FCPS Past Papers: Medicine January 2009

Q#1.a 45 yr old male comes with the complaint of acute abdominal pain with migratory thrombophilibitis. what is the diagnosis?


a. Acute pancreatitis

b. Chronic relapsing pancreatitis

c. C.a pancrease (ans)

d. D.M


Q#2.Iron is stored in parenchyma as:

a. Ferritin

b. Hemosiderrin

c. Transferrin


Q#3. Least site of metastasis is:

a. Spleen

b. Liver

c. Lung

d. Kidney

e. Lymph nodes


Q#4.Major stress hormone is:

a. ACTH

b. Epinephrine

c. Norepinephrine


Q#5. Benedict test is used for:

a. renal glycosuria

b. urinary ketone.

c. urine glucose test


Q#6.A lady with hepatitis B; Serology shows: HbsAg +, HbeAg +ve,Anti HBe -ve, Hbv Dna +ve. Anti HBc IgM +ve...what does it show?


a. Acute Hepatitis B (ans)

b. Chronic hepatitis B

c. Viral load is decreasing

d. Immunized


Q#7.A healthy baby comes apparently with the complaint that he does not take breast milk instead he prefers the bottle feed. What is the diagnosis?


a. Cleft hard and soft palate (ans; most probably)

b. Cleft soft palate

c. Hormonal deficiency

d. Nasolacrimal duct block

e. Laryngeal weakness


Q#8.Penetrating injury in left 4th ics will damage which of the following structure?

a. Intercostal membrane

b. Intercostal muscle

c. left lung

d. left ventricle

e. Left atrium


Q#9.In Hyperglycemia, which 1 will increase:


a. Epinephrine

b. Cortisol

c. Glucagon

d. Insulin (ans)


Q#10.Regarding polycystic kidney:


a. It is autosomal dominant

b. It is autosomal recessive

c. Genetic mutation

d. Only females suffer

e. Only male suffer


Q#11.After 3 months to gastrectomy, Pt will develop:


a. Microcytic hypochromic anemia

b. Microcytic hyperchromic anemia

c. Megaloblastic anemia (ans)

d. Hemolytic Anemia

e. Macrocytic Anemia


Q#12.Non-myelinated nociceptor fibre directly synapses with:


a. Dorsal spinothalamic tract..................sorry cant remember other options


Q#13.Somites are derived from

a. Mesoderm





Q#14.Pseudomembranous colitis is caused by


a. Clostridium difficile (ans)

b. C.perferinges

c. Helicobacter pylori


Q#15.A 2 yr old child (premature); which cardiovascular anomaly will most likely develop:


a. Coarctation of aorta

b. Failure of closure of foramen ovale

c. PDA (ans)


Q#16.Which is the major circulating phagocyte?


a. Neutrophil

b. Mast cell

c. Monocyte

d. Macrophage (ans)


Q#17.ICF differs from ECF in:


a. Has increased Na+

b. Has increased K+ (ans)

c. Has increased Ca+


Q#18.Neurotransmitter of corticostriatal fibres is


a. Glycine

b. Dopamine

c. Ach

d. GABA


Q#19.Bile salts are normally absorbed from


a. Duodenum

b. Jejunum

c. ileum

d. Stomach


Q20. S1Q3T3: ......cant remember options for this Qz


Q#21.Antidote for Morphine:


a. Nalaxone (ans)


Q#22.which of the following is absent in Axon hillock


a. R.E.R (ans)

b. S.E.R

c. Microtubules

d. Microfilaments

e. Mitochondria


Q#23.Glucronide conjugation of drugs


a. Cause inactivation of drug

b. Is type 1 reaction

c. Makes drug insoluble


Q#23.Dorsal rami of cervical nerves innervate


a. Abductor pollices

b. Extensors of limbs

c. Extensors of trunk

d. Stabilizers the shoulder


Q#24.Upper end of esophagus is at the level of


a.C6


Q#25.Which part of kidney produces Erythropoiten:


a. MACula densa

b. pertubular capillary (ans)

c. Pct

d. DCT

e.Loop of henle


Q#26.Liver biopsy from a pt shows a lesion which is comprised of central collection of structureless material surrounded by epitheloid cells and lymphocytes. One large cell with multiple nuclei arranged close to membrane is also seen.The most likely change is:


a. Caseous necrosis

b. Coagulation Necrosis

c. Fatty change

d. Hydropic change

e. Liquefective necrosis


Q#27.Tissue damage by Ionization Radiation is due to:


a. Damage to Golgi bodies

b. Formation of free Radicles

c. Hydropic change

d. metaplasia of cell

e. swelling of cell


Q#28.Side effects of thiopental

a. Nausea

b. Seizure


29.Posterior belly of diagastric is supplied by:


a. Glossopharngeal nerve

b. Facial nerve

c. Trigeminal


Q#30.Which immunoglobulin has pentameric structure:


a. IgA

b. IgM

c. IgD

d. IgE

e. IgG


Q#31.Which is highest in human milk?


a. IgM

b. IgA

c. IgE

d. IgD

e. IgG


Q#32.Blood supply of Visual area:


a. Ant:Cerebral Artery

b. Middle cerebral Artery

c. Posterior cerebral artery




Q33.Aneurysm of arch of aorta will most like compress


a. Esophagus

b. Left main bronchus

c. Phrenic nerve

d. Thoracic duct


Q34.Gastroduodenal artey arises from


a. Celiac

b. Hepatic

c. Splenic

d. Superior mesentric


Q35. Slow growing tumor of thyroid is:


a. Anaplastic

b. Medullary

c. Follicular

d. papillary


Q36.Which does not lead to Pre-malignancy


a. Iodine deficiency

b. HIV

c. HBV

d. Melanosis


Q37.A 34yr old man can’t abduct his arm due to fracture of humerus. which nerve is damaged?

a. Axillary

b. Median

c. Radial

d. Ulnar

e. Musculocutaneous


Q38.Aldosterone will increase with:


a. Increased serum K+

b. Increased serum Na+

c. decreased plasma volium

d. Increased ACTH




Q39.A 14 yr Boy comes with the complaint of his abnormal Height and secretion from mammary glands. Histology of pitutary will show;


a. Increased Chromophobes

b. Increased Acidophilic cells (most probably diz was the ans)


Q40.A 35 yr old female is protected against osteoporosis due to


A. Estrogen (ans)

B. Progestron


41.Which is not “ Major Basic tissue”


a. Epithelium

b. Nerve (ans)

c. Bone

d. Blood

e. Muscle

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FCPS past papers: Radiology January 2009

1. Most imp. stress hormone
ACTH*
Epinephrine
Norepinephrine
Growth hormone

2. wat is not in relation with right kidney
decending colon*
ascending colon
duodenum
spleen

3. wat is not in relation with pitutary gland
Facial nerve*
Abducent nerve
Sphenoid sinus
Trigeminal

4. tributery of external carotid vein
Anterior jugular vein*
Facial vein


5. side effect of thophyllin
nausea and vomiting*
hypertension
bradycardia
seizures

6. Nor-epinephrine & serotonin degration by
MAO*
COMT



7. chemotaxic factor
leukoterine B4*
C3b
C5 complex
histamine


8. wat is not in post. relation with left kidney
Deudenum*
Ascending colon
Descending colon



9. wat is in between celeiac trunk and superior messentry artery
Pancreas*
Pancreas + jujenum
Transverse colon + ilium



10. what is secreted in breast milk
Ig G*
Ig A
Ig M
Ig D
Ig E



11. wat cannot pass placenta
Ig G
Ig A
Ig M*
Ig D
Ig E

12. ant and post spinal arteries arise from

vertebral artery gives anterior spinal, PICA gives post. Spinal*
Internal carotid
Vertebral artery and ant cerebellar artery



13. from which foramen facial nerve enters temporal lobe
internal accustic meatus*
stylomastoid foramen
foramen ovale
foramen spinosum



14. When r the ventricles filled with blood
Diastasis*
Atrial systole
Rapid in flow

15. A boy had behavior problem, loss of memory but resolve …..he is agressive in his mood, where is damage
Mammillory bodies
frontal lobe*
temporal lobe
parital lobe
occipital lobe

16. a new born presented with obstructive jaundice,,,,, gall bladder looks ok in U/s, cause
Atresia of CBD*
Atresia of entire extra hepatic apparatus
Atresia of hepatic duct
Choledochal cyst

17. A man with noticed weakness of left side of the body, hypotonia of the left limb, he swangs to left side, where is the lesion
Cerebral hemisphere
Left cerebellum *
superior c puduncle
Red neucleus

18. adrenalcortical insuficancy causes
hypokelimia
hyponatremis
hypoglycemia*
alkalosis

19. In resting stage actin is attached to
tropomyocin
troponin
titin
myosin


20. if there is damage to sciatic nerve, supply to the dorsum of foot is by
sephenous nerve*
Sural nerve
Common peroneal
Deep peroneal

21. patient with difficulty in standing from sitting postion....
Gluteus Maximum*
Gluteus medius
Tensor fascia lata
Quadricep femoris

22. wat is not in relation with left recurrent nerve
SVC*
Arch of aorta
Lig arteriousum
Trachea
Esophagus

23. stucture compressing Esophagus
Left bronchus (correct)
Left Venticle
Right Atrium
Right ventricle
Thymus

24. Esophagus constriction at
Aortic arch*
Left ventricle
Rt atrium

25. wat vein run with Post. interventricle artery
great cardiac vein
middle cardiac *
small cardiac

26. utrine cancer spread to labia majore via
Round ligament*
utrosacral ligament

27. Basalic vein .
drain in axillary ven*
runs on radial side
starts from palmar surface


28. median nerve
supply lateral 2 lumbricals*
causes wrist drop

29. injury of neck of the humerus, nerve damage
Axillary nerve*
Musculocutaneous
Radial
Ulnar

30. wat is in proximal layer of carpal bone, true
Scaphoid, lunate triqutral & pisiform*


31. broncopulmonary segment wat is true
anatomical, fuctional n unit of the lung*
contains lobar bronchus
pulmonary veins run in intersegmental tissue


32. urinary bladder, wat is true
supplied by anterior division of internal iliac*
separated from uterus by pouch of Douglas
in males has seminal vesical above and vas deferens below


33. sephenous nerve wat is true
drain into femoral 3.5cm inferior n lateral to pubic tubercle*
has only 1 tributary
connected to short sphenous by perforators


34. down syndrome
trisomy 21*
18
15
13

35.Which of the following tissue is most radiosensitive
Skeletal muscle
Cartilage*
Bone




36. diagnostic test for strptococuss is
ASO titer
Blood culture*
Urine Dr


37. 65% of Na and water reabsorbed from
PCT*
DCT
Loop of Henle
Collecting duct

38. injury to hippocampus
Memory loss*

40. .Erythropoietin is secreted from
Yellow marrow
Macula densa
Preitubualr capillaries*
PCT

41. medial part of breast supply which node
internal thoracic*
lateral grp
ant grp
medial grp

42. diapharam contraction cause
increase in thoracic pressure
increase in thoracic diameter

43. thoracic duct
passes with aorta *


44. sypathetic supply by alpha receptors
dilator pupilary musscle of eye*
brochoconstriction
cardioacceleration


45. parasympathetic supply
inc. secretioin of slivary gland*

46. gastric emptying delayed by
CCK*
Secretin
Gastrin
Vagus




47. A boy has edema due to protien loss of 3.5g in urine..., wat is the cause of edema
Plasma colloid pressure is decreased*
Increase hydrostatic pressure
Increased capillary permeability


48. wat is not supplied by internal thoracic artery
Inferior portion of rectus muscle*
Ant abd wall upto umbilicus
Pericardium
Thymus


49. Patient Gravida 4 with anemia and occult blood in stool
Iron deficiency anemia *
Sideroblastic anemia
Thalassemia
Megaloblastic anemia

50. iron absorb in
ferruos form*
oxalate


51. Bile salt absorb from
Ileum*
Proximal jejunum
Distal jejunum
doudenum

52. Trachea start from ….wat is true
C6*
C4
C5
Cricoid cartilage

53. wat is true abt CSF
secreted at rate of 500 ml/day*
choroid villi are seen by naked eye
aqueduct transmits CSF from 4th ventricle to spine


54. blood supply to Bundle of His.
Circumflex artery a br. Of left coronary artery
Posterior interventricular artery
Main Left coronary artery
Main right coronary artery

55. metastatic carcinoma least common site
brain
lung
liver
spleen(correct)

56. premotor area , which artery supplies
Anterior and middle cerebral (correct)
Anterior
Middle
Middle and post. Cerebral
Anterior and pst. Cerebral

57. arterial supply to primary visual area
PCA*
ACA
MCA
PICA

58. A boy defecate just after he takes meal, wat the reflex
gagtrogastric reflex
gastro coic reflex (correct)


59. Median of 20,20,25,25,30,30.35,40
25
20
27.5*
30

60. nerve supply to latismus dorsi
thoracodorsal*
subscapular
long thoracic

61. Right bronchus as compare to left
is longer
ant to pul artery
right bronchus is more vertical than left*

62. A surgeon did a study on patients with heamorroids
he included 100 pt in grpA and treated them surgicall
whil kept the other 100pt on high fiber diet
he interviewd them after 12mons and found that the grp with surgical treatment had a better response…… wat type of study is this?
Case control
Cohort
Prospective
Randomized control trial

63. Doctor patient relations and how good a doctor is known by
his degrees
his records
his pleasant behavior and bed side manners*

64. if a patient develops a fatal disease it is best to
hide it from him
tell it to him and his family as soon as possible*

65.Benedicts test is done for
blood sugar
urinary glucose
urinary reducing sugars*

66.sup parathyroid gland
is related to sup thyroid artey*
lies outside the pretracheal fasciae
lies anterolatral to thyroid

67.MHC complex is
related to HLA typing*
blood grp antigens
same in identical twins

68. first part of axillary artery ends at
border of pectoralis major
border of pec minor *
border of teres major

69.Esophagus is related to which structure whose dilatation can cause dysphagia
l atrium*
left vent
SVC
Rt atrium

70. If RCA is occluded distal to the origin of right marginal artery which part of the heart will be affected most?
Rt atrium
SAnode
AVnode*
Apex of the heart

71. Myleination of the brain wat is most inappropriate?
Starts at birth
Occurs hapharzadly
Sensory neuros are myelinated first
Occurs by oligodendrogliocytes

72. A patient with multiple fractures and BP 90/60 pulse 60/min wat is the most appropriate initial treatment?

IV fluids*
Reduction os fractures





73. Factor 9 def wat is the appropriate treatment?

Cryoppt*
FFP
Whole blood
WBC


74. DIC most inappropriate

low FDP*
consumptive coagulopathy
treated with heparin
low platelets

75. Kleinfelters syndrome
chromosomal deficiency
autosomal dominant
autosomal recessive
extra X chromosome*
extra Y chromosome

76. Fat embolism most unlikely
urinary test is diagnostic*
occurs due to trauma to fatty tissues
caused bt acute pancreatitis

77. Highest mortality rate
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E

78. Diphtheria is transmitted by
sexual contact
respiratory *
feco oral


79.which organ has least chance of metastasis
lung
bone
liver
kidney
spleen*

80. which organism causes meningitis secondary to pyogenic lung abscess?
Strep
Staph
Pneuococcus
h.influenzae

81. thromboembolism is most common in?
leg*
liver
brain
kidney

82. OCP increase the risk of
breast cancer
endometrial cancer
thromboembolism*
osteoporosis

83. Osteoporosis is less in premenopausal women due to effect of
estrogen*
testosterone
progesterone
androgens

84. A trauma patient in shock with stab wound along left 10th rib which organ is damaged?
Liver
Spleen*
Colon
Duodenum

85. in autosomal recessive disease
all siblings are affected
both parents are affected
only mother is affected
all siblings have a chance of one into four of contracting the disease*

86.which of these is not caused by bacteria
histoplasmosis*

87. Most likely finding in CSF

inc glucose in fungal meningitis
dec glucose in viral meningitis
lymphocytosis in aseptic meningitis
dec glucose in pyogenic meningitis

88. most imp for wound contraction
myoblasts
fibroblasts
myofibroblasts*
epithelium
collagen

89. smooth muscles are
striated
voluntary
mostly arranged in circular and longitudinal layers *

90. hyperparathyroidism causes least likely
hypertension
dystrophic calcification*
inc PTH




91. Ductus deferens ends into
Prostate
u.Bladder
S.vesicles
Prostatic urethra
Ejaculatory duct*

92. About large gut
descending colon has no haustra
appendix has no tenia*
all large gut is supplied by inf mesenteric artery
ascending colon has a mesentry

93. most probable abt gall bladder.
Has thick submucousa
Mucousa has extensive folds*

94. a patient with known HBV infectio comes with
HBSAg + HBe ab+ HBV DNA + HBC IGM ab+
Wat is the diagnosis?
Acute dis *
Chronic carrier
Chronic active

95. Which HBpathy presents with crises
sickle cell trait
sickle cell disease*
thalassemia
Hb C

96. unconjugated bile is carried by which protein?
Albumin *
Pre albumin
A globulin
B globulin
Fibrinogen

97.After gastrectomy patient will develop
iron def anemia
megaloblastic anemia due to folic acid def
pernicious anemia*
sideroblastic anemia




98. 60 yr male with lymphandenopathy and low hb low platelets and increased wbc
microscopy show large mature cells wats the diagnosis?

CLL*
Burkitts
Follicular
NHL



99. what Is true abt Hb
consisits of alpha and gamma chains in adults
imp buffer of H+ *
not assoc with CO2 transport

100.PDGF is secreted from which part of platelets
alpha granules
dense bodies
cytoplasm
lysosomes

101. which cells produce antibodies
plasma cells*
T cells
Bcells
Platelets

102. Heparin is released from which cells.
Mast cells*
Eosinophils
IgE

103. Epitheloid cells in granulomas are formed by which cells
macrophages
lymphocytes
langerhans cells*

104. thyroid is invested in which fascia?
Pretracheal*
Deep cervical
Prevertebral

105. wat is true abt thyroid
consists of collecting ducts and acini
epi changes shape according to state of activity.*
Has parthyroids ant to it

106. wat is true abt pituitary
ant pitutiary derived from neurons
no portal vessels btw hypothalamus and post pituitary*



107. Satiety center is located in which part of hypothalamus
anterolateral
VPL
VL
Medial*

108. D & C at 18 days after LMP endometrium will show which stage of uterine cycle?
Follicular
Ovulatory
Secretory*
Proliferative

109. at the end of pregnancy uterus is most sensitive to which hormone?
Estrogen
Progesterone
Prolactin
Oxytocin*

110. Most abundant phagocytic cells in circulation
basophils
monocytes
macrophages
neutrophils*

111. ICF & ECF differ in

inc K+ in ICF


112. most potent stimulus for release of aldosterone is

inc K+ *
inc Na+
inc glucose

113. Pallegra is due to def of
riboflavin
thiamine
niacin *
vit C

114. Trauma to the middle meningeal artey causes
subdural hemorrhage
epidural hemorrhage*
SAH

115. patient with loss of fine touch proprioception and vibration injury to which part of spinal cord?
Fasiculus gracilis
Fasiculus cuneatus
Post white column*
Lateral white column

116. in females which structure lies btw ureter and peritoneum
uterine artery*
inf vesicle artery


117. which of these muscles is a part of the pelvic diaphragm
deep transverse perinei
puborectalis*
bulbospongiosus
ischeocavernosus


118. wat is not true abt adrenal gland
fetal gland is 1/3 size of the adult gland
it is invested by renal fascia
adrenal cortex is derived from mesoderm

119. which structure is most ant in popliteal fossa
popliteal vein
politeal artey *
tibail nerve
bicep femoris
gastrocnemeus

120.tendon of which of these muscles is intracapsular
bicep femoris
plantaris
popliteus*
semitendinosus

121. which of these are the major resistance vessels
arteries
veins
capillaries
arterioles*
venules

122. patient losses 1 litre of body fliud in 1 hour wat will happen first
inc PR
inc BP
inc veno spasm*

123. a person in a room with optimum enviormental conditions how will the heat loss occur

convections
sweating
breathing
radiation and conduction*
voiding



124. major part of energy utilized during breathing is to overcome
elastic recoil of lungs*
resistance of chest wall
large airway resistance
small airway resistance

125. a bullet pierces the intercostals space which layer will it come after the intercostals muscles

parietal pleura
visceral pleura
endothoracic fascia*
pleural cavity

126. which vessel will be damaged if the phrenic nerve is cut

musculophrenic
int thoracic
pericadiophrenic*

127. which of these is not a branch of internal iliac
sup rectal*
middle rectal
inf vesicle
sup vesicle

128. lymphatic of uterus do not drain into
int iliac nodes
ext iliac nodes
sup ing nodes
inf mesenteric nodes*

129. a patient with hoarseness and lyrangeal nodule which is most unlikely
atrophy *
nodule
hypertrophy
hyperplasia

130. pseudo hypoparathyroidism.
Due to inc ca
Dec vit D
PTHrP

131. wat is seen in dysplasia
pleomorphism
inc NC ratio*
inc mitosis





132. metastatic tumors are identified by

invasion of other structures*
pleomorphism
inc NC ratio
inc mitosis

133. sarcomas have
rapid growth
inc vascularity*
capsule
benign

134. epi of a smoker will show

inc ciliated epi
mixture of st sq and pseudostratified cells*
dec goblet cells


135. most unlikely abt glomerulus is

has urinary space btw 2 layers
is cup shaped
is blind ended part of tubule
has stratified epi*
has podocytes

136. which vessel is involved and dilated in portal HTN

portal vein*
hepatic artey
hepativ vien
SMV

137. most unappropraite abt liver
has dual blood supply
hepatic artey gives only 35% of O2
portal vein has 70% O2 *

138. not part of the portal tract

portal vein
hepativ artery
bile duct
hepatic vein*

139. not a part of axillary nodes
ant grp
medial grp
apical grp
central grp
deep cervical*

140. Clavipectoral fascia
completely covers pectoralis minor*
forms suspensory lig of breast
forms axillary tail

141. in males uretric stones mostly lodge at which point
just below kidney*
at crossing of ext iilac vessels
at pelvic brim
at ischeal spine

142. if there is fracture of the acetabulum post and superiorly which bones r inv
ileum and ischium *
ileum and pubis
isschium and pubis


143. most constricted part of the male urethra?
Ext meatus*
Infandibukum
Navicular fossa

144. at the level of second part of duodenum wat is unlikely

aorta at the right of SVC*
left renal vein

145. pain of the ovary is transmitted to the medial side of thigh thru which nerve
femoral
obturator*
ilioinguinal

146. left ventricle does not contain
supraventricular crest
chordae tendinae
aortic vestibule
papillary muscles

147. epidural space
contains venous plexus*
contiues into skull at foramen magnum
attached to dorsal coccyx
upto S2

148. Otic ganglion lies under

foramen ovale*
foramen spinosum
maxillart nerve
stylomastoid foramen



149. middle menigeal artery enters thru which foramen?

Foramen spinosum*
Foramen rotundum
Foramen ovale

150. Superior petrosal sinus lies in
falx cereberi
fakx cerebelli
tentorium cerebellli*
diaphragma sella

151. Great cerebral vein does not drain
deep cerebral vein
sup cerebral vein
basal vein
thalamic vein

152.which of these is not a basic tissue of the body
epi
nerve
muscle
blood
CT

153. Osmotic pressure depends on
electrical equivalence
conc gradient
yenp
no of particles
mol size

154. chemoreceptors respond to
inc PCO2*
dec PO2
inc Ph
inc temp

155. Processus vaginalis
covers testis only*
covers ductus deferens
forms ext spermatic fascia
arises from parietal peritoneum
arises from visceral peritoneum

156. Dorsal rami of nerves supply
ext of trunk
ext of limbs




157. which vessel lies ant to IVC
left renal vein
left renal artery
right renal vein
right renal artery
right testicular vein*

158. if inguinal canal of a female is opened wat does it contain

round ligament and ilioinguinal nerve


159. lymphatic drainage of testis is into

para aortic nodes
sup ing nodes
int iliac nodes
ext iliac nodes

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FCPS PAST PAPERS: Surgery June 2009

Q1.WHICH LOBE OF LUNG HAS 2 SEGMENT
A.RT;UPER LOBE
B.RT LOWER LOBE
C.RT MIDDLE LOBE
D.LEFT LOWER LOBE
E..LEFT UPPER LOBE

Q2.EARLIEST SIGN OF ASPIRIN OVER DOSE?
A.TINNITUS
B.GASTRIC UPSET
C.METABOLIC ALKLOSIS

Q3.MAIN SIDE EFFECT OF LIDOCAINE
A.ARRTHYMIA
B.TONIC CLONIC SEZIRES
C.NAUSEA VOMITING

Q4.ENTAMOBEA HISTOLYTICA?
A.DOES NOT HAVE CARRIER
B.LIMITED TO G.I.T
C.PROTZOA

Q5.T.B ULCER MARGIN?
A.EVERETED
B.INVERTED
C.INDIFINE
D.INDURATED

Q6.SECTRION OF HARMONE INCREASE AS DARKNESS INCREASING?
A.CORTISOL
B.GROWTH HARMONE
C.MELATONINE
D.INSULIN

Q7.INDICATION OF SPLEENECTOMY?
A.AUTOIMMUNE HEMOLYTIC ANEMIA
B.SICKEL CELL ANEMIA
C.G SIX PHOSPATES DIF
D.THROMBOCYTOPENIA

Q8.RBC CELL MEMBRANE?
A.ACTIN
B.MYOCIN
C.SPECTRIN
D.HEMOGLOBIN

Q9.CLOSTRIDIUM DIFFIC?
A.CAUSES LOCAL HYPOXIA
B.AEROBES
C.ALPHA TOXIN
D.CONVERSVATIVLY TREAT.

Q10.INGUINAL HERNIA?
A.INDIRECT PASSES ONLY SUPER;RING
B.DIRECT PASSES THROUGH HESSAL BECH TRIANGLE
C.DIRECT LYING ON MEDIAL SIDE OF INF:EPIGASTIC ARTERY

Q11.CONTENT OF INGUINAL HERNIA?
A.INF:EPIGASTRIC ARTERY
B.LYMPH OF FUNDUS OF UTERUS.
C.OVARIAN ARTERY.
D.FEMORAL ARETY

Q12.DIALYSING FLUID COMPOSTION SAME AS PLASMA AXCEPT WHICH ONE HIGH?
A.GLUCOSE
B.UREA
C.K*
D.CA

Q13.COMMON ORGAINSM INFECTION IN LIVER TRANSPLANT PT:
A.HEP.B
B.HEB C
C.CYTOMEGALO VIRUS
D.INFLUENZA

Q14.RT:CORNOARY ARETY?
A.RISES FROM RT:POST AROTIC SINCUS
B.SUPPLY BOTH ARTIUM
C.RUN IN POST INTERVENTRICULAR GROOVE
D.BR:CIRCUMFELX

Q15.BRUN PT; HYPOTENSION,TACYCARDIA?
A.D.I.C
B.INFECTION


Q16.BOY WITH INCREASE BLEEDING TIME AFTER CIRCUMCISION,HIS COUSIN ALSO HAVE SAME PROBLEM?
A.BT
B.CLOTTING TIME
C.APTT
D.PT

Q17.SECOND HEART SONUD?
A.CLOUSER OF TRICUSPID VALVES
B.FILLING OF VENTRICLE
C.CLOSURE OF SEMILUNAER VALVES

Q18.BLADER CA?
A.TRANSITIONAL CELL CA.
B.Sq: CELL CA
C.EPITHOID CA

Q19.CALCITONIN?
A.INCREASE BLOOD CA LEVEL
B.INC;ABSORTION OF CA INTESTINE
C.INC:ABSORTION FROM RENAL TUBULES
D.INC:BONE REABSORBATION

Q20.AFTER MULTIPULE BLOOD TRANSFUSION?
A.HYPOKALEMIA
B.HYPERKALEMIA
C.HYPOCALCEMIA
D.RAISED BUN

Q21.COMPENSATION AFTER MILD BLOOD LOSS?
A.TACYCARDIA
B.DEC: COMP OF VEIN
C.NORMAL B.P

Q22.IN ALL TYPE OF SHOKE?
A.HYPOVOLEMIA
B.TACYCARDIA
C.UNCONSIOUS

Q23.FAT EMBOLSIM?
A.SYPMTOMS AFTER 12 HRS
B.80% FATAL
C.COMON CAUSE THROMBPHILIBITIES
D.BREAST TRUMA

Q24.CHILD THIN,DEPIGMENTED,APATHY
A.MARASMUS
B.KASHIKOR
C.DIARREHA

Q25.PT:WITH GRANULOMATOUS LESION IN BLADDER DEVELOPED CA.CAUSE?
A.SHISTSOMIA MANSONI
B.CIGGRATE SMOKING
C.SHIS;HEMATOBOIUM
D.DIYES

Q26.RETROGRADE AMNEISA?
A.FRONTAL LOBECTOMY
B.AGGREVATE BY TEMPORAL LOBE TRUMA


Q27.METAPLASIA,INCORRECT?
A.IRREVERSIBLE
B.BRONCHIAL EPI;
C.GASTRO ESOPHAGEAL JUNCTION
D.CERVIAL JUNCTION

Q28.APPENDIC EPIPLOIC PRESENT IN?
A.DEUDENUM
B.RECTUM
C.JEUJENIUM
D.ILIUM

Q29.COMMON COMPLICATION OF BETAL NUTS?
A.SUBMUCOSAL FIBROSIS
B.EPITHEIAL POLYP
C.CA; EPITHILIUM

Q30.FEMORAL SHEATH?
A.FASICA ILISCA
B.FASICA TRAVERSALIS
C.FASCIA TRANSVERSALIS AND ILISCAP

Q31.LOCALLY MALIGNANT TUMOR?
A.CHOLESTATOMA
B.NEUROBLASTOMA.

Q32.COMMON SIGN OF OF AGRUNLOSYTOSIS CAUSES BY ANTIEPILEPTICS?
A.WT:LOSS
B.SORE THOART
C.BLEEDING
D.GIT UPSET

Q33.DURING OPERATION OF POST;CERVICAL LYMH NODE BIOPSY?
A.CRANIAL PORTION OF ACCERY NERVE.
B.SPINAL PORTION OF ACCESSRY NERVE.
C.AXILLARY NERVE
D.LOWER CORD OF BRACHIAL PLEXUSES
E.PHERINIC NERVE.

Q34.PT: WITH ROAD TRAFFIC ACCEDIENT,UNABLE DORSIFLEX AND EVERT FOOT?
A.SUPER; PERONEAL NERVE
B.DEEP PERONEAL NERVE
C.COMON PERNEAL NERVE
D.TIBEAL NERVE

Q35.ESTABLISHED ANTIOXIDANT?
A.VIT A
B.VIT D
C.VIT E
D.VIT C
E.VIT B

Q36.URORECTAL SEPTUM?
A.SEPRATE RECTUM AND URINARY BLDER
B.SEPRATE RECTUM AND UROGENITAL SEPTUM
C.SEPRATE RECTUM AND SIGMOID COLON
D.SEPRATE RECTUM AND URETHRA

Q37.70% OXYGEN EXTRACT IN RESTING CONDITION IN WHICH TISSUE?
A.HEART
B.BRAIN
C.KIDNEY
D.LUNG
E.SK;MUSLES

Q38.PT: WITH THE S/S OF PANCREATITIS BUT NORMAL AMYLASE,WHAT NEXT DIAGNOSTIC TEST?
A.LFT
B.CHLESTROL
C.GLUCOSE
D.AST/ALT

Q4930 YRS OLD PERSON AHS STAB WOUND ON RT;SIDE OF CHEST?
A.IPSILATERAL LUNG COLLPASE AND IPSILATERAL CHEST WALL SPRING OUT
B.IPSILATERAL LUNG COLLAPSE AND CONTRALATERAL CHEST WALL COLLAPSE.
C.NO CHANGE IN CHEST WALL
D.CONTRALATERAL LUNG COLLAPSE AND IPSELATERAL CHEST WALL COLLAPSE

Q40.DURING OPERATION ILIUM REMOVE?
A.DEC;ABSORTION OF AMINO ACID
B.DEC ABS:OF WATER
C,INC ABSORBATION OF FAT
D.DEC; IRON ABSORBATION

Q41.COMA(DEMAGE OF PART OF BRAIN)
A.NUCLEUS CERULOSIS
B.RETICULAR FORMATION AREA
C.AREA POSTREMA

Q42.TRUE HERMOPHADISM?
A.XX/XY
B.XXY
C.XXX
D.XYY

Q43.AFTER APENDICTOMY,PT;DEVELOPED CHRONIC WOUND ABBCESS AND DRAING SINUS,CONTAING YELLOW GRANULES?
A.NOCARDIA
B.ACTINOMYCOSIS
C.H.PYLORI
D.E.COLI
E.ENT.HISTOLYTICA

Q44.RT:TESTIS LUMPH NODE DRAINGE?
A.DEEP INGUINAL NODE
B.SUP:MEDIAL GROUP INGUINAL NODE
C,PARAORTIC LYMPH NODE

Q45.FAT,CHO AND LIPID DEPOSTION BY WHICH HARMONE?
A.INSULIN
B.GLUCAGON
C.CORTISOL.
D.GROWTH HARMONE

Q46.MICROCYTIC,HYPOCROMIC ANEMIA?
A.IRON DEF;ANEMIA
B.CHORNIC BLOOD LOSS
C.SICKEL CELL ANEMIA
D.HEMOLYTIC ANEMIA

Q47.CYNOSIS?
A.DEC CONTENT OF HB%
B.INC:CONCENTRATION OF DEOXY;HEMOGLOBIN
C.ANEMIA

Q48.UNLOCKING MUSCLES?
A.POPLITIUS
B.SEMITANDANNIOUS
C.SEMIMEMBRANOUS
D.SARTORIUS

Q49.URETER CONSTRICTION?INCORRECT
A.PUJ JUNCTION
B.PELVIC BRIUM
C.CROSS THE COMON ILLIC ARTERY
D.RUN ON PSOS MUSCLE

Q50.COMON SITE OF RIB FRACTURE?
A.HEAD OF RIB
B.ANGLE OF RIB
C.BODY OF RIB

Q51.INCREASE BLEEDING TIME CAUSE BY?ACCEPT
A.HENOCH,SHIL:PUPURA
B.CIROHSIS
C.DEC PLATELETS
D.THROMBOCYTOSIS.

Q52.SLOWEST GROWING TUMOR?
A.PAPILLARY CA
B.MEDULLARY CA
C.FOLLICULAR CA

Q53.TURNER SYNDROME?
A.LONG HIGHT
B.MENTAL RETARDATION
C.CARRING ANGLE REDUCED
D.HIGHT 4.5CM

Q54PELVIC DIAPHAGRM FORMED BY MUSCLES EXCEPT?
A.COCCYGUS
B.PYriformus MUSCLES
C.ILOCOCCGUS

Q55.STD CAUSES ULCER ACCPET?
A.SYPHILIS
B.HERPES
C.GONOCOCCUS


Q56.PT WITH HYPOVOLEMIC SHOKE,TREATED.WHAT WILL BE DECREASE?
A.HEART RATE
B.urine OUTPUT
C.B.P

Q57.after 48 HRS OF STRAVATION,WHT WILL BE BREAKDOWN TO PROVIDE ENEGRY
A.CHO
B.FAT
C.PROTIEN

Q58.CHRONIC HEMOLYSIS AND INTRACELLULAR PIGMENT ACCUMULATION?
A.BILIRUBIN
B.HEMOSIDRIN
C.BIVIRDIN

Q59.BASCILIC VEIN?
A.RUN OF RADIAL SIDE OF FORARM
B.FORM ON THE PALMER SURFACE OF HAND
C60.CONTINUE AS AXILLARY VEIN

Q.DRUG LEAST NEPHROTOXIC
A.GENAMYCIN
B.NEOMYCIN
C.CLINDAMYCIN

Q61.ANT:DISLOCATION OF SHOULDER JOINT WHICH NERVE DEMAGE?
A.AXILLARY
B.RADIAL
C.MUSCULOCUTANEOS
D.MEDIAN
E.LOWER BRACHIAL PLUXES

Q62.TESTOSTERONE PRODUCED BY ?
A.LYDING CELL
B.EPIDYDEMUS
C.SRTOLI CELL

Q63.APEX OF HEART?
A.3RTH INTERCOSTAL SPACE.
B.TOWARDS RIGHT
C.8CM FROM MID LINE

Q64.AFLATOXIN B1 CAUSES CA?
A.HEPATOCELLUAR CA
B.BLADDER CA
C.LEUKEMIA
D.SKIN CA

Q65.BLOOD GROUP CAUSES REACTION?
A.B+
B.A+
C.AB-
D.O+

Q66.MUSCLES DIVIDE SUBMEDIBULAR GLAND?
A.STYLOPHARAGEUS MUSCLES
B.MYLOID
C.STYLOGLOSSIUS

Q67.PT:CANNT ABDUCT THE ARM UPTO 30 DEGREE?
A.INFRASPINATUS
B.SUPRA SPINATUS
C.DELTOID

Q68.MAJOR INSPIRATORY MUSCLES?
A.INTERNAL INTERCOSTAL MUSCLES
B.EXT:INTERCOSTAL MUSCLES
C.DIAPHGRAM

Q69.LEFT SUP:RENAL VEIN DRAIN IN WHICH VEIN?
A.RENAL VIEN
B.AZYGOS VIEN
C.HEMIAZYGOS VIEN
D.ACCESSARY AZYGOS VIEN

Q70.PARASYMPATHATIC SYS CAUSES ALL OF FOLLWING AXCEPT?
A.SPINCTER CONSTRICTION
B.DILATE THE PUPIL
C.EMPTY BLADDER

Q71.PT:LOSS OF ABDUCTION, ADDUCTION OF FINGERBUT NO LOSS OF SENSATION?
A.MEDIAN NERVE
B.ULNER NERVE.
C.RAIDAL NERVE
D.DEEP BR;OF ULNER NERVE

Q72.MALE WITH T4N1M1 SERVIVAL RATE LESS 50%,S/S?
A.CACHXIA
B.ANEMIA
C.ARRTHEYMIA

Q77.FUNCTION OF LIMIC SYS AXCEPT?
A.MEMORY
B.AGGRESTION
C.SPINAL REFLAX

Q78.STRONGEST LIGAMENT?
A.ILIOFEMORAL
B.ISCHEO FEMORAL
C.DELTA LIGAMENT/MEDIAL LIGAMENT

Q79.SHORT GASTRIC ARTERY BR:OF
A.SUP:EPIGASRIC ARTERY
B.HEPATIC ARTERY
C.SPLENIC ARTERY

Q80.TYMPANIC MEMBRANE?
A.FORMED LATERAL WALL OF TYMPANIC CAVITY
B.SUPPLY BY VAGUS AND TRIGEMINAL NERVE
C.OPENING OF AUDITARY TUBE IN POST WALL.

Q81.HEPARIN
A.EMBOLISM
BSECRTED BY .BASOPHIL
C.DISLODGMENT
D.DISOLVMENT OF CLOT

Q82.VERBAL COMUNICATION?
A.BY PRESENTATION
B.INVOLVE IN RESEARCH WORK

Q83.37%POST MENUPOSAL WOMEN TAKING HRT,63 WOMEN TAKING NO MEDICATION,HOW YOU SHOW IN CHART
A.BAR CHART
B.PIE CHART
C.PICTORIAL CHART

Q84.THYROXINE CAN BE USE OTHER THEN THYROID TREATMENT?
A.WEIGHT LOSS
B.INCREASE APPEPITTE.
C.BMR

Q85.THYMUS?
A.REGRESS AFTER BIRTH
B.FORMED BY 4TH PHARENGEAL ARCHES
C.PRODUCED T CELL

Q86.GROOVE OF SUBCLAVIN ARTERY?
A.1ST RIB
B.2ND RIB
C.3RD RIB
D.CLAVICLE

Q87.PIVOT JOINT?
A.ATLANTOAXIAL JOINT
B.MANDIBULAR JOINT
C.ELBOW JOINT

Q88.CA REALSE FROM SKETAL MUSCLES FROM?
A.SARCOPLASMIC RETICULIUM
B.MITOCHONDRIA
C.LYSOSOME
D.T-TUBULES

Q89.PROJECTION FIBERS PRESENT IN?
A.CORPUS CALOSUM
B.INTERNAL CAPSULES
C.RETICULAR FORMATION

Q90.PERIPHERAL AND CENTRAL CHEMO RECPTORS BOTH RESPONES TO?
A.PCO2
B.PO
C.OXYGEN CONCENTRATION
D.H+

Q91.ESSENTIONAL AMINO ACID
A.TYROSINE
B.ALANINE
C.ARGININE
D.PHENYALANINE

Q92.LUMBER PUNCTURE?
A.L2 TO L3
B.L4 TO L5
C.POST;SUP;ILIC SPINE

Q93.CEREBRAL CORTEX
A.RECEIVE NO SENSORY INFORMATION
B.PRESENT ONLY IN FRONTAL LOBE
C.ESSENTIONAL FOR INITATION OF VOLUENTRY MOVEMENT

Q94.WATER ABSORBTION IN PROXIMAL CONVULATED TUBULES?
A.55% ABSORED
B.ASECNDING LIMB IS PERMIALE FOR WATER
C.WATER ABSORED THORUGH FASCILITED DIFFUSION

Q95.SUBARCHANID LYER END AT?
A.L2
B.S2
C.S5

Q96.DORSAL COLUMN MEDIAL LAMINUSCUS COTAIN?
A.FINE TOUCH
B.CROUDE TOUCH
C.PAIN
D.TEMP

Q97.GLYCOLYSIS?
A.GIVE 1 MOLECULES OF PYRUVATE
B.2 MOLECULE OF GLUCOSE

Q98.THICK FILAMENT?
A.MYOSIN
B.ACTIN
C.ACTOMYOSIN

Q99.ORGAN TRANSPLANT REJECTED IN 10 MIN
A.CELL MEDIATED IMUNITY
B.ANTIBODY
C.PLASMA CELL
D.NATURAL KILLER CELL

Q100.WHICH FOLLOWING CHEMICAL EXPOSURE CAUSES CA?
A.METHYL ALCOHAL
B.BENZENE
C.CARBON TETRACHLORIDE

Q101.CRANIAL NERVES CARRINYING PARASYMPATHATIC FIBERS?
A.3,7,8,10
B.3.7.9.10
C.4,7,9,10
Q102.DURING PREGNANCY HICH DRUG SAFEST IN HYPOTHYRIOD PT:
A.BETA BLOCKERS
B.DIAZEPAM
C.PROPYTHIORACIL
D.CARBAMAZIPINE

Q103.ARCHES OF LEFT LUNG?
A.AZYGOS VEIN
B.THORACIC DUCT
C.ARCH OF AORTA

Q104.DIAPHGRAM SUPPLY BY?
A.C,3,4,5
B.INTERCOSTAL NERVE
C.C 2,3.4

Q105.WHICH DRUG CAUSES CORNEAL OPACITY
A.CHLOROQUINE
B.ERTHROMYCIN


Q106.CAVERNOUS SINUS COTAIN?
A.TROCHLER NERVE
B.INTERNAL JUGULAR VEIN
C.ABDUCENT NERVE

Q107.WHICH DRUG INCREASE CYTO P450 SYS
A.BARBITURATES
B.SULFA DRUGS
C.ISONIAZID
D.KETOKANAZOLE

Q108.EASIEST METHOD TO DIAGNOSED MENINGOCOCCUS?
A.CULTURE
B.STAINING
C.SERUM ANTIGEN

Q109.BALCK WATER FEVER CAUSES BY?
A.PLAS;MALARIA
B.PLAS:FALCIPARUM
C.QUATRUN MALARIA

Q110.OXYTOCIN AND ADH ORIGENATED BY?
A.POST PITUTARY
B.HYPOTHALAMUS
C.ANT PITUTARY

Q111.CEREBLLAR DISORDER?
A.UNABLE TO PERFORM VOL;MOVEMENT
B.STATIC TREMORS
C.INTENSTION TREMORS

Read More

Men 'prefer curvy women to those who are size zero', study claims

Hollywood actresses Scarlett Johansson or Kate Winslet are considered more attractive and healthy-looking than Victoria Beckham or Paris Hilton, Scottish researchers found.
The University of St Andrews study, published in the scientific journal Perception, surveyed a group of students, aged between 18 and 26, were asked to rate photographs of female faces for attractiveness and health.

They concluded that young men rated girls in the “normal” weight range as the most attractive and healthy looking.

The researchers say the findings send a strong message to young women who believe that you need to be underweight to be considered attractive.
“We often remark on how healthy or unhealthy someone looks, but it can be very difficult to say precisely how we know this,” said lead researcher Vinet Coetzee.
“Scientists have been trying to answer this question for decades, and have made many breakthroughs in our understanding of health and attractiveness, but until now they have tended to overlook the influence of weight."

The University's Perception Lab asked 84 female students a variety of questions on their health, took their blood pressure and photographed them.
The photographs were then shown to a group of male students who were asked to rate them for health, attractiveness and weight.

Professor David Perrett added: "A take home message for young people is that maintaining a normal weight benefits current health and will improve good looks.
"In our study, people in the normal weight range were judged healthier and more attractive than under or overweight individuals.
"This sends a strong message to all the girls out there who believe you have to be underweight to be attractive.

“The people making judgments in our study were all between the ages of 18 and 26 and they did not rate underweight girls most attractive.

“They preferred normal weight girls."

Read More

Why grandmothers prefer their son's daughters

The study, published in the journal Proceedings of the Royal Society B, found that a grandmother's love for her grandchildren is partially rooted in DNA.
The Cambridge University scientists concluded that a grandmother shares most genes with her son's daughters – and the least with her son's sons.

Applied to the Royal family, it would mean that Prince Andrew's daughter's, Beatrice and Eugenie, should find it easier to please the Queen than Charles's sons William and Harry.
And as sons of a son, the two princes should be among her least favourite grandchildren.
The researchers first used the laws of inheritance to work out how genetically similar a woman is to her children's children and found that overall, a grandmother and grandchild share around a quarter of their genes.

But differences in the way the genes on the X chromosome are passed through the generations mean that some grandchildren share more than this.
A woman passes around 31 per cent of her genes to her son's daughters but just 23 per cent to her son's sons. Her daughter's children fall in the middle, with both sexes sharing around 25 per cent of their genes.

The data was drawn from seven societies across the world and from the 17th to the 21st centuries.

Writing in the journal Proceedings of the Royal Society B, the researchers said: "Our sex-specific analysis shows that paternal grandmothers have a consistent opposite effect on boys and girls."

They add that a child may give off "signals" that make it easy for grandmothers to work out how close they are genetically. The clues may be in smell form, or may be as simple as facial resemblance.

Read More

Do Cellular Phones Lead To Bone Weakening?

Wearing a cell phone on your belt may lead to decreased bone density in an area of the pelvis that is commonly used for bone grafts, according to a study in the September issue of The Journal of Craniofacial Surgery, under the editorship of Mutaz B. Habal, MD, FRCSC. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

With long-term exposure, electromagnetic fields from cell phones could weaken the bone, potentially affecting the outcomes of surgical procedures using bone grafts, according to the new study by Dr. Tolga Atay and colleagues of Suleyman Demirel University, Isparta, Turkey.

Bone Density Slightly Reduced on Side Where Cell Phone Is Worn

The researchers measured bone density at the upper rims of the pelvis (iliac wings) in 150 men who were cell phone users and carried their phones on their belts. The measurements were performed using a technique called dual x-ray absorptiometry the same test used to measure bone density in patients with osteoporosis and other bone diseases.

Bone density was compared on the side where the men wore their phones (the right side in 122 men and the left side in 28) versus the opposite side. The men carried their phones for an average of 15 hours per day, and had used cell phones for an average of 6 years.

The results showed a slight reduction in iliac wing bone density on the side where the men carried their phones. The difference was not statistically significant, and did not approach the reductions seen in osteoporosis. However, the researchers point out that the men were relatively young average 32 years and that further bone weakening may occur with longer follow-up.

The results raise the possibility that bone density could be adversely affected by electromagnetic fields emitted by cell phones. Studies are evaluating the use of electromagnetic fields as a treatment to increase bone density in osteoporosis. However, those studies have used very low frequencies of 15 to 52 MHz. In contrast, the men in the new study carried cell phones with frequencies of 900 to 1,800 MHz.

The ilac wings are a widely used source of bone for bone grafting, so any reduction in bone density may be of special importance to reconstructive surgery. At least in procedures where bone density is important for good outcomes, surgeons may want to consider the possible effects of exposure to electromagnetic fields from cell phones.

The researchers emphasize that their findings are preliminary. Coming generations of mobile technology may lead to the development of new cell phones with lower exposure to electromagnetic fields. Meanwhile, Dr. Atay and colleagues conclude, "It would be better to keep mobile phones as far as possible from our body during our daily lives."

Read More

What Are Flat Feet (pes Planus, Fallen Arches)? What Causes Flat Feet?

Source: Medical News Today

Most people have a gap under the arch of their foot when they are in a standing position. The arch, the inner part of the foot is slightly raised off the ground. People with flat feet or fallen arches either have no arch, or it is very low.

The feet of people with flat feet may roll over to the inner side when they are standing or walking, and the feet may point outwards as a result.

A significant number of people with fallen arches (flat feet) experience no pain and have no problems. Some, however, may experience pain in their feet, especially when the connecting ligaments and muscles are strained. The leg joints may also be affected, resulting in pain. If the ankles turn inwards because of flat feet the most likely affected areas will be the feet, ankles and knees.

Some people have flat feet because of a developmental fault during childhood, while others may find that the problem develops as they age, or after a pregnancy. There are some simple devices which may prevent the complications of flat feet.

According to Medilexicon's medical dictionary, pes planus (flat feet) means "a condition in which the longitudinal arch is broken down, the entire sole touching the ground."
What are the signs and symptoms of flat feet or fallen arches?
A symptom is something the patient feels and reports, while a sign is something other people, including the doctor may detect. An example of a symptom may be pain in the ankle, while a sign may be a swelling.

Symptoms may vary and generally depend on the severity of the condition. Some have an uneven distribution of bodyweight and find that the heel of their shoes wears out more rapidly and more on one side than the other. The most common signs or symptoms of flat feet are:
Pain in..


..the ankle (inner side), there may also be swelling
..the foot in general
..the arch of the foot
..the calf
..the knee
..the hip
..the back
..the general lower leg area



People with flat feet may also experience stiffness in one or both feet.

One or both feet may be flat on the ground (either no arch, or very slight arch).

Shoes may wear unevenly.

What are the causes of flat feet?

Family history - experts say fallen arches can run in families.

Weak arch - the arch of the foot may be there when no weight is placed on it, for example, when the person is sitting. But as soon as they stand up the foot flattens (falls) onto the ground.

Injury

Arthritis

Tibialis posterior (ruptured tendon)

Pregnancy

Nervous system or muscle diseases - such as cerebral palsy, muscular dystrophy, or spina bifida.

Tarsal Coalition - the bones of the foot fuse together in an unusual way, resulting in stiff and flat feet. Most commonly diagnosed during childhood.

Diabetes

Age and wear and tear - years of using your feet to walk, run, and jump eventually may take its toll. One of the eventual consequences could be fallen arches. The posterior tibial tendon may become weakened after long-term wear a tear. The postario tibial tendon is the main support structure of the arch of our feet. The tendon can become inflamed (tendinitis) after overuse - sometimes it can even become torn. Once the tendon is damaged, the arch shape of the foot may flatten.
Our feet are incredibly well specialized structures. There are 26 different bones in each foot, held together by 33 joints and more than 100 muscles, tendons and ligaments (in each foot). They way they weave and align together determine the formation of our arches.

The aim of the arches is to give us spring and distribute our body weight across our feet and legs. The structures of the arches of our feet determine how we walk - they are rigid levels which allow us to move smoothly. However, the arches need to be sturdy as well as flexible to adapt to various surfaces and stresses.

During childhood it is normal to have flat feet. This is because our feet form during our childhood. In other words, having what appears to be flat feet during early childhood does not necessarily mean that it will persist throughout the individual's life.

People with very low arches or what appear to be no arches at all may experience no problems.

What are the risk factors for flat feet?

A risk factor is something that increases the likelihood of an illness or condition developing. For example, people who are obese are more likely to develop diabetes type 2 compared to slim people. Therefore, obesity is a risk factor for diabetes.

The following risk factors are linked to a higher probability of having flat feet:
Obesity
Diabetes
Getting older (aging)
Pregnancy
Rheumatoid arthritis
Foot or ankle injury
Posterior tibial tendon tear or dysfunction

How are flat feet or fallen arches diagnosed?

People who have flat feet without signs or symptoms that bother them do not generally have to see a doctor or podiatrist about them. However, if any of the following occur, you should see your GP or a podiatrist:
The fallen arches (flat feet) have developed recently
You experience pain in your feet, ankles or lower limbs
Your unpleasant symptoms do not improve with supportive, well-fitted shoes
Either or both feet are becoming flatter
Your feet feel rigid (stiff)
Your feet feel heavy and unwieldy
Most qualified health care professionals can diagnose flat feet just by watching the patient stand, walk and examining his/her feet. A doctor will also look at the patient's medical history. The feet will be observed from the front and back. The patient may be asked to stand on tip-toe while the doctor examines the shape and functioning of each foot.

In some cases the physician may order an X-ray, CT (computed tomography) scan, or MRI (magnetic resonance imaging) scan.

What are the treatment options for fallen arches (flat fleet)?

Some patients with flat feet may automatically align their limbs in such a way that unpleasant symptoms never develop. In such cases treatment is not usually required.
Pain in the foot that is caused by flat feet may be alleviated if the patient wears supportive well-fitted shoes. Some patients say that symptoms improve with extra-wide fitting shoes.

Fitted insoles or orthotics (custom-designed arch supports) may relieve pressure from the arch and reduce pain if the patient's feet roll or over-pronate. The benefits of an orthotic only exist while it is being worn.

Patients with tendonitis of the posterior tibial tendon may benefit if a wedge is inserted along the inside edge of the orthotic - this takes some of the load off the tendon tissue.

Wearing an ankle brace may help patients with posterior tibial tendinitis, until the inflammation comes down.

Rest - doctors may advise some patients to rest and avoid activities which may make the foot (feet) feel worse, until the foot (feet) feels better.

A combination of an insole and some kind of painkiller may help patients with a ruptured tendon, as well as those with arthritis.

Patients with a ruptured tendon or arthritis who find insoles with painkillers ineffective may require surgical intervention.

Patients, usually children, whose bones did not or are not developing properly, resulting in flat feet from birth, may require surgical intervention to separate fused bones (rare).

Bodyweight management - if the patient is obese the doctor may advise him/her to lose weight. A significant number of obese patients with flat feet who successfully lose weight experience considerable improvement of symptoms.
What are the possible complications of flat feet or fallen arches?
As fallen arches can affect the way a person's body is aligned when standing, walking or running, the risk of subsequent pain in the hips, knees or ankles is significantly greater.

People with other foot problems may find that flat feet either contribute to them or make symptoms worse. Examples include:
Achilles tendinitis
Arthritis in the ankle(s)
Arthritis in the foot (feet)
Bunions
Hammertoes
Plantar fasciitis (pain and inflammation in the ligaments in the soles of feet)
Posterior tibial tendinitis
Shin splints

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Long-term use of mobile phones 'may be linked to cancer'

Source: The Daily Telegraph
A preliminary breakdown of the results found a “significantly increased risk” of some brain tumours “related to use of mobile phones for a period of 10 years or more” in some studies.

The head of the Interphone investigation said that the report would include a “public health message”.

Britain’s Department of Health has not updated its guidance for more than four years. It says that “the current balance of evidence does not show health problems caused by using mobile phones”, and suggests only that children be “discouraged” from making “non-essential” calls while adults should “keep calls short”.

In contrast, several other countries, notably France, have begun strengthening warnings and American politicians are urgently investigating the risks.

The Interphone inquiry has been investigating whether exposure to mobile phones is linked to three types of brain tumour and a tumour of the salivary gland.

Its head, Dr Elisabeth Cardis, backed new warnings.

“In the absence of definitive results and in the light of a number of studies which, though limited, suggest a possible effect of radiofrequency radiation, precautions are important,” she said.

“I am therefore globally in agreement with the idea of restricting the use by children, though I would not go as far as banning mobile phones as they can be a very important tool, not only in emergencies, but also maintaining contact between children and their parents and thus playing a reassurance role.

“Means to reduce our exposure (use of hands-free kits and moderating our use of phones) are also interesting.”

The project conducted studies in 13 countries, interviewing tumour sufferers and people in good health to see whether their mobile phone use differed. It questioned about 12,800 people between 2000 and 2004.

Previous research into the health effects of mobile phones, in the short time they have been in use, has proved inconclusive. However, a breakdown of the latest findings, seen by The Daily Telegraph, shows that six of eight Interphone studies found some rise in the risk of glioma (the most common brain tumour), with one finding a 39 per cent increase.

Two of seven studies into acoustic neurinoma (a benign tumour of a nerve between the ear and brain) reported a higher risk after using mobiles for 10 years. A Swedish report said it was 3.9 times higher.

A summary said a definitive link could not be proved because of difficulties with subjects’ memories.

An Israeli study found heavy users were about 50 per cent more likely to suffer tumours of the parotid salivary gland.

The Interphone inquiry has faced criticism for including people who made just one call a week, and leaving out children, which some experts said could underplay the risks. Some results for short-term use appeared to show protection against cancer, suggesting flaws in the study.

The final paper, funded partly by the industry, has been delayed as its authors argued over how to present the conclusions. But it has been sent to a scientific journal and will be published before the end of the year.

A spokesman for the Health Protection Agency said there was “no hard evidence at present” of harm to health. Use by children for non-essential calls should be discouraged, he added.

A spokesman for the Mobile Operators Association said more than 30 scientific reviews had found no adverse health effects.

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Watching television late into the night could make you depressed

Researchers found that too much artificial light at night can alter mood and lead to similar symptoms to depression such as lack of energy and enthusiasm.

The team from Ohio State University believe the connection could explain why levels of depression have increased as the use of electric lights have increased.

The "blue light" from televisions could be especially disruptive.

The psychologists found that mice housed in a lighted room 24 hours a day exhibited more depressive symptoms than did similar mice that had a normal light-dark cycle.

The results suggest that more attention needs to be focused on how artificial lighting affects emotional health in humans, according to study co-author Professor Randy Nelson, a professor of neuroscience and psychology.

"The increasing rate of depressive disorders in humans corresponds with the increasing use of light at night in modern society," he said.

"Many people are now exposed to unnatural light cycles, and that may have real consequences for our health."

The study, which will appear in the journal Behavioural Brain Research, involved mice who were subjected to varying degrees of light at night.

The rodents subjected to the most artificial light were found to be the most depressive using tests used by pharmaceutical companies to test anti-depressive and anti-anxiety drugs in animals before they are used in humans.

The researchers believe that the findings do apply to humans.

"This is important for people who work night shifts, and for children and others who watch TV late into the night, disrupting their usual light-dark cycle," said Laura Fonken, lead author at Ohio State University.

She said that the ability to escape light did help remove the symptoms.

There are many other practical implications. Nelson noted that most intensive care units are brightly lit all night long, which may add to the problems of their patients.

"Light at night has significant social, ecological, behavioural, and health consequences that are only now becoming apparent,"said Professor Nelson.

"We suspect that suppression of melatonin may be involved in the effects of light at night on depressed affect. Blue light is especially good at suppressing melatonin so watching TV at night may reduce the nocturnal rise in melatonin."

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Yoga And Tai Chi As Pathways To Better Health

For an investment of 20 minutes each morning, the payback is reduced stress, a sense of calm and peace, improved strength, limberness, better immune function and lower blood pressure.

It's not too good to be true. The investment is practicing yoga or tai chi, which were developed and revised over many centuries. The October issue of Mayo Clinic Health Letter includes an in-depth Special Report on Yoga and Tai Chi, covering health benefits, differences between yoga and tai chi, tips for learning postures and poses, simple stretches, how breathing enhances energy, and resources to learn more.

An important advantage of yoga and tai chi is that they combine key elements of exercise -- aerobic, strength training, core stability, flexibility and balance -- into unified approaches. Certain benefits, particularly stress reduction, can be seen in as little as one day. People report better sleep and improvements in digestive health within the first few days. Better digestive health can mean better bowel function and decreased constipation. Practiced regularly, yoga and tai chi may help reverse some effects of aging, such as restricted and narrowed movements.

After 10 to 12 weeks of regular sessions, practitioners often notice significant health benefits in other areas. For example, a study of yoga and people who experience migraines found that those doing yoga had less frequent and less intense headaches than did those taking medication.

In addition, those who practiced yoga saw improvements in anxiety and depression. Yoga and tai chi can improve bone density and cardiovascular health and decrease blood pressure.

The best way to learn yoga or tai chi is by taking a class or working with a qualified instructor. These classes, which teach the art of breathing, meditation and posing, are offered at many health clubs and senior centers and through community education.

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FCPS PAST PAPERS: Radiology January 2009

1. Gastric emptying inhibited by
Ans. CCK

2. Which hepatitis has the most mortality
a. hepA
b. hep B
c. hep C
d. hep D ( ans)
e. Hep E

3. Aldosterone secretion increases in response to
a. hyponatremia
b. increase ACTH
c. hyperkalemia (ans)

4. 65% Na reabsorption is in
a. PCT (ans )
b. DCT

5. osmotic pressure depends on
a. increase molecular size
b. increase no of particles (ans)
c. electric charge

6. regarding heamoglobin
a doesnot carry CO2
b. acts as a buffer (answer )
c. contains 2 alpha and 2 gamma chains

7. diffusion is inversely proportional to
a. thichness of the membrane (ans )

8. infants tend to defecate immediately after they eat because of
a. gastroileal reflex
b. gastrocolic reflex (ans)

9. cause of achlasia is
a. loss of myenteric plexus (ans )

10. appendix
a. does not have tenia coli (ans )

11. what is the energy source after 48 hrs of starvation
a. muscle glycogen
b. liver glycogen
c. muscle proteins (answer)

12. which is not the part of portal tract
a. hepatic artery
b. connective tissue
c. portal vein
d. hepatic vein (ans)
e. bileduct

13. what results after portal hypertension
a. increase portal diameter (ans )

14. Benedict test is used for
a. urine glucose
b. urine ketones (ans)
c. serum glucose

15. iron absorption increases in
a. ferrous form (ans)

16. total gasrectomy results in
a. iron def anemia
b. microcytic anemia
c. pernicious anemia (ans)

17.women with gravida 4 hb 8 occult blood in stool cause
a. iron def anemia (ans)

18.which hormone is responsible for fetal brain development
a. growth hormone
b. prolactin
c. thyroid hormone (ans)

19.adrenal cortical def results in
a. hyperglycemia
b. hypokalemia
c. hyponatremia (ans)
20. hyperPTH will be in all except
a. brown atrophy
b. dystrophic calcification (ans)

21.pseudohyper PTH is seen in
a. vit D def
b. paraneoplastic PTH release from tumours ( I think it is the answer )

22. diagnostic criteria for pre malignant condition
a. increase nuclear cytoplasmic ratio
b. pleomorphism
c. mitotic figures

23. diagnostic criteria for malignant tumours
a. pleomorphism
b. mitotic figure
c. local invasion

24. diagnostic criteria for soft tissue tumours
a. pleomorphism
b. mitotic figures
c. increase vascularity

25. patient with decrease hb, decrease platelets but increase TLC with generalized lymphadenopathy. Lymphocytes normal appearance cause
a. tuberculous lymphadenitis
b. non Hodgkin lymphoma
c. hairy cell
d. CLL

26.patient with CML develop joint pain, which investigation
a. uric acid (ans)
b. RA factor

27. most important chemotactic agent
a. leukotriene B4
b. C5 complex (ans)
c. histamine

28. heparin is released by which cells
a. mast cells
b. basophils ( I think so it is the ans )
c. platelets
d. neutrophils

29. most radiosensitive tumour
a. bone
b. lung
c. lymphnode
d. brain

30.least site of metastasis
a. brain
b. lung
c. liver
d. lymphnode
e. spleen ( ans )

31.sideeffect of theophylline
a. hypertension
b. seizures (ans)
c. nausea vomiting
d. apnea

32. most common side effect of estrogen contraceptive
a. thromboembolism ( ans)

33. which hormone decrease cholesterol
a. progesterone
b. estrogen ( ans)

34.women with lower abdominal pain on 18 day of LMP presented with secondary infertility . diagnostic D&C will show endometrium in which sage
a. ovulatory
b. secretory
c. proliferative
d. premenstrual

35. insulin def will result in
a. protein synthesis
b. glycogen syntheseis
c. ketogeneis in liver (ans)

36. which is a stress hormone
a. cortisol (ans)
b. NE

37. severe dehydration will result in
a. loss of ICF only
b. loss of ECF only
c. loss of total body water (ans)

38. most imp ICF electrolyte in excess
a. K+(ans)
b. Na
c. Cl-
d. HCO3

39. Bilesalts absorb from
a. ileum (ans)
b. jejunum

40.factor 1X def what should be given
a. cryoprecipitate
b. FFP
c. whole blood

41.heavy smoker with hoarseness vocal cord will show
a. hyperplasia (ans)
b. tumour
c. atrophy

42.what is not present in bowman capsule
a. podocytes
b. stratified epithelium (ans)

43. habitual smoker the epithelium will be
a. continuous stratified sq epi
b. pseudo stratified epi with patches of stratified sq epi

44. regarding CSF
a. produced by chroidplexus which is cauliflower in shape coverd by smooth muscle
b. daily production is 500 ml per day(ans)

45. axon doesnot contain
a. mitochondia
b. nissl substance (ans)

46. PDGF released from which organelles of platelets
a. alpha granules (ans)
b. dense granules
c. cytoplasm
d. cell membrane

47. smooth muscle is
a. striated
b. cardiac muscle is a specialized smooth muscle (ans)

48.somites are formed from
a. ectoderm
b. mesoderm (ans)
c. mesenchyma

49.pt has difficulty rising from sitting position but flexion of leg is normal, which musle is involved
a.ileopsoas
b.gluteusmaximus (ans)
c. sartorius

50.pellagra is due to
a. niacin def (ans)

51.which enzyme common to metabolism of both NE and serotonin
a. COMT
b. MAO (ans )

52. thin filament is covered by
a. titin
b. tropomyosin ( ans)
c. troponin t

53.narrowest part of urethra
a. external meatus (ans)
b. membranous urethra
c. navicular fossa

54.dorsal rami contribute to
a. extensors of trunk(ans)
b. flexors of neck
c. extensors of leg

55.diapgragm doesnot arise from
a. T10(ans)
b. 7th costal cartilage
c.9th rib
d. L1

56.bones of carpel
a. proximal row contains scaphoid, lunate,triquetral, pisiform(ans0

57.lattismus dorsi nerve supply
a. thoracodorsal n (ans)

58.artery which is adjacent to the phrenic nerve
a. internal thoracic
b. musculophrenic
c. pericardiophrenic (ans)

59.lt recurrent laryngeal n not associated with
a. arch of aorta
b.ligamentum arterisus
c. trachea and esophagus
d. sup vena cava (ans)

60.foreign body enters into rt lung because
a. it is more vertical and wider than left lung(ans)

61.enlargement of which part of the heart causes esophageal obs
a. left atrium (ans)
b. rt atrium
c. rt ventricle

62. which vein of heart is located in posterior interventricular sulcus
a middle cardiac vein(ans)
b. anterior cardiac vein
c. great cardiac vein

63.contraction of diaphragm causes
a.increase thoracic pr
b.decrease abdominal pr
c. increase thoracic volume (ans)

64.medial quadrant of breast lymph drainage
a. internal thoracic nodes (ans)
b. posterior nodes
c. axillary nodes

65. tumour of cervix will spread to labius majora via
a. roung ligament of uterus (ans )

66clavipectoral fascia
a. invests pectoral minor muscle (ans)
b. is pierced by axillary artery
c.is continuous with prevertebral fasia

67. blockage of rt marginal artery will result in interruption of blood supply to
a. SA node
b. interatrium wall
c. rt atrium (ans)

68.thoracic duct
a. passes thru aortic opening (ans)

69.structure precent b/w celiac trunk and sup mesenteric artery
a. pancrease and jejunum
b. pancrease (ans)

70. structure not lying posterior to left kidney is
a. duodenum (ans)
b. spleen
c. tail of pancrease

71. most anterior structure in popliteal fossa is
a. popliteal vein
b. common peroneal n
c. tibial n
d. popliteal artery (ans)

72. regarding autosomal recessive trait
a. chances of siblings to be affected is one in four

73. sup petrosal sinus is related to
a. diaphragmatic sella
b. tentorium cerebelli
c. sella turtica
d. falx cebri

74. middle cerebral vein drains into
a. cavernous sinus
b. straight sinus

75. proximal portion of CBD is supplied by
a. cystic artey (ans)
b. rt hepatic artery
c. left hepatic artery

76.cbd is divided in to following portions
a. retroduodenal+infraduodenal+supraduodenal+intraduodenal(ans)

77. lesseromentum is divided inti following portions
a. gastrohepatic+hepatoesophageal+hepatoduodenal+gastrodenal (ans)

78. regarding mekels diverticulum
a. it is a remanant of embryonic yolk sac (ans)
b. it is precent in 10% of population
c. it is 60cm distal to ileocecal valve
79. what is the commenest site of ureter stone obstruction in a standing male patient
a. lateral wall of pelvis
b. pelvic brim (ans)
c. upper part of ureter

80. calculate the median in following data 20,24,25,30,30,35
a. 30
b. 28.5(ans)
c. 35

81. regarding behavioural sciences , how is the professionalism of a doctor judged
a. punctuality
b. reputation
c. knowledge

82. in order to disclose news regarding fatal disease
a. patient should know fist
b. relatives should be told first
c. information should be hidden

83. two gps of patients given haemmorhoidal treatment and their effect seen with time
a. prospective cohort study(ans)

84.antibodies are produced by which cells
a. neutrophils
b. plasmacells(ans)
c. macrophages
d. lymphocytes

85fat embolism all are true except
a. take place with damage to fat tissue only (ans)
b. trauma to the breast

86.in atherosclerosis following are seen
a. foam cells (ans)

87. migratory thrombophlebitis is seen in
a. acute pancreatitis
b. chronic recurrent pancreatitis
c. pancreatic tumour (ans)

88.which structure crosses the aorta
a.left renal vein (ans)
b rt renal vein
c. left ovarian vein

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Children Viewing Adult-targeted TV May Become Sexually Active Earlier In Life

Early onset of sexual activity among teens may relate to the amount of adult content children were exposed to during their childhood, according to a new study released by Children's Hospital Boston. Based on a longitudinal study tracking children from age six to eighteen, researchers found that the younger children are exposed to content intended for adults in television and movies, the earlier they become sexually active during adolescence. The findings are being presented at the Pediatric Academic Societies meetings on Monday, May 4 in Baltimore.

"Television and movies are among the leading sources of information about sex and relationships for adolescents," says Hernan Delgado, MD, fellow in the Division of Adolescent/Young Adult Medicine at Children's Hospital Boston and lead author of the study. "Our research shows that their sexual attitudes and expectations are influenced much earlier in life."

The study consisted of 754 participants, 365 males and 389 females, who were tracked during two stages in life: first during childhood, and again five years later when their ages ranged from 12 to 18-years-old. At each stage, the television programs and movies viewed, and the amount of time spent watching them over a sample weekday and weekend day were logged. The program titles were used to determine what content was intended for adults. The participants' onset of sexual activity was then tracked during the second stage.

According to the findings, when the youngest children in the sample--ages 6 to 8-years-old--were exposed to adult-targeted television and movies, they were more likely to have sex earlier when compared those who watched less adult-targeted content. The study found that for every hour the youngest group of children watched adult-targeted content over the two sample days, their chances of having sex during early adolescence increased by 33 percent. Meanwhile, the reverse was not found to be true that is, becoming sexually active in adolescence did not subsequently increase youth's viewing of adult-targeted television and movies.

"Adult entertainment often deals with issues and challenges that adults face, including the complexities of sexual relationships. Children have neither the life experience nor the brain development to fully differentiate between a reality they are moving toward and a fiction meant solely to entertain," adds David Bickham, PhD, staff scientist in the Center on Media and Child Health and co-author of the study. "Children learn from media, and when they watch media with sexual references and innuendos, our research suggests they are more likely to engage in sexual activity earlier in life."

The researchers encourage parents to follow current American Academy of Pediatrics viewing guidelines such as no television in the bedroom, no more than 1 to 2 hours of screen time a day, and to co-view television programs and have an open dialogue about its content with your children. They also suggest that--while the results demonstrate a longitudinal relationship--more research needs be done to understand how media influences children's growing awareness of human relationships and sexual behavior.

"Adolescent sexual behaviors may be influenced at a younger age, but this is just one area we studied," adds Dr. Delgado. "We showed how adult media impacts children into adolescence, yet there are a number of other themes in adult television shows and movies, like violence and language, whose influence also needs to be tracked from childhood to adolescence."

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How Do Our Attitudes About Beauty Change As We Age?

What people find beautiful about themselves may be different than what they find appealing in another person. That's just one finding from a recent consumer survey conducted on the BeautyforLife website (a joint venture of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.) Visitors were asked "What aspect of physical beauty do you find most appealing in another person?" In their 20s, 30s, and 40s, respondents look for a fit, well proportioned body; youthful skin ranked at the top for respondents in the 50s and 60s.

When considering "Which part of your body are you most concerned about?" respondents ranked their abdomen/hips number one in their 30s. But surprisingly, respondents listed the face, not their body, as the most popular choice in the 20s, 40s, 50s and 60s. "It is always important to understand what our patients are most concerned about at different stages of their lives. We want to be equipped to help our patients make the right decisions to maintain their beauty at every age-no matter which type of cosmetic medical procedure they are interested in." said ASAPS President Renato Saltz, MD. Additional results were revealed when answering "Which part of your body are you most concerned about?" While respondents primarily chose their face, significantly more respondents are concerned about their abdomen/hips than their breasts (chest)-with the disparity increasing throughout the decades: 1. 30s - 37% chose abdomen/hips as their top concern while only 18% chose breasts 2. 40s - 32% selected abdomen/hips and only 10% breast 3. 50s - 25% chose abdomen/hips compared to 7% breast 4. 60s - 23% indicated concern about their abdomen/hips, while only 7% selected breast Community members were also asked to consider "The most important reason to maintain your physical appearance." "To boost self-confidence" was the top choice across all decades, with "To attract potential partners" a close second for the 20s.

In the 30s and 40s, the second-most popular choice shifted to "To increase professional opportunities," which remained the number two choice in the 50s, but by a much smaller percentage. In the 60s, increasing professional opportunities fell to third behind "To help make friends." "The survey on the BeautyforLife website has provided interesting data about patients' attitudes, motivation and perception. Our goal is to provide useful tools for prospective patients to help them first decide if a cosmetic medicine procedure is right for them and then to provide information on how to choose an appropriate provider," said Dr. Richard D'Amico, past president of ASPS. Another question asked members to contemplate "The most important factor in maintaining beauty." While adherence to a healthy diet, regular exercise and skin care were popular choices, approximately one in five members felt that a cosmetic medical procedure was most important in the 50s and 60s.

This survey was conducted by The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, via their Beauty for Life program-a series of patient education tools, including the interactive website http://www.beautyforlife.com/ -designed to help people look and feel their best throughout their lives. More detailed survey results are available at by contacting the organizations.

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True Tales of Military Medicine: One Sunday in March

Since it’s Veteran’s Day, I thought it would be a good time to share one of my more memorable days in the Air Force Medical Corps. While this story does not deal with battlefield medicine, it does highlight some of the differences between civilian and military medicine.
It was the first Sunday in March. I was deployed to a small air base in the Middle East with the 820th RED HORSE, a group of construction engineers. We were halfway through a six-month deployment designed to improve the local infrastructure and air fields. I was the only physician assigned to RED HORSE (though there was another doc who took care of the rest of the base). I had two excellent medics working under me, and we had been able to keep the injuries and sicknesses to a minimum despite the construction crews working round the clock, seven days a week.
It had been a quiet Sunday morning in the medical tent so far. I was finishing the medical portion of our weekly situation report and thinking about that night’s midnight meal. Sunday was the one night a week the mess hall made waffles. This far from home, good food was always welcome and the waffles they made were unbelievably good. A sudden call over the radio broke my reverie.
“Man down at the checkpoint!” the radio blared. “Trapped under a concrete-”
I grabbed my kit and was out the door before the sentence had finished. The checkpoint was about ¾ of a mile away over desert terrain and I was running full tilt. Out of the corner of my eye, I saw a pickup crossing the sand in the same direction. Our vice-commander was driving and heading the same place I was. He slowed down and I jumped in the cab and we sped off to the checkpoint.
Once we got there, the source of the call was clear. A concrete road barrier had fallen over, trapping the entire right leg of John, one of our younger troops. As we arrived, a group of soldiers had managed to lift off the heavy block. A quick exam showed that his leg looked intact though the ankle was clearly pointing in the wrong direction. About this time the ambulance pulled up and Jesse, my senior medic, hopped out. After a second quick exam, we got John splinted, strapped onto a stretcher and loaded in the back of the ambulance. Jesse and I climbed in back with him while the driver got in front and we raced off.
Like many Arab nations, the country where we were stationed had several vastly different levels of hospitals. There were the lower quality hospitals that anyone, national or foreign-national, could visit. Next, there were the military hospitals. They had a much higher quality of care and that’s where we were headed. Finally, there were the elite hospitals only open to the aristocracy. We weren’t allowed to use these except in the direst emergencies, and even then we had to get permission.
The ambulance driver was relatively new at the job, so hadn’t yet realized that pure speed is not always the best choice. As Jesse, John, and I were tossed around the back of the ambulance, I wished that I had had the foresight to bring along some pain medicine for John.
We arrived at the hospital and John was whisked inside. I followed along while Jesse went back to update our commander. John was placed on an exam table and the Emergency Room doctor examined him. He called for x-rays. John was clearly in a great deal of pain, but refused to admit it. It took several doses of morphine before he was able to relax enough to get a good series of x-rays. The films showed quite a bit of damage: a tri-malleolar fracture, comminuted tib/fib fractures and a pelvic fracture. Remarkably, the femur was intact and the pelvis only had the single fracture — which is somewhat unusual.
The Emergency Department care at the local military hospital was good, but not up to American standards. The exam had focused only on the clearly injured parts of John’s right leg. Cautiously, I suggested that we perform a thorough inspection and we soon found several areas of skin severely damaged by the crushing concrete block. Because of the crush injury, there were concerns about a possible compartment syndrome and an IV was placed and run wide open.
An hour or so later, the local orthopedic resident came down and looked over John. He was clearly excited about the chance to operate and called his attending physician. The attending said that he’d come down and look at John, but it would take a few hours. The resident sauntered off and I settled down with John to wait. Frankly, I hadn’t been too impressed with the resident. His bedside manner was poor and his exam skills abysmal. I had concerns over a possible compartment syndrome, but the resident brushed them aside pointing out that John still had good capillary refill. While it’s true that capillary refill is compromised in compartment syndrome, it is one of the last signs to appear, and by the time it does appear the damage may be too severe to repair.
John and I had several long talks over the next few hours. He was in good spirits but was upset that he wouldn’t be able to finish his assigned mission. I did my best to cheer him up. More importantly, I made sure that he was properly taken care of. The Emergency Room staff seemed to forget he was there, so I made it my job to be the “squeaky wheel” and get him his IV fluids and pain medicine.
Finally the orthopedic attending arrived and decided that this hospital was not equipped to deal with such a severe set of fractures. The best hospital was a two hour drive away. I had serious reservations about transporting John for two hours in the back of a bumpy ambulance to the hospital I knew nothing about. I called the other physician on base and we decided our best option was to call for a Med Evac to take John to the US Army hospital in Landstuhl, Germany. I was concerned about his pelvic fracture as well as the poor local quality of medical care. An unstable pelvic fracture can cause a significant amount of bleeding, and while this one appeared stable, I wasn’t entirely convinced it would remain that way. I felt that US military medicine was John’s best option. I called the base and alerted our commander. He agreed.
After nearly ten hours cooped up in the local hospital, I was overjoyed to see our Air Force ambulance pull up. As we loaded John in the back, Jesse handed me a bag he had picked up from the only McDonald’s in the nation. It was a cold hamburger and fries, but at this point I was glad for any kind of food.
I had already updated Jesse on the plans by phone earlier and he had done a good job organizing the Med Evac. The plane was supposed to arrive at our airstrip at midnight. As we pulled onto base and were being searched at the vehicle search area, my phone rang. It was Doug, my other medic.
“James just tried to commit suicide,” he said.
James was one of our electricians who had come to me about two weeks into the deployment and told me that he may have made a mistake when he stopped taking his Prozac. He was a fairly depressed and anxious person who had been put on the anti-depressant while back in the US. It worked well enough that he decided he was “all better” so decided not to bring it along on deployment. I ordered some more from home for him, but that was a six-week shipment, and then it takes Prozac about four weeks to kick in. All the medics and I had done our best to help him, and I thought he had been doing much better. Apparently he had received some bad news from home and that pushed him over the edge. He ran into the command tent (where Doug was working on the computer), ripped off his wedding ring, threw it on the ground and stated that he was going to go kill himself by grabbing hold of some live wires. Knowing he was an electrician, Doug figured he meant business. Doug and the vice-commander tackled him and took him to our medical tent.
After Doug updated me on James, I called our commander back. I updated him on the latest situation and told him that we needed to ship James out as well. We simply didn’t have the manpower required to have someone watch over James at all times and there were no mental health facilities in the area. The Colonel listened to what I said and ultimately agreed. When the Med Evac came, it would take James as well as John to Germany.
It was now 2200. The medical tent was crowded. On one cot lay James under suicide precautions. That meant no shoelaces, no belt and one of the senior electricians was at his bedside watching over him. About ever half hour, we’d give him another injection of a milligram or two of Valium to keep him calmed down. On the other side of the tent strapped to the other cot was John. About every half hour, we’d give him another injection of a milligram or two of morphine to take care of his pain. It took us most of the next ninety minutes to fill out the proper paperwork and get all the minor details of the evacuation arranged.
When it was nearly midnight, we loaded them both in the back of the ambulance and headed out to the airstrip. Shortly after we arrived, a Med Evac C-130 landed. We pulled up to where it had finished taxiing. We handed the patients over and watched as the crew securely tucked them in. In a few minutes, the C-130 had taken off again. We jumped back in the ambulance and headed back to our tent. We cleaned everything up, inventoried the controlled substances, and then headed off to the mess hall. Sadly, we were too late. They had served the last waffle ten minutes before.

Courtesy: Scott

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New 'Molecular Condom' Meant To Prevent AIDS In Women

University of Utah scientists developed a new kind of "molecular condom" to protect women from AIDS in Africa and other impoverished areas. Before sex, women would insert a vaginal gel that turns semisolid in the presence of semen, trapping AIDS virus particles in a microscopic mesh so they can't infect vaginal cells. "The first step in the complicated process of HIV (human immunodeficiency virus) infection in a woman is the virus diffusing from semen to vaginal tissue. We want to stop that first step," says Patrick Kiser, an associate professor of bioengineering at the University of Utah's College of Engineering. "We have created the first vaginal gel designed to prevent movement of the AIDS virus. This is unique. There's nothing like it." "We did it to develop technologies that can enable women to protect themselves against HIV without approval of their partner," he adds. "This is important - particularly in resource-poor areas of the world like sub-Sahara Africa and south Asia where, in some age groups, as many as 60 percent of women already are infected with HIV. In these places, women often are not empowered to force their partners to wear a condom.
" A study testing the behavior of the new gel and showing how it traps AIDS-causing HIV particles will be published online later this week in the journal Advanced Functional Materials. Kiser is the senior author. "Due to cultural and socioeconomic factors, women often are unable to negotiate the use of protection with their partner," says Julie Jay, the study's first author and a University of Utah doctoral candidate in pharmaceutics and pharmaceutical chemistry. So the researchers developed a vaginal gel that a woman could insert a few hours before sex and "could detect the presence of semen and provide a protective barrier between the vaginal tissue and HIV," Jay says. "We wanted to build a gel that would stop HIV from interacting with vaginal tissue." Kiser estimates that if all goes well, human tests of the gel would start in three to five years, and the gel would reach the market in several more years. He and Jay want to incorporate an antiviral drug into the gel so it both blocks HIV movement and prevents the virus from replicating.
A Rocky Road to Microbicides against AIDS
The effort to develop microbicides - intravaginal gels, rings and films - to prevent transmission of the AIDS virus has been halting. The few that have reached human clinical trials in Africa failed to prevent HIV transmission - either because they carried antiviral drugs that were not long-lived or strong enough, or because patients failed to use them. Some experimental microbicides increased the risk, possibly by irritating vaginal tissue and attracting immune cells that are targeted by the virus. In 2006, Kiser and colleagues published a study on their development of another "molecular condom" to be applied vaginally as a liquid, turn into a gel coating at body temperature, then, in the presence of semen, turn liquid and release an anti-HIV drug. Unfortunately, few antiviral drugs bind to and attack HIV in semen. And in Africa, high air temperatures prevent the gel from turning liquid so it could coat the vagina evenly, Kiser says. The new "molecular condom" gel in the current study works in the opposite way. Like the old version, it changes in response to changes in pH - acidity or alkalinity - in the vagina caused by the introduction of semen during sex.
But unlike the old gel, which became liquid at the higher (less acidic) pH of semen, the new "molecular condom" becomes a semisolid at the pH of semen, forming a mesh of "crosslinked" molecules. The new gel is applied as a gel, and then becomes more solid and impenetrable as changes in pH alter the strength of the bond between the gel's two key components, both of which are polymers, or long, chain-like molecules made of many smaller, repeating units: PBA, or phenylboronic acid, and SHA, or salicylhydroxamic acid. Slowing and Blocking the AIDS Virus Kiser's team first published a study about the invention of the polymers and their behavior in 2007. A patent is pending on the invention. The chemical bonds between the two polymers constantly attach and detach at normal, acidic vaginal pHs of about 4.8, allowing the gel to flow, Kiser says. But at a pH of 7.6 - the slightly alkaline condition when semen enters the vagina - the PBA and SHA polymers "crosslink" and stick tightly together, he adds. Part of the new study characterized the flow of the gel.
"It flows at a vaginal pH, and the flow becomes slower and slower as pH increases, and it begins to act more solid at the pH of semen," Jay says. HIV moves slowly within the gel, even when the gel is at lower pHs (higher acidity) and still flowing, but the virus is blocked at higher pHs caused by the entry of semen into the vagina. The crosslinked polymers form a mesh that is smaller than microscopic, and instead is nanoscopic - on the scale of atoms and molecules - with a mesh size of a mere 30 to 50 nanometers - or 30 to 50 billionths of a meter. (A meter is about 39 inches.) By comparison, an HIV particle is about 100 nanometers wide, sperm measure about 5 to 10 microns (5,000 to 10,000 nanometers) in cross section, and the width of a human hair is roughly 100 microns (100,000 nanometers). Kiser says the gel should block other viruses and sperm, thus could work as a contraceptive and possibly prevent infection by herpes viruses and human papillomavirus (HPV), a major cause of cervical cancer. The gel also could help prevent AIDS by blocking movement of immune system cells that try to combat infectious agents but instead get hijacked by the AIDS virus. During the study, coauthors from Northwestern University in Chicago used a sophisticated microscope to track how fast HIV particles marked with fluorescent dye moved when they were caught in the gel, and how the speed varied with changes in pH. The researchers compared movement of HIV particles with latex particles, which revealed that under somewhat acidic conditions, the HIV particles are slowed down in part because their surfaces react chemically with the polymers. By adding an anti-AIDS drug such as tenofovir to the gel, "the virus would have two barriers to get through: the polymer barrier and then the drug barrier," Kiser says. Unlike an antiviral used with the old gel, tenofovir would not attack HIV directly, but protect immune cells in the vagina from infection. Kiser says that after sex, the vagina gradually becomes acidic again, and any residual HIV particles would be inactivated both by acidity and an antiviral drug within the remaining gel, which still impedes HIV to some extent at normal vaginal acidity.
Kiser and Jay conducted the study with four other University of Utah researchers: bioengineering undergraduates Kristofer Langheinrich and Melissa Hanson, bioengineering graduate student Todd Johnson, and bioengineering researcher Meredith Clark. Other coauthors were from the Department of Cell and Molecular Biology at Northwestern University Medical School in Chicago: Thomas Hope, Shetha Shukair and Gianguido Cianci. The study was funded by National Institutes of Health. Kiser's research team is continuing the effort to develop microbicides to prevent AIDS thanks to a $100,000 grant from the Bill and Melinda Gates Foundation. Upcoming work includes assessing the HIV-prevention potential of other polymers, testing the safety of the new gel on vaginal cells, and studying how well the new gel blocks the transport of HIV into samples of human vaginal and penile tissue from hysterectomies and circumcisions, respectively.

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