Tuesday, 25 November 2014

Hodgkin's lymphoma


Most common lymph node affected - cervical lymph node.
WHO classification ( 2 types on the basis of Reed Sternberg cells)
A) CLASSICAL—(following 4 subtypes)
Best / most specific marker for classical RS cells - CD 30 (100% of classical HL). 
Other markers CD 15 ( 75-85% ), PAX 5.

• Most common HL (world)
• Mediastinal involvement most common in this HL.
• Male and female are equally affected ( other HL, males are more commonly affected)
• Lacunar reed Sternberg cells are seen (cytoplasmic lacuna formed due to tissue fixation artefact )
• “Collagen Bands” are forming nodules in Lymph nodes.

• Most common HL in India
• Maximum RS cells are seen.
• Least common type of HL
• RS cells (various names) ---pleomorphic / Mummified / necrobiotic
• Worst prognosis

• Minimum RS cells are seen.


• Popcorn RS cells (or lympho - histiocytic (L&H ) RS cells )
• Immunophenotyping- CD 20 (=BCL6+ve), CD 45, CD 79a, EMA (Epithelial Membrane Antigen)
• Best prognosis amongst all HL.

‪#‎HIGH‬ yield info about HL:-

• EBV and HIV infections ,both are most commonly a/w(amongst Hodgkins lymphoma subtype)----MIXED CELLULARITY (HODGKINS LYMPHOMA)
• HIV associated Hodgkins Lymphomas are ----
mixed cellularity (most common)
nodular sclerosis and 
lymphocyte depleted
• EBV not associated with HL—
1) Nodular sclerosis
2) lymphocyte predominant

Saturday, 22 November 2014

Aiims nov 2014

1. Harakiri - suicide by stabbing abdomen
2. H-reflex - to test S1 nerve root
3. Mc method of parasuicide 1)cutting wrist 2)hanging 3) drugs
4. 1st disease to be described based on deficiency of a single neurotransmitter - parkinson’s/huntington/alzheimer/schizophrenia
5. psych patient with epigastric crepitus, alopecia, vomiting - Trichobezoar
6. drug not given in alcohol dependence - phenytoin/disulfirum/acamprosate ans-disulfiram
7. Congenital cataract - CRYAA gene
8. time dependent and post antibiotic effect - clindamycin (repeat)
9. turkish saddle/sella turcica - pituitary
10. pic of bullous pemphigoid
11. Wrong about GIST? MC mesenchymal tumor of intestine, from cajal cells, prognosis depends on size, ALK mutation ans - alk mutation in neuroblastoma, RCC
12. fatal dose of arsenic is 100-200mg
13. abatecept is used in rheumatoid arthritis
14. schwannoma - antoni a and b bodies seen
15. cri du chat - chromosome 5
16. lithium toxicity occurs at >2?
17. false about NSAIDS: decreases effectiveness of antihypertensives/used in neuropathic
18. /causes renal failure/can be used topically - ans - used in neuropathic pain?
19. long term followup of intraocular foreign body is with ERG
20. Not used in hyperkalemia - beta antagonist
21. Child with k/c/o bronchial asthma comes with resp distress rate 48/min cant speak 2 words,occasionsl wheeze.Saturation 95%you give 3 doses of salbutamol nebulisation then he started to speak a sentence but saturation falls to 85% A.VP mismatch B.R to left shunt C.Due to salbutamol D.Faulty pulse oxymeter ans - VP mismatch
22. arteritis not seen in adults - kawasaki
23. question on gout arthritis (repeat)
24. apoptosis caused by glucocorticoids (repeat)
25. exploratory burr hole technique - opposite to side of dilated pupil/ left temporal ans - if no localizing signs, hole in left temporal(dominant lobe)
26. life style choice to increase fertility are all except? decrease weight/increase weight/decrease exercise/veg food ans -
27. drug not causing edema - nsaid,digoxin,estrogen and cyclosporin? ans - cyclosporine?
28. child with chronic cough h/o TEF correction. h/o cough from day of surgery. tracheomalacia/subglottic stenosis/asthma ans - tracheomalacia (Arun Babu)
29. 7 month child vomiting after fruit juice feeds. enzyme defn to be evaluated? aldolase/hepatic kinase?
30. major risk of disk battery stuck in nose? local toxicity/tetanus
31. Not true about malignant otitis externa - granulation tissue in superior wall/ MC presents as severe deafness/ - ans
32. Not true about rhegmatogenous retinal detachment - can extend upto ora serrata/ surgery is the primary treatment/pull of vitreous (?)
33. asbestos exposure, mass in upper lobe - mass with long villi (repeat)
34. t3 laryngeal CA treatment - concurrent chemoradiation (repeat)
35. pellagra like dermatitis, AR - hartnup disease
36. picture of thyroid nodule 2x2 cm - biopsy - papillary/follicular
37. FNAC cannot distinguish btwn follicular carcinoma
38. picture of kidney biopsy after death of a patient with ureteric obstruction - pyelonephritis with hydronephrosis/ADPKD/cystic dysplasia
39. child with respiratory distress at birth. displacement of trachea, - congenital lobar emphysema/TTN/pneumonia ans -cong lobar emphysema (Arun babu)
40. fungal keratomycosis treatment -silver sulphadiazine/ Linezolid/Vancomycin/Doxycycline silver sulfadiazine?
41. girl visits a village, meningitis and death in 5 days. organism - naeglaria fowleri
42. Calibre - distance between two lands of a rifle
43. receptors for noxious stimulin in intestine/spleen/liver/mesentery - ans - mesentery
44. all are given in abnormal uterine bleeding in 13 year old except - E+P, P, tranaexamic acid, mefenemic acid - ans - mefenemic acid (mostly anovulatory)
45. Panniculus adiposus is seen in eye lid/orbit/penis/scrotum - ans - orbit
46. glass piece injury in forefinger - first investigation - plain radiograph
47. 1st line in management of female child abuse with severe bleeding from perineum - blood transfusion/airway - ans - airway (Arun Babu)
48. Not a vaccine derived polio virus - aVDPV, cVDPV, mVDPV, iVDPV ans - mVDPV
49. Intake of excess calcium causes - milk alkali syndrome/osteoporosis/osteomalacia - milk alkali syndrome
50. newborn has not passed meconium for 48 hours , investigation of choice - lower gi contrast study
51. most dangerous finding in 10 day old neonate - increased unconjugated bilirubin ..its conjugated bilirubin
52. child with white stools, icterus in eyes. next best investigation - USG/ CT abdomen/liver function tests - ans - USG?
53. PTSD treatment of choice - CBT?
54. Wrong about paclitaxel - stablizes spindle/most important toxicity is bone marrow suppression/
55. subretinal demarcation lines( high water marks ) is seen in - acute retinal detachment/chronic retinal detachment ans - chronic rhegmatogenous RD
56. wrong about rituximab - anti CD20/dose independent kinetics/infusion reactions
57. ideal time for elective caesarian section - 37/38/39.40 weeks. Ans - 39 weeks. (Acog)
58. 16/f with nodulocystic acne - treatment of choice - isotretinin/acetretinin
59. sunray appearance in osteosarcoma is because of periosteal reaction?
60. most efficient anti larval measure in urban areas - clean drainage/close overhead tanks/cover pits
61. rough estimate of infant population in a village - follifer tablets consumed in the past one year?
62. picture of acne rosacea
63. picture of taenia versicolor, next step - KOH smear
64. Head injury with CSF rhinorrhea - conservative managemnt for 4-5 days?
65. MC method of parasuicide - drug/slit wrist
66. technique to visualize biomolecule - xray crystallography?
67. every 10th person is selected from a population - systemic random sampling
68. muscle pain after day care surgery with propofol and Sch - Sch
69. features of colles fracture are all except - volar tilt/distal displacement/radial displacment/supination
70. normal height with absent pubertal features - Pure gonadal dysgenesiis/Kallman/testicular feminisng syndrome/turner ans - Kallman
71. not seen in fungal corneal ulcer - photophobia more than signs
72. 3rd generation cephalosporin with anti MRSA - ceftriaxone/aztreonam/cefazolin/ceftabiprole
73. marker for diagnoising acute hepatitis B - IgM antiHbC
74. nurse with HbSAg and HbEAg - acute infectious hepatiis
75. breathing circuit of choice for spontaneous ventilation - Mapleson A
76. component of normal ageing is all except - dementia/pseudodementia/amnestic syndrome/delerium
77. not included in mental health act 1982? minimum mental health care for all 2)human rights of mentally ill 3)application of mental health knowledge in health care. 4) provision of mental health services to all
78. dexmedetomidine - centrally acting alpha 2 agonist
79. esi act correct?⅛ state (repeat) (repeat)
80. TOC for tension pneumothorax - needle in second intercostal space (repeat)
81. all are true about sphincter urthrae except -
82. 12 year girl , child abuse, fracture pelvis, bleeding, treatment? 1)blood transfusion, 2) airway,
83. sickle cell anaemia (repeat)- single nucleotide mutation
84. g+ bacilli causing meningitis in new born-listeria?
85. intusseception-red colored stools 6 month baby
86. pre malignant except? peutz jagger, ulcerative colitis, crohns, barrets esophagus.
87. 70 year male , routinely doing gauic test, fresh bleeding ,toilet bowl fullfatigue, pallor, diagnosis? hemrroids, early colon ca, diverticulitis
88. rt illiac fossa mass and aching pian anaemia in 50 year old male- t.b?appendicular mass,ca
89. middle age female with lytic bone lesions , fracture clavicle , periosteal resorption of 2 nd 3 metatarsals? renal osteo dystrophy, ostomalasia, hyper parathyroidism, hyperthyroidism
90. pronation of foot angles parallel?
91. drug not given in hep B? zydovudine, entacavir, lamivudine, telbivudine ans - zidovudine
92. Elective caesiarian -(?)38 weeks
93. Le Veen shunt . ascitis, SVC renal pelvis, ans - SVC
94. EDD 5% @40 weeks, 3 weeks SD, 60%, 80%.
95. facial colliculus deeper? abducent nerve?
96. Self tonometry -Rebound/Perkin/Diaton ans rebound tonometry
97. Brechner and Bethune associated with -Et CO2 Precordial dopler, Trans oesophageal echo cardiography,Plethysmography Probable answer Et CO2
98. Concentration and Attention? parietal, frontal, thalamus ans - frontal lobe
99. Tuberous Sclerosis all are seen except -Ependymoma/ white matter lesions/ giant cell astrocytoma/ sub ependymal nodules ans - ependymoma/white matter lesions?
100. membrana tectoria is a continuation of anterior longitudinal ligament\anterior ans - posterior longt ligament
101. Child with “no pneumiona” (repeat)
102. False about obstructive sleep apnea. it affects more women/ a/w hypertension/ day time sleepiness/ >5 episodes/hour ans - it affects more women than men
103. significance of mucoid strain pseudomonas aeroginosa - produces biofilms?
104. 90% association with HLAB27 is seen with ans - Ankylosing spon
105. Not an abdominal method of tubal ligation - pomeroy/parkland/essure/irving ans - essure
106. Person suffers seizure on waiting for train. Has band showing him to be epileptic and the meds he takes. Meds are in his pocket. So what should you do? 1. Take person away from train make sure he does not fall meanwhile call for medical help and transfer to hospital 2. Take person away from train stuff handkerchief in his mouth hold his hands and feet till seizure subsides then tranfer to hospital 3. Take person away from train make him lie down hold his leg up give the meds and water then transfer to hospital 4. Take person away from train give meds and water then transfer to hospital ans - 4.
107. triad of angina, syncope and … ans - aortic stenosis
108. all are matched correctly except - tachypnea - acidosis
109. painless loss of vision with raised iop (60) - glaucomatocyclitic crisis
110. discharge from umbilicus while crying - urachal fistula
111. microbe with ET, EH, EP strains - E.Coli
112. Steroids contraindicated in antrochoanal polyp (repeat)
113. all are true except - ans - desmin marker for sarcoma
114. severe MS on auscultation - all are true except loud S1/S3/ opening snap- ans - S3?
115. timing for repair of cleft palate - 6-9 months, 9-12 months, 15-22 months
116. bone dysplasia - fault in development
117. microvesicular fatty liver in reye’s syndrome is due to defect in beta oxidation
118. 40/M presents with primary infertility and absent vas deferens. ans - CFTR mutation
119. all are complications of post adenoidectomy except - hyponasal voice/Grisel syndrome/velopharyngeal insufficiency/retropharyngeal absess
120. not a long term side effect of PPI? hypothyroidism/osteoporosis/pneumonia/c.difficile infection ans - hypothyroidism?
121. treatment of advance prostate ca - goserlin (repeat)
122. MALT is located MC in stomach/ileum?
123. chairman of district blindness society -district collector/district programme manager/district medical health officer/opthalmic surgeon district collector
124. laser trabeculectomy is used for chronic angle closure/chronic open angle ans - chronic open angle glaucoma
125. sleep spindles and Kcomplexes in stage 2 NREM (repeat)
126. similar to albumin in molecular weight MW 30000 and can cause less reactions but should be cautious - dextran/HES/polygeline/polyphloridone Ans Poly geline
(Page 645 of new Tripathi Book)
127. Penicillin G is given for rat bite fever (repeat)
128. grey white mass in central bronchus with distal bronchiectasis/pneumonia ans - histopath of carcinoid
129. not used in dilated pupils - gonioscopy (repeat)
130. APLA syndrome patient routine treatment to prevent abortion ans- LMWH + aspirin
131. afro american with c/f of sickle cell - single nucleotide mutation
132. investigation of choice for child with appendicitis - USG?
133. Measuring variation between different units- variance, coeeficient of variation, standard error of mean. Standard deviation. Measuring variation between different units- variance, coeeficient of variation, standard error of mean. Standard deviation. Measuring variation between different units- variance, coeeficient of variation, standard error of mean. Standard deviation. ?
134. death from post influenza pneumonia. most common cause? CMV/Staph aureus
135. reason for H5N1 influenza not becoming a pandemic - man to man transmission is rare
136. mechanism to measure single ion channel - iontophoresis/patch clamp technique ans - patch clamp technique
137. category B drug in pregnancy - brimonidine/latanoprost/pilocarpine/dorzolamide ans -brimonidine
138. 3 days after taking haloperidol, schizophrenic patient with rolling up of eyes - acute dystonia
139. augmentation of labour , all are true except - oxitocin is contraindicated in twins/ methods of augmentation does not increase the risk of operational managment - ans - methods of augmentation does not increase the risk of operational management
140. all pass through foramen ovale in picture except - maxillary nerve
141. school closing in influenza epidemics. which is not recommended?
142. all are made of dense regular collagen except? tendon/ligament/periosteum/aponeurosis ans - periosteum?
143. elevated lactate in traumatic brain injury. all are true except? uptake of lactate from circulation/increased lactate a/w bad prognosis/
144. nephrotic syndrome patient after diarrhea presented with acute kidney injury with creatine 4.5. all are possible reasons except? renal vein thrombosis/diarrhoea water depletion/frusemide water depletion/steroid induced diabetes ans - steroid induced diabetes?
145. counter current mechanism is seen in all except - thin desending loop, thick ascending loop, collecting duct, vasa recta ans - thick ascending loop
146. all are true about sphincter urethrae except? located at bladder neck, pudendal nerve supplies it, voluntary, origin from ischiopubic rami ans - located at bladder neck
147. all are used in epigenetic studies except - hplc, bisulphite sequencing, Chlp-chip and chip-seq ans - hplc
148. non typable h. influenza can cause all except - meningitis, otitis media, puerperal infection ans - meningitis
149. true about viral antibodies? formed before intererons, formed against nuclear sequences…
150. stimulated in knee jerk reflex? static bag and chain muscle spindle, golgi tendon, golgi tendon and muscle spindle, dynamic intrafusal fibres
151. all are true about dengue hemorrhagic fever except? malnutrion is protective/lamivudine is drug of choice ans - lamivudine is drug of choice
152. true about idiopathic non specific pulm fibrosis good prognosis/honey comb lung/male predominance/elderly- ans - good prognosis
153. TOC for C. difficile - oral vancomycine (repeat)
154. commonly seen mutation in cancers? methylation of tumor suppressor genes/ demethylation of tumor oncogenes ans - methylation of tumor supporessor genes
155. Under ICDS, pregnant women are given - 300kcal + 15gm protein (MH repeat)
156. exercise in study of correlation between smoking and heart disease - confounder?
157. investigation of choice in acute head trauma - NCCT
158. Chandler’s index. all are true except? can be used for monitoring treatment?
159. benign tumor breast histo - tightly bound with dycohesive nuclei(repeat)
160. normal value in EOG - >180% (>1.8)
161. followup of vision in intraocular metallic foreign body - EOG/ERG/Arden index
162. Not true about autism - ⅔ are mentally retarded/poor eye contact/ language developement delay/dermatoglyphic abn ans - dermatoglyphic abn?
163. anesthetic for day care surgery - propofol (repeat)
164. MC site of osteoporosis in hemiplegic patient after one year? humerus/ proximal femur/radius/lumbar verterbrae
165. raised htn bradycardia - cushing’s triad
166. which of the following is true about meniere’s disease ? surgery is the treatment of choice/ some manoever
167. guiac test negative, fresh blood in stools - dilated veins in colon
168. all are tertiary amines except atropine/glycopyrrolate ans - glycopyrrolate
169. brethcer and bethune research a/w EtCO2 device
170. all are carried by dorsal column except pain (repeat)
171. NPCB outcome indicator? decreas in prevalence of blindness/ no. of people with improved vision following surgery
172. all are components of collagen except glycine/lysine/proline/desmosine ans - desmosine
173. all of the following can be used for embolizing mass in thigh except? absolute alcohol/polyvinyl alcohol /gelfoam hemostasis
174. all are absolute contraindications to corneal transplant except? death from rabies/ tb meningitis/ unknown cause of death ans - tb meningits?
175. RNTCP diagnosis is based on sputum microscopy
176. lucent defect in tibia lined with sclerotic bone - fibrous cortical defect
177. Not a method to increase ventialtion in patient on ventilator? make him prone/ increase PEEP
178. rheumatic fever is not associated with pulmonary stenosis (repeat)
179. women pulled hand of child - pulled elbow
180. Inability to carry out any activity without discomfort- NYHA grade 4
181. type of hypersensitivity in transfusion reaction following penicllin adminsitration - type 2?
182. true about inertialization is all except? use cement/ increased water contamination/ for drugs/ ans - increased water contamination?
183. Not a type of lichen planus - lichen scrofulasium
184. homicide case ,doctor should inform police crpc 39
185. definition of population attributable risk
186. not a marker of heart failure? crp/sirtuin/bnp/troponin
187. most effective drug in severe falciparum malaria - quinine/cholorquine/artesunate ans - quinine?
188. discharge pv / chlamydia? presentation. most sensitive test for diagnosing? nucleic acid amplification test/ gram stain ans - NAAT?
189. all are true about patient perceiving different size images except? because of unequal convex lens/ because of use of cylindrical lens/ called anisekonia
190. MCC corneal edema in hypoxia? co2, lactate, pyruvate ans -?
191. gold standard for diagnosis of bronchiectasis? HRCT chest
192. cataract surgery rate. its a rate/ target is 3000/1 million
193. screening test is used for all except endometrial sampling for endometrial CA (repeat)
194. MHC 1 and MHC 2 for antigen presentation (repeat)
195. all are true about entamoeba histolytica except stool trophozoites are essential for diagnosis, cause disease in brain, liver ans - stool trophozoites are essential ?
196. Bilious vomiting in child. Investigation of choice - USG/CT/
197. MCC vocal cord palsy in adults - surgical trauma
198. brief high frequency stimulation of hippocampus with 5Hz produces? long term potentiation, post tetanic potentiation, depressions. ans - long term potentiation

Thursday, 20 November 2014

Exam recalls

1. Dawson finger- Multiple sclerosis
2. Snow storm app (knee) ' Synovial chondromatosis
3. Topoisomerase 1 Ab - Diffuse scleroderma
4. SEARO head quarter - Delhi
5. Paranasal sinus investigation ct
6. Salt n pepper skin scleroderma
7. dent channelopathy chloride
8. Dissociative anesthesia - ketamine
9. Dane particle- Haepatitis B
10. Pachymetry- Corneal thickness
11. MCC of Acute otitis media - Pnemococci
12. small intestine opened by enterotome
13. Cimetidine- A/E Gynaecomastia
14. Trophoblastic differentiation : 8th day
15. Broca's: Non fluent aphasia
16. Apple jelly nodules: lupus vulgaris
17. national blindness control programme 1976
18. no. of female mites to diagnose scabies 10-15
19. sleep spindles stage 2 sleep
20. eligible couple in india 150-200
21. verapamil s/ e constipation
22. alosteron s/e constipation
23. longest LA .... dibucaine
24. jones tendon transfer radial nerve
25. le fortes operation for elderly
26. Ricketsia -doc doxycycline
27. Cuscos specullam
28. Effrent arterioler constriction more than afferent?>>Increased then decreased
29. peliosis hepatis bartonella
30. intranuclear basophilic cmv
31. alcohol destroys bacteria by protein coagulation
32. steroid non depolarising myo relaxant
33. Milk stored in lactiniferous sinuses
34. tachy noire is chane in. eyes aftr death
35. tropical splenomegaly which immungloblin is increaeed???igm
36. renal part of ivc is from subcardinal vein
37. Common peroneal-fibula#
38. Clue cells.. bact vaginosis
39. Owl eye inclusion cmv
40. Somites at 5th wk- answer is 38 pair
41. Suprascapular is not a branch of axilary artery
42. flexor extensor retinaculum picture with tendons
43. Tachy noir me its deposition of debris n mucus..
44. Sphenopalatine ganglion -pain sensation
45. Verapamil mc s/e .. constipation
46. For staging of  non-hodgins.... Pet is first choice f /b nmri....
47. anasthetic widLowest mac is methoxyflurane
48. Not perceptual - illusion
49. Sacrospinous ligament -degenerated ischiococcygeous muscule
50. grievious hurt 320sec
51. m stage specific anti neoplastic drug.....vincristine
52. axillary n. supplies deltoid
53. max source of vit a.... halibut liver oil
54. subpoena -written document
55. prob village - not included guinea worm
56. max conc of sodium channel.....initial segmnt of neurom
57. mifepristone and misoprostol can be used for early abortion up to 63 days after the start of the last menstrual period
58. face to pubis delivery anthropoid pelvs
59. Tx of mtx toxicity >> folinic acid
60. ht inc in 2nd yr -12cm
61. benzodizepine without active metabolite....oxazepam
62. acetyl coa carboxylase enzyme - biotin req
63. co attach to complex 4
64. Inf gama -cytotoxic n helper tcel also nk cel
65. rail road pm changes retina
66. T hb stabilised by 23 BPG
67. small pox eradication 8 may 1980
68. acidophilic cell -gh
69. molotov cocktail -petrol bomb
70. somites frm paraxial mesoderm
71. n to myelohoid -ant belly of digastric
72. hemochromatosis hpfe gene
73. alveeoli dry due to negative interstitial pressure FINAL
74. substrate level phosphorylation succinyl thiokinase
75. alveoli prevented from collapsing due to surfactant
76. alosetran s/e constipation
77. Blood vol returns normal in preg after 4-8 wks post delivery 
78. Pontiac fever - legionella
79. Sister joseph nodule- metastasis
80. bad prognosis of wich heart dis in preg. .pulmo. hypertn ,eisenmengr - pulm htn is answer
81. max sensitivity of taste bud glucose sucrose or strychtrine or naclanswer is strychrine
82. Least penetration is cocaine
83. Diffuse tropoblastic infiltration in complete mole
84. Central pontine myelinosis - hyponatremia rapid correction
85. Restrictive catdiomyopathy - amylodosis
86. Length of Eustachian tube - 36mm
87. Chandipura vector - Sandfly
88. Folfox - colorectal CA
89. Horse shoe kidney - lower pole joined and at L4
90. Malonate - competitive inhibitor Succ DH
91. 2003 epidemic - SARS
92. Bosniak classfn - renal cysts
93. ivermectin dose 200 mcg or 400 mcg answer is 200 mcg
94. peds pt.. hib meningitis... inv done is bera
95. Hawkins sign.. For subtalar lucency
96. what is na ecf level abswer is 142
97. shortest actin muscle relaxant miva
98. neuro retinal rim of optic disc is thick nasally orr inferior final answer is inferiorly
99. non casseous granuloma CD
100. Albendazole dose in children in neurocysticercosis 15 to 20 mg per kg per day for 3 weeks
101. doc hypothy preg -ptu
102. Which is not absolute contra for thrombolytics 1.bp more than 180/110 2.✔diabetic retinal hmrage 3.h/o cerebral hmrage 4.aortic disection
103. Sublingual gland is Mucos
104. Spiral CT - 3mm in 30 secs
105. Swelling better palpated than seen - scalp
106. A pancreatic pseudocyst is a circumscribed collection of fluid rich in pancreatic enzymes
107. Buschke-Ollendorff sign This is a sign to be elicited in case of secondary syphilis
108. Hanging curtain sign in pitriasis rosea
109. sign of child abuse/ beating # scapula, rib , long bone , digits answer is long bones
110. Pronator drift - pyramidal tract lesion
111. All cause sudden death in infant and pediatric age grp except.  A) romanoward  b) AS  c) hypoplastic left heart  d) kawasaki answer is hypoplastic left heart disease
112. tropical spleenomegaly igm
113. Mental age 8 .patient age 10.... -----IQ 80
114. 100 mg hydrocort = 20 mg prednisolone
115. Dose of iv anti D in ITP--- 75 micrograms/kg
116. Meningococi n gonococi differenciated by maltose fermentation
117. Allodynia- due to stimulus which doesnt normally illicit pain
118. Ercp--- gold standard fr chr pancreatitis
119. Holler Miller sign - Juvenile nasoph angiofibroma
120. favorable factor in neuroblastoma ???? a.less than 18 months b.amplification on n-myc c. increase in telomerase. d. absence of scwann stroma. answer is b
121. cerebral infarct earliest detected in diffusion wt mri
122. Human ear can hear up to wt freqncy?? 500-3000hz
123. ritters disease by staph aureus
124. Munro micro abscess - Psoriasis
125. Snowbanking seen in intermediate uveitis
126. prostate sinus - prostate duct opening
127. kappa angle.....btwn pupillary axis n visual axis
128. Maple syrup dis mutation answer E1a
129. Blood volume becomes pre pregnant state which week ??4weeks
130. muller sign aortic insufficiency
131. atherosclerosis asso with chlamydia Chlamydia pneumonia to be specific
132. media for listeria -tsye medium,oxford medium and palcam medium
133. metamorphopsia diagnosed by-amsler grid
134. source of nitrogen in urea-nh4+ and aspartate
135. cu 380a failure rate-0.4%
136. banana shaped left ventricle seen in-hypertrophic cardiomyopathy
137. hart's rule-concept that laws are made by human beings and that law and morality are not connected
138. reflected part of inguinal ligament is formed by-external oblique
139. in head injury patient,cerebral perfusion pressure is maintained at-50-70 mmhg
140. drug for idiopathic intracranial hypertension-acetazolamide
141. pseudotumor cerebri vit A toxicity
142. Troilism (sometimes spelled triolism) refers to sexual activity in which three persons take part simultaneously
143. Pre-emptive analgesia is a treatment that is initiated before the surgical procedure in order to reduce this sensitization
144. Metamorphosia test-amsler grid for macular degeneration
145. neurolep anaesthesia Droperidol2.5 plus fentany0.05 plus n2o
146. Hbm-histidine replaced by tyrosine
147. severe mental retardation.... 20-35
148. best inv of ca breast - biopsy
149. sleep drunkeness - somnolentia
150. Ca pancreas detail view
151. Mc oncogene is kras
152. Mc tumor suppressor is p 53
153. line of genmari visual cortex
154. tsh action by cAMP
155. Not crossing placenta are Insulin Pth Calcitonin Tsh
156. ipc fr concealing birth.... 318
157. telefona.....beating on both ears
158. Falagna.. Beating on soles
159. common cold is virus
160. Aplastic crisis.. parvo b19
161. h/o watery discharge itching papilla on upper conjunctiva..... rx....steroid
162. cyclin d- IgH- mantle cell lymphoma
163. mc site fr ectopic pancreas.....stomach
164. sumatriptan agonist....5H1d
165. Peliosis hepatitis... bartonella
166. methotrexate poisoning.....treatmnt.....folinic acid
167. unwinding of dna replication.....by helicase
168. Minimum in 1 breath in 30 sec is 5 cm
169. Mid sagital brain mri visible is pons
170. Thickness of bacterial cell wall 20 to 25 nm
171. fungus causing hair n skin infection......microsporum
172. death after rupture of berry aneurism d/t...SAH
173. noise limit fr factory.... India me 90 for 8 hrs, Who me 85 for 8 hrs
174. salmon patch leprosy
175. common s/e of verapamil....constipation
176. influenza pandemic pattern cyclical
177. ineffective staph--- 3rd gen cephalospor
178. malignant hyperthermia.....succinylcholine, Treatment is dantrolene
179. 1st sign malign hyperthermia is tachycardia
180. bankart lesion......ant surface of labrum in ant dislocation of shoulder, Hill sach is posterolateral
181. Mc dislocated joint in shoulder
182. osgood shatters dis is osteochrondritis of tibial tuberce
183. Shortest acting non depolarozing muscle relaxant.. Mivacurium
184. Preemptive ansthesia Jst be4 operations
185. Jay vigyan mission mode project.. Rheumatic heart disease
186. anti D to rh negtv pregnant before delivry....which kind of immunity.......  passive
187. Double diffusion method.. Octetlony
188. Cryoglobinemia seen in hep c inf
189. Mcc of meningitis in immunocompromised pt-cryptococcus
190. Mc cause of mental retardation.. Downs synd
191. Treatment type 2 hyperlipopr - Niacin
192. plasmid which gets integrated in jost dna---- episomes
193. tmp n smx combination dose 160 plus 800
194. Stria of gennari seen in occiptl lobe In visual cortex
195. Dose of rTPA in stroke - 0.9mg/kg
196. defense mechanisms are unconscious
197. Non closer of posterior neuropore- spina bifida
198. Unilateral dysmenorrhea - Rudimentary horn in double uterus
199. Acl &pcl both r supplied by middle genicular vessels& nerves
200. mc problem in males answer is erectile dysfunction
201. angular acceleration cristae
202. photosensitivity caused by....demeclocycline
203. mc spinal mets extradural
204. sinus that develops first is maxillary
205. ldh5 is present in liver
206. Christmas tree pattern - Pityriasis Rosea
207. denominator General fertility rate = females in age group 15 to 45
208. lyell syndrome -TEN
209. korthoff media leptospirosis
210. kirby bauer chart antibiotic wafers
211. Pseudo pancreatic cyst contains pancreatic enzymes
212. hypocretins less cause narcolepsy
213. orlistat antiobesity drug acts peripherally
214. seritonin related to depression
215. old blood stains acid elution technique
216. mc side effect of thiazide.....hypokalemia
217. somatostatin decreases insulin
218. excretry portion of kidney formed by....mesonephric duct
219. Azithro can be given with theophylline
220. medial aspect of greater toe supplied by...deep peroneal n.
221. Collecting portion by ureteric bud
222. bupivacaine.....cardiotoxic
223. Buschke ollendorf sign secondary syphilis
224. NAPCB  1976
225. Anatomical snuff box -The posterior border of the snuffbox is the tendon of the extensor pollicis longus.The anterior border (closest to the edge of the hand) is a pair of parallel and intimate tendons, of the extensor pollicis brevis and the abductor pollicis longus.The proximal border is styloid process of the radius. The floor of the snuffbox varies depending on the position of the wrist, but both the trapezium and primarily the scaphoid can be palpated.
226. Not true about gluteus maximus Supplied by superior gluteal nerve
227. Indira Gandhi pension scheme for >65yrs bpl
228. Vibices is post mortem staining
229. Motorcyclist fracture is fracture of base of skull
230. indicator fr burden of disease..... proportional mortality ratio
231. pachymetry.....corneal thickness
232. Rhodopsin gene RHO on chromosome 3
233. Hmb 45 melanoma
234. Bamboo spine ank spondylisis
235. Ivermectin 200ug/kg
236. Testicular feminizing is 46 XY
237. Iodine defn -- prevalence: NNHT,  Effectiveness of intervention/prog: preg urine levels
238. papillary necrosis....not seen in benign nephrosclerosis
239. PQLI does not take account per capita income
240. CD20 maltoma
241. Ix fr chr pancreatitis.....ercp
242. choledocholithiasis caused by.... clofibrate
243. torcetrapib :cetp inhibitior
244. nutmeg liver....chf
245. Unit of study in ecological study is population
246. clue cell...by gardenella in bacterial vaginosis....
247. waterlow classification....malnutrition in children
248. Intranuclear inclusion CMV
249. stave cells in spleen
250. Vit in TCA cycle r B1 B2 niacin n pantothenic acid
251. Summons crpc 61 to 69
252. Best Std prevention by- condom
253. svc formed by rt. ant. cardinal and common cardinal veins
254. Hep virus wit dna HBV
255. Sandifer syndrome ka dd is seizure
256. Femoral. Dorsal L2,3,4
257. delivery by flexion in face presentation
258. Parvo virus 19- erythema infectiosum
259. Stomatostatin _ decrease insulin
260. Disability free - suvillian index
261. Leiner's disease-biotin deficiency
262. Muscle tested to diff b/w high and low radial nerve palsy- brachioradialis
263. Chronic granulomatous disease defect due to macrophages
264. 3rd part of duodenum related to sup mesentric artery
265. Maculae cerulae - pthyrus pubis
266. Agnes hunt traction - hip deformity
267. Cyclin D and Ig H fusion gene defect - mantle cell
268. Vidian neurectomy for vasomotor rhinitis
269. Epornithic - epidemic related to birds.
270. Coenocytic aseptate fungus- zygo
271. Greenish discolouration of skin due to sulph hb
272. Refsum's disease - def of phytanic acid oxidase
273. Chr prostatitis - antib given for 4-6 wks..
274. Mcc of renal calcium stones - idiopathic
275. Deep hair follicle infectn- furuncle
276. Tibialis post - causes inversion foot and attached to navicular bone
277. Jan vigyan mission project - RHD
278. cecal volvulus answer is right hemicolectomy and ileocolostomy for sure..
279. Icd 10 unnamed disease classifed under U section.
280. Mc type of scoliosis is idiopathic.
281. Fistula formation in HCC CANAL.
282. Tropical splenomegaly IgM inclusion
283. Cyclin d nd igh gene mantle cell lymphoma
284. O' dounouge triad acl + mcl+mm
285. Rickettsia ConroI nt in Australia
286. Bronchial smooth muscle hyperplasia in asthma
287. Ivory vertebrae in paget's disease
288. Tyrosinemia type 1 - fumaryl acetoacetate hydroxylase deficiency
289. Mc site of occupational carcinoma - skin
290. Candle wax drippings - seen in sarcoidosis
291. Acidophil cells produce GH and prolactin
292. Most specific index for renal tubular function-- is urine concentrating abilty.. Bt it ws nt in options so ansr May b specific gravity..plz confirm dis
293. Lysine helps in crosslinking of collagens, providing strength to the skin
294. Structure seen at the base of 4 th ventricle..Stria terminals Stria medullaris Stria medullaris thalami Ans..stria medullaris
295. Vit d rda 400 iu
296. father of nonparalytic polio- j.Salk (confirm)
297. Atleast 10000bacilli/ml for sputumbb smear positivity

Anorexigenic hormones/neurotransmitters:

Anorexigenic hormones/neurotransmitters: GP NαILS CCC

Glucagon-like peptide (GLP)
Peptide YY (PYY)
α-Melanocortin-stimulating hormone (α-MSH)
Corticotropin-releasing hormone (CRH)
Cholecystokinin (CCK)
Cocaine- and amphetamine-regulated transcript (CART)

Orexigenic hormones/neurotransmitters: CAGE GAMON

Agouti-related protein (AgRP)
Galanin (GAL)
Amino acids
Melanocortin-concentrating hormone (MCH)
Orexins A and B
Neuropeptide Y (NPY)

Eggs of medicine


• Oligodendroglial components are characterized
histologically by a moderately cellular collection of cells
with round nuclei and perinuclear halos ("fried egg"

• The mycoplasmas are typically slow growers with a
generation time of 1-6 hours. They produce small
colonies typically described as a fried-egg appearance.

• Diphtheria 'Intermedius colonies' are small, 2 mm in size,
lustreless with domed centre and irregular margin with
'frog egg' appearance.

• Crumbled egg---> Hydatid Liver Cyst

• Scrambled egg---> Pancreatic cancer; Best Disease

• Egg in cup appearance Constrictive pericarditis
• Egg on side appearance TGV ( transportation of great
vessels )

• Egg on a string : Appearance of the heart that may be
seen with transposition of great arteries.

• Odour in poisoning: H2S--> Rotten egg

• Egg cell calcification of the hilar node: Silicosis >

• Schistosome Eggs::
Egg with
Terminal spine--> S.Hemotabium (TSH)
Lateral Spine---> S.Mansoni (LSM)
Lateral Knob--> S.Japonicum (LKJ)

• Non-bile stained egg:
Necator americanus
Enterobius vermicularis
Ancylostoma duodenale

Obstetrics and Gynecology

IOCs for various conditions
fibroid - USG
tubal payency- HSG
Mullerian anomalies - MRI
Endometriosis - Laproscopy
post coital bleeding - PAPS
post menopausal bleeding -
endometrial biopsy
pid - USG
adenexal mass - USG
amenorrhoea - hormonal asessment
molar - USG
Ectopic - TVS
ovulation - follicular monitoring
hirsutism with menstrual irregularity- -serum testosterone
Adenomyosis - MRI
ovarian reserve - FSH
VVF - Cystoscopy

Cancers incidence

(GLOBOCAN 2012 fact sheet/latest)
Most common cancer

1) Incidence---Lung cancer
2)Mortality---Lung cancer


1)Incidence----Breast ca
2)Mortality----Breast cancer

● Most common incidence and mortality both---Lung cancer


Most common cancer
1) incidence ---Lung ca> oral cavity and lips cancer....
BUT ...Oropharyngeal cancer > Lung cancer
2) Mortality----Lung cancer

● Incidence and mortality both --Breast cancer
● mortality and incidence both--Breast cancer

Wednesday, 19 November 2014

Oranges in medicine

Orange things in med...!
*orange placenta---- syphilis
*orange tonsils --- Tangiers disease
*peau'd orange appearance--- ca breast
*orange discolouration of urine-- dehydration drugs--rifampicin, furazolidone, sulfosalazine, Rifabutin,Entacapone,Clofazimine
*orange discolouration of skin--carotenodermia
*orange/saffron coloured amniotic fluid-- post maturity
*Orange skin cornea is seen in Mustard Gas poisoning used in biological warfare...
*orange cylinder - - Cyclopropane
*orange book --- related to bioequivalence

Kearns-Sayre syndrome :-

Kearns-Sayre syndrome :-

Muscle weakness:
1.Proximal myopathy (difficulty rising from a squat)
2.Ptosis (usually bilateral but may be symmetrical initially)
3.External ophthalmoplegia.

CNS dysfunction:
1.Retinitis pigmentosa
2.Cerebellar ataxia
3.Cognitive deficits
4.CataractsEncephalopathy (in acute presentation with lactic acidosis)

2.Congestive cardiac failure

1.Short stature (38% of affected individuals)
2.Hypogonadism (20% of affected individuals)
3.Other (eg, signs of hypothyroidism)

TB Facts

1962- national tb programme
1992 - RNTCP
Tb declared as global emergency by WHO in 1983
Tb most common opportunistic infn in hiv in India
Tb barometer of social welfare in india
Every tb pt infects 10-15 ppl in a yr
World tb day 24 march
Tb bacteria alive in sputum for 1 day n droplet nuclei for 10 day
ARI 1.7% in india
Prevalence of infection 40% in india

National TB institute- banglore
Tb research centre- chennai
LRS inst of TB n respiratory diseases - New delhi
BCG vaccine manufactured in Guindy
Minimum bacillary load for positive result >10000 bacilli per ml sputum

High yield

Traube-Hering waves are fluctuations in BP synchronized with respiration.

Nugent Score is a gram stain scoring system for pap tests to diagnose bacterial vaginosis.

Normally pleural fluid is formed at the rate of 0.6ml/hr (14.4 ml/day).
Kevorkian sign- It is a post mortem change where there is fragmentation or segmentation of retinal vessels

Baroreceptors are more sensitive to diastolic BP than systolic BP.

Tetradotoxin and Saxitoxin blocks voltage gated Na+ channels.

The source of calcium ions for skeletal muscle is Sarcoplasmic reticulum whereas for Smooth muscle & Cardiac muscle, the main source of calcium ions is ECF and partly SR.

Charcot-Marie Tooth Disease is due to mutation in the gene encoding for connexins.

Gastric juice contains Na+, K+, Mg2+ and H+ but does not contain Ca2+

Nysten's rule states that Rigor mortis does not start in all muscles simultaneously, it appears first in involuntary muscles.

Postfixed brachial plexus occurs when the T2 ventral ramus contributes to the brachial plexus. 
Contributions to the plexus usually come from C6 - T2. 

An elevated level of IL-6 in CSF is a feature of CNS involvement in Behcet's disease. (Neuro - Behcet disease) 

The normal value of P50 on the oxygen dissociation curve in an adult is 3.6kilopascal/25mmHg 

Thyroid hormones increase the metabolism in all tissues except brain and testis. 

Addiction is particularly associated with nucleus accumbens

Recombinant Erythropoetin derivatives which are used in anemia of chronic renal failure are Epoietin and Darbopoietin-alpha

Radiolucent stones

Orotic acid
Uric Acid

Drugs and save adverse effects

Drugs specific adverse effect :::

Vanishing bile duct syndome -- chlorpromazine

Coronary steal phenomena -- dipyridamole and isoflurane

Toxic ambylopia --- ethambutol

Fatal myocarditis ---clozapine

Idiosyncratic hepatic necrosis in infant --sodium valproate

Pseudo porphyria -- piroxicam

Amotivational syndrome-- marijuana

Fetal aplasia cutis -- carbimazole/methimazole in pregnancy

Drug induced mysthenia gravis-- d- penicilamine

Salt and pepper fundus -- thioridazine

Blue halo effect -- sidenafil

Calciphylaxis -- warfarin use in hemodylasis pt

Livedo reticularis -- amantidine

DRESS ie drug related eosinophila and systemic symptoms -- allopurinol

Pseudolymphoma syndrome -- anticonvulsants

Delayed bone marrow suppresion --nitrosourea anticancer drugs

Predisposition to listeria infection -- fludarabine

FSGS --heroin

Peripheral neuropathy resembling motor neuron disease -- dapsone

Vacuolar myopathy -- vincristine

Acute hepatic necrosis in pregnancy -- tetracycline

Cytokine release syndrome --muromonab cd3

Hand foot syndrome -- capcitabine

Hemorragic cystitis -- ifosfamide

Haemolytic uremic syndrome -- mitomycine c


1. hot tub lung - Mycobacterium avium & cladosporium species
2. tap water lung - Mycobacterium spp
3. chemical worker's lung - Isocyanates
4. air conditioner's lung - Aureobasidium
5. cheese washer's lung - penicillium casei
6. compost lung - Aspergillus
7. Detergent worker's lung - Bacillus subtilis enzymes
8. laboratory worker's lung - male rat urine
9. Japanese summer type - Trichosporon
10. Mushroom worker's lung - Thermophilic actinomycetes
11. Miller's lung - Sitophilus granarius
12. Tobaco Workers lung - aspergillus
13. Winegrowers lung - botryitis species
14. Farmer's lung - Micropolyspora faen


Movat stain:Aortic wall in aortic dissection
Warthin Starry silver stain:Bacillary angiomatosis {bartonella }
Congo red:Amyloidosis
Von kossa stain:Calcium
Rhodanine stain:Wilsons disease for demonstrating Cu
Orcein stain: Wilsons disease for demonstrating Cu-associated protein
Reticulin stain:Differentiation of Pituitary adenoma {+ve} from hyperplasia{-ve}
Brilliant cresyl blue {Supravital stain}:
Coomassie blue stain
:SDS-PAGE analysis of RBC membrane {for protein demonstration}
PAS:SDS-PAGE analysis of RBC membrane {for Glycophorin demonstration}
SYBR Green dye:PCR
Filipin stain:Cholesterol
Schultz stain:Cholesterol esters
Calcium lipase stain:Mono-,di-,and tri-glycerides
Nile blue sulphatase:
Psosphatidyl choline and phosphatidyl serine
Plasmal reaction:Phosphatidyl ethanolamine
Ferric hematoxylin:Sphingomyelin
Fuelgen stain
Methyl green pyronin
Gallocyanin chrome alum method
Acridine orange:DNA
Annexin V:Apoptotic cells
Triphenyl tetrazolium chloride:Myocardium
Viable –magenta
Masson-Trichrome stain:Mature collagen in tissues
PAS +ve ,Diastase resistant:Alpha1 antitrypsin
Pas +ve Diastase sensitive:Glycogen
Orcien/Aldehyde fuschin stain:Ground glass hepatocytes in Chr.hepatitis
Hopps –Brown stain,
Modified Giemse stain
Ethin srarry silver stain
Ethidium bromide stain: H.pylori on gastric mucosa
Toluidine blue:
Supravital staining of Laryngeal lesions for diagnosis


Ahlback disease : medial femoral condyle = SONK
Brailsford disease : head of radius
Buchman disease : iliac crest
Burns disease : distal ulna
Caffey disease : entire carpus or intercondylar spines of tibia
Dias disease : trochlear of the talus
Dietrich disease : head of metacarpals
Freiberg infraction : head of second metatarsal
Friedrich disease : medial clavicle
Hass disease : humeral head
Iselin disease : base of 5th metatarsal
Kienbock disease : lunate
Kohler disease : patella or navicular
Kummel disease : vertebral body
Legg-Calvé-Perthes disease : femoral head
Liffert-Arkin disease : distal tibia
Mandi disease : greater trochanter
Milch disease : ischial apophysis
Mueller-Weiss disease : navicular
Panner disease : capitellum of humerus
Pierson disease : symphysis pubis
Preiser disease : scaphoid
Sever disease : calcaneal ephiphysis
Thiemann disease : base of phalanges
Van Neck disease : ischiopubic synchondrosis


3 zones of proximal 5th metatarsal fracture
Zone 1- styloid process (cancellous tuberosity) – pseudo jones # - avulsion of peroneus brevis&plantar fascia
Zone 2 – true jones fracture – fracture at metaphyseo-diaphyseal junction
Zone 3 – extension into diaphysis

Maisonneuve fracture - #medial malleolus + distaltibiofibularsyndesmosis injury + # proximal third fibula
Tillaux-Chaput fracture – fracture anterolateral aspect of the distal tibialepiphysis (salter harris type 3)
Triplanar fracture – fracture of distal tibia only occurring in adolescents (type 4 salter harris type)
Pilon fracture – communited distal intraarticular fracture tibia (ruedialgower classification)
Bosworth fracture – fracture-dislocation of the ankle (fracture of the fibula and posterior dislocation of the talus.)
Cotton fracture – trimalleolar fracture
Pott fracture – bimalleolar fracture
Lefortwagstaffe fracture – avulsion fracture of medial aspect of the distal fibula due to avulsion of the anterior talofibular ligament attachment


Jones (true) fracture - # metaphysiodiaphyseal junction of base of 5th metatarsal
Pseudo jones fracture - #styloid process of base of 5th metatarsal
Lisfranc injury- tarsometatarsal fracture dislocation
Lover’s fracture- calcaneal fracture
Aviator fracture- fracture neck of talus
March fracture- stress # 2nd metatarsal foot
Chopart fracture – fracture dislocation through intertarsal joints

Segond fracture – avulsion fracture of lateral aspect of tibialplateau + ACL tear (75%)

Duverney fracture – isolated iliac wing fracture
Malgaigne fracture – ipsilateral superior &inferior rami fracture and sacroiliac joint disruption.
Dashboard fracture – fracture of posterior lip of acetabulum with posterior dislocation of hip
Straddle fracture – B/L superior &inferior pubic rami fractures

Burst fracture- comminuted fracture of vertebral body
Chancefracture (car seat belt injury) – horizontal fracture of vertebrae extending from body to the posterior element caused by strong flexion distraction force
Clay- shoveller fracture – avulsion fracture of spinous process of lower cervical or upper thoracic vertebrae
Hangman fracture – C2 fracture + C2-C3 subluxation
Jafferson fracture – fracture of atlas (#C 1)

Tumour markers

Tumour markers

Testicular Tumor - AFP , LDH , Beta-HCG

Colon Ca - CEA , CA-19-9 , CA-125

Prostate Ca - PSA , Prostatic Acid Phosphatase

Hepatocellular Ca - AFP , CEA
Teratoma - AFP

Endodermal Sinus Tumor - AFP
Pancreatic Neuroendocrine Tumor - Gastrin

Breast Ca - CEA , CA-19-9
Lung Ca - CEA , CA-125 ( CK- BB [ Small cell Ca ] )

Ovarian Ca - CA-125 , CEA , Beta-HCG , Placenta Alkaline Phosphatase

Pancreatic Exocrine Ca - Ca-19-9 , CEA , CA-125

Chorio Carcinoma - Beta-HCG

Medullary Ca Thyroid - calcitonin

Papillary Ca Thyroid - Thyroglobulin

Carcinoid Tumor - HIAA in Urine
Neuroblastoma - VMA , HVA , NSE

Cervix Ca - Keratin

Pituitary - ACTH

Multiple Myeloma - Beta 2 - Microglobulin

Hairy cell Leukemia - CD-25

Liver lobes

Most common Lobe involved in different pathological conditions::
Right upper lobe,
1.Lung abscess(posterior segment)
2. Post Primary Tuberculosis (Primary TB: middle and lower lung zones)
Left upper lobe
1. Bronchial atresia
2. Congenital lobar emphysema
Left lower lobe:
1. Bronchopulmonary Sequestration
2. Atelectasis
3. Bronchiectasis: Left lower > right lower
Right lower lobe
1. Foreign Body
2. Hydatid cyst of Lung
3. Pulmonary embolism
4. Aspiration Pneumonia: If the patient is on the right side, the right upper lobe is at risk
Right middle lobe:
Aspiration Pneumonia:
- In supine patients, the superior segments of the lower lobes are most often involved.
Silicosis, sarcoidosis and eosinophilic granuloma involve
the upper lobes more frequently.

Wednesday, 5 November 2014



1. first ssri discovered was fluoxetine
2. only ssri approved for childhood depression - fluoxetine
3. longest half life - fluoxetine
4. does not require dose tapering/does not cause withdrawal - fluoxetine
5. ssri having maximum anticholinergic effect - paroxetine
6. ssri having maximum sedation - paroxetine
7. ssri least safe in elderly - paroxetine 
8. Fluvoxamine, paroxetine, sertraline, and fluoxetine are indicated for treatment of OCD in persons over the age of 18 years. 
9. Fluvoxamine and sertraline have also been approved for treatment of pediatric OCD (ages 6 to 17)
10. most common long term associated side effects of ssri - sexual dysfunction(manifests as anorgasmia)... it does not decrease with continued usage
11. mc side effects are gi side effects (bcoz of 5ht3 receptors) include nausea, diarrhea, anorexia, vomiting, flatulence, and dyspepsia... (aiims question loose stools >> anxiety)  
12. mc ssri implicated in causing paradoxical anxiety - fluoxetine
13. mc ssri blamed to cause increase in suicidal risk especially in children - fluoxetine 
14. mc ssri causing insomnia - fluoxetine
15. ssri with shortest half life - fluvoxamine
16 .ssri with most enzyme inhibition - fluvoxamine 
17.ssri with most drug interactions - fluvoxamine 
18.all ssri are us fda approved for depression except - fluvoxamine
19.  rare s.e of ssri includes - SIADH...

Tuesday, 4 November 2014

Anaesthesia of choice

▪Internal version:: halothane
▪Removal of placenta:: halothane
▪HOCM :: halothane
▪Children:: sevoflurane/ ketamine *
▪B/A::ketamine  > halothane
▪R»L shunt:: ketamine
▪L»R shunt:: isoflurane
▪Cardiac surgery:: isoflurane
▪Neurosurgery:: isoflurane
▪Controlled hypotension:: isoflurane
▪Renal disease:: Desflurane
▪Hepatic disease::Desflurane
▪IHD:: etomidate
▪Aneurysm surgeries:: etomidate
▪Malignant hyperthermia:: propofol
▪Hemorrhagic shock:: cyclopropane
▪Shock:: ketamine
▪CHF:: ketamine
▪ECT:: methohexitone
▪Thyrotoxicosis:: thiopentone
▪Epilepsy:: thiopentone
Malignant hyperthermia
Agent of choice
▪IV:: Propofol
▪Inhalation:: N2O
▪LA:: Procaine
▪MR:: d-TC
Maximum effect of GA::
▪Max respiratory depression:: enflurane
▪Max  decrease CO:: enflurane
▪Max. Decrease BP:: isoflurane
▪Max. Bronchodilator (asthamatic) :: halothane
▪Max intracranial flow:: halothane
▪Max intracranial tension:: halothane
▪Max. Bronchodilator (non- asthamatic):: sevoflurane
▪Max analgesic:: trielene
▪Max MR:: ether

Cavernous sinuses

The cavernous sinus is one of the dural venous sinuses. It is located on either side of the pituitary fossa and body of the sphenoid bone between the endosteal and visceral layers of the dura.

Vascular connections
It receives blood from the
inferior ophthalmic vein (or a branch thereof)
superficial middle cerebral vein
inferior cerebral veins
sphenoparietal sinus
and occasionally
central retinal vein
frontal tributary of the middle meningeal vein

Drainage of the cavernous sinus is via:
superior petrosal sinus to the transverse sinus
inferior petrosal sinus directly to the jugular bulb
venous plexus on the internal carotid artery to the pterygoid plexus
emissary viens passing through the:
sphenoidal foramen
foramen ovale
foramen lacerum
Depending on relative pressures the superior ophthalmic veins either drain to or drain the cavernous sinus.

Additionally the cavernous sinuses connect to each other via the intercavernous sinuses.

The cavernous sinus transmits multiple cranial nerves to the superior orbital fissure and foramen ovale. These are:
In the lateral wall from superior to inferior:
oculomotor nerve (CN III)
trochlear nerve (CN IV)
trigeminal nerve (CN V) ophthalmic and maxillary divisions.
Traversing the sinus lateral to the ICA
abducents nerve (CN VI)
These can be remembered with the mnemonic OTOM CAT.

The internal carotid artery enters the posterior inferior aspect of the sinus, and bends upon itself as the carotid siphon (cavernous segment - C4). Two branches arise from this segment: meningohypophyseal trunk and inferolateral trunk.
The artery is surrounded by a plexus of sympathetic nerves from the superior cervical ganglion.

Effects on gravity

Effects of gravity on blood pressure-
Positive g
-occurs while ascending up
-CO decreases
-blood rushed towards lower limb
-black out of vision occurs

Negative G
-occurs while diving
-blood s rushed towards head
-CO increases
-red out occurs

Magnitude of gravitational effect - 0.77mmHg of vertical distance above/below the heart


Most common cardiac tumor - metastasis
Most common primary cardiac tumor in adults - myxoma
Most common primary cardiac tumor in children - rhabdomyoma
Most common deficiency in HS - ankyrin
Most common tumor of appendix - adenocarcinoma
Most common heritable hematological disorder affecting humans - sickle cell anemia
Most common clinical feature of multiple myeloma - anemia
Most common M protein in multiple myeloma - IgM
Most common sites of involvement in myeloma - vertebrae > ribs > skull > pelvis > femur > clavicle > scapula
Most common chromosomal anomaly in MDS - del 5q
Most common chromosomal anomaly in MDS in adults - del 5q
Most common chromosomal anomaly in MDS in children - monosomy 7
Most common site of carcinoid - GIT
Most common site of carcinoid in GIT - distal ileum > appendix
Most common congenital heart disease - VSD
Most common mode of Mendelian inheritance - autosomal recessive
Most common genetic cause of mental retardation - downs syndrome
Most common cause of pathological jaundice in newborn - Rh incompatibility
Most common hematological malignancy in downs syndrome - ALL
Most common species of Malaria in India - Plasmodium falciparum (as per latest ICMR stats)
Most common cause of Nephrotic syndrome in adults - FSGS > membranous GN
Most common cause of Under five mortality - ARI > Diarrhoea
Most common cause of infant diarrhea - ETEC > EPEC (if asked about India)
If India not mentioned then EPEC > ETEC and same true for children also
Most common cause of death in Multiple myeloma - infections
Most common AML with chloroma - M2
Most common AML with DIC - M3
Most common AML with gum hypertrophy - M5
Most common AML in Downs syndrome - M7
AML with best prognosis - M3
Most common hematological malignancy associated with Pure red cell aplasia- CLL
Most common cause of brain masses in hematologic malignancy - NHL
Most common of paraneoplastic skin disease -  Sweet syndrome or febrile neutrophilic dermatosis
Of patients with malignancy-associated Sweet syndrome, 85% have a hematologic malignancy, most commonly AML
Most common soft tissue tumors in adults- Lipoma
Most common soft tissue sarcoma - Liposarcoma
Most common intracranial tumor-  secondaries
since all secondaries are malignant most common malignancy is also secondaries
Most common primary cns tumor -  meningioma 
Most common primary malignancy-  GBM
Most common cause of primary hyperparathyroidism : Solitary parathyroid adenoma
Most common renal lesion in leprosy : membranous > membranoproliferative
Most commonly involved organ in Amyloidosis : Kidney
Most common cause of death in primary amyloidosis: Cardiac
Most common cause of death in secondary amyloidosis: Kidney.
Anastamosis in Whipple's which leaks the most: Pancreaticojejunostomy
Most common type of lymphoma to present with massive splenomegaly- splenic marginal zone lymphoma
Most common Lymphoma affecting spleen: NHL (Diffuse large B cell)
Most common primary benign neoplasm of the spleen: Hemangioma
Most common tumor of spleen: metastasis
(Reference Wintrobe's- Although still rare, carcinoma of the spleen from metastasis or direct tumor extension is more common than primary disease.)
Most common altered oncogene in pancreatic cancer - KRAS
Most common inactivated tumor suppressor gene in pancreatic cancer - CDKN2A
Most common fungal infection of oral cavity - Candida albicans (It is a normal component of oral flora in 50% of the population!)
Most common form of candidiasis - Pseudo membranous (also called thrush)
Most common site of oral hairy leukoplakia - lateral border of tongue
Most common head and neck cancer - squamous cell carcinoma
Most common location for dentigerous cyst - Impacted third molar (wisdom tooth)
Most common odontogenic tumor - odontoma
Most common type of sinonasal papilloma - exophytic
Most common underlying factor causing deformation - uterine constriction
Most common developmental defect of forebrain and midface - holoprosencephaly
Most common cause of neonatal mortality - congenital anomalies > prematurity
Most common cause of respiratory distress in neonates - hyaline membrane disease
Most common cause of death in patients with cystic fibrosis - cardiovascular > transplant associated > liver disease
Most common finding in infants who die of SIDS - multiple petechiae (thymus, visceral and parietal pleura, epicardium)
Most common teratomas in infancy - sacrococcygeal teratoma
Most common type of emphysema - centriacinar (more than 95% of clinically significant cases, as per new Robbins)
Most common mass in anterior mediastinum - thymic neoplasm
Most common mass in middle mediastinum - cysts (bronchogenic)
Most common mass in posterior mediastinum - Neurogenic tumors
Most common mass in mediastinum (overall) - thymoma (adults) and neurogenic tumors (children)
Most common type of warm autoantibody - IgG
Most common type of cold autoantibody - IgM
(autoantibody in PCH is IgG)
Most common neoplasm of salivary glands : Pleomorphic adenoma > Warthins tumor
Most common site of pleomorphic adenoma : Parotid
Most common tumor of parotid gland : Pleomorphic adenoma
Most common malignancy of minor salivary glands : Adenoid cystic carcinoma
Most common bilateral or multi focal salivary gland tumor : Warthin tumor (found exclusively in the parotid gland)
Most common salivary gland tumor in pediatric age group : Hemangioma > Pleomorphic adenoma
Most common malignant salivary gland tumor in pediatric age group : Mucoepidermoid carcinoma > Acinic cell carcinoma
Most common salivary gland malignancy : Mucoepidermoid carcinoma
Most aggressive primary salivary gland tumor :  Salivary duct carcinoma
Most common cancer in India
Males :  lung
Females : cervix
If specifically asked for metropolitan females: breast
Most common cancer in world
Males : lung
Females : breast
Most common tumor to metastasize to breast : Malignant melanoma
Most common solid tumor to metastasize to breast :  Lung (small cell carcinoma)
Most common site of primary in following secondary sites
1. Brain :  Lung
2. Lung : breast > colon > stomach > pancreas > kidney
3. Liver : carcinoma > lymphoma
Upper GI tract (stomach, gall bladder, pancreas) > colorectal > lung > breast
4. Bone : breast
5. Pleural effusion : bronchogenic carcinoma
6. Breast - malignant melanoma > lung
7. Ovary - colon
8. Thyroid - malignant melanoma > breast > kidney > lung
Most common cancer to cause SVC syndrome : Breast cancer
Most common lung cancer to cause SVC syndrome : small cell > squamous
Most common cyst of spleen : pseudocyst
Most common true cyst of spleen : hydatid
Most common infectious cyst of spleen : hydatid
Most common tumor of spleen : hemangioma
Most common primary benign tumor of spleen : hemangioma
Most common malignant tumor of spleen : malignant lymphoma
Most common malignant primary non lymphoid tumor of spleen : angiosarcoma
Most common sites of distant metastasis (other than regional lymph nodes) in following primary tumors-
1. Breast - skeletal system (lumbar vertebrae) > lung > liver
2. Kidney - lung > skeletal system (pelvis and femur)
3. Liver - lung
4. Lung - brain
5. Oesophagus - liver > lung > adrenal glands
6. Stomach - liver > peritoneum > lung 
7. Colorectal - liver
8. Ovarian serous carcinoma - contralateral ovary > peritoneal cavity
9. Prostate -  (osteoblastic, but can be osteolytic also) Lumbar spine > sacrum > pelvis
10. Malignant melanoma - liver > lung > git > bone > CNS

High yield

“Most radiosensitive cell of body is lymphocyte”
“Most radiosensitive ovarian tumour or of wholebody is dysgerminoma”
“Most common radiosensitive lung tumor is smallcell carcinoma of lung”
“Most common radiosensitive testicular tumor is seminoma”
“Most common radiosensitive bone tumours are multiple myeloma and Ewings sarcoma”
“Most common radiosensitive brain tumor medulloblastoma”
“Most common radiosensitive renal tumor willms tumor”
“Thumbprint sign is seen in ischaemic colitis”
“Mercedes Benz sign is sign is seen in radiopaque gall stones”
“Double bubble sign s seen in duodenal atresia single in pyloric and multiple bubble sign is seen in ileal`jejanal atresia”
“Driven snow sign is seen in pindborgs tumor”
“Flower vase sign is seen in Horse shoe kidney”
“Vertebra plana s seen in eosinophillic granuloma”
“Rat tail oesophagus s seen in oesophagal carcinoma”
“Cork screw oesopgagus is seen in diffuse oesophagal spasm”
“Thimble bladder is seen in tb bladder”
“Sand patches in bladder are seen in schistosomiasis”
“Chain of lakes is seen in chronic pancreatitis”
“Golfhole ureter is seen in tb ureter”
“Soap bubble app is seen in osteoclastoma”
“Snowmans sign is seen in TAPVC”
“Boot shaped heart is seen in TOF”
“Tram track calcification is seen in sturge weber syndrome”
“Bilateral spider leg appearance is seen in polycystic kidneys”
“Air bronchograms are seen in consolidation”
“String of kantor is seen in crohns disease”
“Apple core sign is seen in left colon cancer”
“Snow storm appearance is seen in hydatiform mole”
“Camaleotes sign is seen in hydatid disease of liver”
“Colon cutt off sign is seen in acute pancreatitis”
“Saw tooth sign is seen in diverticulosis”
“Egg in cup appearance is seen in renal papillary necrosis”
“Codmans traingle and sunray app is seen in osteosarcoma”
“Coffee bean sign is seen in sigmoid volvulus”
“Bamboo shaped spine in ankylosing spondylitis”
“Salt and pepper skull in hyperparathyroidism”
“Strawberry gingiva is seen in wagners granulomatosis”
“Strawberry tounge is seen in scarlet fever,toxic shock syndrome and kawasakis disease"
“Strawberry cervix is seen in trachomoniasis”
“Strawberry nose is seen in rhinosporidosis”
“Strawberry skin and nasal mucosa is seen in sarcoidosis”
“Calots triangle is made superiorly by inferior border of liver,medially by common hepatic duct and inferiorly by cystic duct”
“Contents of calots triangle are lymph node of lund,right hepatic artery,cystic artery"
“Billing method of contraception is a behavioural method”
“Hasses rule is used for calculation of gestational age based on length of fetus”
“Hellens rule says twins as
1 in 80,2 in (80*80),3 in (80*80*80)
“In Mayer Rokintansky kuster Hausers syndrome ovary is normal bcos it develops from genital ridge”
“Most common cause of perinatal death in multi fetal pregnancy is prematurity”
“Most common cause of maternal death in india is hemorrhage>anemia>sepsis”
“Intersitial ectopic pregnancy ruptures later bcos of closer endometrial suppourt”
“Progesterone is common harmone in both Arias stella and decidual reaction”
“Pentoxifyline has proved to b best for treating hepatorenal syndrome”
“Amoebic ulcers are flask shaped”
“Typhoid ulcers are longitudinal”
“Tubercular ulcers are tranverse”
“Tubercular enteritis cause strictures of gut”
“Dementia is a late feature of whipples disease but bad prognostic feature”
“Ito cells containg vitamin A are present in space of disse”
“Most common site of gastrinoma is duodeneu
m psaros triangle”
“D xylose test is used to mak difference between malabsorption due to intestine and pancreas”
“D xylose will b negative in pancreatic malabsorption,malnutrition,gastrectomy”
“D xylose wl b false positive in ascites,pleural effusion,blind loop syn,renal failure”
“Alpha feto protein in normal in hepatolammelar tumour of liver but increased in hcc”
“In mallory weiss mucosa n submucosa are involved however Boerhaave is transmural”
“In proximal short bowel syndrome symptoms wl b malabsorption,iron deficiency and calcium malabsorption”
“In terminal ileum short gut syndrom sx wl b megaloblasticanemia,malabsorption,cholesterol gall stones and oxalate kidney stones”
“Potential of malignancy is highest in uc as compared to CD”
“5ASA is drug of choice in IBD however sulfinpyradine moeity is responsible for side effects and use in rheumatoid arthritis”
“Chronic gastritis caused by h pylori involves fundus body and antrum but autoimmune involves fundus body only”
“Barrets metaplasia cause adenocarcinoma always”
"paracussis willlisi is better hearing in noisy environtment seen in otospongosis"
"Tulio phenomenom is associated with endolymphatic hydropis"
"pulsatile tinnitus is seen in glomus jugalare"
"pulsatile ottorhea is associated with Asom"
"effect of local anesthetics on nerve fibres is Type C>B>A
Hypoxia B>A>C ,,Pressure A>B>C"
"life span of Mirena iucd is 5 yrs
Cu T 380 A 10 years
Nova T 5 yrs,,, progestert 1 year,,,CU T 200 3 years,, cu T 200B 4 yrs "
"incision in tubectomy is given at isthumus"
"Bupivacaine is most cardio toxic local anesthetic"
"lermoyz syndrome is a variant of Meneries in wich sx occurs in reverse fashion"
"carraths notch in otosclerosis occurs at 2 kHz however dip in barotrauma occurs at 4 khz"
"dribbling of saliva from angle of mouth is sure sign of death due to hanging"
"Hyoid fracture is mostly seen in throttling"
"potts puffy tumor and mucocele occurs mostly in frontal sinus"
"max dose of lignocaine is 300 and 500 mg with adrena"
"death in drowning occurs due to ventricullar fibrillation or cardiac arrest"
"Heneberts sign is associated with Meneries disease"
"AC>BC and weber lateralised owards normal ear means normal or sensoneural deaffness or presbyccusis"
"contraceptiv of choice in emergent conditions is levonorgestral"
"lucio phenomenom is seen in LL type leprosy"
"type 1 lepra reaction type 4 type and type 2 is type 3 type hypersenstive rxn as per comb and gel classification"
"otoverrugurth fold and pseudodementia is associated with depression"
"la belle indifference is seen in conversion disorder"
"quinsy is peritonsillar abscess and citteli is in posterior digastric belly"
"sphenopalatine artery is called artery of epistaxis"
"ipc 320 defines grievous hurt"
"stockers line is seen in pterygium"
"x rays are produced by linear and beta accelerators"
"concentration of ethinyl estradiol in Mala N and Mala D is 30 microgrm
“Investigation of choice for early renal tb is IVP”
“Inv of choice in advanced renal tb is CT”
“Inv of choice for blunt abd trauma is CT”
“Inv of choice for avascular necrosis is MRI”
“Inv of choice for cholecystitis n gall stones is ultrasound”
“Investigation of choice for bone density and osteoporosiiis DEXA bone test”
“Inv of choice for GERD is 24 hour ph metry”
“Inv of choice for VUR and posterior valves is MCU”
“Inv of choice for cytotoxic drug induced cardiotoxicity Is endomyocardial biopsy”
“Inv of choice for obstetric probs is USG”
“Inv of choice for PE is CECT>angiography>v/Q scan”
“Inv of choice for acute cerebral hemorrhage CT”
“Inv of choice for chronic cerebral hemorrhage is MRi”
“Inv of choice for posterior med tumor,pancoasts tumor,posterior cranial fossa is MRI”
“Inv of choice for subarachnoid hemmorhage diagnosis unenhanced CT”
“Inv of choice for subarachnoid hemorrhage etiology is 4vessel MR angiography”
“Inv of choice for interstitial lung disease and bronchectasis is HRCT”“
“Inv of choice for stable dissecting aneurysm is MRI”
“Inv of choice for dissecting aneurysm unstable is transoesophagal usg”
“Inv of choice for traumatic paraplegia is MRI”
“Celiac sprue is malabsorption syndrome caused by gliadin protein in wheat diagnosis is based on”
1.Relief of sx on restriction of gliadin diet
2.Serology that is antiendomyseal,antireticulin,anti tissue transglutaminase,and antigliadin antibodies.antiendo and anti tissue trans are specific antibodies
3.Non specific lesion on biopsy that is absence of villi
“Specific fndings on intestinal biopsy
are seen in three malabsorption syndromes only”
Abetalipoproteinemia,Whipples disease and Agammaglobunemia
“Antisaccaromyces antibodes are seen in chrons disease”
“Anti mitochondrial in primary billiary cirrhosis”
“Anti histone in drug induced lupus”
“Anti smooth muscle in autoimmune hepatitis”
“Biopsy finding in whipples syndrome is PAS positive macrophages in lamina propria”
“IBS is associated with abdominal pain,alternate contipative n diarrhoic episodes with stress aggarvation of symptoms”


Complications of FALCIPARUM :-


F-Fever(black water)
L-Low blood sugar
C-Cerebral malaria
P-Pulmonary edema
R-Renal failure
U-Urine output decrease
M-Metabolic acidosis

Clinical Features of Down Syndrome :-


S- Short neck
H- Hair thin
I- IQ level (20-75)
T- Transient Leukemoid reaction
D- Doudenal Atresia
O- Occiput Flat
W- Wide Ulnar loop
S- Simian crease
Y- Yellow skin (jaundice)
N- No fertility
D- Delayed fontanelles closure
R- Rolling eye
O- Only male infertility , female fertile
M- Mentally ill
E- Epicanthic folds

Sarcoidosis Clinical Findings :-


S- Skin findings (Erythema Nodusum , Plaques)
A- Arrythmias
R- Renal stone
C- Cranial Nerve Palsies
O- Osteoporosis
I- Interstitial Lung disease
D- Diabetes Inspidus
O- Ocular findings (Uveitis , Photophobia)
S- Splenomegaly
I- Inguinal Lymph node enlargement
S- Stridor

Hyperprolactinaemia Causes :-


P- Pregnancy
R- Reserpine
L- Lactation
A- Antidepressant Drugs
C- Chronic Renal Failure
T- Tumor of Pituatry
I- Idiopathic
N- Nipple Stimulation
S- Stress

Cushing Syndrome Clinical Features :-


M- Moon Face
O- Obesity
O- Osteoporosis
N- Neurological Problems
S- Striae
H- Hirsutism , Hypertension
A- Acne
P- Plethora
P- Peptic Ulcer
E- Edema
N- No Sexual Desire (Libido,Impotency)
D- Diabetes Mellitus

Nephritic and Nephrotic

1) nephritic syndrome :
a) 'P'edia = 'P'SGN
b) 'A'dults= ig 'A'

c) over'A'll = ig 'A'

2) nephrotic- syndrome:
a) children=mcd
b) adults=fsgs
c) old age=membranous
d) overall=fsgs

Opthalmology mnemonics

Remember Keratoconus with the help of CONES:

Central scarring & Fleischer ring 
Oil drop reflex / Oedema (hydrops) 
Nerves prominent 
Excessive bulging of lower lid on downgaze (Munson’s sign) 
Striae (Vogt’s)

Remember Iridocorneal Endothelial Syndrome with ICE

Iris Naevus
Chandler Syndrome
Essential Iris Atrophy

Remember Behcet's Disease with the help of ORAL UPSET

Occlusive periphlebitis 
Anterior uveitis 
Leakage from retinal vessels 
Ulceration (aphthous/genital) 
Pustules after skin trauma (Pathergy test) 
Scratching leaves lines (dermatographism) 
Erythema nodosum 

Remember posterior scleritis with POST SCLER

Swelling of disc 
Thickening of sclera (US/CT) & T sign (fluid in sub-Tenon’s space) 
Subretinal exudates 
Choroidal foLds 
Exudative RD 
Ring choroidal detachment

Remember causes of Choroidal neovascular membrane with HAMMAR

Multifocal Choroiditis
Rupture of the choroid

Remember the causes of trabecular pigmentation withPIGMENT

Pseudoexfoliation & Pigment dispersion syndrome
Glaucoma (Post angle closure Glaucoma)
Melanosis of angle (oculodermal melanosis)
Endocrine (Diabetes & Addison’s Syndrome)
Naevus (Cogan-reese syndrome)

Remember sterilization in ophthalmology with ABCDEFG

CHEMICALS like Alcohol (Rectified spirit), Isopropyl alcohol/CIDEX: 2% Glutaraldehyde
DRY HEAT temperature of 150°C is used for 90 minutes
ETHYLENE OXIDE for sterilization of IOL etc.
FUMIGATION of operation theatre/ FORMALIN vapour
GAMMA-IRRADIATION: Gamma rays from Cobalt-60

Remember the ocular structures derived from neuroectoderm with MORE

Muscles of pupil
Optic Nerve
Retina (with RPE)
Epithelium of Iris
Epithelium of Cilliary Body

Remember the structures derived from surface ectoderm with S1L2E3

Skin of Eyelids and its derivatives viz. cilia, tarsal glands, conjunctival gland
Lacrimal Gland,
Epithelium of Conjunctiva,
Epithelium of Cornea,
Epithelium of lacrimal passage

Remember Stromal dystrophies with Marilyn Monroe Always Gets Her Man in LA City.

Macular dystrophy
Alcian blue

Granular Dystrophy
Hyaline material
Masson's Trichrome

Lattice Dystrophy
Congo Red

Remember the drugs causing cataract with ABCD


Remember the causes of Uniocular diplopia as ABCD

Behavioral: psychogenic
Dislocated lens

Remember microtropia with 3 A


Angle small

Absent central field (Central suppression scotoma)

Remember the refractive indices of ocular media with8303 (from anterior to posterior)

cornea 1.38
aq humour 1.33
lens 1.40
vit humour 1.33

Remember the types of colour blindness with TuB PaR DoG




Remember the causes of lid retraction with 4 MP

4M= MMarcus Gunn jaw winkling syndrome,Myotonic causes like dystrophica myotonica.Metabolic cuses like uraemia,cirrhosis

4P=Perinauds syndrome,Parkinson's Disease/Progressive supranuclear palsy,PPalsy (aberrant III crnaial nerve regeneration)

Remember content & veins draining the Cavernous Sinus with Rule of 3

3 Afferent veins: Sphenoparietal sinus (Vault veins), Supf Middle cerebral Vein (Brain), Ophthalmic vein (Orbit)
3 Efferent Veins: Superior petrosal sinus, Inferior Petrosal Sinus, Communicating vein to pterygoid plexus
3 Contents; Cranial Nerves (III,IV, V1,V2 & VI)
3 Areas Drain into it: Vault Bones, Brain (Cerebral Hemisphere), Orbit
3 Nerves: Motor(III,IV,VI),Sensory (V1,V2), Sympathetic

Remember the causes of pseudo tumor cerebri with " Idiopathic IDEA"


Infections-Otitis media,mastoiditis,viral infections etc

Drugs-Steroid withdrawl,Vitamin A intoxication,Nalidixic acid,amidarone,cyclosporin,minocycline

Endocrine-obese,amennorrheic woman of child bearing age, Hypoparathyroidism


Remember the causes of downbeat nystagmus withDoWNBEAT

Degeneration,Demyelination or Drugs (Lithium)

Wernicke's Encephalopathy

Neoplasm or paraneoplastic cerebeller degeneration

Brainstem disease (Syringomyelia)


Arnold-Chiari malformation

Trauma or Toxin

Remember characteristics of congenital nystagmus withCONGENITAL

Convergence & eye closure dampens

Oscillopsia absent

Null zone that is present,increases foveation time which results in increased acuity

Gaze poisition doesnot change the horizontal direction of nystagmus

Equal amplitude and frequency in each eye

Near acuity is good

Inversion of optokinetic response

Turning of head to acheive null point

Abolishes in sleep

Latent (occlusion) nystagmus occurs

Remember "DWARF" for decribing Nystagmus

Direction=plane of movement-horizontal,vertical

Waveform= Pendular or Jerky

Amplitude= fine or coarse

Rest=At primary position or gaze evolked

Frequency= How often the eye moves

Remember the characteristics of Perinaud's Dorsal Midbrain Syndrome with "CLUES"

Convergence retraction nystagmus

Lightnear Dissociation

Upgaze paralysis

Eyelid retraction

Skew deviation

Remember ocular features of acromegaly with ACROM

Angiod streaks

Chiasmal syndrome


Optic atrophy,papilloedema

Muscle enlargement

Remember the systemic features of Marfan syndrome withMARFANS

Mitral prolapse

Aortic dissection

Regurgitant aortic valve

Fingers long (arachnodactyly)

Arm span>height

Nasal voice (high arched palate)

Sternal excavation

Remember the ocular features of Marfan’s syndrome withCLUMPS

Cupping (glaucoma)


Upward lens subluxation


Cornea Plana

Sclera blue

Remember angle structures with "I Can See Till Schwalbe's Line"

Iris root

Cilliary Body

Scleral spur

Trabecular Meshwork

Schwalbe's Line

Drugs of choice

1. Paracetamol-poi soning :- acetyl cysteine
2. acute bronchial- asthma :-salbutamol
3. acute gout :- NSAIDS
4. acute hyperkalemia:- calcium gluconate
5. severe DIGITALIS toxicity :-DIGIBIND
6. acute migraine :- sumatriptan
7. cheese reaction :- phentolamine
8. atropine poisoning :-physostigmine
9. cyanide poisoning :- amyl nitrite
10. benzodiazepine poisoning:-flumazenil
11. cholera :- tetracycline
12. KALA-AZAR :- sodium stibgluconate
13. iron poisoning :-desferrioxamine
14. MRSA :- vancomycin
16. warfarin overdose :- vitamin-K
17. OCD :- fluoxetine
18. alcohol poisoning :- fomepizole
19. epilepsy in pregnency :-phenobarbitone
20. anaphylactic shock :-Adrenaline