1. EABEA 6. BDABE 11. ABADG 16. AADBB 21. FDCED 26. FEDEA 31. GCBCA 36. BCBCA 41. FECAE 46. DABDE
1.EE
HMG-coA reductase inhibitors are more eecti!e "or brin#in# the $D$ to norma% %e!e%.... &he' inhibit cho%estro% cho%estro% (recursor)Me!a%onate (recursor)Me!a%onate *+E...,habdom'o%isis re!ersib%e hi#h %e!e% %i!er "unction test
$o!astatin)(ra!astatin)sim!astatin)A $o!astatin)(ra!astatin)sim!astatin)Ator!astatin), tor!astatin),oso!astatin.......... oso!astatin...........astatin .astatin ,e(ort Abuse ,e/BME 0 b%oc 1 1 to 52310 mar'am2 - ++11 7
2.AA
8a9r%ucast)Monte%ucast.....$eu 8a9r%ucast)Monte%ucast.....$euoterine oterine rece(tor b%ocers (re!ent bronchoconstriction ,e(ort Abuse ,e/BME 0 b%oc 1 1 to 523161 mar'am2 - ++11 7
3.
bet:en B and C....;<%% choose C bcause accordin# to !erba% recommendation )sendin# a %ist o" %o: sodium diet :ith (atient that needs to "o%%o: it is more e=cient.
i" there is an' other ideas)(%ease add )&>
,e(ort Abuse ,e/BME 0 b%oc 1 1 to 523160 usm%e?#u' - ++11 3
:e ha!e to in"orm the (atient about :hat "oods ha!e hi#h sodium sodium... ...&h &hat< at
4.EE
the tumor sho:s a ha(ha@ard arran#ement o" somatic tissues re(resentin# deri!ati!es o" ecto...)meso.. and endoderm.....it is a characteristic o" #erm ce%%s.
.AA
&ric'c%ic antide(ressant o!erdose....&ric'c%ics ha!e a narro: thera(eutic inde) i.e.) the thera(eutic dose is c%ose to the toic dose.
&he (eri(hera% autonomic ner!ous s'stem) centra% ner!ous s'stem and the heart are the main s'stems that are aected "o%%o:in# o!erdose. ;nitia% or mi%d s'm(toms t'(ica%%' de!e%o( :ithin 2 hours and inc%ude tach'cardia) dro:siness) a dr' mouth) nausea and !omitin#) urinar' retention) con"usion) a#itation) and headache. More se!ere com(%ications inc%ude h'(otension) cardiac rh'thm disturbances) ha%%ucinations) and sei@ures. E%ectrocardio#ram ECG abnorma%ities are "reuent and a :ide !ariet' o" cardiac d'srh'thmias can occur) the most common bein# sinus tach'cardia and intra!entricu%ar conduction de%a' resu%tin# in (ro%on#ation o" the ,* com(%e and the ,+& inter!a%s. *ei@ures) cardiac d'srh'thmias) and a(nea are the most im(ortant %i"e threatenin# com(%ications. ,e(ort Abuse ,e/BME 0 b%oc 1 1 to 523213 mar'am2 - ++11 111
6.BB
ro"essiona% ACs are !er' e=cient at interna%i@in# anti#en) either b' (ha#oc'tosis&he acidic com(artments o" macro(ha#es are a%so res(onsib%e "or the de#radation o" in#ested micro-or#anisms or b' rece(tor-mediated endoc'tosis) and then dis(%a'in# a "ra#ment o" the anti#en) bound to a c%ass ;; MHC mo%ecu%e) on their membrane. &he & ce%% reco#ni@es and interacts :ith the anti#en-c%ass ;; MHC mo%ecu%e com(%e on the membrane o" the anti#en(resentin# ce%%.
,e(ort Abuse ,e/BME 0 b%oc 1 1 to 52324 #od - ++11 12
0. D 'ru!ate carbo'%ase is a mitochondria en@ime reuirin# biotin. ;t is acti!ated b' acet'%CoA "rom beta- oidation. &he (roduct oa%oacetateAA) a citric acid c'c%e intermediate) cannot %ea!e the mitochondria but is reduced to ma%ate that can %ea!e !ia a Ma%ate shue. ;n the c'to(%asm ma%ate is reduced to AA. 'ru!ate carbo'%ase de9cienc' is an inherited disorder that causes %actic acid and other (otentia%%' toic com(ounds to accumu%ate in the b%ood. Hi#h %e!e%s o" these substances can dama#e the bod'
0.DD
A de9cienc' o" ('ru!ate carbo'%ase can cause %actic acidosis as a resu%t o" %actate bui%d u(. /orma%%') ecess ('ru!ate is shunted into #%uconeo#enesis !ia con!ersion o" ('ru!ate into oa%oacetate) but because o" the en@'me de9cienc') ecess ('ru!ate is con!erted into %actate instead. As a e' ro%e o" #%uconeo#enesis is in the maintenance o" b%ood su#ar) de9cienc' o" ('ru!ate carbo'%ase can a%so %ead to h'(o#%'cemia ,e(ort Abuse ,e/BME 0 b%oc 1 1 to 523202 mar'am2 - ++11 136
7.AA
;-ce%% disease is an autosoma% recessi!e disorder caused b' a de9cienc' o" G%c/Ac (hos(hotrans"erase) :hich (hos(hor'%ates mannose residues to mannose-6-(hos(hate on /-%ined #%'co(roteins in the Go%#i a((aratus :ithin the ce%%.
Iithout mannose-6-(hos(hate to tar#et them to the %'sosomes) the en@'mes are trans(orted "rom the Go%#i to the etrace%%u%ar s(ace) resu%tin# in %ar#e intrace%%u%ar inc%usions o" mo%ecu%es reuirin# %'sosoma% de#radation in (atients :ith the disease .
&he Go%#i a((aratus is unab%e to tar#et the %'sosoma% (rotein :hich is norma% to the %'sosome. Iithout (ro(er "unctionin# o" /-acet'%#%ucosamine1-(hos(hotrans"erase) a bui%d u( o" substances occurs :hen en@'mes are unab%e to tra!e% inside o" the %'sosome ,e(ort Abuse ,e/BME 0 b%oc 1 1 to
523203 #od - ++11 130
7. A ;- Ce%% Disease ;nc%usion ce%% disease. ;nherited %'sosoma% stora#e disorderJ "ai%ure o" addition to mannose 6 (hos(hate to %'sosome (roteins en@ime are secreted outside the ce%% instead o" bein# tar#eted to the %'sosme. ,esu%t in coarse "acia% "uture) c%ouded corneas) restricted Koin mo!ement) and hi#h (%ama %e!e%s o" %'sosomes. "ten "ata% chi%dhood. htt(++en.:ii(edia.or#+:ii+;-ce%%?disease
.BB
1.EE
M'asthenia #ra!is is a chronic autoimmune neuromuscu%ar disease characteri@ed b' !ar'in# de#rees o" :eaness o" the se%eta% !o%untar' musc%es o" the bod'.
&he ha%%mar o" m'asthenia #ra!is is musc%e :eaness that increases durin# (eriods o" acti!it' and im(ro!es a"ter (eriods o" rest. Certain musc%es such as those that contro% e'e and e'e%id mo!ement) "acia% e(ression) che:in#) ta%in#) and s:a%%o:in# are o"ten) but not a%:a's) in!o%!ed in the disorder.
;n m'asthenia #ra!is) antibodies b%oc) a%ter) or destro' the rece(tors "or acet'%cho%ine at the neuromuscu%ar Kunction :hich (re!ents the musc%e contraction "rom occurrin# ,e(ort Abuse ,e/BME 0 b%oc 1 1 to 523277
mar'am2 - ++11 144
hi there)ee( #oin#);<%% come %ater)&han 'ou ,e(ort Abuse ,e/BME 0 b%oc 1 1 to 5232117
#od - ++11 12
11. A
A constant rate o" in"usion o" GnH, :i%% cause a transient increase in $H and FH* secretion) "o%%o:ed b' a decrease caused b' the do:nre#u%ation o" #onadotro(h rece(tors. a(%an (h'sio%o#' a#e 3. htt(++en.:ii(edia.or#+:ii+Gonadotro(in-re%easin#?hormone ,e(ort Abuse ,e/BME 0 b%oc 1 1 to 523212
#od - ++11 126
12. B Crest *'ndrome Ca%ci9cations) ,a'naud
*c%erodact'%') and &e%an#iectasia. $imited sin in!o%!ement) o"ten con9ned to 9n#ers and "ace. More beni#n c%inica% course. Associated :ith Anticentromere Antibod'. ,e(ort Abuse ,e/BME 0 b%oc 1 1 to 5232127
#od - ++11 122
13. A Acute a((endicitis htt(++en.:ii(edia.or#+:ii+A((endicitis ,e(ort Abuse ,e/BME 0 b%oc 1 1 to 5232136
#od - ++11 1234
14. D
A;D* ar!o!irus B1 is a cause o" chronic anemia in indi!idua%s :ho ha!e A;D*. ;t is "reuent%' o!er%ooed. &reatment :ith er'thro(oetin or intra!enous immuno#%obu%in ha!e been he%("u% in some (atients. &he (ar!o!irus in"ection ma' tri##er an inLammator' reaction in A;D* (atients :ho ha!e Kust be#un antiretro!ira% thera('.14.
htt(++en.:ii(edia.or#+:ii+ar!o!irus?B1 1. G Ihen associated :ith the %un#) it o"ten causes ecto(ic (roduction o" (arath'roid hormone-re%ated (rotein &Hr) resu%tin# in h'(erca%cemia. *uamous-ce%% carcinoma o" the %un# is more common in men than in :omen. ;t is c%ose%' corre%ated :ith a histor' o" tobacco smoin#) more so than most other t'(es o" %un# carcinoma. ;t most o"ten arises centra%%' in %ar#er bronchi) and :hi%e it o"ten metastasi@es to %ocore#iona% %'m(h nodes (articu%ar%' the hi%ar nodes ear%' in its course) it #enera%%' disseminates outside the thora some:hat %ater than other maKor t'(es. $ar#e tumors ma' under#o centra% necrosis) resu%tin# in ca!itation. A suamous-ce%% carcinoma is o"ten (receded "or 'ears b' suamous-ce%% meta(%asia or d's(%asia in the res(irator' e(ithe%ium o" the bronchi) :hich %ater trans"orms to carcinoma in situ. ;n carcinoma in situ) at'(ica% ce%%s ma' be identi9ed b' c'to%o#ic smear test o" s(utum) bronchoa%!eo%ar %a!a#e or sam(%es "rom endobronchia% brushin#s. Ho:e!er) suamous-ce%% carcinoma in situ is as'm(tomatic and undetectab%e on N-ra' radio#ra(hs. E!entua%%') it becomes s'm(tomatic) usua%%' :hen the tumor mass be#ins to obstruct the %umen o" a maKor bronchus) o"ten (roducin# dista% ate%ectasis and in"ection. *imu%taneous%') the %esion in!ades into the surroundin# (u%monar' substance. n histo(atho%o#') these tumors ran#e "rom :e%%-dierentiated) sho:in# eratin (ear%s and ce%% Kunctions) to ana(%astic :ith on%' minima% residua% suamous-ce%% "eatures. htt(++en.:ii(edia.or#+:ii+*uamous-ce%%?carcinoma
16.AA a#et
&he (atho#enesis o" a#et
i. steoc%astic acti!it' ii. Mied osteoc%astic-osteob%astic acti!it' iii. Ehausti!e burnt out sta#e ;nitia%%') there is a mared increase in the rate o" bone resor(tion at %oca%i@ed areas caused b' %ar#e and numerous osteoc%asts. &hese %oca%i@ed areas o" osteo%'sis are seen radio%o#ica%%' as an ad!ancin# %'tic :ed#e in %on# bones or osteo(orosis circumscri(ta in the su%%. &he osteo%'sis is "o%%o:ed b' a com(ensator' increase in bone "ormation induced b' osteob%asts recruited to the area. &his is associated :ith acce%erated de(osition o" %ame%%ar bone in a disor#ani@ed "ashion. &his intense ce%%u%ar acti!it' (roduces a chaotic (icture o" trabecu%ar bone OmosaicO (attern) rather than the norma% %inear %ame%%ar (attern. &he resorbed bone is re(%aced and the marro: s(aces are 9%%ed b' an ecess o" 9brous connecti!e tissue :ith a mared increase in b%ood !esse%s) causin# the bone to become h'(er!ascu%ar. &he bone h'(erce%%u%arit' ma' then diminish) %ea!in# a dense O(a#etic bone)O a%so no:n as burned-out a#et
10.AA a%% choices ece(t A are arti9cia% (rocedures that (ro%on# his %i"e. 17. D && &hrombotic &hromboc'to(enia ur(ura is a rare disorder o" the b%ood-coa#u%ation s'stem) causin# etensi!e microsco(ic thromboses to "orm in sma%% b%ood !esse%s throu#hout the bod' thrombotic microan#io(ath'.23 Most cases o" && arise "rom inhibition o" the en@'me ADAM&*13) a meta%%o(rotease res(onsib%e "or c%ea!in# %ar#e mu%timers o" !on Ii%%ebrand "actor !IF into sma%%er units. A rarer "orm o" &&) ca%%ed P(sha:-*chQR%man s'ndrome) is #enetica%%' inherited as a d's"unction o" ADAM&*13. ;" %ar#e !IF mu%timers (ersist there is tendenc' "or increased coa#u%ation. htt(++en.:ii(edia.or#+:ii+&hrombotic?thromboc'to(enic?(ur(ura & FA (a#e 34 *'m(toms (entada o" neuro%o#ic and rena% s'm(toms) "e!er) thromboc'to(enia) and microan#io(athic hemo%'tic anemia. $ab *chistoc'tes) increase $DH.
1. D /iemann (ic disease ;s an Autosoma% recessi!e disease) ro#resi!e neurode#eneration) de!e%o(menta% de%a') cherr' red s(ot on macu%a) "oam ce%%s. De". en@ime *(hin#om'e%inaseJ Accumu%ated substrate *(hin#om'e%in. FA (a#e 111
$i(o"uscin is the name #i!en to 9ne%' #ranu%ar 'e%%o:-bro:n (i#ment #ranu%es1 com(osed o" %i(id-containin# residues o" %'sosoma% di#estion. ;t is considered one o" the a#in# or O:ear and tearO (i#ments) "ound in the %i!er) idne') heart musc%e) adrena%s) ner!e ce%%s) and #an#%ion ce%%s. ;t is s(eci9ca%%' arran#ed around the nuc%eus) and is a t'(e o" $i(ochrome. $i(o"uscin accumu%ation is a maKor ris "actor im(%icated in macu%ar de#eneration) a de#enerati!e disease o" the e'e.
Abnorma% accumu%ation o" %i(o"uscin is associated :ith a #rou( o" diseases o" neurode#enerati!e disorder t'(e ca%%ed %i(o"uscinoses) e.#.) neurona% ceroid %i(o"uscinosis) a%so no:n as Batten disease) as :e%% as some other names.
atho%o#ica% accumu%ation o" %i(o"uscin is im(%icated in A%@heimer
1 is BBBBBBBBBBBBB is &a' *ach Disease ; "or#ot that the #ir% is Ashena@i Ke:ish descent htt(++en.:ii(edia.or#+:ii+&a'SE2S7S3*achs?disease &a' sach disease A,) ro#resi!e neurode#eneration) de!e%o(menta% de%a') cherr' red s(ot on macu%a) %'sosoma% :ith onion sin ) / HEA&MEGA$>. De". en@ime Heosaminidase AJ Accumu%ated substrate G2 #an#%ioside. FA (a#e 111.
2. B %"ator' C/ ; is the on%' C/ :ithout tha%amic re%a' to corte. Function *me%% FA 413 21.FF the ans:er is F because the uestion don
Psin# the "ormu%a....CTDose+Ud Uo% o" distribution "or N is + T1 "or> is +2.T2
22.DD neumothora is de9ned as the (resence o" air or #as in the (%eura% ca!it') that is) in the (otentia% s(ace bet:een the !iscera% and (arieta% (%eura o" the %un#. &he resu%t is co%%a(se o" the %un# on the aected side. Air can enter the intra(%eura% s(ace throu#h a communication "rom the chest :a%% ie) trauma or throu#h the %un# (arench'ma across the !iscera% (%eura. rimar' s(ontaneous (neumothora * occurs in (eo(%e :ithout under%'in# %un# disease and in the absence o" an incitin# e!ent . ;n other :ords) air is (resent in the intra(%eura% s(ace :ithout (recedin# trauma and :ithout under%'in# c%inica% or radio%o#ic e!idence o" %un# disease. ,iss "actors "or (rimar' s(ontaneous (neumothora * inc%ude the "o%%o:in# VW*moin# VW&a%%) thin stature in a hea%th' (erson VWMar"an s'ndrome VWre#nanc' VWFami%ia% (neumothora B%ebs and bu%%ae sometimes ca%%ed em(h'sematous%ie chan#es or E$Cs are re%ated to the occurrence o" (rimar' s(ontaneous (neumothora. *econdar' s(ontaneous (neumothora ** occurs in (eo(%e :ith a :ide !ariet' o" (arench'ma% %un# diseases) that is) these indi!idua%s ha!e under%'in# (u%monar' structura% (atho%o#' see the ima#e be%o:. Air enters the (%eura% s(ace !ia distended) dama#ed) or com(romised a%!eo%i. atients ma' (resent :ith more serious c%inica% s'm(toms and seue%ae due to comorbid conditions. Diseases and conditions associated :ith secondar' s(ontaneous (neumothora inc%ude the "o%%o:in# VWChronic obstructi!e %un# disease CD or em(h'sema ;ncreased (u%monar' (ressure due to cou#hin# :ith a bronchia% (%u# o" mucus or (h%e#m bronchia% (%u# ma' (%a' a ro%e. VWAsthma
VWHuman immunode9cienc' !irus+acuired immunode9cienc' s'ndrome H;U+A;D* :ith C in"ection VW/ecroti@in# (neumonia VW&ubercu%osis VW*arcoidosis VWC'stic 9brosis VWBroncho#enic carcinoma or metastatic ma%i#nanc' VW;dio(athic (u%monar' 9brosis VW;nha%ationa% and intra!enous dru# use e#) mariKuana) cocaine7 VW;nterstitia% %un# diseases associated :ith connecti!e tissue diseases VW$'m(han#io%eiom'omatosis VW$an#erhans ce%% histioc'tosis VW*e!ere acute res(irator' s'ndrome *A,* A re(orted 1.0S o" * A,* (atients de!e%o(ed s(ontaneous (neumothora. VW&horacic endometriosis and catamenia% (neumothora VWCo%%a#en !ascu%ar disease) inc%udin# Mar"an s'ndrome htt(++emedicine.medsca(e.com+artic%e+42440-o!er!ie:5a14
23.CC Gancic%o!ir is an anti!ira% medication used to treat or (re!ent c'tome#a%o!irus CMU in"ections ;t is 9rst (hos(hor'%ated to a deo'#uanosine tri(hos(hate dG& ana%o#ue. &his com(etiti!e%' inhibits the incor(oration o" dG& b' !ira% D/A (o%'merase) resu%tin# in the termination o" e%on#ation o" !ira% D/A. Ad!erse eectsGancic%o!ir is common%' associated :ith a ran#e o" serious haemato%o#ica% ad!erse eects. #ranu%oc'to(enia) neutro(enia) anaemia) thromboc'to(enia) "e!er) nausea) !omitin#) d's(e(sia) diarrhoea) increased serum creatinine and b%ood urea concentrations &oicit'Gancic%o!ir is considered a (otentia% human carcino#en) terato#en) and muta#en. ;t is a%so considered %ie%' to cause inhibition o" s(ermato#enesis. &hus) it is used
Kudicious%' and hand%ed as a c'totoic dru# in the c%inica% settin# 24.EE Ho%os'sto%ic murmur is best heard at the a(e in the %e"t %atera% decubitus (osition....Mitra% ,e#ur#itation . MurmurB%o:in# ho%os'sto%ic murmur Heard best at the a(e ,adiation to the ai%%a and in"erior ed#e o" %e"t sca(u%a. ossib%e associated 9ndin#s *2 :ide (h'sio%o#ic s(%ittin# *3 htt(++de(ts.:ashin#ton.edu+(h'sd+heart+tech.htm%
2.DD Coronar' b%ood Lo: occurs most%' durin# diasto%e) because durin# s'sto%e the b%ood !esse%s :ithin the m'ocardium are com(ressed. ;ncreased heart rates) :hich reduce the time "or diasto%e 9%%in#) can reduce the m'ocardia% b%ood su((%' and cause ischaemia.D'namic eercise increases coronar' b%ood Lo: in (ro(ortion to the heart rate) :ith (ea !a%ues durin# maima% eercise t'(ica%%' three to 9!e times the restin# %e!e% . 26.FF *e!ere%' (remature in"ants ma' ha!e underde!e%o(ed %un#s) because the' are not 'et (roducin# their o:n sur"actant. &his can %ead direct%' to res(irator' distress s'ndrome) a%so ca%%ed h'a%ine membrane disease) in the neonate. &o tr' to reduce the ris o" this outcome) (re#nant mothers :ith threatened (remature de%i!er' (rior to 34 :ees are o"ten administered at %east one course o" #%ucocorticoids) a steroid that crosses the (%acenta% barrier and stimu%ates the (roduction o" sur"actant in the %un#s o" the "etus. 20.EE in DXA beta-H'dro'but'ric acid is a etone bod'....inc Due to %oss o" :ather......inc. serum osmo%a%it'. &he anion #a( is the dierence in the measured cations and the measured anions in serum) (%asma) or urine. &he ma#nitude o" this dierence i.e. O#a(O in the serum is o"ten
ca%cu%ated in medicine :hen attem(tin# to identi"' the cause o" metabo%ic acidosis. on%' /aY) C%Z and HC3Z Y+- X are used :hen ca%cu%atin# the anion #a(... hea%th' adu%ts is 7-12 mE+$ /aY Z C%ZYHC3Z a use"u% mnemonic to remember the hi#h anion #a( is MPD;$E* methano%) uremia) diabetic etoacidosis) (ro('%ene #%'co%) isonia@id) %actic acidosis) eth'%ene #%'co%) sa%ic'%ates.
27.DD ;t is a Gram-ne#ati!e) aerobic) rod-sha(ed bacterium :ith uni(o%ar moti%it' and oidase (ositi!e . aeru#inosa secretes a !ariet' o" (i#ments) inc%udin# ('oc'anin b%ue-#reen)Because it thri!es on most sur"aces) this bacterium is a%so "ound on and in medica% eui(ment) inc%udin# catheters) causin# cross-in"ections in hos(ita%s and c%inics. ;t is im(%icated in hot-tub rash.
2.EE Mar"an s'ndrome can %ead to mitra% !a%!e (ro%a(se MU.
3. A Beta tha%asemia (re!a%ent in mediterranea (o(u%ation. De"ect (oint mutation in s(%icin# sites and (romoter seuences Beta tha%asemia minor hetero@'#ote 1. beta chain in un(roduced 2. usua%%' as'ntom(tomatic 3. D con9rmed b' increase HbA2 [ 3.S Beta tha%asemia maKor Homo@'#ote 1. beta chain is absent- se!ere anemia reuirin# b%ood trans"usion 2V\ hemochromatosis 2. Marro: e(ansion cre: cut on su%% -ra'- se%eta% de"romities) chi(mun "acies
Both maKor and minor - increase Hb F FA (a#e 343. htt(++:::.#oo#%e.com+search] sourceidTna!c%ient^aT^oTbetaYtha%asemia^ieTP&...tha%assemia
31. G Beta 2 adrener#ic a#onist Bronchodi%ation re%a bronchia% smooth muc%es htt(++en.:ii(edia.or#+:ii+Beta2-adrener#ic?a#onist
32. C &*H &h'roid-stimu%atin# hormone a%so no:n as &*H or th'rotro(in is a (e(tide hormone s'nthesi@ed and secreted b' th'rotro(e ce%%s in the anterior (ituitar' #%and) :hich re#u%ates the endocrine "unction o" the th'roid #%and. &*H is the 1st ste( in e!a%uation o" th'roid "unction. htt(++en.:ii(edia.or#+:ii+&h'roid-stimu%atin#?hormone
33. B Adenocarcinoma o" the endometrium Carcinoma endometria% is the Most common #'neco%o#ic ma%i#nanc'. (ea occurrence at -6'ear o" a#e. C%inica%%' (resents :ith !a#ina% b%eedin#. &'(ica%%' (receded b' endometria% h'(er(%asia. ,is "actors inc%ude (ro%on#ed use o" estro#en :ithout (ro#estins) obesit') diabetes) h'(ertension) nu%%i(arit' and %ate meno(ause. ;ncreas m'ometria% in!asion) decrease (ro#nosis. FA (a#e 470 htt(++en.:ii(edia.or#+:ii+Endometria%?cancer
34. C arinson disease *ur#er' and dee( brain stimu%ation %acement o" an e%ectrode into the brain. &he head is stabi%ised in a "rame "or stereotactic sur#er'.&reatin# motor s'm(toms :ith sur#er' :as once a common (ractice) but since the disco!er' o" %e!odo(a) the number o" o(erations dec%ined.3 *tudies in the (ast "e: decades ha!e %ed to #reat im(ro!ements in sur#ica% techniues) so that sur#er' is a#ain
bein# used in (eo(%e :ith ad!anced D "or :hom dru# thera(' is no %on#er su=cient.3 *ur#er' "or D can be di!ided in t:o main #rou(s %esiona% and dee( brain stimu%ation DB*. &ar#et areas "or DB* or %esions inc%ude the tha%amus) the #%obus (a%%idus or the subtha%amic nuc%eus.3 Dee( brain stimu%ation DB* is the most common%' used sur#ica% treatment. ;t in!o%!es the im(%antation o" a medica% de!ice ca%%ed a brain (acemaer) :hich sends e%ectrica% im(u%ses to s(eci9c (arts o" the brain. DB* is recommended "or (eo(%e :ho ha!e D :ho suer "rom motor Luctuations and tremor inadeuate%' contro%%ed b' medication) or to those :ho are into%erant to medication) as %on# as the' do not ha!e se!ere neuro(s'chiatric (rob%ems.2 ther) %ess common) sur#ica% thera(ies in!o%!e the "ormation o" %esions in s(eci9c subcortica% areas a techniue no:n as (a%%idotom' in the case o" the %esion bein# (roduced in the #%obus (a%%idus.3 htt(++en.:ii(edia.or#+:ii+arinson
3. A Dee( Fibu%ar ner!e Ieaness in!ersion) $oss etension o" the di#its) %oss dorsiLeion "oot dro() sensor' %oss on antero %atera% %e# and dorso o" the "oot) 9rts :eb s(ace. Xa(%an anatom' (a#e 2 and 2. htt(++en.:ii(edia.or#+:ii+Dee(?9bu%ar?ner!e
36. B %aceta accreta An in!asion o" the m'ometrium :hich does not (enetrate the entire thicness o" the musc%e. &his "orm o" the condition accounts "or around 0S o" a%% cases. %acenta (erccreta &he :orst "orm o" the condition is :hen the (%acenta (enetrates the entire m'ometrium to the uterine serosa in!ades throu#h entire uterine :a%%. &his !ariant can %ead to the (%acenta attachin# to other or#ans such as the rectum or b%adder1. htt(++en.:ii(edia.or#+:ii+%acenta?accreta
30. C Crohn Disease A%so no:n as re#iona% enteritis) is an inLammator' disease o" the intestines that ma' aect an' (art o" the #astrointestina% tract "rom mouth to anus) causin# a :ide !ariet' o" s'm(toms. ;t (rimari%' causes abdomina% (ain) diarrhea :hich ma' be b%ood' i" inLammation is at its :orst) !omitin#) or :ei#ht %oss)123 but ma' a%so cause com(%ications outside the #astrointestina% tract such as sin rashes) arthritis)
inLammation o" the e'e) tiredness) and %ac o" concentration.1 Crohn
37. B e (redicti!e !a%ue ositi!e U &+ &YF UT 0+0Y3T .17 in this case a(ro. .1 U ositi!e redicti!e Ua%ue
3. C Membranous G%omeru%one(hritis $M -diuse ca(i%%ar' and GBM thicenin#. EM O s(ie and domeO a((earance :ith sube(ithe%ia% de(osits. ;F - #ranu%ar. Caused b' dru#s (enici%%amine) Go%d) /*A;D. Most common cause o" adu%t ne(hrotic s'ndrome. &he c%ose%' re%ated terms membranous ne(hro(ath'1 and membranous #%omeru%o(ath'2 both re"er to a simi%ar conste%%ation but :ithout the assum(tion o" inLammation. *ome (atients ma' (resent as ne(hrotic s'ndrome :ith (roteinuria) edema :ith or :ithout rena% "ai%ure. thers ma' be as'm(tomatic and ma' be (iced u( on screenin# or urina%'sis as ha!in# (roteinuria. A de9niti!e dia#nosis o" membranous ne(hro(ath' reuires a idne' bio(s'. htt(++en.:ii(edia.or#+:ii+Membranous?#%omeru%one(hritis5C%inica%?(...resentation 4. A
;ntoication "or Am(hetamine s'chomotor a#itation ) im(aired Kud#ment) (u(i%%ar' di%ation) h'(ertension) tach'cardia) eu(horia) (ro%on#ed :ea"u%ness sand attention) cardiac arr'thmia) de%usions) ha%%ucinations) "e!er. FA 447 Am(hetamine B%ocs o" neurotransmiter u(tae at the (res'na(tic ner!e termina% 41. C F%eion or ante!ersion 14V_ i%io(soas :ith (soas maKor "rom !ertebra% co%umnJ tensor "ascia %atae) (ectineus) adductor %on#us) adductor bre!is) and #raci%is. &hi#h musc%es actin# as hi( Leors rectus "emoris and sartorius. 42.E Duchenne muscu%ar d'stro(h' DMD is a recessi!e N-%ined. &he disorder is caused b' a mutation in the d'stro(hin #ene) %ocated in humans on the N chromosome N(21. &he d'stro(hin #ene codes "or the (rotein d'stro(hin) an im(ortant structura% com(onent :ithin musc%e tissue. 43.C Media% co%%atera% %i#amentO no:n as the tibia% co%%atera% %i#ament too.MC$ strains and tears are "air%' common in American "ootba%%. Most%' the center and the #uards are ones :ho #et this inKur') due to the #ri( trend on their c%eats. An MC$ inKur' can be !er' (ain"u% and is caused b' a !a%#us stress to a s%i#ht%' bent nee) o"ten :hen %andin#) bendin# or on hi#h im(act. De(endin# on the #rade o" the inKur') the %o:est #rade #rade 1 can tae bet:een 2 and 1 :ees "or the inKur' to "u%%' hea%. ,eco!er' times "or #rades 2 and 3 are di=cu%t to (redict because o" the amount o" dama#e done can tae :ees to se!era% months. ;t is di=cu%t to a((%' (ressure on the inKured %e# "or at %east a "e: da's.
44. e' ans:er is A. 4.E *t `ohn3A4) but a%so C>2C. &his resu%ts in the increased metabo%ism o" those dru#s) resu%tin# in decreased concentration and c%inica% eect. Eam(%es o" dru#s causin# c%inica%%'-si#ni9cant interactions :ith *t `ohn
non-nuc%eoside re!erse transcri(tase
ben@odia@e(ines a%(ra@o%am) mida@o%am hormona% contrace(tion combined ora% contrace(ti!es immunosu((ressants tacro%imus
ca%cineurin inhibitors) cic%os(orin)
others) di#oin) methadone) ome(ra@o%e) (henobarbito%) theo(h'%%ine) :ar"arin) %e!odo(a) suboone) ;rinotecan 46. D htt(++en.:ii(edia.or#+:ii+Diabetic?etoacidosis smotic diuresis is increased urination caused b' the (resence o" certain substances in the sma%% tubes o" the idne's.1 &he ecretion occurs :hen substances such as #%ucose enter the idne' tubu%es and cannot be reabsorbed due to a (atho%o#ica% state or the norma% nature o" the substance. &he substances cause an increase in the osmotic (ressure :ithin the tubu%e) causin# retention o" :ater :ithin the %umen) and thus reduces the reabsor(tion o" :ater) increasin# urine out(ut ie. diuresis. &he same eect can be seen in thera(eutics such as mannito%) :hich is used to increase urine out(ut and decrease etrace%%u%ar Luid !o%ume. *ubstances in the circu%ation can a%so increase the amount o" circu%atin# Luid b' increasin# the osmo%arit' o" the b%ood. &his has the eect o" (u%%in# :ater "rom the interstitia% s(ace) main# more :ater a!ai%ab%e in the b%ood and causin# the idne' to com(ensate b' remo!in# it as urine. ;n h'(otension) o"ten co%%oids are used intra!enous%' to increase circu%atin# !o%ume in themse%!es) but as the' eert a certain amount o" osmotic (ressure) :ater is there"ore a%so mo!ed) "urther increasin# circu%atin# !o%ume. As b%ood (ressure increases) the idne' remo!es the ecess Luid as urine. *odium) ch%oride) (otassium are ecreted in smotic diuresis) ori#inatin# "rom Diabetes Me%%itus DM. smotic diuresis resu%ts in deh'dration "rom (o%'uria and the c%assic (o%'di(sia ecessi!e thirst associated :ith DM. htt(++en.:ii(edia.or#+:ii+smotic?diuresis
44.AA Assumin# A is the correct ans:er.... &he !a%ue "or a stud' shou%d be %ess than .. &his !a%ue means that :hen :e (er"orm a stud') the S o" the time the obser!ations
are rite ^ S o" the time the obser!ation are due to chance a%one. ;n this uestion the !a%ue o" is .3 :hich means that the (robabi%it' that these obser!ations are due to chance a%one is 3S) :hich is not a statistica%%' acce(tab%e number.
40.AA ;n this test) Ostimu%atorO %'m(hoc'tes "rom a (otentia% donor are 9rst i%%ed b' irradiation and then mied :ith %i!e Ores(onderO %'m(hoc'tes "rom the reci(ientJ the miture is incubated in ce%% cu%ture to (ermit D/A s'nthesis) :hich is measured b' incor(oration o" tritiated th'midine. &he #reater the amount o" D/A s'nthesis in the res(onder ce%%s) the more "orei#n are the c%ass ;; MHC (roteins o" the donor ce%%s. A %ar#e amount o" D/A s'nthesis indicates an unsatis"actor' OmatchOJ i.e.) donor and reci(ient c%ass ;; H$A-D MHC (roteins are not simi%ar) and the #ra"t is %ie%' to be reKected. &he best donor is) there"ore) the (erson :hose ce%%s stimu%ated the incor(oration o" the %east amount o" tritiated th'midine in the reci(ient ce%%s. htt(++boos.#oo#%e.com+boos]idTE`N'*-&GPC^(#T,A1-A6^%(#T,A1A6^dTth'...ion^"T"a%se
47.BB $actu%ose inhibits bacteria% ammonia (roduction b' acidi"'in# the content o" the bo:e%. ;t (romotes #ro:th o" co%onic Lora. &he #ro:in# biomass uses ammonia and nitro#en "rom amino acids to s'nthesise bacteria% (rotein) :hich in turn inhibits (rotein de#radation to /H3. $actu%ose %eads to %ess ammonia b' inhibitin# bacteria% urea de#radation and reduces co%onic transit time) thus reducin# the time a!ai%ab%e "or ammonia (roduction and e(editin# ammonia e%imination. 4.DD Barrett
*ecound most common....Ammonium Ma#nesium (hos(hate..*tru!ite....caused b' in"ecction :ith Prease-(ositi!e bu#s.......can "orm sta#horn ca%cu%i Pric acid....associated :ith h'(eruricemia........readio%ucent C'steine...secondar' to C'stinuria..Heo#ona% sha(e........."aint%' radio(aue...treat :ith a%a%i@ation ;n some cases) idne' stones (ass out o" the bod' :ithout (roducin# an' s'm(toms. Most idne' stones) ho:e!er) do cause some s'm(toms. &he most common s'm(tom "rom idne' stones is (ain. &he (ain "rom idne' stones is a resu%t o" the stone #ettin# stuc on its :a' out. ;" "e!er and chi%%s accom(an' an' o" these s'm(toms) an in"ection ma' be (resent and medica% attention is needed sooner rather than %ate. $aborator' &estin#$aborator' testin# inc%udes urina%'sis to detect the (resence o" b%ood hematuria and bacteria bacteriuria in the urine. ther tests inc%ude b%ood tests "or creatinine to e!a%uate idne' "unction) BP/ and e%ectro%'tes to detect deh'dration) ca%cium to detect h'(er(arath'roidism) and a com(%ete b%ood count to detect in"ection. N-ra's A standard -ra' o" the idne') ureter) and b%adder) ma' be adeuate as a 9rst ste( "or identi"'in# man' stones since most are !isib%e on -ra'. P%trasound &his test uses hi#h "reuenc' sound :a!es to (roduce (ictures. P%trasounds can detect a di%ated idne' and ureter caused b' a stone %od#ed in the ureter. P%trasound) ho:e!er) cannot re%iab%' detect a%% stones es(ecia%%' stones %ocated outside the idne'. ;t is the (re"erred ima#in# method "or idne' stone (atients :ho are (re#nant. ;U ;ntra!enous 'e%o#ram For an ;U) a s(ecia% d'e is inKected into the (atient
