Thursday, 17 April 2014

Pacemakers in body

Pacemaker of CVS : SA node
Pacemaker of RS   : Pre-botzinger complex
Pacemaker of GIT : Interstitial cells of cajal
Pacemaker of uterine contractions located in tubal ostia

JIPMER 2014 QUESTIONS AND ANSWERS

1. Drug causing hypothyroidism - amiodarone  
2. Stratosphere sign in usg –pneumothorax 
3. Increased vocal resonance -bronchial ca 
4. Pointing index - ain injury  
5. Alendronate hip pain – invst –xray 
6. Fusion inhibitor –enfuvirtide 
7. Ketone bodies not utilised by - rbc  
8. Muscle not contain - glucose6phosphatase 
9. Most metabolised inhalational anaesthetic –halothane 
10. No cns penetration – glycopyrrolate 
11. Incresed cerebral blood flow by and ci in epilepsy- ketamine 
12. Potent la –bupivacaine 
13. Psychiatry coined by -reil 
14. Wandering acetabulm –tb hip 
15. Mallet finger – extensor tendon avulsion  
16. Fruit bite mark preserved in.........meta bisulphate 
17. Negri body not found in – 
18. Chronic mild depression for two year or more- dysthymia 
19. Magistrate inquest not in -homicide 
20. Espundia caused by - leishmania 
21. Post.cricothyroid – abductor of vocal cord 
22. Globoid bodies - krabbes disease 
23. Mansonia transmits –chickungunya 
24. Hinge fracture –skull # 
25. Drug used in monotherapy of juvenile myoclonic epilepsy in pregnancy -lamotrigine 
26. Drug which does not affect retina? – amiodarone 
27. Non motile- klebsiella  
28. Spontaneous breathing -mapelson a 
29. Hyperkalemia s/e – succinylcholine 
30. Capillary leak syndrome (cls) seen with -gmcsf 
31. Pco2 in the expired air - 32 
32. Medullary ca all are true except- it is usually familial (sporadic is more common) 
33. March fracture - second metatarsal shaft  
34. Montagia # - ulna # wit sup ru jt dislocation  
35. Ateral condyle fracture - cubitus valgus 
36. Maffuci enchondroma wit hemangioma  
37. Light bulb sign - post dislocation humerus 
38. Hill sach lesion -post sup lesion in humeral head 
39. Tom smith - septic arthritis of infancy 
40. Meralgia paresthetica- lat cut nerve of thigh 
41. Hpe of osteosarcoma- malignant cells wit osteoid formation 
42. Mdg to reduce mmr by 0.75 
43. Metazoonosis- plague  
44. International food standards- codex alimentarius  
45. Case control study -rare disease 
46. Not a test of significance - sd  
47. Point source not true - many secondry waves  
48. Killed vaccine- salk 
49. Endoscope sterilisation – glutraldehyde  
50. Waste sharps -blue/white bag 
51. Nrhm asha - community participation   
52. Childhood obesity prevention- primordial prevention 
53. Lithium stopped before surgery- 48 hrs 
54. For post puncture headache--wrong statement - stylet kept inside and needle removed 
55. Retina gas- sf6  
56. Salmonella common to all species - indole negative 
57. Painless ulcer labia majora - treponema pallidum 
58. Freis test -lgv  
59. Whiff test - bacterial vaginosis  
60. Koch’s postulates not true - antibiotics cures the disease  
61. Transmitted through pilus - conjugation  
62. Not a fungal infection -mycosis fungoides 
63. Craige tube - diff b/w motile and nonmotile 
64. Exotoxin not true - heat stable  
65. Staphylococcus not true -catalase negative 
66. Hot spot on t99m—adenolymphoma 
67. Nerve damage by sentinel node biopsy in breast ca--intercostobrachial nerve 
68. Follicular ca.--hematogenous route 
69. Mc blunt trauma injury--spleen  
70. Abdominal desmoid to screen for - colonic ca 
71. Good pasture syndrome- type four collagen 
72. Burkitt -ebv  
73. Lepra 2 rxn - type3 hs  
74. Allograft rejection - delayed hs 
75. Ig in alternate pathway - iga  
76. Rhabdomyosarcoma marker- desmin 
77. Alziemer - a beta amyloid 
78. Inflammatory mediator not from cells -kinin  
79. Whorled epithelium in asthma- curschman spiral  
80. M/c benign tumor of esophagus –leiomyoma 
81. Ct for ca esophagus –cisplatin 
82. Ileostomy complication - necrosis  
83. Intussusception -submucus lipoma 
84. Secondaries neck mass grade - t0 n2a mx  
85. M/c melanoma - superficial spreading 
86. Osteoblastic metastasis -prostate  
87. Damage control surgery- minimum intervention definitive surgery later 
88. Not a complication of tpn -neutrohil dysfunction  
89. Marker for contrast nephropathy -creatinine  
90. Symptomatic spinal injury wit normal radiology –children 
91. Agent for tinea capitis - t.violaceum 
92. Contact dermatitis most effective treatment -moist compress 
93. Thiazide diuretic in rf-metolazone  
94. Betablocker with antioxidant property - carvidilol  
95. Membrane stabilising agent maximum -propanolol  
96. Azole -ergosteron synthesis inhibitor 
97. Not used in chf – clopidogrel 
98. Not a prodrug –ticagrelor 
99. 8 yrs familial hyper cholestrelemia trt - pravastatin  
100. Iodine not true- ci in hypothyroidism 
101. Not a cell adhesion molecule......spectrin 
102. Fetal and maternal blood diff by - apt test 
103. Apt test uses – naoh 
104. Active management of third stage oxytocin =10 u im  
105. Cin2 in pap smear next step- colposcopy  
106. Dysmenorrhea wit uniformly enlarged uterus 14 wks –adenomyosis 
107. Most accurate method of dignosis of pregnancy at 6 wks - usg fetal cardiac activity  
108. Asymptomatic bacteriuria- trt not needed in pregnancy  
109. Hrt not given for- cad prevention 
110. Secretory phase – progesterone 
111. 11 wks method of termination- suction evacuation 
112. M/c progestrone metabolite in urine – pregnanediol 
113. Not a stimuli for insulin- hypokalemia  
114. Mmse for.......dementia  
115. Increased anion gap acidosis a/e -diarrhea  
116. Hyerkalemia a/e - u wave  
117. Bmr decreased in hypothyroidism  
118. Not a feature of thyrotoxicosis hair loss  
119. Alkaline diuresis – phenobarbitone 
120. Mi first marker- myoglobin 
121. Peanut eating tongue swelling -angioneurotic edema 
122. Takayasu mc involved -subclavian artery 
123. Acute pancreatitis not seen -hypoglycemia  
124. Obst sleep apnea next step - wt reduction 
125. Edema in nephritic syndrome due to - reduced oncotic pressure  
126. Alert not responding – stupor 
127. Least sensitive to muscle relaxant- diaphragm 
128. Celiac plexus block- diarrhea and hypotension 
129. Ci for epidural and spinal all except - hyper tension  
130. Red velvetty mucosa - arsenic  
131. Lead poisoning-sideroblasts  
132. Rta - secondary injury  
133. Viper resembles- abrus  
134. Last organ to putrify- prostate  
135. Vision not affected in – papilledema 
136. Visualise angle - gonioscope  
137. Rosette- traumatic cataract 
138. Not seen in vitreous hemorrhage - metamorphopsia  
139. Horner syndrome- miosis  
140. Vertically oval pupil – angle congestive glaucoma 
141. Soft contact lens - hema  
142. Iridotomy -yag laser 
143. Not a part of ethmoid – inferior turbinate  
144. Claudius cells- organ of corti  
145. Mucormycosis - amphotericin  
146. Sinus at birth - maxillary and ethmoid 
147. Ca larynx wit vocal cord fixation- t3  
148. Auditary tube - ant wall of middle ear 
149. Otosclerosis – as curve 
150. Reverse transcriptase - telomerase  
151. Subs level phosphorylation not seen in -pfk 
152. Heparin releases – lpl 
153. Lyase -aldolase b  
154. Insulin dependent glucose transport not in – liver 
155. Low km - high affinity 
156. Immediate change after lying down -increased venous return  
157. Proprioception - a alpha 
158. Electrical synapse- gap junction 
159. Neuropraxia - physiological interruption  
160. Diastolic murmur - pathologic  
161. Mr child wit flank mass and liver swellings -tuberous sclerosis  
162. Adrenaline dose in a neonate- 0,01 mg/kg or .1 mg /kg of 1 /10000  
163. Imp sign in resp disease - retraction  
164. Widened epiphysis wit bow legs – rickets 
165. Erythema of cheek -pure red cell aplasia   
166. Blood nerve barrier formed by perineurium  
167. Collecting duct is derived from metanephros 
168. Null cells or nk cells 5 -10% 
169. Retropharyngeal space extend frm skull base to the level of diaphragm 
170. Hypocalcemia not seen in turniquet application 
171. Best treatment to prolong life in copd- oxygen 
172. Not a sign of increased pulmonary blood flow -kerley b lines 
173. Hypothermia during anaesthesia... Warm saline prevention 
174. Loading dose - to attain the target concentrationrapidly .. 
175. All are associated with sudden death in hocm except?  - mr 
176. Avg.threshold of hearing at 500,1000,1500 is 45db then % of hearing loss is?  30 
177. Icd 10 for psychiatric illnesses : 
178. Atypical lymphocytes in infectious mononucleosis cd8t cells 
179. Aseptic meningitis- intrathecal methotrexate 
180. Not a pleotropic effect of statins - ldl lowering 
181. Plasma osmolality 285-295 
182. Efficacy of phototherapy not depend on level of bilirubin 
183. Osteogenesis imperfecta type 1collagen 
184. Disease transmitted by virus mumps and rabies  
185. Field h2 of forel =lenticular fasciculus 
186. Receptors not true???? Meissner in hairy skin  
187. Receptors not true???? Meissner in hairy skin  
188. In which pneumoconiosis there is snow-storm appearance on c-xr –silicosis 
189. 14 yr old child with abnormal movements with hyperintensity and inv of thalamus pons striatum ? Wilson's disease 
190. Radiation in cervical ca  80-85 -85-90 at point a 
191. Amt of iron req by lactating women-38mg 
192. L:s ratio for - fetal lung maturity  
193. Photoelectric effect -low energy photon nd inner shell electron  
194. Abundant element –flourine 
195. Lung neuroendocrine cells - carcinoids  
196. Urinary catheterised individual no need of any rx  
197. Spider leg -polycystic kidney 
198. Multiple myeloma.....m spike..35% blast  
199. It is not possible to apply koch's postulates to leprosy 
200. M/c mucocele in pns?  Frontal 
201. Regarding trigeminal nerve, false option is arises from midbrain  
202. Melanoma marker s100 
203. %percentage of burn in child wid burn in buttocks ,thigh , head n neck ? 37 
204. Mc form of vaginitis –senile 
205. A patients relative gives a h/o tattoo however it wasnt found on autopsy,wht should b dissected to prove ? Ans = lymph node  
206. Vaginal adenosis precedes  clear cell ca vagina 
207. Eye muscle not supplied by occulomotor? Ans= so 
208. Tonsillectomy? Grisler syndrome is not common 
209. Hepatitis after blood transfusion is c  
210. Anastomosis in arteries except ans = uterine and ovarian artery 
211. Extensor hallucis palsy: l5 palsy 
212. Inferior tympanic artery is is branch of ascending pharyngeal artey 
213. Content of mesorectum except?? - inf rectal arterty 
214. Aortic opening--t12  
215. Lenalidomide and dexamethasone increased risk of thrombo embolism  
216. Earliest serum marker in downs- pappa 
217. The difference between hus & ttp is--fever(not found in hus) 

Cranial Nerves :

Facts About Cranial Nerves :
* Nerves Attached to forebrain : 1,2
* Nerves Attached to Midbrain : 3,4
* Nerves Attached to Pons : 5,6,7,8
* Nerves Attached To Medulla : 9,10,11,12
*Sensory nerves : 1,2,8
* Motor nerves : 3,4,6,11,12
* Mixed sensory-motor nerves : 5,7,9,10
* Smallest Cranial Nerve :Trochlear
* Largest Cranial Nerve : Trigeminal
* Thickest Cranial Nerve : Trigeminal
* Longest Cranial Nerve : Vagus
* C.N to emerge from dorsal aspect of Brain Stem : Trochlear
* C.N with Direct projection To Cerbral Cortex : Olfactory
* C.N supplying outside brain,neck : Vagus
* C.N with longest intracranial course : Trochlear * C.N with longest Extracranial course : Vagus
* C.N with longest intraosseus course : Facial

MATERNAL ANATOMY

1. Langer lines : In the anterior abdominal wall, they are arranged transversely. As a result, vertical skin incisions sustain increased lateral tension and thus, in general, develop wider scars. In contrast, low transverse incisions, such as the Pfannenstiel, follow Langer lines and lead to superior cosmetic results.

2. Hesselbach triangle is the region in the anterior abdominal wall bounded inferiorly by the inguinal ligament, medially by the lateral border of the rectus muscles, and laterally by the inferior epigastric vessels. Direct hernias protrude through the abdominal wall in Hesselbach triangle, whereas indirect hernias do so through the deep inguinal ring lying lateral to this triangle.

3. The anterior abdominal wall is innervated by the abdominal extensions of the intercostal nerves (T7-11), the subcostal nerve (T12), and the iliohypogastric and the ilioinguinal nerves (L1).
4. The ilioinguinal and iliohypogastric nerves can be entrapped during closure of low transverse incisions (such as the Pfannenstiel), especially if incisions extend beyond the lateral borders of the rectus muscle .

5. HART LINE : Stratified squamous epithelium covers the outer surface of each labium. The lateral portion of the inner surface is covered by stratified squamous epithelium to a demarcating line—the Hart line. Medial to this line, each labium is covered by nonkeratinised squamous epithelium.

The minor vestibular glandsare shallow glands lined by simple mucin-secreting epithelium and open along Hart line.

6. VESTIBULAR GLANDS : The pair of Bartholin glands, (greater vestibular glands),are the major glands. Their ducts are 1.5 to 2 cm long and open distal to the hymenal ring at 5 and 7 o’clock. Following trauma or infection, either duct may swell and obstruct to form a cyst or if infected, an abscess.

7. SKENE GLANDS: Largest paraurethral glands—the Skene glands .Their ducts typically lie distally near the urethral meatus. Inflammation and duct obstruction of any of the paraurethral glands can lead to urethral diverticulum formation.

8. POUCH OF DOUGLAS : Posteriorly, between the lower portion of the vagina and the rectum rectovaginal septum is present. The upper fourth of the vagina is separated from the rectum by the recto-uterine pouch, also called the cul-de-sac of Douglas.

9. The vaginal lining is composed of nonkeratinized stratified squamous epithelium There are no vaginal glands. Instead, the vagina is lubricated by a transudate that originates from the vaginal subepithelial capillary plexus and crosses the permeable epithelial layer.

10. LYMPHATIC DRAINAGE OF VAGINA : Lymphatics from the lower third, along with those of the vulva, drain primarily into the inguinal lymph nodes. Those from the middle third drain into the internal iliac nodes, and those from the upper third drain into the external, internal, and common iliac nodes.

Wednesday, 16 April 2014

Immunoglobulin

1. Ig that crosses the placenta ?
Answer: Ig G .
2. Ig present in milk ?
Answer: Ig G and Ig A
3. Ig in seromucinous glands ?
Answer: Ig G and Ig A
4. Ig in primary immune response ?
Answer: Ig M
5. Ig in secondary immune response ?
Answer: Ig G
6. Ig with maximum molecular weight ?
Answer: Ig M
7. Ig with maximum sedimentation rate ?
Answer: Ig M
8. Ig with minimum sedimentation coefficient ?
Answer: Ig G
9. Blood group antibodies belong to which type of
immunoglobulins ?
answer: Ig M
10. Rheumatoid factor belongs to which type of immunoglobulins ?
answer: Ig M ( antibody against Fc fragment of Ig G )
11. Immunoglobulin that is heat labile ?
answer: Ig E .
12. Immunoglobulin mediating the prausnitz kustner reaction ?
Answer: Ig E
13. Ig appearing first in life ?
Answer: Ig M
14. homocytotropism is seen in which Ig ?
answer: Ig E .
15. Ig with maximum serum concentration ?
Answer: Ig G
16. Ig with minimum serum concentration ?
Answer: Ig E
17. Ig with longest half life ?
Answer: Ig G
18. Ig with shortest half life ?
Answer: Ig E
19. Ig with maximum synthesis per day ?
Answer: Ig A
20. Ig with minimum synthesis per day ?
Answer: Ig E
21. Ig responsible for hypersensitivity pneumonitis ?
Answer: Ig G
22. binary exposure to an antigen results in sudden increase in ?
answer: Ig G
23. Ig to fix complements via classical pathway ?
Answer: Ig G1 and Ig M
24. Ig to fix complements via alternate pathway ?
Answer: Ig A , Ig D , Ig G4
BASIC

Tuesday, 15 April 2014

Santorini

Santorini's cartilage: The corniculate cartilage of the larynx.
Santorini's concha: The superior nasal concha (turbinate).
Duct of Santorini: An accessory duct of the pancreas.
Santorini's fissures: Vertical fissures in the anterior part of the cartilage of the external acoustic meatus (ear canal).
Santorini's minor caruncle: Location of the opening of the accessory pancreatic duct into the duodenum.
Santorini's muscle: Bundle of muscular fibers that draw the angle of the mouth laterally. Sometimes called the Albinus muscle; named after German anatomist Bernhard Siegfried Albinus (1697–1770).
Santorini's vein: Vein which passes through the parietal foramen and links the superior sagittal sinus with veins of the scalp.
Santorini's plexus: plexsus of veins found in the cave of retzius.

SPM


MDG 2015
Eradicating extreme poverty and hunger,
Achieving universal primary education,
Promoting gender equality and empowering women,
Reducing child mortality rates,
Improving maternal health,
Combating HIV/AIDS, malaria, and other diseases,
Ensuring environmental sustainability, and
Developing a global partnership for development.
HDI Vs PQLI
Human Development Index Components (KILL):
K - knowledge (Mean yr of schooling)
I - Income
L - Life expectancy at Birth
L - Literacy Rate

Physical Quality of life (PQLI)  components (PILL) :
I - Infant Mortality Rate
L -  Literacy Rate
L - Life expectancy at 1 year
PILL n KILL
kuppuswami(a e i o u)middle 3
Education
Income
Occupation

1)Neonatal tetanus eliminated when incidence – is Less than 0.1/1000
2)Contribution of employer in ESIS – 4.75%
3)Clorination of water criteria – Clear water
4)Rat flea – Endemic typhus
5)Not transmitted by mosquito –Kala azar
6)Epidemiological investigation of choce for kala azar - ELISA / Montenegro test/ Aldehyde test/??
7)Natural mosquito control agent – Pyrethrum
8)reading of abraded skin by dog – Class 2 – So Vaccine only
9)Sullivan's index-life free of disability
10)Entry of pathogen & maximum infectivity-Generation time
11)Definitive diagnosis of leprosy – skin smear
12)Antigenic shift is in – influenza
13)True of carrier in typhoid – urinary carrier with anomaly
14)Shortest incubation period in food poisioning – Staph aureus
15)Chandler's index – ankylostoma duodenle
16)Drakunculosis transmitted by – Drinking Contaminated water
17)Multibacillary Leprosy is followed upto – 5 Years
18)The concept of Female Health guide was given by – Kartar Singh
19)Socrate's method of health education is by – ?Didactic method/Group discussion
20)Best guide of iron defiency – Serum ferritin
21)Different communities best compared by – Age specific death rate
22)Burden of disease formula – (Positives/Tested)*Population
23)Comfortable temp range – 77-80F
24)Mother to be labelled high risk
– Ht less than 140cm
25)Efficiency of Malaria
elimination program is evaluated
using – ABER
26)Prophylaxis to maniac person not on medication coming to bihar ? ans : mefloquine.
27)Percentage of para para in DDT-- 70-80%
28)Corpulence index used in – Obesity
29)Correct statement – ans-Population density 324/sq km /
TFR- 6/ growth ratio – 2.2/


1.rural posting necessary by which committe?/ it's 3month training in psm
Given by Bhore
2.multi prurpose worker initiated by which committe?
kartarsibgh
3.urban slum development by which committe?
Krishnan
4.setting up of universities for studies which committe?
Bajaj
5.committe started to prevent spread of malaria?
Chadah
6.jungle wala committe proposed what?
No private practice fir doctors
7.womb to tomb care given bywhich committee?
Bhore
8.delinking of malaria by which committe
Mukherji
9.village health guide concept by which committe
shrivastva
10.phc not to serve mire than 40000by which committe?Mudaliar