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A 19-year-old college student presents
with fatigue and sore throat. His
peripheral smear shows atypical
lymphocytes. His Monospot test is
positive.
What is the likely causative organism?
Comment upon this.
Try without options.
We have discussed it so many times.
Correct answer: c. Heimlich maneuver
🩺 Explanation:
The image shows the universal choking sign (hands clutching the neck). This is a classic sign of upper airway obstruction due to foreign body aspiration, commonly seen during eating.
---
🚨 Emergency Response in Adults:
If the person is conscious and choking, the first step is to perform the Heimlich maneuver (abdominal thrusts).
This helps to generate high intra-abdominal pressure to expel the foreign object.
> Other options explained:
a & b: Chest thrusts and back slaps are preferred in infants or unconscious patients.
d: Blind finger sweeps should be avoided, as they may push the object deeper.
---
📌 Conclusion:
The patient is a conscious adult with choking, so the best next step is:
> ✅ Heimlich maneuver (Answer c)
Correct Answer -D
Ans. D. All of the above
[Ref Ganong 24th/e p.603; Principles of medical physiology p. 293]
* Cerebrospinal fluid (CSF) is a clear, colorless, almost protein free
filtrate (transduate) of blood
It is present
*
⁃ Around the brain (in subarachnoid space) and inside the brain (in
its ventricles).
⁃ Around the spinal cord (in subarachnoid space) and inside the
spinal cord (in its central canal).
Answer: A) Closure of the aortic valve
Explanation: The dicrotic notch (or incisura) appears due to a brief backflow of blood that closes the aortic valve.
Correct Answer - C Answer: C-Relaxed state • Regarded as normal wavefront • Occur when at rest and eyes closed with active/wandering mind ◦f ie., associated with a decreased level of attention (either during relaxed/subconscious thinking) • Regular Rhythm (Frequency 8-13 Hz Amplitude - 50-100 V)
Читать полностью…
Correct Answer-A
Meissner's corpuscles are dendrites encapsulated in connective tissue and respond to
changes in texture and slow vibrations. Merkel cells are expanded dendritic endings, and
they respond to sustained pressure and touch. Ruffini corpuscles are enlarged dendritic
endings with elongated capsules, and they respond to sustained pressure. Pacinian
corpuscles consist of unmyelinated dendritic endings of a sensory nerve fiber, 2 m In
diameter, encapsulated by concentric lamellae of connective tissue that give the organ the
appearance of a cocktail onion. Theses receptors respond to deep pressure and fast
vibration.
Ref:Barrett K.E., Barman S.M., Boitano & Brooks H.L. (2012). Chapter 8. Somatosensory
Neurotransmission: Touch, Pain, and Temperature. In K.E. Barrett, S.M. Barman, S.
Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.
Correct Answer- A
Ans. A. Suprachiasmatic nucleus
The biologic clock responsible for the diurnal ACTH rhythm is
located in the suprachiasmatic nuclei of the hypothalamus
Correct Answer- A
Ans. A. 1-3 mm/min
Human sperm move at a speed of - 3mm/min through the female
genital tract.
Sperms reach uterine tubes 30-60 minutes after copulation
orrect Answer -C
Ans. C. Sleep
REM sleep decreases GH secretion whereas Slow-wave sleep (N3
of NREM) causes an increase in GH secretio
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Simple diffusion is not carrier mediated
transport hence do not follow saturation
kinetics.
◦ Facilitated diffusion, primary active transport,
and secondary active transport all involve
integral membrane proteins and are called
carrier-mediated transport.
◦ All carrier-mediated transport system follow
saturation kinetics
◦ The figure shows that as the concentration
of the diffusing substance increases, the rate
of simple diffusion continues to increase
proportionately, but in the case of facilitated
diffusion, the rate of diffusion cannot rise
greater than the transport maximum (Tm).
Tm is analogous to maximum velocity
(Vmax) level in enzyme kinetics
The clinical scenario is ectopic pregnancy (most likely a tubal ectopic pregnancy) at 6 weeks with:
Left adnexal mass (3 cm)
Presence of gestational sac and fetal pole (fetal node)
No fetal cardiac activity
---
✅ Best Management: Medical management (Methotrexate)
Answer: d. Medical management
---
💡Explanation:
This is a hemodynamically stable patient with an unruptured ectopic pregnancy, fulfilling criteria for medical management, which include:
✅ Criteria for Methotrexate:
Hemodynamically stable
Ectopic mass < 3.5–4 cm
No fetal cardiac activity
β-hCG level (ideally < 5000 IU/L)
Patient compliant for follow-up
Since:
Mass = 3 cm ✅
No fetal cardiac activity ✅
No mention of rupture or instability ✅
→ Medical management is appropriate
Correct Answer - D
The lower esophageal sphincter, a physiologic entity but not an anatomic structure, plays
an important part in preventing gastroesophageal reflux. Neural, hormonal, myogenic, and
mechanical factors influence the tone of the sphincter. Gastrin, vasopressin, glucagon,
adrenergic agonists, and cholinergic agents increase the pressure. Secretin has the
opposite effect.
Lipid-soluble substances are transported across
the cell membrane via diffusion.
• The rate of diffusion depends directly on the
lipid solubility.
Characteristics of simple diffusion
◦ Only form of transport that is not carrier-
mediated
• Occurs down an electrochemical gradient
(downhil")
• Does not require metabolic energy and
therefore is passive
• Permeability
• Describes the ease with which a solute
diffuses through a membrane
. Depends on the characteristics of the
solute and the membrane
• Factors that increase permeability:
•
0il/water partition coefficient of the
solute increases solubility in the lipid of
the membrane.
" Radius (size) of the solute increases the
diffusion coefficient and speed of
diffusion.
• Membrane thickness decreases the
diffusion distance.
◦ Small hydrophobic solutes (e.g., 02) have the
highest permeabilities in lipid membranes.
◦ Hydrophilice solutes (e.g
Na+) must cross
cell membranes through water-filled
channels, or pores. If the solute is an ion,
then its flux will depend on both the
concentration difference and the potential
difference across the membrane.
Cortisol is not stored before release.
All the steroid hormones (eg: Cortisol) are not
stored before release. As the steroids are highly
lipid soluble, once they are synthesized, they can
simply diffuse across the cell membrane and
enter the interstitial fluid and then the blood.
Hence, the steroid hormones require less time
for synthesis and minimum processing after the
arrival of stimulus, so they need not be stored in
the cell.
All the polypeptide and protein hormones
(eg: Insulin, Thyroxine, Renin) are stored in
secretory vesicles before release. They are
synthesized as much larger polypeptide chains
(preprohormones) that are biologically inactive
and then processed intracellularly by specific
proteases to yield the final hormone molecule
which is stored in the secretory vesicle until
needed.
Reference::
Guyton and Hall Textbook of Medical Physiology,
" 13e Page no: 926-928 "
Correct Answer - A
Ans.A.Decreased insulin
Decreased insulin is the first response followed successively by
increase in glucagon, epinephrine, cortisol and GH.
Correct Answer- A
In a vegetarian diet, nonheme iron is absorbed very poorly because of the inhibitory action
of a variety of dietary components, particularly phosphates, phytates and high fibre content.
Ascorbic acid and meat facilitate the absorption of nonheme iron. Ascorbate forms
complexes with and/or reduces ferric to ferrous iron. Meat facilitates the absorption of iron
by stimulating production of gastric acid; other effects also may be involved. Either of these
substances can increase availability several fold
Ref: Kaushansky K., Kipps T.J. (2011). Chapter 37. Hematopoietic Agents: Growth Factors,
Minerals, and Vitamins. In B.C. Knollmann (Ed), Goodman & Gilman's The
Pharmacological Basis of Therapeutics, 12e
Simple diffusion is not carrier mediated
transport hence do not follow saturation
kinetics.
◦ Facilitated diffusion, primary active transport,
and secondary active transport all involve
integral membrane proteins and are called
carrier-mediated transport.
◦ All carrier-mediated transport system follow
saturation kinetics
◦ The figure shows that as the concentration
of the diffusing substance increases, the rate
of simple diffusion continues to increase
proportionately, but in the case of facilitated
diffusion, the rate of diffusion cannot rise
greater than the transport maximum (Tm).
Tm is analogous to maximum velocity
(Vmax) level in enzyme kinetics
Correct Answer -B
End diastolic volume REF: Guyton's physiology 22nd edition page
111, http://en.wikipedia.org/wiki/Preload_%28cardiology%29
"For cardiac contraction, the preload is usually considered to be the
end-diastolic pressure when the ventricle has become filled"
Quantitatively, preload can be calculated as
LV EDT.LV ÉDR
2h
Where LVEDP = Left ventricular end diastolic pressure, LVEDR =
Left ventricular end diastolic radius (at the ventricle's midpoint), and
h = thickness of the ventricle. This calculation is based on the Law of
Laplace.
Correct Answer-B
Ans.B. Posterior lobe
Pituicytes are glial cells of posterior pituitary.
Correct Answer- A
Ans. A. 1-3 mm/min
Human sperm move at a speed of - 3mm/min through the female
genital tract.
Sperms reach uterine tubes 30-60 minutes after copulation
Correct Answer- B
Ans.B. Posterior lobe
Pituicytes are glial cells of posterior pituitary
Correct Answer-A
Ans. A. Supraoptic
ADH is formed primarily in the supraoptic nuclei, whereas oxytocin is
formed primarily in the paraventricular nuclei".
Correct Answer - A
Ans.A . GH
Acidophils of the anterior pituitary secretes growth hormone
and prolactin.
Correct Answer - C Answer: C-Relaxed state • Regarded as normal wavefront • Occur when at rest and eyes closed with active/wandering mind ◦f ie., associated with a decreased level of attention (either during relaxed/subconscious thinking) • Regular Rhythm (Frequency 8-13 Hz Amplitude - 50-100 V)
Читать полностью…
