NEET PG 2022 Question Paper (Available):Download Solutions with Answer Key

The structure marked “A” in the embryological cross-section represents the ventral mesentery, which contributes to the formation of the falciform ligament. This ligament extends from the liver to the anterior abdominal wall and is derived from the ventral mesogastrium.
Quick Tip: Ventral mesentery gives rise to the falciform ligament; dorsal mesentery forms others like gastrosplenic and lienorenal.

The saphenous nerve is a branch of the femoral nerve and supplies sensory innervation to the medial side of the leg and foot. It runs alongside the great saphenous vein and can be injured during varicose vein surgeries, especially stripping or cannulation.
Quick Tip: Saphenous nerve = sensory to medial leg and foot; often injured in varicose vein surgeries.

The histological section shows lightly stained clusters of cells surrounded by more intensely stained exocrine pancreatic tissue. These pale-staining regions are characteristic of the islets of Langerhans (pancreatic islet cells), which are responsible for endocrine functions such as insulin and glucagon secretion.
Quick Tip: Pale circular clusters in the pancreas = Islets of Langerhans (endocrine pancreas).

The image shows a non-rebreathing mask with a reservoir bag, one-way valves, and a snug fit for high FiO\textsubscript{2 oxygen delivery. It is used in patients needing high oxygen support, such as severe COVID-19 cases with respiratory distress.
Quick Tip: Non-rebreathing mask = high-flow oxygen with reservoir bag, ideal in COVID emergencies.

Hemolytic anemia following treatment with oxidant drugs like primaquine is typical in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. This enzyme functions in the HMP pathway, generating NADPH, which protects red blood cells from oxidative damage.
Quick Tip: Think G6PD deficiency when hemolysis follows oxidant drugs—linked to HMP pathway.

HPV types 16 and 18 are considered high-risk due to their association with cervical and anogenital cancers. The presence of squamous atypia on biopsy further suggests a high-risk HPV strain. Types 6 and 11 are low-risk and typically cause benign warts.
Quick Tip: HPV 16 & 18 = high-risk (linked to dysplasia/carcinoma); HPV 6 \& 11 = low-risk.

The image shows a retracted tympanic membrane with visible fluid level or air bubbles, consistent with serous (otitis media with effusion). This condition leads to conductive hearing loss in children and commonly follows upper respiratory tract infections.
Quick Tip: Serous otitis = fluid without acute infection signs; chronic hearing loss clue.

The image shows the anatomical structure of the incus, one of the three auditory ossicles in the middle ear. It is located between the malleus and stapes and resembles an anvil.
Quick Tip: Incus = Anvil-shaped bone in the middle ear, second in the ossicular chain.

Lead poisoning inhibits ALA dehydratase and ferrochelatase, key enzymes in heme synthesis. This causes anemia, abdominal pain, and neurological symptoms like foot drop.
Quick Tip: Lead poisoning = ALA dehydratase + ferrochelatase inhibition → anemia \& neurotoxicity.

The symptoms described — hair loss, behavioral changes, and lateral eyebrow loss — point towards **thallium poisoning**.

Thallium affects the skin, nervous system, and appendages. Notably:
- **Alopecia (hair loss)** including lateral eyebrow loss is a hallmark.

- **Behavioral changes** result from CNS involvement.

- **Nail changes** (Mees' lines) help in clinical diagnosis.

These signs distinguish it from arsenic or mercury, which may show neuropathies but not this classical triad.
Quick Tip: Think of thallium when there's alopecia with lateral eyebrow loss and neuropsychiatric symptoms.

The CSF findings:
- **Mononuclear cytosis** (lymphocytic predominance)

- **Elevated protein levels**

- **Low sugar levels**

are classical for **tuberculous meningitis** (TBM).


In TBM, mycobacterial infection elicits a chronic granulomatous response in the CNS.
This leads to:
- High protein due to inflammation

- Low glucose due to consumption

- Lymphocytic infiltration (mononuclear cells on microscopy)


Viral (aseptic) meningitis would show lymphocytes but with normal sugar.
Bacterial meningitis generally shows neutrophilic predominance and more drastic glucose reduction. Quick Tip: TB meningitis shows lymphocytes, high protein, and low sugar. Bacterial usually has neutrophils; viral has normal sugar.

The presentation describes a **migraine attack** — a unilateral headache accompanied by nausea, photophobia, and phonophobia.

- **Sumatriptan**, a 5-HT\textsubscript{1B/1D receptor agonist, is the first-line treatment for **acute migraine attacks**.
- It causes cranial vasoconstriction and inhibits neuropeptide release.


Other options:
- **Flunarizine** and **Propranolol** are used for prophylaxis.
- **Topiramate** is also for migraine prevention, not acute relief.
Quick Tip: Remember: Triptans like Sumatriptan are used for immediate relief in migraine; beta-blockers and anticonvulsants are used for prophylaxis.

The combination of:
- **Bilateral facial nerve palsy** (unique to sarcoidosis),
- **Bilateral hilar lymphadenopathy**,
- **Systemic symptoms** (fever, night sweats),
suggests **sarcoidosis** — a granulomatous disease often affecting the lungs and nervous system.


- Tuberculosis can have similar signs but rarely causes bilateral facial palsy.
- Lymphoma causes lymphadenopathy but not typically with cranial nerve palsy.
- Hypersensitivity pneumonitis doesn't involve cranial nerves or lymphadenopathy to this extent.
Quick Tip: Bilateral facial palsy with bilateral hilar lymphadenopathy is a classic pointer toward neurosarcoidosis.

Prophylaxis for infective endocarditis is **not required** in all congenital heart diseases.

According to current guidelines, it is recommended only for:
- Patients with **prosthetic heart valves**
- Prior history of **infective endocarditis**
- Certain **congenital heart diseases**, such as **unrepaired cyanotic CHD**


**Atrial septal defect (ASD)** is usually well tolerated and **does not require prophylaxis**.
Quick Tip: IE prophylaxis is only for high-risk cardiac conditions; simple ASD doesn’t qualify.

The clinical presentation is consistent with **paracetamol (acetaminophen) overdose**, which leads to hepatotoxicity.

- **N-acetylcysteine (NAC)** is the antidote of choice.
- It replenishes glutathione, binds the toxic metabolite NAPQI, and prevents further liver damage.
- It is effective when given within 8–10 hours but can also benefit late presenters.


The other options:
- **Dopamine** is used in shock states, not for detox.
- **Ursodeoxycholic acid** is used for cholestatic liver disease.
- **Furosemide** is a diuretic, not relevant for hepatotoxicity management.
Quick Tip: N-acetylcysteine is the specific antidote for paracetamol poisoning — always suspect it in cases of hepatotoxicity with overdose history.

An **irregularly irregular pulse** with **pulse deficit** suggests **atrial fibrillation**.
In AF:
- The atria do not contract effectively — there is no coordinated atrial systole.
- This leads to an **absence of 'a wave'** in the jugular venous pulse (which is normally due to atrial contraction).


Other options:
- **Absent p wave** is an ECG finding, not JVP.
- **Cannon a waves** occur in AV dissociation.
- **Raised JVP with normal waveform** doesn’t correlate with AF.
Quick Tip: In atrial fibrillation, JVP shows absent 'a waves' due to ineffective atrial contraction.

Spontaneous bacterial peritonitis (SBP) is a common complication of **chronic liver disease with ascites**.

- A neutrophil count **>250/mm³** in ascitic fluid is diagnostic.
- The patient’s count is **>650/mm³**, confirming SBP.

Malignant and tubercular ascites typically present with **lymphocytic predominance**, not neutrophilic.
Intestinal obstruction does not produce neutrophilic ascitic fluid.
Quick Tip: In cirrhotic patients, ascitic neutrophil count >250/mm³ strongly suggests SBP — even without positive culture.

**Obstructive jaundice** is characterized by:
- **Elevated bilirubin (mainly conjugated)**
- **High alkaline phosphatase (ALP)**
- **Normal AST/ALT** or mildly elevated


Hemolytic jaundice increases **unconjugated bilirubin**, not ALP.
Hepatic jaundice shows elevated **transaminases**.
Quick Tip: Think of obstructive jaundice when ALP is high and liver enzymes are relatively normal.

In a patient with **no history of carditis**, **secondary prophylaxis** with **benzathine penicillin** is advised:
- **Every 3 weeks**
- **Duration: 5 years or till 18 years of age**, whichever is longer


Longer durations are advised if carditis or valvular disease is present.
Quick Tip: In RHD prophylaxis, the duration depends on carditis history — no carditis: 5 years or age 18; with carditis: longer.

**MEN 2B** syndrome includes:
- **Medullary thyroid carcinoma**
- **Pheochromocytoma**
- **Mucosal neuromas**
- **Marfanoid habitus**


**Parathyroid adenoma** is seen in **MEN 1 and MEN 2A**, not in MEN 2B.
Quick Tip: MEN 2B = Medullary carcinoma + Pheochromocytoma + Mucosal neuroma + Marfanoid habitus (No parathyroid involvement).

The ECG shows a wide-complex tachycardia (likely **ventricular tachycardia**), which in the setting of chest pain and palpitations in a known CAD patient, is an emergency.


Management of **stable VT** includes:
- **IV amiodarone** as first-line drug.
- Oral agents are not used acutely.
- Beta blockers like metoprolol are not preferred for wide-complex tachycardia.
Quick Tip: In stable ventricular tachycardia, IV amiodarone is the drug of choice.

**Brugia malayi** can be differentiated from other microfilariae by:
- Presence of a **sheathed body**
- **Two distinct nuclei** at the tail end.


In contrast:
- **Wuchereria bancrofti**: sheathed but tail nuclei are absent.
- **Loa loa**: continuous tail nuclei.
- **Onchocerca volvulus**: unsheathed.
Quick Tip: Brugia malayi: Sheathed + 2 distinct tail nuclei. W. bancrofti: Sheathed, no tail nuclei.

The patient has classic signs of **HELLP syndrome**:
- **H**emolysis (elevated LDH)
- **E**levated **L**iver enzymes (SGOT, SGPT)
- **L**ow **P**latelets


BP elevation suggests preeclampsia.
- **Acute fatty liver of pregnancy** shows hypoglycemia, renal dysfunction.
- **Viral hepatitis** shows very high transaminases.
- **Cholestasis** presents with itching and raised bile acids.
Quick Tip: HELLP = Hemolysis, Elevated Liver enzymes, Low Platelets — seen in preeclampsia spectrum.

**Oligohydramnios** (low amniotic fluid) in the second trimester is often due to **renal agenesis**, where the fetus is unable to produce urine — a major component of amniotic fluid.


Other options:
- **TEF** (Tracheoesophageal fistula) and **cardiac abnormalities** do not significantly affect amniotic fluid volume.
- **Ureteral stricture** may affect postnatal renal flow, not fetal urine production.
Quick Tip: In oligohydramnios, always consider fetal renal anomalies like bilateral renal agenesis as primary causes.

The triad of:
- **Drowsiness**
- **Depressed respiratory rate (10/min)**
- **Absent deep tendon reflexes**
is classic for **magnesium sulfate toxicity**.


High Mg\textsuperscript{2+ levels depress the CNS and reflexes.
Diabetic ketoacidosis would present with Kussmaul breathing and acidotic signs, not loss of reflexes.
Eclampsia causes seizures, not hyporeflexia.
Quick Tip: Always monitor reflexes and respiration when administering MgSO\textsubscript{4}; early signs of toxicity include hyporeflexia.

The image shows a **hymen with a midline vertical band** dividing the vaginal orifice into two small openings — characteristic of a **septate hymen**.


Other types:
- **Imperforate hymen**: no visible opening.
- **Semilunar hymen**: crescent-shaped opening.
- **Annular hymen**: round central opening.
Quick Tip: Septate hymen has two vaginal openings separated by a tissue band — often mistaken for imperforate or annular variants.

Following **vesicovaginal fistula (VVF) repair**, the vaginal and bladder tissues need time to heal.
- **Sexual abstinence for 3 months** allows complete healing and prevents disruption of the repair.
- **Avoiding pregnancy for 1 year** ensures stability of repair and reduces pressure on pelvic organs.
Quick Tip: After VVF repair: 3 months abstinence + 1 year pregnancy avoidance is standard to ensure successful healing.

The image shows a **copper-T intrauterine device (IUD)**.
An **absolute contraindication** to IUD insertion includes:
- **Trophoblastic disease (e.g., molar pregnancy)**, due to high vascularity and risk of perforation and infection.


Other options:
- Menstruation is not a contraindication — sometimes used for insertion.
- Post-delivery insertion is possible in specific settings.
- Ruptured condom is an indication for emergency contraception, not a contraindication.
Quick Tip: Always rule out trophoblastic disease before IUD insertion — it’s a red flag contraindication.

The HSG shows:
- A **single uterine fundus**
- **Divided endometrial cavity**, suggestive of a **septate uterus**.
This results from failure of resorption of the uterine septum.


Other anomalies:
- **Bicornuate uterus** has two horns with some fundal indentation.
- **Uterine didelphys** has two separate uteri and cervices.
- **Unicornuate uterus** has a single horn.
Quick Tip: A single fundus with a divided cavity on HSG = Septate uterus; confirm via MRI or 3D USG.

Preeclampsia results from **incomplete remodeling of spiral arteries**. Normally, **extravillous trophoblasts** invade and transform these arteries into low-resistance vessels. Failure of this invasion leads to:
- **High resistance placental circulation**
- **Placental ischemia**
- **Release of antiangiogenic factors → maternal endothelial dysfunction**
Quick Tip: Failure of spiral artery remodeling by extravillous trophoblasts is the key pathology in preeclampsia.

Uterine artery Doppler at 11–14 weeks is used to detect high resistance flow (notching or increased PI), which is predictive of **early-onset preeclampsia**.

It can also suggest risks of FGR, but the primary screening target is **early PE**.
Quick Tip: Uterine artery Doppler in the first trimester helps predict early onset preeclampsia.

When there is **incomplete placental separation** and **massive bleeding**, the immediate next step is **manual removal of placenta** under anesthesia.

Other methods like oxytocin, Crede's, or uterine massage are ineffective in this situation. Delay can increase hemorrhage and maternal risk.
Quick Tip: In retained placenta with hemorrhage, manual removal is the definitive and immediate step.

**Amniotic fluid embolism (AFE)** is a catastrophic obstetric emergency typically occurring during labor, delivery, or immediately postpartum.
- It leads to sudden **cardiopulmonary collapse**, **severe hypotension**, and **DIC**.
- The classic triad includes **respiratory distress**, **coagulopathy**, and **shock**.


Other causes like **uterine rupture** or **cardiomyopathy** can cause collapse but not DIC to this extent.
Quick Tip: Think of AFE in sudden postpartum collapse with bleeding and signs of DIC.

The findings indicate **arrest of descent** in the **second stage** of labor:
- **Station 0** with **molding and caput** suggests **cephalopelvic disproportion (CPD)**.
- Fetal position is not optimal (occipitotransverse), and labor has been prolonged.
- Vaginal delivery is not safe.


Thus, **LSCS** is the safest and most appropriate intervention.
Quick Tip: In second stage arrest with molding, caput, and malposition — go for cesarean section.

**Active labor** is defined as:
- **Cervical dilatation ≥6 cm** (some guidelines use ≥5 cm)
- **With regular contractions**
- **Complete or progressing effacement**


Other options:
- Fetal head palpability doesn’t confirm labor stage.
- Contractions alone don’t confirm active labor.
- Rupture of membranes can happen before or during labor.
Quick Tip: Active labor is defined by ≥5–6 cm cervical dilatation with strong contractions and effacement.

The image highlights the **midpelvis**, also known as the midplane of the pelvis.
It lies between:
- **Pelvic inlet** (superior) and
- **Pelvic outlet** (inferior).

It is bounded anteriorly by the **lower margin of the pubic symphysis** and posteriorly by the **junction of the 2nd and 3rd sacral vertebrae**.
Quick Tip: Midpelvis is the region between the inlet and outlet, critical for evaluating labor progress.

On the **second postpartum day**, the uterus continues to involute.
- It is typically found **1 finger breadth (about 1 cm)** below the umbilicus.
- It continues to regress by about 1 cm/day postpartum.
Quick Tip: Uterine fundal height decreases by 1 finger breadth per day postpartum.

During pregnancy, energy needs increase:
- **First trimester**: +300 kcal
- **Second trimester**: +340 kcal
- **Third trimester**: +450–500 kcal


However, Indian guidelines often suggest **300 kcal/day additional energy starting from the 1st trimester** for simplicity and safety.
Quick Tip: Start increasing calorie intake from the first trimester itself by about 300 kcal/day.

**Cervical cerclage** is contraindicated in cases of:
- **Active labor**
- **Chorioamnionitis**
- **Vaginal bleeding**
- **Ruptured membranes**


Rupture of membranes increases infection risk and limits cerclage success.
Other options may increase risk but are not absolute contraindications.
Quick Tip: Cervical cerclage should not be done after rupture of membranes — risk of infection and failure is high.

**Right occipito-posterior (ROP)** is a common malposition, but:
- Many cases rotate spontaneously to occipito-anterior during labor.
- With a **gynecoid pelvis**, **adequate contractions**, and **no distress**, **expectant management** is justified.


Thus, allow for **normal vaginal delivery**.
Quick Tip: ROP with good labor progress and gynecoid pelvis can often be delivered vaginally without intervention.

A previous **classical cesarean section** is a contraindication to labor due to the risk of **uterine rupture**.
- Breech presentation further complicates the case.
- Thus, **elective cesarean delivery at 37 weeks** is the safest approach.

External cephalic version (ECV) is contraindicated in women with a classical scar.
Quick Tip: In women with a classical cesarean scar, ECV and labor are avoided — schedule cesarean at 37 weeks.

**Placenta previa** refers to placental implantation over or near the **internal cervical os**, leading to painless **bleeding in the second or third trimester**.


Other options describe ectopic pregnancy sites and do not explain second-trimester vaginal bleeding.
Quick Tip: Profuse painless bleeding in the second trimester? Think placenta previa at internal os.

In early pregnancy with **inconclusive ultrasound** and **β-hCG <1500**, the next step is **repeat β-hCG after 48 hours**.
- Normal intrauterine pregnancy should double β-hCG in 48 hrs.
- If values plateau or drop, suspect ectopic or failing pregnancy.
Quick Tip: For early pregnancy with unclear USG, repeat β-hCG after 48 hrs to assess viability or ectopic risk.

**Mala (combined oral contraceptive pills)** regulate menstrual cycles and reduce menorrhagia.

- In a **non-breastfeeding woman** 18 months postpartum, COCPs are suitable.
- They reduce endometrial proliferation and bleeding.


Other methods:
- **Progestasert** and **Copper-T** may increase bleeding.
- **Depot progestins** can cause irregular bleeding.
Quick Tip: In non-lactating females with heavy bleeding, COCs like Mala help regulate menses and offer contraception.

The histology shows seminiferous tubules lined exclusively with **Sertoli cells**, lacking germ cells — typical of **Sertoli Cell Only Syndrome**.
- It's a common cause of **non-obstructive azoospermia**.
- Testosterone levels are usually normal due to intact Leydig cells.


Other options:
- **Testicular atrophy** shows fibrosis.
- **Orchitis** has inflammation.
- **Neoplasm** would show disorganized cellular proliferation.
Quick Tip: Sertoli Cell Only Syndrome = empty tubules with only Sertoli cells; common in primary infertility.

For **medical abortion** up to 9 weeks of gestation:
- First, **Mifepristone** (anti-progestin) is given to detach the gestational sac.
- Followed by **Misoprostol** (a prostaglandin) to induce uterine contractions and expel contents.


Other combinations (e.g., methotrexate) are less commonly used today.
Quick Tip: Medical abortion = Mifepristone (anti-progesterone) + Misoprostol (uterotonic)

In fetal development, **hCG from the placenta** mimics LH and stimulates **Leydig cells** in the testes to produce **testosterone**, essential for male genital development.


- Maternal LH doesn't cross the placenta.
- Fetal GnRH comes later in development.
Quick Tip: Placental hCG acts like LH and triggers fetal Leydig cells to produce testosterone.

The image shows **white flaky material** on the **anterior lens capsule**, particularly in a target-like distribution — classic for **Pseudoexfoliation syndrome (PXF)**.
PXF is a systemic condition leading to deposition of fibrillary material in the eye, often linked to **secondary open-angle glaucoma**.


Other differentials:
- **Vossius ring** appears as pigment on the lens post-trauma.
- **Intraocular foreign body** is typically visible and irregular.
- **Ocular trauma** can have different presentations.
Quick Tip: PXF shows dandruff-like material on lens; it's a major risk factor for secondary glaucoma.

**Sympathetic ophthalmia** is a **bilateral granulomatous panuveitis** following trauma or surgery to one eye.
- It involves **all layers** of the uveal tract — iris, ciliary body, and choroid.
- Often triggered by **autoimmune response** to ocular antigens.
Quick Tip: Sympathetic ophthalmia = granulomatous panuveitis affecting both eyes after trauma to one.

**Neovascularization at the disc (NVD)** is a hallmark of **proliferative diabetic retinopathy**.
- The treatment of choice is **pan-retinal photocoagulation (PRP)**.
- PRP reduces VEGF levels and causes regression of neovascularization.


Focal/grid laser is used for **macular edema**, not NVD.
**Scleral buckling** is for **retinal detachment**, not diabetic retinopathy.
Quick Tip: NVD in diabetics = Proliferative stage → Treat with pan-retinal photocoagulation.

**Scleromalacia perforans** is a severe ocular manifestation of **rheumatoid arthritis**, especially in women.
- It presents as **painless thinning of the sclera** without significant inflammation.
- The image shows an area of dark uveal tissue shining through the thinned sclera, characteristic of this condition.


Other options:
- **Ciliary staphyloma** involves outward bulging and is inflammatory.
- **Coloboma** is congenital.
- **Melanoma** appears as a dark intraocular mass.
Quick Tip: Scleromalacia perforans = painless scleral thinning in RA; not associated with redness.

The image shows a patient who underwent **corneal collagen cross-linking (C3R)**, a treatment indicated for **Keratoconus** — a progressive thinning and bulging of the cornea.
- It helps in halting the progression of the cone-shaped cornea.


Other conditions like keratoglobus and dystrophies have different management strategies.
Quick Tip: C3R is used to stabilize the cornea in progressive keratoconus — best done early.

The image shows a **cherry red spot at the macula**, a hallmark of **Tay-Sachs disease**.
- It results from **GM2 ganglioside accumulation** due to **hexosaminidase A deficiency**.
- Clinical features include **neurodegeneration, hypotonia, seizures**, and vision loss.


While other storage diseases like **Gaucher’s and Niemann-Pick** may show cherry red spots, Tay-Sachs is the most classic association.
Quick Tip: Cherry red spot + neuroregression + no hepatosplenomegaly = Tay-Sachs disease.

The X-ray shows **multiple radiolucent lesions in the metaphyseal regions of the hand bones**, characteristic of **enchondromas**.
- When these are multiple, the condition is referred to as **Ollier disease**.
- Enchondromas are benign cartilaginous tumors within the medullary cavity.


Other options:
- **Brown tumors** are related to hyperparathyroidism and appear lytic but with different distribution.
- **Fibrous dysplasia** presents with a ground-glass appearance.
- **Exostoses** are bony outgrowths.
Quick Tip: Multiple enchondromas = Ollier disease; appears as multiple lytic lesions in hands/long bones.

The image demonstrates a **knee-spanning external fixator**, often used in:
- **High-energy periarticular fractures** (e.g., distal femur or proximal tibia).
- It stabilizes the joint and allows soft tissue healing before definitive fixation.


Other fixators like Ilizarov are circular and used for bone lengthening or deformity correction.
Quick Tip: Spanning external fixators are used for temporary stabilization in periarticular fractures with soft tissue injury.

**Fat embolism syndrome (FES)** is classically seen after long bone fractures.
- Triad:
- **Respiratory distress**,
- **Neurological symptoms**,
- **Petechial rash** (especially on chest, conjunctiva).
- It typically appears **24–72 hours after injury**.


Air embolism presents with sudden collapse and chest pain, not petechiae.
VTE lacks rash and occurs later.
Quick Tip: Fat embolism = fracture + hypoxia + petechiae within 2–3 days post trauma.

**Osteogenesis imperfecta (OI)** is a genetic disorder characterized by **defective collagen synthesis (Type I collagen)**.
- Leads to **brittle bones**, frequent fractures, and sometimes deformities.
- In severe cases (e.g., Type II OI), fractures can be detected **in utero** on antenatal ultrasound.


Other options like **achondroplasia** cause dwarfism but not in-utero fractures.
Quick Tip: Multiple antenatal fractures = Think Osteogenesis Imperfecta (especially Type II).

The image shows an **untreated lateral condyle fracture** in a child.
- The **most common complication** if left untreated is **cubitus valgus**, an increase in the carrying angle.
- This can later lead to **tardy ulnar nerve palsy**.


Non-union is also a risk but cubitus valgus remains the most characteristic deformity.
Quick Tip: Untreated lateral condyle fracture → Cubitus valgus → Risk of ulnar nerve palsy.

The peripheral smear shows **sickle-shaped RBCs**, suggesting **sickle cell disease**.
- Children with sickle cell disease are **particularly susceptible to Salmonella osteomyelitis**, especially involving long bones.
- This contrasts with **Staph aureus**, which is most common in general pediatric osteomyelitis.
Quick Tip: Osteomyelitis in sickle cell = Suspect Salmonella. Staph is more common in normal children.

This presentation is classic for a **clavicle fracture**, particularly in children.
- The **fall on the shoulder** with supporting of the elbow by the opposite hand is known as the "**cradle sign**".
- Most common site: **middle third of the clavicle**, which is the weakest part.
- The X-ray shows a displaced fracture of the clavicle.
Quick Tip: Fall on shoulder + supported elbow = suspect clavicle fracture, especially in kids.

The image shows a **displaced ankle fracture dislocation**.
- Immediate step is **neurovascular assessment**, followed by **urgent reduction** to restore alignment and prevent soft tissue compromise.
- A **posterior slab** is preferred initially to allow for swelling.
- Definitive fixation is planned later after edema subsides.
Quick Tip: Dislocated fractures: Always assess neurovascular status, reduce, and immobilize with slab early.

The histology shows **white fibrocartilage**, identifiable by:
- **Parallel rows of chondrocytes** within lacunae
- Alternating with **dense bundles of collagen fibers**
- Found in intervertebral discs, pubic symphysis, and menisci.
- Lacks perichondrium unlike hyaline cartilage.
Quick Tip: White fibrocartilage = rowed chondrocytes + dense collagen = shock absorber tissue.

Telomeres are **repetitive nucleotide sequences** at the ends of chromosomes that protect genomic integrity.
- With each cell division, **telomeres shorten**.
- Eventually, critical shortening leads to **cell senescence or apoptosis**, contributing to aging.
- Thus, **decreased telomere length is a hallmark of cellular aging**.
Quick Tip: Shorter telomeres = older cells. Telomerase helps prevent aging by maintaining telomere length.

This clinical scenario is consistent with **trigeminal autonomic cephalalgias**, involving the **trigeminal nerve (CN V)**, particularly **V1 and V2** divisions.
- The image label 3 corresponds to the **trigeminal ganglion/nerve**.
- Symptoms: lacrimation, hemifacial pain, photophobia – all in the sensory territory of CN V.
Quick Tip: Trigeminal nerve (CN V) is key in facial pain, especially in trigeminal neuralgia and cluster headaches.

The image shows **Train-of-Four (TOF)** neuromuscular monitoring.
- The **ulnar nerve** is most commonly used, with observation of **adductor pollicis muscle (thumb movement)**.
- It provides a reliable assessment of **neuromuscular blockade recovery** after surgery.


Other nerves (median, radial) are less preferred due to inconsistent muscle response.
Quick Tip: Ulnar nerve + adductor pollicis = gold standard for neuromuscular monitoring in anesthesia.

**Cystic fibrosis** is caused by mutations in the **CFTR gene** on chromosome 7 and follows an **autosomal recessive** inheritance.
- Both copies of the gene must be mutated for the disease to manifest.
- Other listed options like Huntington’s and achondroplasia are autosomal dominant.
Quick Tip: Autosomal recessive = both alleles mutated. Think CF, thalassemia, sickle cell.

Long-chain fatty acids are transported into the mitochondrial matrix by the **carnitine shuttle**.
- **Carnitine acyltransferase I** and **II** assist in translocation.
- This step is essential for **beta-oxidation**.
Quick Tip: Carnitine = fatty acid transport across mitochondrial membrane for oxidation.

A **nonsense mutation** leads to a **premature stop codon**, halting protein translation.
- This results in a **truncated, non-functional protein**.
- Missense = single amino acid change.
- Silent = no amino acid change.
Quick Tip: Nonsense = STOP the nonsense! Premature stop codon introduced.

**Histones** are positively charged proteins that **bind to negatively charged DNA**, forming nucleosomes.
- This enables **tight packing of DNA** into chromatin.
- Histone H1 helps with higher-order chromatin folding.
Quick Tip: Histone proteins help DNA wrap into nucleosomes → chromatin → chromosomes.

The condition described is **McArdle disease (Glycogen Storage Disease Type V)**.
- It is caused by **myophosphorylase deficiency**, which leads to **impaired glycogen breakdown in muscles**.
- Symptoms: muscle cramps, weakness after exercise, myoglobinuria.
Quick Tip: Myophosphorylase deficiency = McArdle’s → muscle cramps + myoglobinuria post exertion.

**Glutathione reductase** uses **FAD (derived from vitamin B2)** as a coenzyme.
- Its activity in **RBCs** reflects the body's riboflavin (B2) status.
- A decrease in glutathione reductase activity is a diagnostic marker of B2 deficiency.
- Transketolase (TPP-dependent) is used for vitamin B1 assessment.
Quick Tip: Think B2 → FAD → glutathione reductase activity (in RBCs).

The image shows **Bitot’s spots**—foamy patches on the conjunctiva, classic for **vitamin A deficiency**.
- Often associated with **xerophthalmia**, dryness, and risk of **corneal ulceration/blindness**.
- Vitamin A is essential for epithelial health and visual pigment formation.
Quick Tip: Bitot’s spots = Vitamin A deficiency = Night blindness + xerosis + corneal changes.

These features are classic for **Gaucher disease**, a **lysosomal storage disorder**.
- Caused by **glucocerebrosidase deficiency** → accumulation of glucocerebroside in macrophages.
- Bone marrow biopsy: **“crumpled tissue paper”** macrophages (Gaucher cells).
Quick Tip: Gaucher = Glucocerebrosidase ↓ → lipid-laden macrophages = crumpled paper cells.

**Cyanide** inhibits **cytochrome c oxidase (Complex IV)** in the electron transport chain, halting cellular respiration.
- This prevents the final step of electron transfer to oxygen, leading to severe hypoxia and cell death.
- Oligomycin inhibits ATP synthase (Complex V), and ouabain affects Na⁺/K⁺ ATPase, not ETC.
Quick Tip: Cyanide = deadly = inhibits Complex IV → stops ATP production → cellular death.

The condition is **mycetoma**, which presents with **granules and discharging sinuses**.
- Can be caused by **bacteria (actinomycetoma)** or **fungi (eumycetoma)**.
- Involves subcutaneous tissue and often bone, but **not just superficial**.
Quick Tip: Mycetoma = granules + sinus + both fungi and bacteria possible.

**Chromoblastomycosis** is a chronic fungal infection characterized by:
- Verrucous (cauliflower-like) lesions
- **Copper-colored sclerotic bodies** (Medlar bodies or copper penny bodies) on microscopy.
- Common in farmers and rural workers.
Quick Tip: Copper penny bodies = Chromoblastomycosis = chronic verrucous foot lesion.

Nail changes in **psoriasis** include:
- **Irregular pitting**
- **Subungual hyperkeratosis**
- Onycholysis and nail discoloration.
These findings help distinguish psoriasis from alopecia areata and eczema.
Quick Tip: Think psoriasis with nail pitting + hyperkeratosis = nail matrix + nail bed involvement.

Telogen effluvium is a common cause of diffuse hair shedding typically occurring 2–3 months after a triggering event. In this case, the woman had COVID-19 eight months ago, and now, after a lag period, she presents with hair loss lasting for 3 months. The condition is often precipitated by systemic illness, stress, or major life events. The clinical picture and timing strongly suggest telogen effluvium rather than fungal infections, self-inflicted hair pulling, or patterned hair loss.
Quick Tip: Telogen effluvium typically starts 2–3 months after a physical or emotional stressor and presents with diffuse thinning of hair.

In a diabetic patient presenting post-COVID with facial pain and loosening of teeth, mucormycosis should be a high clinical suspicion. Though imaging like MRI helps in assessing the extent, definitive diagnosis requires biopsy with histopathological examination to identify fungal hyphae. It is the gold standard to confirm invasive fungal infections like mucormycosis.
Quick Tip: Always confirm mucormycosis with tissue biopsy; imaging only shows extent, not diagnosis.

The facial nerve (cranial nerve VII) innervates the muscles of facial expression. Its dysfunction can result in inability to close the eyelid, drooping of the mouth corner, and drooling, all of which are seen in lower motor neuron facial nerve palsy. Trigeminal nerve is mainly sensory to face and motor to mastication, oculomotor nerve affects eye movement, and glossopharyngeal controls pharyngeal functions and taste from posterior tongue.
Quick Tip: Involvement of facial muscles including inability to close the eye indicates lower motor neuron facial nerve palsy.

The Heimlich maneuver is the recommended first aid for conscious adults experiencing choking due to airway obstruction by a foreign body. The maneuver involves abdominal thrusts that elevate the diaphragm and generate a rapid increase in intra-thoracic pressure to expel the obstructing object. The image shows the classic technique where the rescuer positions their hands just above the navel and thrusts inward and upward.
Quick Tip: Heimlich maneuver is the first-line response for conscious choking adults to dislodge airway obstruction.

The electrophoresis findings—elevated HbA2 and HbF—are classic for beta thalassemia. HbS spike may be seen in thalassemia-sickle cell disease co-existence (sickle beta-thalassemia). History of recurrent infections, transfusion dependence, splenomegaly, and icterus further support a diagnosis of beta thalassemia major or intermedia.
Quick Tip: Beta thalassemia shows elevated HbA2 and HbF on electrophoresis with clinical features of anemia, transfusions, and splenomegaly.

The image shows a swelling located just below the ear, in the region of the parotid gland. A parotid abscess typically presents as a firm, tender, and slow-growing mass in this location. It may be associated with pain, fever, and sometimes trismus or pus discharge from Stensen’s duct. Other options like Bezold abscess occur deeper and posteriorly, and lymphadenopathy would usually be more superficial and mobile.
Quick Tip: A swelling below the ear that is firm, tender, and localized is often due to a parotid abscess.

Samter's triad consists of asthma, nasal polyps, and aspirin sensitivity. Aspirin and other NSAIDs inhibit cyclooxygenase, leading to increased leukotriene production, which exacerbates respiratory symptoms in these patients. Therefore, aspirin should be strictly avoided in individuals with this triad.
Quick Tip: In Samter’s triad (asthma, nasal polyps, aspirin sensitivity), aspirin should be avoided to prevent bronchospasm.

Warburg metabolism refers to the preference of cancer cells to undergo aerobic glycolysis rather than oxidative phosphorylation. Although less efficient in ATP generation, this pathway rapidly provides essential intermediates for nucleotide, amino acid, and lipid synthesis necessary for cell proliferation.
Quick Tip: Cancer cells use aerobic glycolysis (Warburg effect) to support rapid cell growth by producing biosynthetic precursors.

High-frequency sounds are detected near the base of the cochlea, where the basilar membrane is narrow and stiff—close to the oval window. In contrast, low-frequency sounds are detected at the apex, near the helicotrema. Hence, a lesion affecting high-frequency hearing implicates structures near the oval window.
Quick Tip: High-frequency hearing loss involves the base of the cochlea near the oval window.

Nasopharyngeal angiofibroma is a benign but highly vascular tumor, typically seen in adolescent and young adult males. It presents with recurrent epistaxis and nasal obstruction. Imaging and endoscopy reveal a reddish, vascular mass in the nasopharynx extending from the posterior choana.
Quick Tip: In young males with recurrent epistaxis and nasal mass, suspect nasopharyngeal angiofibroma.

The peripheral smear shows numerous spherocytes, which are typical of hereditary spherocytosis. This condition involves extravascular hemolysis, leading to anemia, hemoglobinuria, elevated LDH, and splenomegaly. The spleen removes spherocytes from circulation, causing its enlargement.
Quick Tip: Spherocytosis is associated with splenomegaly due to increased RBC destruction in the spleen.

Neutrophil extracellular traps (NETs) are composed of nuclear chromatin and antibacterial proteins expelled by neutrophils in response to pathogens like bacteria. They are detectable during sepsis and serve as an immune defense. However, mitochondrial DNA is not typically involved—it's nuclear DNA that constitutes NETs.
Quick Tip: NETs are formed from nuclear chromatin, not mitochondrial DNA, and trap pathogens in sepsis.

The wound in the image shows features of a near-contact or close-range firearm injury, with signs like a central punched-out wound and surrounding abrasion collar. These features are consistent with a pistol fired at near range. Shotguns generally produce a more dispersed wound pattern with multiple pellet entries.
Quick Tip: Pistol wounds at near range have central penetration with abrasion collar due to bullet impact and gas effects.

Malakoplakia is a rare inflammatory condition of the bladder characterized by yellow-white plaques on cystoscopy. Histologically, it shows large macrophages (von Hansemann cells) with basophilic inclusions called Michaelis-Gutmann bodies. These inclusions are diagnostic and represent partially digested bacteria within lysosomes.
Quick Tip: Look for Michaelis-Gutmann bodies in bladder biopsies with yellow-white plaques to confirm malakoplakia.

Defense wounds are seen on the palms and forearms when a person tries to ward off an attack, especially in assault cases. The image shows injuries on the palmar surfaces of the hands, consistent with active defensive attempts to block a weapon, typically seen in homicides.
Quick Tip: Defense wounds commonly occur on hands and forearms as a victim tries to protect themselves from a weapon.

Caloric restriction, especially a 30% reduction, has been consistently shown in animal studies to increase lifespan. It reduces metabolic rate, oxidative stress, and inflammatory responses, thereby delaying the onset of age-related diseases. While exercise and stress management are beneficial, caloric restriction has the strongest direct evidence for lifespan extension.
Quick Tip: Among various interventions, calorie restriction shows the most consistent evidence for lifespan extension in studies.

Informed consent is a process by which a patient voluntarily confirms their willingness to undergo a particular medical intervention, after being informed of all the risks, benefits, and alternatives. It is a legal and ethical obligation in medical practice, especially for procedures like surgery.
Quick Tip: Informed consent involves explaining risks and benefits and getting voluntary agreement from the patient.

In severe COVID-19 infections, the lungs often show diffuse alveolar damage with both acute and chronic alveolar hemorrhage. These findings reflect the widespread inflammation and vascular injury characteristic of COVID-19 pathology in critically ill patients.
Quick Tip: COVID-19-related lung pathology often includes alveolar hemorrhage and diffuse damage due to cytokine storm and vascular leakage.

Ligature strangulation typically presents with a horizontal ligature mark completely encircling the neck, usually found below the thyroid cartilage. The absence of dribbling of saliva also favors strangulation over hanging, where dribbling is commonly seen.
Quick Tip: Horizontal ligature mark and no dribbling of saliva suggest ligature strangulation over hanging.

Performing surgery under the influence of alcohol is a clear breach of duty with disregard for patient safety, constituting criminal negligence. This act shows gross deviation from the standard of care expected from a medical professional.
Quick Tip: Negligence with recklessness or intoxication during duty qualifies as criminal negligence in court.

Leading questions—those that suggest the answer—are generally not permitted during direct examination or re-examination. However, they are allowed during cross-examination, as the witness is presumed to be hostile or at least aligned with the opposing side.
Quick Tip: Leading questions are allowed during cross-examination but not during direct or re-examination.

The peripheral smear shows microcytic hypochromic anemia. The low MCV (60 fL), combined with a history of piles (which can cause chronic blood loss), strongly points toward iron deficiency anemia. The most appropriate next step is to measure serum ferritin, the most sensitive marker for iron stores.
Quick Tip: In suspected iron deficiency anemia, serum ferritin is the best test to confirm low iron stores.

The presentation and smear findings are classic for chronic myeloid leukemia (CML). The hallmark of CML is the Philadelphia chromosome, which results from a t(9;22) translocation creating the BCR-ABL fusion gene. This gene leads to unregulated tyrosine kinase activity and excessive proliferation of granulocytic cells.
Quick Tip: CML is strongly associated with the t(9;22) Philadelphia chromosome and responds to tyrosine kinase inhibitors.

This is a case of diabetic ketoacidosis (DKA). Management involves rapid fluid resuscitation along with insulin therapy. Regular insulin is the insulin of choice as it is short-acting and can be titrated based on glucose and ketone levels. Long-acting insulin is not used for acute correction.
Quick Tip: In DKA, initial management includes IV fluids and IV regular insulin to correct dehydration and acidosis.

The most accurate indicator of HAART efficacy is the patient's viral load. It reflects the amount of active viral replication. Effective therapy leads to a rapid decline in viral load. CD4 count is used to assess immune status, but viral load directly reflects response to treatment.
Quick Tip: Monitoring HIV treatment efficacy is best done with serial measurements of viral load.

The chest X-ray likely shows pulmonary edema, a common complication of uncontrolled hypertension and heart failure. Nitro-glycerine, a vasodilator, helps to reduce preload and afterload, improving the patient's condition by decreasing the workload on the heart and promoting fluid redistribution.
Quick Tip: In hypertensive patients with pulmonary edema, intravenous nitro-glycerine is used to reduce preload and afterload.

In a neonate, failure to pass urine in the first 24 hours of life is usually a sign of dehydration or a urinary tract obstruction. First-line management should include ensuring adequate breast feeding. If this does not resolve the issue, further investigations, such as ultrasound or other imaging, may be necessary.
Quick Tip: If a neonate hasn't urinated in the first 24 hours, ensure adequate breast feeding before further investigations.

Wide QRS complexes and right axis deviation are indicative of drug toxicity, likely from tricyclic antidepressants (TCAs). Sodium bicarbonate is used in TCA overdose because it helps to stabilize the cardiac membranes, reverse the sodium channel blockade, and correct acidosis.
Quick Tip: In TCA overdose, intravenous sodium bicarbonate is the treatment of choice to prevent arrhythmias.

The CT scan shows consolidation with air bronchograms, which is characteristic of pneumonia. Air bronchograms occur when the alveoli become consolidated with fluid or exudate, while the airways remain filled with air, making the bronchi visible on imaging.
Quick Tip: Air bronchogram sign is typical of consolidation in pneumonia, where the airways remain patent while the alveoli fill with exudate.

The child has developed tumor lysis syndrome (TLS), which is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia due to the rapid breakdown of tumor cells. The first step in management of TLS is adequate hydration to prevent acute kidney injury by flushing out the excess metabolites.
Quick Tip: In cases of tumor lysis syndrome, hydration is critical to prevent renal damage and help in the excretion of uric acid.

The barium enema image shows a "coiled spring" appearance, which is characteristic of intussusception. This occurs when a part of the intestine telescopes into an adjacent part, leading to obstruction and ischemia. It is a common cause of abdominal pain and vomiting in infants and requires prompt intervention.
Quick Tip: Intussusception is a pediatric emergency. The barium enema can sometimes be both diagnostic and therapeutic.

Bromocriptine is a dopamine agonist that reduces the secretion of prolactin from the pituitary gland. It is used in the treatment of prolactinomas, which are pituitary tumors that secrete prolactin, leading to galactorrhea.
Quick Tip: Dopamine agonists like bromocriptine are the first-line treatment for prolactinomas, as they reduce prolactin levels and shrink the tumor.

Lupus nephritis is a common complication of systemic lupus erythematosus (SLE), which is associated with fever, arthralgia, ulcers, fatigue, and renal involvement. The presence of RBC casts and proteinuria on urine examination supports the diagnosis.
Quick Tip: Lupus nephritis can present with a variety of symptoms, including systemic manifestations and renal findings such as RBC casts and proteinuria.

Flat T waves and prominent U waves on ECG are characteristic findings of hypokalemia, which is a common side effect of diuretic therapy. Hypokalemia can lead to muscle weakness and ECG changes.
Quick Tip: ECG changes like flat T waves and prominent U waves are key indicators of hypokalemia. Diuretics are a common cause of this electrolyte imbalance.

The patient presents with a low pH (7.2), high pCO2 (81 mmHg), and a normal bicarbonate level (40meq/L). These findings are consistent with respiratory acidosis, where the body retains CO2 due to impaired ventilation, leading to an acidic environment.
Quick Tip: In respiratory acidosis, pCO2 is elevated due to impaired lung function or hypoventilation, leading to a compensatory increase in bicarbonate over time.

MDR-TB is resistant to at least isoniazid and rifampicin, which are the two most powerful first-line drugs used to treat tuberculosis. Resistance to fluoroquinolones and kanamycin may be present in extensively drug-resistant (XDR) tuberculosis but not necessarily in MDR-TB.
Quick Tip: MDR-TB is defined by resistance to the two most critical first-line drugs: isoniazid and rifampicin. Treatment often requires second-line drugs.

The serology results showing positive HBsAg and anti-HBc (IgM) indicate acute hepatitis B infection. The negative anti-HBs and anti-HCV antibodies further support this diagnosis.
Quick Tip: In acute hepatitis B, IgM antibodies to the core antigen (Anti-HBc IgM) are positive, and HBsAg remains positive.

Deferoxamine is used in the treatment of iron poisoning, as it chelates iron and enhances its excretion. This is the most effective treatment for acute iron toxicity.
Quick Tip: For iron overdose, deferoxamine is the antidote. Activated charcoal is not effective in iron poisoning.

The 17D strain of the yellow fever vaccine is highly effective in preventing yellow fever, which is the likely cause of the patient’s symptoms, as indicated by the presence of Torres bodies in the liver.
Quick Tip: Yellow fever can be prevented by the 17D strain of the yellow fever vaccine, which is highly effective.

Rickettsia prowazekii is the causative organism of epidemic typhus, which presents with a rash sparing the palms and soles and is often associated with lice.
Quick Tip: Rickettsia prowazekii causes epidemic typhus and is transmitted by lice. The rash typically spares the palms and soles.

Trichophyton rubrum is a common dermatophyte that produces red pigment and is known for causing dermatophytosis, such as tinea corporis and tinea cruris. The presence of pencil-shaped macroconidia is a distinguishing feature.
Quick Tip: Trichophyton rubrum is a common cause of dermatophyte infections and produces characteristic red pigments and pencil-shaped macroconidia.

CHRO Magar is a selective medium used for the isolation of Candida species, particularly Candida albicans, which is a common cause of vaginal infections presenting as thick white secretions.
Quick Tip: CHRO Magar is specific for Candida species and can help identify the causative agent in cases of vaginal discharge.

Leptospirosis is characterized by fever, hepatomegaly, conjunctival suffusion, and jaundice (icterus). It is often associated with exposure to contaminated water. The other options do not present with the same constellation of symptoms.
Quick Tip: Leptospirosis presents with hepatomegaly, fever, and conjunctival suffusion, particularly in individuals exposed to contaminated water sources.

The causative agent of cholera, Vibrio cholerae, acts on the GM 1 ganglioside receptor in the intestine. This interaction leads to the characteristic rice water stools.
Quick Tip: Cholera toxin binds to GM 1 ganglioside receptors in the small intestine, leading to severe diarrhea and rice water stools.

The best method for detecting Clostridium difficile is a combination of glutamate dehydrogenase and toxin assays. The glutamate dehydrogenase assay detects the enzyme produced by C. difficile, and the toxin assay detects the presence of toxins A and B produced by the bacteria.
Quick Tip: For accurate detection of C. difficile, a combination of glutamate dehydrogenase and toxin assays is recommended for higher sensitivity.

Mucor species are characterized by broad, non-septate hyphae with dichotomous branching. This is a common finding in mucormycosis, which can cause pneumonia in immunocompromised patients, especially diabetics.
Quick Tip: Mucormycosis is often seen in diabetic patients and presents with typical histopathological features of dichotomous branching of hyphae.

Clostridium difficile infection is toxin-mediated, and the diagnosis is typically confirmed by detecting the toxins in stool, not by an IgM assay. Fidaxomicin is the drug of choice for treatment.
Quick Tip: For C. difficile infection, stool toxin assays (not IgM assays) are used for confirmation. Oral fidaxomicin is effective for treatment.

A high thyroid-stimulating hormone (TSH) level in a newborn is indicative of congenital hypothyroidism. The next best investigation is radiotracer uptake with technetium to assess thyroid function and morphology.
Quick Tip: In congenital hypothyroidism, a technetium scan helps evaluate the structure and function of the thyroid gland.

This infant most likely has infantile spasms, also known as West syndrome. The drug of choice for this condition is adrenocorticotropic hormone (ACTH), which is effective in controlling seizures and improving developmental outcomes.
Quick Tip: ACTH is the first-line treatment for infantile spasms with hypsarrhythmia on EEG.

For infants born to HIV-positive mothers, HIV DNA PCR is the most reliable test to confirm HIV infection in the infant. A positive result would require further management and monitoring.
Quick Tip: HIV DNA PCR is the gold standard for diagnosing HIV in infants born to HIV-positive mothers.

This image suggests Duchenne muscular dystrophy, which is a type of muscular dystrophy. This condition often presents in early childhood, with difficulty walking and muscle weakness. Typically, death occurs in the 3rd decade due to respiratory and cardiac complications.
Quick Tip: Duchenne muscular dystrophy is characterized by progressive muscle weakness, with early death due to respiratory failure or heart failure.

The sensory nerves, particularly the A fibers, are more susceptible to compression or pressure. This leads to symptoms like paresis (weakness) but not numbness, as pressure affects the motor fibers more than sensory fibers in this case.
Quick Tip: Pressure on the nerves, particularly A fibers, can cause motor dysfunction (paresis), but not sensory loss (numbness).

The baroreceptor reflex is a classic example of negative feedback, where an increase in blood pressure leads to a compensatory decrease in heart rate to lower the pressure back to normal levels.
Quick Tip: The baroreceptor reflex operates via negative feedback to maintain stable blood pressure by adjusting heart rate and vessel tone.

The image shows signaling between neighboring cells, which is characteristic of paracrine signaling. This type of signaling occurs over short distances, where the signaling molecules affect nearby target cells.
Quick Tip: Paracrine signaling involves the release of signaling molecules that affect nearby cells, unlike endocrine signaling, which affects distant cells through the bloodstream.

The cystometrogram demonstrates pressure changes during bladder filling. Segment I(b) corresponds to the effect of Laplace's law, which describes the relationship between pressure and volume in the bladder.
Quick Tip: Laplace’s law is important in understanding the mechanics of bladder pressure during filling. It affects the bladder wall tension and pressure.

In stage A, when the hypothalamic setpoint is raised (point C), the body responds with vasodilation and increased blood flow to the skin to dissipate heat. This is a compensatory mechanism to bring the body temperature back to normal.
Quick Tip: Increased blood flow to the skin is part of the body’s response to cooling mechanisms when the hypothalamic thermostat is reset.

Involuntary, violent, and flinging movements are characteristic of hemiballismus, which is usually caused by a lesion in the subthalamic nuclei. This results in the loss of the inhibitory input to the motor cortex, causing uncontrollable movements.
Quick Tip: Hemiballismus, caused by a lesion in the subthalamic nuclei, presents with violent, flinging movements on one side of the body.

Bulimia nervosa is characterized by episodes of binge eating followed by inappropriate compensatory behaviors, such as self-induced vomiting. This pattern is typical of bulimia nervosa rather than anorexia nervosa or other eating disorders.
Quick Tip: Bulimia nervosa involves binge eating followed by compensatory behaviors such as vomiting or excessive exercise.

Postpartum blues are common and often present within the first week postpartum, characterized by mood swings, tearfulness, and mild insomnia. It typically resolves within 2 weeks.
Quick Tip: Postpartum blues are common and usually self-limited, resolving within a few days to weeks.

The image provided shows a PET CT scan, which combines positron emission tomography (PET) with computed tomography (CT) to provide functional and anatomical imaging. This modality is commonly used in oncology and cardiology.
Quick Tip: PET CT is used for functional imaging in addition to providing detailed anatomical information.

The patient likely has a traumatic pneumothorax, indicated by the X-ray and clinical presentation of tachypnea and hypotension. Chest tube insertion is the next step to relieve the pressure and allow lung expansion.
Quick Tip: Chest tube insertion is the treatment of choice for traumatic pneumothorax to relieve pressure and re-expand the lung.

The child is showing signs of severe dehydration, such as drowsiness, inability to feed, and delayed skin turgor. Severe dehydration requires immediate management to prevent shock and organ failure.
Quick Tip: Severe dehydration is characterized by lethargy, inability to feed, and delayed skin turgor, requiring prompt rehydration.

Vesicoureteric reflux is a condition where urine flows backward from the bladder into the ureters and kidneys, which can cause recurrent urinary tract infections. The image shows the classic radiologic findings of this condition.
Quick Tip: Vesicoureteric reflux is associated with recurrent urinary tract infections and requires early diagnosis to prevent kidney damage.

Post-thyroidectomy, perioral numbness may indicate hypocalcemia, which can result from inadvertent removal or damage to the parathyroid glands. Checking calcium, phosphate, and parathormone levels is the best next step.
Quick Tip: Hypocalcemia is a common complication after thyroid surgery due to parathyroid gland injury. Monitoring calcium and parathormone levels is crucial.

Children considered at risk for low birth weight are those who have poor nutritional support (e.g., babies on artificial feeds) or come from socially disadvantaged environments (e.g., babies of working or single parents).
Quick Tip: Low birth weight is a result of inadequate growth during pregnancy, often linked to poor nutrition or maternal health.

Thromboelastography is a technique used to assess the coagulation status of a patient. It is particularly useful in monitoring blood clotting during surgery, such as in trauma cases where liver injury is treated with primary repair.
Quick Tip: Thromboelastography provides real-time assessment of coagulation and is used in trauma surgery for effective management of bleeding.

Bladder exstrophy is a congenital anomaly where the bladder is located outside the body. The image shows a characteristic presentation of the condition with an exposed bladder.
Quick Tip: Bladder exstrophy requires early surgical intervention to close the bladder and prevent further complications.

The peau d'orange appearance, seen in the image, is caused by infiltration of the subdermal lymphatics, a feature seen in breast cancer when the tumor obstructs lymphatic drainage.
Quick Tip: Peau d'orange is a clinical sign often associated with advanced breast cancer, caused by lymphatic obstruction.

Unilateral hyperinflation in a child with acute onset dyspnea suggests a foreign body aspiration, which causes the ball-and-valve mechanism leading to air trapping in the affected lung.
Quick Tip: Ball and valve mechanism in foreign body aspiration leads to hyperinflation, which can be identified on a chest X-ray.

Given the history of stab injury and the image showing possible peritoneal injury or organ involvement, the next step would be emergency laparotomy to assess for internal injuries, even if the child is stable. Observation is only for minor or superficial wounds.
Quick Tip: Always consider the risk of internal injury in stab wounds, especially in the abdominal region, and err on the side of caution with laparotomy.

The child is likely suffering from Henoch-Schönlein purpura (HSP), which is associated with purpura, abdominal pain, and arthralgia. The treatment typically involves glucocorticoids to reduce inflammation.
Quick Tip: HSP is a vasculitis that often resolves with glucocorticoid therapy, though supportive care may be required for kidney involvement.

Rupture of a saccular aneurysm most commonly causes subarachnoid hemorrhage, which is seen on CT or MRI scans. This type of hemorrhage occurs when blood from the ruptured aneurysm enters the subarachnoid space.
Quick Tip: Saccular aneurysms, also known as berry aneurysms, are a major cause of subarachnoid hemorrhage, particularly in older adults.

Ultrasound doppler is commonly used for the assessment of arterial blood flow, especially in cases of sudden-onset leg pain which could be due to a vascular event like deep vein thrombosis or arterial occlusion.
Quick Tip: Ultrasound doppler is a non-invasive, first-line diagnostic tool for evaluating peripheral vascular conditions.

Minimal change disease is characterized by effacement of podocytes on light microscopy. It is most common in children and has an excellent response to corticosteroids.
Quick Tip: Minimal change disease is the most common cause of nephrotic syndrome in children and responds very well to steroid therapy.

Basal cell carcinoma is a common skin cancer that typically presents as a small, raised nodule, often on the face. It is known for slow growth and a low risk of metastasis. The image suggests basal cell carcinoma due to its characteristic appearance.
Quick Tip: Basal cell carcinoma is the most common skin cancer, commonly appearing on sun-exposed areas such as the face.

The positive test for HLA-DQ2 and symptoms such as diarrhea and weight loss suggest celiac disease, which is managed with a strict gluten-free diet. This helps reduce inflammation and prevents further damage to the intestine.
Quick Tip: A gluten-free diet is essential in managing celiac disease and preventing complications.

Sialolithiasis refers to the formation of stones in the salivary glands, leading to pain, especially when eating, as salivary flow increases. The ultrasound image shows a stone in the gland.
Quick Tip: Sialolithiasis can be managed with massage or surgical removal of the stone.

The image shows delayed filling of the renal pelvis and calyces, which is indicative of pelviureteric junction (PUJ) obstruction. This condition leads to hydronephrosis and requires surgical intervention.
Quick Tip: Pelviureteric junction obstruction is the most common cause of hydronephrosis in children and may require surgical correction.

The most common site of injury in trauma involving the urethra is the membranous urethra, especially in pelvic fractures. Blood at the meatus often indicates urethral injury.
Quick Tip: In cases of urethral injury, avoid catheter insertion and perform retrograde urethrogram to assess the injury.

Theophylline works by inhibiting the adenosine A1 receptor, which leads to bronchodilation and increased urine output due to its diuretic effect.
Quick Tip: Theophylline can increase urine output by blocking the adenosine A1 receptor, commonly seen in COPD management.

FNAC can be diagnostic in cases of thyroid cancer and other lesions. The condition described seems to be a thyroid cancer or related condition. Nuclear characteristics are crucial for identification.
Quick Tip: FNAC is usually diagnostic for thyroid cancer; however, some cases may require further diagnostic imaging.

Metformin is not associated with pulmonary fibrosis, while methotrexate, bleomycin, and nitrofurantoin are known to cause pulmonary toxicity.
Quick Tip: Methotrexate, bleomycin, and nitrofurantoin are known to cause pulmonary fibrosis as side effects.

The ultrasound findings in combination with the family history of hypertension and early death suggest autosomal dominant polycystic kidney disease (ADPKD), which commonly presents with hematuria and kidney pain.
Quick Tip: ADPKD is a genetic disorder that presents with multiple cysts in the kidneys. It commonly leads to hypertension and kidney failure in adulthood.

The patient's presentation with acute abdominal pain and the chest X-ray indicating free air suggests a perforated viscus. The next step in management is to stabilize the patient (resuscitation) and perform a laparotomy to manage the perforation.
Quick Tip: A perforated abdominal viscus is a surgical emergency. Immediate resuscitation and laparotomy are required for stabilization and management.

The given finding (skin necrosis) is a known side effect of warfarin. This condition is called warfarin-induced skin necrosis and occurs due to the protein C and S deficiency induced by warfarin.
Quick Tip: Warfarin-induced skin necrosis is a rare but serious complication, particularly in the first few days of treatment. If suspected, discontinue warfarin immediately and initiate alternative anticoagulation.

Using the modified rule of nines for children, the body surface area involved is calculated. For preschool children, burns affecting the chest, back, and upper limbs typically represent 25-30% of the total body surface area (TBSA).
Quick Tip: Remember that the rule of nines is adjusted in children. The head and neck account for a larger proportion of TBSA in children compared to adults.

Metoclopramide is a dopamine antagonist that can cause extrapyramidal symptoms, such as acute dystonia, bradykinesia, and tremors, especially when given at high doses. This is known as drug-induced parkinsonism.
Quick Tip: Metoclopramide is commonly used for nausea and vomiting but can cause neurological side effects like dystonia and parkinsonism due to its dopamine antagonism.

The weight loss medication in question is likely orlistat, which inhibits the absorption of fat-soluble vitamins, including vitamin K. A deficiency in vitamin K can lead to easy bruising and increased menstrual bleeding due to impaired blood clotting.
Quick Tip: Orlistat inhibits fat absorption, which can interfere with the absorption of fat-soluble vitamins, leading to deficiencies such as vitamin K, which is important for blood clotting.

Leukoplakia is characterized by thickened white patches in the oral cavity. It is commonly associated with chronic irritation from alcohol or tobacco use. The presence of ulcers and a burning sensation is also suggestive of this condition.
Quick Tip: Leukoplakia is considered a precancerous condition and should be monitored for any malignant changes.

The drug in question is likely a fluoroquinolone, which inhibits DNA gyrase, an enzyme critical for bacterial DNA replication. This can lead to tendon rupture and arthropathy, especially in older adults.
Quick Tip: Fluoroquinolones are known to cause tendonitis and tendon rupture, particularly in the Achilles tendon.

A pulsatile mass, especially in the abdominal or groin area, is suggestive of an aneurysm or vascular abnormality. Ultrasound Doppler is typically the first-line imaging modality to assess the blood flow and vascular involvement in such cases.
Quick Tip: Doppler ultrasound helps to assess blood flow in real-time and is ideal for detecting vascular issues such as aneurysms.

The patient has digoxin toxicity, which is confirmed by the 3rd-degree heart block. The next step is the administration of digoxin-specific antibodies (ovine-derived Digoxin immune fab) to reverse the effects of digoxin.
Quick Tip: Digoxin toxicity can cause arrhythmias, including heart blocks. Digoxin-specific antibodies are used to treat severe toxicity.

Epinephrine causes a shift of potassium into the cells by stimulating the \(\beta_2\) adrenergic receptors, which activates the Na+/K+ ATPase pump. This helps to reduce the elevated potassium levels in the blood.
Quick Tip: Epinephrine administration can be used in hyperkalemia to shift potassium back into cells, especially in life-threatening conditions like cardiac arrhythmias.

Octreotide is a somatostatin analog that inhibits the release of growth hormone. It is the first-line treatment in patients with acromegaly who cannot be treated adequately by surgery alone.
Quick Tip: Octreotide helps control growth hormone secretion in cases of acromegaly, especially when surgery is not completely effective.

Pegvisomant is a growth hormone receptor antagonist used to treat acromegaly by blocking the action of growth hormone. It helps alleviate symptoms like excessive sweating and enlargement of hands and feet.
Quick Tip: Pegvisomant is used in patients with acromegaly who have not responded to surgery or other treatments. It directly blocks the growth hormone receptor.

Prostate cancer commonly spreads to the bones, especially the lumbar vertebrae, via the prostatic venous plexus, which communicates with the vertebral venous system.
Quick Tip: The prostatic venous plexus allows direct spread of cancer to the vertebral column, which is a common site for metastatic prostate cancer.

The presence of broad-based aseptate hyphae with branching at right angles is characteristic of mucormycosis, which is a life-threatening fungal infection. Amphotericin B is the drug of choice for mucormycosis.
Quick Tip: Mucormycosis is an aggressive fungal infection that requires immediate antifungal treatment with Amphotericin B.

The image and clinical presentation are indicative of a vascular pathology at the aortoiliac bifurcation level. This is because bilateral resting pain and impotence in the presence of vascular changes are characteristic of such blockages. The aortoiliac bifurcation is where the major arteries that supply the lower limbs split, and occlusion here can lead to the symptoms presented.
Quick Tip: For patients with lower limb ischemia, identifying the level of occlusion is key in guiding treatment, especially in cases of impotence and resting pain.

Patients on anti-tubercular treatment, especially those with alcohol consumption, are at risk for vitamin B6 deficiency. Vitamin B6 is important for nerve function, and deficiency can lead to peripheral neuropathy, which is commonly seen in this patient with tingling sensations and paresthesia. This vitamin is often depleted in patients undergoing long-term anti-tubercular therapy, necessitating supplementation.
Quick Tip: Vitamin B6 supplementation is essential for patients on anti-tubercular treatment, especially if they consume alcohol or have signs of neuropathy.

The image clearly shows signs of necrotizing fasciitis, a hallmark of Fournier's gangrene. This life-threatening condition involves rapid tissue necrosis in the genital and perineal regions, often accompanied by severe pain, swelling, and discharge, as observed in the patient. It requires urgent surgical intervention and broad-spectrum antibiotics.
Quick Tip: Fournier's gangrene presents with sudden, severe pain and swelling in the scrotal region. Early recognition and treatment are crucial for survival.

Botulinum toxin works by inhibiting the release of acetylcholine at the neuromuscular junction, which prevents muscle contraction. This is why it is used in the treatment of wrinkles, as it paralyzes the muscles temporarily, reducing the appearance of wrinkles.
Quick Tip: Botox works by blocking the acetylcholine release, leading to temporary muscle paralysis, which helps in treating wrinkles.

Ringer lactate is a commonly used intravenous fluid that has a composition similar to plasma and includes electrolytes like sodium, chloride, potassium, calcium, and lactate. The fluid described matches the composition of Ringer lactate, which is used to replace fluids and electrolytes in patients.
Quick Tip: Ringer lactate is often used for fluid resuscitation and electrolyte balance during surgeries or trauma.

Evolocumab is a monoclonal antibody that inhibits PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9), which leads to increased LDL receptor activity and reduced levels of LDL cholesterol in the blood. It is used to treat hypercholesterolemia.
Quick Tip: PCSK9 inhibitors like evolocumab are used to lower LDL cholesterol and prevent cardiovascular events.

Stage 4 pressure sores involve full-thickness tissue loss with exposed bone, tendon, or muscle, as seen in the image. These sores are the most severe and require aggressive treatment, including possible surgical intervention.
Quick Tip: Stage 4 pressure sores are the most severe and require immediate attention to prevent further tissue damage and complications.

Selegiline is a selective MAO-B inhibitor used in the treatment of Parkinson’s disease. It helps to increase the levels of dopamine in the brain, thereby managing symptoms such as rigidity, tremors, and facial expression changes.
Quick Tip: Selegiline is often used to treat symptoms of Parkinson’s disease by inhibiting the breakdown of dopamine.

The subhepatic space is the most common location for an intraperitoneal abscess. This area is often involved in cases of appendicitis or post-surgical infections, and fluid accumulation in this region can lead to abscess formation.
Quick Tip: Subhepatic abscesses are commonly seen in post-operative patients or those with intra-abdominal infections.

Fistula in ano is a chronic infection of the anal gland that results in a recurrent discharge of pus, and the condition often causes pain around the anus. This is a typical presentation seen in individuals with a long-standing history of these symptoms.
Quick Tip: Fistula in ano requires surgical treatment, and recurrent discharge is a common clinical sign.

In triage, green category refers to ambulatory patients who can walk and are not in immediate danger. These patients are not critically ill or injured and can wait for further evaluation or treatment.
Quick Tip: Green patients are typically non-urgent and can be treated after more critical cases.

QALY (Quality-Adjusted Life Year) is calculated by multiplying the additional years of life gained by the utility value. Since the life expectancy increased by 15 years with a utility value of 0.8, QALY can be calculated by multiplying 15 years by 0.8.
Quick Tip: QALY takes into account both the quantity and quality of life. It's commonly used to evaluate the value of medical interventions.

A key part of disaster preparedness is to conduct drills and simulations to assess the response of staff and systems. This ensures that the team is well-prepared to handle a real disaster scenario effectively.
Quick Tip: Simulating disaster scenarios helps test readiness and ensures the team can respond quickly and efficiently.

The most effective and cost-efficient approach to controlling rabies is through mass vaccination and controlling the stray dog population. This prevents the spread of the virus and reduces future risks.
Quick Tip: Vaccination of dogs, combined with controlling the stray dog population, is the most effective way to prevent the spread of rabies.

The STEP approach of the World Health Organization focuses on assessing the behavioral, psychological, and physical aspects of health. Therapeutic assessment, however, is not part of this approach.
Quick Tip: The STEP approach of WHO is designed for comprehensive health assessment but does not include therapeutic evaluations.

A negative sputum examination after the completion of the full tuberculosis treatment regimen indicates that the patient is cured. Regular follow-up and sputum testing ensure that the treatment has been effective.
Quick Tip: A negative sputum test after completing the full course of tuberculosis treatment generally indicates a cure.

A risk ratio (RR) of less than 1 (in this case 0.84) indicates a protective effect. Therefore, the cohort study suggests that green tea reduces the risk of developing diabetes.
Quick Tip: A risk ratio below 1 suggests that the exposure (in this case, drinking green tea) reduces the risk of the outcome (diabetes).

To start an urban community health center, it is necessary to have a 100-bed facility in metro cities as per the guidelines for establishing a community health center to cater to a larger population and meet healthcare demands.
Quick Tip: A 100-bed facility is required for urban community health centers in metro cities to manage healthcare needs effectively.

In biomedical waste management, broken vaccine vials are disposed of in puncture-proof blue bins to ensure safety and avoid contamination. This is part of the standard practice for handling infectious waste in healthcare settings.
Quick Tip: Puncture-proof blue bins are used to safely dispose of broken vaccine vials and other sharps in healthcare facilities.

Under the Janani Suraksha Yojana, the mother is provided with 1000 rupees and 400 rupees for the ASHA worker who helps motivate the mother for institutional delivery. This is part of the scheme to promote safe delivery in rural and urban areas.
Quick Tip: Janani Suraksha Yojana incentivizes both the mother and the ASHA worker for institutional deliveries to improve maternal health.

UNICEF is known for its involvement in applied nutrition programs in schools, where it provides seed and manure as part of promoting better nutrition and health among children. UNICEF supports many nutrition initiatives globally.
Quick Tip: UNICEF is a key player in promoting nutrition and health in schools, including providing essential resources like seeds and manure.

In a case-control study, the control group is typically made up of individuals who are similar to the case group (e.g., from the same area) but who do not have the disease. In this case, children who were exposed to the suspected environmental factor (cytotoxic waste) but do not have ALL would be used as controls.
Quick Tip: In case-control studies, controls should be selected from the same population as the cases but without the disease under study.

The facial nerve is the most commonly involved nerve in conditions affecting the face, such as Bell’s palsy or other facial nerve disorders, leading to facial numbness and an anesthetic patch.
Quick Tip: Facial nerve involvement can lead to loss of sensation and facial muscle weakness. The trigeminal nerve can also be affected in cases of facial pain or sensory loss.

Once a vial is opened, it cannot be used for the next session due to the risk of contamination. Since the pentavalent vaccine can be used within its specific timeframe after opening, the MR vaccine must be discarded as it was not used.
Quick Tip: Once opened, vaccines must be used immediately or discarded if not used, as they can lose potency or become contaminated.

The lesion on the neck, along with a body mass index (BMI) of 30 kg/m², is suggestive of metabolic syndrome. This syndrome often includes insulin resistance, central obesity, and is associated with increased risk of cardiovascular diseases.
Quick Tip: Metabolic syndrome often presents with visceral obesity, and this lesion can be associated with conditions such as acanthosis nigricans.

Talaromyces marneffei is a dimorphic fungus that causes systemic infections in immunocompromised patients. The characteristic velvety growth and red diffusible pigment on culture are diagnostic features of this organism.
Quick Tip: Talaromyces marneffei infection is commonly seen in HIV-infected individuals and can present with systemic involvement.