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# Anaesthesia @ Anesthesia for absence seizure in pregnancy #Pathology @ Esr effect in tb Increase size rbc Decreased ....

Improvement from tb No 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 theatre suddenly became unconscious and pulseless. What is the next step: a. check breathing b. call ambulance c. give two breaths d. chest compressions @ Benign breast tissue on histopathology shows a) STROMAL PROLIFERATION # Anatomy @ elevation at site of prostatic utricle is formed due to: a. glands b. insertion of detrusor c. insertion of trigone d. preprostatic sphincter #Dermatology # Medicine @ pt with 60 packs per yr cigarette consumption, tumor in lung, on biopsy, small == symptoms mc due to PNS @ . Tests for malabsorption test all except TRICLOSAN BREATH TEST @All are true about CLL treatment except a) Treatment given to maintain the leucocyte count b) Treatment given to prevent recurrence .

@ 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 of anti-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 is actually a carrier.

@ 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 the investigator wants to know about the population between 45% and 55% in 95th percentile , then wat is the minimum population to be taken ..?? A)100 B)200 C)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 insignificant B)previously insignificant data becomes significant c. no change in significance d.

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

The confidence level is the probability that the parameter estimate is within 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 blind schools and general population- UNDER ESTIMAYE @ The prevalence of a disease in a group of 100 people is 80 percent. What is the 95 percent confidence interval a.70 -90 b.72- 88 c. d. # oPHTHALMOLOGY @ diabetic patient with transient loss of vision followed by complete loss after few days..important investigaton to be done a)Serum ACE b)Serum homocysteine c)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 perform following surgical procedure most commonly ? A. Phacoemulcification B. DCR C. Bilateral Lamellar Tarsus Rotation D. Pars plana vitrectomy Ans: C

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 to primary site same binding site same 3D Structure

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 noncompetitively 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 antiepileptic 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.

# bIOCHEMISTRY @ insulin resistance develops in liver disease because of a)inhibition of release of insulin b)dysfunction of hepatocytes c)

Steatosis is one of major factor caus- ing insulin resistance during liver diseases The principal action pathway of insulin involves sequential activation of the insulin receptor, insulin receptor substrates (IRS), phosphatidyl insositol-3-kinase (PI3K), Akt and protein kinase [57]. Akt is a serine-threonine-kinase that phosphorylates proteins in several pathways regulating aspects of metabolism, apoptosis, and proliferation. Insulin resistance (IR) results from defects at the level of ligandreceptor-response pathway. Such a defect may occur either at the receptor 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 was reported that IRS-1 controls peripheral glucose uptake and IRS-2 regulates both peripheral and central insulin action [12]. This shows that IRS-2 is more important for insulin signaling and glucose homeostasis in the live

. # mICRO @ Major function of MHC 1 and 2

# Paediatrics

@ pinhead silvery nodules child

# ENT

@ biominerlisation.... seen in?? 1 pinna ( anatomy) 2 hooves of cattles 3 honeycomb 4 mull shell

# Forensic

# pHYSIOLOGY @ Cyanosis requires CRITICAL CONCENTRATION OF Hb @ in RTA with multiple injuries , pCo2 raises because of 1 respiratory centre affected 2 respiratory apparatus affected 3 both 4 Lung injury @ tracheobronchial receptors @fick s law ? 1)passive osmosis along conc gradient 2)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 SENSORY MOTOR SCALE

# Radiology

@ stage of neurocysticercosis without edema on imaging # Orthopaedics @ Old woman on alendronate for 7 years develops pain in hip nd thigh. Investigation of choice? a) Xray b) ALP levels c) DEXA d) Vit D levels Answer- Xray?? Thinkin it mite be pathological fracture.. @ A person lying unconscious with right lateral position on the road with suferficial injury to the face, bruises on the right arm, and injury to the lateral knee...what could be the reason for his condition? a) common peroneal nerve injury b) radial n injury c)? femoral n d) trigeminal n. ans: should be a @ hockey player with injury to right knee presents after 3 monthswith laxity in fully extended knee but no laxity in 90 degree. what is the structure damaged? a) Anteromedial part of ACL b) Posterolateral part of ACL c) PCL d) Anterior horn of medial meniscus Answer- PCL?? poteromedial part of anterior cruciate ligament??? @ 1. Forgotten muscle in rotator cuff shoulder, which was not given importance earlier but now coming back in focus: a. subscapularis b. teres minor c. supraspinatus

d.infraspinatus @ . Supracondylar fracture humerus wat is false: a. distal segment is mostly displaced posteriorly b. cubitus varus is more common than cubital valgus c. injury causes weakness of elbow flexion d. nerve injury related manifestations are transitory @ a child is given Gallows traction. he is having what fracture: a. shaft of femur b. neck of femur c. femur trochanter d.

@ 29. in patient of rickets on calcium supplementation, surgical treatment of deformity should be started when: a. x ray shows healing b. serum vit d levels become normal c. serum alkaline phosphate level normalises d.