Last Minute Revision

AFMG-LAST MINUTE REVISION FACTS 2019
MESSAGE FROM THE DIRECTOR
We at AFMG put in a constant effort to provide you the best quality education material as
part of our wholesome coverage of course modules for FMGE.
We have been associated with this examination in the form of a coaching institute since
2004 and are very well aware of the constant changes in exam pattern over the years .
The book has 60 pages with most relevant must know information has been provided. Book
has been developed keeping in mind the recent trends in exam patterns.
We at AFMG thank to all our brilliant teachers our PG students, DR. MILIN SHINDE,
DR. SHASHI KUMAR, DR. PRIYANSH JAIN, DR. AMAN SETIYA, DR. NISSARG PATEL,
DR SUGAT for putting their sincere efforts to provide the most relevant material which will
be useful for the students before Exam.
Best of Luck
Dr. Vikas kumar

MBBS, MD
Any suggestions and queries are welcome @ afmgindiaglobal@gmail.com

 Theory of web of causation was given by Mc Mohan and Pugh

 James Lind is related to the discovery of Prevention of scurvy
 Gap in time between entry of the organism and the appearance of signs and symptoms is the incubation period
 When disease enters and first symptom appears is known as incubation period
 Time between entry of the organism and to produce maximum infection is known as generation time
 Serial interval is the time between onset of primary case and secondary case
 Epidemiology can be defined as the study of the distribution and determinants of frequency of disease in humans
 Study of time, place, person is known as descriptive epidemiology
 Prevalence of disease can be assessed by cross sectional study
 Longitudinal studies for identifying risk factors of disease
 Incidence rate can calculated by prospective study
 Study of a person who has already contracted the disease is called case control study
 Odds ratio is calculated from case control study
 Cohort study gives Relative risk and attributable risk
 Selection bias can be eliminated by randomization
 Missing cases are detected by sentinel surveillance
 First step in investigation of epidemic to confirm diagnosis
 Secular trend refers to gradual change in a particular direction
 Secular trend is best demonstrated by line diagram
 In an epidemic the first case to come to the notice of the investigator is the index case Secondary attack rate is a good
measure of the communicability of a disease
 Contact with hospital personnel is the most common mode of transmission of nosocomial infections
 Diseases which are imported into a country in which they do not otherwise occur is exotic
 TT is the most efficacious vaccine
 Adjuvant used in DPT vaccine is aluminium hydroxide
 Normal saline is used as diluent for BCG
 BCG vaccine is administered to children intradermally
 WHO recommends Danish 1331 strain for BCG vaccine production
 Immunization against Hepatitis B is included by WHO in immunization schedule recently
 Neurological complications at the rate of 0.5/1000 is seen with rabies nervous tissue vaccine
 Live vaccine is Yellow fever vaccine
 In acetone killed typhoid vaccine, the immunity lasts for 3 years
 Immunity develops In 30 days after the administration of Japanese encephalitis vaccine
 The vaccine for yellow fever is valid till 10 years
 17 D is a live vaccine
 MMR is a Live attenuated
 Vitamin A prophylaxis is an example of specific protection
 Vaccination against diseases is an example of specific protection
 Iron and folic acid supplementation forms Specific protection
 Primordial prevention deals with individuals without risk factor
 Desks provided with table top to prevent neck problems is an example of primary prevention
 Screening of the diseases is secondary prevention

 ICD-10 has 22 chapters PQLI includes IMR, life expectancy at 1 year, literacy
 One DALY signifies 1 year of healthy life lost
 In case fatality rate, numerator and denominator are 2 separate quantities
 Maternal Mortality Rate is calculated by maternal deaths/100000 live births
 Denominator in maternal mortality rate is the total number of live births
 Perinatal mortality rate includes death from 28 week to within the 1st wk of life
 Incidence is defined as the number of new cases occurring during a specified period
 Longer duration of the disease will cause an increase in the prevalence of the disease
 Increase in new cases in a community denotes increase in incidence rate
 Most important factor for a test to be a good screening test is sensitivity
 The ability of a test to correctly diagnose the percentage of sick people who are having the condition is called sensitivity
Positive predictive value is most affected by prevalence
 Specificity of a screening test is the ability of a test to detect true negative
 Diagnostic power of the test is reflected by: Predictive value
 Savlon contains Cetrimide + Chlorhexidine
 Bacillus stearothermophilus is used to test the efficiency of sterilization of an autoclave
 The amount of bleaching powder necessary to disinfect choleric stools, is 50 gm/lit
 Sterilization and disinfection of blood spills is done by sodium hypochlorite
 Syringes and glassware are sterilized by hot air oven
 Mean and SD can be worked out only if the data is on Interval / Ratio scale i.e. continuous
 Likert scale is an ordinal scale
 The response which is graded by an observer on an agree or disagree continuum is based on Likert scale Weight in kg is
a continuous variable
 Suitable method for presenting frequency distribution of data from continuous variables is histogram
 Graph to study relationship between two quantitative data is a Scatter diagram
 Best method to show trend of events with passage of time is a Line diagram
 Trends can be best represented by a line diagram
 Mode is a measure of central tendency:
 Regarding measures of central tendency, if more outlying observation is larger than the rest of the values ,the median
will be smaller than the mean
 TRUE ABOUT a negatively skewed data is that the mode is more than median.
 In a Left skewed curve, true state-ment is that the Mean<Mode
 In a standard normal curve, mean ± 2 standard deviation covers 95.4%
 Rejecting a null hypothesis when it is true is called as Type 1 error Chi-square test is for standard error of difference
between Proportions
 In a 3X4 contingency table, the number of degrees of freedom equals to 6
 Suggested intake of dietary fat per day in pregnancy is 30g
 NPU is the ratio of total nitrogen retained by total N2 intake multiplied by 100
 The protein efficiency ratio (PER) is defined as the gain in weight of young animals per unit weight of protein-consumed
 Egg protein is known as reference protein
 Salter scale is a useful method employed in the field to measure is birth weight
 Omega-3 fatty acids is a cardio-protective fatty acid Halibut liver oil is the richest source of vitamin A
 Under NIS, total dose of Vit A given to a child is 17 lac IU
 Pellagra is caused by deficiency of Niacin
 Iodized salt at production level and at consumer level should be 30 ppm and 15 ppm
 Safe limit of fluorine in drinking water is 0.5-0.8 mg/lit.
 Nalgonda technique is useful in endemic fluorosis.
 Cereals are deficient in Lysine
 Pulse proteins are poor in Methionine
 Maize is deficient in Tryptophan
 IgG is present in high amount in breast milk (Most abundant Ig in breast milk – IgA )
 Breast milk has more lactose in comparison to cow's milk
 Fish is deficient in Iron
 Reference weight of Indian men and women is 60 and 55 kg respectively
 One dietary cycle comprises of 7 days
 Test performed on pasteurized milk is Phosphatase test
 Test for efficacy of pasteurization of milk is Phosphatase test
 The toxin implicated in lathyrism is BOAA
 Aflatoxin is produced by Aspergillus flavus
 Toxin responsible for epidemic dropsy is Sanguinarine
 Food standards in India have to achieve a minimum level of quality under PFA standards
 Mid-day meals provided in schools is One-third of calories and one half of protein
 Nitrates in excess of 45 mg/L may cause infantile methemoglobinemia
 The vital layer in a slow sand filter is zoogleal layer
 Trickling filter has biological zoogleal layer
 Chlorine demand of water is measured by Horrock’s apparatus
 Disinfecting action of chlorine is due to Hypochlorous acid
 Residual chlorine is determined by Orthotolidine test
 Minimum chlorine content of water after chlorination should be 0.5 mg/L
 Indicator solution in Horrock’s apparatus contains Starch iodide
 Softening is recommended for drinking water when hardeness of water is more than 150 mg/litre
 Normal fluoride level for drinking purposes is in mg per liter 0.5-0.8 mg / l
 Nalgonda technique for de fluoridation is in the sequence : Lime + Alum
 Most reliable evidence of fecal contamination of water is provided by coliforms
 Ecoli is as an indicator for recent fecal contamination of water
 Cooling power of air is measured by Kata thermometer
 CO2 is the major greenhouse gas emission
 Humidity is measured by sling psychrometer
 Air velocity is measured by anemometer
 Recommended illumination (lux) for general office work is 400
 Whispering produces sound of 20-30 db
 Rupture of Ear drum may actually occur at a decibel level above 160
 Chronic noise exposure above 100 db level causes permanent deafnesss
 The maximum permissible limit of daily exposure to noise level without causing damage to hearing is 90 db
 Sewage is defined as waste water from community containing solid and liquid excreta
 Sullage is defined as waste water which does not contain human excreta
 The amount of sewage flowing in a system in 24 hours is called dry weather flow
 Biological oxygen demand gives an indication of organic matter
 Paris green is a larvicidal for Anopheles
 Malathion spray is effective for 3 months
 Dose of malathion used for residual insecticidal action is 100-200 mg/sq. foot
 Mite transmits scrub typhus
 Sand fly is a vector in Kala-azar
 Dengue is transmitted by Aedes
 Endemic typhus is transmitted by flea
 Epidemic relapsing fever is transmitted by louse
 Smallpox was declared globally eradicated on 8th May 1980
 Koplik's spots are seen in Rubeola (Measles)
 Erythemainfectiosum is known as Fifth disease
 The incubation period of mumps is 18 days
 For Mantoux test the standard dose of tuberculin used in India is 1.0 TU
 The most common mode of HIV transmission in India is sexual transmission
 The highest number of AIDS cases in India have occurred in the age group of 30-44 years
 Nevirapine is used to prevent transmission of HIV from an infected pregnant mother to newborn child
 MC subtype of HIV in India is HIV – C
 HIV virus was discovered in the year 1983
 In an HIV infected child OPV should not be given
 Window period for HIV infection is 3-12 weeks
 Lymphogranuloma venereum is caused by Chlamydia trachomatis
 Recommended adult prophylaxis for meningococcal infection is Rifampicin 600 mg twice daily for 2 days
 Prophylaxis of meningococcal meningitis is Rifampicin
 In salmonellosis, isolation is done till 3 consecutive negative stool cultures
 In AFP surveillance, re-evaluation of post polio residual paralysis is done after 60 days
 Lepromin test is used for prognosis
 In lepromin test, Mitsuda reaction is read after 4 weeks
 In typical tuberculoid form of leprosy, lepromin test is highly positive
 Herpes simplex-2 is sexually transmitted disease
 In India the natural reservoir of plague is Teteraindica
 Most diagnostic of rabies is negri bodies
 Eight site rabies vaccine schedule is 8-0-4-0-2
 Rabies vaccine for pre exposure prophylaxis is given at: 0, 7, 28 days
 Post exposure vaccine of rabies already immunized patient is 0-3-7
 Age is is the most important risk factor for becoming a chronic carrier following an acute episode of hepatitis B
 A.culicifacies is the commonest vector for malaria transmission in India
 Number of holes per square inch of a standard mosquito net is 150
 Sporozoites is the infective stage of malarial parasite
 The organism most commonly causing genital filariasis in most parts of Bihar and Eastern U.P. is Wuchereriabancrofti
 In India, the most important vector for Japanese encephalitis is Culex tritaeniorhychnus
 In staphylococcal food poisoning signs and symptoms develops in 2-6 hours
 Tetracycline is the drug of choice for chemoprophylaxis of cholera
 Dog is the definite host for Echinococcus granulosus
 Blindness as defined by WHO is the visual acuity of less than 3/60
 Commonest cause of blindness in India is cataract
 Goal for blindness under NCPB is to reduce prevalence of blindness in 2020 to 0.3%
 In vision 2020 ophthalmic surgeon population ratio is follows is 1:500000
 Mass treatment is given in trachoma if prevalence of moderate and severe trachoma in children below 10 years of age
is more than 5%
 SAFE strategy is recommended for trachoma
 Type of surveillance included in integrated disease control program for non-communicable disease is periodic regular
survey
 Normal range of BMI Asian Individual is 18.5 to 22.99
 The most common cause of maternal mortality in India is obstetric hemorrhage
 Denominator in maternal mortality ratio is is the total number of live birth
 The vitamin A supplement administered in prevention of nutritional blindness in children programme contains 1 lakh
IU/ml
 National Programme for the healthcare of elderly was started in year 2007
 Regarding ‘Late expanding phase of demographic cycle’, death rate declines more than birth rate
 India is in the late expanding phase of demographic cycle
 First disability census was done in the year 2001
 If annual growth rate of a population is 1.5 – 2%, then 47-35 yrs will be required to double the population
 Demographic Gap attains its maximum limit in late Stage II
 Total fertility rate is an indicator of COMPLETED FAMILY SIZE
 Denominator in General fertility rate is women in reproductive age group in a-given year
 Contraception of choice in newly married couple is OCP
 Contraceptive of choice in lactating female is progesterone only pill
 Best index of contraceptive efficacy is Pearl index
 Pearl index is defined as accidental pregnancies per 100 women-years of exposure
 Conventional contraceptives includes condom
 Emergency Contraception of choice is IUD
 Most common complication associated with IUD is bleeding
 Most common complication resulting in removal of IUD is pain
 MTP Act was passed by Parliament in 1971
 Under MTP Act, termination can be done maximum upto 20 weeks
 Amount of infectious waste among hospital waste is 1.5%

 Disposal of placenta at PHC is treatment with bleaching powder and burial
 3-D in hospital waste management means Disinfection, Disposal, Drainage
 Yellow plastic bags containing biomedical wastes are treated by incineration
 Animal waste is disposed off by incineration
 Mercury is disposed by safely collect and re-use
 Best way to dispose e-waste is recycling
 Most commonly reported disease in the post disaster period is gastroenteritis
 In post disaster phase; for ensuring safe water supply, it is advisable to have a Residual Chlorine Level of: 0.7 mg/ litre
 In draughts, commonly noticed vitamin deficiency is Vitamin A
 As per the most common classification of Triage system that is internationally accepted, the colour code that indicates
high priority treatment or transfer is Red
 Black color in triage is death
 Triage is green-ambulatory
 Flood is the calamity with most amount of damage
 Natural disaster causing maximum deaths hydrological
 District is the nodal centre for disaster management
 Triage is categorization of patients and treating them according to the available resources
 Maximum permissible level of whole body occupational exposure to ionizing radiation is 5 rem per year
 0.5-3 microns dust particles gets lodged in the respiratory tract: Respirable dust
 Anthrax, according to The Workmen's Compensation Act, 1992, is considered an occupational disease
 Thermoactinomyces sacchari causes Bagassosis
 Bagassosis can be prevented by spraying 2% propionic acid
 Main cause of Farmer's lung is due to Micropolyspora faeni
 Monday fever is associated with Byssinosis
 "Snow-storm" appearance is seen in Silicosis
 Silicosis affects upper lobes of lungs
 Lead is the most common heavy metal poisoning in the world
 Lead poisoning in industries commonly occurs by inhalation
 Useful screening test for lead is measurement of coproporphyrin in urine
 The clinical symptoms of lead toxicity are associated with blood levels of 70 mcg/100ml blood
 Occupational exposure that may cause sterility in females is Lead
 Wrist drop may be caused as industrial hazard in battery use
 Nearly 3/4th of occupational cancers are Skin Cancers
 Naphthylamine are associated with Bladder cancer
 Benzene is associated with Leukemia
 Sickness absenteeism is a useful index to assess the state of health of the workers
 Ergonomics is adjusting the worker to his job
 Indian constitution has declared that children less than 14 years should not be employed in factories or mines
 'Safety officers' have to be appointed in factories where no. of workers is more than 1000
 According to "Factory Act, 1948" maximum permissible working hours per week are 48
 Minimum area per person mandatory under the factory act is: 500 cu. ft
 Under ESIS act, the state government's share of expenditure on medical care is 1/8
 "Eugenics" is the study of hereditary improvement of the human race by controlled selective breeding (Genetic
Manipulation)
 Environmental Manipulation which enables genes to express themselves readily is known as Euthenics
 Hardy Weinberg law is related to Population genetics
 Punnet's square is used for finding genotype of offspring
 Most commonly abused agent in India tobacco
 Maximum loss of DALY occurs in depression of all the psychiatric disorders
 Amphetamine is known as “superman drug”
 Hereditary cause of mental health disorder is schizophrenia
 Mental retardation is defined if IQ is below:70
 One sub-centre caters to the population of 5000
 Planned endpoint of all activities is known as Objective
 Recommendations of Bhore committee include major changes in medical education to prepare “social physicians”
 Multi-purpose worker scheme in india was introduced following the recommendation of Kartar singh committee
 A group on medical education & support manpower was popularly known as Srivastava committee
 Bajaj committee recommends health manpower policy
 Integration of health service was first proposed by Jungallwalla committee
 Rural health scheme introduced by Srivastava committee
 One PHC is located for a population of 30,000
 Eligible couple Register is maintained at Subcentre
 One health assistant male female should be posted for every 30000 population
 A Sub-centre is manned by multipurpose worker
 Avian influenza DOC – Oseltamivir 150mg BD X 5 days
 MC disorder to be screened in neonates – Neonatal hypothyroidism
 Richest source of Vit – A/D is – Halibut liver oil
 Bedqquline targets mycobacterial ATP synthase
 Zika virus is transmitted to people through the bite of an infected aedes species mosquito, through sexual contact &
could pass to body during pregnancy
 Tetra ethyl Ammonium blocks potassium channel.
 Most common overall tumor of lacrimal gland is Non-Non-hodgkins lymphoma.
 Loading dose depends on volume of distribution.
 Maintainance dose depends on clearance.
 Linagliptin and liraglutide are safe in renal failure.
 Merkels discS are responsible for two points discrimination and brailie reading.
 Kvp determines contrast and penetrating power.
 Modified shock index-HR /Mean arterial BP
 Good prognosis factor of ALL-hyperdiploidy.
 Most common malignant tumor of minor salivary glands- adenoid cystic carcinoma.
 Dariers sign seen in - urticaria pigmentosa.
 Pemphigues vulgaris - Suprabasal cleft. Fish net patterns on IF.

 Most sensitive test for diagnosis of H. Pylori: Rapid urease test .
 Number connection test is done to detect: Hepatic encephalopathy .
 Reversible myocardial ischemia is best diagnosed by: PET scan.
 Conglomerate bodies And sheurman bodies found in: Sarcoidosis.
 The SMA is the most commonly involved vessel in Diverticular bleed.
 Mature pincer grasps develops at 12 months.
 The ideal time when invertogram should be done in a newborn : After 6 hours
 Causes of SVCS are : Squamous cell and Small cell lung Ca,Lymphoma,Thrombosis following intra venous catheter
use, Metastasis from Testicular and Breast Ca.
 Most common causes of intestinal obstruction in neonates.
o 1st day- deodenal attresia
o 1-2 weeks- midgut valvulus.
o 3-4 Weeks - CHPS.
 Intussuception is frequently associated with: Sub mucosal lipoma.
 The Alkali Denaturation Test(Apt test) Used to differentiate fetal or neonatal blood from maternal blood
(Qualitative).
 Most common type of uterine fibroid - intramural
 Baricitinib recently approved drug for rheumatoid arthritis.
 NNN media used for leishmania.
 Winter bottom sign is seen in African sleeping sickness(Trypanosomiasis).
 Revised trauma score-SBP+RR+GCS
 Bromocriptine recently approved for- diabetes me litmus.
 Sickle cell anemia is associated with medulla running renal carcinoma.
 Call exner bodies seen in granulosa cell tumors.
 Light bulb sign in X-ray shoulder is seen in: Post dislocation of shoulder .
 Pointing index in supracondylar fracture is due to : Anterior interosseous nerve injury . Best
 management of open fracture is: Debridement .Increase in bone girth occurs by appositional bone formation by
generative cells in the deepest layer of periosteum.
 The Classic O’Donoghue Triad:
 The anterior cruciate ligament
 The medial collateral ligament (or tibial collateral ligament)
 The medial meniscus.
 Function of cruciate ligaments: Prevents anteroposterior instability.
 Parasympathetic outflow - CN 3,7,9,10 And S2, S3, S4.
 Oprelvekin - Recombinant IL11 used in thrombocytopenia
 Filgrastin - Recombinant Granulocyte CSF
 Sargomustine- Recombinant Granulocyte Monocyte CSF
 Boiled lobster syndrome caused by Boric acid.
 Osler-Weber- rendu syndrome - hereditary hemorrhagic telengectasia.
 Chandler index is done for hook worm.
 Zika virus transmitted by Aedes mosquitoes.

 Selenocystine - UGA Pyrrolysine - UAG
 Gardner syndrome- Polyposis +lipomas +osteomas +Desmoid
 Turcot syndrome - Polyposis + Astrocytomas (glioma)
 Severe combined Immunodeficiency - Defect in Non homologous End joining.
 Xeroderma pigmentosa - Neucleotide excision repair defect
 BCYE media - Legionella
 Coccidiomycosis - Desert rheumatism.
 Segmented virsuse- bunya / orthomixo /Arena /Reovirus.
 White Piedra - Trichophyton beigelli
 Black Piedra - Trichosporon Hortae.
 Paris Green - stomach poison.
 Marquis test -Opium poisoning
 Marsh test/ Reinsh /Gutzeit Test - Aresenic poisoning.
 Lee Jones test - cyanide poisoning.
 Cremasteric reflex - L1, L2
 Mu agonist and kappa antagonist - Buprenorphine
 Kappa Agonist and Mu antagonist- Pentazocine
 Minute ventilation - Tidal volume X RR
 Weight for height/ WHO grade for acute severe malnutrition : Z score less than -3
 Bedwetting is considered normal in girls and boys till the age of: 4 and 5 years respectively .. Chromium→
Potentiates the action of insulin. Zinc stabilizes insulin.
 The middle ear communicates with the mastoid area posteriorly and the nasopharynx (via the pharyngotympanic
tube) anteriorly . Inferior tympanic artery is a branch of : Ascending pharyngeal artery .
 The collecting duct develops from the ureteric bud and is thus technically not part of the nephron.
 Posterior Cricoarytenoid: The only muscle produce abduction of vocal cord (open the rima glottides).
 Claudius Cells are considered as supporting cells within the Organ of Corti in the Cochlea.
 Secretory phase of endometrium is due to which hormone : Progesterone.
 Most common progesterone metabolite in urine : Pregnanediol .
 Together with endothelial cells of blood vessels within the fascicle, perineurial cells constitute part of the blood-
nerve barrier.
 Only thiazide used in renal failure-ure-Metalozone.
 Most common virus associated with transfusion hepatitis-HCV
 Most common cause of budd chiari syndrome – Polycythemia vera
 MCC of nephrotic syndrome in adult – membranous gromerulo pathology (FSGS : undevloping country)
 Most common cause of nephrotic syndrome in children: minimal change disease
 Syphilis Most common affect : arch of aorta
 Most common hereditary nephritis: alport syndrome (XLD)
 Most common type of vascuitis – Temporal arteritis (giant cell)
 Most type of hepatitis in India: HAV (MC overall children-A, MC acute E , mc in pragnancy HEV)
 Most common type of gall stone : mixed
 MC viral cause of myocarditis-Coxsackie B virus
 Most common cause of sudden death due to heart disease-VF
 MCC of endocarditis with prosthetic valvue: S. epidermidis
 Most heart disease with increase severity in pregnancy : RHD with MS
 Most type of porphyrea: porphyreia cutaneous tarda - Porphyrea
 MC type of leprosy in india-Neuritic type
 MC site of rupture of berry aneurysm- anterior cerebral circulation
 Most common type of stroke: Ischaemic stroke
 MCC of calcification of brain-Neurocyticercosis
 Lucid interval is seen in –Epidural Hematoma
 MC site of bleed in hypertension –Putamen or basal ganglian
 MCC of hematemesis-peptic ulcer disease
 Light’s criteria is helpful in –pleural effusion
 MCC of portal hypertension –Non cirrhotic portal fibrosis

 Ranson’s criteria is useful in-Acute pancreatitis
 MC site of polyp in peutz jeguer syndrome-Jejunum
 MC site of perforation in gastric ulcer-Lesser sac
 Most common site of perforation in duodenal ulcer –ANT
 Most common sign of vitamin A deficiency –Bitot sports
 Most common type of fistula in Crohn’s disease-Colocolic
 MCC of nephrotic syndrome in adult-membranous glomerulopathy
 MCC of occult blood in babies stool-Hookworm
 MCC of adenocarcinoma of esophagus-Barret’s esophagus
 MCC of cushing’s ulcer-increased intracranial pressure
 IOC in Achlasia cardia-Manometry
 Mode of vertical transmission of AIDS in India-Infective birth caval
 MCC of meningitis in AIDS-Cryptococcus doc-Amphetericin B
 MC type of HIV in India-HIV 1 Type C
 Most common carcinoma in AIDS-NHL
 MC organ affected in Amyloidosis-Kidney
 MC site of ca stomach –Esophagogastric junction and cardia
 MC type of intestinal polyp-Hyperplastic polyp
 Most sensitive to hypoxia –cerebral cortex-neuron-myocardial cell neurons>myocardial cells
 MC complication of diphtheria –Myocarditis
 MCC of mononeuritic multipler-DM
 Most common adult muscular dystrophy-myotonic dystrophy
 Type of vaculities in berger’s disease –Panvascuitis
 MC body part affected in Reynaud’s disease –Upper limb
 MC vessel involved in Takayasu Disease –Sub clavian artery
 Syphilis most common affect –arch of aorta
 MC pathogenic organism in mycotic aneurysm –staph auerus
 Most common type of gliomas-Astrocytoma
 MC site of cerebral infarction-Middle cerebral artery
 MC area affect in TB meningitis-basal cisterna
 MCC of subdural empyema in adult-Streptococcus
 MCC of sporadic viral encephalitis-HSVI
 MCC of viral meningitis – Entero virus
 Main cause of MDR TB- Non compliance
 MC TB location in GIT- Illeocaecal junction
 Most common nerve involved in increased ICT: abducens Nerve
 Most common cause of cyclophosphamide therapy : Hemorrhagic cystitis
 Most common manifestation of MEN 1 syndrome: Hyperparathyroidism
 Most common cardiac manifestation of carcinoid syndrome : TR
 Most common Death in Polio: Diaphragm paralysis
 Most common cause of Vulvo vaginitis in DM: candidiasis
 Most common ascending paralysis : Gullain Barr Syndrome
 Oligoclonal bands in CSF is seen in : Multipal sclerosis – oligo clonal
 MC manifestation of neurocysticerosis-seizures
 MC type of vaculities-temporal arteritis (Giant cells)
 Anti CCP antibody is seen in –Rheumatoid arthritis
 Anti SCI 70antibody is seen in-Diffuse scleroderma
 Reynauld’s pentad is seen in –Ascending cholangitis (charcot traid + altered mental status hypotension)
 Charcot triad consists of-pain Abdomen, fever, jaundice
 Earliest sign to scurvy –Perifollicular bleeding
 MCC of sudden death in DM –hypoglycemic unawareness
 MCC of death in HOCM-Ischaemic ventricular fibrillation
 MC site involved in atherosclerosis-Tunica intima
 Macrophages in kidney called as mesangial cells
 MC type of emphysema-Irregular or Mixed

 MCC of bronchiolitis-RSV
 MC clinical presentation in genital TB-sterility
 MC type of acute hepatitis in India-HEV
 Curshemann spiral and chorcot leidar crystal seen in-BA
 MCC of SIADH-=head trauma
 MCC of infection in burn patient-Pseudomonos
 MCC of death in multiple myeloma-Renal failure
 MC benign tumor of spleen-Hemangioma
 Most common early kidney sign is DM-Micro albuminuria
 MCC of adrenal in sufficiency in India-TB
 MCC of Cushing’s syndrome –iatrogenic steroid
 MC symptom of pheochromocytoma –intermittent occipital headache
 MC type of pancreatic adenoma in MENI-gastrinoma
 MCC of central bronchiectasis-Aspergillosis
 MCC of neuropathy-B12 deficiency
 MCC of CKD- Diabetes
 Good pasture syndrome is-Type 2 Hypersensitivity reaction
 C ANCA is specific for-wegner’s granulomotosis
 Antibody useful in congenital heart block in SLE-anti Ro AB
 Serological marker of mixed connective tissue disorder-Anti U1 – RNP
 Purtscher’s retinopathy is associated with of acute pancreatitis
 Walleuburg syndrome involve-PICA
 Fastening gait is seen in –Parkinson’s disease
 Antibody in DLE-Anti histone induced
 Antibody specific for Crohn’s disease- anti anti saccharomyces cervisae
 Antibody specific for celiac sprue-Antiendomysial ,Anti TTG
 Antibody specific for SLE- AnH DHAse
 MC symptom of primary Billiary cirhossis-Pruritus
 MCC of peritonitis in a patient with cirrhosis-E.coli
 Raised sweet electrolytes is a feature of cystic fibrosis
 Scanning speech is seen in –Multiple sclerosis
 Minimum air required to produce air embolism-100ml
 Rasmussen aneurysm invaves- Pulmonary artery
 Farmer’s lung is due to Thermophilic actinomycetes
 Shrinking lung is seen in-SLE
 Lupus perinio-Seen in –Sarcoidosis
 Reid’s index seen in – chronic bronchitis
 Alpha 1 antitrypsin deficiency causes-Panacinar emphysema
 Paradoxical breathing is seen in –Flail chest
 HLA associated with Myasthenia gravis-B8
 Wide fixed split heart sound is seen in –ASD
 Quincke’s sign is seen in-Aortic Regurgitation
 Australia antigen is related to HBsAg
 DOC for pseudomembranous colitis –Metronidozole
 MC site of hydatid cyst –Liver
 MC carcinoma associated with AIDS is caused by –HHV 8
 HIV principally affects which of the following –CD4(T cells)
 Type of neuropathy in diabetes-Sensory Polyneuropathy
 Schilling test is done to detect-Vit B12 malabsorption
 Hormone used for managing hyperkalemia-insulin
 Doc for tetanus-Penicillin
 Micronutrient used in willson’s disease-Zinc
 Loeffler’s syndrome is caused by-Ascaris lumbricoides
 Doc for pneumocystis cariniil –co-trimoxozole
 MC manifestation of pulmonary embolism-dyspnea

 Beck’s triad is seen in-Cardiac tamponade
 Basic defect in hereditary spherocytosis-Ankyrin
 Pseudo –hypertrophy of calf muscles is seen in –Duchne’s MD
 Caplan syndrome associated with -Rheumatoid arthritis
 Doc for toxoplasmosis –Sulfadiazine + pyrimethamine
 Bite cells are seen in –G6PD
 Pretibial myredema is seen in –Hyperthyroidism (Graves)
 Pneumocystis prophylaxis is started when CD4 is below-200
 Anemia in CKD is due to-Erythropoietin deficiency
 MCC of secondary hypertension –Renal parenchymal disease
 DOC for kalaazar –AMPHOTERICIN B > Sodium stibgluconate
 RED INFARCT ( venous occlusion) –organ with dual blood supply-gut, liver,lungs
 Dystrophic calcification occure in – dying tissue ( calcium level NORMAL)
 Line of zahan are seeb in- thrombus
 Chicken fat clot – postmortem thrombus
 Heart failure cell seen in – left lung
st
 Cell 1 involve in cell injury – neutrophils
 Most abundant collagen of human body – type 1
 Basal lamina has – type 4 collagen
 Virchow’s triad- endothelial injury, stasis, hypercogulabilty
 Inflammatory mediator which does not occure in fever- nitric oxide
 T(8;14)- burkitts lymphoma
 T(11;21)- ewings sarcoma
 Mcc of myocarditis- viral
 Mc primary cardic tumour – myxoma
 Dresslers syndrome is autoimmune
 Lipofuscin – golden yellow pigment seen in heart muscle in atrophy
 Charcot leyden crystals seen in – asthma
 Cruschmann soiral- asthma
 Reid index used for – chronic bronchitis
 Alpha 1 anti trypsin deficiency is associated with- panacinar emphysema(Smoking- centri acinar emphysema)
 Test use for sarcoidosis- kveims test
 Vita. Deficiency in biliary cirrhosis- vita. K
 Crescents (epithelial cell+ fibrin+macrophage) are seen in – RPGN
 B/L RCC may seen in – VHL
 Luetic/syphilitic aneurysm involves- ascending aorta
 Hyaline arteriosclerosis is seen in – benign hypertension
 Multiple myeloma- russell bodies and and flame cells are seen , bence jones proteins are light chains,urea level in MM
are raised , bone lytic lesion,
 Csf finding in pyogenic meningitis- increased protein, decresed sugar
 Mc primary brain tumour – glioma(mc glial tumour- astrocytoma)
 Mc tomour in adults- astrocytoma
 Mc posterior fossa tomour in child –cerebellar astrocytoma
 Enemal like structur is found in – craniopharyngioma
 Pseudo rosette are seen in – nueroblastoma
 Mc B/L breast tomour- lobular ca.
 Klinefelter syndrome associated with – mediastinal germ cell tomour
 CAT EYE SYNDROME is associated – defect in chromosome 22
 Rapid diagnostic test for malaria – HRP-2
 Early manifestation of hyponatremia-Altered sensorium
 Spike and dome pattern of EEG is seen in-Absence seizure
 Prominent U waves on ECG are seen in-Hypokalemia
 Blindness in temporal arthritis is due to-Posterior ciliary artery
 Anti Jo 1 antibodies is due to-Polymyositis, Dermatomyositis
 MCC of subacute bacterial endocarditis-Strep. viridians

 Differential cyanosis is seen in –PDA
 DOC for hairy cell leukemia-Cladribine
 Graham steel murmur-pulmonary regurgitation
 Bronze diabetes is related to-Hematochromatosis
 Albumino –cytological dissociation in CSF-GBS
 Gold standard for diagnosing interstitial long disease –HRCT
 MC inherited bleeding disorder –von willebrand disease
 Parameter used to monitor short term diabetic control-Serum fructosamine
 IOC for chronic SAH-MRI
 Gold standard for diagnosing pulmonary embolism-Angiography
 Most common posterior wall fossa tumor in children –cerebellar astrocytoma
 Kimmel stein Wilson nodule is always :Diabetic nephropathy
 Pain and temperature is carried by which tract-lateral spinothalamic track
 DOC for minimal change disease- Steroids
 High stepping gait is seen in –foot drop
 Diagnosis of pheochomacytoma is done by-Urine VMA
 WBC cast in urine suggest-Pyelonephritis
 Obstruction of hepatic vein-Budd chari syndrome
 Color changes of reynaud’s phenomenon-white-blue-red
 DOC for HOCM-beta blocker
 DOC for trigeminal neuralgia-Carbamazepine
 Pseudo Tumor cerebri is caused by-Hypervitaminosis A
 Salt losing nephropathy is known as-Interstitial nephritis or urinary tract obstruction
 Management of congenital hydrocele-Herniotomy
 Most serious complication of onchocerciasis-blindness
 HLA associated with IDDM –DR3 (Mainly)
 Gastric MALI lymphoma is caused by which organism-H.pylori
 MALT worker’s lung is caused by –Aspergilles fumigates
 Granulomatous condition a/w hypercalcemia-Sarcoidosis
 DOC for amoebiasis and giordiasis-Metronidazole
 Keratoderma blenorrhogica –seen in reiter’s syndrome
 Autoimmune hemolytic anemia seen in which blood cancer-CLL
 Oster’s nodes are seen in infective endocarditis
 Inferior notching of ribs is seen in co arctation of aorta
 Hepatitis virus carrying worst prognosis in pregnancy-HEV
 Standard treatment of Kawasaki disease-IV immumoglobulin
 skip lesions are seen in Crohn’s disease
 Ground glass appearance or x-ray chest –ARDS
 IOC for mitral stenosis-ECHO
 DOC for PSVT-Adenosine
 MC carcinoma causing superior venecava syndrome –small cell ca

 Signs seen on HRCT in brochiectasis-Tram track signet ring
 Acid fastness of mycobacterium TB is due to –mycolic acid
 Maccallum patch is seen in which condition –Rheumatic heart Disease
 Wire loop lesions is seen in-Lupus nephritis
 DOC for inflammatory bowel disease- 5-Amino salicylic acid
 Angina pectoris and syncopal attacks are seen in which valvular condition-Aortic stenosis
 Which bacteria is causes atherosclerosis –chlamydiaa
 Mask like facies is seen in parkinsonism
 Tremors at rest occurs in lesions of basal ganglia.
 Characteristics histological feature of DM nephrology-nodular glomerolosclerosis
 Lung carcinoma with worst prognosis-small cell ca
 Commonest site of thyro-glossal cyst-Sub hyoid
 Mild head injury having a GCS is -13-15
 Commonest cause for hyperparathyroidism –Single Adenoma
 Treatment of choice for cystosarcoma phyllodes-simple mastectomy
 Carcinoma breast with best prognosis –tubular
 Occult thyroid malignancies are usually –papillary
 Commonest cause of ureteric injury during surgical operation is-hysterectomy
 Golf-hole ureteric orifice is seen in-TB urinary bladder
 The common organism isolated in emphysematous pyelonephritis is-E.Coli
 Renal calculi associated with proteus infection-Triple phosphate(Staghorn)
 Lord’s and Jabouley’s operation is done for-hydrocele
 Screening test for ca prostrate-DRE+PSA
 Most important prognostic indicator of RCC-pathological stage
 Ideal time for orchidopexy incase of undescended testes is-6 months
 Hydrocele is a type of exudation cyst
 MC Predisposing factor for pyelonephritis –VUR
 Most malignant testicular tumaor-choriocarcinma
 First symptom of TB of kidney –Increased frequeury of micturition
 Mayo operation is done for-umbilical hernia
 Howship rombery sign is seen in-Obturator hernia
 The TOC for inguinal hernia in infants-herniotomy
 Ochner sherren regimen is used in –Appeudicular mass
 Heller’s operation is done in-Achlasia cardia
 Commonest complication of Meckel’s diverticulum-bleeding
 Ramsted’s operation is done for-congenital pyloric stenosis
 Sister mary Joseph nodule is mc seen in-Ca stomach
 MC dynamic cause of intestinal obstruction-postoperative adhesions
 MC site of curling’s ulcer-Duodenum
 MC of esophagitis-Esophageal reflux
 MC type of intusssusception –Iieo colic

 MC early complication seen in illeostomy-skin necrosis
 Corkscrew esophagus is seen in –Diffuse esophageal spasm
 Best treatment of zollinger elison syndrome-excision of tumor
 Surgery done for meconium ileus-Bishop Koop operation
 Diagnosis of hirschsprung’s disease is done by -Rectal biopsy
 Child’s criteria is employed for-Cirhossis
 Casoni’s test is done for-Hydatid disease
 IOC for hydatid disease-CT SCAN
 Most sensitive and specific test for acute pancreatitis – S. trypsin
 MC site of cholangioca -Hilum
 Chronic and recurrent pancreatitis -may be a feature-Homocystinuria
 Best way to diagnosis gallbladder stones-USG
 .MCC of hemobilia is-Trauma
 Grey turner’s sign is seen in-acute pancreatitis
 MC vodule seen in liver-Hemangioma
 Best way to localize extra-adrenal pheochromocytona-MIBG scan (metaiodobenzylguanidine)
 MCC of peripheral limb ischemia in India-Atherosclerosis
 IOC for varicose veins-Duplex USG imaging
0
 Platelets can be stared at 20-24 C For 5 days
 Hunter’s ligature is employed for-Aneursysm
 Earliest and MC feature of DVT-rise in temperature
 MC vessels to be affected in Buerger’s disease-anterior tibial artery
 MCC of death due to burns in early period is- hypovolemic shock
 MC primary source of mets to brains-ca lung
 Commonest site of sialectasis –Parotid
 Sebacous cyst is-Epidermoid cyst
 Sardonic grin is associated with-Tetanus
 Commonest tumor of parotid gland –pleomorphic adenoma
 The term universal tumor refers to-lipoma
 MC Tumor of anterior mediastinum is-thymoma
 A boil due to staphylococcal infection of –follicle
 Commonest site of meningomyelocele lumbo-sacral
 Catgut suture is derived from intestine of-sheep
 Transplant of kidney from mother to son is-allograft
 Hyperacute graft rejection is due to –performed anti body
 Prolapsed intervertebral disc is mc of –L4-L5
 .MC type of renal transplantation in india – Allograft
 Crush syndrome result into-Renal failure
 Prevention of colorectal carcinoma can be possible by intake of –Nsaids
 MC histological type of and cancer-Squamous cell ca anal
 IOC for solid thyroid nodule-FNAC

 Desmoids tumor arises from-muscule –aponeurotic tissue
 B/L breast carcinoma –Lobular
 .TOC for cystic hygroma-Excision
 Meckel’s divertianum is a remnant of –vitello-intestinal duct
 MC site of colorectal ca-Rectum
 Whipple’s tried is seen in –Insulioma
 MC site of basal cell ca-inner canthus of eyes
 Retention cyst of subliuglal gland is-ranula
 Pair technique is used for-Hydatid cyst
 MCC of urinary obstruction in male infant-posterior urethral valve
 Nicoladoni branham sign is seen in-AV Fistula
 MC site of pseudpaucreatic cyst-lesser sac
 MC part of colon involving -sigmoid
 IOC for VUR-MCU
 MC TYPE OF HYPOSPADIAS –Glandular
 Dukes classification is employed for-Rectal ca
 Benign prostrate hypertrophy arise from-periurethral region in transitional zone
 Best way to prevent DVT in post of period –Heparin
 Invertogram is done for-Imperforate Anus
 Cleft lip repair at 3 months
 Vitamin K dependent factors are-2,7,9,10
 Reverse 3 sign or bariom studies is seen in –ca Head of pancreas
 Spigelion hernia is seen of the level of –arcuate line
 IOC for lump is-Biopsy
 MC vessels to be affected in Buerger’s disease is-Small and medium sized vessels
 Which vaccine is indicated in ca urinary bladder-BCG
 Most common ca of the testis in young age group-Teratoma
 Example o radiolucent stone-Uric acid
 MC organ ruptured in blunt injury to abdomen- spleen
 Pelvis in which Ap diameter is more than transverse diameter-Anthropoid pelvis
 One of the common complication of dichorionic diamniotic twins-preterm Labor
 Earliest time when twin pregnancy can be diagnosed on USG-10th week
 MC site of ectopic pregnancy-Ampulla
 Placenta succenturiate is-Placenta having 2 different lobes
 What is seen in help syndrome –Hemolytic anemia
 Treatment of idiopathic cholestasis of pregnancy-Ursodeoxycholic acid
 Cord compression shows which type of deceleration in fetal heart rate-variable deceleration
 Agent of choice to treat hyperthyroidism in pregnancy-propylthioracil
 Condition in which pregnancy should be terminated-pulmonary hypertension
 Immune hydrops is associated with-Rh compatibicity
 Karyotype of complete Mole-46XX

 Oligohydramnios associated with-Renal agenesis
 A female with recurrent abortions and isolated prolonged a PTT patient is most likely associated with-Lupus anti
coagulant
 Volume of amniotic fluid is maximum at which gestational weeks-36-38
 Theca lutein cysts are associated with which of the following-complete mole
 Chadwick’s sign time-8weeks
 Timing for performing amniocentesis -12-20weeks
 Dark brown colored amniotic fluid is seen in-Intra uterine death
 What will occur if chorionic villous sampling is done before 10weeks of gestation-Orofacial limb defects
 Spalding sign is-Overlapping of skull bones
 A lady presented with 24 month molar pregnancy-management of choice-suction evacuation
 Most chances of death are seen in which type of twin pregnancy-monochorionic monoamnionic
 MCC of death in twin pregnancy –cold compression
 MC tubal pregnancy to rupture in which part-Isthmus
 Target to maintain systolic BP in severe pre-eclampsia patient by drug therapy-<140
 First sign to appear indicating toxicity of MgSo4-diminished plantor response
 Ovulation returns in non –lactating women occurs offer how many weeks-4 weeks
 Increase in cardiac output in pregnancy is by-40%
 Ideal time for screening of blood sugar to rule out diabetes in a pregnant female-24-28 weeks
 Polyhydramnius is defined as amniotic fluid volume of more than-2000ml
 ovary is formed from-Genital ridge
 Primordial follicles present at birth-2million
 Uterns develops from-paramesonephric ducts – uterus
 Contraceptive which is supplied by government free of cost-Mala-N
 Shortest and narrowest past of fallopian tube-interstitial
 Pearl index is used to calculate –accidental pregnancies
 Technique of cu-T insertion-withdrawal technique
 Which of the following IUCD has a life span of 10years –CU380A
 MC site of ligation by clip in female sterilization –isthmus
 Progesterone of choice in emergency contraception –levonorgesterane
 Gold standard investigation in diagnosing PID-laparoscopy
 Strawberry vagina is seen with-Trichomonas vaginalis
 The commonest complication of pregnancy after complete treatment of gential TB-Ectopic pregnancy
 MC symptom of acute pelvic inflammatory disease is-abdominal pain
 Face to pubis is common in which type of pelvis-anthropoid
 Insulin status in pregnancy-increases
 Polyhdramnios is associated with –Esophageal ,duodenal, atresia
 Longest diameter of fetal skull-Mentovertical
 Graphical representation of stages of labor is-Partogram
 A young girl with 6 weeks of amenorrhea with abdominal mass and empty uterus on USG –Ectopic pregnancy
 Earliest sign of immune hydropson USG –Scalpedema

 MC heart disease associated with pregnancy-Mitral stenosis
 MCC of PPH-uterine atony
 MC organism responsible for puerperal pyrexia-streptococcus
 Smallest pelvic diameter in AP plane of inlet-Obstetric conjugate
 Best time to diagnose fetal anomalies by USG-18weeks
 MC type of vertex presentation-Left occipito anterior
 MC presentation of H-mole- Bleeding PV
 Bishops classification is used for-Need of induction of labor
 Average blood loss in normal delivery-500ml
 MCC of uterovesical fistula in India-obstructed labor
 MCC of ectopic pregnancy-Previous tubal disease
 Increased LH:FSH ratio is seen in –PCOD
 Menstrual blood in menorrhagiais-80ml
 MCC to secondary amenorrhea in India-Preganncy> TB
 Hot flushes in postmenuopausal women are best treated with which of the drug-Estrogen
 Cystoglaudular hyperplasia is a feature of –Metropathia hemorthagica
 Irregularand infrequent menstruation is k/a-oligomenorrhea
 MCC of postmeuoppausal bleeding in woman is-ca endometrium
 MCC of pyometra –Ca cervix
 Best management of a 40 year old lady with CIN III –total abdominal hysterectomy
 MC degenerative change in uterine myoma-Hyaline generation
 Toc for choriocarciuoma-Chemotherapy with methotrexate
 Pap smear shows ca in site next stop –Chemotherpay and biopsy
 Treatment of red degeneration of fibroid during pregnancy-Analgesics and reassurance
 Marker for granulose cell tumor-inhibin
 Meig’s syndrome is commonly associated with-Fibroma
 Chemotherapy for dysgermiuoma-cisplatin,etoposide,bleomycin
 Condyloma accuminate is caused by-HPV
 Onset of LH surge precedes ovulation by-36hrs
 Post coital test is employed to assess-cervical factor
 Best diagnosis of ovulation is by-Endometrial biopsy
 Best investigation to assess tubal patency is-laparoscopic chromotubation
 B lynch suture is applied on –Uterus
 MC genital fistula in India is-Vesicovaginal
 MC presentation of uterus didelphys-Dyspareunia
 MC site and symptom of endometriosis-site-ovary-symptom-dysmenorrhea
 The commonest cause of breech presentation-prematurity
 A 45 years old female presenting with dysmernorruea and nenorrhagia, diagnosis is-uterine fibroid
 The most effective drug in Sheehan’s syndrome-Corticosteroids
 Sexual development in the adolescent gins occurs in the following order-ans: Thelarch, pubarch, growth menarch
 Corpus luteum function maximally without an implantation -9days
 Doc for cholera in pregnancy-Furazolidone
 Accurate diagnosis of anencephaly is seen in USG at weeks-14weeks
 Endomic disease means-That a disease is constantly present in a given population group
 Good indicator to assess the severity of an acute disease-case fatality rate
 Antibiotic treatment of choice for treating cholera in an adult is a single dose of - Doxycycline
 The most common cancer affecting Indian urban woman in Delhi ,Mumbai, Chennai is-Brest cancer
 The recommended daily energy intake of an adult woman with heavy work-2900 kcal
 What is the color coding of bag in hospitals to dispose of human anatomical waste such a body parts-Yellow
 The diagnostic power of a test to correctly exclude the disease is reflected by-Negative predictivity
 The best indicator for monitoring the impact of iodine deficiency disorders control programmer is-Urinary I2 excretion
 Under WHO vision 2020 programme SAFE strategy is adopted for which disease –Trachoma
 WHO defines adolescent age between -10-19 years
 Transplantation of human organs act was passed by government in India in-1994
 Prevalence of TB infection in a community is done by-Tuberculin test

 According to International health Regulation there is no risk of spread of yellow fever it the aedes, aegypti index
remains below-1
 Multipurpose worker scheme in India was introduced following the recommendation of –Kartar singh committee
 If the grades disease is classified as mild moderate severe the scale of measurement used is-ordinal
 The usefulness of a screening test in a community depends on its –Sensitivity
 Denominator while calculating the secondary attack rate includes –All susceptible amongst close contact
 The organism most commonly causing genital Filiariasis in most parts of Bihar is- Wuchereria bancrotti
 Class ii exposure in animal bites includes the following –Licks on a open wound
 Leprosy is considered a public health problem it the prevalence is more than-1per10,000
 In the management of leprosy ,lepromic test is most useful for-prognosis
 Most important epidemiological tool used for assessing disability in children is-wing’s handicaps ,behavior and skills
 The vitamin A supplement administered in prevention of nutritional blindness in children programmer contain-1lac
IU/ml
 The protein efficiency ratio is defined of-The gain of weight of young animals per unit volume of protein –consumed
 Iron & folic acid tablets supplied under the national programme for anemia prophylaxis-100mg iron 500 microgram folic
acid
 Elemental iron and folic acid contents of pediatric iron folic acid tablets supplied under rural child heath programme-20
mg iron ,100 microgram folic acid
 Chi –square test is used to measure the degree of –Association between two Qualitative variables
 Iron and folic acid Supplementation forms-Specific protection
 The most important function of sentinel surveillance is-To find the total amount of disease in population
 Serial interval is-Time gap between primary and secondary case.
 The infectivity of chicken pox lasts for -6days after onset of rash
 Acute flaccid paralysis is reported in a child age-0-15 years
 Cereals and pulses are considered complimentary since –cereals are deficient in lysine ,pulses in methionice
 Under the national TB programme for a PHC to be called a PHC –requisite is –Microscopy plus Radiology
 A subcentre in a hilly area caters to a population of -3000
 In a community an increase in new cases denote-increase in incidence rates
 Sampling error is classified of –Alpha error
 Virulence of a disease is indicated by-case fatality rate
 Best test to detect iron deficiency in community is-serum ferritin
 In culex mosquito the type of biological transmission for filarial parasite Cyclodevelopmental
 Reverse cold chain is used for-Carrying stool samples of polio patient from PHC to the lab
 Commonest complication of mumps is-Orchitisl oophoritis
 Vector control for yellow fever ground an airport is done upto a distance of -400mts
 The best measure of incidence of TB in a community is-Tuberculin conversion index
 Tuberculin test denotes-previous or present sensitivity to tubercle proteins
 Definition of blindness by WHO includes –visual acuity <3/60
 A health guide works at-Each village level
 Village health guide measures the state of malnutrition in an under 5 child by using-Mid arm circumference
 Food poisoning within 6 hrs of intake of milk is caused by-Staphylococcus aureus
 Universal precaution is applied to-SEMEN
 The behavior science used extensively in PSM is-anthropology
 Triad of physical quality life index
o infant mortality
o life expectancy at age 1
o literacy
 Best comparison of health status of two population is-standardized mortality rate
 Bhopal gas tragedy is an example-point source epidemic
 Reconstituted measles vaccines should be used within-1hr
 The diluent used for BCG-normal saline
 Commonest cause of infant mortality rate in India is-prematurity
 Extra calorie requirements for a lactating mother are-600kcal /day
 Nalgonda techniques used in –Endemic fluorosis

 Osmolality of WHO ORS is-330 (now 245)
 Under the registration act of 1969,death is to registered within -7days (now 21 days)
 95% of confidence limit exist between = +-2SD
 Population covered by a PHC in hilly region is-20,000
 Difference between Dispensary and PHC is that a PHC –gives integrated services
 Sickness benefits under ESI is available for a period is-91 days
 HOSPICE refers to- Special group of people helping the old and terminary in patients
 Incidence rate is measured by-longitudinal study
 Scrub typhus is transmitted by-Mite
 Total fertility rate is-Indicates approximate magnitude of completed family size
 Denomitator of MMR-1000 live births (now per 10000 live birthds)
 MCC of maternal mortality in India is-Hemorrhage
 Minimum duration of developing coal minor pneumoconiosis ->10 years
 Sensitivity is-True positivity rate
 FATHER OF PUBLIC HEALTH- CHOLERA
st
 Yoga day- 21 june(premodial prevention)
 Baromarker of social welfare-T.B.
 Black death- plague
 herd immunity examples- polio, diphtheria, measles
Type a alpha virus-chikungunya arbo virus 
Type b flavi virusJE,YF,DENGUE,KFD
DIAPHRAGMATIC OPENINGS
 Level of vena caval opening: T8
 Level of esophageal opening: T10
 Level of aortic opening: T12
 Caval opening is through: Central part
 Aortic opening is through: Osseo-aponeurotic opening (not a true opening)
 Esophageal opening is through: Muscular part of diaphragm
 Right phrenic nerve passes through: Vena caval opening
 Vagus nerve passes through: Esophageal opening
 Esophageal branch of left gastric artery passes through: Esophageal opening
 Azygous vein passes through: Aortic opening
ARTERIES
 Formed by union of 2 vertebral arteries: Basilar A.
 Inferior vesical artery is a branch of: Anterior division of internal iliac artery
 Uterine A. is a branch of: Anterior division of internal iliac A.
 Inferior thyroid A. is a branch of: Thyrocervical trunk
 Ascending pharyngeal A. is a branch of: External carotid A.
 Internal pudendal A. is a branch of: Anterior division of internal iliac A.
 Left gastro-epiploic A. is a branch of: Splenic A.

 Splenic A. is a branch of: Coeliac trunk
 Cystic A. is a branch of: Right hepatic A.
 Cilio-retinal A. is a branch of: Choroidal A.
 Middle meningeal A. is a branch of: Maxillary A.
 Anterior spinal A. is a branch of: Vertebral A.
 Ophthalmic A. is a branch of: Internal carotid A.
 Medially, superior thyroid artery is related to: External branch of superior laryngeal nerve
EMBRYOLOGY
 Prochordal plate & primitive streak is seen on: 14th day
 Oogonia & germ cell are derived from: Yolk sac
 1st polar body is formed during: Oogenesis
 1st polar body is extruded: At the time of ovulation
 Y chromosome is: Acrocentric
 Sperms are stored in: Epididymis
 Length of human sperm: 50-60 microns
 Number of chromosomes are reduced down to half in: 1st meiotic division
 In humans, implantation begins on the: 6th day after fertilization
 Initiation and maintenance of primitive streak is because of: Nodal gene
 Primitive streak develops in which week: 3rd week
 Structure developed from cloaca:
o The cloaca develops into the rectum and upper 2/3 of the anal canal,
o While its anterior subdivision, the urogenital sinus, develops into the bladder and
o In the female, the urethra and vestibule,
o While in the male the prostatic urethra.
FETAL STRUCTURES & ADULT REMNANTS

 Meckel's diverticulum: Remnant of vitelline duct
 Ligamentum venosum: Remnant of ductus venosus
 Ligamentum arteriosum: Remnant of ductus arteriosus
 Median umbilical ligament: Remnant of urachus
 Medial umbilical ligaments: Remnant of 2 umbilical arteries
 Ligamentum teres: Remanant of left umbilical vein
DERIVATIVES OF GERMS LAYERS
 Mesodermal in origin: Kidney, Muscle (EXCEPT musculature of iris), Bone etc.
 Trigone of bladder: Mesoderm
 Somites: Paraxial mesoderm
 Epithelial lining of biliary tract: Endoderm
 Tympanic membrane: All the 3germ layers Derivatives
of neural crest:
Neurons of
 Dorsal root,
 Sensory &
 Autonomic/ sympathetic ganglia Schwann
cells,
Melanocytes,
Mesenchyme of dental papillae etc.
EMBRYOLOGY OF GENITOURINARY SYSTEM

 Collecting duct develops from: Ureteric bud
 Epithelium of Ureter develops from: Mesonephros
 Uterus/ appendix testes develops from: Mullerian duct/ paramesonephric duct
 Ovary develops from: Genital ridge
 Scrotum develops from: Genital swelling
 Clitoris develops from: Genital tubercle
PHARYNEGEAL ARCH DERIVATIVES

 Meckel's cartilage develops from: 1st pharyngeal arch
 Sphenomandibular ligament develops from: 1st pharyngeal arch
 Stapes develops from: 2nd pharyngeal arch
 Stylohyoid ligament develops from: 2nd pharyngeal arch
 Greater cornua of hyoid develops from: 3rd pharyngeal arch
 Posterior belly of digastric develops from: 2nd pharyngeal arch
 Anterior belly of digastric develops from: 1st pharyngeal arch
 Platysma develops from: 2nd pharyngeal arch
DERIVATIVES OF PHARYNGEAL POUCHES

 Palatine tonsil develops from: 2nd pharyngeal pouch
 Inferior parathyroid gland & thymus develops from: 3rd pharyngeal pouch
 Superior parathyroid gland & ultimobranchial body develops from: 4th pharyngeal pouch
 Parafollicular cells are derived from: NCC > Ultimobranchial body
TONGUE
 Muscle of tongue develops from: Occipital myotomes
 Muscles of tongue are: Both smooth & skeletal muscles

 Safety muscle of tongue: Genioglossus
 Pain of Ca base of tongue is referred to the ear through: Glossopharyngeal nerve
 Circumvallate papillae of tongue are supplied by: Glossopharyngeal nerve
 Anterior 2/ 3rd of tongue develops from: Lingual swellings & Tuberculum impar
 Tate sensation from anterior 2/ 3rd of tongue is by: Chorda tympani (facial)
 Posterior 1/3rd of tongue develops from: Hypobranchial eminence
EPITHELIUM
 Mesothelium of pleura, peritoneum & pericardium is lined by: Simple squamous epithelium
 Nasal cavity, nasal air sinuses, nasopharynx, larynx (EXCEPT vocal cords), trachea & bronchi are lined by: Ciliated pseudo-
stratified columnar epithelium
 True vocal cords, cornea, tonsil & vagina are lined by: Non keratinized stratified squamous epithelium
 Epithelium with extra reserve of cell membrane: Transitional epithelium
 Calyces, Ureter, ureterovesical junction & urinary bladder have: Transitional epithelium
ST
 1 step in investigating an epidemic is- verification of diagnosis
 3 moths training in psm was prposed by – bhore committee
 Chlorination is by – hypochlorus acid
 Wernikes encephalopathy due to deficiency of – thiamine (B1)
 ACRODERMATITIS ENTEROPATHICA responds dramatically to – zinc
 Anton test is done for – listeria monocytogenes
 Morbidity is measured by-Active surveillance
 Most sensitive index of recent transmission of malaria is –Infant parasite rate
 Annual growth rate is-crude birth rate –crude death rates
 The goal of NRR-can be best achieved by use of following contraceptive methods-vasectomy
 Maize are deficient in –Tryptophon & lysine
 According to ICMR protein ,requirements during lactation include as extra-600 kcal/d
 Sanguinariue is derived from-Argemone oil
 Mid day meals provided in schools provide-1/3 of daily total calories and ½ ofdaily protein
 Malathion is used once every-3months
 Square root of mean deviation is also called as –standard deviation
 Health education is-Health promotion
 Berke sonian bias refers to –Bias arising from differates rates of admission to the hospital
 In a case control study , the most characteristics feature is- odds ratio estimation
 The perinatal rate in India is-late fetal death + early neonatal death
 BOAA-beta oxalyl amino alanine
 Case control studies are used for-finding multiple risk factors
 Pre-exposure prophylaxis for rabies-3doses
 India belongs to which stage of the demographic cycle-Late expanding
26
AFMG (DELHI, CHENNAI, TRIVANDURM, UDAIPUR, PUNE, AHMEDABAD)
Helpline: 9810308460, 9810608460 visit us at: www.afmg.co.in, f: afmgmciscreening
 An IQ between 50 -70 would be classified as what kind mental retardation –Mild

 Niacin deficiency in a maize eating population is due to –high leucine
 Kuppuswami classification is base on-
o Income
o Occupation
o Education
 In a epidemic of poliomyelitis ,the best way to stop spread is by-OPV drops to all children
 Chandler index is used for-Ancysostoma duodenale
 In India the MI vector of Japanese encephalitis is- Culex tritaeniorhynchus
 Under NMEP the function of fever treatment depot is-Collection of slides +treatment of fever
 The safe limit of fluoriue in drinking water is-0.5-0.8mg/dl
 Highest biological value of protein is seen in –egg
 Pearl index is used for calculating- accidental contraceptive failure
 Toxin of epidemic dropsy – sanguinarine
 Leptospirosis is transmitted by- infected rat urin
 Most essential fatty acid- linoleic acid
 Most heat sensitive vaccine- RECONSTITUTE BCG>OPV>RECN.MEASLES>HEP.B>BCG>T.T.
 Cold sensitive-hep B>DPT>DT>T.T.
 Causative agent of acute suppurative rititis media-Pneumococcus otitis
 Endolymph is present in –scola media
 Oxygen of corti is present in –cochlea
 Otoacoustic emissions are low intensity sounds produced by-Cochlea
rd rd
 Singer nodule is present at Junction of anterior 1/3 and posterior 2/3 of vocal cords
 MCC of tonsilitis –Group A beta hemolytic streptococci
 IAC open in to – nasopharynx
 Bell’s palsy – hsv
 organ of corti is covered by- tectorial membrane
 tympanpmetry –Type A – NORMAL
 type As curve- otosclerosis
 type Ad – ossicles Dislocation / perforated t.m.
 Type B-( FLAT CURVE) –GLUE EAR
 Type C – RETRACTIVE T.M.
 CARHART NOTCH seen in – otoslerosis (2KHZ) OR/ 2000HZ
 Jvp causes - hsv6,hsv11
 Atrophic Rhinitis/ ozeana is a autoimmune dis.
 Some important signs-
 AQUINO'S SIGN: Glomus tumors
blanching of the tympanic mass with gentle pressure on the carotid artery
 BATTLE SIGN: petrous temporal bone fracture (middle fossa #)
 Bruising behind ear at mastoid region
27
 BEZOLD'S SIGN: mastoiditis

Inflammatory edema at the tip of the mastoid process
 BOCCA’S SIGN : Ca Larynx
Absence of post cricoid crackle(Muir’s crackle)
 BROWNE'S SIGN : Glomus tumor
 BRYCE SIGN: combined laryngocele & external laryngocele
compression will cause a hissing sound as the air escapes from it into the larynx (but don’t try!)
 DELTA SIGN: Lateral sinus thrombosis
CT or MRI with contrast shows an empty triangle appearance of the thrombosed sinus surrounded by contrast
enhanced dura (empty triangle sign)
 GRIESINGER'S SIGN: lateral sinus thrombosis
-Erythema and oedema posterior to the mastoid process resulting from septic thrombosis of the mastoid emissary vein
 HALO SIGN/ HANDKERCHIEF SIGN:CSF rhinorrhea
CSF will separate from blood when the mixture is placed on filter paper resulting in a central area of blood with an outer
ring or halo

 HENNEBERT'S SIGN : false positive fistula test(congenital suphylis)
 LIGHT HOUSE SIGN: Acute suppurative otitis media<acute mastoditis
(small pin hole perforation with a pulsatile ear discharge)

 OMEGA SIGN: LARINGOMALACIA (epiglottis)
 PHELP’S SIGN : glomus jugulare
RISING SUN SIGN : glomus tumour
 SCHWARTZ SIGN : active phase of otosclerosis(otospongiosis)
 STEEPLE SIGN: Acute laryngotracheobronchitis
 TEAR DROP SIGN : Orbital floor fracture
 THUMB SIGN : Epiglottitis
 TEA POT SIGN: CSF rhinorrhoea
 CAUSE OF NPC – EBV VIRUS
- Trotter's triad – U/L CONDUCTIVE DEAFNEES
th
-TRIGEMINAL NEURALGIA( d/t-5 c.n.)
th
- palatal palsy ( d/t-10 c.n.)
 Nerve involved in Frey’s syndrome –Auriculotemporal
 MCC of malignant otitis exterua-pseudomonas aeroginosa
28
st
 Eustachian tube develops from -1 pharyngeal pouch
 MC complication of CSOM-Mastoiditis
 Bezold’s abscess lies in relation to which muscle-Sternocleidomastoid
 Triad of deafness, vertigo tinnitus –Meniere’s disease
 MC involve structure in acoustic neuroma-superior vesticular nerve
 Mikulicz cells are seen in-Rhinoscleroma
 CSF Rhinorrhea is seen in # of –Cribriform plate of ethmoid
 MC site of epistaxis –little’s area
 Abductor of vocal cord-Posterior Crico arytenoids
 MC causative agent of Quinsy-Streptoccus pneumonia
 MCC of strider of newborn-Laryngomalacia
 Methods use for corneal parameter
Corneal thickness- patchymeter
Corneal curvature – keratometer
Corneal shining – placido’s disc
Corneal endothelium- specular microscope
Corneal surface – placido’s disc, window reflex
Corneal staining – flurescein staining:- ulcer stained brilliant green
Mcc of Staphyloma :- 1.anterior staphyloma- corneal ulcer

2.posterior staphyloma-degenerative high AXIAL MYOPIA
MUSCLES NERVE SUPPLY

1.orbicularis - facial
2.levator palpebrae - oculomotor
3.muller’s - sympathetic fibres
Hornor syndrome- is caused due to compression of sympathetic nerve plexus by an apical tumor called as pancast tumor
panjabi- ptosis
M-miosis
E-enophthalmos
A -anhidrosis
L-loss of ciliospinal reflex
- Max. cones are seen in fovea centralis
- 1 mm change in the axial length of the eyeball produce a change in refractive index by 3 diopter.
- Depth of anterior chamber of eye 2-3 mm.
- Normal ph of tear 7.5 .
- Max.refractive power of eye structure- anterior surface of cornea.
- Thinnest part of eye- posterior
- Thinnest part of lens – posterior
29
- Attachment of vitreous is longest- around ora serrata.

- In direct opthalmology image is magnified by 15 times
- Darkroom test is the most reliable provocative test for ACG
- SCHIMER TEST DONE FOR DRY EYES.
- ISOCHROMATIC CHART / ISHIHARA CHART USE FOR COLOR VISION TESTING.
- HIRSCHBERG TEST DONE FOR –SQUINT
- FINCHAM’S TEST – distinguish b/w coloured halos of cataract and glaucoma
- Cover-uncover test done for – latent squint
- Field vision tested by perimetry, bjerum’s screen
- Trachoma:- doc-azithromycin
- Corneal ulcer
- Herbert’s pit
- Arlt’s line
- Follicles
- Papillary hyperplasia
- Pannus
- Sago grain follicles
- Hp bodies ,
SAFE strategy – (S- surgery , A-antibiotic, F- facial cleanliness, E-enviromental improvement), blaket therapy
- Karatoconus:- fleischer ring
-vogt’s striae
- munson’s sign
-high myopic astigmatism
Rx- RGP CONTACT LENSES
- HERBERT’S PIT IS SEEN IN CHLAMYDIAL CONJUNCTIVITIS.
- Angular conjunctivitis is caused by moraxella axenfeld
- Haemorrhagic conjunctivitis is caused by enterovirus 70
- fungal corneal ulcer:-convex hypopyon, hyphate margins,SATELLITE LESIONS are seen
- diagnostic test for the corneal ulcer is sadium fluorescein dye
- neovascular glaucoma is caused by CRVO, CRAO, and diabetes mellitius
- dangerous zone of eye- ciliary body
- after cataract is secondary cateract-1.sommering’s
- 2.- elshning pearl
- Nd –yag laser is use in Mxof after cataract
- Blue dot cataract mc type of congenital cataract
- Hard contact lens made by PMMA
- Soft contact lenses made by-HEMM
- ARGYLL ROBERSON PUPIL- a pupil responds to accomdation but light reflex is absent.
- Legal blindness- <3/60
- Economic blindness<6/60
30
st th
- 1 nerve affected in cavernous sinus thrombosis-6 c.n.
- Vestibulo ocular reflex is important for the perception of :- image
- Mc part injured in orbital blow out fracture- inferior wall
 Antero posterior length of eyeball-24mm

 Nerve supply to superior oblique muscle –Trochlear (SO4LR6)
 Pupil in angle closure glaucoma is –Vertically oval, mid dilated ,fixed
 Ropy discharge from eye is suggestive of –spring catarrh
 Muscle commonly affected in thyroid opthalmopathy – Inferior rectus
 DOC for acute anterior Uveitis-Steroids
 MCC of blindness in children in India-Vitamin –a deficiency
 Kayser Fleisher rings in eye are seen in –Wilson’s disease
 Roth spots in eye are seen in –Sub acute bacterial endacarditis(SABE)
 Dalen fuch’s nodules are seen in –Sympathetic opthalmitis
 Iris pearls are noticed in –leprosy
 Organism which can penetrate normal intact cornea -Neisseria gonorrnea, N meningitidis Diphtheria
 Neurotrophic keratitis involves-Trigemiyal nerve
 Recurrent corneal erosions are seen in corneal – corneal dystrophy
 Flexner winter steiner rosettes on microscopy are seen in –Retinoblastoma
 Lens used to correct astigmatism –cylindrical
 Recurrent vitreous hemorrhage is a feature of –Eales disease
 MC drug used in open angle glaucoma-Timolol
 Cause of sudden loss of vision in diabetic patient –Massive vitreous hemorrhage
 Fincham,s test is done to differentiate between –colored holos of acute congestive glaucoma and cataract
 Inital manoeuvre done in a congenital dacrocystitis-Massaging
 MC parasitic cause of uveitis is –toxoplasmosis
 Night stick #- #shaft ulna
 Chauffeur #- intra-articular oblique # of radial styloid
 Side –swipe #/ baby car #-injury to protruding elbow, combinantion of distal humerus and proxiamal radius/ulna #
 Bumper #- comminuted , depressed # of lateral condyle of tibia
 Pott’s #- bimalleolar ankle # , cotton’s #- trimalleolar ankle #
 Avitaor’s #- # neck of talus
 Jone’s #- avulsion # base of 5th metatarsal
st
 Jefferson #- # of 1 cerivical vertebrae
 Hangman’s # - b/l lamina and pedical # at C2
th
 Boxer’s #-# neck of 5 metacarple
 Thurstons Hollond sign is a feature of Salter Harris type-II
 Hill sachs lesion is observed in –Recurrent anterior dislocation of shoulder joint
 Triple deformity of knee includes-Flexion, posterior subluxation and external rotatin of tibia.
 Brittle bone disease is also known as-Osteopetrosis
31
 Mcc of pathological #- osteoporosis

 Gustilo-anderson classification- open /compaund #
 Pauwel’s classification- # neck of femur
 Mc liga. Injury- ATLF( anterior telofebular liga.)
 Strongest ligament –iliofemoral liga
 Russell’s traction – trochantric #
 Gallow’s and bryant traction - # shaft femur in child <2 yrs
 Dunlop’s traction and smith traction- supracondylar # humerus
 Arthritis classification
 1. InflamMatory ;- (a) seropositive- RA, LUPUS,SCLERODERMA, VASCULITIS,SJOGREN’S
 (B) SERONEGATIVE- ANKYLOSING SPONDYLITIS, PSORIATIC,REACTIVE, INFLAMMATORY BOWEL
DIS. ARTHRITIS,REITER’S DIS.( CONJUNCTIVITIS, ARTHRITIS, URETHRITIS)
 (C)INFECTIOUS
 (D) CRYSTAL INDUCED- GOUT
 2. NON INFLAMMATORY;- OA
 CARPL TUNEL SYNDROME- mcc- idiopathic>hypothyroididsm
C-compressed midean nerve
A-acromegaly( GH. High)
R- R.ARTHRITIS
P- pregnancy
L- low thyroid( hypothyroidism)
Syndrome- sansation ( tingling and buming)
 MC site of gout-Great toe
 Age group affected in Ewing’s sarcoma-5-20years
 Splaying of metaphysic is in –Rickets
 IOC for traumatic paraplegia-MRI
 Tardy Ulnar nerve palsy is seen with-#Laternal humeral condyle
 Galeazzi fracture involves-Distal radius
 MC complication of fracture of neck of femur-Non-union
 Most common symptom of TB spine-Bachache
 Barlow test is done for-Developmental dysplasia of hip
 Fracture of radial styloid process is known as –Chauffer’s#
 Housemaid’s knee is due to –Prepatellar bursitis
 Swan neck and Z deformity of fingers is seen in –Rheumatic Arthritis
 Forward slipping of 1 vertebra over other-Spondylolisthesis
 Heterotopic bone formation in a muscle belly is known of – myositis ossificans
 Tension band wiring is best done for –Olecranon and patella fractures
 MC type of TB spine-Paradiscal
 Kienbock’s disease is avascular necrosis of –lunate bone
 Acute stage of poliomyelitis last-10-15days
32
 Best and most successful treatment of bronchial asthma-Avoidance of antigen

 Epiphyseal dysgenesis is a pathoglomonic of –Hypothyroidism
 Best method to diagnose childhood HIV –PCR
 MCC of nephrotic syndrome in children –Minimal change disease
 Duchne muscles dystrophy is a disease of –Sarcoleemmal protein
 MCC of meningitis is a post natal period –Streptococcus pneumonia
 MCC of death in diphtheric child-Myocorditis
 Noctural enuresis may be considered normal upto-5years
 TOC for bronchiolitis in children is –Ribovirin
 The MC presentation of neonatal meningitis –Poor feeding
 Most common malignancy of the childhood –ALL
 MCC of heart failure in infancy –Congenital heart disease
 MCC of cholestatic jaundice in newborn-Neonatal hepatitis
 A neonate born to infected hepatitis B mother should be treates with –Immunoglobulin are HEPB vaccines
 True for vitamin D resistant rickets-Defect in proximal tubular real sorption
 Breast feeding should be initiated within- ½ hr
 Head control is possible in a infant by-3months
 Child speaks sentences of-2years
 A baby knows his/her gender at the age of -3years
 DOC of myoclonic epilepsy in children-Valproic acid
 Temperature of a child in severe hypothermia- C320 C
 MCC of death in klinefelter syndrome –Infections
 MC form of intracranial hemorrhage in preterm neonates is –Subependymal hemorrhage
 Physiological jaundice in preterm bodies last for-14days
 Anterior fontanel fuses by-18months
 MC type of seizure in newborn-Subtle
 In apoptosis Apaf -1 is activated by release of which of the following substance from mitochondria-Cytochrome C
 A simple bacterial test for mutagenic carcinogens is-AMES test
 Stain specific for Amyloid –Congo red
 Type of Amyloidosis is caused by mutation of the transthyrting protein –Familial amyloidotic polyneuropathy
 In famillal mediterorean fever the gene the following protein undergoes mutation –pyrin
 The classification purposed by the international lymphoma study group for NHL is-REAL classification
 Sub type of Hodgkin’s disease which is geniticancy district from are the other sub types is- lymphocyte psedominant
 The membrane protein clathrin is involved in –receptor mediated endocytosis
 Lipoxins belongs to family of-Arachidonic acid metaboullites
 Genes favoring Apaptosis-bax,bad ,bcl-X5
 Genes that inhibit apoptosis-bcl2,bcl-xl
 Most common cytogenetic abnormality in adult MDS-nonosomy 7
 Most abundant glycoprotein present in basement membrane-type IV
33
 The blood in the vessels normally doesn’t clot bec2-vascular endothelium is smooth and coated with glyocalxy
 The correct sequence of cell cycle is-Go –GI-S-G2-M
 Routine technique for karyotyping using light microscopy-G banding
 Gluten sensitive enteropathy is most strongly associated with which HLA system-HLA
 Pan T lymphocyte marker –CD3
 Memory T cells can be identified by using marker-CD45RO
 NHC class III gene encodes –TNF and are important elements in governing susceptibility to auto immuue disease
 Raised level of lipoprotein a is a predictor of –atherosclerosis
 The epithelliod cell and multinucleated giant cells of granulomatous inflammation are derived from-Monocytes
macrophages
 The following feature is common to both cytotoxic T cells and NK cells –effective against virus infected cells
 A myocardial infarct showing early granulation tissue has most likely occurred –within 1 week
 Enzyme that protects brain from free radical injury –Superoxide dismutase
 Autoimmuue hemolytic anemia is seen in –CLL
 Massive blood transfusion result is –Metabolic Alkalosis
 The marker for B lymphocyte is -- CD19
 Firm warty vegetation along the line of closer of valves is due to –Rheumatic heart disease
 Flat vegetations in pockets of valves are due to-libman sack’s endocarditis

 Characteristic feature of rheumatic carditis is –Pancarditis
 MC histological types of lung ca in India – Squamous cell ca
 A highly ionized drug –is excreted mainly by the kidney
 Theophyline has on antagonistic interaction with which receptors -adenosive receptors
 Dry mouth during anti depressant therapy is caused by blockage of receptors- Muscarinic acetylcholine receptors
 Antiosychotic drug induced parkinsonism is treated by –anticholinergics
 Inverse against of benzodia zepine receptor is-Beta-carboline
 Hemorrhage secondary to heparin administration can be corrected by administration of –PROTOMINE SULPHATE (
AIIMS Nov.18)
 Antibiotic bacitracin acts of –cell wall
 The most effective drug against M.leproe is-Rifampicin
 Bosentan is –Endothelin receptor blocker
 Barbiturates are contraindicated in which disorder-Porphyria’s
 Proton pump inhibitos are most effective when they are given-shortly before meals
 The mechanism of action of sodium nitroprasside is-increased guanylate cydase
 True statement regarding inverse against is-birds to receptor and causes opposite action
 True statement regarding first order kinetics-A constant proportion of plasma concentration is eliminated
 Mechanism of action of tetracycline –Birds to A site and inhibit of attachment of t-RNA
 In low doses aspirin acts on –cyclo –oxygenase
 β-blocker with peripheral vasodilator action is-carvedilol
 Diagnosis of myasthenia gravis is by-Edrophonium
34
 Coronary steal phenomenon is caused by-Dipyridamole

 The nitrate which does not undergo first pass metabolism –Isosorbide mononitrate
 A patient has hepatic encephalopathy the drug used for gud sterilization in this patient is-Neomycin
 A patient taking ketoconazole tertenadine both is prove for cardiac arrhythmia
 The treatment of contacts of meningococcal meningitis is by-Rifampicin
 Cyclosporin act’s by inhibiting the proliferation of IL-2
 DOC for malaria during pregnancy is – chloroquine
 MESNA is given with cyclophosphamide- To avoid side effect of hemorrhagic cystitis
 DOC in acute central anticholinergic syndrome – Physostigmine
 Difference between action of diethylcarbazepine and Ivermectin in a scrotal filariasis is –DEC act’s on adult and
ivermectin on microfilariae
 Milk alkali syndrome may be caused by investigation of –calcium carbonate
 Tetrahdrocannabinol is the active component of –marijuana
 First drug to be used in anaphylactic shock =S.C.Adrenaline
 MC site effect of 5 Fluroro-Uracil I s-G.I Toxicity
 Prolonged use of steroids may cause-Decrease in bone matrix protein
 In the small intestine cholera toxin acts by –ADP ribosylates of the G-regulatory protein
 A bacteria disease that has been associated with i.e Rats Ricefield, Rainfall is –leptospirosis
 The MC pathogens responsible for nosocomial pneumonia in the ICU are –Gram negative organisms
 Virus mediated transfer of host DNA from due cell to another is known as-Transduction
 HIV can be detected and confirmed by-RT PCR
 Which protozoal infection leads to malabsorption –G lamblia
 The capsule of Cryptococcus neoformons in CSF sample is best seen by –India ink Preparation
 The serum concentration of which IgG subclass is maximum-IgG
 Adenosive deaminase deficiency is associated with-Serve combined immunodeficiency
 A 20 year old man presented with hemorrhagic colitis the stool sample grew E coil in pure culture The following type of
E coil is likely to be its causative agent-01577 A7
 The most sensitive method for detecting cervical Chlamydia trachomatis infection is-PCR
 Heat labile instruments for use in surgical procedures can be best sterilized by-Ethyene oxide gas
 The earliest immunoglobulin to be synthesize by the fetus –IgM
 Rate of automaticity in AV node-40-60beats/min

 Conduction velocity of impulse is maximum in which part of heart –Purkinji fibres
 Which part of ventricle is repolorized at last –base of heart
 Cannon ‘a’ wave is seen in JVP in which disease-CHB
 Most accurate method to measure cardiac output-Fick’s principle
 Acidification of urine occurs in –CD
 Maximum absorption of sodium and water takes place in which part of nephron-PCT
 Mutation of Na++k+2cl channel lead to –Barter’s syndrome
+ -
 Mutation of Na Cl Channel lead to –Gitelman’s syndrome
35
+
 Hyper functioning of Epithelial Na channel in collecting duct lead to-Liddle’s syndrome
 Mutation of Ryanodine receptor leads to –Malignant hyperthermia
 Bell magendie low-
o Sensory –
o Dorsal horn
o Motor –ventral Horn
 Bipolar neurons are seen in –Retina ,olfactory sensory nerves, cochlea
 Rest membrane potential of neuron is-70mv
 Mutation of voltage gated calcium channels in nerve leads to –hypokalemic periodic paralysis
 Myelin sheath in peripheral nervous system is formed by-schwann cell
 Blood brain barrier is formed by- Astrocytes
 MC fracture in all age groups –Clavicle fracture
 Nerve supply to serratus anterior muscle(boxer’s muscle)-long thoracic nerve (palsy resulting winging scapula)
th
 Accessory nerve(11 cranial nerve)Supplies two muscles-Trapezius ,sternocleidomostoid muscles
 Lattisimus dorsi muscle is supplied by-Thoracodorsal nerve
 Rhomboideus major ,minor levator scapulae are supplied by-Dorsal scapula nerve
 Adhesive tendinitis of rotats to cuff muscles is known as-Frozen shoulder
 Axillary nerve supplies two muscles –Teres minor,deltoid muscles
 Biceps brachii,coracibrachialis ,brachiates muscles are supplied by-Musculocutaneous nerve
 The short head of biceps and coracobrachialis muscle have a common origin from-Tip of coraccid process
 Student’s elbow is- Olecranon bursiti’s
 Pulled elbow or nerve maid elbow-Subluxation of head of radius from annular ligament
 Golfer’s elbow is known as-Medial epicondylitis
 Tennis elbow is known as –Lateral epicondylitis
 Hinge joints –Elbow Joint, Ankle joint interphalangeal joint
 Main abductor of arm-Deltoid muscles
 Book test card test ,froment’s sign done in –Ulnar nerve palsy
 Structures having length of 45cms –Spinal cord ,vas deferens adult femurs thoracic duct
 Motor supply of diaphrasm-Phrenic nerve
 Most common type of congenital diaphragmatic hernia-Bochdalek most common left side
 Thoracic part of Esophagus is supplied by artery-Esophageal branch of thoracic aota, bronchial artery
 Little’s area is formed by-Anterior ethmoidal artery ,sphenopalatine artery superior labial branch of facial artery
 Structures opening into middle meatus -frontal sinus, maxillary sinus ,anterior ethmoidal sinus, middle ethmoidal sinus
 Largest branch of external carotid artery-Maxillary artery
 Middle cerebral artery is a branch of –Internal carotid artery
 The muscle which opens the mouth-Lateral pterygoid muscle
 All the muscles of mastication are supplied by-Mandibular nerve (masseter, Temporalis, medical pterygoid ,lateral
pterygold)
 Waldeyer’s ring around the oral cavity is formed by-Adenoids ,tubal tonsils, palative tonsils ,lingual tonsils
 Tensor palatine muscle of soft palate is supplied by-mandibular nerve
36
 Stylopharyngeus muscle is supplied by-Glussopharyngeal nerve

 Submandibular and sublingual glands is supplied by-Facial nerve
 Parotid gland is supplied by-Glossopharyngeal nerve

 Safety muscle of tongue which causes protraction-Genioglossus
rd
 Posterior 2/3 of tongue and circumvallate papillae is supplied by which nerve-Glossophorygeal nerve
 Cricothyroid muscle of larynx is supplied by –Superior laryngeal nerve
 The three unpaired cartilages of larynx are-Epiglottis ,thyroid cricoids
 Abductor muscle of vocal cord(main) –Posterior cricoarytenoid
 Adductor muscle of vocal cord-lateral cricoarytenoid
 Sensory supply of supraglottic comportment of larynx is by-Internal laryngeal nerve
 Sensory supply of infraglottic compartment of larynx is by-Recurrent laryngeal nerve
 Main movements at ankle joint are-Dorsi flexion plantor flexion
 The most common ligament to be involved in the sprains of ankle joint is-anterior talofibular ligament
 Subtalar joint is a type of-plane synovial joint
 Ligament spring is present at which joint-Subtalar joint
 Patella develops in tendon of which muscle-Quadriceps femori
 Prepatellar bursitis is known as-housemaid’s knee
 Infrapatellar bursitis is known as-Clergymon’s knee
 Anterior compartment of leg muscle of supplied by-Deep peroneal nerve
 Posterior compartment of leg muscle is supplied by-Tibial nerve
 Hamstring muscles of thing are supplied by-Sciatic nerve
 Nerve compressed in Tarsel tunnel syndrome-Tibial nerve
 Compression of sciatic nerve at posterior comportment of thing is known as-Sleeping foot syndrome
 Dortos muscle of a scrotum is supplied by-L1 Root of Ilio inguiual nerve
 Cremasteric muscle of testis is supplied by-L1L2 root of genitofemoral nerve
 The tendon of fabella (sesamoid bone)lies in-lateral head gastronemus muscle
 MC Carpal bone to get fracture is-Scaphoid
 Adductor pilicis is supplied by-ulnar nerve
 The main motor nerve of hand-ULNAR nerve-(Musician’s nerve)
st
 1 Carpometacorpal joint is a type of-Saddle joint
 Wrist joint is a type of –Condyloid or ellipsoid joint
 Callot’s triangle is formed by-Common Hepatic duct, Cystic duct, Lower border of liver
 Portal vien is formed by-Superior me senteric vein + splenic vien
 Contents of inguinal canal –Spermatic cord ,ilioiguilnal nerve ,genital branch of genitor femoral nerve
 Conjoint tendon is formed by-=Fusion of aponeurotic fibres of internal oblique and transverse abdominis
 Superior epigastric artery is a branch of –Musculophrenic artery(Branch of internal thoracic artery)
 Left gastric artery is a branch of –Celiac trunk
 Gastroduodonal artery is a branch of-Common hepatic proper artery
 Appendicular artery is a branch of –Ilecolic artery
37
 Middle rectal and inferior rectal arteries are branches of –Internal iliac artery
st
 Maxillary artery and Mandibular nerve are derived from which bronchial arch-1 arch(mandibuls arch)
 Internal pudeudal artery is a brancle of-Internal iliac artery
nd
 Muscles of facial expression and stapedial artery are derived from which branchial arch-2 arch
rd
 Common carotid artery and stylopharyngeus muscle are derived from which branchial arch-3 arch
th
 Cricothyroid muscle and aortic arch are derived from which branchial arch-4 arch
th
 Muscles of larynx and duct arteriosus are derived from which branchial arch-5 arch
 Remnant of ductus venosus-Ligamentum venosus
 Remnant of left umbilical vein-Ligamentor teres
 Physiological closure of ducts arteriosus takes place within -1-3days
 Shortest cranial nerve is-olfactory nerve
 Total no of spinal nerve-12pairs
 Cranial nerve with largest intracranial nerve-IV CN
 The neurotransmitter released at preganglionic fibres of sympathetic nerve system is-Acetylcholine
 The pre and postganglionic fibres release which neurotransmitter-Acetylcholine
 The largest ganglion of parasympathetic nervous system supplying the lacrimal gland via greater superficial petrosal
nerve is-Pterygopalatine ganglion
 IF damage to area 22 wernicke’s area-Lead to SENSORY APHASIA
 If damage occurs to area 41,42 (Auditory area)leads to-Motor Aphasia
 Pyramidal tracts are –Corticospinal tract ,corticobulbur or corticonuclear tracts
 Extra pyramidal tract are-Vestibulospinal, olivospinal,Reticulospinl rubrospinal ,tectospinal tracts
 MC vessel involved in extradural hemorrhage-Middle muscle artery
 MC vessel involved Intracerebral hemorrhage in hypertensive bleed is-Lenticulostriate branch of middle cerebral artery
 Site of formation of CSF is –Lateral ventricles of brain
 Which is longest muscle of body (Tailor’s muscle)-Sartorius
 Lateral compartment muscle of leg are supplied by which nerve-Superficial personal nerve
 Muscle which is caused as Peripheral heart of body - “Soleus”
 Strongest ligament in the body-Iliofemoral
 Strongest tendon in the body-Tendoachilles
 Locking muscle of knee joint –Quadriceps femoris
 Unlocking muscle of knee joint –Popliteus
 Main flexor muscle of knee joint –hamstring muscles
 Popliteal artery branches
o Anterior tibial artery
o Posterior tibial artery
 Inferior epigastric artery is a branch of –External iliac artery
 Superficial epigastric artery is a branch of –Femoral artery
 Descending genicular artery is a branch of-Deep Branch of femoral artery
 Main Flexor muscle of hip joint-Iliapsoas muscle
 Main extensor muscle of hip joint-gluteus maximus
38
 Abductors of hip joint

o Gluteus medius
o Gluteus miniumus
o Tensor facia lata
 Nevus which is pre malignancy highly-Junction nevus
 Shortest acting muscles relaxant-Succinyl choline
 Hoffman’s elimination is related with-Atracurium
 Dissociative anesthesia is related with –Ketamine
 Agent of choice for day care surgery-Propofol
 Anaesthetic agent causing adrenocotical Supression-Etomidate
 Anesthetic agent causing postpartum hemorrhage-Halothane
 Pin index of nitrous oxide is-3.5
 Second gas effect /diffusion hypoxia is seen with-Nitrous oxide
 Cause of post dural puncture headache-CSF leak
 Mallampati grading is done for-Assessment of oral cavity before intubation
 Site of spinal anaesthesia in infants-L4-L5
 Agent of choice for induction in pediatric are grap-sevoflurane
 Anesthetic agent having low blood and tissue gas partition coefficient-Desflurane
 Anesthetic agent which sensitizes heart to adrenaline-Halothane
 Anesthetic agent which cerebro protective-Propofol
 Anesthetic agent causing profound analgesic-Ketamine
 Position of head and neck during intubation-Neck flexed and head extended
 MC complication of intubation is-sore throat
 Aspirin should be stopped how many days before surgery -7
 Most potent antiemetic used in premedication-Hyosine
 CVP is measured most commonly in which vein-Right internal jugular vein
 Most common site for intra-arterial cannulation-Radial
 Narrowest part of larynx is adult is-Glottis
 Location of pneumotaxic center-Upper pons
 Xylocaine should not be used with adrenalin for blocks in which region-Ring block penile block
 Normal V/Q ratio is-0.8- 0.9 l/min
 Normal breath holding time should be more than>25seconds

 Directly acting muscles relaxant drug – Dantrolene
 All local anesthetics are vasodilators except-Cocaine
 Which muscle relaxant safe renal/liver failure-Atracurium
 Best general anesthetic in status asthmotics-Ketamine
 DOC for bier’s block-Lidocaine
 Amongest flurances ,fastest acting induction agent is –Desflurane
 N20 is contraindicated in –Pneumothorax
39
 Difference between auxiliary temperature and core temperature is-0.5

 Safety system developed to discourage incorrect cylinder attached-pin, index
 Block used for labour analgesic /painless labor-Epidural
 Touhy’s needle is employed for admisnstery –Epidural block
 MC Factor related to post dural puncture headache-Size of needle
 Location of postdural puncture headache-Occipital or bifrontal
 MC complication of subarachnoid block-CSF leakage resulting in headache
 Shortest acting non-depolarizing muscle relaxant –Mivacurium
 Toorniquet time for upper limb-45minutes to 1hr
 CVP reflects pressure of which chamber of heart –right atrium
 During endotracheal intubation ,endotracheal tube commonly positioned to which sided brochial-Right side
 Supraclavicular block is employed for surgeries on which parts of body-upper limb
 Blue color of cylinder indicator which gas-Nitrous oxide
 Carina is at the level of thoracic vertebrae-T4
 High spinal anesthesia is characterized by – hypotensive bradycardia
 In spinal anaesthesia first nerve fiber to get block are-Automomic preganglionic B fibres
 Neurotransmitter involved dementia-Acetylcholine
 Drug of choice in ADHD in children –methylphenidate
 False unshaken belief not amenable to resoning is know as – Delusion
st
 1 symptom of pschizophrenia to go with treatment – auditory hallucination
 Paranoid schizophrenia may be associated with the use of which drug-Amphetamine
 Longest acting SSR1-Fluoxetine
 Abnormal pre-Occupation and normal body function is known as-Hypochondriasis
 Irresistible desire to drink alcohol is known as-Dipsomania
 Fear of animals is known as-Zoophobia
 Nihilistic ideas are seen in-Depression
 Grandiosity and fight of ideas may be a feature of –Mania
 Most common severe symptom of alcohol withdrawal is-Delirium tremens
 Flashback phenomenon is associated with use of –LSD
 Nightmares are seen in which phase of sleep-REM
 Agent of choice for prophylaxis in monia-Lithium
 DOC for phobia-Paroxetine
 DOC for OCD-Fluoxetive
 Value of IQ for severe MR-20-34
 Tactile hallucinations and jet black tongue are associated with abuse of –Cocaine
 Disorder of content of thought-Delusion
 Child with difficulty in forming social relationships-Autism
 To diagnose mania, symptoms should be present for at least-7days
 Effect of long term lithium therapy on thyroid-Hypothyroidism
 Drug useful in acute attack of migrane –Sumatripton
40
 Main feature of korsakoff’s psychosis-Confabulation

 Disulfirum alcohol reaction occurs due to the inhibition of which enzyme-Aldehyde dehydrogenates
 Maximum loss of DALY occurs in which psychiatric disorder-Depression
 Bad trip weed is-LSD
 Othello syndrome is-Morbid jealousy
 Worst prognosis in which type of schizophrenia-Hebephrenic
 Noctural enuresis is considered normal up to the age of -5years
 Major depression is defined as depressed mood on daily basis for a minimum duration of -14days
 Alcoholic seizures occurs after how many hours of heavy bout of drinking-24-48hours
 Delirium tremens occurs within how many days of abstinous from alcohol-4days
 Magnan symptoms are seen with abuse of –Cocaine
 Patchy impairment of personal memory is-Dissociative amnesia
 Value of IQ for profound MR -<20
 A mentally in person smells odour when none is present this is an example of-Olfactory hallucination
 Undue familiarity to unknow objects is-Déjà vu
 Absolute C/I to ECT is-Raised intracranial tension
 Most common symptom of alcohol with drawa is-Tremors
 Drug used in opoid dependence to prevent relapes-Naloxane
 A 30 Year old man was started on haloperidol and developed hyperpyrexia ,muscles rigidity ,alkinesia and increased BP
Likely is diagnosis –Neuroleptic malligant syndrome
 A patient avoids public transport to go to his place of place as he is having fear of being in a crowd. This is
claustrophobia
 A person missing from home is found wondering purposefully. Likely is – dissociative fugue
 A 22 year old lady seeks plastic surgery for her nose which is normal she rarely meets her friend diagnosis is-Body
dysmorphic disorders
 A 36 year old woman with a 16 year old history of vague and chronic physical complaints she says that she is always
been in pain in abdomen ,chest ,legs Diagnosis is somatization disorder.
 A22 year old lady experiences a sudden loss of vision after a fight with husband but appears uncorrected (la belle
pudifference diagnosis is-Conversion disorders)
 Waxy flexibility ,negativism ,echclalia ,echopraxia are a feature of which type of schizophrenia-Catatonic
 Substance having same atomic mass and different atomic number is-Isobars
 Most penetrating rays-gamma rays
 MRI rooms are shielded by-copper/Aluminium
 Sugar used in PET scan-De oxyglucose
 Tram track appearance of skull on CT scan is seen in –Sturge weber syndrome
 Triple bubble sign is seen in –Jejunal atresia
 Radiological feature of ureterocele –Adder head appearance
 IOC for chronic Subarachnoid hemorrhage –MRI
 IOC for perthe’s disease –MRI
41
 Best method to detect minimal pleural effusion on right effusion on right effusion –USG
 Claw sign is seen in –Intussusception
 Measure of activity of radiation –Bec Querel (s.i unit) curie non-SI unit)
 Most radio sensitive phase of cell cycle-G2M
 Use of gamma knife-stereo-tactic radio surgery
 Radiologjcal feature of pulmonary hamortoma-pop corn calcification
 Frost berg’s reverse 3sign is seen in –ca head of pancreas
 IOC for interstitial lung disease –HRCT
 Coeur’eu sabot heart is seen in TOF
 Rays having maximum ionizing power-Alpha rays
 Earliest radiological change of mitral stenosis on radiography –Straightening of left border of heart
 Investigation which itself can lead to acute pancreatitis –ERCP
 Air crescent sign is seen in which lung pathology –Aspergilloma
 Signet ring sign is associated with which lungs pathology-Bronchiectasis
 Hampton hump is a radiological feature of –Pulmonary embolism
 IOC for osteoporosis-DEXA SCAN
 Shepherd crook deformity of femur is a radiological feature of –Fibrous dysplasia
 Figure of 3’ on chest x-ray is suggestive of –Co arctation of aorta
 Dropping flower sign is suggestive of –Ectopic/Duplication of ureter
 Water lily sign is suggestive of –Hydatid cyst lung
 Right border of heart on –x-ray is formed by-superior vena cava, right atrium ,inferior vanacava
 Frog eye appearance in USG is suggestive of –Anencephaly
 IOC for renal vein thrombosis and IVC thrombosis-Doppler USG

 X-RAY for closed Pneumothorax is done in which stage of respiration-Expiration
 Figure of 8 appearance is seen in –TAPVC
 DTPA and DMSA scans are used for which organ-Kidney
 Half life of radiolodine is-8days
 IOC for remnant spleen is-Tc 99 labelled RBC
 Si unit of radiation absorbed dose is-gray
 .IOC for kidney morphology is-DMSA
 Egg shell calcification in hilar node suggestion-Silicosis sarcoidosis
 Strings of beads /sausage appearance of the renal artery is seen in fibromuscular dysplasia
 Meckel’s diverticulum is best diagnosed by-TC 99 Scan
 Dye used for myelography –Metrizamide
 Gold standard investigation in acute cholecystitis-HIDA scan
 Shield used in radiology are made up of which metals lead
 Fetus is most radio sensitive at what gestational age is -3weeks
 Angiographic findings in burger’s disease is-Corkscrew vessel
 Chain of lake appearance is seen in –Chronic pancreatitis
42
 Chain of lake appearance is seen in carcinoma-CA colon

 Solitary hypoechoic lesion of liver with septa and debris is seen in –Hydatid cyst
 Superior & inferior radioulnar joints are an example of: Pivot joint
 Pointing index- Loss of fl ex. Digitorum superfi cialis+ Flex.digi. Pollicis
 Duputryen’s contracture is seen in cirrhosis of liver.
 Anatomical snuff box –present at thumb( laterally-Ext.Poll. Brevis + APL and medially- Ext. Poll. Longus)
 Int. thoracic art. Is also called as internal mammary artery.
 Rt. sided superior gluteal nerve injury causes Lt. sided lurching gait and vice-versa.
 High stepping gait is seen in foot drop is seen in foot drop.
 Muscle aff ected in Carpal tunnel syndrome- Abductor pollicebrevis.
 Claw hand- injury to Median + Ulner nerve.
 Winging of scapula – caused by injury to long thoracic nerve.
 Erb’s palsy aka policeman’s tip deformity involves C5-6
 Klumpke’s deformity involves C8T1
 Median nerve is also called as eye of hand
 Ape thumb deformity caused be involvement of Abductor pollicis brevis (most aff ected) + opp. Pollicis
 M.C. peripheral artery for aneurysm- Poplitial artery.
 M.C art. involeved in Berry’s aneurysm- Ant. Communicating artery
 Clergyman’s knee – Infra-patellar bursitis.
 Students elbow – Enlarged Olicrenon.
 Hunter’s canal/adductor canal/ subsartoreal canal is present at mid thigh.
 Meckel’s diverticulum – True diverticulum
 Zanker’s diverticulum- False diverticulum
 Nerve supply of platysma: Facial nerve
 Salivary gland, NOT supplied by facial nerve: Parotid
 All palatal muscles are supplied by cranial accessory nerve through pharyngeal plexus EXCEPT: Tensor veli palatini
 Azygos vein passes through Aortic hiatus
 Source of bleeding in extradural haemorrhage: Middle Meningeal artery
 Haversian canal is a histological feature of: Compact bone/ cortex
 Uterine artery is a branch of: Anterior division of Iliac artery
 1st polar body is extruded at the time of: Ovulation
 Meckel's diverticulum is a remnant of: Vitellointestinal duct
 Structure derived from all the three germ layers: Tympanic membrane/ ear drum
 Stapes develop from Ilnd pharyngeal arch
 Safety muscle of tongue: Genioglossus
 Taste sensation from anterior 2/3rd of tongue is carried by: Chorda tympani
 Epithelial lining of tonsil: Stratified squamous non-keratinized epithelium
 Peritoneal cavity is lined by: Simple squamous epithelium
 Intercalated disc is a histological feature of: Cardiac muscle
 Erb's point is: C5, C6
43
 Injury to lower trunk of brachial plexus is known as: Klumpke's palsy

 Adductor pollicis is supplied by: Ulnar nerve
 Teres minor & deltoid muscle are supplied by: Axillary nerve
 Nerve supply of gluteus maximus: Inferior gluteal nerve
 Ligament preventing hyperextension at the hip joint: Iliofemoral ligament/ Ligament of Bigelow
 Inversion & eversion occurs at Subtalar joint
 Joint between epiphysis & diaphysis is: Primary cartilaginous
 Vessels in umbilical cord:2 arteries & 1 vein (right vein disappears, left vein is LEFT)
 Ligamentum arteriosum is derived from: Ductus arteriosus
 Artery present in anatomical snuff box: Radial artery
 Sperm are stored in:Epididymis
 Hassal's corpuscles is seen in:Thymus
 Peyer's patches are present in: Ileum
 Nerve supply to hypothenar muscle is from: Ulnar nerve
 Nerve passing deep to flexor retinaculum at wrist: Median nerve
 Nerve related to spiral groove of humerus: Radial nerve
 Azygos veins drain into: Superior Vena Cava
 Housemaids knee is inflammation of Prepatellar bursa
 Superficial inguinal ring is a defect in the: External oblique aponeurosis
 Left testicular vein drains into: Left renal vein
 Left gastro-epiploic artery is a branch of: Splenic artery
 MC position of appendix: Retrocaecal
 Nasolacrimal duct opens into inferior meatus
 Parasympathetic secretomotor fibres to submandibular gland is through: Facial nerve
 Opening of parotid duct:opposite upper 2nd molar
 Abductor of vocal cord: Posterior cricoarytenoid
 In adults spinal cord ends at the lower border of L1 vertebra (in children, it is at lower border of L3)
 Muscle supplied by spinal part of accessory nerve: Sternocleidomastid & trapezi us
 Unlocking of knee is done by: Popliteus
 Type of cartilage in auricle of ear: Elastic
 Nerve supply of superior oblique muscle: Trochlear
 Muscle producing abduction, intorsion & depression of eyeball: Superior Oblique
 Tay sachs – hyperacusis, cherry red spots, microcephaly and loss of motor skills
 Gauchers disease Deficiency of beta glucosidase
 Erlenmask fl ask deformity- Gauchers disease
 Sandhoff s - deficiency of beta- hexaminadase A & B
 Wolmans disease -calcifi cation of adrenal glands
 Hormone sensitive lipase is activated by -glucagon
 Hormone sensitive lipase is inactivated by - insulin
 Apo A1 activates LCAT
44
 Apo E is rich in arginine

 Apo E3 is most common
 Tangier disease - Mutation in gene encoding ABCA1
 Norum disease - LCAT defi ciency
 Rate limiting enzyme of cholesterol synthesisHMG CoA reductase
 Type 1 hyperlipoproteinemia is due to LPL defi ciency
 Accumulation of sphingomyelin in phagocytic cells is a feature of Niemann Pick disease
 Defect in alpha oxidation of phytanic acids REFSUMS DISEASE
 Cu acts as co enzyme for Tyrosinase, Dopamine β-hydroxylase, Cytochrome oxidase, Lysyl oxidase
 Zn acts as co enzyme for -carbonic anhydrase, glutamate DH, LDH, alcoholDH, superoxide dismutase, leucine
aminopeptidase, retinine reductase, alkaline phosphatase, DNA polymerase, RNA polymerase & d-ALA
dehydratase
 McArdle disease is a prototypical muscle energy disorder as the enzyme defi ciency (Ms. glycogen phosphorylase)
 limits ATP generation by glycogenolysis and results in glycogen accumulation
 Length of okazaki fragment sin eukaryotes 100-250 nucleotides
 Shortening of DNA is prevented by TELOMERASE/ TELOMERE
 Pompes disease is a deficiency of acid alpha, 1-4- glucosidase /acid maltase
 NADPH producing enzymes -G-6-P-D & 6- phosphogluconate dehydrogenase
 Muscle cannot use glycogen due to lack of G-6-phosphatase.
 Faconi bickel syndrome - Glucose transporter 2 defi ciency
 Site of absorption of iron -Proximal duodenum
 Site of absorption of folic acid - Proximal jejunum
 Site of absorption of cobalamin -Ileum
 Most common site of cholesteatoma Prussack’s space
 Samter’s triad -Aspirin sensitivity, Asthma and nasal Polyp
 Best Radiological view to evaluate maxillary sinus – Water’s view
 Best Radiological view to evaluate sphenoid sinus -Submentovertical view
 Most common sinus involved in osteoma - Frontal sinus
 Most common sinus involved in squamous cell CA - Maxillary sinus
 Hot potato voice is seen in - Quincy (peritonsillar abscess)
 Semon’s law is a hypothesis for - RLN palsy
 Key hole glottis is seen in this condition – Phonasthenia
SKIN NEUROCUTANEOUS SYNDROMES

 Neurofibromatosis involve chromosome – 17,22
 Button hole sign – simple neurofibroma
 Bag of worms sign – plexiform neurofibroma
 Most pathognomic sign of Neurofibramatosis – Axillary freckling
 Neurofibromatosis Café au lait macules – regular rounded margins –coast of California
 Café au lait macules – irregular margin – coast of maine
45
 Tuberous sclerosis involve chromosome – chromosome-9,16

 Vogt’s triad – epilepsy , Adenoma sebaceum , low intelligence (EPILOA)
 Most common site of ashleaf macule is – trunk
 Shahgreen patch is a collagenoma
 Koenentumor is seen in – periungual areas
 SEGA(subependymal giant cell astrocytoma) is found in – foramen of munro
 Tram track calcification is seen in sturge weber syndrome best seen in
 Sturge weber syndrome is characterised by U/L port wine stain
 Port wine stain is vascular malformation in region of trigeminal nerve
 Treatment of port wine stain – pulse dye laser
STD
 Single painless INDURATED ulcer with RUBBERY , SHOTTY lymphnodes – syphilis
 First test to become positive in syphilis – FT-ABS
 Best test to monitor patient for followup – VDRL
 Test for Neurosyphilis performed in CSF is – VDRL
 Patient of latent syphilis shows chancre like lesions on the site of previous chancer – CHANCRE REDUX(spirochete can
be isolated from chancre)
 Patent of tertiary syphilis shows chancre like lesions at the site of previous cancre – PSUEDO CHANCRE (spirochete cant
be isolated from chancre)
 Treatment in neurosyphilis – crystalline penicillin or procaine penicillin
 Unilocular bubo is found in – Chancroid caused by hemophylusducreyi
 Multilocular bubo found in – LGV
 Groove sign seen in – LGV
 Donovanosis has no lymphadenopathy, PSUEDOBUBO +
 DOC of genital warts – podophyllin
 DOC of genital warts in pregnancy – Cryotherapy
 Criteria for Bacterial vaginosis – Amsel criteria
 Chlamydia trachomatis causes which STD-Lymphogranulomavenereum
 Soft chancre is caused by –Hemophilusducreyi
SKIN MANIFESTATION OF INTERNAL DISEASES

1. Granuloma annulare – seen in diabetes mellitus , commonly on the dorsum of hands
2. Necrobioticalipoidicadiabeticorum – seen in diabetes , orange plaque on shin
3. Seborrhic Keratosis(SK) – stuck on appearance….multiple eruptive SK in non- sun exposed sites – LASER TRELAT SIGN -
seen in gastric carcinoma
4. Sweet syndrome – acute febrile neutrophilic dermatosis seen im AML , Chrons disease
5. Necrolytic migratory erythema – erosions in peri anal area seen in glucagonoma
6. Hypertrichosis lanuginose – hair present everywhere on face seen in gastric adenoma
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7. Sister joseph nodule – gastric adenoma

8. Erythema gyratum – lung cancer
VASCULAR LESIONS
9. Urticaria – red dermatographism
10. White dermatographism seen in –Atopic Dermatitis
11. Hereditary angioedema has C1 esterase deficiency
12. DOC f hereditary angioedema – Danazol
13. Most common cause of erythema multiforme is HSV 1 virus
14. Target lesions seen in – erythema multiforme
SCABIES
1. Scabies mite burrows till stratum corneum
2. Incubation period of scabies – 4 weeks
3. Itching area – circle of hebra
4. DOC of scabies – permethrin 5%
5. Oral ivermectin dose in scabies – 200 microgram/kg or cap 12 mg stat
Pediculosis
6. Pediculosishumaniscorporis also known as Vagabond disease
7. MACULAE CERRULAE seen in pediculosiscorporis and pediculosis pubis
8. Eyelashes involved in pubic louse not head louse
FUNGAL INFECTIONS
9. Dermatophytes infect stratum corneum
10. Most common cause of Tineacapitis – Microsporumcanis
11. Scutula are seen in – Favus(inflammatory Tineacapitis)
12. Furfuraceous or Rice powder scales seen in -Pityriasisversicolor
13. 10% KOH of P.versicolor – Sphagetti and meat ball appearance
14. Commonest fungal infection of genetalia in diabetes is Candida
15. cigar shaped bodies and asteroid bodies- sporotrichosis
16. Malasezzia furfur causes-pityriasisversicolor
17. Best diagnostic test for fungal skin infection-KOH amount
BACTERIAL INFECTIONS
LEPROSY
• Virchow lepra cells or foamy macrophages found in – LL Hansen
• Mc cranial nerve involved- facial nerve(7)
• Ulnar nerve>common peronial>posterior tibial
• Unmyelinated c fibres affected first
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• Cold>hot>pain>touch>pressure
• Most common type of leprosy in india – BT HANSEN
• saucer right side up– TT hansen
• Satellite lesionsnear margins – BT Hansen

• Bizarre geographicallesion ,Annularlesions, Swiss cheese or punched out- BB Hansen
• Inverted saucer lesions – BL Hansen
• Thalidomide has no role in Type 1 lepra reaction
• DOC of both type 1 and 2 lepra reaction is steroids
• Most effective antileprotic drug is – Rifampicin
• Leprosy does not affect which organ of females-Uterus
• Lucio phenomenon is seen in –Leprosy
• Leonine facies is seen in-Lepromatous leprosy
TB
1. Most common cutaneous TB is Scrofuloderma
2. Second most common is Lupus vulgaris
3. Annular lesion with central scarring – Lupus vulgaris
4. Apple jelly nodule on Diascopy seen in Lupus Vulgaris
5. Swimming pool granuloma or Fish Tank Granuloma caused by- M. marinum

6. Buruli ulcer-M. ulcerans
Other bacterial infections
7. HONEY COLOURED CRUST Seen in Impetigo contagiosum
8. Woods lamp – coral red flouroscence seen in Erythrasma
9. Most common site for impetigo - Face ---around nose
10. Most common etiology for impetigo – Staph Aureus
11. annular lesion with central crusting VOLCANO sign- cutaneous leishmaniasis
12. infiltrated papular lesions in the central area of face (Muzzle sign)-PKDL
VIRAL INFECTION
1. DOC OF WART – PODOPHYLLIN
2. DOC of wart in pregnancy – cryotherapy
3. Condyloma is caused by-Human papilloma virus
PAPULO-SQUAMOUS DISEASE
1. Grattage test and Auspitz sign positive in psoriasis
2. only indication of systemic steroids in psoriasis - Impetigo herpetiformis
3. Most specific nail sign in psoriasis – oil drop sign -Focal onycholysis at the centre of nail
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4. 5 P’s: pruritic, purple, polygonal, plane topped, papules& plaques – lichen planus
5. Dorsal pterygium: wing like extension of proximal nail Seen in lichen planus
6. Civatte bodies are seen in-Lichen planus
7. Collarette scales are seen in – Pityriasisrosea
8. Von Zumbusch –lakes of pus - acute generalised pustular psoriasis
9. TOC of erythrodermic psoriasis - Methotrexate
VESICULO-BULLOUS DISEASE
1. Row of tombstone appearance seen in- Pemphigus vulgaris
2. Cluster of jewels appearance or string of pearl appearance - Linear IGA disease
3. corpronds and grains in skin biopsy seen in – Darier disease
4. Dilapidated brick wall appearance in skin biopsy seen in haileyhailey disease
5. Skin condition associated with gluten sensitive enteropathy-Dermatitis herpetiformis
6. Chronic familial benign pemphigus is also known as-Hailey Hailey disease
MICROBIOLOGY & FORENSIC MEDICINE

 Germ theory was given Louis Pasteur, he is the father of microbiology, he laid the principles of sterilization and
disinfection
 Principles of asepsis in surgery was introduced by Joseph lister
 Robert Koch discovered the causative organism for tuberculosis and cholera
 Prokaryoties have N acetyl muramic acid and N acetyl glucosamine in their cell wall. They lack nuclear membrane and
cytoplasmic organelles.
 The cell wall of gram negative bacteria contains lipopolysaccharide, periplasmic space and outer membrane.
 Prions are least susceptible to disinfectants and antiseptics.
 Thermal death point is the lower temperature that kills all microbes in 10 min
 Isograft is best suited for renal transplantation
 In transplantation reaction, Eichwald-Silmer effect is unilateral sex linked histocompatibility
 Most common agent associated with neonatal bacterial meningitis is streptococcus agalactiae and E. coli
 Identification of possible high risk births by rectal and lower vaginal swabs at 35-37 weeks of pregnancy is most likely to
reduce the incidence of group B streptococcal disease in an infant.
 Neissria species in that the pathogenic species grow well in enriched media.
 Meningococci differ from gonococci in the presence of a polysaccharide capsule
 Pasteurella multocida is oxidase and catalase positive and does not grow on macconkey agar. It is commensal in URT of
several animals, eg. Dogs/cats. It causes wound infections of cat and dog bites
 Francisella tularensis is a gram negative bacillus which causes tularaema/rabbit fever, voles, rabbits, and muskrats are
reservoir hosts. Most common type ulceroglandular (60-70%)
 About 50% of world population affect 80-85% of population is infected in some developing countries.
 H. aegyptius causes pink eye and brazilain purpuric fever
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 Mycoplasma needs cholesterol and other lipids for growth

 Rickettsia are gram negative coccobacilli, obligate intracellular form basophilic inclusion bodies that stain with
Castaneda or giemsa stain.
 The tuberculosis bacillus was discovered by Robert Koch
 National institute of tuberculosis is located at Bangalore
 Quantitative assays like plaque assay and pock assay are done for quantifying the number of infectious virus particles
 Quantal assays indicates only presence or absence of infectious viral particles
 Parvovirus B19 has single stranded DNA genome, it is the smallest pathogenic virus.
 Cytomegalovirus (CMV) remains latent in salivary glands and kidneys
 Hepatitis A virus belongs to genus enterovirus of family picornavirus. Nonenveloped ss RNA virus. Feco oral
transmission. No chronic complications.
 Myxovirusese like influenza virus are cultured on aminotic cavity and allantoic cavity of chick embyo
 Orthomyxoviruses(influenza virus) has a segmented genome. Genetic recombinant strains due to this kind of genome.
 In case id death custody the inquest must be conducted must be conducted by judicial magistrate
st
 Juvenile court is usually presided by 1 class woman magistrate
 Non-compliance of court summon from a criminal court may be punished under section 174 IPC
 If a person survives after giving dying declaration is not admitted but has corroborative value.
 The most important type of evidence in a court of law is oral
 Punishment of perjury is given in section 193IPC
 Warning notice is issue for violation of medical ethics.
 Disciplinary control over a registered medical practitioner in under state medical council.
 During registration in a state medical each applicant is given a copy of the following declaration to read and agree to
abide the same declaration of geneva.
 Red cross emblem can be used by only membersof medical services of armed forces.
 Appeal against the professional death sentence after exhausting all the remedies in state medical council is made to
central health ministry.
 Infamous conduct is serious professional misconduct.
 Receiving commission for referring case is known as Dichotomy.
 Privileged communications means exception to the general rule of professional secrecy.
 A medical practitioner can be charged of criminal negligence if he exhibits gross lack of competency.
 Section of IPC in which a doctor is punishable if convicted of criminal negligence is 304 A
 For age estimation from skull sutures the most reliable is sagittal.
 For estimation of age 16 years x-raysis best advised is elbow
 At the end of 1 year ,the number of carpal bones seen in x-ray of hand is 2
 The best single criterion for determining age from 3rd to 5th decades of life symphysis pubis.
 Cortex thickness of human hair in comparison with medullary thickness is five times (4to 10times)
 Human hairs have scales.
 Human hair differs from animal hair by medulla is thin.
 Hasse rule is used for age estimation (foetus)
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 Karl pearson ‘s formula is used for determination of stature.

 The least common pattern of fingerprint is composite.
 In dactylography points of similarity should be matching for establishing identity is16.
 Fingerprinting as a method of identification is also known as galton system.
 Post –mortem staining is not seen in pressure points.
 Post –mortem staining is seen in both in internal organs and skin of dependent parts.
 Nysten’s rule is related to rigor mortis.
 Rigor mortis is simulated by cadaveric spasm.
 When group of muscles of a dead body were in state of strong contraction immediately prior to death and remain so
even after death ,the condition is termed as cadaveric spasm.
 If a woman died due to some unnatural cause within 7 years of her marriage-inquest is done under 176 crPC
punishment in 304B IPC
 In an unconscious patient with head injury requiring emergency surgery, if there are no relatives to give consent the
doctor should operate without consent (sec 92IPC)
 An accused person can be forcefully examined if requested by an investigating officer not below the rank of sub
inspector under section 53 CPC
 Grievous injury is defined under section 320IPC
 The 6th cause of section 320 IPC (grievous hurt)permanent weapon or means is punished under section 326 IPC
 Section 304-B of Indian pancel code is related to dowry deaths
 Section 302 of Indian penal code is related punishment of murder
 Adultery is punishment under section 497 IPC
 Outrage of modesty of a woman is punishable under section 354 IPC
 Sexual harassment is punishable under section 354 A IPC
 Stalking is punishable under section 354 D IPC
 Under section 376 IPC minimum punishments for committing rape is 7 year of rigorous imprisonment
 The punishment of a repeat offender of rape is given under section 376 E IPC (
 Disclosure of name of rape victim is punishable under section 228A IPC
 Section 377 IPC deals with sodomy (unnatural sexual offence)
 Unnatural sexual acts are punishable under section 377 IPC
 Causing voluntary miscarriage is punishable under section 312 IPC
 McNaughton’s rule is accepted in india and included in section 84 IPC
 Vitriolage is punishable under section 326-A IPC
Diatoms in bone marrow of long bones are suggestive of death due to –drowing Burking is – homicidal
Crocodile skin is seen in – electrical burn
Lichtenburg/filigree figure are due to – superficial burn of skin resembling branches of tree like pattern due to ELECTRICAL
DISCHARGE from cloud
CEPHELIC INDEX
1 D DOLICO CEPHALIC (long head ) – 70-75 eg. Africans,aaryon, nigro
2 M MESTI CEPHALIC (medium head ) – 75-80 eg. Europian (indian , chinese)
3 B BRACHY CEPHALIC (round head) – 80-85 eg . mangolian ( max c.index but short head )
SMELL OF DIFFERENT POISONS
1.Garlic like – phosphorus and arsenic
2. burn rope – cannabis poisoning
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3. bitter almond – cyanide

- chalky white teeth – sulfuric acid(H2so4)
- BLACK TONGUE AND TEETH - COCAINE
ARSENIC POISON:-
A-Alderich mess line ON NAIL
R-4R- Rain drop pigmentation, red velvety mucosa of stomac , rash , rice waterly diarrhea
S- Subendocardial hemorrhage , sentation (tingling) , skin>hair>nail>bone
E-excessive pigmentation of palm and soles
N- Neuritis
I-iron oxide + BAL ( TREATMENT)
C- mimics CHOLERA , some time use for CRIMINAL ABORTION
m- marsh test done for detection
LEAD POISONING:-
A-Anemia (MCHC)
B-BURTONION LINE(on gum), BASOPHILIC stippling
C-CONSTIPATION, colic
D-drop :- 1. Foot drop , 2. Wrist drop
E-Encephlopathy
F-FACIAL PALLOR ( earliest sign)
G –GUM LINE ( burtonian)
H- hormonal problems
MERCURY POISON:-
HATTER SHAKING / GLASS BLOWER’S/SHAKER’S PALSY
DANBURY TREMORS
Salivation
Membraneous colitis, MGN, minimatas disease
Lens deposition( mercuria lentis)
Mercurial erethism
Acrodynia
THE VACCINATION SCHEDULE UNDER THE UIP
National Immunization Schedule
Vaccine When to give Dose Route Site
For Infants
0.1ml (0.05ml
At birth or as early as possible till one
BCG until 1 month of Intra -dermal Left Upper Arm
year of age
age)
Hepatitis B Birth At birth or as early as possible within 24 Anterolateral side of

0.5 ml Intramuscular
dose hours mid thigh-LEFT
At birth or as early as possible within the

OPV Birth dose 2 drops Oral -
first 15 days
OPV 1,2 & 3 At 6 weeks, 10 weeks & 14 weeks 2 drops Oral -
IPV (inactivated Anterolateral side of

14 weeks 0.5 ml Intramuscular
Polio Vaccine) mid thigh-RIGHT
Pentavelant 1,2 & Anterolateral side of

At 6 weeks, 10 weeks & 14 weeks 0.5 ml Intramuscular
3 mid thigh-LEFT
52
Rota Virus Vaccine At 6 weeks, 10 weeks & 14 weeks 5 drops Oral -
9 completed months-12 months. (give up

st
Measles 1 Dose to 5 years if not received at 9-12 months 0.5 ml Subcutaneous Right Upper Arm
age)
Vitamin A,
st At 9 months with measles 1 ml (1 lakh IU) Oral -
1 Dose
For children
st Anterolateral side of
DPT 1 booster 16-24 months 0.5 ml Intramuscular
mid thigh-LEFT
OPV Booster 16-24 months 2 drops Oral
nd
Measles 2 dose 16-24 Months 0.5 ml Subcutaneous Right Upper Arm
nd 16 months with DPT/OPV booster, then,

Vitamin A (2 to
th one dose every 6 month up to the age of 2 ml (2 lakh IU) Oral -
9 dose)
5 years)
nd
DPT 2 Booster 5-6 years 0.5 ml. Intramuscular Left Upper Arm
TT 10 years & 16 years 0.5 ml Intramuscular Upper Arm
For Pregnant Women
TT – 1 Early in pregnancy 0.5 ml Intramuscular Upper Arm
TT – 2 4 weeks after TT – 1 0.5 ml Intramuscular Upper Arm
If received 2 TT doses during pregnancy

TT - Booster 0.5 ml Intramuscular Upper Arm
within last 3 years
Minimum time gap between two doses of any vaccine must be 4 weeks; two live vaccines can be given at the same time but at
different sites.
14.7.2 Introduction of Inactivated Polio Vaccine (IPV)
The planned introduction of IPV for polio eradication will represent the fastest global introduction of any routine vaccine in
recent history by a factor of 4—5X. From January 2013 to May 2015, the number of countries making a commitment to
introduce IPV has increased by 126.
In January 2013, as we have already read above, the Global Polio Eradication Initiative (GPEI) launched the Polio Eradication &
Endgame Strategic Plan 2013-2018 which was developed with an approach to tackle both wild and vaccine virus eradication in
parallel rather than sequential manner. A coordinated withdrawal of the type 2 component of trivalent oral polio vaccine (tOPV)
from immunization programmes by April 2016 was recommended. For countries which use only tOPV in their routine infant
immunization programmes, this will require switching from tOPV to bOPV (containing only types 1 and 3) for that purpose. Prior
to this switch, it is recommended that all countries introduce at least one dose of inactivated poliovirus vaccine (IPV) into their
53
infant immunization schedules as a risk mitigation measure by providing immunity in case a type 2 poliovirus re-emerges or is
reintroduced.
Initially, introduce IPV at least 6 months in advance to the proposed switch date in order to provide adequate time to
enhance population immunity against type 2. It is recommended that one dose of IPV should be administered at or after 14
weeks of age through routine immunization (RI), in addition to the 3-4 doses of OPV.
Three main risks are identified following type 2 poliovirus removal. These include immediate time-limited risk of circulating
vaccine-derived poliovirus type 2 (cVDPV2) emergence; medium- and long-term risks of type 2 poliovirus re-introduction from a
vaccine manufacturing site, research facility, diagnostic laboratory or a bioterrorism event; and spread of virus from rare
immune-deficient individuals who are chronically infected with OPV2. All these risks have the potential to cause substantial polio
outbreaks or even re-establishment of polio virus transmission in polio-free regions.
GOVERNMENT OF INDIA INITIATIVES: Government of India (GoI) has taken following decisions regarding polio immunization
during implementation of endgame strategies in India:
• Introduction of at least single dose (0.5 ml) of intramuscular IPV (IM-IPV) administration on antero-lateral aspect of
right thigh at 14 weeks or first contact afterwards in the Routine Immunization along with 3rd dose of DTP and OPV in 6
states viz Bihar, Uttar Pradesh, Madhya Pradesh, Gujarat, Punjab and Assam;
• Nationally coordinated switch from tOPV to bOPV all over the country on 25th April 2016 associated with cessation of
use, withdrawal, destruction and validation of all available tOPV stocks from all over the country.
• Introduction of fractional dose (0.1 mL) intradermal IPV (ID-fIPV) at 6 and 14 weeks in Orissa, Andhra Pradesh,
Telangana, Tamil Nadu, Kerala, Karnataka, Maharashtra and Puducherry from April, 2016. This change in approach from
single-dose intramuscular IPV to fractional-dose intradermal IPV is mainly due to scarcity of IPV.
Inactivated Polio Vaccine (IPV) is an injectable form of polio vaccine which can be administered alone or in combination with
other vaccines like OPV (oral polio vaccine), diphtheria, tetanus, pertussis, hepatitis B, and haemophilus influenza.
Contraindications for IPV:
There are two contraindications for IPV:
- If anyone has a history of an allergic reaction
- If any infant has known allergy to streptomycin, neomycin, or polymyxin B as these are inactive components for IPV
Safety of IPV: IPV is safe for premature infants. IPV can be safely administered to children with immune deficiencies (e.g., HIV,
congenital or acquired immunodeficiency, sickle cell disease). In fact, because of the elevated risk of vaccine-associated paralytic
polio after the use of OPV in patients with immune deficiencies, IPV is universally recommended in these children.
RECENT UPDATES IN PUBLIC HEALTH : IMPORTANT FOR EXAMINATION

• SUSTAINABLE DEVELOPMENT GOALS:
The principle theme on which SDGs are aimed revolves around: People, Planet, Prosperity, Peace and Partnership (5 –
P)….. There are 17 Goals and 169 Targets in SDG.
Health related goal is Goal No. 3 with Nine targets and four sub targets. Reducing Maternal, Neonatal and Child Mortality is
still target number 1 & 2.
New focus areas for SDG in contrast to MDG are: Non-communicable disease, Road traffic accidents, Substance abuse, Universal
health coverage, Hazardous chemicals & Indoor air pollution.
SDG : Goal 3. Ensure healthy lives and promote well-being for all at all ages
3.1 by 2030 reduce the global maternal mortality ratio to less than 70 per 100,000 live births
3.2 by 2030 end preventable deaths of newborns and under-five children
3.3 by 2030 end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne
diseases, and other communicable diseases
3.4 by 2030 reduce by one-third pre-mature mortality from non-communicable diseases (NCDs) through prevention and
treatment, and promote mental health and wellbeing
3.5 strengthen prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
3.6 by 2020 halve global deaths and injuries from road traffic accidents
3.7 by 2030 ensure universal access to sexual and reproductive health care services, including for family planning, information
and education, and the integration of reproductive health into national strategies and programmes
3.8 achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services,
and access to safe, effective, quality, and affordable essential medicines and vaccines for all
3.9 by 2030 substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution
and contamination
3.a strengthen implementation of the Framework Convention on Tobacco Control in all countries as appropriate
3.b support research and development of vaccines and medicines for the communicable and non-communicable diseases that
primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the
Doha Declaration which affirms the right of developing countries to use to the full the provisions in the TRIPS agreement
regarding flexibilities to protect public health and, in particular, provide access to medicines for all
54
3.c increase substantially health financing and the recruitment, development and training and retention of the health workforce
in developing countries,
3.d strengthen the capacity of all countries, particularly developing countries, for early warning, risk reduction, and management
of national and global health risks
1) The Swachh Bharat Abhiyan, which is already in place, would be supported, and whose success would be measured by the
reduction of water and vector borne diseases and declines in improperly managed solid waste.
2) Balanced and Healthy Diets: This would be promoted through action in Anganwadi centers and schools and would be
measured by the reduction of malnutrition, and improved food safety.
3) Addressing Tobacco, Alcohol and Substance Abuse: (Nasha Mukti Abhiyan) Success would be judged in terms of measurable
decreases in use of tobacco, alcohol and substance abuse.
4) Yatri Suraksha: Deaths due to rail and road traffic accidents should decline through a combination of response and
prevention measures that ensure road and rail safety-. This concept could be expanded to include injuries on account of other
causes.
5) Nirbhaya Nari- Action against gender violence ranging from sex determination, to sexual violence would be addressed
through a combination of legal measures, implementation and enforcement of such laws, timely and sensitive health sector
responses, and working with young men.
6) Reduced stress and improved safety in the work place would include action on issues of employment security, preventive
measures at the work place including adequate exercise and movement, and occupational health- strengthening understanding
of occupational disease epidemiology and demonstrate measurable decreases.
7) Promotion of Yoga at the work-place, in the schools and in the community would also be an important form of health
promotion, that has a special appeal and acceptability in the Indian context.
• NATIONAL HEALTH ASSURANCE MISSION
List of diseases and conditions drawn up for the preventive campaign are: measles - rubella, malaria, cancer, diabetes,
hypertension, TB and chronic pulmonary diseases, leprosy, obesity, cataract, deafness, geriatric and AIDS.
Lifestyles are also a focus. In this area, tobacco and alcohol consumption are named others include the merits of
sanitation, public and personal hygiene, the importance of organ donation, the promotion of blood donation and
awareness of health care of the elderly
• NPCB : Goal To reduce preventable blindness to 0.3 % by 2020 , presently it is 1%.
Types of Blindness:
Economic blindness: Inability of a person to count fingers from a distance of 6 meters or 20 feet technical Definition
Social blindness: Vision 3/60 or diminution of field of vision to 10°
Manifest blindness: Vision 1/60 to just perception of light
Absolute blindness: No perception of light
Curable blindness: That stage of blindness where the damage is reversible by prompt management e.g. cataract
Preventable blindness: The loss of blindness that could have been completely prevented by institution of effective preventive or
prophylactic measures e.g. xerophthalmia, trachoma and glaucoma
Avoidable blindness: The sum total of preventable or curable blindness is often referred to as avoidable blindness.
• “MISSION--INDRADHANUSH” : “To achieve full immunization coverage for all children by 2020 through a Catch-Up
campaign” depicting seven colours of the rainbow, aims to cover all those children by 2020 who are either
unvaccinated, or are partially vaccinated against seven vaccine preventable diseases which include diphtheria,
whooping cough, tetanus, polio, tuberculosis, measles and hepatitis B.
• 2015 onwards three new vaccines to be included are rotavirus, rubella and inactivated poliovirus vaccine (IPV) will be
made available to all children through India’s Universal Immunization Programme (UIP), while Japanese encephalitis
vaccines will be introduced in 179 endemic districts across nine states.
• IMPORTANT DATA
1. HDI, : 0. 640
2) GFR: 2.3
3) SR in India= 940/1000 / 4) 0-6 Sex ratio= 914/100
5) Lowest Sex Ratio overall= Delhi
6) Highest Sex Ratio overall= Kerala
7) Highest Sex Ratio 0-6 = Mizoram
8) Birth Rate= 20.4 9) Death Reate = 6.4
10) Growth Rate= 1.4 %
11) IMR=34/1000 LB
12) MMR=134 /Lac LB
13) < 5 Mortality = 52/1000 LB
14) % Expenditure of GDP on Health = 4.05
16) The prevalence of HIV among Pregnant women aged 15-24 years 0.39% in 2010-11.
17) The annual incidence rate (cases of malaria/1000 population) of Malaria 0.88 cases per 1000 population in 2012.
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18 ) The malaria death rate in the country was 0.04 deaths per lakh population in 2012.
19) Prevalence rate of TB 249 in 2011 per 100, 000 population.
20) Mortality due to TB has reduced from 24 per lakh population in 2011.
21) During 2012, in rural India, 88.5% households had improved source of drinking water while in urban India 95.3%
households had improved source of drinking water.
22) HIV prevalence :0.27 % (2013)
23) Prevalence of Blindness = 1.1% (2012) TARGET is to be 0.3% by 2020
24) RSBY : Funded by Ministry of Health and F Welfare
25 ) SC = 148366 , PHC = 24049 , CHC = 4833 , Medical College= 356
• ICDS Recent update

No. Category [Revised] (per beneficiary per day)
Cal(K Cal) Protein (g)
1. Children (6-72 Months) 500 12-15
2. Severely malnourished children (6-72 months) 800 20-25
3. Pregnant & Nursing Female 600 18-20
• NATIONAL URBAN HEALTH MISSION (NUHM)

 Covers all cities and towns with more than 50,000 population as well as District headquarters and State
headquarters.
 Urban Primary Health Centres (U- PHCs) and Urban Community Health Centres (U-CHCs). U-PHCs for app. 50,000
population, preferably located near slums
• U-CHCs for providing in-patient care in cities having population above five lakhs have been envisaged.
• NUHM also provides for engagement of ANMs for conducting outreach services to target groups particularly slum
and the vulnerable population through ASHA and Mahila Arogya Samiti (MAS).
• MAS for every 50-100 households having 250-500 population .
• One ASHA per 1000-2500 population covering approximately 200-500 households would serve as an effective,
demand-generating link between the health facility and the urban slum population.
GOALS OF NATIONAL HEALTH MISSION
1. Reduce MMR to 1/1000 live births
2. Reduce IMR to 25/1000 live births
3. Reduce TFR to 2.1
4. Prevention and reduction of anaemia in women aged 15–49 years
5. Prevent and reduce mortality & morbidity from communicable, non- communicable; injuries and emerging diseases
6. Reduce household out-of-pocket expenditure on total health care expenditure
7. Reduce annual incidence and mortality from Tuberculosis by half
8. Reduce prevalence of Leprosy to <1/10000 population and incidence to zero in all districts
9. Annual Malaria Incidence to be <1/1000
10. Less than 1 per cent microfilaria prevalence in all districts
11. Kala-azar Elimination by 2015, <1 case per 10000 population in all blocks
The Nobel Prize in Physiology or Medicine 2015 was divided, one half jointly to William C. Campbell and Satoshi Ōmura "for their
discoveries concerning a novel therapy against infections caused by roundworm parasites" and the other half to Youyou Tu "for
her discoveries concerning a novel therapy against Malaria". William C. Campbell and Satoshi Ōmura discovered a new drug,
Avermectin, the derivatives of which have radically lowered the incidence of River Blindness and Lymphatic Filariasis, as well as
showing efficacy against an expanding number of other parasitic diseases. Youyou Tu discovered Artemisinin, a drug that has
significantly reduced the mortality rates for patients suffering from Malaria.
School health Service
1. No class room should accommodate more than 40 students
2. Per capita space for students in a classroom should not be less than 10 sq ft
3. Desks should be minus type
4. Window area should be at least 25 percent of the floor space; windows should be placed on different walls for cross
ventilation
5. Ventilators should not be less than 2 % of floor area
6. One urinal for 60 students and one latrine for 100 students
7. School Health Committee – 1961
8. Child labor (prohibition and regulation) act 1986- below 15 children
9. Child Marriage restraint act, 1978
10. Child guidance clinic- deal with all children or adolescents who for one reason or other, are no fully adjusted to their
environment (juvenile delinquency)
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11. Orphanages- children who have no home or who for some reason could not be cared for by their parents are placed in
orphanages
12. Foster homes- several type of facilities for rearing children other than in natural families. Child is provided with love,
security, affection.
13. Borstal homes- boys over 16 yrs who are too difficult to handle in a certified school or have misbehaved there- are sent to
borstal home, sentence for 3 yrs, 6 homes in India, governed by State Inspector General of India
14. Remand Homes- child is placed under the care of doctors, psychiatrist and other trained personnel- to improve the mental
and physical well being of the child.
D. Baby friendly hospital Initiative WHOI UNICEF- 10 steps

1. Helping the mother initiate breast feeding within the first hour of birth in a normal delivery and 4 hours following caesarean
section
2. Encourage breast feeding on demand
3. Allow mothers and infants to remain together for 24 hours a day except for medical reasons
4. Give newborn infants no food or drink other than breast milk, unless medically indicated
5. EBF to be promoted til14-6 months
6. No advertisement, promotional material or free products for infant feeding should be allowed in the facility.
Some important definitions to be mugged up:

1. An objective is a planned end point of all activities; it may or may not be achieved.(AI;18)
2. Target often refers to discrete activity that has to be achieved within a given time frame. These are small measurable
component of the entire goal. They permit the concept of degree of achievement.
3. Goal is define as the ultimate desired state towards which objectives and resources are directed. Goals are not constrained by
time or the existing resources nor are they necessarily attainable.
4. Mission in turn refers to attainment of a certain goal within a stipulated time period with added impetus to the program
wherein all resources and activities are to be utilized to its fullest extent to achieve the desired result. Lot of attention is also
given to the supervisory and evaluation aspect; in a nutshell it is the mode in which we function to attain the target.
Attitudes are acquired characteristics of an individual. They are more or less permanent ways of behaving. Attitudes are not
learnt from books, they are acquired by social interaction, e.g., attitude towards persons, things, situations and issues. Once
formed attitudes are difficult to change. (AIIMS May 2018)
6. Belief is the psychological state in which an individual holds a proposition Values are considered subjective, vary across
people and cultures and are in many ways aligned with belief and belief systems. Types of values include ethical/moral values,
doctrinal/ideological (religious, political) values, social values, and aesthetic values. It is debated whether some values are
intrinsic.
 "Values are beliefs and attitudes about the way things should be. They involve what is important to us. Values are applied
appropriately when they are applied in the right area. For example, it would be appropriate to apply religious values in times of
happiness as well as in times of despair. "A way of measuring what people value is to ask them what their goals are.
I. Health committees and their recommendations:

1. Bhore committee, 1946 q
a. Setting up of national programs for health system development in the country.
b. Integration of preventive and curative services.
c. Setting up of primary health centres (PHCs).
2. Mudaliar committee, 1962

a. Looked into progress made since the Bhore committee report.
b. Strengthening of district hospitals and regional health services.
3. Chadah committee, 1963

a. Looked into the activities of the National Malaria Eradication Programme.
b. Introduced the concept of a basic health worker per 10,000 population.
Mukerji committee, 1965
a. Recommended separate staff for family welfare programme.
b. Recommended de linking of malaria activities from family planning activities.
5. Jungalwalla committee, 1967
a. Recommended integration of health services at all levels.
6. Kartar singh committee, 1973
a. Recommended that auxiliary nurse midwifes (ANMs) be replaced by ‘Female Health Workers’.
57
b. Introduced the concept of ‘Multipurpose Workers’.

c. One primary health center per 50,000 population, each divided into 16 sub centers of 3000 population each.
7. Shrivastav committee, 1975

a. Creation of bands of paraprofessional and semiprofessional workers from the community itself.
b. Reforms in health and medical education.
II. Health system setup

1. At central level
a. Union ministry of health and family welfare.
b. Directorate General of Health Services (DGHS).
c. Central Council of Health.
2. At state level
a. State ministry of health
b. State Health Directorate
3. At district level
It is the principal unit of administration in India. Within district there are 6 types of administrative areas –
a. Sub-divisions
b. Tehsils
c. Community Development Blocks in rural areas (100,000 population)
d. Municipalities and Corporations in urban areas
e. Villages
f. Panchayats
4. Health Statistics of India

a. Districts: 642
e. Allopathic doctors: 767,500
f. Doctors: population – 0.5 / 1000
g. Bed: population: 0.9 / 1000
h. WHO Recommended doctor population ratio: 1:300
National Health Policy - 2017

Health Status and Programme Impact
2.4.1.1 Life Expectancy and healthy life
a. Increase Life Expectancy at birth from 67.5 to 70 by 2025.
b. Establish regular tracking of Disability Adjusted Life Years (DALY) Index as a measure of burden of disease and its trends by
major categories by 2022.
c. Reduction of TFR to 2.1 at national and sub-national level by 2025.
2.4.1.2 Mortality by Age and/ or cause
a. Reduce Under Five Mortality to 23 by 2025 and MMR from current levels to 100 by 2020.
b. Reduce infant mortality rate to 28 by 2019.
c. Reduce neo-natal mortality to 16 and still birth rate to “single digit” by 2025.
2.4.1.3 Reduction of disease prevalence/ incidence
a. Achieve global target of 2020 which is also termed as target of 90:90:90, for HIV/AIDS i. e,- 90% of all people living with HIV
know their HIV status, - 90% of all people diagnosed with HIV infection receive sustained antiretroviral therapy and 90% of all
people receiving antiretroviral therapy will have viral suppression.
b. Achieve and maintain elimination status of Leprosy by 2018, Kala-Azar by 2017 and Lymphatic Filariasis in endemic pockets by
2017.
c. To achieve and maintain a cure rate of >85% in new sputum positive patients for TB and reduce incidence of new cases, to
reach elimination status by 2025.
d. To reduce the prevalence of blindness to 0.25/ 1000 by 2025 and disease burden by one third from current levels.
e. To reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.
2.4.2 Health Systems Performance

2.4.2.1 Coverage of Health Services
a. Increase utilization of public health facilities by 50% from current levels by 2025.
b. Antenatal care coverage to be sustained above 90% and skilled attendance at birth above 90% by 2025.
58
c. More than 90% of the newborn are fully immunized by one year of age by 2025.
d. Meet need of family planning above 90% at national and sub national level by 2025.
e. 80% of known hypertensive and diabetic individuals at household level maintain „controlled disease status‟ by 2025.
2.4.2.2 Cross Sectoral goals related to health

a. Relative reduction in prevalence of current tobacco use by 15% by 2020 and 30% by 2025.
b. Reduction of 40% in prevalence of stunting of under-five children by 2025.
c. Access to safe water and sanitation to all by 2020 (Swachh Bharat Mission).
d. Reduction of occupational injury by half from current levels of 334 per lakh agricultural workers by 2020.
e. National/ State level tracking of selected health behaviour.
2.4.3 Health Systems strengthening

2.4.3.1 Health finance
a. Increase health expenditure by Government as a percentage of GDP from the existing 1.15% to 2.5 % by 2025.
b. Increase State sector health spending to > 8% of their budget by 2020.
c. Decrease in proportion of households facing catastrophic health expenditure from the current levels by 25%, by 2025.
2.4.3.2 Health Infrastructure and Human Resource

a. Ensure availability of paramedics and doctors as per Indian Public Health Standard (IPHS) norm in high priority districts by
2020.
b. Increase community health volunteers to population ratio as per IPHS norm, in high priority districts by 2025.
c. Establish primary and secondary care facility as per norms in high priority districts (population as well as time to reach norms)
by 2025.
2.4.3.3 Health Management Information

a. Ensure district-level electronic database of information on health system components by 2020.
b. Strengthen the health surveillance system and establish registries for diseases of public health importance by 2020.
c. Establish federated integrated health information architecture, Health Information Exchanges and National Health
Information Network by 2025.
3. Policy Thrust
3.1 Ensuring Adequate Investment The policy proposes a potentially achievable target of raising public health expenditure to
2.5% of the GDP in a time bound manner. It envisages that the resource allocation to States will be linked with State
development indicators, absorptive capacity and financial indicators. The States would be incentivised for incremental State
resources for public health expenditure. General taxation will remain the predominant means for financing care. The
Government could consider imposing taxes on specific commodities- such as the taxes on tobacco, alcohol and foods having
negative impact on health, taxes on extractive industries and pollution cess. Funds available under Corporate Social
Responsibility would also be leveraged for well-focused programmes aiming to address health goals.
3.2 Preventive and Promotive Health The policy articulates to institutionalize inter-sectoral coordination at national and sub-
national levels to optimize health outcomes, through constitution of bodies that have representation from relevant non-health
ministries. This is in line with the emergent international “Health in All” approach as complement to Health for All. The policy
prerequisite is for an empowered public health cadre to address social determinants of health effectively, by enforcing
regulatory provisions.
The policy identifies coordinated action on seven priority areas for improving the environment for health:
o The Swachh Bharat Abhiyan
o Balanced, healthy diets and regular exercises.
o Addressing tobacco, alcohol and substance abuse
o Yatri Suraksha – preventing deaths due to rail and road traffic accidents
o Nirbhaya Nari –action against gender violence
o Reduced stress and improved safety in the work place
o Reducing indoor and outdoor air pollution
NEW DRUGS IN SURGERY

NEW DRUGS IN CA BREAST
Ixabepilone - Used for anthracycline and taxane resistant breast
cancer
Lapatinbi - - Inhibitor of Her 2 neu and EGFRP tyrosine kinase
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- Second line Her-2-neu therapy

Sunitinib - Approved for advanced renal cancer and refractory
metastatic breast cancer
Drug Indication
Imatibi mesylate - GIST * CML
st
- 1 line treatment for advance & unresectable DFSP
(dermatofibrosarcoma protuberans
Sunitinib - - Imatinib resistant GIST, Advanced renal cancer,
Refractory metastatic breast cancer
Sorafenib - Unresectable HCC
Lapatinib - - Inhibitor of Her-2neu and EGFR tyrosine kinase *
second line Her-2-neu therapy
Vandetanib 9EGFR inhibitor) - - Only drug approved by US FDA for treatment of
advanced & progressive MTC
IMPORTANT DRUG SCHEDULES IN INDIA.

Schedule G – List of drugs that don’t need preescription but requires a mandatory text on label. “ Caution: It is dangerous to
take this preparation, except under medical supervision”. E.g. Antihistaminics.
 Schedule H – List of drugs that can be sold only when a prescription is produced.Most drugs belong to this category.
 Schedule P – It’s about drug expiry period i.e.maximum period till which drug can be used with intact potency.
 Schedule W – List of drugs marketed under generic names only.
 Schedule X – List of psychotropic drugs which need special license for manufacture and sale.
 Schedule Y - Guidelines on clinical trials, import and manufacture of new drugs.
Sleep stages and EEG changes

Sleep spindles Stage II NREM
PGO spikes REM
K complexes Stage II NREM
Active dreams REM
Nightmares REM
Deep sleep Stage IV NREM
Alpha waves Parieto occipital lobe
Beta waves Frontal lobe, highest frequency
Theta waves Hippocampus, more in children

Delta waves Deep sleep, least frequency (BAT DANCE)
OPOIDS
 Prime –physical dependence
 Minister-miosis
 Caring -constipation
 Adorable-analgesic
 Ruthless –resp.suppression
 Energetic-euphoria
 Shri narendra modi-sedation
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CLEFT LIP AND PALATE SURGERY
DEFECT TIMING OF SURGERY

Unilateral cleft lip 3-6 months
Bilateral cleft lip 4-5 months
Cleft lip + palate 5-6 months
Cleft lip + Palate 12-18 months
Soft plate 6 months
Cleft palate Hard Palate 12-18 months
Mycology
Only pathogenic yeast Cryptococcus neoformans
Pseudomycelium Candida
Tinea pedis Epidermophyton Floccosum and Trichophyton rubrum
Tinea cruris Trichophyton Rubrum and Epidermophyton Floccosum
Commonest predisposing factor for candida Diabetes
Chlamydospores on corn meal agar Candida
Germ tube test ( Reynolds Braude phenomenon) Candida albicans
Botryomycosis Staphylococcus aureus
Sclerotic bodies Chromoblastomycosis
Asteroid bodies Sporotrichosis
Only deep mycosis common in India Cryptococcosis
MEDICINE IMPORTANT POINTS TO REVISE

• Propranolol is DOC in patient who present with HTN and essential tremor.
• Patient with severe aortic stenosis have chest pain due to increased myocardial oxygen demand.
• Hypertrophic cardiomyopathy is AD disease affecting beta myosin heavy chain gene. Patient present with syncope after
heavy exercise. Can cause death at early age.
• Dressler syndrome -weeks after myocardial infarction patient present with chest pain that improved by leaning
forward.
• Amiodarone is classIII anti-arrhythmic drug ,can cause pulmonary fibrosis and also can cause hypothyroidism and
hyperthyroidism , hepatotoxicity, corneal deposit and skin discoloration.
• Bupropion is approved for smoking cessation.
• Side effect of Lithium include nephrogenic diabetes insipidus, hypothyroidism and Ebstein’s anomaly in fetus.
• SSRI are first line medicine for generalized anxiety disorder.
• Remember the common causes of priapism:Sickle cell disease

• Medications - such as trazodone and prazosin
• Cushing's syndrome is caused by corticosteroid excess. Hypokalemia and hypernatremia are the electrolyte
abnormalities most commonly observed
• High-dose intravenous acyclovir can cause crystalluria with renal tubular obstruction. Administering intravenous fluids
concurrently with the drug can help reduce the risk of acute kidney injury.
• Hydration is the cornerstone of therapy for renal stone disease. A detailed metabolic evaluation is not needed when a
patient presents with his first renal stone.
• Muddy brown granular cast -Acute tubular necrosis
• RBC casts - Glomerulonephritis
• WBC casts - Interstitial nephritis and pyelonephritis
• Fatty casts - Nephrotic syndrome
• Broad and waxy casts - Chronic renal failure
61
• Physical examination in patients with pleural effusion usually shows decreased tactile fremitus, dullness to percussion,
and decreased breath sounds over the effusion.
• Hydrocele is the accumulation of fluid around the testis and spermatic cord and between theparietal and visceral layers
of the tunica vaginalis. Communicating hydroceles usually present in infancy and are frequently reducible but may also
increase in size with the Valsalva maneuver. Noncommunicating hydroceles do not usually change in size with
positional changes.
• Rapid treatment with calcium gluconate is necessary in a patient with hyperkalemia who develops significant EKG
changes.
• Acyclovir can cause crystalline nephropathy if adequate hydration is not also provided.
• Glomerular hyperfihrationis the earliest renal abnormality seen in diabetic nephropathy. It is also the major
pathophysiologic mechanism of glomerular injury in these patients. Thickening of the glomerular basement membrane
is the first change that can be quantitated.
• Nephrotic syndrome is a hypercoagulable condition which manifests as venous or arterial thrombosis, and even
pulmonary embolism. Renal vein thrombosis is the most frequent manifestation. Complications of nephrotic syndrome
include: protein malnutrition, iron-resistant microcy1ic hypochromic anemia, increased susceptibility to infection, and
vitamin D deficiency.
• Obstructive uropathy causes flank pain, low volume voids with or without occasional high volumevoids, and (if bilateral)
renal dysfunction
• Drugs with anticholinergic properties can cause acute urinary retention by preventing detrusor muscle contraction and
urinary sphincter relaxation. The treatment involves urinary catheterization and discontinuing the medication.
Dear students last 10 day when you are supposed to only study the important and high yield topics from all 19 subjects Team
AFMG Team AFMG have prepared list that will help you with the important topics please go through one before one week exam
HOT TOPICS
 1.HEMISECTION OF SPINAL CORD
 2.- PHARYNGEAL CLEFT, ARCH, POUCH
- BRAIN AND BONES RADIOLOGICAL PICTURES
 3. parkland formula
 4.GSD TYPES AND THERE DEFECTIVE ENZYMES
 5.HIV, D.M.,T.B.( READ FROM ALL SUBJECTS)
 6.MC TYPES OF CANCERS A/C ORGANS, GENDERS, AGE,
 7.MIDDLE EAR ANTOMAY
 8. PSM – TP, TN , FP,FN, PPV, NPV, ODD’S RATIO
 9.VACCINE
 10. TYPES OF #
 11. PATHOLOGICAL FINDING OF DIFFERENT BODIES IN DIFFERENT DIS.
 12.GENERAL PATHO
 13.GENERAL PHARMA AND GENERAL SURGERY
 15.hypersensitivity rxn
 16.genetic disoder classification
 17. Blood cells cancer classification
Believe in yourself .you can and you will
*BEST OF LUCK*
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AFMG-LAST MINUTE REVISION FACTS 2019

AFMG-LAST MINUTE REVISION FACTS 2019

MESSAGE FROM THE DIRECTOR

Dr. Vikas kumar

Any suggestions and queries are welcome @ afmgindiaglobal@gmail.com

 Theory of web of causation was given by Mc Mohan and Pugh

 Screening of the diseases is secondary prevention

 Amount of infectious waste among hospital waste is 1.5%

 Pemphigues vulgaris - Suprabasal cleft. Fish net patterns on IF.

 Zika virus transmitted by Aedes mosquitoes.

 MCC of portal hypertension –Non cirrhotic portal fibrosis

 MC type of emphysema-Irregular or Mixed

 MC manifestation of pulmonary embolism-dyspnea

 MCC of subacute bacterial endocarditis-Strep. viridians

 MC carcinoma causing superior venecava syndrome –small cell ca

 MC type of intusssusception –Iieo colic

 IOC for solid thyroid nodule-FNAC

 Karyotype of complete Mole-46XX

 Earliest sign of immune hydropson USG –Scalpedema

 Prevalence of TB infection in a community is done by-Tuberculin test

 Nalgonda techniques used in –Endemic fluorosis

 Left gastro-epiploic A. is a branch of: Splenic A.

FETAL STRUCTURES & ADULT REMNANTS

EMBRYOLOGY OF GENITOURINARY SYSTEM

PHARYNEGEAL ARCH DERIVATIVES

DERIVATIVES OF PHARYNGEAL POUCHES

 Muscles of tongue are: Both smooth & skeletal muscles

 An IQ between 50 -70 would be classified as what kind mental retardation –Mild

 BEZOLD'S SIGN: mastoiditis

Mcc of Staphyloma :- 1.anterior staphyloma- corneal ulcer

MUSCLES NERVE SUPPLY

- Attachment of vitreous is longest- around ora serrata.

 Antero posterior length of eyeball-24mm

 Mcc of pathological #- osteoporosis

 Best and most successful treatment of bronchial asthma-Avoidance of antigen

 Flat vegetations in pockets of valves are due to-libman sack’s endocarditis

 Coronary steal phenomenon is caused by-Dipyridamole

 Rate of automaticity in AV node-40-60beats/min

 Stylopharyngeus muscle is supplied by-Glussopharyngeal nerve

 Parotid gland is supplied by-Glossopharyngeal nerve

 Abductors of hip joint

 Normal breath holding time should be more than>25seconds

 Difference between auxiliary temperature and core temperature is-0.5

 Main feature of korsakoff’s psychosis-Confabulation

 IOC for renal vein thrombosis and IVC thrombosis-Doppler USG

 Chain of lake appearance is seen in carcinoma-CA colon

 Injury to lower trunk of brachial plexus is known as: Klumpke's palsy

 Apo E is rich in arginine

SKIN NEUROCUTANEOUS SYNDROMES

 Tuberous sclerosis involve chromosome – chromosome-9,16

SKIN MANIFESTATION OF INTERNAL DISEASES

7. Sister joseph nodule – gastric adenoma

• Satellite lesionsnear margins – BT Hansen

5. Swimming pool granuloma or Fish Tank Granuloma caused by- M. marinum

MICROBIOLOGY & FORENSIC MEDICINE

 Mycoplasma needs cholesterol and other lipids for growth

 Karl pearson ‘s formula is used for determination of stature.

3. bitter almond – cyanide

THE VACCINATION SCHEDULE UNDER THE UIP

National Immunization Schedule

Vaccine When to give Dose Route Site

Hepatitis B Birth At birth or as early as possible within 24 Anterolateral side of

At birth or as early as possible within the