Thursday, 31 October 2013

prognostic factor for following carcinoma

1.Soft tissue sarcoma-grade
2.breast carcinoma-LN involvement
3.stomach cancer-depth of invasion
4.wilms tumor-histology
5.renal cell ca-stage
6.bladder ca-depth of invasion
7.Hodgkins lymphoma-stage
8.AML-age at diagnosis
9.multiple myeloma-stage


Volume > 1.5ml
ph> 7.2
Sperm concentration 15million/ml
Total sperm count 39million/ejaculate Motility 32%progressive motility
Total motility 40%
Normal morphology > 4%
Wbc count <1 million/ml
Vitality 58% live sperm


Mc type is type 1
Mc to cause epidemic is type 1
Most common to cause paralysis is type 1
Most difficult to eradicate is type 1
Most antigenic strain is type 2
most common to cause vaccine associated paralysis is type 3

Uterus Rupture

spontaneous rupture during pregnacy -- upper segment
rupture during labour due to non obstrutive cause -- fundal area
due to obstruction -- ant lower segament transversely
rupture of scar in classical cs -- upper segment
rupture of scar in lscs -- lower segment ..

Radiologist love animals

beheaded dog app: spondylythiasis
panda app on mri: wilsons
spider leg app: polycystic kidney
fish mouth vertebra: sickle
tiger eye app: hallaverdon spatz
bat wing app: cardiogenic pulm edema
bird beak app: achalasia cardia 🐥
humming bird : progressive supranuclear palsy
panda sign: sarcoidosis
swan neck deformity: rheumatoid art....
Crocodile tears: facial nerve
Sparrow feet mark: windsheild glass injury
Bag of worms.: varicocoele
Rat tail app: ca oesophagus
Salt pepper. Skull-hperparthyroidism
Hot cross -Cong syphlis
Geographic skull -LCH
HAIR ON end app
     Sickle cell an
Caffey's sign
Aka Crescent or Salter's
seen in Subchondral fracture in Perthes disease (linear radiolucency within the femoral head epiphysis)

Caffey's disease
infantile cortical hyperostosis
a disease of young infants characterized by soft tissue swellings over the affected bones, fever, and irritability, and marked by periods of remission and exacerbation; called also Caffey disease.
dwarfism, cortical thickening of tubular bones & transient hypocalcemia
Structure pasing throgh sup orbital fissure
CN 6✅(abducent)
CN 1
CN 2
0phthal N


🔷 Natural v/s Synthetic
🔸 Natural : Silk, Catgut, Linen etc.
🔸 Synthetic : Polyglycolic acid (Dexon), Polyglactin (Vicryl), Polypropele (Prolene), Polydiaxone (PDS), Nylon etc.
🔷 Absorbable v/s Non-absorbable
🔸 Absorbable : Catgut, Vicryl, Dexon, PDS etc.
🔸 Non-absorbable : Silk, Linen, Prolene, Nylon etc.
🔷 Monofilament v/s Braided
🔸 Monofilament : Catgut, Prolene, Nylon, PDS etc.
(Contain single strand of fibre.....Adv.: Less chance of bacterial contamination.....Disadv.: More difficult to handle and knot tied may become loose.)
🔸 Braided : Silk, Linen, Vicryl etc.
(Multiple fine strand which are braided together....Adv.: Easier to handle and less chances of loosening of tied knot......Disadv.: Bacteria may lodge in cervices of sutures, and so, they are not suitable for use in presence of infection.)
🔷 Straight v/s Curved
Most commonly used during surgery is 'Curved needle', while straight needles are very rarely used.  Moreover, it is also indicated by the curved needle symbol on pack. (This needle has a curvature equal to three eighth circumference of a circle.)
🔷 Round bodied v/s Cutting
🔸 Round bodied : Needle is uniformly round in cross section. It only separates the fibres of tissue through which it is passed (without cutting them). So, it is more suitable for use in soft and delicate tissues like mucosa, muscles, blood vessels etc. Indicated by a 'Circular' symbol on packet.
🔸 Cutting : Needle is triangular in cross section. It cuts the fibres of tissue through which it is passed. So, it is more suitable for use in tough tissue like skin etc. Indicated by a 'triangular' symbol on packet.

Lymph nodes and staging

🍇Positive paraaortic lymph node for ca ovary/ ca endometrium--stage 3
🍇Pelvic lymph node in ovarian cancer-- stage 2b
🍇Pelvic lymph node in endometrial cancer-- stage 3c
🍇Inguinal lymph node in ovarian cancer-- stage 3
🍇Inguinal lymph node in endometrial cancer-- stage 4

Pre packed STD coloured kits

kit 1 - grey - for urethral discharge, ano rectal discharge and cervicitis
kit 2 -green -for vaginitis
kit 3 -white, kit- 4blue, kit-5 red- genital ulcers
kit -6 -yellow for lower abdominal pain
kit-7-black-for scrotal swelling

Anesthesia High yield Points

Most cardiostable volatile agent? Isoflurane
Anaes causing coronary steal phenomena? Isoflurane
Robin hood phenomena is caused by? Thiopentone
Autoregulation is blunted by? Halothane
High output renal failure is caused by? Methoxyflurane
Retrograde amnesia is caused by? Diazepam
Most cardiostable agent is? Etomidate
Anaesthesia in child with Duchene's? Propofol
M/x used skeletal ms relaxant? Vecuronium.

Some rules

Rule of 4
type 1dm-type 4hypersensitivity
type 2 dm-type2
Rule of 5
type 1 lepra reactn-type 4
type 2 -type3
Rule of8

Hypersensitivity reactions.

- Anaphylaxis.
- Allergic and atopic disorder.

- Hemolytic anaemia.
- Pernicious anaemia.
- Idiopathic thrombocytic purpura.
- Erythroblastosi -s Foetalis.
- Acute hemolytic trasnfusion reaction.
- Rheumatic fever.
- Good pastures disease.
- Bullous Pemphigoid.
- Pemphigus Vulgaris.
- Myasthenia Gravis.

- SLE.
- Rheumatoid arthritis.
- polyareteritis nodosum.
- Serum sickness.
- Arthus reaction.
- Hypersensitivit -y pneumonitis (farmers

- type I DM.
- MS.
- GB synd.
- Hashimotos Thyroiditis.
- Graft vs Host dsz.
- PPD.
- Contact dermatitis.

Update on Hepatic Mets from Colo-rectal cancers (Important for AIIMS)

• Liver is the most common site of mets from colo-rectal cancers
• Liver metastasis is not a contra-indication for surgery in these patients.
• CECT is the most frequently used modality to detect these lesions
• Intra-operative USG is the most sensitive modality for these lesions
• Criteria for identifying patients who can undergo metastatectomy:
1. number of lesions (less than four, in the same lobe)
2. maximum lesion dimensions (less than 5 cm)
3. absence of metastatic spreading outside the liver, 
4. adequate (more than 1 cm) margin of healthy liver tissue for all resected lesions
5. an adequate liver remnant after resection 
• K –RAS is an independent prognostic factor in these patients
• Hepatic artery infusional chemo can be used as an adjuvant treatment in these patients.
• Bevacizumab (anti-VEGF antibody) and Cetuximab/ panitumumab (anti- EGFR) agents have been approved for management of these patients
• CUSA (Cavitron Ultrasonic Surgical Aspirator) can be used for hepatic resection""

NBE Notes 3

Mc complication of mumps ? Aseptic meningitis
mc  complication in adults ?? Orchitis
Mc complication in children?? Aseptic meningitis
MC opportunistic viral infection in AIDS??Cmv✔✔
MC opportunistic fungal infection in AIDS??Candida✔✔
MC opportunistic  infection causing pnemonia in AIDS?? Strp pnuemonia

Best drug for leprosy is dapsone because less chances of resistance because of multi step mutation
Most Effective drug - is Rifampicin - more chance of resistance to develop
Nutritional melalgia is caused by?- Pathotenic acid✔

An abscess of the thymus(also known as "Dubois'abscesses") is a condition that is one of many possible causes of cysts in the mediastinum .

Kikuchi-Fujimoto disease (KFD) was described in 1972 in Japan. It is also known as Kikuchi disease, histiocytic necrotizing lymphadenitis, Kikuchi necrotizing lymphadenitis, phagocytic necrotizing lymphadenitis, subacute necrotizing lymphadenitis, and necrotizing lymphadenitis

Oguchi disease, also called congenital stationary night blindness, Oguchi type 1 or Oguchi disease 1 , is an autosomal recessive form of congenital stationary night blindness associated with fundus discoloration and abnormally slow dark adaptation.

A prolonged dark adaptation of three hours or more, leads to disappearance of this unusual discoloration and the appearance of a normal reddish appearance. This is known as the
Mizuo Nakamura phenomena and and is thought to be caused by the overstimulation of rod
cells .[

Pulmonary surfactant is a surface-active lipoprotein complex (phospholipoprotein) formed by type II alveolar cells. The proteins and lipids that comprise the surfactant have both a hydrophilic region
and a hydrophobic region.
By adsorbing to the air-water interface of alveoli with the hydrophilic head groups in the water and the hydrophobic tails facing towards the air, the main lipid component of surfactant,

dipalmitoylphosphatidylcholine (DPPC), reduces surface tension.

Charcot–Marie–Tooth disease (CMT) , also known as Charcot–Marie–Tooth neuropathy , hereditary
motor and sensory neuropathy (HMSN) and peroneal muscular atrophy (PMA)
Wasting of muscle tissue of the lower parts of the legs may give rise to a "stork leg" or "inverted bottle" appearance.

Wolff–Parkinson–White syndrome ( WPW ) is one of several disorders of the conduction system of the heart that are commonly referred to as pre-excitation syndromes . WPW is caused by the presence of an abnormal accessory electrical conduction pathway between the atria and the ventricles .
Electrical signals travelling down this abnormal pathway (known as the bundle of Kent
The bundle of Kent is an abnormal extra or accessory conduction pathway between the atria and ventricles that is present in a small percentage (between 0.1% and 0.3%)
 One beat from a rhythm
strip in V 2
characteristic findings in
syndrome. Note the
characteristic delta wave
(above the blue bar), the
short PR interval (red
bar) of 80 ms, and the
long QRS complex (blue
bar plus green bar) at
120 ms.

Neonatal jaundice is measured roughly, clinically with Kramer's  method
prognosis is good! if yellowish tinge present in head and neck area (Zone 1)
prognosis poor if yellowish tinge present in palms and soles (Zone 5)

Hunner's Ulcers occur in 5
to 10 percent of people who
have the bladder disease

Interstitial cystitis . They
form on the wall of the
bladder and, like any ulcer,
they can bleed, ooze, and
may vary in size. They were
first described by Dr. Guy
LeRoy Hunner

vogts line- keratoconus
Vogts triad -tuberous sclerosis

m/c indication of spleenectomy-trauma
m/c indication of elective spleenectomy-ITP

Wimberger sign refers to bilateral metaphyseal destruction in the medial proximal tibias seen in congenital syphilis.
Wimberger ring or wimberger's ring sign is a sclerotic ring around the epiphysis indicating loss of epiphyseal density in children with scurvy

Lutembacher's syndrome- ASD with rheumatic MS.
Maladie de Roger- small VSDs in muscular portion of septum.

The accepted lethal dose when white phosphorus is
ingested orally is 1 mg per kg of body weight,
although the ingestion of as little as 15 mg has resulted in death.[91] It may also cause liver, heart or kidney damage.[89] There are reports of individuals with a history of oral ingestion who have passed
phosphorus-laden stool ("smoking stool syndrome"). [91] Its extreme toxicity is due to the generation of free radicals, especially in the liver, where they
accumulate and are not easily metabolized.

Smoky stool syndrome is ingestion of white phosphorus

Chromosomal aberration...G1
Chromaid aberration.G2

till 3 weeks. YOLK SAC
by 3 months LIVER
At 4 month BONE MARROW
till puberty BONE MARROW

Wolf-Hirschhorn syndrome is a
condition that affects many parts of
the body. The major features of this
disorder include a characteristic
facial appearance, delayed growth
and development, intellectual
disability, and seizures.
Almost everyone with this disorder
has distinctive facial features,
including a broad, flat nasal bridge
and a high forehead. This
combination is described as a
"Greek warrior helmet" appearance.

Nephelometry : principle light attenuated in intensity by scatter light

Only heat labile.immunoglobulin?-igE
Maximum concentration ig?-igG
Maximum weight?igM
Lowest weight?igG
Lowesr concentration?igE
Maximum intravascular ig?-igM
Maximum extraravascular ig?-igA

The Adamkiewicz artery sometimes arises from a lumbar vessel.
2. In approximately 30% of people it arises from the right side.
3. One quarter of people have two large anterior segmental medullary arteries.
In 75% of people, the artery of Adamkiewicz originates on the left side of the aorta
between the T8 and L1 vertebral segments.

The suprapleural membrane, eponymously known as Sibson's fascia, is a structure described in
human anatomy.
It is named for Fran
fabella (Latin for little
bean ) (see also: Flabella) is
a small sesamoid bone
found in some mammals
embedded in the tendon of
the lateral head of the
gastrocnemius muscle
behind the lateral condyle of
the femur.

Heubner's artery (also known as the recurrent artery of Heubner or Medial Striate A.), named after the German paediatrician Otto
Heubner is a branch from
the anterior cerebral artery ,

The Batson venous plexus ( Batson veins ) is a network of valveless veins in the
human body that connect
the deep pelvic veins and
thoracic veins (draining the
inferior end of the urinary
bladder , breast and
prostate ) to the internal
vertebral venous plexuses .

The normal range of cardiac index in rest is 2.6 - 4.2 L/ min per square meter. It is frequently measured and used in intensive care medicine, and cardiac intensive care. It is a useful marker of how well the heart is functioning as a pump by directly correlating the volume of blood pumped by
the heart with an individual's body surface area.
If the CI falls below 1.8 L/min/m², the patient may be in cardiogenic shock. Cardiac index ( CI) is a
haemodynamic parameter that relates the cardiac output (CO) to body surface area (BSA), [1] thus relating heart performance to the
size of the individual. The
unit of measurement is litres
per minute per square
metre (l/min/m 2 ).

The labyrinthine artery( auditory artery , internal auditory artery), a long
slender branch of the
anterior inferior cerebellar
artery (85%-100% cases) or
basilar artery (<15% cases),
arises from near the middle
of the artery; it accompanies
the vestibulocochlear nerve
through the internal
acoustic meatus, and is
distributed to the internal
ear .

Most of the CAMs belong to four protein families: Ig ( immunoglobulin)
superfamily (IgSF CAMs), the
integrins , the cadherins , and
the selectins .

Meige's syndrome is a type of dystonia. It is also known as Brueghel's syndrome and oral facial dystonia . It is actually a combination of two forms of dystonia, blepharospasm and
oromandibular dystonia (OMD).

Ischaemic time of
Neuron 3-5 min
Cardiac musc 20 min
Peripheral nerve 8 hrs
Skeletal musc 24 hrs
Bone 72 hrs

Atol sign = reverse CT halo sign : Defined as central ground-glass opacity surrounded by denser
consolidation. Is relatively specific sign for cryptogenic organizing pneumonia (COP)

Sprengel's shoulder is characterized by abnormally high scapula. It is due to failure of scapula to descend (from its embroyological position in neck).Normally the descent is completed
by the end of 3rd Intra uterine
There may be an Omovertebral / suprascapular bone with this deformity.

Multiple cutaneous metastatic lesions from primary adrenal neuroblastoma is known as Blueberry
Double PCL(posterior cruciate ligament) sign is seen in Bucket handle tear (80% cases are of Medial
meniscus tear)

Benign Cartilagenous lesions :
Central -
Chondromyxoid fibroma
Peripheral - Osteochondroma

Tropical (pulmonary) eosinophilia, or TPE, is characterized by coughing, asthmatic attacks, and an enlarged spleen, and is caused by Wuchereria bancrofti.

Ollier disease - non-hereditary,sporadic, skeletal disorder characterised by multiple

Very important point to remember :
Foreign body - Coins in the esophagus are oriented in the coronal plane whereas coins in the
trachea are oriented sagittally.
Jones fracture is a transverse fracture at the base of the fifth metatarsal.

The Boari flap is used for ureteral reimplantations involving blockages in an area of the ureter further from the bladder.
In this procedure, which may be combined with a psoas hitch, the surgeon creates a new, tongue-like
flap of bladder tissue that is then stretched closer to the ureter and sutured shut.

Chamberlain’s line" - line joining back of hard palate to posterior lip of the foramen magnum on a lateral view.
Helps to identify "basilar invagination".

The whirlpool sign is seen when bowel rotates around its mesentery, with mesenteric vessels creating the whirls.
Seen in :
Malrotation complicated by midgut volvulus.

The double duct sign is simultaneous dilatation of the common bile and pancreatic duct. (Can be seen on MRCP, CT , ERCP , USG)
Most Common Causes include :
1. Carcinoma of the head of the pancreas.
2. Carcinoma of the ampulla of Vater Posterior urethral valve
- MC congenital obstructive lesion of the urethra
- usually at the dorsal aspect (back) of the prostatic urethra (near verumontanum )
- Type I - Most common type; due to
anterior fusing of the plicae colliculi,
mucosal fins extending from the
bottom of the verumontanum distally
along the prostatic and membranous
- IOC : Voiding cystourethrogram
The body of the normal meniscus
averages 9–12 mm in width.
Sequential, sagittal, 4–5-mm-thick
images should reveal the body of the
meniscus. The absent bow tie sign is
an indication of a possible bucket-
handle tear. The term “bucket-handle
tear” relates to its appearance, in
which the inner, displaced meniscal
fragment resembles a handle and the
peripheral, nondisplaced part
resembles a bucket. Because of the
displaced inner fragment, fewer than
two bow tie segments will be seen on
sequential, sagittal MR images.

Accordion sign is seen with pseudomembranous colitis.

Acoustic neuroma:most common intracranial schwannoma .80% of all cp angle tumours .its benign.
B/l acoustic neuroma is diagnostic of NF2 .
Most common age group is 40 to 60 yrs of age. Tumour is radioresistant.90 % cases are u/l .
Most schwannomas are sporadic.
Earliest symptom : deafness , tinnitus .retrocochlear hearing loss,true vertigo not seen due to central adaptation.marked difficulty in speech understanding.earliest nerve involved is 5th cranial nerve.2nd nerve is facial.
Acoustic neuroma continued:Earliest sign :corneal reflex is impaired.histelberger sign and teal's sign +ve .recruitment is negative.BERA : delay in 5th wave.mri is gold standard investigation.vertebral angiography done for differentiation from other cp is TOC.gamma knife surgery. For hearing rehabilitation in b/l acoustic neuroma :auditory brain stem implant.

Gridiron's incision(Mc Burney's incision)
Described in 1894 by McBurney, used for appendectomy. An oblique incision made in the right
lower quadrant of the abdomen, classically used for appendectomy Incision is placed perpendicular to the spinoumblical line at Mc Burney's point, i.e. at the junction of lateral one-third and medial two-third of spino-umblical line.

Kocher’s incision
An oblique incision made in the right upper quadrant of the abdomen, classially used for open cholecystectomy .Named after Emil Theodor Kocher . It is appropriate for certain operations on the
liver , gallbladder and biliary tract .This shares a
name with the Kocher
incision used for thyroid
surgery: a transverse, slightly
curved incision about 2 cm
above the sternoclavicular


Radiological Signs
Egg-on-a-string— a large, ovoid- shaped heart on newborn CXR, classically signifying complete
transposition of the great vessels with intact ventricular septum.
Cobblestone appearance— this sign
is produced on barium studies due to
ulcerative pockets, usually in the
terminal ileum, indicative of Crohn's.
Honeycomb lung— used to describe
any pathologic process that causes
radiographic appearance of multiple
small, thick-walled cystic spaces; e.g.
pulmonary fibrosis.
Codman's Triangle —a triangle on
plain film of extremities that signifies
reactive bone, classically associated
with osteosarcoma, or other
infectious/hemorrhagic process that
causes periosteal elevation.
Coin lesion— solitary pulmonary
nodule; may be cancer or granuloma.
Cookie Cutter lesions— metastatic
lesions to bone cortex, or Paget's.
Crescent sign— classic sign of
avascular necrosis, femoral head.
Ground glass— a “white-out” on CXR, usually PCP pneumonia or ARDS.
Hampton's Hump— a peripheral triangle, usually near pleural edges, classically PE.
Lead pipe sign— classic narrowing of bowel lumen, with loss of haustra— UC.
Napkin Ring sign— see Apple core lesion above; pathology identical, but lumen more narrowed.
Onion-skinning —layered look of periosteum in Ewing's Sarcoma.
Apple Core lesion —signifies annular carcinomas of the colon—looks like an
apple core or napkin ring(see below)
due to circumferential narrowing of
the lumen, noted on contrast studies.
Rachitic Rosary —this is a “string of beads” appearance on x-ray, a thickening of costochondral margins that is noted in Ricketts(Vit. D Deficiency).
Sail sign —fat pad noted on plain
film, indicative of shoulder
String sign —thin, slightly irregular
shadow in narrowed lumen of ileum,
suggestive of Crohn's.
Silhouette sign —obliteration of
cardiovascular silhouette due to
adjacent disease, ie pneumonia, TB,
Sunburst appearance—“clouds, clumps, and consolidated rays” of tissue emanating from bone cortex, or within bony structures, indicative of osteosarcoma.
Thumb(print) sign —on lateral c- spine, an enlarged epiglottis appears as a “thumb”—epiglottitis.
Westermark's sign —abrupt end to a pulmonary vessel, signifying
Bamboo Spine —fused spinal
segments with their syndesmophytes
look, on radiographs, similar to
bamboo stalks—classically associated
with ankylosing spondylitis.
Stepladder appearance —distended
bowel loops, often indicative of
obstruction, usually SBO
Bird's Beak— noted on Upper GI with contrast, a dilated upper/middle
esophagus with an abrupt taper to
exceptionally narrowed lumen, typical
of achalasia.
Scotty dog(collar) —on posterior oblique, the lumbar vertebrae look
like a Scottish terrier. The neck is the
pars interarticularis, and a break(a
collar) noted there indicates
Boot-shaped Heart —due to RVH, the
LV is lifted above the edge of the
diaphragm, forming the “toe” of the
boot. Classic for Tetralogy of Fallot.
Bat's Wing/Butterfly —this
appearance on CXR is classically
associated with CHF and resultant
pulmonary edema.
putty kidney-seen in end stage
infection with TB
Bullet Nose Vertebrae--achondroplasia
Coffee Bean sign--- strangulation of incompletely obstructed loop of small
Chevron sign--ball and socket
epiphysomeataphyseal junction-----> seen in achondroplasia
Champagne Glass pelvic inlet d/t narrow sacrosciatic notch seen in achondroplasia
Eye-of-the -tiger-sign-------> markedly hypointense globus pallidus on T2W1
surrounding a higher intensity centre...associated with Hallervorden spatz syndrome
HOLY Leaf plueral calcificatio on xray.----> asbestosis
Molten Candle wax appearance----> Meloreostosis(leri's disease)
Motheaten appearance on v:p scan in
Mathe's sign- Absence of downward
displacement of kidney in perinephric
Roche's sign-Body of testis n
epididymus can be separately felt in
epididymitis but not in torsion testis.
Blu dot sign- torsion hydatid cyst of
Morgagni of tetis
jack stones >>> another name for vesical jagged stones
*trident hands champagne glass pelvis chevron sign ( shaped notch in grwth
bullet nose vertebra tomb stone iliac bones
funnl shpd foram magnum
post scalloping vertebra
*paired post iliac horns seen in>>>
nail patella synd

Frostberg's reversed 3 sign => Ca head of pancreas
Driven snow appearance =>
pindborg's tumor
chain of lake appearance=> chronic
wave sign,sail sign, notch sign =>
tram track appearance => sturge
weber syndrome
Pelkan's sign=> scurvy
floating water lily sign=> hydatid cyst
inverted moustache sign=> mitral
popcorn calcification => lung
Canoe paddle ribs - Appearance of
ribs that may be seen with
Cord sign - Sign of intracranial dural
sinus thrombosis.
David Letterman sign -Sign of
scapholunate ligament disruption
Honda sign - Sacral insufficiency
Lace-like pattern - Ultrasound
appearance of hemorrhagic ovarian
Snowstorm pattern (breast) - US
pattern for breast implant rupture
Strawberry skull - Appearance of skull
that may be seen on fetal US with
Trisomy 18.
Tram-track sign (chest) - Sign of
Tram-track sign (neuro) - Sign of optic
nerve meningioma.
- Appearance of cortical calcifications
that may be seen with Sturge-Weber
Tram-track sign - Bone scan finding
that may be seen with hypertrophic
Toothpaste sign represents an
extrusion of a disc into epidural
space. It is called after the shape of
extruded material relatively to the
parent disc in a sagittal view.
Power Doppler and Vocal Fremitus
* to help distinguish malignant from
beingn tumours
* get patient to say AHHHH or 99 very
* cancer - vibrations conducted along
tumour infiltration into centre, hence
color pixels run into centre of tumour
and fill it in
* benign lesions (eg fat lobules) -
cannot get power doppler into centre
of lesion
* Not a useful test in superficial
lesions OR large breasts
Oil cysts- Mamographic finding in FAT NECROSIS
An Octreoscan is a scinitigraphic
study that uses a 111In labelled
octreotide which is a somatostatin
analog. It is particularly useful for
assessment of neuroendocrine
A MIBG scan is a scintigraphic study
that uses metaiodobenzylguanidine
labeled to Iodine-123 or Iodine-131.
It is indicated in the investigation of
Radiographic features
Intrauterine ultrasound findings
* increased nuchal thickness
* cystic hygroma
* coarctation of the aorta 15 - 20%
* bicuspid aortic valve
* horseshoe kidney
* mild IUGR
Paget's disease related signs
* blade of grass sign
* jigsaw pattern bone or mosaic
pattern bone
* picture frame vertebra
* cotton wool appearance of bone
* banana fracture
Christmas tree pattern cataract- myotonia dystrophica
Oil drop pattern cataract-galactosemia
Maxwell Lyon sign- ropy discharge seen in spring catarrh.
psuedokidney sign
target sign: intussupection on usg

Trinucleotide repeats are
A.fragile x--CGG
B.frederick's ataxia--GAA
C.Huntington's Disease--CAG
D.Myotonic dystrophy--CTG


Golden's S Sign -S shape caused by edge of elevated minor fissure and hilar mass in RUL
Ghost Vertebrae -bone- in-a-bone seen in spine with Thorotrast injection in childhood
Gloved Finger Sign- finger-like projections from hilum from bronchial mucoid impaction in allergic
bronchopulmonary aspergillosis or asthma
Goblet Sign -dilated, cup- shape of the ureter distal to an intraluminal filling defect such as
tumor, seen best on retrograde studies
Gull Wing Sign-DIP joints showing central erosions and marginal osteophytes in erosive
Golfball-on-a-Tee Sign- large cavity seen on CT urogram or IVP formed by sloughed necrotic
papillae in renal papillary necrosis
Gooseneck Sign -in left ventricular angiography, the shape of the LV and aorta in an endocardial
cushion defect

Most Chemosensitive tumors-      Acute leukemias,Lymphoma,Small cell lung ca,Ovarian tumors,Pediatric tumors.      
Most radiosensitive tumors-
Lung-Small cell ca.                    
Bone-Ewings and M. myeloma

Ranolazine, is an
antianginal medication.
and Drug Administration
(FDA) for the treatment of
chronic angina pectoris.
 Ranolazine, a partial fatty
acid oxidation inhibitor,
shifts ATP production from
fatty acid to more oxygen-
efficient carbohydrate
oxidation. [6][7]
Inhibition of fatty acid
oxidation (e.g., with
etomoxir or ranolazine) was
also found to sensitize
human leukemia cells to
apoptosis induction.

Antiretroviral =
Integrase inhibitors-raltegravir
Entry inhibitors-
Fusion inhibitor- Enfuviratide
Growth factors in pharmacology-
Erythropoiten recombinant-epoetin alpha and darbe poetin alpha- t/t of anemia

Filgrastim (G-csf)-neutropenia.
Sargramostim (GM- CSF)-Neutropenia.
Oprelevekin (IL-11)-Thombocytopenia.

ROMIPLASTIN-Idopathic trombocytopenic purpura.
Aprepitant (Neurokinin receptor NK1 antagonist)  -prevent nausea and vomiting from high emitogenic chemo.
Erlotinib-Her1/EGFR Tyrosine kinase inhibitor- Non small cell lung carcinoma.
Rimonabant (Acomplia) is a
recently developed
 anti- obesity medication. It is
cannabinoid (CB1) receptor antagonist that act centrally on the brain thus
decreasing appetite.
Orlistat (Xenical) reduces
intestinal fat absorption by
inhibiting pancreatic lipase.
Some side-effects of using
Orlistat include frequent,
oily bowel movements
( steatorrhea
thrombolytic drugs
tissue plasminogen
activator t-PA:
alteplase (Activase )
reteplase (Retavase )
tenecteplase (TNKase )
anistreplase (Eminase )
streptokinase (Kabikinase,
Streptase )
urokinase ( Abbokinase)

Fibrates prescribed
commonly are:
Bezafibrate (e.g. Bezalip)
Ciprofibrate (e.g.
Clofibrate (largely obsolete
due to side-effect profile,
e.g. gallstones )
Gemfibrozil (e.g. Lopid)
Fenofibrate (e.g. TriCor)

Bile acid sequestrants are the principal therapy for the
diarrhea found in bile acid malabsorption .
Cholestyramine , colestipol
and colesevelam

SERMs are used dependent on their pattern of action in
various tissues:
Name Uses
clomifene used in anovulation
femarelle managing
ormeloxifene contraception
raloxifene  osteoporosis ,
breast cancer
tamoxifen breast cancer

ABciximab: antagonist of IIb/IIIa receptors (antiplatelet)
INFliximab: binds TNF (Rheumatoid arthritis and Crohn disease)
TASTtuzumab: ERB-B2 antagonist (breAST cancer)
PaliVIzumab: blocks respiratory syntycial VIrus

Nesiritide (Natrecor) is the recombinant form of the 32
amino acid human B-type
natriuretic peptide, which is
normally produced by the
ventricular myocardium.
 Neseritide was believed initially to be beneficial for acute decompensated congestive heart failure.
 Nesiritide is only administered intravenously

Rotigotine (Neupro) is a dopamine agonist of the non-ergoline class of medications indicated for the treatment of Parkinson's disease (PD) and Willis- Ekbom Disease [1] (WED) formerly known as restless legs syndrome (RLS) in Europe and the United States. [2][3] It is formulated as a once-daily transdermal patch which provides a slow and constant supply of the drug over the course of 24 hours.[2][2] Like other dopamine agonists, rotigotine has been
shown to possess antidepressant

Some poisons & their specific antidotes :-
1. Anticholinergics --> Cholinergics.
2. Atropine and/or scopolamine --> Physostigmine.
3. benzodiazepines and barbiturates --> flumazenil.
4. Calcium Channel Blockers (Verapamil, Diltiazem) --> Calcium Gluconate.
5. Isoniazid --> Pyridoxine.
6. Magnesium --> Calcium Gluconate.
7. opioids --> naloxone.
8. paracetamol (acetaminophen) --> N-acetylcysteine.
9. Thallium --> Prussian blue.
10. Nicotine --> Bupropion and other ganglion blockers.
11. ethylene glycol --> ethanol or fomepizole, and thiamine.
12. methanol --> ethanol or fomepizole, and folinic acid.

Filgrastm used in: neutropenia
Vit k cofactor in carboxylatn
Ezetimibe: dec absorptn of cholestrol

Clopidogrel less neutropenia dan ticlopidine

DABIGATRAN is an oral anticoagulant from the class of the direct thrombin
inhibitors . It is used for various clinical indications, and in some cases it offers an alternative to warfarin as the preferred orally administered anticoagulant
("blood thinner"),
Mechanism of action
Ingested orally, dabigatran
is a competitive and
reversible direct thrombin
inhibitor. [10]
Hirudin and derivatives were
originally discovered in
Hirudo medicinalis: Hirudin
Bivalirudin (transient inhibition - is cleaved by thrombin)
Univalent DTIs include:
Melagatran (and its
prodrug ximelagatran)
Argatroban (as well as the
hirudins) are used for
thrombocytopenia ,
Ximelagatran showed good
efficacy compared with
warfarin in several trials in
prevention and treatment of
deep vein thrombosis and as
thromboprophylaxis in atrial
abciximab (ReoPro)
eptifibatide (Integrilin)
tirofiban (Aggrastat)
Glycoprotein IIb/IIIa
inhibitors are frequently
used during percutaneous
coronary intervention
( angioplasty with or without
intracoronary stent
Factor Xa has been developed. These include the drugs
rivaroxaban , apixaban, betrixaban , LY517717, darexaban (YM150), edoxaban
Do not give Proton pump inhibitors to patients who are on Clopedogrel,
as they inhibit CYP2C19, which is
required for the metabolism of
Clopedogrel, hence the anti-platelet effect of the Clopedogrel will be

Drug Of Choice - SEIZURES
Valproate - GTCS, tonic, atonic, clonic, myoclonic, atypical absence
Lorazepam - status epilepticus
Diazepam - febrile seizures
Carbamazapine - trigeminal neuralgia & partial seizures
Absence seizures - <3y ethosuximide
                                >3y  valproate
Infantile spasm - vigabatrine
Ganaxolone - catamanial epilepsy
Gabapentin - post herpitic and diabetic neuralgia
MgSO4 - ecclampsia
Infantile-ACTH now
Absence--all case valproat

Vaccines and strains used:
Measles-edmonston zagreb strain
BCG-Danish 1331 strain
Mumps-jeryl lynn strain

Lorglumide ( CR-1409 ) is a
drug which inhibits gastrointestinal motility and
reduces gastric secretions, acting as a cholecystokinin
antagonist , [1] with fairly high selectivity for the CCKA
subtype. [2] It has been suggested as a potential treatment for a variety of
gastrointestinal problems including stomach ulcers,irritable bowel syndrome, dyspepsia , constipation and

1) doc fr invasive aspergilloma? VORICONAZOLE
2) doc for mucaromycosis? POSACONAZOLE
3)Only S/ E of micafungin?  Histamine release..itching
4)Wat r 3 C of fuconazole and 2 C of flucytocine?3c- Rx against candida, coccidiomycosis and cryptococcal meningites
5) visual disturbance seen in wich anti fungal drug? Voriconazole...oyhers diarrhoea, rash, QT prolongation

Alpha 2 agonists
Brimonidine apraclonidine in glaucoma
Tizanidine muscle relaxant
Clonidine and alpha methyl dopa RX  of htn
Dexmeditomidine- pre anaesthetic medication

1.vinca alkaloids act on which phase of cell cycle? M phase
2.mtor inhibitor? Tacrolimus
3.pfox inhibitor? Trimetazidine raanazoline
4.irreversible otoxicity by which fluriquinolone? Streptomycin
5.dreaded complication of clozapine? Agranulocytosis
6.truth serum? Sodium penthotal amibarbitone and vmax in competitive inhibition? Km increase vmax same
8.height of DRC indicate? Efficacy
9.shift of DRC to left indicate? Increase potency
10.which drug usedc to keep pda patent?prostaglandin e1 analogue like alprostadil

1.Tetracycline wit vestibular toxicity ?minocycline
2. Max incidence of phototoxicity among quinolones? Sparfloxscin
3. Doc of legionnare's? Erythromycin
4.  pseudo jaundice adverse effect of? 
5. Where s docosanol used n it's moa?
6. Protease inhibitor which doesn't cse lipodystrophy? Aztazanavir
7. Doc of late cns stage of trypanosomiasis? Pentamidine
8. Antimalarial drug known  to cause neuropsychiatric adverse reaction? Chloroquine
. Absorption of whixh anti malarial,  anti fungal, anti cancer,  anti viral increases wit food.?
10.Whats log kill hypothesis?

1 Hypertrophic pyloric stenosis due to drug ? Erythromycin
2 mobeius synd ? Misoprostol
due to intake of misoprostl.6 nd 7 cranial nrv palsy
3 t/t mountain sickness?
4 doc for cheese rxn ?
5 t/t of choice beta blocker poisoning?
6 doc pvd ? Periph vasc disease ? Pentoxyphylline
7 doc mgso4 toxicity?
Calcium gluconate
8 post herpetic neuralgia ???
9 anti craving drug alcohol ??? Acamprost
10 alcohol withrawal doc ?
Long acting bzd
7. Doc kala azar?sodium stibo
8. Doc sea sickness?meclizine
9. Shortest acting nitrate?gtn
10. Where is storcit used?stroke
4. Hand foot syndrome by?5fu capecitabine
5. Red man?vanco
6. Radiation recall reaction in?adriamycin
Doc for various condition :
Absence seizure - typical :
Ethosuccimide ,
If it is atypical : sod valproate ,
Ocd: fluoxetine ,
Lithium induce DI : amiloride ,
Myclonic seizure : valproic acid .
Mrsa : vancomycin ,
Vrsa : linezolid ( thrombocytopenia ) ,
Px of febrile seizure ie complicated : phenobarbitol n valproate ,
1.DOC for pertussis? Macrolide
2.Shortest acting mydriatic is? Tropicamide
3.Beta blocker with alpha activity? Carvedilol
4.Max dose of ezetimide is? 10mg daily
Gemifibrozil is a? Fibric acid derivative
5:Drug for actinomycetes?  Penicillin
Fentanyl (also known as
fentanil , brand names
Sublimaze, [3] Actiq ,
Durogesic , Duragesic,
Fentora, Matrifen, Haldid,
Onsolis, [4] Instanyl,[5]
Abstral , [6] Lazanda[7] and
others [8] ) is a potent,
synthetic opioid analgesic
with a rapid onset and short
duration of action. [9] It is a
strong agonist at the μ-
opioid receptors.
Fentanyl transdermal patch
Matrifen) is used in chronic
pain management
Remifentanil (marketed by
GlaxoSmithKline and Abbott
as Ultiva) is a potent ultra
short-acting synthetic opioid
analgesic drug. It is given to
patients during surgery to
relieve pain and as an
adjunct to an anaesthetic .
Remifentanil is used for
sedation as well as
combined with other
medications for use in
general anesthesia .
Broad spectrum.anti convulsants??
Broad spec anti arrythmics??
Broad spec anti cancer
Pegvisomant (trade name Somavert) is a growth hormone receptor antagonist used in the treatment of acromegaly.[1] It is used if the tumor of the pituitary gland causing the acromegaly cannot be controlled with surgery or radiation, and the use of somatostatin analogues is unsuccessful. It is delivered as a powder
that is mixed with water and injected under the skin
Pegvisomant blocks the action of growth hormone at
the growth hormone receptor to reduce the production of IGF-1.[3][4] IGF-1 is responsible for most of the symptoms of acromegaly thus
normalising its levels is effective to control the
symptoms. Side effects Side effects of Pegvisomant include reactions at the
injection site, swelling of the limbs, chest pain, hypoglycemia, nausea and hepatitis.[5] Blocking of the growth hormone's receptor reduces
feedback control of the growth hormone regulation leading to approximately doubled GH levels
This was d drug used for transdermal patch to rx parkinson  disease ,
Once daily regimen , it slowly release d drug in 24 hrs of time

*Doc in leukemias
A.CLL- fludarabine
C.hairy cell--cladiribine
D.multiple myeloma-- melphan
E.resistant multiple myeloma--bortezomib

Drug Of Choice - SEIZURES
*Valproate - GTCS, tonic, atonic, clonic,                              *myoclonic, atypical absence
*Lorazepam - status epilepticus
*Diazepam - febrile seizures
*Carbamazapine - trigeminal neuralgia & partial seizures
*Absence seizures -
<3 yrs ethosuximid
>3y valproate
*Infantile spasm - vigabatrine
Doc -acth
If infantil+tuberous sclerosis---vigabatrine
*Ganaxolone - catamanial epilepsy
*Gabapentin - post herpitic and  Diabetic neuralgia
*MgSO4 - ecclampsia
Mc typ
All over--gtcs
action, side effects 6 P's: Prolongs action potential duration Photosensitivity Pigmentation of skin Peripheral neuropathy Pulmonary alveolitis and fibrosis Peripheral conversion of T4 to T3 is inhibited -> hypothyroidism

chief judicial magistrate - 7 yrs.. Unlimited fine
first class judicial magistrate- 3 yrs+5000 fine....
second class judicial magistrate - 1 yr imprisonment+ 1000 fine

S/e of cyclophosphamide---->>Se is haemorrhagic cystitis
Mesna given fr treatment
Ifosfamide is more potent congener of cyclophosphamide
Mesna is drug of choice but treatment of choice is---->>
Continuous irrigation and followed by mesna
intravesical bcg fr bladder carcinoma
Doc for chemotherapy induced vomiting---->>
(Palensetron as it prevents delayed vomiting also)
1st line chemotheraputic agent in ovarian carcinoma--->>Carboplatin and Cisplatin
Cisplatin has max emetogenic potential
what is used for cisplatin induced emesis--->>  APRIPITANT which is NK1 receptor and Substance P antagonist
Doc for febrile neutropenia ---- Ceftazidine
Anticancer Drug causing disulfiram like reaction--
Busulfan,bleomycin nd carmustine cause pulled.fibrosis as side effect
Drug causing radiation recall synd:
 docetaxel,
 gemcitabine,
Amifostine is radiiprotector( ammijaan protects)
Cisplatin is a radiosensitizer(CIS sense)
Cerebellar ataxia s.e of--->>cytarabine nd 5fu
Cerebellar ataxia is also a side effect of phenytoin remember
Most common side effects of anticancer drugs overall--->>
Nausea and vomiting
Max ototoxic nd nephrotoxic is tacrolimus na
Tacrolimus other name is---->>Fk 506
Hand foot syndrome caused by---->> 5FU and capecitaben
Vinca alkaloids r mitotic inhibitors.. Bind to tubulin n prevent polymerization.
Taxanes has opposite action. Enhance polumerization of tubulin and lead to stablization.
Cell cycle specific drugs
G1-- Vinblastine
S -- Mtx, Cytarabine, 6-MP, hydroxyurea, mitomycin C,
Doxorubicin, Daunorubicin.
G2 -- Daunorubicin, Bleomycin, Etoposide, Topotecan.
M -- Vincristine, Vinblastine, paclitexel.
S/e of cyclophosphamide---->>
Se is haemorrhagic cystitis
Mesna given fr treatment
Ifosfamide is more potent congener of cyclophosphamide
Mesna is drug of choice but treatment of choice is---->>
Continuous irrigation and followed by mesna
intravesical bcg fr bladder carcinoma
Doc for chemotherapy induced vomiting---->>
(Palensetron as it prevents delayed vomiting also)
1st line chemotheraputic agent in ovarian carcinoma--->>Carboplatin and Cisplatin
Cisplatin has max emetogenic potential
what is used for cisplatin induced emesis--->>  APRIPITANT which is NK1 receptor and Substance P antagonist
Doc for febrile neutropenia ---- Ceftazidine
Anticancer Drug causing disulfiram like reaction--
Busulfan,bleomycin nd carmustine cause pulled.fibrosis as side effect
Drug causing radiation recall synd:
 docetaxel,
 gemcitabine,
Amifostine is radiiprotector( ammijaan protects)
Cisplatin is a radiosensitizer(CIS sense)
Cerebellar ataxia s.e of--->>cytarabine nd 5fu
Cerebellar ataxia is also a side effect of phenytoin remember
Most common side effects of anticancer drugs overall--->>
Nausea and vomiting
Max ototoxic nd nephrotoxic is tacrolimus na
Tacrolimus other name is---->>Fk 506
Hand foot syndrome caused by---->> 5FU and capecitaben
Vinca alkaloids r mitotic inhibitors.. Bind to tubulin n prevent polymerization.
Taxanes has opposite action. Enhance polumerization of tubulin and lead to stablization.
CARDIOTOXICITY is a unique adverse effect Of which anticancers--->
Anthracycline group of drugs--->>
Daunorubicin, Doxorubicin(adriamycin)
Dose of chemotheraputic drug is commonly caluclated by---->> BSA
Dose of Carboplatin is caluculated by--->> Renal Function Test also known as CALVERTS formula
Cell cycle specific drugs
G1-- Vinblastine
S -- Mtx, Cytarabine, 6-MP, hydroxyurea, mitomycin C,
Doxorubicin, Daunorubicin.
G2 -- Daunorubicin, Bleomycin, Etoposide, Topotecan.
M -- Vincristine, Vinblastine, paclitexel.
Rituximab uses??
All anti cancer causes bone marrow suppression except??

QUINIDINE.--- Diarrhea, thrombocytopenia
ACARBOSE--- Flatulence, GI distress
METHIMAZOLE--- Agranulocytosis, aplastic anaemia
PRAZOSIN---- First dose syncope
TOLCAPONE.---- HEPatotoxicity
THIORIDAZINE.--- retinal deposits, torsade
CIMETIDINE---- Gynaecomastia
KETOCONAZOLE-- Gynaecomastia
ETOMIDATE-- Adrenal suppression
CHLOROFORM,ETHER--- Hyperglycemia
NICOTINIC ACID--- Icthyosis
CALCIUM AGONISTS--- Constipation
PROTON PUMP INHIBITORS--- Rediatribution of fat, hyperglycemia
POMPES-- acid maltase
CORIS--- Debranchin enzyme
ANDERSONS--- Branchin
MCARDLES--- Muscle phosphorylase
HERS-- Hepatic phosphorylase
TAURIS--- Phosphofructokinase 1

Drugs increasing QT interval...
I Imipramine
C Cisapride
H Haloperidol
E Erythromycin
A Amitryptiline and Amiodarone
T Terfenidine
E. granulosus – common hydatid.
E. multilocularis – alveolar type.
E. oligarthus – in the Americas
E. vogeli – polycystic hydatid.
 PAIN in
1.external hemorroids due to inferior rectal nerve branch of
pudendal nerve
2.internal hemorroids due to inferior hypogastric nerve from sym plexus (l1,l2)

MEDIAN NERVE [labourer's nerve]--C5,6,7,8,T1
Pen test
Ape thumb
Loss of opposition
Pointing index
ULNAR NERVE [muscian nerve]---C8,T1
Supply ADDuctor pollicis
Book test(Fromet sign)
Card test
Egawa's test
RADIAL NERVE---C5,6,7,8,T1
Wrist drop
Thumb drop
Finger drop
Mackler triad
Sc emphysema
Chest pain
quinkes triad
upper gi bleed
Biliary colic
Dieufaloys triad
Hyperaesthesia[al 3 at mc burney pt]

Order of radiographic densities, least to most - Air, fat, water, bone, metal.
Obvious findings - Cover them up and continue to read the film utilizing
proper search patterns.

MNEMONICS and imp points for NEET

Wooden chest: Alfentanyl
Wooden legs: Scurvey
Woody nose : Rhynophymoma (k/a
potato tumor)
Hebra nose: Rhinoscleroma
Hebra triangle: Scabies

Malnutrition in children

MCC of death in PNH : Thrombosis
MCC of death in polycythemia vera :
Pulmonary thromboembolism
MCC of death in klienfelters:
MCC of death in Downs : Cardiac
MCC of death in Amyloidosis: Renal
MCC of death in cirrhosis: HRS
some gene locations and inherited
mutations causing syndromes
APC gene: 5q (colon Ca & FAP)
(gene for blood group is located on -
Chromosome 9)
P16 gene: 9p (Malignant melanoma)
PTEN : 10q (mutation causes COWDEN
WT1 : 11p (Wilms tumor)
Rb : 13q (Retinoblastoma
NF-1 : 17q
BRCA 1: 17q (male n female breast
BRCA 2: 13q (exclusively male breast
P53 : 17p (Li fraumeni syndrome)
NF 2 : 22 q (Acoustic

Cyanotic heart diseases: 5 types Hi
Yield [ID 1707]
¬ Use your five fingers:
1 finger up: Truncus Arteriosus (1
2 fingers up: Dextroposition of the
Great Arteries (2 vessels transposed)
3 fingers up: Tricuspid Atresia (3=Tri)
4 fingers up: Tetralogy of Fallot
5 fingers up: Total Anomalous
Pulmonary Venous Return (5=5 words)

S1,2 = ankle jerk
L3,4 = knee jerk
C5,6 = biceps and brachioradialis
C7,8 = triceps:

Ureter to ovarian/testicular artery
relation [ID 56]
"Water under the bridge":
The ureters (which carry water), are
posterior to the ovarian/testicular
¬ Clinically important, since a
common surgical error is to cut ureter
instead of ovarian artery when
removing uterus.
Spleen: dimensions, weight, surface
anatomy [ID 54]
Spleen dimensions are 1 inch x 3
inches x 5 inches.
Weight is 7 ounces.
It underlies ribs 9 through 11.
Thoracic duct: relation to azygous
vein and esophagus [ID 26]
"The duck between 2 gooses":
Thoracic duct (duck) is between 2
gooses, azygous and esophagus.
Bicipital groove: attachments of
muscles near it [ID 27]
"The lady between two majors":
Teres major attaches to medial lip of
Pectoralis major to lateral lip of
Latissimus (Lady) is on floor of groove,
between the 2 majors.
Interossei muscles: actions of dorsal
vs. palmar in hand [ID 293]
"PAd and DAb":
The Palmar Adduct and the Dorsal
¬ Use your hand to dab with a pad.
Inversion vs. eversion muscles in leg
Second letter rule for inversion/
¬ Eversion muscles:
pErineus longus
pErineus brevis
pErineus terius
¬ Inversion muscles:
tIbialis anterior
tIbialis posterior
Carotid sheath contents [ID 669]
"I See 10 CC's in the IV":
I See (I.C.) = Internal Carotid artery
10 = CN 10 (Vagus nerve)
CC = Common Carotid arter

Organs outside blood brain barrier
( Marble S O A P)
Median eminence
Subfornicial organ
Organum vasculosum lamina terminalis
Area postrema
Posterior pituitary
Granulomatous vasculitis
(Get The World Cup)
Gaint cell arteritis
Wegener Granulomatosis
Churg strass syndrome
Both Granulomatous n Necrotisin vasculitis
Wegener Granulomatosis
Churg strass syndrome

Most common post op complication of
ILEOSTOMY(LATE)-Parastomal hernia
COLOSTOMY(EARLY)-Skin irritation and necrosis
COLOSTOMY(LATE)-Parastomal hernia
Correct me if wrong....
Mechanism of resistance-Mutation in tb , leprosy
Conjugation for multiple drug resistance
Transduction for staphylococcus
Soap bubble appearance
1.xray bone-gct
2.abd xray newborn-meconium ileus
3.mri brain-cryptococal meningitis
4.usg-muticystic dysplastic kidney
Rickets all seen , cranitabes , alkaline phosphate , Bow leg ( genu valgum-outelward curve of long bones)     (except- increase acid phosphate)                             baby starts speaking sentance of few words - 2yrs                                        MCC of death in PDA - cardiac failure                     ASD pt with murmur similat to MR & left axis deviation of 40 • is having? Floppy mitral valve                                         first sign of puberty in females -Thelarche     ( males - testicular enlargement)                          Generalized 3-4 hz spike &slow wave complexes on EEG seen in? Juvenile myoclonic epilepsy                               3 year old child with recurrent stridor , what is the most probable  diagnosis? Laryngotrracheo-bronchitis                                 MC gasrltrointestinal malignancy of childhood ? Lymphoma                      first set of milk teeth appear at what age? 6 months           true about gomez classification of malnutrition- weight is only parameter 12/10 (doubtful)
Chronic granulomatous disease :
NADPH oxidase defect
Deficiet of free radicals .
heterogenous disorders
xlinked defect of gp91phox
recurrent lung infection with catalase positive organisms
Hla and diseases
B27 - ankylosin spondylitis . Reiters syndrome. Reactive arthritis. Psoriatic arthritis.
Dr2 -      narcolepsy . Goodpasture syndrome.
Multiple sclerosis
  dermatitis herpetiformis
Chronic active hepatitis
Adrenal insufficiency
Graves disease
Pemphigus vulgaris
Rheumatoid arthritis
Serology to diff hdv and hbv - coinfection and superinfection
- Superinfection
igm anti hdv +
Igm anti hbcag -
Igm anti hdv +
Igm anti hbcag +
Cladribide-doc 4 hairycel leak
ABVD-ADIAMYCIN,blomycin,vincistin,dacarbazin 4 hogk lymph
Imatimib mesyl-cml
In ALL CNS prophy-intrathecal methotrexat or cytarabin
All transretinoc acid,arsenic oxide 4 Ac promy leuk
Mc mutant in beta thalas-intron1
Imatinib also for gist
Sorafenib for hcc
Suratinib Fr imatinib resistant GIST
Courtesy Tej n sunil
Malaria Progrrames
National Malarial Control Programme-1953
National Malarial Eradication Programme-1958
Urban Malarial Scheme-1971
Enhanced Malarial Control Project(Worlbank Supported)-1997
National Antimalarial Programme-1999
Kala Azar
Japanese Encephalitis
Chickengunya Fever
"bracket"calcification on skul mri?
Corpus callosum lipoma
Cork screw type glands seen in
Late secretry
tooth paste like stool is found in?
Hirshprung disease

reduced amount-alpha thalass
Defective mRNAprocessing:reduced amount-beta thal
Point mutation:abn structure-sickle cell

Pasavant ridge palatopharyngeus muscle
icepack test mysthenia gravis
m|c|c of RDmyopia
vincristine n vinblastine cell cycle M specific
glans penisdeep ing ln
spinocerebellumsoothen n co ordination
neocerebellumplanning n programming
donoghue triad
Medial meniscus

5)lens derives its nutrition from-aqueous humor✅
6)CYFRA 21-1 Tumor marker is elevated in-Non small cell ca lung✅
11-multiple sclerosis antibody against----myelin basic protein
12-amniotic fluid replacement by every ??----3hr
13-dukaoral vaccine ----cholera vaccine
14-dieulafoy's lesion---also called persistent caliber artery--->large-caliber arteriolar that runs                      immediately benath gi mucosa and bleed through pinpoint mucosal erosion -->mc n lesser
15-vossius ring- blunt trauma-ant capsule f lens
16-Haads straie---cong glucoma(bupthalmous)
17- Hoffman degradation --atracuronium
18-thiopentone sodium--..c/i ---porphyria
19-pugilistic attitude taken from--burns
20-Gartner duct remanant of---mesonephric duct in female

1.Dose of vit.c for t/t of scurvy? 200mg/day
2.Reticulocyte count falls to adult levels by? 2weeks
3.Inflation pressure for first breath? 25-40cm of h20
4.Antiviral used for acute bronchiolitis? Ribavarin
5.Volume of first breath? 30-67ml
6.Favourable sex in prognosis of ALL? Female

1.mees lines a/w?as
2.anti ige used in asthma?omalizumab used in bier's block?prilo
4.granisetron wch receptor antagonist?5HT3 antag
5.boiled lobster appearance seen in?boric acid toxicity
oral drug for lead poisoiningsuccimer
true aneurismpopliteal artery
crp not raised inOA
ramsted operationCHPS
maralgia pararsthesialateral cut. Nerve of thigh
strongest lig in our bodyiliofemoral
cell wall def bacteriamycoplasma
L form bacteriamycoplasma
paul bunnell testtube agglutination test
space of tuckerparaepiglottis
1.lift off test suscapularis
2.aeroplane splint brachial plexuses injury
3.undertaker # c6 c7
4.lisfranc# tarso meta tarsal
5.chopart# mid tarsal
6 esr dec in polycythemia vera
7 mc rhabdomyosarcoma - embryonal
8 mcc cause of breech ? Prematurity
9 bacteria Not follw koch ? M leprae
10 mercury affects which part kidney ? Pct
1 beevor sign seen in?
2. Not a complication of Bld transfusn> hyperkalemia/citrate toxicity/metab acidosis/hypothermia
3. T/t of kawasaki disease?
4. Test 4 reversible cardiac ischemia?
5. Gene therapy given for >CF/ Thallasemia/ SCA / SCID?
1.  Abdominal muscle in spinal injury b/w t6 to t10 levels✅✅
2. Metab acidosis✅
4. Thalium scan✅

1.1q: Which of the following is the weakest
support of uterus?
a.Mackenrodt ligament
b.Uterosacral ligament
c.Round ligament
d.Broad ligament
2q: Midgut is supplied by
a.Superior Mesenteric artery
b.Inferior mesenteric artery
c.Celiac trunk
d.None of the above
1 beevor sign seen in  Abdominal muscle , in case of spinal injury b/w t6 to t10 levels✅✅
5q: Foramen of magendie which is in midline
acts as an exit point of which of the following?
a.Lateral ventricles
b.Third ventricle
c.Fourth ventricle
d.None of the above
C✅ f eustachian tube frm horizontal line....35' f tucker seen in...larynx
3..chromosome responsible fe hereditory menieres ds???..6 n 14
4...m.c. nerve damage in maxilary #??infra orbital nerve
5...asteroid hyalosis composed f???...calcium
1. CA 15-3 is tumor marker fr? sinus malignancy in wood workers? cancer in males in india? solid tumors in children?
5.robinson s staging system is fr which cancer?
6.most important prognostic factor in neuroblastoma is?
7.all cancers metastasizs except?
8.fnac is absolutely c/i in which cancer
9. Mc radiation induced salivary gland tumor? breast mass in <50 yrs woman? breast
2.ethmoidal adeno ca
3.oral ca
4.brain tumor
5.renal cell ca
6.age at presentation
7.glioma of cns and bcc
8.testicular ca
9.muco epudermoid ca
10. Fibro cystic disease
1. Laser used in iridotomy is? CO2 Laser
2. Iris pearl seen in? Hansens disease
3. Annexin V associated with? Apostosis
4. Alpha oxidation of fatty acids takes place in?  Peroxisomes
5. Amino acid used in carnitine synthesis is? Lysine
14.artery involved in dysphagia lusoria?
Not seen after removal of testis
Loss of libido
Ms weakness
Decrease fsh
5. Vit Deficiency in breast milk
B complex
11. Inferior angle of scapula is at level of ?
12. Daily req of potassium is .....g/day ?
Yes 2-3 g/day✔
13. End product of purine metabolism is ?
Uric acid
14. Blood agar is an example of what type media ?

15. Xenograft means transplanting organs from ?
One species to another species ✔
17. World anti-tobacco day is celebrated on ?
May 31
In parous women vaginal delivery shape of external os
Vertical slit
Horizontal slit
in waldenstorm macroglobulinemia which immunoglobulin increase ?
A Ig A
C Ig M
D Ig E
Annular pancreas encircles the ?
A 1 st part of duodenum
B 2nd part of duodenum
C head of pancreas
D tail of pancreas
Bochdalek hernia ?
A anteromedial
B anterolateral
C posteromedial
D posterolateral
In warfarin therapy level of INR then goes to surgery ?
A 1.2
B 1.4
C 5
D 3.5
18. 85db for 8hr
19. 90db for 6hr
6 which is the most important n decisive factor in CPR ?
A O2 inhalation
B endotracheal intubation
C inj epinephrine
D defibrillations
D ???
7 which isotope is used for treating bone cancer ?
A Sr
B Ha
C Tc
D I 123
9 in lupus nephritis which type is most common n dangerous?
A 1
B 2
C 4
D 7
10 in R.A most common ocular manifestation?
A uveitis
B keratitis
C episleritis
D thrombosis
10 in R.A most common ocular manifestation?
A uveitis
B keratitis
C episleritis
D thrombosis
12 in multiple sclerosis most effective drug is
A natalizumab
B mitoxantrone✅
C beta interferon
D fingolimod
13 in kluver bucy syndrome lesion  occur at?
A occipital lobe
B amygdala ✅✅✅
C frontal
D temporal
9. Contrast agent used for mri?
10.type of calcificatn found in sturge weber synd?
Tram track
10.type of calcificatn found in tubersclerosis in skull xray?
Candle guttering
1.most useful in diag of splenic rupture? Usg✅☑
2.most malignant testis tumor? Chorio ca☑✅ complication of pseudo pancreatic cyst? Duodenal obstruction✅☑
5.hunterian ligature for? Aneursym☑✅
11.nalgonda technique for defluorinatn in what sequence?
Soda+ alum
Alum+ soda
6.plasma membrane of cell z bounded to cytoskeleton by?
7.daily requirement of k+ ?(gram per day)
8.cryptosporidium cyst identified by which stain in stool sample?
C.acid fast
D.h & e
9.mst effective therapy for acute lead poisoning
B.chelation therapy 
C.forced saline diuresis
D.removal from exposure
10.which z not a s/e of prostaglandins?
Convulsions 
12.when we say" the difference z significant " it means?
Its unlykly by chance when p< 0.05
13.Double apical impulse seen in
14.most effective rx of DKA z?
IV fluid
15.ochsner sherren regimen z used for?
Apendicular lump
4. Mc site of sialolithiasis? Submandi✅☑
1. Amphotercin B toxicity is monitored by -- Potassium Measurement
3. Local Anaesthetic in patient with Hepatic disease – Procaine
4. Granisetron – 5HT3 antagonist
5. Antiparkinsonian drug c antiapoptotic activity -- Selegeline
7.cotton's grading??
Sub glottic stenosis✅
koro syndromegenital retraction
magnan sydromecocaine
fox fordyce dzapocrine milleria
fordyce spotsebaceous glang
vegabond dzlouse
serus deluminous gland present insublingual n submandibular
cannabisrun amok
cannabis ka neurotransmitter in brainanandamide CB1
pons posterior relatiomcerebellar peduncle2 pair

. inferior angle f scapula is at??? T7
2..coronary bllod flow max during???...isovolumetric relaxation
3...arachnoid acid synthesis frm???linolic acid...
4.drug f choice fr absence siezure in child less than 2 yr???...ethosuccimide
5...doc fr JME???valproate
6...looop diuretics acts on ???thick ascendibg loop f henle f beds in phc fr indoor pt is???..6
8..double apical impulse in???HOCM...
9...effect on pottasium level in type 4 RTA??? HYPER K+....
10..stone present in which type f RTA??? type 1.....

1-alpha oxidation of fatty acids take place in?peroxisomes
2-amino acid used in carnitine synthesis?lysine
3-dna replication occurs in which phase of cell cycle??s phase
4-iodine uptake into thyroid gland is an example of which transport?secondary active transport
5-no of nucleus presents in mature cyst of e histolytica?4
1. three layers of the embryo formed at wht age ??
1. 21 days✅
1. Avg number of mites found on the body of a person suffering frm scabies is? 10-15
2. Orbital cellulitis occurs aftr which sinus infection? Ethmoidal
3. In #maxilla mc nerve involved is? Infraorbital nerve
4. Alkali injury to eye causes?  Symblepheron
5. DOC for acyclovir resistant hhv is? Foscarnet  type of urethral injuries? Bulbar
2.intra op fluid of choice fr irrigation while doin turp? 1.5% glycine symptok of primary biliary cirrhosis? Pruritus pathogen causin emphysematous chilecystits? Clostridium >e.choli cause of lower gi bleedin in india? Amoebic dysentry
6. Hinchey classification is fr? Perforation of colon due to diverticulitis site fr ectopic pancreatic tissue ? Stomach
 in froment sing which mus z tested ??
   ☑ add policic
 threthowan test z used to detect which cndtn ??
☑ scfe(sliped capital femoral epiphysis)
 volkman ischemia mc invopv
☑ flxr digitorum profundus
 looser zones z caracteristic f
☑ osteomalacia
loose bodies n bouchard's nodes ??
☑ osteoarthritis
NEET 2012
4p deletion
typical facial appearance-->Greek warrio r helmet facies
mental retardation growth delay
seizures (or EEG anomalies)
: Isha
thymus dev from
3rd arch
somite dev frm..paraxial mesoderm
foot plate dev frm reichert cartilage
c cell of thyroid derived frm ..ultimobrachial body
length of mature human spermatozoo...50 to 60micro
sperm after for stored in..epididymis
y chromosome z acrocentric
notochord dev in 3rd wk

1)Greater occipital nerve injection is used in treatment of
A. Migraine
B. Cluster headache✅
C. Temporal arteritis
D. Basilar insufficiency
2)Amifostine is
A. Fibrinolytic
B. Cytoprotective✅
C. Mucolytic
3)Drug used orally for scabies
B.sodium stibogluconate
4)In a hospital a bacterium was found to be growing inside dettol bottles,mostly it is?
5)Agent used in PET scan-2 fluoro 2 deoxy glucose✅
6)Term dementia precox was given by
Emil Kraepelin✅
7)Dimples sign is seen in
B. Pyogenic granuloma
C. Dermatofibroma✅
D. Keloid scar
8)Gunshot residue on hand can be tested by
Dermal nitrate test✅
9)Right subphrenic space is called-Morrison's space✅
10)Eosinophilic hyaline matter in bone
A. Aneurysmal cyst
B. Ewingd sarcoma
C. Osteoclastoma
D. Enchondroma✅    
11.beta hcg increases in gastroschiasis
12.warfarin in pregnancy causes..contradis syndrome
13.double test contains b hcg n pappa     
14. cryposporidium cyst identified by which stain - acid
15.anti-rabies vaccine prepared from- Fixed virus
16.blood agar example of - enriched media     
17.Northern blot test used for seperation of - Rna  
18.pseudomembranous colitis caused by- clostri. Difficle           
19.condition required for autoclave -121' C for 15min
 20.HIV primarily replicates in - T helper cells

6. Best time to do chorionic villi sampling is
7-9 wks
9-11 wks
11-13 wks
14-16 wks
C ?

 recurance rate f hellp syndrom
☑ 5%
 wharton jelly f umbilival cord derived 4m?'
☑ mesoderm
 crural index
☑ length f tibia/length f femur *100 (indian=86.49)
 cephalic index
☑ identificatn f race(indian=70-75)
☑ done with d help of nylon 10-0 suture (NOT VICRYL 10-0)
mc evan sign
Morbid jealousy
Magnan symptoms
Jet black toungue
Run amok
Paranoid halluci
Dissociative anasthesia site of genital tb? Fallopian tubes☑☑
16.coenzyme required for sulfite oxidase
17.alpha oxidation of fatty acid occur in
18.dietry fibers reduces atherosclerosis by
Binding to cholesterol
19.wood industry workers r at increased risk of
AdenoCA of para nasal sinuses
20.ohngren's lyn z related 2
Maxillary CA

Max. no. Of oocytes at 5th month in uteri
No. of oocytes at birth ✅ 2 MILLION
No. of follicles at puberty :-- 4 lack
Of them only 400 will ovulate during repro period

21.freys syndrome which nerve involved?
22.m/c site of felon
23.breast CA with best prognosis?
,D.tubular 
24.marker for small cell CA lung
25.m/c breech presentation
Left sacroposterior
7. Enz def in parkinson is tyrosine hydroxylase
8. Best confirmatory serological test for syphilis is fta abs
9. Significant weight loss is defined as
A 5% in 2-3 months
B 5% in 1-2 months✔
C 7% in 2-3 months
D 7% in 1-2 months
San 
Most effective rx in dka is
A insulin
B iv fluids✔
C sod bicarbonate
D kcl
20. exudative retinal detachment is seen in ?
a. high myopia
b. diabetes mellitus
c. eales disease
d. uveitis
21. brush burn is associated with ?
a. electrocution
b. arborescent mark
c. grazed abrasion
answer: grazed abrasion .
22.time limit for exhumation in india ?
answer: no time limit .
23. which of the following drugs used in HIV infection can be given subcutaneously ?
answer: enfuviritide .
24. what is the mechanism of action of maraviroc ?
answer: CCR5 inhibitor .
25. the drug with least extrapyramidal symptoms ?
a. haloperidol
b. clozapine
answer: b . clozapine .
26: confirmatory test for hydronephrosis ?
a. clinical examination
b. X ray
c. ultrasound
d. none
answer: c .
27. Calymmatobacterium is ?
a. gram positive
b. gram negative
c. acid fast
d. none
answer: b . gram negative .
28. Single umbilical artery is associated with ?
answer: congenital fetal anamolies .
29. all of the following cause definitive hemolysis in G6PD deficiency except ?
a. naphthalene
b. ciprofloxacin
c. primaquine
answer: b . ciprofloxacin .
30.what is the cause of jaundice in a new born ?
answer: erythroblastosis foetalis .

1.Koch triangle-Av bode
2.pregnancy-respiratory alkalosis
3.invertors tibialis anterior extensir hallucis longus
4.evertors peroneus longus brevis
5.thenar muscle supplied by ulnar adductor pollicis

3: Laryngocele arises from herniation through
a.Thyrohyoid membrane
b.Cricothyroid membrane
3 a benign tumour of bone - Osteochondroma
10. Most common true benign tumour of bone - osteoid osteoma
11. Mc benign tumour of hand bone - enchondroma
12 low lap score - cml and pnh
1. meileu int means ??? a. ecf b. icf  c. plasma  d. lymph
6.Most common tumour associated with
Neurofibromatosis I in children is?
D. JMML (Juvenile myelomonocytic leukemia)
5. Hba1c is dec most by ??a. bigunanides  b. sulfonylureas c. thiazolidinediones  d. acarbose ??
6. microtubule formation is inhibited by ??   a. paclitexel b. vincristine  c. etoposide  d. irinotectan
8...posterior staphyloma asso with???
a.patho myopia
c.psudo cornea
d.a.c. glucoma
2-hbA1c decrease most by? Sulphonylureas
3-drug use in post prandial sugar control?
15 cystic hygroma mc in turners
16 cvs done at wat tym completed 10 wks
17 pisaceks sign for lateral implantation in uterus
18 testis enlargement till wat tym in boys 91/2 yrs
19 smr 5 tanner complete maturation
20 youth is 15 to 24 yrs
 species f trichophyton z zoophilic
father f  modern toxicology
sub pubic angle in gynaecoid pelvis
(in android-60-75)
schwalbe's line
☑ pos limit f descemnt mem f cornea
term "mileu interior"  was givn by
☑claude bernard
 red cross foundr
☑ henry dunant
 populatn genetics principl givn by
☑ hardy weinberg
 father f orthopedics
☑sir nocolus andrey
 pop discovred by
hip arthroplasty
☑sir john charnley
 amount f maintanance fluid givn in a 10 mnth old child
A. 4ml/kg/hr
B. 10
C. 12
D. 15
26. Most lat deep cerebelar nucleus
dentate nucleus
27.intervertebral disc z example of
28.schrimer's test z used in evaluation of function of
Facial nerve
29.signs of CRF appear when renal fn z decreased by
More than 60%
30.most sensitive nd specific ab of celiac sprue
Antiendomysial ab
31.non oliguric renal failure seen with
32.prophylaxis against p.carinni needed when
CD4 count below 200
33.susceptibility bias removed by
34.rural health scheme was introduced by
Shrivastava committee
35.anti sachromyces cervessiae ab z found in
Chrohns dz
Nuys - breast ca
Nyhus - inguinal hernia
Thymic sail sign is pneumomediastinum ✅
Other is a/w shoulder disloc
7.button hole sign? Neurofibromatosus

1)Multifactorial inheritance seen in -CLEFT LIP✅
2)Atheroembolic phenomenon does not affect-LIVER✅
3)Fir tree appearance-Bacillus anthracis✅
4)Endothelial keratoplasty done in-Congenital corneal dystrophy✅
5)Plaque jaune-seen in cerebral contusion✅
6)Dye used to stain the ant capsule of lens
7)CysLT1 receptor blocker-Zafirlukast✅
8)Specimen of pseudopolyposis coli
9)DOC for madura foot-Voriconazole✅
10)Koro-false belief of retracting genitals✅
11)Preconscious state in which classification-Topographical classification of mind✅

8.inaccurate perception of existing sensory stimuli? Illusion
1. burkhoderia cepacia is infrequently seen in ??? a. pools  b. plants  c. soil  d. air
1. d✅
2. true abt wiskott aldrich syndrome ??  a. primary defect is  b cell def  b . prim def is t cell defect  c. wasp gene mutation d. defect in phagocytosis
2. c ✅
4. all of the following are used in atrial arrythmias except :  a. digoxin  b. verapamil  c. quinidine  d. lignocaine
5. cyclopropagative type of life cycle is seen in ??  a. cholera  b. filaria  c . plague  d. malaria
5. d✅
16. Cephalic index fr indians?
17. Most senstive period fr develpment of amblopia
a.first 6 mnths of age
b """" 1 year """"""
d. """"" 5yrs """"""
16. 70-74.9
17. A
1-doc for acyclovir resistant hhv??foscRnet
22-doc for diarrhea in AIDS?? Octrotide
23-doc for neurogenic diabetes insipidus.? Desmopressin
24-doc for CML? Imatinib
25-HIV which is found in west African? HIV 2
1 absolute indic for cesarean is cpd
2. Brow presentation seen with mentovertical engagement
3. Vertical transmission of hiv risk 14-25%
4. Hiv transmission via breast feeding - 14% risk
5. Vaginal ph least is during pregnancy

 gas reaches colonic end in a newborn by ??
☑8-10 hrs
cozen test don 4
☑ tennis elbow
 most resistant mus to nm blokage
 tensn band wiring used for
☑ olecranon (displaced oblique #)
 salt n papr pot appearance f skull
☑ hypr parathyrodism
eale's dz z
☑ recurrent vitrous hmrg
 cystatin c z used for
☑ dignosis f arf
( also used in - cardiovascular dz n alzhemr dz)
bld glu in childrn >2 mnths with hypoglcemia z
A. <40 mg/dl
B. <45
C. <50
D. <54
13.absorption increased by fatty food - griseofulvin
14. White infarct is seen in heart spleen kidney
15. Asteroid bodies- sarcoidosis
16. Gamma gandy bodies not seen in secondary billiary cirrhosis
24. Dazoxiben is a?
A.cox inhibitor
b.thrombaxane a2 inhibitor
c. Factor 10 a inhibitr
d. Thrombin inhibitr

1.Chorda tympani is
a) Sympathetic preganglionic
b) Sympathetic postganglionic
c) Parasympathetic preganglionic ✅
d) Parasympathetic post ganglionic
2.Which of foll is supplied by abdominal aorta
a.accessory lung lobes
b.brochopulmonary segment
c.sequestred lung tissue✅
d.base of lung
3.Not a composite muscle
a.adductor magnus
4.Inf thyroid vein drains to jugular V
c.ext jugular vein
d.brachiocephalic v✅
5.All lie betn 1st rib and apex of lung except
a.thoracic duct✅
b.sup. intercostal artery
c.symp trunk
d.first post intercostal V
36.gotron's sign z a feature of
Dermatomyositis fordyce dz affects
Apocrine sweat glands
38.lidocain which z used with adrenaline in concentration of
1: 200000
39.anesthetic agent excreted by kidney z
40.arthritis multilans seen on X-ray in
Psoriatic arthropathy
41.cranial irradiation z given in
Small cell ca of lung
42 distant Mets of bone can b best detected by bone scan
43.earliest sign of raised ICT z
Erosion of dorsum Sella
44.septal hematoma z treated with
Incision nd drainage
45.kisselbach's plexus dsnt involve
A.ant ethmoidal a. ethmoidal a.  √√
C.sphenopalatine a.
D.greater palatine a.

coloboma of iris m/c in ?inferonasal part
UGA stop codon codes for which AA?
BCG Is for tx of whoch ca?ca bladdr
HHV 8 causes?
kaposis sarcoma
first L forms were seen in?streptobacillus monaliformis
longest duration cu t?

1.m/c cause of pid in iucd users? Actinomyces
2.m/c infection a/w early abortions? Mycoplasma
3.Fetal growth is max affected by? Insulin
4.Most imp form of estrogen? Estriol
5.Desogestrel is? 3rd gen progesterone
6.Sialistic vaginal ring contains? LNG 20mg release daily
7.Least failure rates in tubal ligation are seen with? Bipolar cautery
8.Most specific marker fr early detection of NTDs? AchEstarase
9.Major source of amniotic fluid? Fetal urine
10.Pea souped amniotic fluid is a feature of? Fetal distress

1-major role of 2,3 bisphosphoglycerate in rbc? Release of oxygen
2-wolf chaikoff effect is seen due to??  Inhibition of organic binding of iodide
3-physiological dead space?? 150 ml
4-in JvP, a wave is due to?? Atrial contractions
5-ach is secreted in eye from?? Amacrine cells
6-hematopoietis first start in? Yolk sac
7-circardian rhythm is controlled by? Supra chiasmatic nucleus

1. Mc lung ca in world - adenocarcinoma
2. Mc lung ca in india - scc
3. Mcc of chronic metb acidosis - ckd
4. Whitaker test is for Hydronephrosis
5. Mc site of edh - temporoparietal region

1.deep peroneal n. provides sensory inervatn to
--> 1st web space
2.sesamoid bone present in
--> adductor pollicis
3.proximal tubules have
--> aquaporin 1
4.tick born relapsing fever z caused by
--> borreila hermsii
5.tarsal tunnel syndrome z caused by which arthritis?
--> RA

 housing scal devloped 4 rural
✅pareek (also prasad 's scale)
Kupuswamy for urban
dying declaratn cms undr
✅sec 32 iea
 max o2 conc attained in venturi mask
(nasal canula 44%)
earlirst feature f tubrs sclerosis
✅hypomelanic macule(ash leaf spot)
length f umbilical cord
✅30-100 cm (~50)
 nerv terminal or synapse  release chemicals- discovered by
✅ otto  loewi
5. Max conc. Of secreting cells in ant pituitary is somatotroph 50 %
6. Minimum concentration is of thyrotrop 5%
7. Recurrent hemoptysis .xray normal. Next step hrct
8.duchene muscle dystrophy presents with mental retardation also.. absent in beckrs
9 sphenoid wing dysplasia - nf1
10. Max benefit in multiple sclerosis is by mitoxantrone but bcoz of side effects not used
11 doc of multipl sclerosis - ifn beta

MC cause of acute  infantile gastroenteritis ? Rota virus                    
 true about Turner syndrome ? Normal intelligence                           
 MC cause of death in klienfelter syndrome?  Infection                      
in females , maximum growth spurt occurs ? Tanner breast stg 3, axillary stg 3                          false about Wilms? Presents at age of 5 years                                  
most common thyroid tumor in children? Papillary ca                    
what should be given first in severely malnourished child?  Dextrose                                     amount of fluid given in 3 year old child? ???                                   
fast breathing in a child ? > 40                                        
cong rubella causes - deafness , cataract , cardiav defect (except- hydrocephalus )                                    
gas reaches colonic end in newborn at end of - 8-10 hrs                                  
5 year child with enlarged liver , uncontrolled hypoglycemia & ketosis .      Most prob. Diagnosis? Glycogen storage disease                                    
response not seen in newborn as measure of thermogenesis? Shivering                               
large dose of vitamin K in newborn causes? Hemolytic anaemia                              
which does not cause pneumonia? Mumps                               
Mx of 1 yr old with imperforate anus & meconuria?  Diversion colostomy with sleeve resection followed by pull through                                   
true about vitamin D resistant rickets? Defect in proximal tubular reabsorption                                 iron &folic acid required for 6mth to 10yrs old child ? 20 mg elemental iron & 100 microgram folic acid                  
 not a common feature  of DMD ? Distal muscle involvement                      
 as per RCH 2 vit. A dosage at 9th monthof  age? 1lakh units                        
female child with hypertension, hyperpigmentation & virilization , she is most likely suffering from? 11 beta hydroxylase deficiency                             
hypoglycemia in infant >24 hrs of age defined as blood glucose ¿?>45 mg/dl                  
true about alpha 1 antitrypsin ? Severe pulmonary disease                 
Mc cune-albright syndrome characterised by? Cafe -au lait macules
xiphoid process fuses to d bdy f strnm at
✅40 yrs
manubrium fuses to d bdy f strnm at
✅60 yrs
 uveoparotitis(herfordt's sx) seen in
siffert katz sign seen in
✅blount's dz
8.21st amino acid ? Selenocystine
9. Most non polar a.a ? Leucine
10.melatonin is sunthesized frm? Trytophan
11.mealanin frm ? Tyrosine
12. Restin miscles preferrd fuel ? Fatty acid

1.nephelometry z based on the principal of
L8 attenuated in intensity by scattering
2.RNA polymerase recognize
Promotor site
3.Neurohypophysis contains
Herring bodies
4.Max vit c found in
Adrenal cortex csf comparison to blood plasma are all except
A.low CA++
B.low Na+
C.low Cl-   √√√
D.low cells
6.fn of stepedius
Protects ear from loud frequency sound
7.mcc of acute RVF
Massive pulmonary embolism
8.not seen in complications of blood transfusion
Met acidosis
9.1st drug to be used in absence seizures
10.rx of choice glue ear
Myringotomy with ventilation tube insertion

1..vestibule f vagina developed frm???....urogenital sinus
2...anti d to rh incompeteble woman given on which muscle???deltoid
3...pappaenheimer bodies composef f???  iron
4.. most specific marker f SLE???  anti smith ab...
5..most sensitive marker f sle??? anti ds ab..
6...most accurate marker f sle???anti ds ab...

Which vit essential for met f sulfr cntaining a.a
✅ folic acid
coronary blf flow z max during
✅isovolumic relaxatn
which isotop used for rx bone can
tapetum z part f
✅corpus callosum
von ebner glands mainly present in

1. Satellite lesion seen in which corneal ulcer ? Fungal
2. Earliest ocular sign in acoustic neuroma is ? Loss of corneal sensation
3. Uveoparotitis is seen in ? Sarcoidosis
4. Secondary vitreous develops from ? Ectoderm
5. According to who, blindness is visual acuty less than ? 3/60
5. . which of the following stage of taenia solium is infective
stage to pig?
a. eggs
b. cyst
c. inverted scolex
d. everted scolex proglattids
Double apical Hocm ✔
Blue sclera marfan rarely 

dnb 2007 recall
1.Glycosylated Hb represent glucose control over :
a.2 days
b.2 wks
c.4 wks ?ans:: 6-8 wks
d.not time dependant
212.T1/2 of I 132:
a.8 hrs
b.8 days
c.2.3 hrs - ans✅
3.Pink secretion & pigmentation is caused by:
a.clofazamine -ans✅
4.True about amebic liver abscess a/e:
a.caused by e.histolytica is invasive disease caused by e.dispar
c.pus is not always anchovy chocolate type
5.OCP efficacy decreased by :
a.rifampicine -ans✅
6.HIV treatment of a pt. Who had contact with a advanced case of AIDS :
a.zidovudin for 4 wks
b.zidovudin & lamivudin for 4 wks 
c.zidovudin,lamivudin & nelfinavir for 4 wks
7.Following is a prodrug :
Prodrugs :: All ACE inhibitor except captopril & lisinopril
8.Following can be given in Renal failure :
a.doxycycline -ans✅
9.suprasellar tumor with calcification:
b.craniopharyngioma -ans✅
10.Best prognosis among following is :
c.meningioma -ans✅

1. Loosers bone - osteomalacia
2.octrotide not given orally
3. Ewings intramedullary tumour
4.arias stella reaction seen in both normal and ectopic pregnancy
5. Max dose of lignocaine for spinal anesthesia is 100mg
6. Dose of morphine in pre anesthetic medication- 10 mg
7 arthroscopy c/I in hemophilia.
8 clotting factor present in serum -factor7

Xanthine oxidase cofactor-Molybdenum✅

In intermittent porphyria what is present in urine?
Enterobius commonly inhabits
Prolactin secretion stimulated by-
Urban health centre caters to a population of-
1)10 lakhs
2)1 lakh
Size of dust regarded as health hazard
1)0.1-0.3 microns
100% Oxygen not effective in
1)pulmonary edema
CVP is usually meaured in
4)Subclavian vein
MC post op compli of intubation
2)sore throat✅
4)abductor paralysis
which has max t1/2
1) I131✅
2) I132
3) I123
4) all hav equal
1st stage f lung developmnt z ?

1. Action of palmar interrossei - adduction
2. Winging of scapula is due to injury to - n to serratus anterior
3. Coronary blood flow max in isovolumetric relx phase
4. Mc site of morgagnian hernia is right anterior
5. Corkscrew esophagus - des

1 antagonist of  benzodiazepines? Flumezanil
2.oxytocin antagonist? Atosiban
3. Min age for organ donation in India? 18yrs
3. Contributary negligence is by part of? Both doctor and patient
5. Mc site of perforation of tymapnic memb in ASOM ? Ant inf quadrant

1...emergency contraceptive contain??? Lng
2...metastasis to lung in gestational trophoblastic ds is good or bad prognosis????
3...ecthyma gangrenosa by ??? Pseudomonas
4...psoriasis affects!?? Extensor surface
5... First order neuron in  visual pathway??? Rods n cones
6... PFA std fr food quality std  by govt f india indicates minimum level f quality....
7...accuracy given by???
   LJ chart

1.Which vit essential for met f sulfr cntaining a.a
Ans. folic acid
2.coronary blf flow z max during
Ans.isovolumic relaxatn
3which isotop used for rx bone can
4tapetum z part f
Ans.corpus callosum
5von ebner glands mainly present in
1. Section for rash and negligent driving is ? 304 a ipc
2. Brain stored in which preservative for autospsy study ? 10% formalin
3. Underwater autopsy of the heart is done in ? Air embolism
4. Blood samples for dna fingerprinting should be transported in ? Edta
5. Four carpal bones are present at what age ? 4 yr
 in cmplt clft d hard papate z totly seprated 4m
✅ vomer
 xanthesma bupbar all r true xcept
✅A.dots occuring on lateral side f eye
B. Middl age women
C. Creamy yellow in color
D. A/w diabetes
 in india, splenectomy z most cmnly performed for
✅ trauma
 sphincterotomy f sphincter f oddi z prformed at
✅ 11 o clock positn
(to avoid injury to pancreatic duct)
 transmitn f hiv by BF
✅ 10-15%
Most common post prandial motility is seen in ?
A ascending colon
B transverse colon
C descending colon
D sigmoid colon quervain's dz classically affects Extencer pollisis brevis and abducter pollicis long us
2.heberden nodes seen in DIP joints in OA
3.internal podalic version done for Transverse lie of 2nd baby in twince
4.infertility d/t chlamydia bcz of Salpingitis
5.mcc of vaginal bleeding in neonate z Hormonal
6.delusn z disorder of thought
7.HIAA z metabolite of Serotonin
8.antipsycotic induced akathisia char by? Restlessness
9.lingual block site z Mandibular foramen
10.helmich valve z for drainage of Pneumothorax

INR of warfarin?
Brunner's glnd prsnt in
✅ duodenum
 EMLA cntain
✅2.5% lignocain n 2.5% prilocaine
boyle appratus 1st dvlped in
frog eye appearance in usg
✅ anencephaly
x ray f closed pnemothorax z don at
✅full expiration
 Mcrobert manoeuvr z 4
✅shouldr dystocia
hb f at 4 mnths intrauterin life z
✅ 80% f total
 bile pigmnt consist what % f total bile
✅ 3%
 tonic labyrinthin reflex z integrated at
✅ medulla
thickest nerv f d body
✅ sciatic