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1 E ? (not clear which one is posterior cruciate) posterior cruciate ligament/ ? meniscus
stability is lost in posterior part of knee due to the extensive posterior movement of tibia relative to
femur
A- quardriceps tendon
B-articular cartilage
C-patellar ligament
http://healthprofessions.missouri.edu/cpd/RS/sast/images/MRKneeSag.jpg
2 A compressed # of L4
Osteoporosis-type 1
3 C- yg athelete, stress # tibia, decreased bone density,
Light reflex
irritable
manic episode
Dx -- bipolar d/o
6 b-if u have 100 kids...... n u start listing the UTI number in every kid, first u'd write "0" 25 times, then u'd
write "1" 30 times, "2" 10 times and "3" 35 times...... so in the middle of the list ie the 50th and 51st no ( cz
this is an even no of kids) u have "1" n "1" so their mean wd be 1.... so median is 1
7 A different cases can come to center and it can affect the mortality
like if the serious terminal cases , less severe cases can give different result of mortality rates
we are not controlling the same condition for the complexity of the cases
the more complex the cases are , the larger the mortality rate it would be
e) sample size --- usually affects power of the test
Tertiary hospitals usually get more complicated cases than do community hospitals.
pul arteries
bronchial arteries
9 D D is the right answer
A epidural biconvex
10 E ? posterior longi ligament protecting it medially that's why it herniates to its lateral compressing the
spinal nerve passing thru the intervertebral foramen.Now in the Qz it says
herniation into spinal canal and posterior longitu ligament is the only thing between disc and the spinal canal.
Ligamentum Flavum is on the otherside of the canal
11 c- c substantia nigra, D-red nucleu
A - Periaquiductal grey
D - Red nucleus
c - Substantia nigra
B - IIIrd nerve
E cerebral peduncle
12 C- 12) C http://www.visualdxhealth.com/infant/molluscumContagiosumPediatric.htm
13 C Spaceflight osteopenia refers to the characteristic bone loss that occurs during spaceflight.
Astronauts lose an average of more than 1% bone mass per month spent in space." "These effects can
be minimized through a regimen of exercise."
loss of gravity-metabolic acidosis-bone loss
"Female-specific side effects [of anabolic steroid abuse] include increases in body hair, deepening of
the voice, enlarged clitoris, and temporary decreases in menstrual cycles." "Weight lifting reduces the
risks of osteoporosis."
14 A
15 D [5:51:27 PM] physiology: RR99,299
http://www.cdc.gov/mmwr/preview/mmwrhtml/00049386.htm
[5:52:10 PM] physiology: Cutaneous anergy defect in cell-mediated immunity.Anergy skin testing
assesses the responses to skin-test antigens to which a cell-mediated, delayed-type hypersensitivity
(DTH) response is expected. Persons who have positive skin tests are considered to have relatively
intact cell-mediated immunity. Persons who do not mount a DTH response are considered to be anergic
and to be at elevated risk for complications of deficient cell-mediated immunity
16 A ?
17- F TIE
FA 212
: IgA 76-390
IgG 650-1500
IgM 40-345
young boy with eczema, thrombocytopenia, and recurrent infections with encapsulated
germs. Immunologic findings include low IgM, high IgA and IgE, poor antibody
3) Carbaminohemoglobin [5%
19 D
Sensory neuronal deafness-weber lat to opposite side and ac> bc both ear.
Rinne's Test
A vibrating tuning fork (512 cps) is placed on the mastoid process. When it becomes inaudible to the patient, the
vibrating end is placed near the external auditory meatus. If heard at the external auditory meatus, air conduction
is greater than bone conduction (i.e. Rinne positive). In reverse situation, if heard on mastoid process after air
conduction lost, the test is Rinne negative
Interpretation:
(+) Air conduction < bone conduction - Conductive deafness (e.g. wax, perforated tympanum, otosclerosis, glue
ear, otitis media, foreign body, dislocated ossicles, tumours, meatal stenosis, exostoses, barotrauma)
(+) Air conduction > bone conduction - Normal hearing
(+) Reduced time - Perceptive deafness (e.g. presbycousis, vascular causes, measles, mumps, influenza,
meningitis, labyrinthitis, congenital causes [maternal rubella], trauma [blast], prolonged noise exposure, drugs
(e.g. streptomycin, aspirin, quinine), Menière's disease, late otosclerosis, CNS tumours, haemorrhage, leukaemia,
multiple sclerosis, vitamin B deficit), psychogenic
Weber's Test
Vibrating tuning fork placed on midline of forehead or a central incisor, is normally heard at midline
Interpretation:
In conductive deafness sound is referred to deafer ear. In perceptive deafness sound is referred to the better ear
Pathophysiology:
Often unreliable. In conductive deafness the cochlear is undisturbed by extraneous noises encountered by the
better ear
20 H merkel-touch
21 D
22 C- Acquired bronchiectasis with lobar Pneumonia
Mucociliary escalator –cilia push mucous up the airway and remove particles. Microorganisms hoping
to infect the respiratory tract are caught in the sticky mucus and moved up by the mucociliary
escalator..
Smoking destroy cilia of the mucociliary escalator-increase susceptibility of the respiratory tract to
infection
A-muramyl dipeptide-Acomponent of the cell wall of the mycobacteria - enhances T cell mediated
immune responses.
B- Macrophages in the alveolar spaces phagocytose particles and infectious agents that are deposited in
the alveoli. Some macrophages travel to lymph nodes and may re-enter the alveolar space. Other
macrophages are wafted up the mucociliary escalator and are swallowed.
D-Ig A first line of defence against invasion by inhaled and ingested pathogens at the vulnerable
mucosal surfaces.
E- Coughing is a reflex action started by stimulation of sensory nerves in the lining of the respiratory passages -
the tubes we use to breathe.
something in the respiratory passages that should not be there. This can be caused by breathing in dust
particles in the air or when a piece of food goes down the wrong way
The mucociliary escalator consists of the ciliary beat that push mucous (produced by the columnar
epithelial cells in the respiratory epithelium as well as the bronchial glands) up the airways. The
mucociliary escalator is responsible for removing particles that sediment out in the airways as a result
of the branching of the tracheobronchial tree (filtering mechanism).
The cilia are continually beating, pushing mucus up and out into the throat. The mucociliary escalator is
a major barrier against infection.
23 B- the amount of air that reaches the alveoli and is available for gas exchange with the blood per unit time.
24 B
25
B. Pseudopapilledema is optic nerve head elevation caused by hyaline deposition within the optic
nerve head itself. An elevated nerve exists, but not true disc edema. The vessels will have an anomalous
branching pattern and tiny hyaline deposits can be seen in the optic nerve head ophthalmoscopically.
C-type I pneumocytes(are- large, thin cells stretched across a large surface area)
D--type II pneumocytes( are-granular and roughly cuboidal in shape)-are mainly found at the alveolar
septal junction
29 A
30 B
31 A ? conductive aphasia secondary to a MCA stroke. Arcuate Fasciculus connects Broca to Wernicke
so he can hear and understand but cannot reply nor can he repeat.
d- he uncinate fasciculus is a white matter tract in the human brain that connects parts of the limbic
system such as the hippocampus and amygdala in the temporal lobe with frontal ones such as the
orbitofrontal cortex. Its function is unknown though it is affected in several psychiatric conditions
32 cc
-Huntingtons does have progressive dementia as a symptom, and the writhing movements are
characteristic of athetosis which signifies a Basal Ganglia problem (aka striatum)...therefore basal
ganglia disease + dementia = Huntingtons
33 D
34 C 401pg,,,,left sided homonymous hemianopia with partial macular sparing.
d. one of several branches of the basilar artery and the posterior cerebral arteries supplying blood to the
midbrain and thalamus withamnesic syndrome, convergence difficulty, third nerve palsies, eyelid
retraction, dysarthria, ataxia and involuntary limb movements.
How the impulse is transmitted?:> action potential reaches the presynaptic terminal…voltage Ca
channels open—influx of ca –synaptic vesicles fuse with membrane(exocytosis)---neurotransmitters are
released into cleft and diffuse to postsynaptic membrane---neurotransmitter binds to neuroreceptor on
postsynaptic membrane –cause Na channels to open and Na flows into postsynaptic membrane if
threshold is reached then action potential is initiated…neurotransmitter is broken down by specific
enzymes in the synaptic cleft.
38 A ? attributable risk is the difference in rate of a condition between an exposed population and an
unexposed population
39 d- Experience of uncontrolled anxiety for at least 6 months
a. Acute Stress Disorder is characterized by the development of severe anxiety, dissociative, and other
symptoms that occurs within one month after exposure to an extreme traumatic stressor (e.g.,
witnessing a death or serious accident).
b. Agoraphobia is a fear of being in places where help might not be available. It usually involves fear of
crowds, bridges, or of being outside alone
40 C
41 EFOR SCROTUM IT MUST BE SUPERFICIAL BUT FOR TESTES IT MUST BE AORTIC
• The external pudendal arteries supply the anterior aspect of the scrotum.
44 E
45 B
46 F
47 D
48 d this is a role sciatica lesion occurs with lumbar disc prolapse or compression in S1 L5 roots so
once u see ciatica in the exam just look for S1 or L5 in answers the deference between S1 and L5 is 1-
ankle reflex lost onley in s1 + only post pain + intact patellar
49 D
50 I Musculocutaneous
Supplies Brachialis, biceps and corachobrachialis and ends as the lateral cutaneous nerve of forearm.
· oxygen reversibly combines with Hb maximum amount of O2 that can combine with the Hb of blood:
i) Normal arterial blood: 100 ml blood combines with 19.4 ml O2 [97% sat; PO2 95]
ii) Venous blood: 100 ml blood combines with 14.4 ml O2 [75% sat; PO2 40 mm Hg]
iii) Thus, 5ml of O2 is transported by each 100 ml blood through the tissues per cycle
i) Exercise —> increased cellular O2 utilization -> decreased interstitual PO2 [15mmHg]
ii) Venous blood: 100 ml blood combines with 4.4 ml O2 [20% sat; PO2 18 mmHg]
iii) Thus, 15ml of O2 is transported by each 100 ml blood through the tissues per cycle
iv) Therefore, increased cellular O2 utilization -> increase rate of O2 release from Hb
· utilization coefficient
i) utilization coefficient = fraction O2 released from blood as passes via tissue capillaries
· Hb helps maintain a constant PO2 in tissue fluids (oxygen buffer function of Hb) despite exercise or
changes in atmospheric changes in PO2
i) total amount of O2 available each minute for use in any given tissue is determined by:
ii) if rate of blood flow approaches zero, amount of O2 available also approaches zero
i) Normal arterial blood: 100 ml blood has dissolved 0.29 ml O2 [PO2 95 mmHg]
ii) Venous blood: 100 ml blood has dissolved 0.12 ml O2 [PO2 40 mm Hg]
iii) Thus, 0.17ml of O2 is transported by each 100 ml blood through the tissues per cycle in the
dissolved state
Bohr Effect: increase in CO2 in blood will cause O2 to be displaced from the Hb thereby promoting O2
release in tissues [ie oxygen dissociation curve shifts to the right]; reverse effect occurs in the lungs
B) Transport of Carbon dioxide in the blood
· Normally 4 ml of CO2 is transported from the tissues to the lungs in each 100 ml blood
2) Bicarbonate [70 %]
ii) carbonic anhydrase catalyzes the reaction of CO2 & H2O 5000 X
v) HCO3- diffuse into plasma; Cl- diffuses into rbc [chloride shift]
vi) administration of an carbonic anhydrase inhibitor —> reduced CO2 transport —> elevated tissue
PCO2
3) Carbaminohemoglobin [23%]
i) CO2 combines reversibly with Hb (and to a much lesser extent other plasma proteins)
· Haldane effect
vi) approximately doubles the amount of CO2 picked up in the tissues and released in the lungs
· the formation of carbonic acid decreases the pH in venous blood [effect is attenuated by buffers]
Source(s):
http://www.merck.com/mmhe/sec04/ch038/ch…