Bleeding arteries

Source of haemorrhage/ bleeding:
1. Extra dural haemorrhage - middle meningeal artery
2. Sub dural haemorrhage - bridging or diploic veins
3. Sub arachnoid haemorrhage - rupture on berry aneursym
4. Tennis bal injury to eye - circulis iridis major
5. Epistaxis - Sphenopalantine artery
6. During tonsillectomy - para tonsilaar veins, tonsilar and ascending
palantine artery
7. Tracheostomy - isthemus and inferior thyroid vein
8. Heamoptysis-bronchial artery
9. Gastric ulcer- left gastric, splenic artery
10. Duodenal ulcer - gastroduodenal artery
11. Hemmorrhoids - submucous rectal venous plexus formed by
superior rectal vein & inferior rectal vein
12. Retropubic proastatectomy - dorsal venous plexus
13. Hysterectomy - internal illac artery
14. Menstruation - spiral arteries

Child Psychiatry

1. Attention  deficit  hyperactivity  disorder  –  Three components  with onset  before  12 years  of  age  include inattention  and  hyperactivity/impulsivity.   Children  with ADHD may attack  a  test  rapidly, but answer  only the  first two  questions.  They may  be  unable  to  wait  to  be  called  on in  school  and  may  respond  before  everyone  else.  At home,  they  cannot  be  put  off  for  even  a  minute.  Children with ADHD are  often  explosive  or  irritable.  The  irritability may be  set  off  by relatively  minor  stimuli,  which  may puzzle  and  dismay the  children.  They are  frequently emotionally labile  and  easily set  off  to  laughter  or  to tears; their  mood  and  performance  are  apt  to  be  variable and  unpredictable.  Impulsiveness  and  an  inability  to delay gratification  are  characteristic.  Children  are  often susceptible  to  accidents.  Ref:  Synopsis  of  Psychiatry, Kaplan and Sadock, 10th edn, P. No. 1210.

2.  70.  -  According  to  the  DSM-IV-TR, mental  retardation  is defined  as  significantly subaverage  general  intellectual functioning  resulting  in,  or  associated  with, concurrent impairment  in  adaptive  behavior  and  manifested  during the  developmental  period,  before  the  age  of  18.    General intellectual  functioning  is determined  by  the  use  of standardized  tests  of  intelligence,  and  the  term significantly subaverage  is defined  as  an  IQ  of approximately  70 or  below  or  two  standard  deviations below  the  mean  for  the  particular  test.  Adaptive functioning  can  be  measured  by  using  a  standardized scale,  such as  the  Vineland  Adaptive  Behavior  Scale.  Ref: Synopsis  of  Psychiatry,  Kaplan  and  Sadock,  10th  edn,  P.  NO. 1140.

3.  Retts  disease  -  It has  been  seen  primarily  in  girls,  and case  reports  so  far  indicate  complete  concordance  in monozygotic twins.  During  the  first  5  months  after  birth, infants  have  age-appropriate  motor  skills,  normal  head circumference,  and  normal  growth.    At  6  months  to  2 years  of  age,  however,  these  children  develop  progressive encephalopathy  with a  number  of  characteristic  features. The signs  often  include  the  loss  of  purposeful  hand movements,  which are  replaced  by stereotypic motions, such as  hand-wringing; the  loss  of  previously acquired speech;  psychomotor  retardation; and  ataxia.  Ref: Synopsis  of  Psychiatry,  Kaplan  and  Sadock,  10th  edn,  P.  NO. 1200.

4.  Autism  -  The Modified  Checklist for  Autism  in Toddlers  (M-CHAT;  Robins,  Fein,  &  Barton,  1999).    The M-CHAT  is validated  for  screening  toddlers  between  16 and  30  months  of  age,  to  assess  risk  for  autism  spectrum disorders  (ASD).  Children  who fail  more  than  3 items total  or  2 critical  items  (particularly if  these  scores remain  elevated  after  the  follow-up interview) should  be referred  for  diagnostic  evaluation  by a  specialist trained to evaluate ASD in very young children.

5.  Mental  retardation    An  Act  to  provide  for  the constitution  of  a  body  at  the  national  level  for  the  Welfare of  Persons  with Autism, Cerebral  Palsy, Mental Retardation  and  Multiple  Disabilities.  The  act  provides  for social security and legal guardianship for these children.

6.  Visual  impairment  -  Pervasive  developmental disorders  include  several  that  are  characterized  by impaired  reciprocal  social  interactions,  aberrant  language development,  and  restricted  behavioral  repertoire. Pervasive  developmental  disorders  typically emerge  in young  children  before  the  age  of  3 years.  Other  associated features  include  intellectual  disability (70-75%  of patients),  mood  instability  and  varying  responses  to sensory  stimuli.    Ref:  Synopsis  of  Psychiatry,  Kaplan  and Sadock, 10th edn, P. NO. 1196

Ries-Buckler dystrophy

4R
•Recurrent corneal erosions
•Reticular pattern
•Reduced corneal sensations
•Recurrence after graft
2 F
•fibrous tissue replaces epith basement membrane and bowmans membrane
•ferritin lines in epithelium.
#ophtha
•pepper pot fundus--chorioretinitis
•Pepper pot skull—hyperthyroidism�

• cavernous optic atrophy also k/a Schnables atrophy
-atrophy of nerve fibres
-no glial cell proliferation
-mucoid degeneration of glial cells leading to lacunae formation

Physiology

100 important points of physiology
1. Potassium is mainly regulated by - Aldosterone.
2. Tip of scapula at level – T7.
3. Oblique fissure of the lung at level - T3 to T6 Costochondral.
4. Decussating of medial lemniscuses - Internal Arcuate Fibers.
5. Superficial temporal artery relation with which nerve - Auriculotemporal nerve.
6. Correct about Thyroid gland - lymph drainage to deep cervical lymph nodes.
7. Anemic hypoxia occur in – Methemoglobulenemia.
8. In cerebral circulation brain arteries - Do not anastomose once entered in the brain (controvertial).
9. Phase 1 of transformation of drug metabolism – Oxidation.
10. Standard deviation shows - Variability of individual observation.
11. Counseling in patients is - To help themselves.
12. A young girl who is going to die and asks you “Am I going to die?” Doctor response should be – “What your parents have told you?”
13. In whole wheat – Thiamine.
14. Cholesterol enriched diet – Egg.
15. Origin of peroxisomes – SER.
16. Organelle where protein combines with carbohydrates, packed and released - Golgi complex.
17. Correct about DNA – Euchromatin is transcriptionally active.
18. ADPKD associated with – Renal failure (vs) Cerebral haemorrhage (controversial) here most probable Renal failure.
19. Cause of delay in healing – Infections.
20. PaO2 decreased, PCO2 increased, hydrogen ion increased; manifestation (looked like kind of COPD) – Hypoventilation.
21. PCO2 31, HCO3 19, pH increased (Metabolic alkalosis scenario) - Hyperventilation
22. Person with tachycardia, and heat intolerance with low level of TSH, on giving TRH; level of TSH and thyroid hormones increases. Diagnosis – Hyperthyroidism with thyroid problem.
23. Origin of oxytocin and ADH – Hypothalamus.
24. Difference between systemic and pulmonary circulation - Low resistance in pulmonary circulation.
25. Mean systemic filling pressure is regulated by - Venous return.
26. Systolic pressure is directly related to which one of the following – Renin.
27. ADH responds to – Osmolarity.
28. Osmoreceptors – ADH.
29. Right border of heart on X-ray also visible a part of – SVC.
30. In MI sensitive cardio marker – Tropinin T.
31. Diabetic nephropathy investigation - Urine albumin.
32. Young boy with generalized edema and proteinuria - Lesion of basement membrane.
33. Lesion of parasympathetic system affects mostly - GI muscles.
34. Stress hormone of our body - ACTH.
35. S2 sound heard on - Closure of aortic and pulmonary valve.
36. A patient with history hemorrhage (trauma) receives a bag stored for 2 weeks mainly contains – RBCs.
37. Due to inspiration – Decreased negative intrapleural pressure.
38. Important buffer of blood - HCO3-.
39. Max increase in ECF due to infusion of - Hypertonic NaCl.
40. Auscultation of tricuspid valve best heard at – Right lower end of the body of sternum.
41. GVE vagus nerve for preganglionic fiber arises from – Dorsal nucleus.
42. Thorn prick in left lower limb caused abscess - Staph aureus.
43. Diabetic female after abdominal surgery; dyspnea and cough - Pulmonary embolism.
44. MCC of pulmonary embolism – DVT.
45. Typhoid fever 1st week test – Blood culture
46. Typhoid fever 2nd week test – Blood culture and Widal test.
47. Typical feature of falciparum - Black water fever.
48. Alcoholic patient with deranged LFTs; on biopsy – Mallory bodies.
49. Councilman bodies seen in – Apoptosis.
50. Natural self-defense against tumors – Apoptosis.
51. P53 gene absent results in - cell survival.
52. Pain mediator - Bradykinins.
53. Metaplasia – Functional change in cells.
54. Female with infection of HPV, comes after 2 years, Pap smear shows prominent nucleoli and increased nucleus size – Dysplasia.
55. Gas exchange occur - Simple squamous epithelial layer.
56. Patient with granulomatous disease, biopsy done. Microscopic finding that suggests TB – Epitheloid cells.
57. The spindle fibers will decrease in discharge of impulses when - Muscle contracts (vs) When efferent gamma discharge occurs. (controversial) here most probable “muscle contracts”
58. Diagnosis for leprosy, initial investigation - Nasal scrapping.
59. Benign neoplasm – Adenoma.
60. 3 germ layers tumor – Teratoma.
61. When adrenalin release from medulla, causes vasodilation by acting on - Beta 2 adrenergic receptors.
62. Increased GFR and increased plasma flow occur due to - Dilation of afferent arteriole.
63. Charateristic of cerebellar lesion - Dymetria
64. Emax of a drug depends on – Efficacy
65. Study in which every person of a population has equal chances of being selected – Random sampling.
66. Amniocenthesis is done - After 14th weeks.
67. 1st response against acute inflammation in tissue – Macrophages.
68. In dark granules containing cells; IgE attaches to – Basophils.
69. Opsonization - C3b.
70. Exudate - more than 3g of proteins.
71. About active transport of drug all are true except - All drugs pass via active transport.
72. Pulmonary artery supply to – Alveoli.
73. Muscles of back innervated by - Dorsal rami.
74. In young boy dyspnea produced on lying - Retrosternal goiter.
75. Most important cause of bronchogenic cancer – Smoking.
76. Edema caused by - Increased hydrostatic pressure.
77. Edema caused by - Lymphatic blockage.
78. BP 210/180mmHg and creatinine 8% damaged part – Juxtaglomerular apparatus.
79. Female with blood group A, have 2 children; one with O and other with AB, blood group of father is – B.
80. Genetically true hermaphrodite – XX/XY.
81. DNA replication occur in – Interphase.
82. Glycogenolysis caused by deficiency of which hormone - Insulin
83. Investigation for liver amoebic abscess – Serology.
84. Surgery of submandibular gland; nerve damaged - marginal mandibular branch of facial.
85. On posterior surface of oblique and transversalis fascia - Arcuate line.
86. Aspirin overdose causes – Coma.
87. Cardiac output measurement via thermodilution – Temperature change downstream with CO.
88. Father with defective gene on one autosomal chromosome, develops disease later in his life; chances of getting disease in children – Half of the children will be affected.
89. If left circumflex artery occluded - Infarction of left atrium and left ventricle.
90. MCC of multiple fractures in adult – Osteoporosis.
91. Patient with fracture of many bones and low BP immediate treatment - Volume replacement.
92. Most common fracture of long bone - Tibia.
93. Collagen fibers – Eosin stain
94. Gamma efferent supply to – Intrafusal muscle spindles.
95. Micturition – Self generating.
96. Hallmark of HIV – Proliferation of virus in T-Cells.
97. 1g protein gives energy – 4 kcalories.
98. Isotonic and isometric contraction difference is that isotonic contraction – consumes more phosphate bond.
99. Autonomic nervous system – parasympathetic increase salivary secretion.
100. Protrusion of mandible – Lateral pterygoid.