Vitamins

CO-FACTORS

vitamin
B1---- oxidative decarboxylation
B2 ---- FAD
B3 ----- NAD
B5 ---- acyl co-A
B6 ---- simple decarboxylation
Biotin ----- carboxylation

co-factors for krebs cycle and pyruvate dehydrogenase- vit B1, B2, B3, B5 & lipoic acid.

co-factors for acyl co-a carboxylase --- CO2/ HCO3- , ATP , biotinm and vit B12

Biochemistry

BIOCHEMISTRY TIPS

ENZYMES AND INHIBITORS
glyceride-3-phosphate dehydrogenase --- iodoacetate
enolase ----- flouride

aconitase ---- fluoroacetate
alpha ketoglutarate dehydrogenase ---- arsenite
succinate dehydrogenase ---- malonate

glycogen phosphorylase ---- protein phosphatase , glucose and
glucose-6-phosphate , insulin { PGI } ATP , fructose-1-phosphate

complex 1 ---- rotenone
complex II ---- malonate
complex III----- phenformin
complex IV ----- CO , H2S , azide , cyanide
complex V ---- oligomycin
ATP ADP translocase ---- atractyloside
uncouplers ----- dinitrophenol , thermogenin , warfarin , bilirubin

hexokinase I,II,III ---- glucose-6-phosphate
hexokinase IV { glucokinase } ---- fructose-6- phosphate

osteochondritis

Types of osteochondritis

a. Keinboch dz- lunate

b. Kohler dz - navicular

c. Perthe - femur head

d. Scheurmann dz- ring
epiphysis of vertebrae

e. Calves dz- central bony nucleas of vertebrae

f. Frieberg - 2nd metatarsal head

g. Islene- 5th
metatarsal head

h. Osgood shaltter's dz -
tibial tuberocity

i. Severe 's dz-
calcaneum

j. Johanson- Larsens dz - lower pole of patella

k. Blounts dz- Tibia

l. Panner's dz -
capitulum of elbow

m. Preiser's Synd - Scaphoid

n. Schmier 's Dz- Pisiform

o. Witt' s dz- triquetrum

p. Agati dz - trapazoid

q. Haglund dz - calcaneus

r. Fleischner Thiemann
dz- phalanges

s. Haas dz - head of
humerus

t. Konig' s Synd -
tubular bones

u. Wegner Synd - osteochondritis with epiphyseal seperation

v. Mouclaire's disease- metacarpal head

CD Markers

CD1a, CD207: Langerhan cell histiocytosis cells
CD2, CD3, CD4, CD5, CD7, CD8: T cells
CD10: Early pre-B cells (immature B cells)
CD11c, CD25, CD103, CD123: Hairy cell leukemia cells
CD13, CD33, CD117: Myeloid cells
CD14, CD64: Monocytic cells (positive in AML-M4 and AML-M5)
CD15: Reed-Sternberg cells, neutrophils
CD16, CD56: Natural killer cells
CD19, CD20, CD21, CD22 : B cells
CD23 and CD5 : Chronic lymphocytic leukemia/small lymphocytic lymphoma
CD23 negative and CD5 positive: Mantle cell lymphoma cells
CD30 and CD15: Reed-Sternberg cells
CD30 positive and CD15 negative: Anaplastic large cell lymphoma cells
CD31: Endothelial cells (positive in angiosarcoma)
CD33: Myeloid cells and precursors
CD34: Stem cells (also positive in angiosarcoma)
CD41, CD61: Megakaryocytes and platelets (positive in AML-M7)
CD45 : All leukocytes (except Reed-Sternberg cells!)
CD45 RO: Memory T cells
CD45 RA: Naive T cells
CD68: Histiocytes (positive in malignant fibrous histiocytosis)
CD99: Ewings sarcoma cells
CD117: Gastrointestinal stromal tumor (GIST) cells, mast cells (positive in mastocytosis), myeloid cells

AIDS

Kaposi sarcoma is the most common AIDS- related tumor in homosexual men and in populations in parts of Africa
2. Non-Hodgkin lymphoma is the second most common AIDS-associated neoplasm
3. The most common ocular manifestation of AIDS is a form of retinopathy consisting of cotton-wool spots, hemorrhages, and capillary abnormalities.
4. Cytomegalovirus (CMV), a double-stranded DNA virus in the herpesvirus family, is the most
common cause of life-threatening opportunistic viral infection in AIDS patients
5. Esophagus is the most common site of HIV related ulcer
6. Candidiasis in AIDS=the esophagus is the most common site of infection
7. The colon is the most common site of involvement of Histoplasma organisms in he gastrointestinal tract in AIDS patients
8. Terminal ileum is the most common gastrointestinal site of disseminated histoplasmosis in the non-AIDS immunocompromised patient
9. Cryptosporidiosis in AIDS=the jejunum is the most common site
10. Pneumonia is the most common manifestation of P carinii infection in AIDS
11. The liver, spleen, and lymph nodes are the most common sites of extrapulmonary pneumocystosis
12. The ileocecal region is the most common site of  tuberculosis in the gastrointestinal tract
13. The most common non-tuberculous mycobacterial infection in AIDS patients is caused by M avium.It is the most common opportunistic infection of bacterial origin in AIDS patients in developed countries . Acquired most commonly through the mouth or gastrointestinal tract
14. Bacillary angiomatosis =cutaneous lesions, which mimic those of Kaposi sarcoma, are the most common manifestation
15. The most common causes of vision loss affecting patients with AIDS --Cytomegalovirus (CMV) retinitis
16. Pulmonary TB is the most common type of TB in persons with HIV infection
(One controversy: PCP is the most common
cause of death in AIDS patient or Liver failure is the most common cause of death in people with AIDS)

Clotting Pathways

HIGH YIELD FACTS

1. Acromegaly – Diagnosis: OGTT followed by GH conc.
2. Cushings – Diagnosis: 24hr urinary free cortisol. Addisons --> short synacthen.
3. Rash on buttocks – Dermatitis herpetiformis (coeliac dx).
4. AF with TIA --> Warfarin. Just TIA's with no AF --> Aspirin
5. Herpes encephalitis --> temporal lobe calicification OR temporoparietal attentuation – subacute onset i.e. Several days.
6. Obese woman, papilloedema/headache --> Benign Intercanial Hypertention.
7. Drug induced pneumonitis --> methotrexate or amiodarone.
8. chest discomfort and dysphagia --> achalasia.
9. foreign travel, macpap rash/flu like illnes --> HIV acute.
10. cause of gout --> dec urinary excretion.
11. bullae on hands and fragule SKIN torn by minor trauma --> porphyria cutanea tarda.
12. Splenectomy --> need pneumococcal vaccine AT LEAST 2 weeks pre-op and for life.
13. primary hrperparathyroidism --> high Ca, normal/low PO4, normal/high PTH (in elderly).
14. middle aged man with KNEE arthritis --> gonococcal sepsis (older people -> Staph).
15. sarcoidosis, erythema nodosum, arthropathy --> Loffgrens syndrome benign, no Rx needed.
16. TREMOR postural,slow progression,titubation, relieved by OH->benign essential TREMOR AutDom. (MS – titbation, PD – no titubation)
17. electrolytes disturbance causing confusion – low/high Na.
18. contraindications lung Surgery --> FEV dec bp 130/90, Ace inhibitors (if proteinuria analgesic induced headache.
21. 1.5 cm difference btwn kidneys -> Renal artery stenosis --> Magnetic resonance angiogram.
22. temporal tenderness--> temporal arteritis -> steroids > 90% ischaemic neuropathy, 10% retinal art occlusion.
23. severe retroorbital, daily headache, lacrimation --> cluster headache.
24. pemphigus – involves mouth (mucus membranes), pemphigoid – less serious NOT mucosa.
25. diagnosis of polyuria -> water deprivation test, then DDAVP.
26. insulinoma -> 24 hr supervised fasting hypoglycaemia.
27. Diabetes Random >7 or if >6 OGTT (75g) -> >11.1 also seen in HCT.
28. causes of villous atrophy: coeliac (lymphocytic infiltrate), Whipples , dec Ig, lymphoma, trop sprue (rx tetracycline).
29. diarrhoea, bronchospasm, flushing, tricuspid stenosis -> gut carcinoid c liver mets.
30. hepatitis B with general deterioration -> hepaocellular carcinoma.
31. albumin normal, total protein high -> myeloma (hypercalcaemia, electrophoresis).
32. HBSag positive, HB DNA not detectable --> chornic carier.
33. Inf MI, artery invlived -> Right coronary artert.
34. Aut dom conditions: Achondroplasia, Ehler Danlos, FAP, FAMILIAL hyperchol,Gilberts, Huntington's, Marfans's, NFT I/II, Most porphyrias, tuberous sclerosis, vWD, PeutzJeghers.
35. X linked: Beck/Duch musc dyst, alports, Fragile X, G6PD, Haemophilia A/B.
36. Loud S1: MS, hyperdynamic, short PR. Soft S1: immobile MS, MR.
37. Loud S2: hypertension, AS. Fixed split: ASD. Opening snap: MOBILE MS, severe near S2.
38. HOCM/MVP - inc by standing, dec by squating (inc all others). HOCM inc by valsalva, decs all others. Sudden death athlete, FH, Rx. Amiodarone, ICD.
39. MVP sudden worsening post MI. Harsh systolic murmur radites to axilla.
40. Dilated Cardiomyopathy: OH, bp, thiamine/selenium deficiency, MD, cocksackie/HIV, preg, doxorubicin, infiltration (HCT, sarcoid), tachycardia.
41. Restrictive Cardiomyopathy: sclerodermma, amyloid, sarcoid, HCT, glycogen storage, Gauchers, fibrosis, hypereosinophilia Lofflers, caracinoid, malignancy, radiotherapy, toxins.
42. Tumor compressing Respiratory tract --> investigation: flow volume loop.
43. Guillan Barre syndrome: check VITAL CAPACITY.
44. Horners – sweating lost in upper face only – lesion proximal to common carotid artery.
45. Internuclear opthalmoplegia: medial longitudinal fasciculus connects CN nucleus 3-4. Ipsilateral adduction palsy, contralateral nystagmus. Aide memoire (TRIES TO YANK THE ipsilateral BAD eye ACROSS THE nose ). Convergence retraction nystagmus, but convergence reflex is normal. Causes: MS, SLE, Miller fisher, overdose(barb, phenytoin, TCA), Wernicke.
46. Progressive Supranuclear palsy: Steel Richardson. Absent voluntary downward gaze, normal dolls eye . i.e. Occulomotor nuclei intact, supranuclear Pathology .
47. Perinauds syndrome: dorsal midbrain syndrome, damaged midrain and superior colliculus: impaired upgaze (cf PSNP), lid retraction, convergence preserved. Causes: pineal tumor, stroke, hydrocephalus, MS.
48. demetia, gait abnormaily, urinary incontinence. Absent papilloedema-->Normal pressure hydrocephalus.
49. acute red eye -> acute closed angle glaucoma >> less common (ant uveitis, scleritis, episcleritis, subconjuntival haemmorrhage).
50. wheeles, URTICARIA , drug induced -> aspirin.
51. sweats and weight gain -> insulinoma.
52. diagnostic test for asthma -> morning dip in PEFR >20%.
53. Causes of SIADH : chest/cerebral/pancreas Pathology , porphyria, malignancy, Drugs (carbamazepine, chlorpropamide, clofibrate, atipsychotics, NSAIDs, rifampicin, opiates)
54. Causes of Diabetes Insipidus: Cranial: tumor, infiltration, trauma Nephrogenic: Lithium, amphoteracin, domeclocycline, prologed hypercalcaemia/hypornatraemia, FAMILIAL X linked type
55. bisphosphonates:inhibit osteoclast activity, prevent steroid incduced osteoperosis (vitamin D also).
56.returned from airline flight, TIA-> paradoxical embolus do TOE.
57. alcoholic, given glucose develops nystagmus -> B1 deficiency (wernickes). Confabulation->korsakoff.
58. mono-artropathy with thiazide -> gout (neg birefringence). NO ALLOPURINOL for acute.
59. painful 3rd nerve palsy -> posterior communicating artery aneurysm till proven otherwise
60 late complication of scleroderma --> pumonaryhypertention plus/minus fibrosis.
61. causes of erythema mutliforme: lamotrigine
62. vomiting, abdominal pain, hypothyroidism -> Addisonian crisis (TFT typically abnormal in this setting DO NOT give thyroxine).
63. mouth/genital ulcers and oligarthritis -> behcets (also eye /SKIN lesions, DVT)
64. mixed drug overdose most important step -> Nacetylcysteine (time dependent prognosis)
65. cavernous sinus syndrome - 3rd nerve palsy, proptosis, periorbital swlling, conj injectn
66. asymetric parkinsons -> likely to be idiopathic
67. Obese, NIDDM female with abnormal LFT's -> NASH (non-alcoholic steatotic hepatitis)
68. fluctuating level of conciousness in elderly plus/minus deterioration --> chronic subdural. Can last even longer than 6 months
69. Sensitivity --> TP/(TP plus FN) e.g. For SLE - ANA highly sens, dsDNA:highly specific
70. RR is 8%. NNT is ----> 100/8 --> 50/4 --> 25/2 --> 13.5
71. ipsilateral ataxia, Horners, contralateral loss pain/temp --> PICA stroke (lateral medulary syndrome of Wallenburg)
72. renal stones (80% calcium, 10% uric acid, 5% ammonium (proteus), 3% other). Uric acid and cyteine stone are radioluscent.
73. hyperprolactinaemia (allactorrohea, amenorrohea, low FSH/LH) -> Da antags (metoclopramide, chlorpromazine, cimetidine NOT TCA's), pregnancy, PCOS, pit tumor/microadenoma, stress.
74. Distal, asymetric arthropathy -> PSORIASIS
75. episodic headache with tachycardia -> phaeochromocytoma
76. very raised WCC -> ALWAYS think of leukaemia.
77. Diagnosis of CLL --> immunophenotyping NOT cytogenetics, NOT bone marrow
78. Prognostic factors for AML -> bm karyotype (good/poor/standard) >> WCC at diagnosis.
79. pancytopenia with raised MCV --> check B12/folate first (other causes possble, but do this FIRST). Often associayed with phenytoin use --> decreased folate
80. miscariage, DVT, stroke --> LUPUS anticoagulant --> lifelong anticoagulation
81. Hb elevated, dec ESR -> polycythaemua (2ndry if paO2 low)
82. anosmia, delayed puberty -> Kallmans syndrome (hypogonadotrophic hypogonadism)
83. diag of PKD -> renal US even if think anorexia nervosa
85. commonest finding in G6PD hamolysis -> haumoglobinuria
86. mitral stenosis: loud S1 (soft s1 if severe), opening snap.. Immobile valve -> no snap.
87. Flank pain, urinalysis:blood, protein -> renal vein thrombosis. Causes: nephrotic syndrome, RCC, amyloid, acute pyelonephritis, SLE (atiphospholipid syndrome which is recurrent thrombosis, fetal loss, dec plt. Usual cause of cns manifestations assoc with LUPUS ancoagulant, anticardiolipin ab)
88. anaemia in the elderly assume GI malignancy
89. hypothermia, acute renal failure -> rhabdomyolysis (collapse assumed)
90. pain, numbness lateral upper thigh --> meralgia paraesthesia (lat cutaneous nerve compression usally by by ing ligament)
91. diagnosis of haemochromatosis: screen with Ferritin, confirm by tranferrin saturation, genotyping. If nondiagnostic do liver biopsy 0.3% mortality
92. 40 mg hidrocortisone divided doses (bd) --> 10 mg prednisolone (ie. Prednislone is x4 stronger)
93. BTS: TB guidlines – close contacts -> Heaf test -> positive CXR, negative --> repeat Heaf in 6 weeks. Isolation not required.
94. Diptheria -> exudative pharyngitis, lymphadenopathy, cardio and neuro toxicity.
95. Indurated plaques on cheeks, scarring alopecia, hyperkeratosis over hair follicles ->>Discoid LUPUS
96. wt loss, malabsoption, inc ALP -> pancreatic cancer
97. foreign travel, tender RUQ, raised ALP --> liver abscess do U/S
98. wt loss, anaemia (macro/micro), no obvious cause -> coeliac (diarrhoea does NOT have to be present)
99. haematuria, proteinuria, best investigation --> if glomerulonephritis suspected --> renal biopsy
100. venous ulcer treatment --> exclude arteriopathy (eg ABPI), control oedema, prevent infection, compression bandaging.
101. Malaria, incubation within 3/12. can be relapsing /remitting. Vivax and Ovale (West Africa) longer imcubation.
102. Fever, lymphadenopathy, lymphocytosis, pharygitis --->EBV ---> heterophile antibodies
103. GI bleed after endovascular AAA Surgery --> aortoenteric fistula
104. Young girl – suspect Anorexia Nervosa – linugo hair, finctional hypogonadotrophic hypogonadism -> amennorhea. LH and FSH both low. All other hormones are usually normal. Ferritin low.
105. Reiters Syndrome – arthritis, uveitis, urethritis – Chlymidia, campylobacter, Yersinia, SALMONELLA , Shigella. Balanisits.
106. PKD – aut dom Chr 16/4 assoc berry aneurysm, mitral/aortic regurg
107. Porphyria – photosensitivity, blisters, scars with millia, hypertrichosis
108. heart sounds: Aortic Stenosis s2 paradoxical split, length proportional to severity
109. Vitiligo – commonest assoctions pernicious anaemia >>> type 1 DM , autoimmune addisons, autoimmune thyoid dx
110. Gout – blood urate high/low/normal, joint aspirate pos birif, ppt thiazides, NO allopurinol/aspirin in acute phase
111. Peripheral neuropathy – a) B12 – rapid, dorsal columns (joint pos, vibration), sensory ataxia, pseudoathetosis of upperlimbs b) diabetic – slow, spinothalamic (pain, temp?) c)alcohol – slow progressive, spinothalamic d) Pb – motor upper limbs
112. CNS abnormalities in HIV: toxoplaasmosis (ring enhancing), lymphoma (solitary lesion). HIV encephalopathy, progressive multifocal leucoencephalopathy (PML – demylination in advanced HIV, low attenuation lesions)
113. Travellers diarrohea: chronic (>2 WEEKS) giardia (incidious onset rx. Metronidazole), SALMONELLA (serious systemic illness), E.coli (rx. Ciprofloxacin) , Shigella
114. Renal syndrome – minimal change disease, membanous, IgA nephropathy, post-streptococcal.
115. If you see blood on urinalysis forget about RAS
116. Thyroid Malignancy – tend to be non-functional, anaplastic has worse prognosis, local infiltration -> dysphagia, vocal cord paralysis
117.ALMOST Pathognomic for the exam
fatiguability -> myasthenia gravis
fasciculations -> Motor neurone diease
silvery white scale -> PSORIASIS
hypopigmented -> vitiligo/pityriasis versicolor
pretibial myxoedema --> Graves (NOT lid lag, NOT exopthalmus)

OBG: Rapid Fire:-

OBG: Rapid Fire:-

1. Cyclical hematuria suggests which type of fistula in females:
Uterine-vesical

2. Commonest site of secondary metastasis in Choriocarcinoma:
Lungs

3. Treatment of inevitable abortion in 10th week of pregnancy: Dilatation & evacuation

4. Commonest site of ectopic pregnancy:
Ampulla

5. Alpha-fetoprotein is low in:
Down syndrome

6. Heart disease having highest mortality in pregnancy:
Eisenmenger’s complex

7. Trial of labor is CONTRAINDICATED in:
Previous 2 or more Cesarean section

8. Commonest cause of breech presentation is:
Prematurity

9. Low Forceps are applied when the station of head is:
+2

10. Maximum breast milk secretion occurs at which month:
3 months

11. Use of steroids in neonates is required in:
Bronchopulmonary dysplasia

12. Karyotype in androgen insensitivity syndrome: 46XY

13. Size of uterus:
3 x 2 x 1 inches.

14. Stress incontinence is best corrected by:
Bladder neck repair

15. Gonococcal infection spreads by:
Involvement of adjacent structures/ Ascending route

16. OCP of choice in lactation period:
Minipill/ progesterone only pill

17. A woman has 20 ml menstrual blood loss every 35 days. She suffers from: Oligomenorrhea

18. MC site of Endometriosis:
Ovary

19. Commonest ovarian tumour complicating pregnancy:
Dermoid

20. Most definitive clinical sign of pregnancy is:
Fetal heart sounds

2. Involution of the uterus is completed by:
6 weeks

22. Earliest indication of concealed acute bleeding in pregnancy is:
Tachycardia 

23. A patient presents at 28 weeks gestation with severe abdominal pain, bleeding and hypertension. The most likely diagnosis is:
Accidental hemorrhage

24. Feature suggestive of ectopic pregnancy in a young woman with acute abdomen:
Amenorrhoea,
Abdominal pain,
Vaginal bleeding.

25. MC type of pelvis associated with direct OccipitoPosterior position is:
Anthropoid

26. Most unfavorable presentation for vaginal delivery is:
Mento-posterior

27. Deep Transverse Arrest is commonly seen in which type of pelvis:
Android

28. An absolute indication for Classical Caesarean section is:
Central placenta previa

29. Best contraceptive method in a patient with heart disease is:
Barrier methods

30. MC complication of IUCD is:
Bleeding

31. Antituberculous drug CONTRAINDICATED in pregnancy:
Streptomycin, pyrazinamide

32. Safest drug in pregnancy is:
INH (also rifampicin)

33  Antithyroid of choice in pregnancy:
Propylthiouracil (also methimazole)

34. Chorionic villous sample is done at what time:
10-12 weeks

35. Fetus in a diabetic mother are at risk of developing which cardiac lesions: 
ASD, VSD, COA

36. Menopausal hormonal change:
Increased Gonadotropins, Decreased estrogen

37. Progesterone is produced by: Granulosa luteal cells (corpus luteum)

38. Procedure of choice to diagnose uterus didelphis is:
Hysterosalpingography

39 Rarest complication in a fibroid uterus is: Sarcomatous change (0.5%)

40. Cryptomenorrhoea occurs due to:
Imperforate hymen

41. MC complication of an ovarian tumour is:
Torsion

42. MC complication of cryotherapy is:
Watery discharge

43  Most effective drug in Sheehan’s syndrome is:
Corticosteroids

44. MC indication of In-Vitro Fertilization is:
Abnormality of fallopian tube

45. Jaundice at birth or within 24 hours of birth is commonly due to:
Erythroblastosis fetalis

46. Genetic disorders are diagnosed at 11 weeks of pregnancy by:
Chorionic villous biopsy

47. Abnormal alpha -fetoprotein is seen in:
Open neural tube defects,
multiple gestation

48. Weight of placenta at term is: 500 gm

49. Associated with oligohydramnios:
Renal agenesis

50. Treatment of a 40 year old P(4+2) female, who has been diagnosed to H. mole is:
Total hysterectomy

51. Management of Choriocarcinoma is:
Methotrexate

52. Ectopic pregnancy is MC in:
Previous history of recurrent PID

53. In puerperium, uterus becomes a pelvic organ after:
2 weeks

54. PIH can be predicted by which test:
Gant’s rolling over test

55. Prognosis in Rh-incompatibility depends on:
Serum bilirubin

56. Anti-hypertensive NOT given in pregnancy:
ACE inhibitors

57. Antimalarial of choice in pregnancy:
Chloroquine

58. Pap smear in pregnancy is:
Routine as a part of screening

59. Fetal scalp pH: 7.3

60. Earliest conclusive evidence of intrauterine death:
Intra-aortic gas

61.  Fetal blood loss in abnormal cord insertion is seen in:
Vasa previa

62. Fetal scalp edema on USG is suggestive of:
Rh incompatibility

63. Drug which may be used for post-coital contraception:
RU 486/ mifepristone

64. Activity of corpus luteum activity is maintained by:
LH

65. Hormone responsible for positive ‘Fern test’ is:
Estrogen

66. Drug used for induction of ovulation:
Clomiphene, Tamoxifen

67. Ovarian tumour likely to involve the opposite ovary by metastasis:
Granulosa cell tumour

68. Pelvic Ca which can cause Krukenberg’s tumour:
Ovarian Ca

69. LEAST observed laboratory finding in neonatal sepsis:
Neutrophilia

70. Site of fertilization:
Ampulla

71. Peak growth velocity in adolescent girls is seen just after:
Appearance of pubic hair and axillary hair

72. Phocomelia is:
Defect in long bones

73. Progress of labor is charted on:
Partogram

74. Score for checking need of induction of labor:
Bishop score

75. Shortest diameter for fetal skull:
1. Bimastoid
2. Bitemporal

76. MC heart disease associated with pregnancy:
Mitral stenosis 

77. Common congenital malformation seen in a diabetic pregnant woman: 
Cardiac defects 

78. Feature of a contracted pelvis has a transverse diameter of:
10 cm

79. Type of pelvis associated with increased incidence of ‘Face to pubis’ delivery:
Anthropoid

80. Manoeuvre used for delivering after coming head of breech presentation is:
Burn Marshall technique

81. Rupture of membrane is said to be premature when it occurs at:
Prior to 1st stage of labor

82. Likely size of uterus at 8 weeks post-partum is:
100 gm

83. Post-partum decidual secretions are referred to as:
Lochia

84. IUGR is defined when:
Birth weight below 10th of the average gestational age

85. IUCD with half life of 10 years:
Cu T 380A

86. Asymptomatic carriage of gonococcal infection in female is commonly seen in:
Endocervix

87. Primary amenorrhoea with 45 XO, short stature suggest:
Turner syndrome

88. Karyotype of Klinefelters syndrome 47XXY

89. Carcinoma cervix extends upto lateral pelvic wall. The stage would be:
Stage III

90. A 42 year old female P3+0+0+3 is found to have carcinoma in situ. Best treatment would be:
Hysterectomy

91. Masculizing/ virilizing tumour of ovary:
Arrhenobloastoma

92. Best prognosis for reversibility is seen in which type of female sterilization:
Isthmic-isthmic type

93. A middle aged female presents with increasing visual loss, breast enlargement & irregular menses. Investigation of choice would be: 
Serum prolactin

94. Failure rate of Pomeroys method:
0.4%

95. Copper eluted from Cu T daily:
50 microgram

96. Antispermal antibodies in cervical mucus can be checked by:
Post coital test

97. Genital ridge forms:
Ovary

98 Length of fallopian tube: 10 cm

99. Platelet count in pregnancy:
Decreases

100. Which disease carries high chances of transplacental transfer in first trimester:
Rubella

Pheochromocytoma

►Pheochromocytoma Key Points::

Neurofibromatosis type 1 (NF 1) was the first described pheochromocytoma-associated syndrome

►Features of Pheochromocytoma::
HTN > Headache > Perspiration > Palpitations > Anxiety > Tremors
HTN = 90% cases
Headache = 80% cases
Perspiration = 70% cases
Palpitations = 60% cases
Anxiety = 50% cases
Tremor = 40% cases

►MTC is seen in virtually all patients with MEN 2, but pheochromocytoma occurs in only about 50% of these patients. Nearly all pheochromocytomas are benign and located in the adrenals, often bilateral.

►Major metabolites in Pheochromocytoma::
Large adrenal Pheochromocytoma(>5cms):: NE > Epi
Small adrenal Pheochromocytoma(<5cms):: Epi > NE
MEN associated Pheochromocytoma:: Epi > NE (as they are usually small)
Extra-adrenal Pheochromocytoma:: NE > Epi
Overall its Nor-epinephrine

►Biochemical Diagnosis of Pheochromocytoma
Most specific :: Urinary dopamine, Plasma free normetanephrine+ Clonidine suppression test(100%) > Urinary total-metanephrine/Epinephrine/NE(99.6%) > Urinary total metanephrines and catecholamines(99%)
Most Sensitive: Plasma free metanephrine

►Imaging IOC: Adrenal/ extraadrenal- MRI ,
Extraabdominal-MIBG ,
Most accurate-DOPA - PET
But regarding extrabdominal cases when we have to rely on radionuclide scans,,, DOPA PET is IOC... It has never been in the options YET, hence MIBG is what we remember.

►Complete tumor removal is the ultimate therapeutic goal. Preoperative patient preparation is essential for safe surgery. -Adrenergic blockers (phenoxybenzamine) should be initiated at relatively low doses (e.g., 5–10 mg orally three times per day) and increased as tolerated every few days.

►Because phenoxybenzamine has a longer duration of action than phentolamine, most clinicians consider phenoxybenzamine the drug of choice for the medical management of patients with pheochromocytoma until surgery is performed

Named glands

SOME NAMED GLANDS
Bartholin's gland = Greater vestibular glands
Blandin's glands = Anterior lingual glands
Bruch's glands  = Lymph follicles in the conjunctiva of lower lid.
Brunner's glands = Duodenal glands
Bulbourethral gland = One of two glands embedded in the substance of the sphincter of the urethra, posterior tothe membranous part of the urethra.
Celiac glands = Lymph nodes anterior to the abdominal aorta.
Ceruminous glands = Cerumen-secreting Coccygeal gland = Glomus coccegeum.
Cowper's gland = Bulbourethral gland
Ebner's glands = Serous glands at the back of the tongue near the taste buds.
Galeati's glands = Duodenal glands
Gay's glands = Circumanal glands
Haversian glands = Synovial vill
Holocrine gland = One whose discharged secretion contains the entire secreting cells.
Littre's glands = Prepeutial glands
Meibomian glands = Sebaceous follicles between the cartilage and conjunctiva of eyelids.
Merocrine gland  = One in
Monoptychial gland = One in which the tubules or alveoli are lined with a single layer ofsecreting cells.
Morgagni's glands = Urethral glands
Nuhn's glands = Anterior lingual glands
Skene's glands = Paraurethral glands in female urethra
Suzanne's gland = A mucous gland of the mouth, beneath the alveolingual groove.
Tarsal glands = Tarsoconjunctival glands = Meibomian glands
Tyson's glands = Prepeutial glands
Weber's glands = The tubular mucous glands of the tongue.
Glands of Zeis  = Modified rudimentary sebaceous glands attached directly to the eyelash follicles.

Water and diseases

Scabies, an infection of the skin caused by Sarcoptes scabiei, is an example of:
a) Water borne diseases
b) Water washed disease
c) Water based disease
d) Water related disease

Answer: Water washed disease
(http://who.int/water_sanitation_health/dwq/S01.pdf)
Explanation:

💐Water and Sanitation related Diseases:
🎯Water-borne diseases-Diseases transmitted by water)
Cholera
Typhoid
Bacillary dysentery
Infectious hepatitis
Giardiasis
Water-washed diseases- Caused by lack of water
Scabies;
Skin sepsis and ulcers
Yaws
Leprosy
Lice and thypus
Trachoma
Dysenteries
Ascariasis
🎯Water based diseases:
Schistomiasis
Dracunuliasis
Bilharziosis
Filariasis
Threadworm
🎯Water-related insect vector diseases:
Yellow fever
Dengue fever
Bancroftian filariasis
Malaria
Onchocerciasis

RED ALERT POINTS For PATHOLOGY

1. Lepra cells are : HistiocytesQ
2. The most diagnostic test for SLE is : Antibodies against DNA cellQ
3. Rossette arrangement of cells is seen in : RetinoblastomaQ
4. Heart : can not undergo hyperplasiaQ
5. Hereditary factor are important in : Retinoblastoma, breast carcinomaQ
6. Dystrophic calcification is not seen in : HaematomasQ
7. Lines of Zahn are seen in : Primary platelet thrombusQ
8. Transudates : has specific gravity less than 1.002, results from hydrostatic alterations arise in the vascular endotheliumQ
9. Amyloid (AA) originates from : Plasma cellsQ
10. Fibrinoid necrosis is not seen in : DMQ
11. Prolonged P-R interval : is not major criteria of rheumatic feverQ
12. The common primary tumor of heart is : MyxomaQ
13. The type of involvement of the heart in rheumatic fever is : PancarditisQ
14. Atrial myxoma commonly arises from : Left atriumQ
15. Most common cause of aortic aneurysm is : AtherosclerosisQ
16. Most common site of myocardial infarction is : Anterior wall of left ventricleQ
17. Concentric myocardial hypertrophy is seen in : Congestive cardiomyopathyQ
18. Asbestos : is associated with Ca lungQ
19. Commonest type of Emphysema is : CentriacinarQ
20. The commonest type of bronchogenic Ca in non-smoker is : AdenocarcinomaQ
21. Alpha -1-antitrypsin deficiency occurs in : EmphysemaQ
22. Gray hepatization of lungs is seen on day : 3-5Q
23. Pneumonia alba is caused by : MycobacteriaQ
24. Most sensitive liver function test to differentiate type of jaundice is : Urine urobilinogenQ
25. Gamma gandy bodies are not seen in spleen in : ThalassaemiaQ
26. Mallory hyaline bodies are not present in : Primary biliary cirrhosisQ
27. Papillary necrosis of kidney is seen in : DM, Analgesic nephropathy, Acute pyelonephritisQ
28. Micronodular cirrhosis is not seen in : Budd Chiari syndromeQ
29. The carcinoma of pancreas usually originate in the : Duct epitheliumQ
30. Most common site of leiomyoma is : StomachQ
31. ‘Lardaceous’ spleen is seen in : AmyloidosisQ
32. The most common type of malignancy of renal pelvis is : Transitional cell carcinomaQ
33. DM : is not a cause of granular contracted kidneysQ
34. Rapidly progressive glomerulonephritis is histologically characterised by the presence of numerous : Hyalinized, sclerotic glomeruliQ
35. Periglomerular fibrosis is considered typical of : Chronic pyelonephritisQ
36. Elevated specific gravity : is the most specific to renal parenchymal diseaseQ
37. Commonest type of intracranial tumour is : SecondariesQ
38. The macrophages in the brain are : MicrogliaQ
39. Commonest cause of cerebral infarction is : Arterial thrombosisQ
40. The commonest cause of intracranial metastasis is malignancy of : LungsQ
41. The most common change in brain tissue due to ageing is : Atrophyof neuronsQ
42. Damage to nervous tissue is repaired by : NeurogliaQ
43. Response to iron in iron deficiency anemia is denoted by : ReticulocytosisQ
44. TB : may be transmitted by bloodQ
45. Leukoerythroblastic reaction is not seen in : Hemolytic anemiaQ
46. Reactivated TB is seen most commonly located near : ApexQ
47. Sideroblastic anemia is seen in chronic poisoning of : LeadQ
48. How long can blood be stored with CTD-A : 35daysQ
49. ‘Stress’ lymphocytes are seen in downey type II infectious mononucleosisQ
50. Echinocytes are types of : RBC’sQ
51. Bone tumor arising from epiphysis is : Giant cell tumorQ
52. Calcification front in bone biopsy can be visualised by using stain : Masson’s trichromeQ
53. Tumor originates from diaphysis : Ewing’s sarcomaQ
54. The commonest diaphysial tumor is : Ewing’s sarcomaQ
55. The commonest malignant bone tumor is : Multiple myelomaQ
56. Bone tumor arising from metaphysis : Osteoid osteomaQ
57. Para thyroid : is most often involved in multiple endocrine neoplasia-IQ
58. Commonest pathological cause of hypercorticism is : HyperplasiaQ
59. Hurthle cells are seen in : Hashimoto’s thyroiditisQ
60. The most common primary malignant tumour of the thyroid is : Papillary carcinomaQ
61. APUD cells are seen in : Bronchial carcinoidQ
62. Ca thyroid with good prognosis : PapillaryQ
63. The most common site for Amoebiasis : CaecumQ
64. Sickle cell anemia : is due to a point mutationQ
65. Spontaneous regression though rare is seen in : NeuroblastomaQ
66. Malignant change in Nevus is characterized by : Increase in sizeQ
67. Mycosis fungoides belongs to : Cutaneous T-cell lymphoma groupsQ
68. HLA complex in man is located on chromosome : 6Q
69. Coomb’s test (direct) is positive with : IgGQ
70. Medullary carcinoma thyroid is associated with : Amyloid stroma, CarcinoidQ
71. Luke’s classification is associated with : LymphomaQ
72. White infarcts are not seen in : LiverQ
73. Linzenmeter is used to measure : ESRQ.
74. Pipestem cirrhosis is seen in : Schistosomiasis Q
75. Most sensitive liver function test is : Prothrombin timeQ
76. Sequestration of lung is seen in : Posterior part of left lungQ
77. In virchow’s triad for thrombosis , hypoproteinemia is not includedQ
78. To differentiate benign and malignant ulcer, best is : Endoscopy and biopsyQ
79. Oncocytes are not found in : Pineal bodyQ
80. Coagulative necrosis as a primary even most often seen in : CNSQ
81. Metastatic calcification is most often seen in : LungsQ
82. Hutchinson’s secondaries in skull are due to tumors in : AdrenalsQ
83. Rosette shaped arrangement of cells are seen in : EpendymomaQ
84. First sign of wound injury is : Dilatation of capillariesQ
85. Pseudopolyposis is seen in : Ulcerative colitisQ
86. The commonest site of diverticulosis is : Sigmoid colonQ
87. Deletion of short arm of chromosome 11 is seen in : Wilm’s tumorQ
88. Increase in alkaline phosphatase is seen in : Leukemoid reactionQ
89. Asbestosis : will develop into lung cancerQ
90. Scar in lung tissue develops into : Squamous cell carcinomaQ
91. Anemia in human is caused by which worm : Hook wormQ
92. Ascending aorta involvement is the commonest site of which aneurysm : SyphiliticQ
93. To test hepatic function to assess bleeding disorder clinical test done is : PTTQ
94. Beta macroglobulin is derived from : B-cellsQ
95. Tissue thromboplastin activates : Factor –VIIQ
96. GABA : is a inhibitory transmitterQ
97. In sickle cell anemia defect is in  :b-chainQ
98. Chromosome 15,17 translocation is seen in : Acute promyelocytic leukemiaQ
99. Damage to nervous tissue is repaired by : NeurogliaQ
100. Mycosis fungoides : Cutaneous lymphomaQ
101. The highest malignant potential is seen in : Familial polyposisQ
102. The highest ESR is not seen in : Polycythemia rubraQ
103. Secondary amyloidosis complicates : Chronic osteomyelitisQ
104. The earliest feature of TB is : LymphocytosisQ
105. The low grade non-hodgkins lymphoma is : FollicularQ
106. Liquefactive necrosis is seen in : BrainQ
107. Increased haptoglobulin : is not features of hemolytic anemiaQ
108. The crescent forming  glomerulonephritis is : RPGNQ
109. Decreased fibrinogen products  : are untrue of D.I. coagulationQ
110. Earliest feature of correction of IDA is : ReticulocytosisQ
111. Kupffer’s cells are found in : LiverQ
112. Heart failure cells are found in : LungsQ
113. Psammoma bodies show : Dystrophic calcificationQ
114. Beta-microglobulin : is not a tumor markerQ
115. Commonest benign tumor of liver : HemangiomaQ
116. Blood when stored at 4 degree celcius can be kept for : 21 daysQ
117. Congo-red with amyloid produces : Brilliant pink colourQ
118. Oedema is caused by fall in plasma proteins below : 5%Q
119. Cloudy swelling does not occurs in : LungsQ
120. Gamma Gandy bodies contains hemosiderin and : Ca++Q
121. Hutchinson’s secondaries in skull are due to tumors in : AdrenalsQ
122. Albumino –cytologic dissociation occurs in cases of : Guillain Barre syndromeQ
123. Metastatic calcification is most often seen in : LungsQ
124. ASLO Titres are used in the diagnosis of : Acute rheumatic feverQ
125. Apoptosis is inhibited by : bcl-2Q
126. An example of a tumour suppressor gene is : mycQ
127. CEA : is not used as a tumor marker in testicular tumoursQ
128. Mitral valve vegetations do not embolise usually to : LungsQ
129. The least common cause of calcification in the lung is : AmyloidosisQ
130. Onion peel appearance of splenic capsule is seen in : SLEQ
131. Lardaceous spleen is due to deposition of amyloid in : Sinusoids of red pulpQ
132. CD-10 is seen in : ALLQ
133. Most common valve not involved in rheumatic fever : TricuspidQ
134. HMB 45 is a marker for : MelanomaQ
135. Hepatocytes : is not a labile cellQ
136. Antigliadin antibodies are detectable in : Celiac diseaseQ
137. Focal diffuse gall bladder wall thickening with comet trail reverberation artifacts on USG is in : Adenomyomatosis of gall bladderQ
138. Organelle that plays a pivotal role in apoptosis : Golgi complexQ
139. In myocardial infarction , microscopic picture of coagulation necrosis with neutrophilic infiltration is seen in : 1-3 daysQ
140. Microalbuminuria is defined as protein levels of : 151-200mg/LQ
141. Paneth cells contain : ZincQ
142. Psammoma bodies are not seen in : Follicular Ca thyroidQ
143. Sickle cell Red blood cells : Protective against adult malariaQ
144. BRCA-1 gene lies on chromosome : 17Q
145. Common complement component for both the pathways is : C3Q
146. Hypersensitivity vasculitis is seen in : Postcapillary venulesQ
147. Essential for tumour metastasis is : AngiogenesisQ
148. Onion skin thickening of arteriolar wall is seen in : Hyperplastic arteriosclerosisQ
149. Most potent stimulator of Naïve T-cell is : Mature dendritic cellsQ
150. Bone infarcts are seen in : Sickle cell anemiaQ
151. Periodic acid Schiff stain shows block positivity in : LymphoblastsQ
152. Perioral pallor and Dennie’s line are seen in : Atopic dermatitisQ
153. Abciximab : is not tumour necrosis factor blocking agents Q
154. Berger nephropathy is due to mesangial deposition of : IgA and C3Q
155. The most common site of ectopic phaeochromocytoma is : Organ of ZuckerkandiQ
156. The tumour causing polycythemia due to erythropoietin production is : Cerebellar hemangiomaQ
157. Thrombocytopenia due to increased platelet destruction is seen in : Systemic lupus erythematosusQ
158. C-C beta chemokine includes : EotaxinQ
159. The most common gene defect in idiopathic steroid resistance nephritic syndrome : NPHS 2Q
160. Mercury affects which part of kidney : PCTQ
161. Brain natriuretic peptide is degraded by : Neutral endopeptidaseQ
162. Nitroblue tetrazolium test is used for : PhagocytosisQ
163. Annexin V is a marker of : ApoptosisQ
164. Tumorgenesis in aging is due to : Telomerase reactivationQ
165. Pauci immune glomerulonephritis is seen in : Microscopic polyangitisQ
166. HLA is present on chromosome : Short arm chr 6Q
167. OmphaloceleQ : is associated with >20% risk of chromosomal anomalies.
168. Karyotyping under light microscopy done by : G-bandingQ
169. MIC-2 positive in : Ewing’s sarcomaQ
170. Stain used in identifying fungi is : Methanamine silverQ
171. Caspases are involved in : OrganogenesisQ
172. In apoptosis , the chief organelle involved : MitochondriaQ
173. Juvenile polyp : is not premalignantQ
174. Paneth cells characterized by : More number of lysosomal enzymeQ
175. Most characteristic features of acute inflammation is : Vasodilation and increased vascular permeabilityQ
176. CD 34 : is not B cell markerQ
177. Low serum haptoglobin in hemolysis is marked by : Bile duct obstructionQ
178. Clue cells are found in : Bacterial vaginosisQ
179. Elevated AFP levels are not seen in : SeminomaQ
180. Inwegner’s glomerulonephritis , the characteristic features seen in : Granulomas in the vessels wallQ
181. Defective DNA repair is associated with : Xeroderma pigmentosaQ
182. C in CRP stands for : Capsular polysaccharide of pneumococcusQ
183. Necrotizing lymphadenitis is seen in : Kikuchi diseaseQ
184. Choledocholithiasis : is not a high risk factor for cholangiocarcinomaQ
185. Kawasaki disease :  is not a common cause of vasculitis in adultsQ
186. Poor prognostic indicator in ALL : Age <2yearQ
187. ABO antigens are not found in : SalivaQ
188. Serum alkaline phosphate is low in : hyperphosphatemiaQ
189. Interleukin responsible for pyrexia is : IL1BQ
190. High hematocrit : is not seen in sickle cell anemiaQ
191. High risk of malignancy is seen in : Complex hyperplasia with atypiaQ
192. Mallory hyaline is characteristic feature of : Alcoholic liver disease Q
193. Most common cause of death in primary amyloidosis is : Cardiac failureQ
194. Anti-saccharomyces cerevisiae antibodies are seen in :  Crohn’s disease Q
195. gp 120 is : Virus attachment Q
196. Mutation of keratin 1 and 10 are associated with : Epidermolytic hyperkeratosisQ
197. Inflammatory bowel disease with transmural involvement and skip lesions is : Crohn’s diseaseQ
198. Barrett’s esophagus is : Columnar metaplasiaQ
199. Caspases is : Involved in apotosisQ
200. Mutation in Marfan’s syndrome is : Fibrillin IQ
201. In Von Willebrand disease , there is : Factor VIII deficiencyQ
202. Glucose is used in stored blood to : Provide nutritionQ
203. Chronic persistent and chronic active hepatitis are differentiated by : Liver biopsyQ
204. Fixation used for bone histopathology :10% formalinQ
205. Prostate gland has : 4 zonesQ
206. Ligase enzyme : is not used in PCRQ
207. Prolonged PT and normal PTT may be found in : Vit. K deficiencyQ
208. Best to diagnose amyloidosis : Rectal biopsy primaryQ
209. Type of nephropathy in DM : NodularQ
210. Secretory antibody is : IgAQ
211. Bevacizumab : Monoclonal Ab against VEGAQ
212. Platelet dense alpha granules doesnot contain : AlphaQ
213. ACP enzyme : is not associated with liver diseaseQ
214. Ca tongue stained by : Toludine blueQ
215. A women present with megaloblastic anemia. Dysphagia has : Plummer Vinson syndromeQ

Amino Acids

Important facts about Amino acids (AA) --

▶ Smallest AA - Glycine
▶ Largest primary AA - Tryptophan
▶ Most basic AA - Arginine (therefore has highest isoelectric pH)
▶ Most acidic AA - Aspartic acid (therefore has lowest isoelectric pH)
▶ AA with imino group - Proline
▶ AA with no amine function - Proline
▶ AA with no chiral carbon (Chirality) , no optical activity & no D-L isomers - Glycine
▶ Flexibility of proteins depend upon - Glycine
▶ AA with best buffering activity at physiological pH - Histidine
▶ Standard AA which can covalently dimerize simultaneously - Cysteine
▶ Most non-polar AA - Phenylalanine
▶ Most polar AA - Glutamine & Asparagine
▶ Absorption of UV light (250-290 nm) - Aromatic AA (Tryptophan > Tyrosine > Phrnylalanine)