·Uncinate fasciculus connects frontal and temporal lobes.

·Musician's nerve is    "

·Ligament of Cooper is related to breast.

·Jacobson's nerve is a branch of IX nerve.

·Fascia cribrosa is related to femoral canal.

·Boa's point is a tender spot felt in the left of T12 in a patient with gastric ulcer.
·Buck's fascia is related to penis.

·Prostoperitoneal fascia is Denonviller's fascia.

·Fascial extension of lacunar ligament along iliopectineal line is Cooper's ligament.

·Alderman's nerve is a branch of X nerve.

·Labourer's nerve is median nerve.

·Veins communicating the cavernous sinus to pterygoid plexus pass through fossa of Vesalli.

·Duct of Rivinus is found in sublingual gland.

·Foramen transversarium transmits vertebral artery.

.Krause's glands are   "

·Hepatorenal pouch is Morrison's pouch.

.Cowper's glands are found in bulbous urethra.

·Duct of Santorini is accessory pancreatic duct.

·Anterior interventricular artery is branch of left coronary artery whereas posterior one is a branch of right
coronary arti

·Thinnest portion of myocardial wall is left and right atria.

.The nerve related to medial epicondyle is ulnar.

·Depressor of mandible is lateral pterygoid.

·Edinger Westphal nucleus is General Visceral Efferent.

·Hofbauer cells are present in placenta.

·Transpyloric plane passes through L1 vertebra.

·c     is Trochlear.

·Charcot's artery is a branch of middle cerebral artery.

·Apelike hand occurs in median nerve palsy at wrist.

·Inferior tibiofibular joint is syndesmosis type of joint.

·Mandibular canal contains inferior alveolar nerve.


·Costocoracoid membrane of axilla is pierced by lateral pectoral nerve.

·Most stable position of the ankle joint is dorsiflexion.

·General sensation of nulliparous uterus is anteversion and anteflexion.

·Highest intercostal space used for liver biopsy is 8th.

·The weakest parts of inguinal canal are superficial and deep inguinal rings.

  hernia commonest on the left is traumatic hernia.

Flexion of the knee joint takes place in the upper compartment.

The nerve responsible for fine movements of the hand is ulnar.

The retraction of shoulder is caused by serratus anterior.

Accessory pancreatic duct is also called Bernard's duct.

Thoracic duct is also called Pecquet duct.

Superficial fatty fascia between umbilicus and pubis is Camper fascia.

Parasympathetic outflow from sacral plexus is nerve Erigentes.

CSF is partly absorbed by lymphatics around I, II, VII and VIII cranial nerves.

The appendix is most often found in retrocaecal position.

Juxta glomerular cells are smooth muscular cells of afferent arteriole.

Fascia of Gerota is thoracolumbar fascia.

Isthmus of the thyroid gland is found across 3-5 th tracheal rings.

  develops from ectoderm.

The movement of version of the foot takes place mainly in subtalar joint, calcaneonavicular and
calcaneocuboid joints.

Incisior foramina in the mouth are foramen of Vesalli.

Peroneal artery is a branch of posterior tibial artery.

Unlocking of knee joint to permit flexion is caused by popliteus.

   or Tailor's muscle in body is sartorius.


Boxer's muscle is serratus anterior.

Toynbee's muscle is tensor tympani.

Muscle used for grinning is Risorius.

OS trigonum is atavistic type of epiphysis.

Umbilical vesicle attains full development in 4 weeks of foetal development.

The principal sensory nerve of the larynx is the superior laryngeal nerve.

The central canal of spinal canal is central in lumbar region.

Atriventricular (A-V) node is supplied by right coronary artery.

Sinoartrial node is situated at the junction of SVC and right atrium.

Koch's triangle is bounded by septal leaflet of tricuspid value, tendon of Todaro and orifice of coronary
sinus.

Germ cells in ovary develop from yolk sac.

Base of heart is formed by both "

Lymphatics from testes or ovaries drain into para aortic lymph nodes.

Broca's area is situated in inferior frontal gyrus.

Tail of pancreas contains more islets of Langerhans.

Saphenous opening is below and lateral to pubic tubercle.

Thymus develops from endoderm of III pharyngeal pouch.

Cell bodies of II order neuron for pain are situated in spinal cord.

In Wolf Parkinson White Syndrome, there is connection between atria and ventricles.

C-cells in thyroid gland are derived from Ultimobranchial body.

Lymphatics from tonsil drain into Juguloomohyoid nodes.

J receptors are situated in alveolar epithelium.

Swallowing centre is situated in medulla.

Angle of mandible is supplied by greater auricular nerve.


Nasolacrimal duct drains into    "

Injury to axillary nerve mainly causes loss of abduction.

Wrist drop (injury in upper arm) or Saturday night palsy injury in radial groove is caused by radial nerve
injury.

Adult larynx extends from C3 to C6.

Great vein of Galen drains into straight sinus.

q   c also called cerebral aqueduct connects III and IV ventricle.

When testicular veins are ligated, the testes areq drained by cremasteric veins.

Horner's Syndrome consists of miosis, ptosis andq anhidrosis.

Uterus develops from Mullerian duct.q

Callot's triangle is bounded by inferior border ofq liver, common hepatic duct and cystic duct.

Failure of fusion of ostium primum and ostium secundumq leads to patent foramen ovale.

Oogonia are supplied from Yolk sac.q

Cartwheel appearance of nucleus is seen in Sertoliq cells.

Pinna is fully formed at birth.q

Ligament of Bigelow is present in hipq joint.

Uterine artery is a branch of anterior internal iliacq artery.

The narrowest part of male urethra is externalq meatus.

Ophthalmic artery is a branch of cerebral part ofq internal cartoid artery.

Wharton duct drains submandibularq gland.

Clavicle is the first bone toq ossify.

Paralysis of gluteus maximus is most noticeablyq affected the gait cycle at heel strike.

Femur is the longest and strongest bone of theq body.

The ischiofemoral ligament is most taut when femur isq extended.

11th and 12th ribs are floatingq ribs.


Cremasteric artery is a branch of inferiorq epigastric.

The largest cranial nerve isq trigeminal.

Deep artery of Penis is a branch of internalq iliac.

Ejaculation is a fraction of sympathetic nervousq system whereas erection is of parasympathetics.

Cystic artery is a branch of rightq hepatic.

Trochlear nerve has the longest intracranialq course.

Vertebral veins drain into brachiocephalicq veins.

Ovum was discovered by von Baer.q

Kerckring's centre for ossification is associated withq occipital bones.

Foramen rotundum transmits maxillaryq nerve.

Gartner's duct is a remnant of Wolffianq duct.

Primordial germ cells are first seen in wall of yolkq sac.

Father of Modern anatomy isq    å "

William Harvey described human bloodq circulation.

Vocal cords are abducted by Posteriorq cricoarytenoid.

Spinal cord in an adult ends at level ofq LI

Mitral orifice lies at level of 4th costalq cartilage.

The central structure of axilla' is said to beq axillary artery.

Strongest ligaments of sacroiliac joint areq interosseus ligaments.

The ligamentum arteriosum extends between theq concavity of the aortic arch and the left pulmonary
artery. It is remnanl the ductus arteriosus, a channel which conducted deoxygenated blood from the
pulmonary artery to the aorta during fetal 1

The transverse fissure is found only in the rightq lung.

A section of the upper lobe consisting of twoq bronchopulmonary segments is known as the lingula.

The surface markings from the lower border of theq lungs during quiet breathing are the 6th costal
cartilage, 8th rib in the axillary line, and the 1 Oth thoracic spine.
The Thoracic duct passes through the aortic opening inq the diaphragm.

The thoracic duct drains lymph from all over the body,q except from the right side of the heart and the
right upper limb.

The joint between the head of a typical rib and twoq vertebral bodies is "

The sternal and costal parts of diaphragm are derived from the septum transversum; a gap between
these two parts is known as foramen of "

An abnormal foramna (of Bochdalek) is sometimes found between the central tendon and the lumbar
section of the diaphragm, it is usually left-sided.

The pool of CSF in the lower lumbosacral region is called the lumbar cistern. It contains the roots of the
lower spinal nerves (cauda equina) and the filum terminale. The spinal cord usually ends at the level of L,,
in the adults. The aorta bifurcates at the level of L4. Mamillary processes are features of lumbar
vertebrae. T, is responsible for the supply of the intrinsip muscles of the hand.

     contained within the spermatic cord are sympathetic nerves and the genital branch of
genitofemoral nerve. A direct inguinal hernia pushes through the posterior wall of the inguinal canal,
medial to the deep ring. An indirect inguinal hernia, on the other hand, passes along a patent processus
vaginalis within the cord.

The formation of the portal vein by the union of the superior mesenteric and splenic veins takes place
behind the neck of the pancreas.

The gastroduodenal artery is an important posterior relation of the first part of the duodenum, and is the
artery which may be eroded by a posterior duodenal ulcer.

The Ligamentum teres is a remnant of the left umbilical vein, which drained into the left branch of the
portal vein in the fetal liver.

The hepatic artery lies on left of CBD and the portal vein behind. Although this is the usual arrangement,
variations are sometimes found.

   lies to the medial side of the neck of the indirect inguinal hernia; it lies lateral to a direct
inguinal hernia. Pararenal fat (Zuckerkandl) is found behind the renal fascia: Perirenal fat (Gerota) lies
between the capsule of the renal fascia.

The Median umbilical ligament is a remnant of the vitelline or yolk duct.

The external ring is an opening in the external oblique aponeurosis just above the crest of the pubis.
Fertilization usually takes place in the ampulla.

The sternal and costal parts of diaphragm are derived from the septum transversum; a gap between
these two parts is known as foramen of Morgagni.

An abnormal foramna (   ) is sometimes found between the central tendon and the lumbar
section of the diaphragm, it is usually left-sided.
The pool of CSF in the lower lumbosacral region is called the lumbar cistern. It contains the roots of the
lower spinal nerves (cauda equina) and the filum terminale. The spinal cord usually ends at the level of L,,
in the adults. The aorta bifurcates at the level of L4. Mamillary processes are features of lumbar
vertebrae. T, is responsible for the supply of the intrinsip muscles of the hand.

The only nerves contained within the spermatic cord are sympathetic nerves and the genital branch of
genitofemoral nerve. A direct inguinal hernia pushes through the posterior wall of the inguinal canal,
medial to the deep ring. An indirect inguinal hernia, on the other hand, passes along a patent processus
vaginalis within the cord.

The formation of the portal vein by the union of the superior mesenteric and splenic veins takes place
behind the neck of the pancreas.

The gastroduodenal artery is an important posterior relation of the first part of the duodenum, and is the
artery which may be eroded by a posterior duodenal ulcer.

The Ligamentum teres is a remnant of the left umbilical vein, which drained into the left branch of the
portal vein in the fetal liver.

The hepatic artery lies on left of CBD and the portal vein behind. Although this is the usual arrangement,
variations are sometimes found.

The artery lies to the medial side of the neck of the indirect inguinal hernia; it lies lateral to a direct
inguinal hernia. Pararenal fat (Zuckerkandl) is found behind the renal fascia: Perirenal fat (Gerota) lies
between the capsule of the   "

The Median umbilical ligament is a remnant of the vitelline or yolk duct.

The external ring is an opening in the external oblique aponeurosis just above the crest of the pubis.

Fertilization usually takes place in the ampulla.

The Tendo calcaneus (Achilies tendon) is the common tendon of gastrocnemius, soleus and plantaris.

The gastrocnemius is a powerful plantarflexor of the foot but can also act as a flexor of the knee.

Both cruciate ligaments play a part in limiting medial rotation of the tibia (lateral rotation of the femur).

The articular surfaces of the subtalar joint are covered with hyaline cartilage.

The subtalar joint lies between the talus and calcaneus.

The movements of inversion and eversion take place at the subtalar and talonavicular joints.

It is medial ligament of ankle joint which is usually referred to as the deltoid ligament.

The tibial collateral ligament is a broad flat band, the fibular collateral ligament is a rounded cord.
The common peroneal nerve travels to the lateral side of the popliteal fossa. The tibial collateral ligament
is closely related to the medial interior genicular vessels and nerve.

   which pass deep to the retinaculum from medial to lateral are : tibialis posterior, flexor
digitorum longus,posterior tibial vessels, tibial nerve, and flexor hallucis longus.

A branch of the obturator artery enters the head of the femur: other nutrient vessels enter the neck of the
bone.

Tensor fasciae inserts into the iliotibial tract. Muscles which insert into the greater trochanter include
gluteus medius,gluteus minimus, piriformis and obturator internus. Obturator externus inserts into the
trochanteric fossa.

    is made up of : (1) the vessel wall; (ii) the arachnoid layer of perivascular sheath; (iii)
the perivascular space; (iv) the pial layer of perivascular sheath, and (v) the neuroglia and the ground
substance of the brain. The barrier, at the capillary level, is reduced to the mere capillary endothelium
with neuroglia and ground substance.

Hemiplegia of an upper motor neuron type is usually due to an internal capsular lesion caused by
thrombosis of one of the lenticulostriate branches of the middle cerebral artery (cerebral thrombosis).

One of the lenticulostriate branches is most frequently ruptured (cerebral haemorrhage); it is known as
Charchot's artery ofcerebral haemorrhage. This lesion also produces hemiplegia with deep coma, and is
ultimately fatal.

Thrombosis of the Huebner's recurrent branch of anterior cerebral artery causes contralateral upper
monoplegia.

Thrombosis of paracentral artery (terminal cortical branch of anterior cerebral artery) causes contralateral
lower monoplegia.

  of posterior inferior cerebellar artery causes lateral medullary syndrome (Wallenberg's
syndrome). It is characterized by :

a.Severe giddiness, due to involvement of vestibular neclei

b.Dysphagia, due to involvement of the nucleus ambiguus.

c.Crossed hemianaesthesia, due to involvement of the lateral spinothalamic tract (contralateral


body) and nucleus of the spinal tract of trigeminal nerve (ipsilateral face).

d. Horner's syndrome due to involvement of sympathetic pathway in the medulla.

e.Cerebellar symptoms and signs.

@    is characterized by (i) paralysis (contralateral hemiplegia); (ii) deep ctfma; (iii)
hyperpyrexia; and (iv)pin-point pupil. It is invariably fatal.

The hunger or feeding centre is placed laterally; the satiety centre, medially in hypothalamus.
The thirst or drinking centre is situated in the lateral part of hypothalamus.

Father of Anatomy² Herophilus.

Largest organ of body² Skin.

Largest sesamoid bone of body²Patella

Largest gland of body² Liver.

Largest branch of femoral artery² Profunda femoris artery.

Largest ganglion of neck is ²Superior cervical ganglion.

Largest vein of body is ²long saphenous vein.

First teeth to appear in infant are ²Lower central incisor.

First permanent teeth to appear are ²First Molar.

    in body²Clavicle.

Second bone to ossify in body ² Mandible.

Most common cause of nerve root compression in neck ² Cervical spondylosis.

Embryonic disk develops during Third week.

Largest branch of femoral Nerve ²Saphenous nerve.

where parietal bones meet each other.

First endocrine gland to appear in foetus²Thyroid gland.

Bregma is the point²Where sagital and coronal sutures meet.

Lambda is the point²Where sagittal and lambdoid sutures meet.

Lambda lies at the location of ² Posterior fontanelle.

Lambdoid suture lies between ²Parietal and occipital bones.

Sternocleidomastoid is innervated by ²Spinal accessory N. & C2, C3 Spinal N.

Trapezius is innvervated by ²Spinal accessory N. &C3, C4 Spinal N.

Minimum time required for irreversible brain death due to ischemia²Four minutes.
Clinically most important layer of scalp is ²Loose areolar tissue.

Kyphosis is an exaggerated thoracic curvature.

Lordosis is an exaggerated lumbar curvature.

Scoliosis is a lateral curvature.

First cervical vertebral is called Atlas.

Second cervical vertebra is called Axis.

An upward projection present in second cervical vertebra is called Dens.

@c

PHYSIOLOGY

 @ 

‡Muscle form 40 to 50% of body mass.

‡About 600 muscles are identified.

Classification of Muscles:

‡Depending on striations: Striated(Skeletal & Cardiac) & Nonstriated(smooth)

‡Depending on Control: voluntary(Skeletal) & Involuntary(Cardiac & smooth)

‡Depending on situation: Skeletal, Cardiac & Smooth.

‡Muscle fiber or cell has a length b/w 1 ± 4cm (Average 3cm) & diameter from 10 ± 100microns.

‡1 myofibril contains 1500 myosin filaments & 3000 actin filaments

‡Sarcomere is the structural & functional unit of skeletal muscle.

Length ± 2.5 to 3.2 mm.

Sarcomere lies b/w two µZ¶ lines

‡Each myofibril consists of alternate light (I or J band) & dark band (A or Q band).

‡Each sarcomere consist of thin (Actin) & thick (myosin) filaments.

Myosin filament is present throughout the µA¶ band.

No movement of myosin during muscular contraction.


‡Actin filaments are formed by 3 types of proteins called actin, tropomyosin & troponin.

‡The skeletal muscle is formed by 75% of water, 20% of proteins & 5%of organic substances.

‡Troponin: is formed by 3 subunits; Troponin I ± attached to F actin; Troponin T ± attached to


tropomyosin; Troponin C ± attached to calcium ions.

‡Following are the muscle proteins; Myosin; Actin; Tropomyosin; Troponin; Actinin; Titin; Desmin; Myogen
& Myoglobulin.

‡There is no movement in the myosin filament during muscle contraction.

‡Actin filaments slide over the myosin filament during muscle contraction.

‡Tropomyosin covers the active sites of actin.

‡Rheobase: this is the least possible, i.e. (minimum) strength (Voltage) of stimulus which can excite the
tissue.

‡Chronaxie: it is the minimum time, at which a stimulus with double the rheobasic strength (voltage) can
excite the tissue.

Chronaxie of skeletal muscle is shorter than that of cardiac and smooth muscles.

Cold lengthens chronaxie. whereas vagal stimulation shortens chronaxie.

‡Refractory period is the period at which the muscle does not show any response to a stimulus.

‡Skeletal muscles are purely aerobic & don¶t have any fuel reserve.

‡Dark, light bands & troponin are absent in smooth muscle.

‡The study of electrical activity of the muscle is done by electromyography.

‡The muscle ruptures when it is stretched to about 3 times its equilibrium length.

   

‡The syncytium of called physiological syncytium because there is no anatomical continuity of the fibers.

‡SA node the pace maker is a small strip of modified cardiac muscle is situated in the superior part of
lateral wall of right

atrium, just below the opening of superior vena cava.

''''AV node is situated in the right posterior portion of interatrial septum.

''''Bundle of his run on either side of the interventricular septum.


''''Rhythmicity of different parts of heart:

o SA node : 70 to 80 / min

o AV node : 40 to 60 / min

o Atrial muscle : 40 to 60 / min

o Ventricular muscle : 20 to 40 / min

''''Velocity of impulse at different parts of the conductive system.

o Atrial muscle fibres : 0.3 meter / second

o Internodal fibers : 1.0 meter / second

o AV node : 0.05 meter / second

o Bundle of his : 0.12 meter / second

o Purkinje fibers : 4 meter / second

o Ventricular muscle fibers : 0.5 meter / second

''''Cardiac cycle includes systole & diastole which practically includes the events of ventricles.

''''When heart beats at the normal rate of 72/min, the duration of cardiac cycle is 0.8 sec.

''''The duration of systole is 0.27 sec & that of diastole is 0.53 sec.

''''The subdivision with duration are

o Systole

§ Isometric contraction = 0.05 sec

§ Ejection period = 0.22 sec

o Diastole

§ Protodiastole = 0.04 sec

§ Isometric relaxation = 0.08 sec

§ Rapid filling = 0.11 sec

§ Slow filling = 0.19 sec

§ Atrial systole = 0.11 sec


§ Total duration of cardiac cycle = 0.27 + 0.53 = 0.8 sec.

''''Atrial systole: atrial contract & a small amount of blood enter the ventricles.

''''Isometric contraction: all the valves are closed, ventricles undergo isometric contraction & pressure
in the ventricles

is increased.

''''Ejection period: semilunar valves opened, ventricles contract & blood is ejected out.

''''Protodiastole: this is the first diastole. The semilunar valves are closed at the end of this period.

''''Isometric relaxation: all the valves are closed, ventricles undergo isometric relaxation & pressure in
the ventricles is reduced.

''''Rapid & slow filling: Atrioventricular valves are opened, ventricles relax & filling occurs.

'''' Pressure difference

Pressure Right Atrium Left Atrium Right Ventricle Left Ventricle Systemic Aorta Pulmonary artery

Max

(mm of Hg) 5±6 7±8 25 120 120 25

Min

(mm of Hg) 0±2 0±2 2±3 5 80 7 ± 8

''''End systolic volume is 70 ± 90 ml

''''End diastolic volume is 130 ± 150 ml.

''''Cause for cardiac murmurs

Systolic murmur Diastolic murmur Continuous murmur

1. Incompetence of AV valve

2. Stenosis of semilunar valves

3. Anemia

4. Septal defect

5. Coarctation of aorta 1. Stenosis of AV valve


2. Incompetence of semilunar valves Patent ductus arteiosus

''''   


Duration

o Interval B/W 2 thick lines: (5mm) = 0.2 second

o Interval B/W 2 thin lines (1mm) = 0.04 second

Amplitude

o Interval B/W 2 thick lines: (5mm) = 0.5 mV

o Interval B/W 2 thin lines (1mm) = 0.1 mV

Speed of the paper

o 25 mm or 50 mm / second

§ Normal heart rate is 72 / min

§ Tachycardia: increase heart rate above 100 / min.

Waves of normal ECG

Wave / segment From ± to Cause Duration

(second) Amplitude

(mV)

P wave - Atrial depolarization 0.1 0.1 to 0.12

QRS complex - Ventricular repolarization 0.08 ± 0.10 Q=0.1 ± 0.2

R=1

S=0.4

T wave - Ventricular repolarzation 0.2 0.3

P ± R interval Onset of P wave to onset of Q wave Atrial depolarization & conduction through AV node
0.18 (0.12 to 0.2) -

Q ± T interval Onset of Q wave & end of T wave Electrical activity in ventricles. 0.4 ± 0.42 -

ST segment End of S wave & onset of T wave - 0.08 -


''''In hyperkalemia, ECG shows a tall T wave.

''''In hypokalemia, ECG shows depressed S-T segment.

''''Heart sounds.

Heart sounds Occurs during Cause Characteristics Duration

(sec) Relation to ECG

First Isometric contraction & ejection period Closure of AV valves Long, soft, & low pitched.
Resembles the word µLUBB¶ 0.10 ± 0.17 µR¶ wave

Second Protodiastole & part of isometric relaxation Closure of semilunar valves Short, sharp, & high
pitched. Resembles the word µDUBB¶ 0.10 ± 014 Precedes or appears 0.09 sec after summit of µT¶
wave

Third Rapid filling Rushing of blood into ventricles Low pitched 0.07 ± 0.1 B/W µP¶ wave & µQ¶
wave.

Fourth Atrial systole Contraction of atrial musculature Inaudible sound 0.02 ± 0.04 B/W µP¶ wave &
µQ¶ wave

§ Bradycardia: decrease in rate below 60 / min.

‡Arrhythmia: irregular heart beat.

§ Sinus tachycardia: increase in discharge of impulse from SA node, upto 100 / min

§ Sinus bradycardia: reduction in the impulses from SA node, about 40 / min § Atrial flutter: Atrial rate
is about 250 ± 350 / min

§ Atrial fibrillation: rate of 300 ± 400 beats / min

§ Ventricular fibrillation: rate is about 400 ± 500 / min

§ Bain Bridge reflex (venous reflex) is characterized by reflex increase in Heart rate on venous
engorgement of the

right atrium.

§ Mary's law states that the Heart rate and Blood pressure have inverse relationship.

§ Stokes Adams syndrome is characterized by repeated fainting attacks associated with complete heart
block.

''''Cardiac Output:

o The amount of blood pumped from each ventricle.


''''Stroke volume: the amount of blood pumped out by each ventricle during each beat - 70ml.

o Stroke volume at rest is 80 - 100 ml.

''''Minute volume: amount of blood pumped out by each ventricle in one minute. Minute volume =
stroke volume X heart

rate. ± 5 liters/per ventricle/minute.

''''Cardiac Index: the minute volume from ventricle expressed in relation to square meter of body
surface area. Normal

value: 2.8 ± 0.3 liters / 1 square meter of body surface area / minute.

''''Ejection fraction: the fraction of end diastolic volume that is ejected out by each ventricle. Normal ±
60 to 65%.

''''Cardiac reserve: the maximum amount of blood that can be pumped out by the heart above normal
value. Normal

healthy adult: 300 ± 400%.

''''Variations in Cardiac output: (Physiological)

o Less in children, females, early morning, changing from recumbent to upright position & in sleep.

o Increased in males, greater body build, day time, emotional upset, after meals, after exercise, high
attitude,

and later months of pregnancy.

'''' Distribution of Cardiac output:

Organ Amount of blood Percentage

Liver 1500ml 30%

Kidney 1300ml 26%

Skeletal muscles 900ml 18%

Brain 800ml 16%

Skin, bone & GIT 300ml 6%

Heart 200ml 4%

Total 5000ml 100%


''''Factors maintaining Cardiac output:

1. Venous return

§ Respiratory pump; Muscle pump; Gravity; Venous pressure; Vasomotor tone.

2. Force of contraction

3. Heart rate

4. Peripheral resistance

''''Regulation of Heart rate:

1. Vasomotor center: bilaterally situated in the reticular formation of medulla oblongata & lower part of
pons.

2. Motor nerve fiber of heart.

3. sensory nerve fiber

''''Haemodynamics:

Factors maintaining volume of flow of blood.

'''' Pressure gradient; Resistance to blood flow; Viscosity of blood; Diameter of blood vessels;
Velocity of blood flow:

'''' Arterial Blood pressure:

''''Systolic pressure: maximum pressure exerted in the arteries during the systole of heart. Normal: 120
mmHg.

(range 110 ± 140)

''''Diastolic Blood Pressure: minimum pressure in the arteries during the diastole of the heart. Normal:
80 mmHg

(range 60 ± 90)

''''Pulse pressure: Difference between the systolic pressure & diastolic pressure. Normal: 40 mmHg.

'''' Mean arterial blood pressure: this is the diastolic pressure plus one-third of pulse pressure. Normal:
93 mmHg.

'''' Variations (Physiological)

o Less in children, females before menopause, early morning & in sleep.


o Increased in males, greater body build, and day time, after meals, after exercise, sleep with dreams.

''''Determinants of Arterial blood pressure:

Cardiac output; Heart rate; Peripheral resistance; Venous return; Elasticity &

Diameter of blood vessels; Velocity of blood flow; Viscosity of blood

'''' Regulation of Arterial blood pressure:

o Nervous mechanism: by vasomotor center & impulse from periphery

o Renal mechanism: by regulation of ECF volume & rennin-angiotensin mechanism.

o Local mechanism

Local vasoconstrictors & Local vasodilators

o Hormonal mechanism:

Hormones increase BP Hormones decrease BP

Adrenaline

Noradrenaline

Thyroxine

Aldosterone

Vasopressin

Angiotensin

Serotonin Vasoactive intestinal polypeptide(VIP)

Bradykinin

Prostaglandin

Histamine

Acetylcholine

Atrial natriuretic peptide

''''Venous pressure:
o Venous pressure in Jugular vein: 5.1 mmHg (6.9 cm H2O)

o Venous pressure in superior vena cava: 4.6 mmHg (6.2 cm H2O)

o Portal venous pressure: 10 mm Hg

o Hepatic venous pressure: 5 mm Hg.

''''Capillary pressure:

o Capillary pressure in the arterial end is about 30 ± 32 mmHg & venous end is about 15 mmHg.

o It is high in Kidney (glomerular capillary pressure), about 60 mmHg ± responsible for filtration.

o Low in lungs (pulmonary capillary pressure), about 7 mmHg.

'''' Venous pulse: (it is the pressure changes transmitted in the form of waves from right atrium to the
veins near the heart)

o Recording of JVP is called phlebogram.

o Phlebogram has 3 positive waves ± a, c & v and 3 negative waves ± x, x1 & y.

o µa¶ wave ± 1st positive wave & it¶s due to atrial systole.

o µx¶ wave ± fall of pressure in atrium, coincides with atrial diastole

o µc¶ wave ± its due to rise in atrial pressure during isometric contraction during which the AV valves
bulges into atrium.

o µx1¶ wave ± occurs during ejection period, when AV ring is pulled towards ventricles causing
distension of atria.

o µv¶ wave ± occurs during isometric relaxation period or during atrial diastole.

o µy¶ wave ± due to opening of AV valve & emptying of blood into ventricle.

Nervous system

'''' Neuron is defined as the structural & functional unit of nervous system.

'''' Neuron does not have Centrosome so it cannot undergo division.

'''' Nissl bodies are organelles containing ribosomes & are concerned with synthesis of protein in
neurons.

'''' Dendrites are conductive in nature & transmit impulses towards the nerve cell body.

'''' Axons are longer process of the nerve cell concerned with transmission of impulse away from the
nerve cell body.

'''' The myelin sheath envelops the axon except at its ending and at the nodes of Raniver.

'''' Myelin sheath is responsible for faster conduction of impulse through the nerve fiber & also acts as
an insulating material.

'''' Neurotrophins are the substances, which facilitate the growth, survival & repair of the nerve cells.

'''' A alpha (Type Ia) nerve fiber is said to be the fastest nerve with a velocity of conduction of 70 to
120 meters / second.

'''' Glial cells are very abundant and as many as 10 to 50 times as neurons.

'''' Astrocytes form supporting network in brain & spinal cord, form basis for blood brain barrier.

'''' Microglia is phagocytic in function.

'''' Oligodendrocytes are responsible for the formation of myelin sheath in CNS because schwann
cells are absent there.

'''' Receptors:

o Exteroceptors: give response to stimuli arising from outside the body. (Cutaneous, Chemoreceptors &
Telereceptors)

o Interoceptors: give response to stimuli arising from within the body.

o Cutaneous receptors:

§ Touch receptors: Meissner¶s corpuscle & Merkel¶s disc (max in lips & fingers)

§ Pressure receptors: Pacinian corpuscles

§ Temperature receptor

o Cold: Krause¶s end organ

o Warm: Raffini¶s end organ

o Warm receptors respond at body temperature of² 30 - 45°C.

o Cold receptors are activated at body temperature of² 10°C or below.

o Warm Sensation is carried by ² C Fibres.

o Cold Sensation is carried by ² A. & C fibres.

§ Pain receptors: free (naked) nerve ending. (sensation which return earliest on recovery)
o Chemoreceptors:

§ Taste: Taste buds

§ Smell: Olfactory receptors

§ Hearing: hairs cells of organ of corti in the internal ear.

§ Vision: Rods & Cones in retina ± for visual sensation.

o Viseroreceptors:

§ Stretch receptors, baroreceptors, chemoreceptors & Osmoreceptors

o Proprioceptors: give response to change in position ± labyrinthine, muscle spindle, golgi tendon,
pacinian

corpuscle, muscle, tendon & fascia.

'''' Neurotransmitters:

o Excitatory neurotransmitter: is responsible for the conduction of impulse from the presynaptic neuron to
the

postsynaptic neuron.

o Inhibitory neurotransmitters: inhibits the conduction of impulse from the presynaptic neuron to the
postsynaptic neuron.

Group Name Action

Amino acids GABA Inhibitory

Glycine Inhibitory

Glutamate Excitatory

Aspartate Excitatory

Amines Adrenaline Inhibitory & Excitatory

Noradrenaline Inhibitory & Excitatory

Dopamine Inhibitory

Serotonin Inhibitory

Histamine Excitatory
Others Nitric oxide Excitatory

Acetylcholine Excitatory

'''' Superficial reflexes:

Reflex Stimulus Response Center

Corneal Irritation of cornea Blinking of eye Pons

Conjunctival Irritation of conjuctiva Blinking of eye Pons

Nasal Irritation of nasal mucus membrane Sneezing Motor nucleus of V cranial nerve

Pharyngeal Irritation of pharyngeal mucus membrane Retching of gagging Nuclei of X cranial nerve

Uvular Irritation of Uvula Raising of Uvula Nuclei of X cranial nerve

'''' Superficial cutaneous reflexes

Reflex Stimulus Response Center ± spinal segment involved

Scapular Irritation of skin at the interscapular space Contraction of scapular muscles & drawing in of
scapula C5 to T1

Upper abdominal Stroking the abdominal wall below the costal margin Ipsilateral contraction of
abdominal muscle & movement of umbilicus towards the site of stroke T6 to T9

Lower abdominal Stroking the abdominal wall at umbilical & iliac level Ipsilateral contraction of
abdominal muscle & movement of umbilicus towards the site of stroke T10 to T12

Cremasteric Stroking the skin at upper & inner aspect of thigh Elevation of testicles L1, L2

Gluteal Stroking the skin over glutei Contraction of glutei L4 to S1, S2

Plantar Stroking the sole Plantar flexion & adduction of toes L5 to S2

Bulbocavernous Stroking the dorsum of glans penis Contraction of bulbocavernous S3, S4

Anal Stroking the perianal region Contraction of anal sphincter S4, S5

'''' Deep reflexes

Reflex Stimulus Response Center ± spinal segment involved

Jaw jerk Tapping middle of the chin with slightly opened mouth Closure of mouth Pons ± V cranial
nerve
Biceps jerk Percussion of biceps tendon Flexion of forearm C5, C6

Triceps jerk Percussion of triceps tendon Extension of forearm C6 to C8

Supinator jerk or radial periosteal reflex Percussion of tendon over distal end (Styloid process) of radius
Supination & flexion of forearm C7, C8

Wrist tendon or finger flexion reflex Percussion of wrist tendons Flexion of corresponding finger C8, T1

Knee jerk or Patellar tendon reflex Percussion of patellar ligament Extension of leg L2 to L4

Ankle jerk or Achilles tendon reflex Percussion of Achilles tendon Plantar flexion of foot L5 to S2

Pathological reflexes:

Babinski¶s sign: there is dorsiflexion of great toe & fanning of other toes. Seen in UMN lesion, also in
infants &

normal persons with deep sleep.

Spinal cord:

Extends from foramen magnum to 1st lumbar vertebra.

Length ± 45 cm in male & 43 cm in females.

Below the lumbar enlargement, the spinal cord rapidly narrows to a cone shaped termination called
Conus medullaris.

Spinal corresponds to 31 pairs of spinal nerves. (C-8; T-12; L-5; S-5; C-1)

Grey matter is the collection of nerve cell bodies, dendrites & parts of axons.

White matter is a collection of myelinated & nonmyelinated nerve fibers.

Neurons in the grey matter of spinal cord

Neurons in Anterior gray horn

Alpha motor neurons; Gamma motor neurons & Renshaw cells

Neurons in lateral gray horn

Intermediolateral horn cells

Neurons in posterior gray horn

Substania gelatinosa of Rolando; Marginal cells; Chief sensory cells & Clarke¶s column of cells.
Ascending tracts of Spinal cord:

Situation Tract Function

Anterior white funiculus Anterior spinothalamic tract Crude touch sensation

Lateral white funiculus Lateral spinothalamic tract Pain & temperature sensation

Ventral spino cerebellar tract Subconscious kinesthetic sensations

Dorsal spino cerebellar tract Subconscious kinesthetic sensations

Spinotectal tract Concerned with spinovisual reflex

Fasiculus dorsolateralis Pain & temperature sensations

Spinoreticular tract Conciousness & awareness

Spinoolivary tract Proprioception

Spinovestibular tract Proprioception

Posterior white funiculus Fasciculus gracilis Tactile sensation

Tactile localization

Tactile discrimination

Vibratory sensation

Conscious kinesthetic sensation

stereognosis

Fasciculus cuneatus

Descending tracts of Spinal cord:

Situation Tract Function

Pyramidal tracts Anterior corticospinal tract Control voluntary movements

Forms upper motor neurons

Lateral corticospinal tract

Extra Pyramidal tracts Medial longitudinal fasciculus Coordination of reflex ocular movement

Integration of movements of eyes & neck


Anterior vestibulospinal tract Maintenance of muscle tone & posture

Maintenance of position of head & body during acceleration

Lateral vestibulospinal tract

Reticulospinal tract Coordination of voluntary & reflex movements.

Control of muscle tone.

Control of respiration & blood vessels.

Tectospinal tract Control of movement of head in response to visual & auditory impulses.

Rubrospinal tract Facilitatory influence on flexor muscle tone.

Olivospinal tract Control of movements due to proprioception.

Effect of upper motor neuron & lower motor neuron lesion:

Effects upper motor neuron lower motor neuron lesion

Clinical observation Muscle tone Hypertonic Hypotonic

Paralysis Spastic type of paralysis Flaccid type of paralysis

Wastage of muscle No wastage Present

Superficial reflexes Lost Lost

Plantar reflex Abnormal ± babinski¶s sign Absent

Deep reflexes Exaggerated Lost

Clonus Present Lost

Clinical confirmation Electrical activity Normal Absent

Muscles affected Groups of muscles are affected Individual muscles are affected

Fascicular twitch in EMG Absent present

Action of sympathetic & parasympathetic divisions of ANS:

Effector organ Sympathetic division Parasympathetic division

Eye Ciliary muscle Relaxation Contraction


Pupil Dilatation Constriction

Lachrymal secretion Decrease Increase

Salivary secretion Decrease in secretion & vasoconstriction Increase in secretion & vasoconstriction

GIT Motility Inhibition Acceleration

Secretion Decrease Increase

sphincters constriction Relaxation

Gall bladder Relaxation contraction

Urinary bladder Detrusor muscle Relaxation contraction

Internal sphincter Constriction Relaxation

Sweat glands Increase in secretion -

Heart rate & force Increase decrease

Blood vessels Constriction of all blood vessels except those in heart & skeletal muscle Dilatation

Bronchioles Dilatation Constriction

Resting membrane potential of various cells of the body.

‡Resting membrane potential of a skeletal muscle is -90mV.

‡Resting membrane potential of a smooth muscle is -50 to -75mV.

‡Resting membrane potential of a cardiac muscle is -85 to -95mV.

‡The resting membrane potential in the nerve fiber is -70mV.

‡The resting membrane potential in the rods is -40mV.

‡The resting membrane potential of inner ear cell is -60mV.

Brain stem: (medulla oblongata, Pons & Midbrain)

‡Pathway for ascending & descending tracts b/w brain & spinal cord.

‡Important centers for regulation of vital functions in body.

Medulla oblongata

‡Respiratory centers: inspiratory & expiratory.


‡Vasomotor center: B.P & Heart rate.

‡Deglutition center: Pharyngeal & Oesophageal stage.

‡Vomiting center: induce vomiting.

‡Superior & inferior salivatory nuclei: controls secretion of saliva.

‡Cranial nerve nuclei: nuclei of 10, 11 & 12 cranial nerves.

‡Vestibular nuclei:

Pons

‡Bridge b/w medulla & midbrain.

‡Forms pathway connecting cerebellum with cortex.

‡Nuclei of 5 to 8th cranial nerve.

‡Pneumotoxic & apneustic centers for regulation of respiration.

Midbrain: (Consist of 2 parts Tectum & cerebral peduncles)

‡Tectum: center for light & auditory reflexes.

‡Cerebral peduncles: control of muscle tone

‡Control of complex & skilled muscular movements, movement of eye balls

Thalamus: Ovoid mass of gray matter, situated B/L in diencephalons)

‡Relay center: for sensations (also called functional gateway).

‡Center for integration of sensory impulses: determining the quality of sensations(discriminative &
affective nature)

‡Center for sexual sensations.

‡Role in arousal & alertness reactions.

‡Center for reflex activity

‡Center for integration of motor functions.

Hypothalamus:

‡Control the secretion of Ant. & Post Pituitary hormones & adrenal cortex & medulla.
‡Control of Autonomic nervous system; Heart rate; B.P; Body temp; Food intake (satiety, hunger &thirst);
water balance; sleep & wakefulness.

‡Role in behaviour & emotional changes.

‡Regulation of sexual function & response to smell.

‡Role in circadian rhythm.

Cerebellum:

‡Vestibulocerebellum: regulates tone, posture & receiving impulse for vestibular apparatus.

‡Spinoncerebellum: regulates tone, posture & equilibrium by receiving impulses from proprioceptors in
muscles, tendons

& joints, tactile receptors, visual receptors & auditory receptors.

''''Corticocerebellum: concerned with the integration & regulation of well coordinated muscular
activities.

‡Different parts are represented in an upright manner in cerebellum. (opp: in cerebrum)

Basal ganglia: (concerned with motor activities of extra-pyramidal system)

‡Control of voluntary motor activity, muscle tone, reflex muscular activity, associated movements.

‡Role in arousal mechanism.

Cerebral cortex:

Frontal lobe Pre central cortex

(Post. Part) Primary motor area

(concerned with initiation of voluntary movements & speech) Area 4 ± center for movement

Area 4S ± suppressor area. Inhibits movements initiated by area 4.

Pre motor area Area 6 ± concerned with coordination of movements initiated by area 4.

Area 8 ± frontal eye field.

Area 44 & 45(broca¶s area) ± motor area for speech.

Supplementary motor area Concerned with co-ordinated skilled movements.

Pre ±frontal cortex


(Ant. Part) Silent area or association area

Center for higher functions ± emotion, learning, memory. Area ± 9 to 14, 23, 24, 29 & 32. Center for
planned action.

Seat of intelligence. Personality of individual.

Parietal lobe Somesthetic area I Area 1 ± concerned with sensory perception

Area 2 & 3 ± integration of these sensations. Spatial recognition. Recognition of intensity,


similarities & diff. B/W stimuli

Somesthetic area II Concerned with perception of sensation.

Somesthetic association area Synthesis of various sensations perceived by S.Area-I. Stereognosis.

Temporal lobe Primary auditory area Area 41, 42 & wernicke¶s area ± concerned with perception of
auditory impulses, analysis of pitch, determination of intensity & source of sound

Auditopsychic area Area 22 ± interpretation of auditory sensation

Area of equilibrium Maintenance of equilibrium

Occipital lobe Primary visual area Area 17 ± perception of visual impulse

Visual association area Area 18 - Interpretation of visual impulses

Occipital eye field Area 19 - Movements of eye

Limbic system: (It is a group of cortical & sub cortical structures which form a ring around the hilus of
cerebral hemisphere)

‡Regulation of olfaction, autonomic functions (B.P, water balance & body temp).

‡Control of circadian rhythm.

‡Regulation of sexual function.

‡Role in emotional state, memory & motivation.

‡Retention of recent memory.

‡Most developed part of Limbic System ² Hippocampal formation

‡Major efferent from Limbic system goes to ² Mid brain reticular formation.
‡Main function of Limbic system is to ² Control the emotional behaviour.

Proprioceptors: (These are receptors which give response to change in the position of different parts of
the body).

‡Muscle spindle: gives response to change in length of muscle.

‡Golgi tendon organ: gives response to change in force developed in muscle.

‡Pacinian corpuscle: pressure receptor in fascia, tendon & joints.

‡Free nerve endings:

Vestibular apparatus:

‡Give response to rotatory movements or angular acceleration of the head.

‡Responsible for detecting the position of head during different movements.

EEG: (ELECTROENCEPHOLEGRAM)

‡Alpha rhythm:

Frequency: 8 to 12 waves / sec

Amplitude: 50 U.

Most marked in parieto-occipital area.

Obtained in inattentive brain as in drowsiness & light sleep.

‡Beta rhythm:

Frequency: 15 to 60 waves / sec

Amplitude: 5 - 10 U.

Recorded during mental activity or mental tension or arousal state.

‡Delta rhythm:

Frequency: 1 to 5 waves / sec

Amplitude: 20 - 200 U.

Seen in tumour, epilepsy, increased intracranial pressure & mental depression.

‡Theta rhythm:
Frequency: 4 to 8 waves / sec

Amplitude: 10 U.

Seen in children below 5 years.

SLEEP:

‡Sleep requirement:

Newborn infants: 18 to 20 hours.

Growing children: 12 to 14 hours.

Adults: 7 to 9 hours.

Old persons: 5 to 7 hours.

‡Types of sleep:

Rapid eye movement sleep(REM) Non rapid eye movement sleep(NREM)

Eye balls move Absent

Dreams occur Absent

Muscle twitching Absent

20 to 30% of sleep 70 to 80% of sleep

‡Normal amount of C.S.F. in man is 150 C.C,

‡Sympathetic nervous system is controlled by ² Posterior hypothalamic nuclei

‡Parasympathetic nervous system is controlled by ² Anterior nuclei and part of middle nuclei of
hypothalamus.

EYE:

§Refractory power is measured in dioptre (D).

§Refractory power of cornea is 42D.

§Refractory power of lens is 23D.

§Refractory power of eye at rest is 59D.

§Focal length of cornea is 24mm.


§Focal length of lens is 44mm.

§The wave lengths of visible light are approximately 397 to 723 nm.

§There are about 6 million cones & 12 million rods in human eye.

§Rods are responsible for dim light or night vision or scotopic vision.

§Cones are responsible for colour vision, sensitive to day light & acuity of vision.

§Rhodopsin is the photosensitive pigment of rods cells.

§Photosensitive pigment in cones are

o Porpyropsin ± Red

o Iodopsin ± Green

o Cyanopsin ± Blue

§ Electroretinogram is the instrument to record the electrical basis of visual process.

§ Test for visual acuity ± snell¶s chart (distant vision) & Jaeger¶s chart (near vision).

§ Test for color blindness ± Ishihara¶s colour chart.

§ Mapping of visual field ± perimetry.

§ Nearest point at which the object is seen clearly is about 7 to 40cm.

§ Farthest point is infinite.

§ Myopia (short sightedness) is corrected by concave lens.

§ Hypermetropia (long sightedness) is corrected by convex lens.

§ Astigmatism is corrected by cylindrical lens.

§ Presbyopia is corrected by convex lens.

EAR:

§ Ear is sensitive to sound between 1000 to 4000Hz range.

§ Hairs cells in organ of corti are the receptors for auditory sensation.

§ Sound becomes painful above 140db.

§ Auditory centers ± 41, 42 & also auditopsychic area 22.


TONGUE:

§ Sense organ of taste sensation is taste buds.

§ There are about 10,000 taste buds & each taste bud is replaced in every 10 days.

§ Each taste bud consists of 4 types of cells and is supplied by about 50 nerve fibres.

§ Receptors are type III cells of taste buds.

§ Taste center ± opercular insular cortex (lower part of post central gyrus).

§ Bitter taste has very low threshold ± 1 in 2,000,000.

§ Sweet taste has high threshold ± 1 in 200.

§ Locations of taste buds are: sweet ± tip; salt ± dorsum; sour ± side; bitter ± posterior.

SMELL:

§ Olfactory mucus consists of 10 to 20 million olfactory receptor cells.

§ Human nose can distinguish 2000 to 4000 different odours.

GASTRO INTESTINAL SYSTEM

‡ GIT is a tubular structures extending from the mouth up to anus with a length of about 30 feet.

‡ A normal healthy adult consumes about 1kg solid diet & about 1 ± 2 liters of liquid diet / day.

‡ Auerbach¶s plexus regulate the movements of GIT.

‡ Meissner¶s plexus regulate the secretory functions of GIT.

‡ Auerbach¶s plexus is present between the middle circular muscle layer & outer longitudinal muscle
layer & its major function is to regulate the movements of GIT.

‡ The total volume of GIT secretions per day is about 8000 ml.

‡ Properties & composition of Saliva:

'''' Volume: 1000 ± 1500 ml / day, (70% by submaxillary glands).

'''' Reaction: pH 6.35 ± 6.85.

'''' Specific gravity: 1.0002 ± 1.012

'''' Composition: 99.5% water & 0.5% solids.


'''' Digestive enzymes: salivary amylase (carbohydrate splitting) & lingual lipase (lipid splitting
enzyme).

'''' Substances like mercury, potassium iodide, lead & thiocyanate are excreted through saliva.

'''' Saliva contains highest conc. of K+.

'''' Volume of stomach is 50 ml when empty & can expand up to 4 liters.

'''' Properties & composition of gastric juice:

'''' Volume: 1200 ± 1500 ml / day.

'''' Reaction: pH 0.9 ± 1.2.

'''' Specific gravity: 1.002 ± 1.004

'''' Composition: 99.5% water & 0.5% solids.

'''' Digestive enzymes: Pepsin, Gastric lipase & other gastric enzymes.

'''' Action of pepsin: attacks peptide bonds adjacent to aromatic amino acids by hydrolysis.

'''' Action of gastric lipase: weak lipolytic enzyme becomes active only when pH is between 4 & 5.

'''' Action of HCL: activates pepsinogen into pepsin, bacteriolytic action, causes acidity of the
chime & provides acid medium for the action of enzyme.

'''' Gastrin is one of the GIT hormones secreted by G cells present in pyloric glands of stomach.

'''' Action of Gastrin: stimulates the secretion of pepsinogen & Hcl by gastric glands, increases the
motility of stomach, secretion of pancreatic juice & production of hormones by pancreas.

'''' Pancreas is a dual organ & has endocrine & exocrine function.

'''' Properties & composition of Pancreatic Juice:

'''' Volume: 500 ± 800 ml / day.

'''' Reaction: pH 8 ± 8.3.

'''' Specific gravity: 1.010 ± 1.018

'''' Composition: 99.5% water & 0.5% solids.

'''' An adult pancreas has 2.5-7.5 lac islets.

'''' Total volume of pancreatic secretion per day is 2.5 liters.


'''' Pancreas is the only organ that contains Trypsinogen.

'''' Ascariasis can also cause acute pancreatitis.

'''' Serum amylase and lipase levels are usually not elevated in chronic pancreatitis.

'''' Duodenum is the principal site of iron absorption.

'''' Most sensitive method for assessing pancreatic exocrine function is Secretin Stimulation Test.

‡ Blood flow reaching the liver via portal versus hepatic artery is 4: 1.

‡ Hepatic venous pressure is 5 mm Hg.

‡ Most common complaints resulting from disorders involving the GIT include pain and alteration in
bowel habit.

‡ Most potent stimulus for bile secretion is bile salt.

‡ Best stimulus for CCK secretion is Fat.

‡ Properties of Bile:

o Volume: 800 ± 1200 ml / day

o Reaction: alkaline

o pH: 8 ± 8.6

o Sp. Gty: 1010 - 1011

‡ Composition of Bile:

o Water: 97.6%

o Solids: 2.4%

‡ Bile is stored in gall bladder; it undergoes many changes in quality & quantity.

‡ There is increase in conc. of bile salts, bile pigments, cholesterol, fatty acids & lecithin.

‡ Functions of bile salts:

o Emulsification of fats, due to emulsification, fat globules are broken down into minute particles.

o Absorption of fats.

o Stimulate the secretion of bile from liver.


o Prevention of gall stone formation.

‡ Properties of succus entericus:

o Volume: 1800 ml / day

o Reaction: alkaline

o pH: 8 ± 8.3

o Sp. Gty: 1010 - 1011

‡ Enzymes of succus entericus:

o Proteolytic enzymes: peptidases ± amino peptidases, dipeptidase & tripeptidase.

o Amylolytic enzymes: sucrase, maltase, isomaltase, lactase, dextrase & trehalase.

o Lipase & enterokinase

‡ Bacterial flora of large intestine synthesizes folic acid, Vit B12 & Vit K.

‡ Vomiting center is situated bilaterally in medulla oblongata near the nucleus tractus solitarius.

‡ Segmentation contraction & pendular movement are involved in mixing of food in small intestine.

‡ Peristaltic movements peristaltic rush are the two movements involved in the pushing of chyme
towards aboral end on intestine.

‡ Desire for defecation is elicited by an increase in the intrarectal pressure to about 20 to 25 cm H2O.

‡ Gastrointestinal hormones:

Hormone Source of secretion Actions

Gastrin G cells of stomach; duodenum, jejunum, Ant. Pit & Brain 1. Stimulates the secretion of gastric
juice.

2. Increase the gastric motility.

Stimulates the release of pancreatic hormones.

Secretin S cells of duodenum, jejunum & ileum Stimulates secretion of watery, alkaline & pancreatic
secretions.

Cholecytokinin I cells in duodenum, jejunum & ileum Stimulates contraction of gall bladder; Activates
secretin; Inhibits gastric motility; Increases secretion of enterokinase & intestinal motility.
Gastric inhibitory peptide (GIP) K cells in duodenum & jejunum Inhibits secretion of gastric juice,
gastric motility & increase insulin secretion.

‡ Digestion of Carbohydrates:

Area Juice Enzyme Substrate End Product

Mouth Saliva Salivary amylase Polysaccharides Disaccharides

Stomach Gastric juice Gastric amylase Weak amylase The action is negligible

Small intestine Pancreatic juice Pancreatic amylase Polysaccharides

Disaccharides Disaccharides ± dextrins, maltose & maltriose

Monosaccharides

Succus entericus Sucrase

Maltase

Lactase

Dextrinase

Trehalase Disaccharides Glucose

Skin

‡ Skin is the largest organ in the human body.

‡ The normal body temperature varies is between 35.8 ± 37.30.

‡ Axillary temperature is slightly lower, while rectal temp. is slightly higher.

‡ Heat lose center is situated in pre-optic nucleus of ant. Hypo thalamus.

‡ Heat gain center is situated in post. Hypothalamic nucleus.

‡ Primary motor center for shivering is situated in post. Hypothalamus, near the wall 3rd ventricle.

RESPIRATORY SYSTEM

‡ The major phospholipids present in the surfactant are di-palmitoylphosphatidyl choline.

‡ Surfactant is secreted by type II alveolar epithelial cells.

‡ Total peripheral resistance falls about 50% in moderate exercise.


‡ Cyanosis is detectable when arterial oxygen saturation falls below 75% corresponding to PO2 of 40
mmHg.

‡ 250ml of oxygen enters the body per min and 200 ml of CO2 is excreted.

‡ 5 ml of 02 is transported to the tissues by 100 ml blood in every cycle

‡ Pulmonary alveolar macrophages form called "Dust cells".

‡ Size and strength of respiratory muscles is 30-40% above normal in athletes whereas it is 20-30%
less in physically weak people.

‡ There are about 300 million alveoli in man.

‡ There is no stimulation of ventilation by hypoxia until the alveolar O2 falls below 60 mm Hg.

‡ Oxygen transported from lung to tissues in chemical combination is 97%.

‡ In a healthy adult, 24 hour production of CO2 is about 330 liters.

‡ Diffusion capacity for carbon dioxide as compared to that of 02 is 20 times.

‡ Average area of the alveolar walls in contact with capillaries in both lungs is about 70 sq. m.

‡ Diffusion capacity of lungs for CO2 is 10-30 ml/min/mmHg.

‡ Normal composition of venous blood is PO2 - 40 mmHg, PCO2 -46 mm Hg and Hb saturation 75%.

‡ Peak expiratory flow rate is 400-500 L/mt.

‡ The presence of Hb increases the 02 carrying capacity of the blood by 70 fold.

‡ Intra-pleural pressure (recoil pressure) required to prevent collapse of the lung ² 4 mm Hg in


presence of surfactant.

‡ Intrapleural pressure at the end of deep inspiration is - 4 mm Hg.

‡ Intrapleural pressure during expiration is - 2 mm Hg.

‡ Compliance of the normal lungs and thorax combined ² 0.13 liter/cm, of H2O.

‡ Compliance of the normal lungs alone is 0.22 liter/cm of H2O.

‡ During normal quiet breathing only 2-3% of the total energy expenditure is needed for pulmonary
ventilation.

‡ The amount of alveolar air replaced by new atmospheric air with each breath is only l/7th.

‡ Expired air contains 2/3rd alveolar air + l/3rd dead space air.
‡ 63% of carbon dioxide is transported as bicarbonate form

‡ 97% of O2 is transported by Hb, rest 3% is in dissolved state in the water of the plasma and cells.

‡ Carbon mono oxide binds with Hb. 230 times more strongly than ()2.

‡ Under resting conditions each 100 ml of blood transports 5 ml of O2 to tissues and carries 4 ml of CO2
from tissues to the lungs.

‡ Death occurs usually when the pH of the blood falls to 6.9.

‡ The decrease in 02 affinity of Hb when the pH of blood falls is called Bohr¶s effect.

‡ The degree of stimulation of chemoreceptors depends on arterial PO2.

‡ Spirometer cannot measure Functional Residual Capacity.

‡ Functional residual capacity is measured by Nitrogen wash out or single breath oxygen method.

‡ Most potent respiratory stimulant is carbon dioxide.

‡ Kausmaul breathing is seen in diabetic ketoacidosis and it is not a feature of Hypercapnic acidosis.

‡ Hering-breuer reflex: impulses from stretch receptors.

‡ Peripheral chemoreceptors are carotid & aortic bodies.

‡ Respiratory centers:

o Inspiration ± dorsal group of neurons near tractus solitarius nucleus.

o Expiration ± ventral group situated in ventral part of medulla.

‡ Normal value of FEV 1 in an adult male is 80%.

‡ Muscles of Inspiration ² Diaphragm and External Intercostals muscle (Others - Stcrnocleidomastoid,


Serratus anterior).

‡ Muscle of Expiration ²Internal Intercostal muscle. (Rectus abdominis).

‡ Intra alveolar pressure during inspiration ² 1 mm Hg.

‡ Tidal volume: 500 ml.

‡ Inspiratory reserve volume: 3300 ml.

‡ Expiratory reserve volume: 1000 ml.


‡ Residual volume: 1200 ml.

‡ Respiratory minute Volume in a normal person is 6.0 L/min.

‡ Inspiratory capacity: 3800 ml.

‡ Vital capacity : 4800 ml.

‡ Total lung capacity: 6000 ml.

‡ Functional residual capacity in a male is 2.2 liters.

‡ Normal dead space air volume ² 150 ml.

‡ Timed vital capacity in 1sec is 83%.

‡ Timed vital capacity in 2 sec is 94%.

‡ Oxygen dissociation curve is µS¶ shape or sigmoid shape.

Shift to right Shift to left

Decrease pH Increase pH

Increase in temp decrease in temp

Excess of 2, 3 DPG Foetal blood

Increase PCO2 (Bohr effect) -

Decrease PO2 -

ENDOCRINE SYSTEM

‡ Hormone which acts on the target cell is called as 1st messenger.

‡ Cyclic AMP is the most common 2nd messenger for protein hormones.

‡ Other 2nd messengers are Ca++, Calmoduline, Inositol triphosphate(IP3) & cyclic GMP.

‡ Anterior pituitary hormones are

o Growth hormone or somatotropic hormone

o Thyroid stimulating hormone

o Adenocorticotropic hormone

o Follicle stimulating hormone


o Luiteinizing Hormone or interstitial cell stimulating hormones in males

o Prolactin.

‡ Posterior pituitary hormones are

o Antidiuretic hormone or vasopressin

o Oxytocin

‡ ADH causes conservation of body water & contraction of vascular smooth muscle.

‡ Gigantism is due to the hyper secretion of growth hormone in childhood or in the pre-adult life before
the fusion of epiphysis of bone with the shaft.

‡ Acromegaly is due to hyper secretion of GH in adults after the fusion of epiphysis with shaft of the
bone.

‡ Dwarfism is a disorder of GH reduction in infancy or early childhood.

‡ Diabetes insipidus is a syndrome developed due the defiency of ADH.

‡ Hormone responsible for uterine contraction during labour & letting down of milk is Oxytocin.

‡ The anterior pituitary has the largest blood flow of any tissue in the body.

‡ Anterior pituitary hormones with diabetogenic effect ± GH, ACTH, TSH, and PRL.

‡ Pigmentation is not a feature of panhypopituitarism.

‡ Hormones of thyroid gland are

o Thyroxine (T4) ± 90%

o Triiodothyronine (T3) ± 10%

o Calcitonin

‡ Potency of T3 is four times more than that of T4.

‡ Graves¶ disease is an auto-immune disease which causes hyperthyroidism.(exophathalmic goiter)

‡ Cretinism is hypothyroidism in children & myxedema due to hypothyroidism in adults.

‡ Parathormone is secreted by para thyroid gland & its main function is to increase the blood Ca++ level
by mobilizing Ca++ from bone.

‡ Calcitonin reduces the blood Ca++ level by decreasing the bone re-absorption.
‡ Tetany results from hypocalcaemia, caused by hypoparathyroidism.

‡ Pancreatic hormones are

o Alpha cell ± Glucagons

o Beta cells ± Insulin

o Delta cells ± Somatostatin

o F or PP cells ± Pancreatic polypeptide

‡ Insulin is the only anti diabetic hormone secreted in the body.

‡ Glucagons actions are antagonistic to that of insulin.

‡ Somatostatin inhibits the secretion of both glucagons & Insulin.

‡ Hormones of Adrenal cortex are

o Mineralocorticoids (secreted by zona glomerulosa)

Aldosterone (Ĺ Na+V & excretion of K+)

11 deoxy corticosteroneV

o Glucocorticoids (zona fasiculata)

CortisolV

CorticosteroneV

o Sex hormones (zona reticularis)

DehydroepiandrosteroneV

AndrostenedioneV

TestosteroneV

‡ Cushing syndrome is a disorder characterized by obesity due to hyper secretion of glucocorticoids.

‡ Conn¶s syndrome is primary aldosteronism.

‡ Addison¶s disease is chronic adrenal insuffiency.


‡ Hormones of Adrenal medulla (Catecholamines) are

o Adrenaline or epinephrine

o Noradrenaline or norepinephrine

o Dopamine

‡ Pheochromocytoma is a condition in which there is excessive secretion of catecholamines.

‡ Melatonin is secreted by parachymal cells of pineal gland, acts on gonads.

‡ Severe stress can raise ACTH and cortisol level by 20 folds.

‡ Fetal lung maturation depends on increased fetal Cortisol just before birth.

‡ Human prolactin causes synthesis of milk in the female breast.

‡ The half life of circulating growth hormone in humans is 20 to 30 minutes.

BLOOD

‡ Blood is a connective tissue in fluid form.

‡ Blood is 5 times viscous than water.

‡ Blood cell count is greater in children than adult.

‡ RBC is microcytic in iron defiency anaemia, prolonged forced breathing & increased osmotic
pressure.

‡ RBC is macrocytic in megaloblastic anaemia, muscular exercise & decreased osmotic pressure in
blood.

‡ Punctate basophlism is seen in lead poisoning.

‡ Goblet ring is seen in certain types of anaemia like malaria.

‡ Red cell vol. can be determined by radio isotope 51 Cr.

‡ Cyanosis appears when the reduced Hb cone, of the blood in the capillaries is more than 5 gm/dl.

‡ In vitro, coagulation is initiated by factor XII.

‡ Life of RBC's in adult human body is 120 days.

‡ Average life span of RBC in a newborn is 100 days.


‡ Average life span of RBC in transfused blood is 90 days.

‡ Life span of transfused platelets is 4 days.

‡ Life span of platelets is 9-12 days.

‡ Complete erythropoiesis occurs in 7 days.

‡ Erythropoiesis occurs in

o In first trimester RBC's are formed in Yolk sac. While in second trimester liver is the main organ. Third
trimester in liver & bone marrow.

o Upto age of 5 ± 6 yrs ± red bone marrow of all bones.

o 6 ± 20 yrs ± red bone marrow of all bones & all membranous bones.

o After 20 yrs ± all membranous bones & ends of long bone.

‡ Hb starts appearing in intermediate normoblastic stage of erythropoiesis.

‡ Nucleus disappears during late normoblastic stage.

‡ Factors needed for Erythropoiesis: erythropoietin, thyroxine, interleukins 3, 6, 11, stem cell factors, Vit
B, C & D. (maturation factors Vit B12 & folic acid).

‡ The iron remains in ferrous state.

‡ The affinity of Hb for CO2 is 20 times more than for O2.

‡ The affinity of Hb for CO is 200 times more than its affinity for O2.

‡ Adult Hb consists of 2 alpha & 2 beta chains.

‡ Fetal Hb consist of 2 alpha & 2 gamma chains.

‡ In sickle cell anemia, the 2 alpha chains are normal but 2 beta chains are abnormal.

‡ In Hb C, beta chains are abnormal.

‡ Bilirubin is the final product formed from the destruction of Hb.

‡ Total quantity of the iron in the body is 4gm.

‡ 1 mg of iron is excreted every day through faeces.

‡ Normocytic normochromic anaemia is seen in aplastic aneamia.

‡ Marcocytic normochromic anaemia seen in folate deficiency, Vit B12 & hypothyroidism.
‡ Pernicious anaemia or addsion's anaemia is marcocytic normochromic anaemia.

‡ Microcytic hypochromic is seen in iron deficiency, thalassemia, heamoglobinopathies & heamolytic


anaemia.

‡ ESR decreases in allergic conditions, sickle cell anaemia, polycythemia & afibrinogenemia.

Character Normal

1. ESR Male: 3 ± 7 mm / hr

Female: 5 ± 9 mm / hr

2. PCV (Packed cell volume)

(Hematocrit) Male: 40 ± 45 %

Female: 38 ± 42 %

3. MCV (Mean corpuscular volume) 90 cu (78 ± 90 cu )

4. MCH (Mean corpuscular Hb) 30 pg (27 ± 32pg)

5. MCHC (Mean corpuscular Hb Conc.) 30% (13 ± 38%)

6. Colour index 1 (0.8 ± 1.2)

7. WBC 4000 ± 11,000 / cmm

8. D.C

Neutrophils

Eosinophils

Basophils

Monocytes

Lymphocytes

50 ± 70%

2±4%

0±1%

2 ± 6%
20 ± 30 %

9. Platelet count 2,50,000( 2 lakhs ± 4 lakhs)

10. Bleeding time 3 ± 6 min

11. Clotting time 3 ± 8 min

12. Prothrombin time 12 sec

13. Activated partial thromboplastin time(APTT) 25 ± 40 sec

14. RBC

Adult male

Adult female

Birth 4 ± 5.5 millions / mm3

5 millions / mm3

4.5 millions / mm3

8 ± 10 millions / mm3

15. Heamoglobin

Adult male

Adult female

New born

14 ± 18 gm / dl

12 ± 16 gm / dl

16 ± 22 gm /dl

16. RBC

Diameter

7.5

17. Blood volume 5 liters


‡ Granulocytes are neutrophils, eosinophils & basophils.

‡ Agranulocytes are monocytes & lymphocytes.

‡ Monocyte is the largest lymphocyte.

‡ In hemophilia clotting time is prolonged in presence of normal bleeding time.

‡ Christmas disease occurs due to deficiency of factor IX.

‡ Clotting factors

Factor I Fibrinogen

Factor II Prothrombin

Factor III Thromboplastin

Factor IV Calcium

Factor V Pro accelerin (labile factor)

Factor VI No such factor

Factor VII Stable factor

Factor VIII Anti hemophilic

Factor IX Christmas

Factor X Stuart-power

Factor XI Plasma thrombplastin antecedent

Factor XII Hegman (Conduct)

Factor XIII Fibrin stabilizing factor (Fibrinase)

‡ Blood group:

Group Antigen in RBC Antibody in serum

A A Anti ± B (ȕ)

B B Anti ± Į

AB A & B No anti body

O No antigen Anti A & Anti B


‡ Universal recipient are Blood Group 'AB because it does not contain either Anti A ab or anti B ab.

‡ Universal donor is Blood Group "()" because it docs not contain either A or B agglutinogen (antigen).

‡ Commonest blood group is O.

‡ Diseases associated with blood groups:

o Group A ± C.A stomach

o Group O ± duodenal ulcer

‡ Normal basic acid output is 5-10 mmol/hour.

‡ Blood is stored in the blood bank at 40C.

‡ The number of iron Heme in one Hb molecule is 4.

‡ The number of O2 molecules carried by one Hb molecule is 4.

‡ Mean corpuscular diameter is 7.5 nm.

‡ Maximum concentration of Hb normally found in RBC's is 34%.

‡ In arterial blood, saturated Hb with 02 is 97%.

‡ Thromboxane A2 is synthesized by platelets and promotes vasoconstriction and platelet aggregation.

‡ In sickle cell anemia, valine is substituted for glutamic acid.

‡ Platelets are derived from megakaryocytes.

‡ Pus contains ² Dead neutrophils, macrophages and necrotic tissues.

‡ Cardiac output in anemia is above normal while in polycythemia is about normal.

‡ Agglutinins are either IgM or IgG.

‡ In Erythroblastosis fetalis, mother is Rh-, father is Rh+, foetus is Rh positive.

‡ Hapatoglobin is a plasma protein responsible for carrying free Haemoglobin.

‡ Usual anticoagulant used for transfusion is a citrate salt.

‡ Earliest feature of iron deficiency anemia is decreased serum ferritin.

‡ Arneth count is used in the determination of the percentage distribution of different types of neutrophils
on the basis of no: nuclear lobes.
‡ Wilson¶s disease is due to decrease in caeruloplasmin.

EXCRETORY SYSTEM

‡ Hormones secreted by kidney are erythropoietin, thrombopoitein, renin & 1, 25 dihydroxy


cholecalciferol.

‡ 1 kidney contains about 1 ± 1.3 millions nephrons.

‡ Ratio of corical nephrons to Juxtamedullary nephrons 85: 15.

‡ The GFR of average sized normal man is approximately 125 ml / minute or 180 liters / day.

‡ At the rate of 125 ml/min, the kidneys filter an amount of fluid equal to 4 times the TBV, 15 times the
ECF vol. and 60 times the plasma volume.

‡ 1 ± 1.5 liters of urine formed / day.

‡ Urine osmolality in diabetes insipidus is 300 mmol/L.

‡ Normal protein excretion is 50 -150 mg%.

‡ The quantity of water lost as sweat per day is 600-800 C.C

‡ Normal urea clearance is 44 ml/min.

‡ Renal blood flow is 25% of cardiac output (1300 ml blood/min).

‡ Total length of distal convoluted tubule is 5 mm.

‡ Glomerulus membrane permits the passage of substances upto 4 nm and almost totally excludes
substance with size greater than 8 nm.

‡ Each glomerulus is a net work of approximately 50 parallel capillaries.

‡ Urinary osmolality in diabetes insipidus is 300 m mol/Lit.

‡ Glucose and amino acid are absorbed in proximal convoluted tubules by secondary active transport or
sodium Co-transport.

‡ Descending limb of thin segment of loop of Henle is freely permeable to


water.

‡ Areas impermeable to water ² ascending limb of thin segment thick segment of loop of Henle.
Proximal half of convoluted tubule.

‡ Areas impermeable to urea ² Distal convoluted tubule & cortical portion of collecting tubules.
‡ Substances completely reabsorbed in PCT ² Glucose, proteins, amino acids, vitamins, acetoacetate.

‡ Substances partially absorbed in PCT²Na. K, Cl (7/8 reabsorbed in PCT).

‡ Substances secreted in PCT ² H+, PAH (para amino hippurate). creatinine.

‡ H+ are actively secreted in proximal tubules, distal tubules, collecting ducts.

‡ Hyperosmilality in the interstitum is the prerequisite for excretion of concentrated urine.

‡ Urea is reabsorbed from inner meduallary collecting ducts only in presence of ADH.

‡ K+ is actively secreted in Late Distal tubules and Collecting ducts.

‡ Macula densa is the epithelial cells of the distal tubule that comes to contact with the arterioles.

‡ Juxtaglomerular cells produce renin.

‡ Renin acts on angiotensinogen & convert it into angiotensin I.

‡ Renal threshold for glucose is reduced in renal glycosuria.

‡ Creatinine clearance represents GFR.

‡ Clearance test for renal function includes inulin clearance, creatinine clearance & PAHA test.

‡ PAHA test is performed to assess renal blood flow.

‡ Micturition is primarily a spinal reflex.

‡ Thick ascending loop of henle is impermeable to water.

‡ Majority of sodium absorption occur in the proximal tubule.

Character Normal

pH 4. 5 ± 6

Volume 1000 ± 1500 ml / day

Specific gravity 1.010 ± 1.025

MALE REPRODUCTIVE SYSTEM

‡ Average pH of semen is 7.5.

‡ Life span of spermatozoa within the female genital tract is upto 24 hours.

‡ Speed of human sperm in female genital tract is about 3 mm/min.


‡ Male sex hormones are called the androgens (secreted by leydig cells); testosterone, dihydro
testosterone & androstenedione.

‡ Mullerian ducts gives rise to female accessory sex organs such as vagina, uterus & fallopian tube.

‡ Wolffian duct gives rise to male accessory sex organs such as epididymis, vas deferens & seminal
vesicles.

‡ Fetal testes begin to secrete the testosterone at about 2nd to 4th month of embryonic life.

‡ The secretion from seminal vesicles contains fructose, phophorylcholine, fibrinogen, ascorbic acid,
citric acid, pepsinogen, acid phosphatase & prostaglandin.

‡ Fructose & citrate acts as fuel for the spermatozoa.

‡ Prostatic secretion is rich in enzymes, fructose & citrate.

‡ Androgen appears to be essential for spermatogenesis. Whereas FSH is required for spermatic
maturation.

‡ Testes do not produce fructose.(seminal vesicle)

‡ Sertoli cells provide nutrition to the developing sperm; secrete oestrogen & hormone binding proteins.

‡ Testosterone is synthesized from pregnanolone.

‡ Testosterone stimulates the process of spermatogenesis, also necessary for the formation of
secondary spermatocyte from primary spermatocyte.

‡ Growth hormone is essential for the general metabolic processes in testis.

‡ Male sex hormone is secreted mainly by interstitial cells of Leydig.

‡ Development of male sex organ in fetal life depends on testosterone produced under the influence of
HCG.

‡ Testosterone circulates in Combination with Gonadal steroid binding globulin.

‡ Hormone used for treating osteoporosis in old age ² Testosterone.

‡ In males FSH promotes spermatogenesis by enhancing the transport of Testosterone to seminiferous


tubules and androgen binding protein synthesis from sertoli cells.

FEMALE REPRODUCTIVE SYSTEM

‡ During menstrual period, upto 20 gm of protein may be lost.


‡ Quantity of blood expelled during normal menstral cycle is 40 ml (approx) & serous ± 35 mls.

‡ FSH level is high in post menopausal women.

‡ Ovarian hormones are estrogen and progesterone

‡ Ovulation occurs on the 14th day of menstrual cycle in a normal cycle of 28 days.

‡ Oxytocin causes contraction of smooth muscles of uterus & enhances labour.

‡ Hormones secreted are HCG, Oestrogen, progesterone & human chorionic somato mammo tropin.

‡ Relaxin is a hormone secreted from the maternal ovary during the later periods of pregnancy.

‡ Biological test for Pregnancy can be performed only after 2 ± 3 weeks of conception.

‡ LH is concerned with follicle maturation and ovulation.

‡ Menopausal hot flushes are due to LH surge.

‡ Estrogen increases the secretion and ciliary beating in fallopian tubes.

‡ Estrogen changes the cuboidal lining of vagina to stratified.

‡ Estrogen changes the break down of glycogen into lactate in vagina.

‡ Estrogen initiates breast development.

‡ Estrogen causes early epiphyseal closure.

‡ Estrogen causes water retention.

‡ Important function of progesterone is to promote secretory changes in endometrium.

‡ Progesterone is the hormone for maintenance of pregnancy.

‡ Progesterone inhibits ovulation.

‡ The most important function of progesterone is to promote secretory changes in endometrium.

WATER & ELECTROLYTE / ACID-BASE BALANCE

‡ In human beings the total body water varies from 45 ± 75 % of body weight.

‡ Total water in the body is about 40 liters. (ICF forms 55% & ECF forms 45%).
‡ The volume of interstial fluid is about 12 liters.

‡ The volume of plasma is about 2.75 liters.

‡ Osmolality is the measure of a fluid¶s capability to create osmotic pressure, also called as osmotic
conc. of a solution.

‡ Osmolarity is the no: of particles / per liter of solution.

‡ Isotonic solutions are having same effective osmolality as body fluids. Eg: 0.9% Nacl solution & 5%
glucose solution.

‡ The insensible water loss from the body is about 600 to 800 ml. per day.

‡ The quantity of water lost as sweat per day is 600 ± 800 C.C.

‡ The normal pH of plasma is 7.4

‡ Acidosis is pH below 7.38

‡ Alkalosis is pH above 7.42

‡ Respiratory acidosis: primary excess of carbonic acid

o Due to hypoventilation as in respiratory diseases & neural diseases.

‡ Metabolic acidosis: primary deficiency of bicarbonate

o As in lactic acidosis, diabetic ketoacidosis, uremic acidosis & diarrhea.

‡ Respiratory alkalosis: primary deficiency of carbonic acid

o Due to hyperventilation as in hypoxia, neural diseases & psychological conditions.

‡ Metabolic alkalosis: primary excess of bicarbonate

o As in vomiting & treatment with diuretics.

  c@  


  

1. Right heart of the border is formed by ? ans. Svc ivc and right atrium remember NOT right ventricle.
2. Arch of aorta begins and ends at which level--- T2/T3/T4/T5 ans- T4
3. Glomus jugulare is present in ans. Carotid Body.
4. Which of the following is NOT the primary prevention for hypertension? Ans²Early diagnosis and
treatment( this is criteria for secondary prevention)
5. Treatment for pleomorphic adenoma? Ans--- Superficial Parotidectomy
6. Villous adenoma presents as ans²Hypokalemia
7. Which of the following is NOT a feature of Nephrotic syndrome ans--- Hematuria(seen in Nephritic
Syndrome)
8. Looser´s zone is present in Multiple myeloma/ Osteomalacia ans²Ostemalacia
9. Which element is present in Phosphofrucktokinase---- ans--- Magnesium
10. Lucid interval is present in ans--- Extradural hematoma
11. Which of the following is false about Wilm´s tumor A. presents before the age of 5 years B. mostly
presents as Abdominal Mass C. spreads mostly by Lymphatics ans--- C
12. Sudden hypocalcemia results in ans²Tetany
13. Subconjuctival hemorrhages are seen in ans²Pertussis( Donot remember other options)
14. Lacunar cells in which type of Hodgkins Lymphoma ans---Nodular Type
15. Basic pathology for renal rickets ans--- vitamin D malabsorption in intestinal cells
16. Antibodies diagnostic for SLE ans²anti ds DNA
17. Esotropia seen in ans²Uncrossed Diplopia
18. Grave´s Ophthalmopathy mostly presents as ans--- Proptosis
19. The most common cause of maternal mortality in india ans²heamorrhage
20. MMR is shown as ans²per lac LIVE BIRTHS
21. Early neonatal mortality doesNOT include ans--- Post neonatal mortality
22. Methionine are defecient in ans--- Pulses
23. Normal requirement of Iron during pregnancy? 2000/1500 not knowing the units as well as answer but
the options were like this.
24. Gower´s sign is seen in ans--- Duchhene Muscular Dystrophy
25. Tuberculosis in Pott´s disease involves what ans-- Spine
26. Munro micro abscesses and Auspitz sign are seen in ans--- Psoriasis
27. Wimberger´s sign seen in ans--- Scurvy ( Skin question)
28. cAMP is seen in Clostridium tetani/ Clostridium difficle/ Clostridium novyi/ and fourth option also was a
subtype of clostridium ans--- Clostridium perfringens
29. Technique used for RNA ans²Northern Blotting
30. Christmas disease is due to deficiency of ans²Defeciency of factor 9
31. Wincham´s striae is seen in Lichen planus/ Psoriasis ans²Lichen Planus
32. Day care anesathesia done by ans--- Propofol( NOT sure whether this question was in the exam or
not)
33. Substance used in Teletherapy Cesium/ Iridium ans--- Cesium
34. Material used for detection of bone metastasis ans²Tc99m
35. Which of the following does NOT present with hemoptysis Mitral stenosis/ Acute pulmonary oedema
ans²Acute pulmonary oedema
36. Malignant intraocular tumor of children Retinoblastoma/ Rhabdomyosarcoma ans--- Retinoblastoma
37. Which of the following is NOT seen in CRF? Ans²Hypophosphatemia
38. VDRL is what type of test ans²Slide flocculation test
39. Heterophile reaction is seen in ans²Weil Felix Reaction
40. Chalcosis is deposition of ans²Copper
41. Early feature of Diabetic Retinopathy ans²Microaneurysms
42. Which of the following is NOT a feature of Red Infarction Venous occlusion/ Occurs in organs having
dual circulation/ Occurs in solid organs ans--- Occurs in solid organs
43. Hirsutism is caused by ans------ Phenytoin
44. Gynacomastia is caused by ans--- ?
45. Which drug is NOT given in pregnancy ans²ACE Inhibitors
46. Arsenic poisoning mimics which disease Acute cholecystitis/ Acute gastroenteritis/?/? ans---? Check
from forensic book
47. Earliest immunoglobulin to be synthesized by foetus ans²IgM
48. Avascular necrosis occurs in ans²Talus( head of femur was not given) remember avascular necrosis
occurs in Femur, Scaphoid, Talus and Lunate
49. Workers working in Textile Industry suffer from ans²Bysinossis
50. ESI act does NOT cover Hotels/ Transpoters/ Railway/ Factory ans²Railway

51. PERT is a type of ans²Network output analysis


52. Which is the indicator of water pollution ans²E coli
53. Hallucinations NOT a feature ans²Always pathological
54. SINGLE drug treatment for trachoma( Read the question carefully) --- Tetracyclin/ Doxycycline/
Azithromycin ans²Doxycycline
55. Sinus NOT present at birth Sphenoidal/ Frontal/ Maxillary ans--?
56. Diagnosis of Interstitial lung disease done by ans²HRCT
57. Charecteristic of type2 respiratory failue ans²Low Pa oxygen and High Pa carbon dioxide
58. Mechanism of action of Cyanide ans--- Blocks Cytochrome enzyme P- 450
59. No Sweating occurs in ans--- Heat Stroke( Forensic Medicine)
60. Buerger´s disease involves ans---- Arteries, Veins and Nerves
61. Measure for Long term measurement Height for age/ Weight for age ans--- Height for age
62. Heller´s Operation is done in ans--- Achalasia Cardia
63. Psedomembranous colitis is caused by ans²Clostridium difficle
64. Folic acid is given during which trimester of pregnancy first/ second/ third/ puerperium ans--- First
65. Juvenile age is ?
66. Whats is Incidence Rate ans²It represents the no. of new cases in the community
67. Child age is 3 years he has how many teeths ans-- ?
68. NOT a part of Lochia rubra( Obs question) --- Blood cells/Decidua/ Platelets««. Ans---?
69. Which of the is NOT true about carbimazole ans--- Safely used in pregnancy(NOTE²Propylthiouracil
is used safely in pregnancy among anti thyroid drugs).
70. Adipocytes use which of following GLUT1/2/3/4 ans--- GLUT4
71. Which is feature of Irreversible cell injury ans--- Swelling of Mitochondria
72. Which is involved in transport in Mitochondria ans--- Carnitine
73. Least mode of transmission in HIV ans--- Sexual Intercourse(0.1-1.0 %)
74. According to census 2001 the urban population of india ans---27.4% ( SPM QUESTION)
75. Platelets are stored at what temperature ans--- 4 degree celsius
76. What area does palmar surface of hand represents in body surface are 1%/2%/3%/4% ans²1%
77. For shock patient best to check for administering fluid therapy ans--- Central Venous Pressure
78. Misoprostol is CONTRAINDICATED in not remembering options
79. Case related to Psychiatry ans²Hypochondriasis
80. Cellulitis is caused by Staph/ Streptococcus/ Klebsiella ans--- Streptococcus
81. Lobar pneumonia is caused by ans--- Streptococcus pnuemoniae
82. Codons are present in mRNA/ tRNA ans--- mRNA
83. Swine Flu caused in 2009 was due to H1N1/H5N1 ans²H1N1
84. Most common cancer WORLDWIDE Lung/ Breast/ Cervix/ Oral Cavity ans--- Lung Cancer
85. Drug of choice in PSVT Adenosine/ Verapamil ans²Adenosine(1st DOC and Verapamil is 2nd DOC)
86. First sign of Sexual maturity in BOYS Increase in height/ Increase in facial hairs/?/? ans--- Increase in
Facial hairs
87. Definition of Blindness ans--- Visual acuity less than 1/60 (Visual acuity less than 3/60 was NOT given
in options)
88. Question related to reflexes of Ambiguous Nucleus NOT seen is ans--- JAW REFLEX.
89. Beta2 adrenergic receptors does NOT act on which of the following ans--- Adipose Tissue
90. Which of the following diseases is NOT under WHO regulation Wild Poliomyelitis/SARS/Human
Influenza/ Cholera ans----- SARS
91. In which of the following interpretation is done in Results Achieved ans---- Cost Effectiveness
92. One question related to following are NOT feature of COST ACCOUNTING( SPM question)
93. First to appear in Anemia ans---- RETICULOCYTOSIS
94. First symptom of anemia Hypochromia/ Microcytic ans--- Microcytic
95. Teratogenic effects has NOT been seen with HIV/ Rubella/ CMV/ Varicella ans--- HIV
96. Nevirapine belongs to ans²NNRTI( Non Nucleoside Reverse Transcriptase Inhibitor).
97. Cherry red spot is seen in CRVO/ CRAO ans²CRAO
98 . Treatment of hypercholestremia Thiamine/Biotin/Pyridoxine/Vitamin B12 It was also some name of
vitamin ans-----Vitamin B12
99. Hartnup´s disease is due to deficiency of Phenyalanine/ Homogentisate ans------- Phenylalanine(
Tryptophan is produced from Phenylalanine).
100. Purine metabolism end product is ans---- Uric Acid

101. Defect seen in Vitiligo not remembering options


102. Flouride ions inhibit ans--- Enolase
103. Pneumatocele is caused by ans--- Staphylococcus
104. What is epiphora ans--- Abnormal flow of tears.
105. What is Peau de orange ( Surgery ques. From breast chapter) ans--- Occurs due to lymphatic
obstruction.
106. Earliest marker to rise in MI ans--- CPK-MB
107. In Dengue hemorrhagic fever, torniquest test is done for diagnosis presence of how many no. of
petechieas necessary 5/10/15/20 ans---20
108. Poliomyelitis is diagnosed by ans. Isolation of virus in stool
109. Wernicke"s disease is caused due to defeciency of ans. Vitamin B1
110. Traveller"s diarrohea is caused by ans. ETEC
111. Keratometer measures ans--- Curvature of cornea
112. Rape is defined under IPC375/376/377/378 ans---IPC375
113. Child of 2 years with mental age of 10years, what is his IQ 20%/ 30%/ 50%/ 70% ans²20%
114. Xanthine Oxidase requires Zinc/ Copper/ Iron/ Molybdenum ans--- Molybdenum
115. 8 sign in CXR seen in ans--- TAPVC
116. Allen´s test done for ans²Ulnar artery patency
117. Aspirin mechanism of action ans---- Irreversibly inhibits COX
118. Reversed cold chain used for AIIMS QUESTION not remembering the options as well as answer
119. Autosplenectomy seen in ans²Sickle Cell Anemia
120. Cobra venom is ans²Neurotoxic
121. ECG changes in Hyperkalemia ans--- Peaked T waves
122. LH surge time duration ans²24 hours
123. Most common site of Volvulus ans²Sigmoid Colon
124. HALDANE EFFECT ( Physio question)
125. Hepatitis E more common in ans--- Pregnancy
126. Most common lung cancer in non-smokers ans²Adenocarcinoma
127. Incubation period of Rabies depends on ans--- Depends on site of bite.
128. Content of Anatomical Snuff Box Anterior interosseous artery/ Posterior interosseous artery/ Radial
artery ans²Radial Artery
129. Anti TB drug being least Hepatotoxic Rifampicin/ Streptomycin ans--- Streptomycin
130. Which of the following does NOT have any cycloplegic and mydriatic effect ans²Pilocarpine
131. Cycloplegics are used for treatment of Angle closure glaucoma/ Closed angle glaucoma/ Iritis ans---
Iritis
132. Oschner-Sherren regimen used in Appendicular abscess/ Appendicular lump ans²Appendicular
Lump
133. Certificate of vaccination of Yellow Fever is valid for ___ years ans²10
134. Which of the following is NOT symptom of defeciency vitamin A Night blindness/ Xerophthalmia/
Follicular hyperkeratosis/ Polyneuropathy ans²Polyneuropathy
135. Safety muscle of Tongue Styloglossus/ Hyoglossus/ Genioglossus/ Palatoglossus ans²
Genioglossus
136. In visual pathway, ganglion cells are 1st order neuron/ 2nd order neuron ans--- 2nd order neuron
137. Mechanism of action of Telmisartan Blocks AT1 receptors/ Angiotensin 2 receptor antagonist ans----
Angiotensin 2 receptor antagonist
138. Predisposing factors for Carcinoma of penis are all except Pagets disease/ Phimosis/
Balanoposthitis/ Papilloma ans--- Papilloma
139. Fetal adrenals predominantly secrete Cortisone/ Aldosterone/ Testosterone/ Oestrogen ans----
Cortisone
140. Which muscle helps in opening Eustachian tube options were like Inferior turbinate/ Superior
turbinate/ Middle turbinate not remembering exact options but it was like this ans---- Inferior Turbinate
141. Which of the following is used in Teletherapy Cesium/ Iridium ans--- Cesium( Remember Iridium is
NOT used in teletherapy)
142. Calorie test activates what ans--- lateral NOT remembering exact otions but answer was this as it
was being asked from old papers of MCI
143. HCG during pregnancy doubles at ans--- 60-70 days
144. Most common donor for a transplant Mother/ Father/ Brother/ Identical twin ans--- Identical twin
145. Pschiatry case related to Acute Psychosis
146. Case on Medicine---- A woman has been Coronary artery disease when opened found gall stones.
Earlier mo history of pain and jaundice. Treatment--- ans--- ?
147. Metoprolol is preffered over Propanolol why? Has negative cholinergic action/ Has negative inotropic
action/ Doesnot blocks beta receptors/ Doesnot blocks alpha receptors ans---- Doesnot blocks alpha
receptors.
148. Benign prostatic hypertrophy is associated with Median lobe/ Posterior lobe/ Periurethral surface
ans²Median lobe ALL INDIA 2005 Q.4 MUDIT KHANNA
149. Cushing disease seen as a Paraneoplastic syndrome in ans---- Small cell lung carcinoma
150. Gastric lavage is contraindicated in ans--- Organophosphorus Poisoning

151. Illness criteria done by ans--- APACHE


152. Lower GI bleeding most common cause in india ans--- ?
153. Which of the following is NOT a feature of megaloblastic anemia Macro ovalocyte/ Megablastosis/
Heinz bodies/ ? ans---- Heinz Bodies
154. Most common symptom for Mountain sickness Headche/ Dizziness ans-- Headache
155. In nephrotic syndrome what infection is more common in children ans--- ?
156. What is Neurapraxia ans--- Defect in nerve conduction only
157. What are side effects of OCP except Thromboembolism/ Breast Carcinoma/ Ovarian tumor/ Liver
disease ans--- Ovarian Tumor( Remember OCP are NOT given In breast carcinoma BUT are used in
benign breast disease)
158. Sjogren´s syndrome all are true except Keratoconjuctivitis sicca/ Rheumatoid arthritis/ Xerostomia
ans--- Fourth option was the answer NOT remembering what was it
159. Peyer´s patches are present in Duodenum/ Jejunum/ Ileum ans---- Ileum
160. Features of Diffuse axonal injury options were related to hours of lost consciousness and some
some more also
161. Wood´s lamp is NOT used for there 2 options related to subtypes of tinea ONE of them was the
answer please confirm from book
162. Best method to prevent infection in a ward ans--- Proper hand washing
163. Features of Bacterial Vaginosis except Ph>4.5/ clue cells/ Increased lactobacillus ans--- Increased
lactobacillus
164. Which of the following DONOT inhibit bacterial cell wall synthesis Vancomycin/ Amikacin / Linezolid/
Aztreonam ans---- Amikacin
165. Which of the following has opsonins on its surface IgG/ IgM ans---- IgG
166. Free friable soft vegetations are seen in Infective endocartitis/ Libman sack´s endocartitis/
Rheumatic fever ans--- Rheumatic Fever
167. Triple arthrodesis doesNOT involve Calcaneocuboid/ Talanovicular/ Talocalcaneal/ Tibiotalar ans----
Tibiotalar
168. One question related to Housemaid´s Knee ( Ortho ques.)
169. Pemphigoid types all are autoimmune except ans--- ?
170. Side effects of glucocorticoids are all except Hyperkalemia/ Cataract/ Proximal myopathy ans----
Hyperkalema
171. Sudden loss of vision occurs in Diabetic Retinopathy reason ans---- Vitreous Hemorrhage
172. Tb bone disease spreads by Direct spread/ Blood/ Lymphatics/ All of the above ans--- All of the
above.
173. Sulfonyl urea drug mechanism of action are all except
174. Pulsus paradoxus is seen in ans--- Severe COPD
175. Rabies vaccine is prepared from which ans²Fixed Virus
176. Hyponatremia is seen in all except CCF/ Nephrotic syndrome ans--- Nephrotic Syndrome
177. Which of the following is true ans---- ICF is more than ECF ( Physio ques.)
178. Lens develop from ans--- Surface ectoderm
179. Chronic inflammation of Meiobian Gland is seen in External hordeolum/ Internal hordeolum/
Chalazion ans²Chalazion
180. Crew cut hair on end appearance on skull X ray seen in
Beta thalassemia/ Sickle cell anemia ans--- Beta thalassemia
181. Kussmaul´s sign is NOT seen in ans²Cardiac tamponade
182. Most common location of appendix ans--- Retrocaecal
183. HCG is secreted by Syncytiotrophoblast/ Cytotrophoblast ans--- Syncytiotrophoblast.
184. What is Rhinophyoma ans--- Hypertrophy of sebaceous glands.
185. Not a screening test for Carcinoma of breast FNAC/ Mammogram/ USG/ Self Examination ans----
FNAC
186. Drug NOT used in glaucoma Timolo/ Metoprolol/ Pilocarpine ans--- Metoprolol
187. Sweating occurs due to Cholinergic/ Anti- cholinergic Action ans--- Cholinergic Action
188. Menstrual regulation is done upto ans²42 days of Amenorrhea
189. NOT a feature of occulomotor palsy ans--- Proptosis
190. There was a question related to Triple glass test of urine done and in first glass test there is beaded
appearance seen What is diagnosis Cystitis/ Proastitis/ Urethritis ans²Urethritis
191. In a burn patient what type of fluid is given Normal Saline/ Ringer´s Lactate ans--- Ringer´s Lactate (
Learn this by heart very imp. and confusing question)
192. There was a question related to features seen in dengue hemorrhagic fever are all except NOT
remembering d options
193. Alzehemeir´s disease pathology Defeciency of cholinergic action/ Excess action of dopamine ans---
Excess action of dopamine
194. How is diagnosis of Vesicoureteral Reflux done ans--- Micturating cystourethrogram
195. Breast milk is produced from ans--- ?
196. Breast carcinoma most common type ans--- ?
197. Carrier state NOT seen in which infection Tetanus/ Ameobiasis/ Pertussis/ Diphtheria ans---- ?
198 . Investigation of choice in Cerebral calcification ans²CT Scan
199. Confirmatory test for Primary Syphilis VDRL/ TPI ans--- ?
200. Crescent air sign in CXR due to ans--- I marked ASPERGILLOSIS ( PLZ CONFIRM)

201. Furosemide mechanism of action in LVF ans²Inhibitor of NA-K-CL ion inhibitor ( Thiazide is inhibitor
of only NA- CL ions only NOT K ions).
202. Trendelenburg test is done in ans²Varicose Veins ( I donot remember the options otherwise it was
difficult to rule out)
203. Iron binding protein is Ferritin/ Apoferritin ans--- Apoferritin ( Plz confirm)
204. Contents of Ringer´s lactate are all except I donot remember exactly but it was something asked
about conc. Of NA K CL and one more.
205. There was one case of Leukemia
206. One more case for Aplastic anemia
207. Most common tumor in Oral area donot remember options as well as answer
208. One ortho question related to HOUSEMAID´S KNEE ( See Q. 168)
209. Melanoma of choroid spreads most commonly where Lungs/ Kidneys/ Adrenals ans-- ?
210. Submandibular gland is NOT supplied by which nerve ans--- ?
211. Mountain sickness prophylaxis ans--- ?
212. What is Xenograft ans--- Graft done from 1 species to other species.
213. Physiological jaundice is characterized by Appears in first 24 hours/ Peaks by some days/
Disappears by 3rd week of life ans--- Disappears by 3rd week of life
214. NOT a feature of Primary complex TB Apical cavity/ Ghon´s focus/ Lymphadenopathy ans--- Apical
cavity.
215. One question related to Radio immunoassay of HCG ans---- HCG detected as early as 8-9 days of
ovulation.
216. Radon226 spits into all except Alpha/ Beta/ Gamma/ X rays ans---- X Rays
217. Acetazolamide decreases IOP by what mechanism Decreases aqueous humor production/
Decreases vitreous volume ans--- Decreases vitreous volume ( Plz confirm)
218. Socially acquired behavior Acculturation/ Custom ( SPM question) ans--- Custom
219. Bezold abscess seen in ans--- Sternocleidomastoid Muscle

    "
  (((" ""

"     )     

"Go Find Rex, Make Good Sex":

ü 

Glomerulosa

Fasiculata

Reticulata


   

Mineralcorticoids
Glucocorticoids

Sex hormones (androgens)

Alternatively for layers: GFR

(Glomerular Filtration Rate, convenient since adrenal glands are atop kidney).

"    


     "  

ABCD:

Alpha = Constrict.

Beta = Dilate.

*"   


       

"PVT TIM HALL

Phenylalanine, Valine,Threonine,

Tryptophan Isoleucine, Methionine

Histidine, Arginine, Lysine, Leucine,

+"       MCAT:

Metronidazole

Chloramphenicol

Aminoglycoside

Tetracycline

&"  #c     ,

Aortic arch gives off the Bracheiocephalic trunk,

the left Common Carotid, and the left

Subclavian artery

$"  

management of acute severe "O SHIT":

Oxygen (high dose: >60%)

Salbutamol (5mg via oxygen-driven nebuliser)

Hydrocortisone (or prednisolone)


Ipratropium bromide (if life threatening)

Theophylline (or preferably aminophylline-if life threatening)

v"    

"Tu Ro Na Pyare Cutte":

‡ In increasing order: Thiamine (B1) Riboflavin (B2) Niacin (B3) Pyridoxine (B6) Cobalamin (B12)

-"   
      

"Betablockers Acting Exclusively At Myocardium"

‡ Cardioselective betablockers are:

· Betaxolol

· Acebutelol

· Esmolol

· Atenolol

· Metoprolol

"       @ ) 


          

My Aunt Raped My Uncle

Musculocutaneous, Axillary, Radial, Median, Ulnar

"         

"A PALM Seed Makes Another Little Palm":

‡ In order from superior to inferior:

1. Apical

2. Posterior

3. Anterior

4. Lateral

5. Medial

6. Superior

7. Medial basal

8. Anterior basal
9. Lateral basal

10. Posterior basal

" @  )




PROlactin stimulates the mammary glands to PROduce milk.

Oxytocin stimulates the mammary glands to Ooze (release) milk.

"   "     c,,,,

Brachioradialis

Extensors

Supinator

Triceps

*"    
  

"Always Bring Polymerase Or Fail Replication":

Arena

Bunya

Paramyxo

Orthomyxo

Filo

Rhabdo

‡ Note: Negative RNA viruses need there own polymerase.

+" ! : "Never Let Mom Eat Beans" and "60, 30, 6, 3, 1"

Neutrophils 60%

Lymphocytes 30%

Monocytes 6%

Eosinophils 3%

Basophils 1:

&" !        ( 

Newborn 3 kg
6 mos 6 kg (2x birth wt at 6 mos)

1 yr 10 kg (3x birth wt at 1 yr)

3 yrs 15 kg (odd yrs, add 5 kg until 11 yrs)

5 yrs 20 kg

7 yrs 25 kg

9 yrs 30 kg

11 yrs 35 kg (add 10 kg thereafter)

13 yrs 45 kg

15 yrs 55 kg

17 yrs 65 kg

—  #c     ,

Aortic arch gives off the

Bracheiocephalic trunk,

left Common Carotid,

left Subclavian artery

—    )    

Sneh Lta's Powdered Face Often Attracts Medical Students.

S= Superior Thyroid

L= Lingual

P= Posterior Auricular

F= Facial

O= Occipital

A= Ascending Pharyngeal

M= Maxillary

S= Superficial Temporal


—  c  c  å


   &

VIT. C&D (Read as Vitamin C & D)

V = Vertebral artery

I = Internal Thoracic artery

T = Thyrocervical Trunk

C = Costocervical trunk ( from first br of left subclavian a. but arises from 2 branch of right side)

D= Dorsal scapular artery (branch of third part)

—      )    : Sally Thompson Loves Sex And Pot pie.

Superior Thoracic, Thoracoacromial, Lateral Thoracic, Subscapular, Anterior Circumflex Humeral,


Posterior Circumflex Humeral, and Profunda Brachii.

—    )

Rohit Tu Dekh Cold Beers:

Roots, Trunks, Divisions, Cords, Branches

—       @ ) 


           

My Aunt Raped My Uncle

Musculocutaneous, Axillary, Radial, Median, Ulnar

—       

Ten Zebras Bought My Car

Temporal, Zygomatic, Buccal, Masseteric, Cervical

—   % FLEZMS


Frontal, Lacrimal, Ethmoid, Zygomatic, Maxilla, Sphenoid

— -   

Starting from the thumb,

         

Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate.

— c  c

Tarzon Call Can Navi LIM3C

1. Talus

2. Calcaneus

3. Cuboid

4. Navicular

5. Lateral cuneiform

6. Intermediate cuneiform

7. Medial cuneiform

— cc
 
 

% PVT. TIM HALL

P-henylalanine V-valine T-threonine T-tryptophan I-Isoleucine M-ethionine H-histidine A-arginine L-


lysine L-leucine

— 
 @!
% ECOLI MT

E-8TH NERVE

C-COCHLEAR NUCLEI

O-SUPERIOR OLIVARY NUCLEUS

L-LATERAL LAMINISCUS

I-INFERIOR COLLICULUS
M-MEDIAL GENICULATE BODY

T-SUP TEMPORAL GYRUS

— " @           

TOMB:

· Tetracycline

· Omeprazole

· Metronidazole

· Bismuth

—      

FORT PR ABC

· Flavivirus/ Filo, Orthomyxo, Retro, Toga

· Paramyxo, Rhabdo

· Arena, Bunya, Corona

—     


% SLIPR:

Swelling, Loss of function, Increased heat, Pain, Redness

—     :-"don't DROP the baby":

· Defect (VSD)

· Right ventricular hypertrophy

· Overriding aorta

· Pulmonary stenosis


— % 
 å  
% "Do Block AV":

Digoxin

B-blockers

Adenosine

Verapamil

—       @c  6

Parietal Ethmoid Sphenoid Temporal Occipital Frontal

—      

Grand son grate living Child.

Brent Spiner Gained Lieutenant Commander

Germinativum or Basal, Spinosum, Granulosum, Lucidum, Corneum

—  
     :- MJ THREADS:

Myocardial infarction Jaundice Tuberculosis Hypertension Rheumatic fever/ Rheumatoid arthritis Epilepsy
Asthma Diabetes Strokes

— @    

"On Days Feeling Low Character, Run a Seven Pace Race":

1. Onset

2. Duration

3. Frequency

4. Location

5. Character
6. Radiation

7. Severity

8. Precipitating factors

9. Relieving factors

—  
   

DEMENTIA:

á Diabetes
á Ethanol
á Medication
á Environmental (eg CO poisoning)
á Nutritional
á Trauma
á Infection
á Alzheimer's

1. (              ,

1. Every - Engagement

2. Damn - Descent

3. Female -Flexion

4. I -Internal Rotation

5. Eat -Extension

6. Returns-Restitution

7. Eagerly-External Rotation

—     = "HAL"

Histidine, Arginine, Lysine.


—    (   

BATS Drink Blood

pt awake & eyes Open² Beta

Pt awake but eyes Closed² Alpha

Stage I ----------------------- Theta

Stage II------------------------- Spindle & k complex

Stage III & IV ------------------- Delta

REM sleep ----------------------- Beta

—  
  

"Eating Contaminated Stuff Causes Very Big Smelly Vomit":

· E. coli O157-H7 [undercooked meat, esp. hamburgers]

· Clostridium botulinum [canned foods]

· Salmonella [poultry, meat, eggs]

· Clostridium perfringens [reheated meat]

· Vibrio parahaemolyticus [seafood]

· Bacillus cereus [reheated rice]

· Staphylococcus aureus [meats, mayo, custard]

· Vibrio vulnificus [seafood]

— (     

#       .

The TIBia is the Thick, Inner Bone. The FibuLa is Finer, Fluted, and Lateral

— c/  ""
%  c c 
·  c (25): uodenum, reter , sophagus, escending colon, cigmoid colon

· c (13) : ctomach, scending colon, ectum

·  (8) : ile duct, ppendices, allbladder

— @
  
 åc

ë 
    

  

1- Cribriform plate of ethmoid

2- Optic canal

3- Superior orbital fissure

4- Superior orbital fissure

5- (S R O ) cuperior orbital fissure f.otundum, f.val

6- Superior orbital fissure

7- f. Stylohoidus

8- Internal acoustic meatus

9- Jugular formen

10- Jugular formen

11- Jugular formen

12- Hypoglossal canal

Ñ  

· %


 c  

· @ %@
  

 


· %å
 c
c  
¢ 

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Ñ  ! 

· %  0    

· %   
· !%!    "

· %$@ "

" #$ $ %$&  ë$'

· %0       

· %%   

· %

· %   

· %   

· %  1 )

· % 0   


( )( 
& 

· %    

· % 

·
%
    

· % 

· %@ ¢ @     

· % 1  

· %   

  

- 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)

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).



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.

@ 

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

Forensic Medicine:

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.

@ 

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.

@ 

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

:

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.

c@

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



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.

 

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.

@ 

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.

  

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.

c 

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



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. Some high yielding topics
in Harrison are: CVS, Kidney(especially glomerulonephritis, renal failure), acid base imbalance,
Hematology, Genetics, Viral Hepatitis. 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

c 
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.

  
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.

Ortho: 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

@ 
Sure Success Ramgopal, Ahuja, High yield psychiatry.

Concentrate on schezophrenia, mood disorders, substance abuse, sleep cycle and disorders, autistc
disorder

  : No books needed here in my opinion. Just do previous years, mcqs and also do from Sure
Success Ramgopal.

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...

Anatomy-3days(will mainly do questions from Tehalka)


Physio- 5 days
Biochemistry-10days
Forensic- 2days
Patho- 30days
Pharma- 10days
Micro- 10days
Eye-7days
ENT- 5days
SPM- 20days
Gynae & Obs.- 20days
Medicine-30days
Surgery-20days
Paeds- 7 days
SARP- 5 days
Ortho- 5days

This roughly comes out to be a little more than 6months. 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.
p