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# Anaesthesia

@ Anesthesia for absence seizure in pregnancy#Pathology@ Esr effect in tbIncrease size rbc

Decreased ....Improvement from tbNo effect# Surgery@ earliest cx of ileostomy---- necrosis

@child with bleeding per rectum ...diagnosis??a)juvenile rectal polyp

b) rectal ulcer

@ . a patient after being given anaesthesia in operation theatresuddenly became unconscious and pulseless. What is the next step:a. check breathingb. call ambulancec. give two breathsd. chest compressions

@ Benign breast tissue on histopathology shows

a) STROMAL PROLIFERATION# Anatomy@ elevation at site of prostatic utricle is formed due to:a. glandsb. insertion of detrusorc. insertion of trigoned. preprostatic sphincter

#Dermatology

# Medicine@ pt with 60 packs per yr cigarette consumption, tumor in lung, onbiopsy, small == symptoms mc due to PNS

@ . Tests for malabsorption test all exceptTRICLOSAN BREATH TEST@All are true about CLL treatment except

a) Treatment given to maintain the leucocyte countb)Treatment given to prevent recurrence

.

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@ HBsAg and HBeAg positive in?a) Chronic hepatitis

Possible interpretations: (1) patient may be recovering from acute infection;(2) patient may be distantly immunetesting does not detect very low level ofanti-HBs; (3) patient may be susceptible, with a false-positive anti-HBc; or (4)there may be an undetectable level of HBsAg in the serum, and the patient isactually a carrier.

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@ In PDA unlikely seen

Co2 washout@ fever wiyh hyptension n red spots@ Treatment for seizure of unknown origin?

# GOB# SPM

@BIOSTASTICS ,..in a population 50 % is diseased.. if theinvestigator wants to know about the population between 45% and55% in 95th percentile , then wat is the minimum population to betaken ..??A)100B)200C)300

D)400

@ sample size was2 be calculated...100,200,300,400

@ in testing a hypothesis, by increasing the confidence limits:A) previously significant data becomes insignificantB)previously insignificant data becomes significantc. no change in significanced.

. The wider the confidence interval, the less the precision.

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The confidence level is the probability that the parameter estimate iswithin the confidence interval. It is represented by (1 ), where is the significance level

@ social pathology?

@ disease under icd surveillance a/e@ Blindness prevalence estimate comparision between blindschools and general population- UNDER ESTIMAYE@ The prevalence of a disease in a group of 100 people is 80percent. What is the 95 percent confidence intervala.70 -90b.72- 88c.d.# oPHTHALMOLOGY

@ diabetic patient with transient loss of vision followed by completeloss after few days..important investigaton to be donea)Serum ACEb)Serum homocysteinec)Serm Creatinine

@ CMV retinitis initial IOC ?PCR for intra vitreal fluid--most sensitive and rapid method for cmv

retinitis

@An ophthalmologist working in district hospital is likely to performfollowing surgical procedure most commonly ?

A. PhacoemulcificationB. DCRC. Bilateral Lamellar Tarsus RotationD. Pars plana vitrectomy

Ans: C

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Phaco Emulsification Machine:-

Phaco is latest technique for cataract operation. In this technique

IOL is implanted through a very small incision. In the post

operative period patient either donot requires spectacles or

requires very small cylindrical numbers in his spects. 10 District

hospitals will be equipped with Phaco Machines and Autoref

#pHARMACOLOGY@ Secondary site for drug binding has which property in relation toprimary sitesame binding sitesame 3D Structure

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Experimental studies have postulated that any drug can bind to numerous

protein binding site .In such circumstances the primary site is the major

binding site and the other as the secondary site; for example, for dicoumarol

site I is the primary site while site II is secondary. Those drugs having

affinity for the same binding sites compete with one another. But the non-

competitively binding drugs either promote or inhibit binding of a drug to

another site. This is usually accomplished by mechanism of coupling. There

are four different sites for the drugs to bind.

Many substances (generally endogenous compounds) such as tryptophan,

saturated fatty acids, unsaturated fatty acids, bile salts or bilirubin etc all

exhibit effective albumin binding . This is due to diversity in the structures of

proteins,

the structures of free drug moiety and their affinity towards the protein

molecule.

The different sites are:

Site I: To this specific site a large population of drugs bind like Non-

Steroidal Anti-Inflammatory Drugs mainly phenylbutazone, indomethacin,

many sulfonamides e.g.; sulfamethoxine, sulfamethizole, and even many anti-

epileptic drugs like phenytoin etc. this site is also called as Warfarin binding

site or as Azapropazone binding site.

Site II: This is actually said to be Diazepam binding site. benzodiazepines,

medium chain fatty acids, ibuprofen, ketoprofen, etc. bind extensively at the

very site. This is so because due to structural changes the following drugs

have high and specific affinity for the site. At both the sites I&II many drugs

are known to bind.

Site III: This very protein site is called as Digitoxin binding site

Site IV: This is referred as Tamoxifen binding site.

At the sites III & IV very few drugs are known to bind.

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# bIOCHEMISTRY@ insulin resistance develops in liver disease because ofa)inhibition of release of insulinb)dysfunction of hepatocytesc)

Steatosis is one of major factor caus- ing insulin resistance during liverdiseases

The principal action pathway of insulin involves sequential activation ofthe insulin receptor, insulin receptor substrates (IRS),phosphatidyl insositol-3-kinase (PI3K), Akt and protein kinase [5-7]. Akt is a serine-threonine-kinase that phosphorylates proteins inseveral pathways regulating aspects of metabolism, apoptosis, and

proliferation.

Insulin resistance (IR) results from defects at the level of ligand-receptor-response pathway. Such a defect may occur either at thereceptor level or in IRS molecules.

Human liver has two important IRS proteins i.e. IRS-1 and IRS-2 [11].Whereas IRS-1 plays role in growth and insulin resistance, IRS-2 is

involved in -cell failure and hepatic insulin resistance. Also it wasreported that IRS-1 controls peripheral glucose uptake and IRS-2

regulates both peripheral and central insulin action [12]. This shows thatIRS-2 is more important for insulin signaling and glucose homeostasisin the live

.

# mICRO@ Major function of MHC 1 and 2

# Paediatrics

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@ pinhead silvery nodules child

# ENT

@ biominerlisation.... seen in??1 pinna ( anatomy)2 hooves of cattles3 honeycomb4 mull shell

# Forensic

# pHYSIOLOGY@ Cyanosis requires CRITICAL CONCENTRATION OF Hb@ in RTA with multiple injuries , pCo2 raises because of1 respiratory centre affected2 respiratory apparatus affected3 both4 Lung injury

@ tracheobronchial receptors@fick s law ?

1)passive osmosis along conc gradient2)active osmosis along conc gradient@ person lie down what happen?immediate increase in venous return@ Ovulation occurs AFTER RIPENING OF FOLLICLE

# pSYCHIATRY

@ out of sight out of wotld theory of child development concrete theory (not sure)

Piaget development model- out of sight, out of mind is SENSORYMOTOR SCALE

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# Radiology

@ stage of neurocysticercosis without edema on imaging# Orthopaedics

@ Old woman on alendronate for 7 years develops pain in hip ndthigh. Investigation of choice?a) Xrayb) ALP levels

c) DEXAd) Vit D levels

Answer- Xray?? Thinkin it mite be pathological fracture..

@ A person lying unconscious with right lateral position on the roadwith suferficial injury to the face, bruises on the right arm, andinjury to the lateral knee...what could be the reason for hiscondition?

a) common peroneal nerve injuryb) radial n injuryc)? femoral nd) trigeminal n.ans: should be a

@ hockey player with injury to right knee presents after 3 months-with laxity in fully extended knee but no laxity in 90 degree. what isthe structure damaged?

a) Anteromedial part of ACLb) Posterolateral part of ACLc) PCLd) Anterior horn of medial meniscus

Answer- PCL?? poteromedial part of anterior cruciate ligament???@1. Forgotten muscle in rotator cuff shoulder, which was not givenimportance earlier but now coming back in focus:a. subscapularis

b. teres minorc. supraspinatus

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d.infraspinatus

@ . Supracondylar fracture humerus wat is false:a. distal segment is mostly displaced posteriorlyb. cubitus varus is more common than cubital valgus

c. injury causes weakness of elbow flexiond. nerve injury related manifestations are transitory

@ a child is given Gallows traction. he is having what fracture:a. shaft of femurb. neck of femurc. femur trochanterd.

@ 29. in patient of rickets on calcium supplementation, surgicaltreatment of deformity should be started when:a. x ray shows healingb. serum vit d levels become normalc. serum alkaline phosphate level normalisesd.