Via twitter @kumarsujeet781 [ all high yield points tweeted upto 28 th april]

212. Meissners and pacinian corpuscle are rapidly adapting touch receptors.

211.pacinian corpuscle is also a touch receptor which primarily responds to deep pressure and vibrat

210.Merkel cells & Meissners corpuscle do most precise localisation of touch as these have smallest receptive field.

209.MERKEL CELLS respond to touch/press and MEISSNERS responds to touch as tap/ flutterof 5-40 hz and do MOST precise localisation of touch.

208.Linear acceleration/gravity is sensed by hair cells of OTOLITH ORGANS whereas angular acceleration by hair cells of semicircular canal.

207.DEMYELINATION of nerves leads to leakage of K+ ions through voltage gated channels which hyperpolarises and fail to conduct action pot.

206. Orthograde transport occurs along microtubule and along length of axon and require 2 molecular motor

205. RETROGRADE TRANSPORT that occurs from nerve ending to cell body along MICROTUBULES at 200 mm/day eg NERVE ROWTH FACTOR and VIRUSES

204. TETNUS TOXIN and BOTULINUM TOXIN B,D,F,G acts by inhibiting a component of fusion -exocytosis complex ie SYNAPTOBREVIN.

203 . BOTULINUM TOXIN C acts on SYNTAXIN.

202. Botulinum toxin A and B acts by inhibiting fusion-exocyotosis complex called as SNAP 25.

201.FICKS METHOD is used to determine cardiac output by measuring amount of O2 consumed by body divided by A-V difference of O2 across lungs

200. Thermodilution / indicator dilution method to measure cardiac output is based upon STEWART HAMILTON EQUATION [ AIIMS MAY 2012]

With vomiting both the pH and food come up. With diarrhea both the pH and food go down.

197 . Most common cause of choroidal neovascularisation in young patients is PATHOLOGICAL MYOPIA and in elderly is AGE RELATED MACULAR DEGEN

196. MODIFIED CALLENDERS HISTOPATHOLOGICAL CLASSIFICATION is used for prognostification of choroidal melanoma.

195. In cornea SARCOIDOSIS is associated with BAND KERATOPATHY [AI 2008]

194. The posterior segment findings of SARCOIDOSIS are = " snow banking of pars plana" and " candle wax drippings" [ JIPMER 93]

193. ISOPTER CONTRACTION is earliest visual field change in POAG [UP 2008]. BUT isopter contraction do not cause visually significant defect

BARING OF BLIND SPOT is 2ND earliest visual field change in POAG and it is first visual field change to cause visually significant defect

191. Range of myopia that can be corrected by LASIK is 2-12 D. Range of myopia that can be corrected by LASEK is 1-6 D.

190. KERATOMETER measures curvaure of central cornea only whereas VIDEOKERATOGRAPHY measures curvature of whole cornea.

189.KERATOMETER measures curvature of cornea whereas PACHYMETER measures thickness of cornea.

The most commonly used direct gonioscope is KOEPP`S GONIOSCOPE. The most commonly used indirect gonioscope is GOLDMANN`S GONIOSCOPE.

187. SPINCTER PUPILLAE and DIALATER PUPILLAE r only muscle in body which do not develop from mesoderm. They develop from neuroectoderm.

186. Drugs causing punctal stenosis/ punctal block are PILOCARPINE , IDOXURIDINE , 5- FU

184.In patients with UA/NSTEMI,TIMI risk score is useful for identifying patients who benefit frm an early invasive strategy

183.CHADS-2 is a risk scoring system for anticoagulant use in patients with ATRIAL FIBRILLATION. IF SCORE 3 OR MORE GIVE WARFARIN (INR=2-3)

182. MELD SCORE is used to asscess mortality after TIPS. CURRENTLY IT IS USED AS SOLE METHOD OF LIVER TRANSPLANT ALLOCATION IN US

181.CHILD-TURCOTT-PUGH SCORE is useful in predicting surgical risks of intrabodominal operations including portocaval shunts in chirrotic pt

180 . CLINICAL PULMONARY INFECTION SCORE ( CPIS) is used for diagonosis of VENTILATOR ASSOCIATED PNEUMONIA (VAP).

179. CURB-65 is a severity of illness score . With scores 3 or more patient may require admission to ICU.

178. PNEUMONIA SEVERITY INDEX(PSI) is a prognostic model used to identify patients at low risk of dying from pneumonia based on 20 variables

177. TIGER-O classification system is used to classify causes of CHRONIC PANCREATITIS.

176. KURTZE EXPANDED DISABILITY STATUS SCORE is useful measure of neurological impairment in MULTIPLE SCLEROSIS.

175. Most patient with EDSS score < 3.5 have RRMS(relapsing remitting multiple sclerosis) , walk normally and are not disabled.

174. Most patients with EDSS score > 5.5 have progressive MS , are gait impaired and occupationally disabled.

173. Progesterone having minimal(3rd gen) / anti androgenic action(4th gen).. have decreased chance of acne& hirsutism, & are lipid freindly

172. 4th gen progesterone eg DROSPIRINONE have anti androgenic and anti mineralocorticoid action .

171. 3rd gen progesterones eg desogestrel &norgestimate have minimal estrogenic/androgenic/anabolic action so they r c/a "impeded androgen".

170 . MALA -D = D levo NORGESTREL (0.15 mg) + ETHINYL ESTRADIOL ( 30 microgram).

169. MALA -N = NORGESTREL (0.30 mg) + ETHINYL ESTRADIOL ( 30 microgram). Distributed free of cost b govt of india.

168. Minimum effective dose of ethinyl estradiol in ocp = 20 microgram [ AIIMS 2004].

167. Third generation progesterons are = norgestrel , desogestrel , gestodene . Fourth generation progesterone = DROSPIRINONE

166. Most of low and very low dose ocp used currently have DESOGESTREL ( a third generation progesterone). Femilon has desogestrel.

165. LOW DOSE OCP reduces the risk of venous thromboembolism as compared to high dose ocp .

164. Very low dose OCP have estrogen less or equal to 20 microgram eg Femilon having 20 microgram of Ethinyl estradiol..

163. Low dose OCP have estrogen less than 50 microgram (usually 21 - 35 microgram) eg MALA-D & MALA-N have 30 microgram of Ethinyl Estradiol

161. HYPER IgM syndrome is due to defect in "CLASS SWITCHING" where IgG and IgA levels are typically very low with high/normal/low IgM level

160. Hyper IgE syndrome is characterised by recurrent abscesses involving skin, lungs and other organs + very high levels of IgE

159. Brutons Tyrosine Kinase(Btk) gene mutation leads to X- linked agammaglobinemia. Sinopulmonary bacterial infection occurs frequently.

158. NUDE SYNDROME = Congenital baldness + nail dystrophy + severe T- cell immunodeficiency.

157. PURINE NUCLEOSIDE PHOSPHORYLASE deficiency leads to T- CELL DEFICIENCY whereas ADA deficiency leads to severe combined immunodeficiency

156. Adnosine Deaminase converts adenosine to inosine which is converted to hypoxanthine by PURINE NUCLEOSIDE PHOSPHORYLASE.

155. On September 14,1990,the first gene therapy for ADA deficient SCID was performed by Dr. William French Anderson on a four year old girl

154. Adenosine Deaminase( ADA) is coded by gene on chromosome no 20. First gene therapy was done for SCID with ADA deficiency.

153. Adenosine Deaminase deficiency accounts for 15% of overall cases of SCID and more than 50% of autosomal recessive forms.

152. Severe Combined Immunodeficiency (SCID) is inherited as either x-linked recessive or autosomal recessive forms.

150. CLIP and OKUDA are the 2 classification systems used for staging of hepatocellular CA

149. XERODERMA PIGMENTOSUM is due to defect in NUCLEOTIDE EXCISION REPAIR whereas HNPCC is due to defective MISMATCH REPAIR GENE.

148. Highly radioresistant tumor = MELANOMA , HEPATOMA , OSTEOSARCOMA , PANCREATIC CA

147 .HCC is suspected if a patient with known liver disease presents with raised AFP and/or DCP ( des- gamma -carboxy prothrombin)

146. ALBUMIN ISH This method has high sensitivity (93%-96%) and specificity (close to 100%) FOR HEPATOCELLULAR CA.

145. Most specific and sensitive immunohistochemical method for differentiating HCC from other tumors is = Hep Par -1 Ab staining

Detection of albumin messenger RNA (mRNA) by in situ hybridization (ISH) ie ALBUMIN ISH is used to differentiate HCC from other tumors.

143.The recently commercially available Hep Par 1 antibody has been reported to be a sensitive marker for HCC in paraffin embedded sections

CLOVERLEAF SKULL is charecteristic of THANTOPHORIC DWARFISM TYPE II

ACHONDROPLASIA is due to defect in FGFR-3 GENE. other genetic disease due to defect in FGFR-3 = THANTOPHORIC DYSPLASIA/DWARFISM.

LOBSTER CLAW DEFORMITY = CLEFT FOOT /HAND . see below for details

CLEFT HAND/FOOT consists of cleft between 2nd & 4th metacarpals as the 3rd metacarpal is absent.Thumb+index and 4TH+5TH metacarpal is fused.

Most sensitive period for teratogen induced limb malformation is FOURTH AND FIFTH WEEK of development.

Limb bud outgrowth is initiated by TBX 5 gene & FGF 10 gene in forelimb and by TBX 4gene & FGF 10 gene in hindlimb.

HOX B8 decides cranial end of forelimb ie Misexpression of HOXB8 leads to altered positon of forelimb during development.(AIIMS 04)

Proper positioning of limbs along craniocaudal axis is of embryo is regulated by HOX GENE (a homeobox gene).

During 7th week of development upper limb rotated 90 degree laterally and lower limb 90 degree medialy to get normally oriented.

Cartilage and bone of limb is developed from SOMATIC LAYER OF LATERAL PLATE MESODERM whereas muscles from myotome of PARAXIAL MESODERM.

Limb buds appear at END OF FOURTH WEEK of development. Morphogenesis of lower limb is approx 1-2 days behind that of upper limb.

Anabolic steroids produce euphoria&hyperactivity which can give way to anxiety,somatization,altered mood, voilent outbursts c/a " roid rage"

VARENICLINE is partial nicotinic agonist used in nicotin dependence treatment.

NICOTINE(smoking+chewing tobbaco) is MOST PREVALENT and deadly substance use disorder.{ref:kaplan&saddock hand book of psychiatry pg140/5ed}

viral encephalitis most likely to lead to AMNESIA is Herpes simplex encephalitis as it typically involves TEMPORAL LOBE.

BINSWANGER DISEASE = SUBCORTICAL ARTERIOSCLEROTIC ENCEPHALOATHIES. It is a type of vascular dementia of subcortical type.

AIDS DEMENTIA COMPLEX is predominantly SUBCORTICAL DEMENTIA

B/L amygdala dysfunction leads to KLUVER BUCY SYNDROME= HYPERSEXUALITY +HYPERORALITY +PLACIDITY. It is more common in pick`s than alzheimers

HUNTINGTON`S disease is an example of autosomal dominant disease with " COMPLETE PENETRANCE = 100% penetrance"

Depression in elderly may present as symptoms of cognitive impairment , it is called as PSEUDODEMENTIA

After ALZHEIMER`S second most common type of dementia is ...VASCULAR DEMENTIA

Blunt force injury to heart leads to COMMOTIO CORDIS , most frequently associated arrythmia with this condition is VENTRICULAR FIBRILATION.

Multifocal atrial tacycardia(MAT) presents with variable P wave morphology ( > 3)&varying P-P interval. MAT is most commonly caused by COPD

PR -SEGMENT depression is highly SPECIFIC for ACUTE PERICARDITIS

PACEMAKER TWIDDLER SYNDROME =Rotation of pulse generator of pacemaker in its subcutaneous pocket,leading to dislodgement and failure to pace

WOLF PARKINSON WHITE SYNDROME = ECG shows triad of ( Short PR interval + wide QRS + Delta wave)

In pulsus bisferience both percussion wave and tidal wave occur during systole and such a pulse is charecteristic of AORTIC REGURGITATION

In a post-MI setting posterior mitral valve cordae rupture is more common than anterior mitral valve rupture

2nd degree TYPE II heart block usually occurs in distal or infra- His conduction system.

CANTRELL PENTALOGY = cleft sternum + ectopia cordis + omphalocele + anterior diaphragmatic hernia + congenital heart defect( vsd , tof)

The cornea and tooth pulp are unique in that they are almost exclusively innervated by nociceptive A delta & C fibres.

Mutation of NOD2 gene is associated with CHRONS DISEASE.

Among various methods of bariatric surgery BILLIOPANCREATIC DIVERSION/ DUODENAL SWITCH has highest rate of nutritional complications.

US FDA has approved PHENTERAMINE+ TOPIRAMATE combination for chronic weight management.

Drugs approved by US FDA for treatment of obesity.. SIBUTRAMINE & ORLISTAT

The most common type of hiatal hernia is type I ie SLIDING HERNIA [upward dislocation of cardia in posterior mediastinum]

TOC in a patient of scleroderma and multiple symptomatic strictures of esophagus is TOUPET FUNDOPLICATION.[Schwartz 9ed pg847]

Critical diameter at which risk of complication is significantly increased is 6cm for ascending aorta and 7cm for descending thorasic aorta

The cervical portion of esophagus receives its main blood supply from inferior thyroid artery.

VALVE LESS VEINS = INFERIOR VENA CAVA , COMMON ILLIAC VEINS, PORTAL VEINS ,CRANIAL SINUSES.

PRUNE BELLY SYNDROME = exrtremely lax lower abdominal musculature, dialated urinary tract including bladder, B/L undecendent testes

PROCEDURE OF CHOICE TO CORRECT BILIARY ATRESIA IS= HEPATOPORTOENTEROSTOMY [as described by KASAI]

The most common type of chpledochal cyst is TYPE I [fusiform dialation of bile duct] ,present in 80-90% cases.

MID GUT VOLVULUS can occur at any age , although it is seen most often in first few weeks of life [ Schwartz 9ed pg 1428]

Intestinal duplications are most commonly located in..ILEUM [usually as cystic mass]

First motion to be affected in FROZEN SHOULDER is INTERNAL ROTATION.

NEER IMPINGEMENT SIGN is +ve in case of anterosuperior impingement leading to/involving subacromial bursitis, rotator cuff tendinitis/tear

Rotator interval is triangular space between supraspinatous and subscapularis muscle.

Long head of biceps arise fron subglenoid tubercle on scapula and is supplied by musculocutaneus nerve (C5 -C6)

As lift-off test is done for isolated rupture of subscapularis, JOBE'S TEST is done for isolated rupture of supraspinatous tendon.

A reverse scapullohumeral rhythm is observed in FROZEN SHOULDER

In case of subacromial bursitis no pain by pressure over deltoid below acromian in abducted arm is called ..DRAWBARN'S SIGN

Among four rotator cuff muscle most common to have tear is ...supraspinatous tendon

HIV PREVALENCE IN INDIA A/C TO 2010 DATA IS 0.29 %

HIV EPIDEMIC IN INDIA HAS FOLLOWED TYPE 4 PATTERN [ HIGH RISK TO BRIDGE POPULATON TO GENERAL POPULATION]

AIDSVAX IS ONLY VACCINE AGAINST AIDS WHICH IS IN PHASE III TRIAL STAGE. IT IS DIRECTED AGAINST gP 120.

According to CDC recomendations , HIV screening in pregnant women is " OPT OUT " testing. IT HAS HIGHER TESTING RATE THAN OPT IN TESTING.

Highest prevalence of HIV is in age group 30-44 year group[56%]

" 3 by 5 target " approach was announced by WHO& UNAIDS ON DEC 2003 which targets providing ART to 3 million people by 2005.[AIIMS NOV 04]

Fulminant demyelinating acute MS without remissions leading to death within 1- 2 years is called as MARBURG'S VARIANT.

MOST ACCURATE METHOD OF DETERMINING PORTAL HYPERTENSION IS HEPATIC VENOGRAPHY.

MILAN CRITERIA= 1 nodule less then 5 cm/two or three nodule < 3cm ,no gross vascular invasion or any extrahepatic spread.(see earlier tweet)

IF RESECTION IS NOT POSSIBLE BCOZ OF POOR LIVER FUNCTION AND HCC MEETS MILAN CRITERIA THAN LIVER TRANSPLANT IS TOC IN SUCH CASES OF HCC

Primary myeloproliferative disorder account for 35 -50 % of cases of primary BUDD CHIARI SYNDROME.( SCHWARTZ 9ED PG 1114)

Myeloproliferative disorders ,schistosomiasis & GVHD cause presinusoidal intrahepatic portal hypertension.

Presence of hypophosphetemia may be associated with improved prognosis for a patient of acute liver failure.(schwartz 9ed pg 1108)

CHILD PUGH SCORE is used in predicting surgical risk of other intraabdominal operations on cirrhotic patients.( schwartz 9ed pg 1111).

MELD SCORE is based upon INR , BillirubiN level,Creatinine level . It is used as sole method of liver transplant allocation in US

Pseudoexfoliation glaucoma is most common identifiable cause of secondary open angle glaucoma.

Gerber lift off test is done to detect subscapularis pathology.

Histopatho of sweet syndrome shows = diffuse dense neutrophillic infiltration in reticular dermis, vasculitic changes are absent.

Normal otoacoustic emission + absent BERA + normal MRI = AUDITORY NEUROPATHY

Van Der Hoeve syndrome = osteogenesis imperfecta + otosclerosis + blue sclera

least ototoxic aminoglycoside is NETILMICIN

NO of apnea episodes in 1 hour is known as APNEA INDEX. It is used to asses OBSRTUCTIVE SLEEP APNEA. 5-20 =mild , 20-40=moderate,> 40=severe

AUDITORY MIDBRAIN IMPLANT is placed at level of INFERIOR COLLICULUS.

The main indication of auditory brainstem implant is in NEUROFIBROMATOSIS 2 after surgery for BILATERAL ACOUSTIC NEUROMA.

Transcanal approach to middle ear and cochlea used for cochlear implantation is known as VERIA TECHNIQUE.

Vibrant Sound Bridge is atype of middle ear implantable hearing device which is directly attached to INCUS .

ABBE EASTLANDER FLAP is based on LABIAL ARTERY and is used for lip reconstruction after primary surgery in case of lip carcinoma

Commonest symptom of glomus tumor is pulsatile tinnitus & cnductive deafness.

Most common benign tumor of middle ear is GLOMUS TUMOR, In middle ear most common site is hypotympanum

POSTERIOR HYPOTHALMUS CONTROLS THE RESPONSE TO COLD . SO LESION WILL CAUSE HYPOTHERMIA.

ANTERIOR HYPOTHALMUS CONTROLS THE RESPONSE TO HEAT ie COOLS DOWN THE BODY , SO LESION WILL CAUSE HYPERTHERMIA

Ventromedial area of posterior hypothalmus is satiety centre.

LATERAL AREA of posterior hypothalmus is concerned with thirst & hunger

Risk scoring for need of aticoagulant use in pt with atrial fibrillation is done by CHADS 2 scoring system.

Neutropenia and glucocorticoid use is primary risk factor for invasive aspergillosis. Hiv patient rarely develop invassive aspergillosis.

Respiratory syncytial virus immune globulin = palivizumab approved fr monthly injection in <2 yr old for RSV prevention.

Porphyria cutanea tarda is most common porphyria and usually arises from SPORADIC GENE MUTATION.

Cardiac involvement in chagas disease involves CARDIOMYOPATHY+CONDUCTION DELAYS (Most commomly Right Bundle Branch Block) and normal angiogm

Prinzmetal angina is associated with ST -SEGMENT elevation and not ST- segment depression.

Tumor metastic to heart are more common than primary cardiac tumor and occurs with highest incidence in metastatic melanoma.

HELMANS TRIAD in childhood is a good predictor of future voilent nature of child. it consists bed wetting+ fire setting +cruelty to animals.

NIGHT TERROR: sudden awakening with intense anxiety. It occurs in deep NREM sleep (stage 3&4). No recall of event in morning.

NIGHT MARE: Vivid dreams in which one awakens frightened .It almost always occurs in REM sleep .Patient has good recall of events during it.

Legionella urine antigen is detectable within 3 days of appearance of symptoms & persists for 2mnth. It is not affected by antibiotic treat.

Neutrophills do not play major role in defence against legionella so Neutropenia do not predispose to legionella infection.

Bacillary angiomatosis occurs in HIV patients with CD 4 count < 100/ micro l. It is caused by Bartonella quintana or Bartonella henslae.

In asplenic patients, dog bite can lead to overwhelming sepsis due to Capnocytophaga canimorsus bacteremia.

Among animal bites, cat bites are most likely to lead to cellulitis due to deep inoculation and frequent presence of Pasturella multicoda.

Risk of developing XANTHOMA is not increased in TYPE 4 hyperlipoproteinemia as compared to other types of hyperlipoproteinemia.

Risk of atherosclerosis is NOT increased in type 1 hyperlipoproteinemia( LPL deficiency) as compared to other types of hyperlipoproteinemia.

EPP (erytropoietic protoporphyria) is most common porphyria to cause symptoms before puberty. ( Hson 17 ed page 2436)

Complete deficiency of HGPRT enzyme causes LESCH NYHAN SYNDROME. Partial deficiency of HGPRT causes KELLY SEGMILLER SYNDROME.

Only enzyme in human which catalyses a rxn were carbon monoxide is produced...HEME OXYGENASE (it converts heme to biliverdin)

The rate limiting enzyme of heme synthesis is ALA SYNTHETASE. The second ratelimiting enzyme in heme synthesis is HMB synthetase.

X-linked sideroblastic anemia is caused by deficiency of erythroid gene ALS2 which codes for ALA synthetase.

Congenital erythropoitic porphyria can manifest even in utero as NON IMMUNE HYDROPS FETALIS.

Now enjoy a small 10 q mcq test(based on previous year mcq) on our website . PGMEE MCQ QUIZ NO 1. Instantly know ur % and correct answers.

Hamilton rating scale is used in psychiatry for Depression (HAM-D scale) and for anxiety (HAM-A scale).

Among patients of personalty disorder pt with borderline personalty disorder are at greatest risk of suicide and self mutilation.

Acoustic radiation arises from Medial geniculate body and passes through SUBLENTICULAR part of internal capsule to auditory cortex.

The buffer which is most effective at pH 4.5 is..(AIIMS 2003) ANS :acetate buffer as its pka =4.76, and buffering is max at pH= pKa

The predominant isoenzyme of LDH in cardiac muscle is...(AI 2005) ANS: LDH 1, It moves fastest among other isoenzymes of LDH.

The basal O2 consumption by myocardium is about 2ml/100gm/min. O2consumption by beating heart is 9ml/100gm/min at rest.(ganong 23rd page519)

CHARCOT BOUCHARD ANEURYSM: lipohyalinosis resulting in weakness of arterial wall (cerebral) and aneurysm formation causing hypertensive Hg.

PNH is due to defect in GPI anchor, so that GPI anchored proteins CD55 & CD59 r absent and cell become prone to complement lysis.

U have heard about trinucleotide repeat disease as huntington ds, name a pentanucleotide repeat disease... Its spinocerebeller ataxia 10

INTERNUCLEAR OPHTHALMOPLEGIA is pathognomonic for MULTIPLE SCLEROSIS

Spinocerebeller Ataxia - 6 Is a channelopathy.[AI 2005]

SGLT1 is responsible for uptake of glucose from gut to enterocytes& GLUT2 transports glucose from enterocyte to interstitium then into blood

SGLT 2 present in PCT is mainly responsible for renal glucose reabsorption.FDA has approved CANAGLIFLOZIN for type II DM. It inhibits SGLT2

MILLER FISCHER SYNDROME = OPTHALMOPARESIS + FACIAL DIPLEGIA+ ATAXIA+ AREFLEXIA + ANTI GQ 1b ANTIBODY

ANTI GQ1b antibody is found in MILLER FISCHER SYNDROME ie a varient of guillan barre syndrome.