First Priority Flashcards
Which space has internal vertebral Venus plexus
Epidural space
Aortic auscultation
RIGHT second intercoastal
Action of genioglossus muscle
Sticking the tongue out
Sensory dysfunction of musculocutaneous nerve compression within coracobrachialis
Hyperaesthesia of lateral forearm
The effective refractory period (ERP) of the atrioventricular (AV) node affected by parasympathetic and sympathetic nerve
P increases ERP
S decreases
Which urethra is entirely surrounded by bucks fascia
Spongy
Large artery passing inferiorly over anterior aspect of pancreatic head
SMA
Posterior relation of kidney with muscles
M. edially psoas M. ajor
L. aterally quadratus L. umborum
most lateral is transversus abdominis
Only difference of posterior relation between kidneys
Left kidney has relation with 11 th rib
Nerve at greatest risk during Lanz incision
Ilioinguinal
Which structure contains splenic vessels
Linorenal ligament
Content of gastrosplenic ligament
Left gastroepiploic vessels and short gastric vessels
Which nerve maybe compressed at arcade of frohse
PIN
This arcade is SUPERFICIAL part of supinator
Which nerve maybe compressed at aberrant gantzer muscle
AIN
Gantzer is aberent part of flexor pollicis longus
Primary source of innervation of anterior scrotal skin
Ilioinguinal
Neck swelling moves sideways
Chemodectoma
Most common symptom of syringomyelia
Loss of pain and temperature sensation mostly of upper limb
Autosomal Type of achondroplasia
Dominant
Most common cause of dwarfism
Achondroplasia
Mechanism of achondroplasia
Defect in Fibroblast growth factor
Bowen disease
In situ SCC
Erythematous scaling patch from sun exposure
Most common site to be affected by osteomyelitis
Cervical spine
Most common site to be affected by TB
Thoracic spine
Recurrent Painful hematuria ,bladder pain , increased frequency without infection in younger patient
Interstitial cystitis
Best imaging for managing fracture
Orthopantomogram
(Panoramic tomography)
Panoramic > wide view
Tomography > cross section through
https://www.google.com/search?q=orthopantomogram&oq=orthopantomogram+&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIHCAEQABiABDIHCAIQABiABDIHCAMQABiABDIHCAQQABiABDIHCAUQABiABDIHCAYQABiABDIHCAcQABiABDIHCAgQABiABDIHCAkQABiABDIHCAoQABiABDIHCAsQABiABDIHCAwQABiABDIHCA0QABiABDIHCA4QABiABNIBCDQ5MDFqMGo5qAIAsAIB&client=ms-android-oneplus-rvo3&sourceid=chrome-mobile&ie=UTF-8
Which muscle is cut during pfannenstiel
Transversus abdominis
Emergency airway access
Piercing cricothyroid membrane
Courvoisier law for what
Carcinoma of pancreatic head causing jaundice
Timing of anal fissure bleeding
Post defecation
What to do for post cholesystectomy RUQ pain
ERCP and stenting
Tender RUQ of a sheep owner
Hydatid cyst
First line treatment of large femoral thrombosis
IV heparin
(Not warfarin- H is before W)
Spinal injury level to cause autonomic dysreflexia
At or above T6
(Higher the lesion greater the risk)
https://en.m.wikipedia.org/wiki/Autonomic_dysreflexia
What may occur following long term varicose vein
Eczema
Follow up after resection of large 4cm carcinoid
CT/PET CT
OR
somatostatin receptor scintigraphy
Follow up for asymptomatic post carcinoid operation
P-CgA twice a year
Annual USG
P-CgA, or chromogranin A, is a protein that can be used to help diagnose and monitor carcinoid tumors
A CgA test can help diagnose carcinoid tumors, especially when combined with a 5HIAA urine test.
Sudden sharp chest pain in pregnancy
Aortic dissection
Specially in the third trimester due to increased blue volume and cardiac output
Tall statute suggests underlying connective tissue disorder associated with it.
Most specific factor for rheumatic arthritis
ANA
Origin of right coronary artery
Anterior cusp above valve
Origin of left coronary artery
Posterior cusp above valve
Cause of hemolysis in splenomegaly
Sequestration by sinusoids
Component of PIGMENTED gall stone
Calcium bilirubinate
Dartos muscle is derived from
Superficial fascial layer
Brachial cyst is derived from with arch
2nd
SA or AV which is part of conducting system
AV
First line treatment of hypercalcemia
IV normal saline
Treatment of antithrombin 3 deficiency
Warfarin for life
Warfarin inhibits synthesis of vitamin-K dependent clotting factors II, VII, IX, and X as well as anticoagulant factors proteins C and S.
Antithrombin III (AT III) is a protein that regulates blood clotting by inactivating factors that contribute to blood clots
AT III is responsible for up to 80% of thrombin inhibition.
Do not operate before what core temperature
36° C
Most common cause of painless fresh PR bleeding in children but having abdominal pain
Juvenile polyp
Sympathetic and peristalsis
Sympathetic activity decreases peristalsis
Epispadias due to
Abnormal positioning of genital tubercle
https://images.app.goo.gl/3mhEPQG8JPbdNwkZ7
Hypospadias is defect of
Urogenital fold
The genital tubercle pulls together the urethral folds (from the cloacal folds) to form the urogenital folds, which will fuse in the midline to become the shaft of the penis in males or the unfused labia minora in females.
Early and late cause of tachypnea and arrest following femur fracture
Early by fat embolism (hours)
Late by pulmonary embolism (days)
Why carbohydrate rich drink before surgery
To reduce insulin resistance and improve nitrogen balance
Cause of low platelet and peticheal rash with high PT and APTT after splenectomy
DIC
Investigation for hypercalcemia from lung cancer
PTH related peptide
(Para neoplastic syndrome)
Most common lab abnormality of Cushing disease
Hypokalemia
Steroid acts as mineralocorticoid and saves sodium and excretes potassium
Adrenaline acts on which Heart receptor to increase heart rate
B1
Affected receptor in myasthenia gravis
Post synaptic cholinergic receptors
Pathology to cause renal damage in white limbs from arterial embolus
Rhabdomyolysis leading to myoglobinuria
Emergency tracheostomy between
Suprasternal notch and cricoid cartilage
Full bladder control even after complete transaction of spinal cord
Intact innervation to internal sphincter
Concentrating urine in loop of Henle meditated by
Water impermeability in thick ascending loop
Lymph from scrotum draining
Superficial HORIZONTAL inguinal
Lymph from lower limb draining into
Superficial VERTICAL inguinal
Lymphatics from anal canal below dentate line
Superficial inguinal
Failure of development of metanephros results in
Renal agenesis
Nerve responsible for Freys syndrome or gustatory sweating
Parasympathetic regeneration of auriculotemporal nerve
Nerve involved in numbness of cheek
Maxillary division of trigeminal
Ions responsible for function of aldosterone
Na/K
Site of action of aldosterone
Collecting duct
Ductus arteriosus originates from which aortic arch
6th
Basis of Cushing reflex
Sympathetic stimulation due to increased ICP
First CBC change after splenectomy
Thrombocytosis
Site of brain hemorrhage after sudden collapse from exercise
Subarachnoid
Medication for brain metastasis from lung cancer
Dexamethasone
Can carcinoembryonic antigen (CEA) test can help detect breast cancer
Yes
but it’s not used to screen for or diagnose breast cancer alone
Tender and red best swelling not responding to antibiotics
Inflammatory breast malignancy
Stabbed at left 5th intercostal space but x-ray normal and patient is stable
What investigation is to do next
Echo cardio gram
Relapse of graves’ disease
What to do
Give carbimazole
And if pregnant then give propylthiouracil
Another option is surgery
Structure going superolaterally from umbilicus
Remnant of umbilical vein to liver
What is ligamentum teres
The ligamentum teres, also known as the round ligament of the liver, is a fibrous cord that connects the liver to the umbilicus and is a remnant of the umbilical vein
Relation if Falciform ligament with umbilical vein
Within the lower edge of the falciform ligament is (Falciform ligament is
A triangular fold of peritoneum)
the ligamentum teres (round ligament), a remnant of the obliterated umbilical vein (ductus venosus) that travels from the umbilicus into the umbilical fissure where it is in continuity with the ligamentum venosum as it joins the left branch of the portal vein.
What forms the median umbilical fold
Urachus
What forms the medial umbilical fold
Umbilical artery
What forms the lateral umbilical fold
Inferior epigastric artery and vein
Non comminuted and STABLE patella fracture
casting
Non comminuted and DISPLACED patella fracture
Wire binding
Comminuted patella fracture
Patellectmy
Swimmer with recurrent otalgia, heart loss and tympanic membrane can’t be visualized
Exostosis
Mechanism of action of year
It activates anti thrombin 3 and forms complex with factor 2,9,10,11,12
4cm Rhomboid excision of face
Full thickness skin graft
Dog bite of nose
Secondary intension
Abscess drainage
Alginate ribbon pack
Superficial wound dehiscence
Vacuum dressing
Full thickness burn
Split thickness skin graft
Pretibial laceration with intact periosteum
Split thickness skin graft
Pretibial laceration with injured periosteum
Flap
Injured pretibial flap which can’t be approximated
Graft
Venous ulcer over medial malleolus
Compression bandage
Supply of SA node
Cardiac plexus
(Combination of both sympathetic and parasympathetic)
Nerve supply of ventricle
Sympathetic
Primary action to clear fourth foreign substance from lung
Mucocililiary action
Best investigation for fistula vs recurrent fistula
Fistulogram
For recurrent do MRI
Hip pain with history of fracture repair
1 year ago
Avascular necrosis
ABDOMINAL aortic aneurysm size<5.5cm
Active observation with USG every 3 months
When to do CT angiography for abdomen aortic aneurysm
To confirm rupture
Myelinated nerve fibers are
A and B
Not C
Diameter and velocity of conducting decreases
A>B>C
Anesthesia in COLLES’ fracture
Hematoma block
Most numerous nerve fiber
Narrowest one C fibre
Normal site of oxyphil cells
Parathyroid
ABNORMAL site of oxyPHil cells
Hurtle cell types of PHollicular carcinoma of thyroid
Definition of metaplasia
Reversible change of cell type in response to local injury
How does a trans cuteneous electrical nerve stimulation relieves chronic pain
Inhibiting of posterior horn of grey matter
By gate theory of pain
Jaundice from Zimbabwe with another ABNORMAL liver function but normal liver USG
Hepatitis A
Most common lung cancer of non smoker
Adenocarcinoma
Most common cause of lymphangitis
Streptococcus pyogenes
Most common renal stone
Calcium oxalate
Multiple
Recurrent
Familial hyper oxaluria
Most radio opaque renal stone
Calcium phosphate
Proteus mirabilis associated with which renal stone
Struvite of staghorn stone
Most radio lucent renal stone
Urate
Renal stone associated with chemotherapy
Xanthine
From cell death
Progression of HIV lymphadenitis
Follicular hyperplasia>mixed>follicular involution
Cardiac muscle contraction is maintained by
Influx of Va2+ through sarcolemma
Cause of pre renal failure from massive hemorrhage
RENAL vasoconstriction from hypovolemia
Which nerve damage cause huperacusis
Nerve to stapedius a branch of facial nerve
Multiparous woman with painful breast lump ,brown nipple discharge with dilated lactation duct in USG
Periductal mastitis
Which acute protein increases after
24 hours
CRP
Action us l of aspirin
Inhibits COX 1 AND
decreases thromboxane
Radiological site of Vesicoureteric junction
Ischial spine
High urine osmolality and low serum osmolality after head injury
Fluid restriction
It’s SIADH
Treatment of raw bone surface
Random flap
Treatment of bone is not exposed
Split thickness skin graft
Swollen leg of pregnant lady just like her mother and maternal aunt
Anti phospholipid antibody
Checking amyloid
With congo red under polarized light
Showing apple green
Which electrolytes imbalance has long QT
Hypocalcemia
Most common cause of fever after
24 hours of cholecystectomy
Pulmonary atelectasis
Metabolic disorder of pyloric stenosis
Hypochloremic hypokalemic metabolic alkalosis
Medication for recurrent emboli despite taking heparin
IVC filter
Appropriate investigation for pulmonary embolism
CTPA
Reconstruction of full thickness burn
By split thickness skin graft
Management of full thickness burn with dry crusty
Occlusive dressing then make wound granulation then split thickness skin graft
Side effect of long term metformin use
Lactic acidosis
Good prognostic factor of Malignant melanoma
Breslow thickness
Nerve involved for lower lip numbness
Mental nerve or inferior alveolar nerve
Which are branches of Trigeminal nerve
Connection between superior and inferior mesenteric arteries
Marginal artery of Drummond
Cause of bleeding in patient taking aspirin
Aspirin induced thrombocytopenia
Differ obstructive and restrictive lung disease by FEV1/FVC
<70% is obstructive
>70% is restrictive
Relation of left coronary artery with pulmonary trunk
LCA runs behind pulmonary trunk
https://images.app.goo.gl/K1AiQVeRTgvq2xVU7
Which muscle causes descend of MEDICALLY adducted eyeball
Superior oblique
https://images.app.goo.gl/imqovHEyfem797eo7
Biliary change after cholecystectomy
Reduced Hepatic circulation of bile salt
Anal canal below dentate line vs lower limbs lymphatic drainage
Anal canal is horizontally related so horizontal superficial inguinal nodes
Limbs are vertically related so
vertical superficial inguinal nodes
Structure at risk during short gastric artery ligation
Fundus of stomach
First action for anaphylaxis
Adrenaline 1:1000 IM
Large amounts of normal saline can cause
An overload of chloride ions in the blood, which can lead to metabolic acidosis. This is because chloride and bicarbonate work together to maintain the ionic balance of cells.
https://images.app.goo.gl/cMPLVkmuxppZfGCG8
ECG having flat P and wide QRS
Hyperkalemia
https://images.app.goo.gl/c7TEwwUN9mFRZ8ic6
Initial treatment of hypercalcemia
IV normal saline
Cause of Bilateral leg edema from extensive burn
Hypoalbuminemia
What divides Subclavian artery into 3 parts
For its passage between scalenus anterior and medius
https://images.app.goo.gl/M8FW5Fk5gHvnFKs48
What divides axillary artery into 3 parts
Pectoralis minor
https://images.app.goo.gl/MjKCwiHK6raQf6oM8
Which anesthesia for a Patient with COLLES’ fracture having CKD and IHD
Bier’s block
Which electrolyte abnormality will cause Paraesthesia after thyroidectomy
Ca
Circumoral paresthesia after a thyroidectomy can be a symptom of hypocalcemia, which can occur when the parathyroid glands are accidentally removed during surgery
Affect of CKD on parathyroid glands
Hyperplasia
PTH increases calcium absorption from food and removes calcium from bones to maintain normal blood calcium levels.
When kidneys are damaged, they can’t activate vitamin D, which is needed to absorb calcium from food. This leads to low calcium levels in the blood, which signals the parathyroid glands to produce more parathyroid hormone (PTH).
Which leads to secondary hyperparathyroidism
HER positive and ER negative for breast cancer
Which chemo should be given
Only herceptin aka trastuzumab
HER positive and ER positive for breast cancer
Which chemo should be given
Herceptin and ECF regimen (epirubicin, cisplatin and fluorouracil)
ECF is considered the “gold standard” chemotherapy regimen for hormone sensitive breast cancer.
dysplasia vs metaplasia
Metaplasia is the replacement of one mature cell type with another mature cell type, while dysplasia is the replacement of a mature cell type with a less mature cell type.
Metaplasia is reversible, while dysplasia is not.
What is another name of premalignant condition
Dysplasia
Peripheral lung carcinoma are
Adenocarcinoma
Large cell carcinoma
Central lung carcinoma
Small cell carcinoma
Squamous cell carcinoma
Next step after finding out post traumatic widened mediastinum on x-ray
CT chest
Renal transplant patient with multiple bone fractures and high serum calcium, low phosphate, high ALP
WHAT IS DX
Tertiary hyperparathyroidism
Which pathology causes multinodular goitre
Hyperplasia
Investigation for diplopia from head injury with apparently normal visual acuity and external orbital anatomy
3D CT
In which disease steroid improves dry mouth
Sarcoidosis
How does Squamous cell carcinoma (SCC) of the lung can cause polyuria
As a result of pituitary metastasis, which leads to central diabetes insipidus
Which bone tumor causes lytic lesion
giant cell tumors (GCTs) are lytic lesions, which means they cause destructive bone lesions
https://images.app.goo.gl/GABFyWRpFijq3xpy8
Complain of pain and stiffness at the fracture site after 20 years.
What might be the cause?
Osteoarthritis
Treatment of subcapital femoral fracture of a patient in wheelchairs
Hemiarthroplasty
Cause patient is hemi mobile
Most common causative organism of discitis
Staphylococcus aureus
Weight loss, Microsoft hypochromic anemia, palpable left supraclavicular node
Gastric carcinoma
Intubated post traumatic patient becomes hypoxic after log rolling
What is the cause
Tracheal tube displacement
Why Regional anesthesia is a key component of Enhanced Recovery
Regional anesthesia is a key component of Enhanced Recovery After Surgery (ERAS) protocols, and plays a vital role in improving patient outcomes. Regional anesthesia can:
Reduce opioid use: Regional anesthesia can help reduce the need for systemic opioids after surgery.
Improve recovery: Regional anesthesia can help patients recover faster.
Improve mobility: Regional anesthesia can help improve mobility after surgery.
Reduce nausea and vomiting: Regional anesthesia can help reduce postoperative nausea and vomiting.
Improve organ function: Regional anesthesia can help improve organ function after surgery.
boerhaave vs mallory weiss
Boerhaave’s syndrome
A rupture in the full thickness of the esophagus wall, also known as a transmural tear. This is a severe condition that usually requires emergency repair and can be life or death. Symptoms include sudden severe chest pain, repeated vomiting and retching, and pain that may radiate to the back or left shoulder.
Mallory-Weiss syndrome
A tear in the inner lining of the esophagus. This is rarely fatal, as the tears usually heal on their own within 48 to 72 hours. Symptoms include vomiting blood, passing black or sticky stools, stomach pain, dizziness, and fainting.
nerve at risk of injury during posterior approach of lower femur
Sciatic/tibial
Can GERD cause malena
Gastroesophageal Reflux Disease (GERD) can cause melena, which is dark, tarry stools that indicate bleeding in the upper gastrointestinal (GI) tract
conditions associated with excessive acid production, such as gastroesophageal reflux disease (GERD), may cause severe inflammation of the esophagus known as erosive esophagitis, which in turn can lead to ulceration and consequent bleeding.
What is a intestinal duplication?
Intestinal duplications are tubular structures that are attached to the intestines and share a common blood supply; their lining resembles that of the gastrointestinal tract.
The clinical picture is usually characterized by epigastric pain, vomiting and palpable abdominal mass,
https://images.app.goo.gl/m4qNax6DXqEQFpY76
Rapidly growing (3 months) thyroid mass in old aged female (70 years)
Anaplastic carcinoma
Which carpal bone dislocation will cause median nerve injury
Lunate
Which spinal injury will involve multiple nerves and followed by bladder and bowel involvement
Sudden central lumber disc prolapse
An example is weight lifting
Treatment of single rib fracture of young patient without pneumothorax or hemothorax
Oral analgesics
First line of investigation for painless thyroid nodule
FNAC
What to do with false arterial aneurysm
Observe with serial USG
Treatment of scald burn
Occlusive dressing by duoderm
most common breathing complications after surgery.
Atelectasis
is the collapse of a lung or part of a lung, also known as a lobe. It happens when tiny air sacs within the lung, called alveoli, lose air.
What is the most common site of atelectasis?
Right middle
Because the right middle lobe orifice is the narrowest of the lobar orifices and because it is surrounded by lymphoid tissue, it is the most common lobe to become atelectatic.
Surgical compilation of autonomic neuropathy
Reduced pulse rate variability
How to increase microcytic hypochromic anemia before surgery
Oral Iron supplement
Most common cause of jaundice, splenomegaly, gall stone in Caucasian
Spherocytosis
What is ankle brachial index
https://my.clevelandclinic.org/health/diagnostics/17840-ankle-brachial-index-abi
So if ABI is within normal range then do only heparinization for dusky swollen leg
Scrotal lymph draining point
Medial group of superficial inguinal nodes
Cause of minor painless PR bleeding in a 5 years old
Juvenile polyp
majority of Pancoast tumors are
non-small cell lung cancer (NSCLC), with adenocarcinoma being the most common subtype
Which nerve root is damaged by Pancoast tumor
T1
Most important lab findings in osteomyelitis/rickets
Raised PTH
Raised ALP
Low calcium
Low phosphate
Bone biopsy will show increased
non mineralized osteoid
Structure divided during pfannenstiel incision
Skin
Rectus sheath
Fascia transversalis
Parietal peritoneum
Most common electrolyte abnormality in Cushing disease
Hypokalemia
Cause of unilateral proptosis with gingivolqbial fullness and cheek anesthesia of old age
Maxillary sinus carcinoma
Immediate management of pneumothorax
Chest drain
30 year of age with focal breast pain but examination is normal and USG normal
What to do
Analgesic ain’t reassurance
Most appropriate treatment for post phlebitis syndrome
Compression stockings
Post-thrombotic syndrome (PTS), also called postphlebitic syndrome and venous stress disorder is a medical condition that may occur as a long-term complication of deep vein thrombosis (DVT).
10 months old
Vomited since birth
Fall to thrive
Recurrent chest infection
Tracheo oesophageal fistula
Management of exposed bone from burn
Free flap
Treatment for morning headache, nausea, blurring of vision in a bronchial cancer patient
Dexamethasone
Brain metastases, or brain mets, are a common occurrence in lung cancer patients, with 16–20% of patients developing them.
They can make you feel better by improving the symptoms caused by increased pressure inside the skull, such as headaches
Treatment given for antithrombin 3 deficiency
Oral anti coagulant for lifelong
Most common electrolyte abnormality in metastatic bone cancer
Hypercalcemia
Treatment of jaundice from pancreatic cancer with metastasis
ERCP and stenting
Time frame of fat embolism
Within 3-4 days
Time frame of pulmonary embolism
After 7 days
Which disease causes Hypochromic stuff microcytic anemia with axillary and inguinal lymphadenopathy
Non Hodgkin’s lymphoma
Post surgical defect of local carcinoma
Local flap
Executional dyspnoea with history of ICU ventilation
Subglottic stenosis
Cause ot laryngomalacia
Withdrawal of compression
After goitre surgery
Minimal displaced closed Spiral tibial fracture in young aged patent
Toe to groin cast
Both knee and ankle joints must be immobilized
What is Paget Schroetter syndrome
PSS is effort-induced thrombosis of the axillary and subclavian veins associated with compression of the subclavian vein at the thoracic outlet.
Manifestation is engorged veins while raising arms
https://images.app.goo.gl/sjy3XYQuizUB82pYA
Causes of Paget-Schroetter syndrome
Repetitive trauma—sports like crochet, swimming, wrestling, or gymnastics, or work in jobs that involve repeated overhead motion.
Anatomical abnormalities—outlet can be abnormally shaped, costoclavicular ligament inserting more laterally than normal ,subclavius and anterior scalene muscles can also hypertrophy
Compression—subclavian vein can be compressed between the clavicle and first rib
Drug for peripheral vascular disease having no effect on heart
Pentoxyphilline
Basis of Morgagni hernia
Defeat of cardioperitoneal membrane
Metabolic effect of adrenaline
Glycolysis
Management of patient with pulmonary embolism
Heparin
Air embolism position
Lateral decubitus
most common site of ruptured thoracic aorta
Proximal descending aorta distal to origin of subclavian artery
X-ray finding of ruptured thoracic aor aorta
Widening medium
factors of intrinsic pathway
8,9,11
factors of Extrinsic pathway
1,2,7,10
What is dabigatran
Thrombin inhibitor
Heart rate of transplanted patient depends on
Atrial filling
Nerve involved in post exercise lower abdominal pain going to groin
Iliohypogastric nerve
Some abdominal planes
Trans pyloric L1
Sub costal L3
Trans umbilical L3-L4
Inter spinous L4
Inter tubercular L5
Blood supply of meckels diverticulum
Vitelline artery
Or
Omphalomesenteric artery
Finding of gut malrotation in children
SMA is right to midline in trans pyloric plane
ABG in septic shock
Low bicarbonate
Compensatory tachypnea causing low co2
Metabolic acidosis is a common acid-base disturbance in patients with septic shock
Indications for renal transplant
K+ > 6.5 despite medical treatment
Hyper Mg
Hyper urecemia
Metabolic acidosis
Urine output < 200
Antibody found in atrophic gastritis
Against parietal cells
Interpretation of urinary outputs decrease
Sudden decrease catheter block
Gradual decrease renal cause
What forms posterior wall of inguinal canal
Conjoint tendon medially
Fascia transversalis laterally
Lymph from Anal canal above pectinate line
Internal iliac
Change of parathyroid in CKD
Hyperplasia
Post op regime for breast cancer with HER +,ER-,PR-
Herceptin and ECF regime
Premalignant lesion aka
Dysplasia
Lung cancer with polyurea
Squamous cell type
Branches of V3
Buccal
Mental
Auriculotemporal
Lingual
Inferior alveolar
Causes of lactic acidosis
Primary -shock, hypoxia, burn
Secondary-metformin
Prognostic factor of malignant melanoma
5mm breslow thickness
Most common site of Pigmentation in malignant melanoma
Sun exposed areas like face, back, arms, legs
The scrotum has multiple layers
Skin: The thin, hairless scrotal skin has many sweat and sebaceous glands that help regulate the temperature of the testicles.
Dartos fascia: A continuation of Colles fascia in the perineum and Scarpa’s fascia in the abdomen.
External spermatic fascia: A continuation of the external oblique aponeurosis.
Cremaster muscle and fascia: A continuation of the internal oblique muscle.
Internal spermatic fascia: Loosely attached to the tunica vaginalis.
Tunica vaginalis: A layer of the scrotum.
Treatment for bradycardia of heart transplant patient
Isoproterenol
Side of action of isoproterenol
B1
Treatment of bradycardia in non heart transplant patient
Atropine
Anesthesia for COLLES’ fracture
Bier’s block with prilocaine
GFR measurement by
Endogenous by creatinine
Exogenous by inulin
Renal plasma flow measurement by
Endogenous by urea
Exogenous by para amino hippuric acid
Gut rotating axis and degree
Axis is SMA
degree is 270
High risk of surgery in a patient with microcytic Hypochromic anemia
Decreased cardiac contractility due to anemic heart failure
Changes after cholecystectomy
Increased rate of bile flow after meal
cause of offensive stool in obstructive jaundice
blockage that prevents bile from reaching the intestines
So reduced enterohepatic circulation of bile salt
Cause of auto digestion in pancreatitis
Trypsin
Cause of auto digestion in hemorrhagic pancreatitis
Fecal elastase
Hemorrhagic pancreatitis is a severe form of acute pancreatitis that causes the pancreas to release a large amount of active elastase.
Elastase is an enzyme produced by the pancreas that helps break down fats, proteins, and carbohydrates during digestion.
Cause of hypertension, bradycardia, low voltage ECG
Hypothyroidism
Metabolic cause of confusion, nausea, vomiting, acute illness in metastatic breast cancer
Hypercalcemia
Cerebral lesion with central necrosis causing midline compression
Glioblastoma
Most likely cause of upper outer quadrant. Breast mass with axillary lymphadenopathy
Invasive ductal carcinoma
Gut resection affecting vit K
Resection of terminal ileum
Receptor for nor epinephrine
A1
Origin point of cranial nerves
2,2,4,4
Cerebrum, midbrain , pons, medulla
https://images.app.goo.gl/fXGn6RXyc9nueeGBA
https://images.app.goo.gl/TSQg9mkP6nwDjBEx5
H/O IHD, hypertensive, tachycardia, cool periphery
Dx?
Carcinogenic shock
Type of parotid tumor with perineural invasion
Adenoid cystic carcinoma
Level of Spinal injury with urinary retention and reduced anal tone
L1-L2
26 years old, unilateral testicular swelling, heterogeneous mass, elevated AFP
Teratoma
Patient is in HDU with difficulty swallowing with mucosal white plaques
Candida oesophagitis
Naloxone antidote to what?
rapidly reverse opioid overdose
can reverse and block the effects of other opioids, such as heroin, morphine, and oxycodone.
ACE inhibitors in case of MI
ACE inhibitors can reduce the rate of myocardial infarction
can oxpentifylline reduce rate of myocardial infarction
No
Artery supply Broca’s area
Middle cerebral
Patient with sudden affection of gait, disequilibrium, nystagmus
PICA syndrome
Or
Wallenberg syndrome
Or
Lateral medial syndrome
Arterial cause of sudden urinary retention and lower limb paresis
Artery of adamchweick which is a branch of descending aorta
Effect of oculomotor nerve injury on iris
Mydriasis
Full names of clotting factors
https://images.app.goo.gl/U6WknvAVciJg3WNw5
Mechanism of heparin action
Activation of antithrombin 3
Inhibition of factor Xa
Origin of ranula
Sublingual gland
Tumor marker for malignant melanoma
S100
Treatment for nasal MRSA positive
Mupirocin ointment
Treatment for skin MRSA positive
Chlorhexidine
Systemic treatment for MRSA positive patient
IV vancomycin
IV Teicoplanin
IV/oral Rifampicin
It resistant then Linezolid
Apocrine metaplasia, epithelial overgrowth, papillary projection
Benign breast cyst
Painless bright red per rectal bleeding
Juvenile polyp
Pressure on which nerve cause torticollis
Spinal accessory
Relation is age of pregnancy with breast cancer
Delayed age increases risk
Increased sympathetic activity, losing 5kg weight in 6 months in female
Graves disease
Morphine overdose on ABG
Respiratory acidosis
What to do after excision of melanoma in situ with 1cm margin
Education about skin self examination and discharge from flow up
Rate of blood pumping during exercise for adult
5-6 litter/minute
2 days old, lower limb cyanosis, Bilateral absence if femoral pulse
Interrupted aortic arch
(Maybe distal to left Subclavian artery)
Cause of dark urine in obstructive jaundice
Increased conjugated bilirubinURIA
Earliest physiological response to hypothermia
Increased constriction of peripheral blood vessels
Diffuse skin pigmentation with hypotension after surgery
Adrenal insufficiency
CO2 sensitivity of blood
Central chemoreceptor
Frank painless hematuria, anemia, prostate mildly enlarged in DRE,PSA normal
Transitional cell carcinoma
Emergency tracheostomy between suprasternal notch and
Cricoid cartilage
5 year Survival rate of dukes B
70%
Angina on pegging laundry after left internal mammary graft for CABG
Subclavian artery steal syndrome
Most common parotid tumor with perineural invasion
Adenoid cystic carcinoma
Ganglion for tear
Pterygopalatine
(Tear—pTerigo)
Weakness of leg after nerve block for inguinal hernia repair
Femoral
Vessel may be injured from a subclavian incision extending from sternoclavicular joint to deltopectoral groove
Thoracoacromial artery
Cause of hypotension/shock, tachycardia, tachypnea
Sepsis
Most common rejection of marrow
Graft vs host
Type of hypertension in graft vs host
Type IV
Clinical presentation of graft vs host rejection
Diarrhoea, rash, jaundice
Type of hypersensitivity in hyper acute rejection
Type ll
Type of hypersensitivity in acute graft rejection
Type lV
Type of hypersensitivity in chronic graft rejection
Type lll & lV
Treatment of old age breast cancer with estrogen receptor positive
Letrozole
But
Tamoxifen for younger
Relation of Radiotherapy with breast conservative surgery
It follows BCS
Indication of Radiotherapy in mastectomy
High grade
Large
Marked lymph vascular invasion
vertebral level of bifurcation of right bronchus
fifth thoracic vertebra
Relation among coagulation pathways with aPTT and PT
aPTT for intrinsic pathway factors 12,11,9,8
PT for extrinsic pathway factors
7,10,5,2
https://images.app.goo.gl/mPeZ1WWdA284gD9v8
https://images.app.goo.gl/1LTUx2Jbtvh42J8c6
elevated jugular venous pressure (JVP) can indicate which type of heart failure
congestive heart failure/venous hypertension/right-sided heart failure/Cardiogenic shock
Which artery runs with recurrent laryngeal nerve
Inferior laryngeal artery which is a branch of inferior thyroid artery
Which artery runs with internal laryngeal nerve
Superior laryngeal artery
Buttock claudication
Aorto iliac block
Thigh claudication
Common femoral
External iliac
Block
Calf muscle claudication
Superficial femoral artery block
Origin of gluteal arteries
Internal iliac artery
Leriche Syndrome
aortoiliac occlusive disease
Cause ofLeriche Syndrome
severe atherosclerosis affecting the distal abdominal aorta, iliac arteries, and femoropopliteal vessels.
Manifestation of Leriche Syndrome
It presents with a triad of claudication, impotence, and absence of femoral pulses
Intra peritoneal fluid collection in spine position
Hepatorenal pouch
Some causes of hypercalcemia
Thiazide
Antacid
Sarcoidosis
Zollinger Ellison syndrome
Effect of Coeliac disease
Hypocalcemia from reduced absorbtion
Relapse of graves’ disease on anti thyroid drugs
Give radio iodine
Relation of calcium with hyperventilation
Hypo
Causing circumoral paresthesia
