Confirmatory test for HIV

Một phần của tài liệu MediCall book series (Trang 159 - 175)

 WESTERN BLOT

The enzyme-linked immunosorbent assay (ELISA), also known as an enzyme immunoassay (EIA), detects HIV antibodies and antigens in the blood. ... However, the Western blot is no longer used, and today the ELISA test is followed by an HIV

differentiation assay to confirm HIV infection 1Q: Hallmark of HIV.

 PROGRESSIVE IMMUNODEFICIENCY

HIV and CD4+ T Cell Depletion.These mechanisms fail in HIV infection

characterized by progressive immune deficiency. Loss of CD4+ T cells and systemic immune activation are the hallmarks of HIV infection

02 May2018 Morning (B)

1Q: Characteristic of amyloidosis

 CONGORED STAIN POSITIVE

Congo red is a vital dye that intercalates in amyloid fibrils to stain,conditions characterized by deposits of Congo red–positive

1Q: Athletes at rest have

 INCREASED STROKE VOLUME

stroke volume increases sharply at exercise onset up to around 40%O2 With aerobic exercise training, stroke volume increases at rest as well

1Q: Polycythemia feature

 INCREASED RBC MASS

Increased RBC mass indicates “true” polycythemia. An increase in plasma Hb attributed to a normal or high normal RBC mass and reduced plasma volume is termed spurious polycythemia. ... When saturation is <90%, hypoxia may cause increased erythropoietin (EPO) production and secondary polycythemia

1Q: Heart rate increased.

 END DIASTOLIC VOLUME DECREASED

Reduced heart rate, which increases ventricular filling time. Increased aortic pressure, which increases the afterload on the ventricle, reduces stroke volume by increasing end-systolic volume, and leads to a secondary increase in ventricular preload 1Q: Parietal cells when stimulated secrete

 ECL AND INTRINSIC FACTOR

The pH of the secreted fluid can fall by 0.8. Gastrin primarily induces acid- secretion indirectly, increasing histamine synthesis in ECL cells,which in turn signal parietal cells via histamine release/H2 stimulation

1Q: Doughnut shaped cyst.

 CRYPTOSPORIDIOSIS

Cryptosporidium parvum oocysts are ring or doughnut shaped 1Q: Right kidney anterior relation

 LIVER (ALL OTHERS WERE ALSO CORRECT SOMEHOW)

The right kidney is 2-8 cm lower than the left Kidney, because of the large liver which sits superior to it.Relationship: Anteriorly the right kidney is related to the Liver, duodenum and hepatic flexure of ascending colon

1Q: Absence of cartilage in terminal bronchioles differentiate it from

 CONDUCTING BRONCHIOLE

The primary bronchi, in each lung, which are the left and right from the tertiary bronchi in that their walls do not have hyaline cartilage and when the conducting zone changes to the respiratory zone

1Q: Maxillary sinusitis.

 STREPTOCOCCUS PNEUMONIAE

Air-fluid level (arrow) in the maxillary sinus suggests sinusitis especially in areas with known Streptococcus pneumoniae resistance

1Q: Lymphoid hyperplasia seen in.

 LEISHMANIASIS

protozoa from the genus Leishmania frequently seen among travellers returning from tropical Cutaneous lymphoid hyperplasia (CLH)

1Q: Bronchopulmonary segments in right lung

 10

Bronchopulmonary Segments.There are 10 bronchopulmonary segments in the right lung (3 in the superior lobe, 2 in the middle lobe, 5 in the inferior lobe), and 8

segments in the left lung (4 in the upper lobe, 4 in the lower lobe) 1Q: Impaction of foreign body at riht upper bronchus, collapse of.

 APICAL SUPERIOR SEGMENT

foreign body is shown in the right lower bronchus.but in most cases the apical segment of the right lower lobe did

1Q: SA node is pacemaker due to

 FASTER RATE OF GENERATING IMPULSES

SA node, the normal pacemaker within the electrical conduction system of the heart. The contraction of cardiac muscle (heart muscle) in all is initiated by electrical impulses known as action potentials

1Q: Highest velocity of conduction in purkinje fibers due to

 MORE GAP JUNCTIONS

The conduction velocity of electrical impulses is much higher in Purkinje fibers (2–3 m/s) than in myocardial cells (0.3–0.4 m/s). The fast propagation is partially due to the different connexins in the gap junctions in these cells

1Q: Ventricles are directly depolarixed by

 PURKINJE FIBERS

The sequence of depolarization is, according to Kisch : right ventricle apex, right ... The duration of depolarization is also much longer in Purkinje fibers

1Q: Low cardiac output seen in

 CARDIAC FAILURE

Cardiac output is the amount of blood your heart is able to pump in 1 minute.

The problem in heart failure is that the heart isn't pumping out enough blood each time it beats (low stroke volume)

1Q: Parotid supply

 GENERAL VISCERAL EFFERENT

General Visceral Efferent (Autonomic—Parasympathetic) The general visceral efferent, or parasympathetic fibers of the glossopharyngeal nerve, initially arises from the tympanic nerve. The following sequence then occurs for the tympanic nerve to supply the parotid gland

1Q: Atlas doesn't have.

 SPINOUS PROCESS

The vertebrae in these spinal regions all have unique characteristics.The atlas doesn't have a vertebral body or a spinous process

1Q: Rustling sound on auscultation, which layer involved

 PERICARDIUM

Fibrous pericardium Is a strong, dense, fibrous layer that blends with the friction sounds like the rustle of silk, which can be heard on auscultation

1Q: COVER-UNCOVER test indicate.

 TROPIA

Single cover test (cover-uncover test) The single cover test is generally

performed first.The presence of ANY movement on a single cover test indicates a tropia. In the case of a phoria, or latent deviation, the examiner observes the eye underneath the occlude

1Q: Abnormally thick saliva than usual, which receptors involved

 BETA1 &2

1Q: Porphyrins bind to.

 HEPTOGLOBIN

each hemoglobin protein can bind four oxygen molecules. One of the most important classes of chelating agents in nature are the porphyrins

1Q: Post-operative analgesia after limb surgery.

 KETOROLAC

Ketorolac significantly reduced the pain intensity 30-min after the operation 1Q: Changes after massive blood loss

 HYPOTENSION, TACHYCARDIA, LOW CVP

massive myocardial infarction or other cause of primary cardiac. Distributive - vasodilatation +/- leakage from endothelium with the following Class 4: 40% blood loss marked hypotension, tachycardia and tachypnea

1Q: Ability of organism to infect maximum with least dose(SOMETHING LIKE THAT)

 VIRULENCE

The infecting dose rises to 108 when the organisms are ingested. The virulence of F. tularensis is based on its ability to survive and replicate

1Q: Vibrio cholera

 RESISTANT TO ALKALINE MEDIUM

Vibrio cholerae O group They tolerate alkaline media that kill most intestinal commensals

1Q: Which nerve supplies a muscle that act On both hip and knee joint.

 FEMORAL

The femoral nerve, together with the iliopsoas muscle, lies more laterally tuberosity, cross both the hip and knee joints, have fascial and ligamentous as well 1Q: Cartilaginous model.

 OSTEOID BECOMES MATURE AFTER DEPOSITION

osteoid is the unmineralized, organic portion of the bone matrix that forms prior to the maturation of bone tissue. Osteoblasts begin the process of forming bone tissue by secreting the osteoid as several specific proteins

1Q: Arteritis involving temporal artery

 GIANT CELL ARTERITIS

Giant-cell arteritis (GCA), also called temporal arteritis, is an inflammatory disease of blood

1Q: Fibroblast secrete

 AMORPHOUS GROUND SUBSTANCE

Ground substance. Ground substance is an amorphous gel-like substance in the extracellular space that contains all components of the extracellular matrix except for fibrous materials such as collagen and elastin Components of the ground substance are secreted by fibroblasts

1Q: Hallmark of chronic inflammation

 LYMPHOCYTES AT SITE

Autoimmune reactions give rise to chronic inflammatory diseases such as rheumatoid arthritis. The hallmark of chronic inflammation is the infiltration of the tissue site by

macrophages, lymphocytes, and plasma cells (mature antibody-producing B lymphocytes) 1Q: Corneal epithelium supported by

 DESCEMENTS MEMBRANE

Descemet membrane is the basement membrane of the corneal endothelium 1Q: Farmer has interstitial fibrosis due to

 INORGANIC DUST

Exposures to inorganic (mineral) dusts among farmers and farm workers may be substantial.Pulmonary fibrosis (mixed dust pneumoconiosis) has been reported in

agricultural Work-related respiratory disorders among Finnish farmers 1Q: 17 alpha hydroxylase deficiency, defect in which step

 PREGNELELONE TO 17 HYDROXYPREGNELELONE

Patients with 17α-hydroxylase deficiency have alterations in their CYP17 gene and/or to carry out the 17,20 desmolase reaction of 17-hydroxypregnenolone

1Q: Fibers connecting mibrain with cerebellum

 SUPERIOR CEREBELLAR PUDUNCLE

Dissection showing the projection fibers of the cerebellum. (Superior peduncle labeled at center top.) In the human brain, the superior cerebellar peduncle (brachium conjunctivum) is a paired structure of white matter that connects the cerebellum to the midbrain

1Q: Fibers in pontocerebellary afferent mainly arise from

 MOTOR CORTEX

pons were motor cortex (areas 4 and 6), parietal association cortex (areas 5 and 7),The pontocerebellar projection is mainly crossed

1Q: Infectious mononucleosis

 CELLS INFECTED WITH EBV

Infectious mononucleosis (IM, mono), also known as glandular fever, is an infection usually caused by the Epstein–Barr virus (EBV)

1Q: 5 HT3 Agonist.

 ALOSETRON

The 5-HT3 antagonists, informally known as "setrons", are a class of drugs that act as receptor antagonists at the 5-HT3 receptor, a subtype of serotonin receptor found in terminals of the vagus nerve and in certain areas of the brain. With the notable exceptions of alosetron and cil etron

1Q: Prolonged oxygen therapy, patient developed.

 SPONATANEOUS PNEUMOTHORAX

The exact incidence of primary spontaneous pneumothorax is uncertain, although the Intubated patients being mechanically ventilated may develop an iatrogenic

1Q: Kaplan-Meir graph.. ??

Kaplan–Meier plot for two conditions associated with patient survival. The Kaplan–

Meier estimator, also known as the product limit estimator, is a non-parametric 1Q: Muscle causing extension and lateral roatation at hip.

 GLETEUS MAXIMUS

Hip abduction occurs when the femur moves outward to the side, as in taking the thighs apart. Each muscle of the lateral rotator group causes lateral rotation of the thigh.

These muscles are aided by the gluteus maximus and the inferior portion of the adductor magnus

1Q: Esophagus compression by enlargement of.

 LEFT ATRIUM

Echocardiography showed a left atrial, right atrial and right ventricular enlargement.

Esophageal manometry revealed hypotonic peristaltic contractions of the esophageal body and a lower than normal resting pressure of the lower esophageal sphincter

1Q: Esophagus

 NORMAL CONSTRICTION AT ARCH OF AORTA

aortic arch producing compression of the trachea and esophagus. Left the patient's left and be relieved of constriction

1Q: Test used to decide between dialysis or tr plant

 CREATININE CLEARANCE

dialysis or a kidney tr plant Creatinine clearance is tested by taking a 24-hour urine sample and a blood sample

1Q: Cerebellar lesion cause

 DYSARTHRIA

Dysarthria that has progressed to a total loss of speech is referred to as anarthria.

Neurological injury due to damage in the central or peripheral nervous system may result in weakness, paralysis, or a lack of coordination of the motor-speech system, producing dysarthria

1Q: Fibrosis will cause

 DECREASE VITAL CAPACITY

In patients with idiopathic pulmonary fibrosis, a restrictive ventilatory defect is typically present. Vital capacity, functional residual capacity, total lung capacity, and forced vital capacity (FVC) all are reduced

1Q: Structure derived from mesenchyme of pharyngeal arches

 LARYNGEAL CARTILAGES

pharyngeal arch structures, including the cartilages, the branchiomotor neurons for skeletal muscles derived from arch mesenchyme

1Q: Mild dyskeratosis noticed, classified as

 CIN1

Diagnosis of low‐grade squamous intraepithelial lesions (CIN 1)dyskeratosis and cytonuclear abnormalities such as multinucleation, nuclear hyperchromasia

1Q: Somites formed by

 PARA-AXIAL MESODERM

Paraxial mesoderm, also known as presomitic or somitic mesoderm is the area of mesoderm in As the primitive streak continues to regress, somites form from the paraxial mesoderm by "budding off" rostrally

1Q: Dormant stage of plasmodium in man.

 HYPNOXOITES

Plasmodium vivax has a dormant stage in the human liver. After the sporozoites enter the hepatocytes not all will develop into schizonts, but some remains as hypnozoites.A dormant stage in P. ovale has recently been questioned. Plasmodium falciparum and

Plasmodium malariae do not have a dormant liver stage

1Q: Degree of heat tr fer by evaporative and non-evaporative me

 DEPEND ON THERMAL GRADIENT

This is because human life implies relatively small temperature gradients

1Q: Wound at knee cap in 6 year child not healing despite daily dressing, cause

 MALNUTRITION OR HIGH MOBILITY??

stiff knee is a common problem and may be caused by an injury or knee condition.affect these movements, limiting the mobility at the joint, leading to a stiff knee

1Q: Post. Duodenal ulcer bleed

 GASTRODUODENAL ARTERY

gastroduodenal artery after unsuccessful left gastric artery embolization for a bleeding gastric ulcer

1Q: Difference between ICF & ECF.

 POTASSIUM HIGH IN ICF

xtracellular fluid (ECF) surrounds all cells in the body.Overall, the ICF contains high concentrations of potassium and phosphate ( H P O 4 2 Recall that an osmotic gradient is produced by the difference in concentration of all solutes

1Q: Breast cancer regarded high grade because of

 NUCLEAR MORPHOLOGY

breast cancers of no specific or of specific type, and was considered meaningless for this group of tumors because of the overlapping morphological and seen in cases with extensive DCIS, notably of high nuclear grade

1Q: Surfactant deficiency

 DECREASE COMPLIANCE

Surface tension is a “collapsing force” which opposes lungs exp ion and decreases compliance. Surfactant decreases surface tension, and hence, increases compliance (This is the why surfactant deficiency in respiratory distress syndrome causes lungs collapse)

1Q: Alternating breathing pattern high tidal volume then suddenly becomes low

 CHEYNE STROKE BREATHING

Cheyne-Stokes respiration is a type of breathing disorder characterized ... predicts worse outcomes and increases the risk of sudden cardiac death. ... breathing (waxing and waning amplitude of flow or tidal volume)

1Q: Dicrotic notch denotes

 AORTIC VALVE CLOSURE

Dicrotic notch and the incisura. This thing is widely believed to be the effect of the aortic valve closing.In fact, when it is measured in the aorta the notch is called the incisura, because it cuts into the waveform. However, further down the arterial tree the incisura disappears

1Q: Nucleus ambigus located in

 MEDULLA

The nucleus solitarius is the nucleus in the medulla that receives afferent

information from the larynx (via cranial nerve X) and posterior pharynx and mediates the gag and cough reflexes (cranial nerves IX and X)

1Q: Notochord derivative

 NUCLEUS PULPOSUS

In anatomy, the notochord is a flexible rod made out of a material similar to

cartilage. A postembryonic vestige of the notochord is found in the nucleus pulposus of the intervertebral discs

1Q: Axoospermia, investigation to be done.

 FSH AND LH

sperm can be found in the semen, then ICSI can be performed using sperm in the ejaculate.In men with azoospermia and normal testosterone, LH, and FSH Investigation of the infertile couple

1Q: Amenorrhea during lactation due to

 GnRH

Lactational amenorrhea is related to high plasma concentrations of prolactin, which appear to suppress the GnRH pulse generator

1Q: Reduce free radicles

 TR ERRIN

The ability of tr ferrin to potentiate oxygen free radical-mediated the release of tr ferrin-derived iron by reduction of tr ferrin-bound ferric iron (Fe3+)

1Q: In hyperthyroidism there is sensitization of heart to

 EPINEPHRINE

epinephrine with marked increases in heart rate and blood It was also learned from clinical experience that the hyperthyroid patient could react to thyroidism results in the clinical manifestations of this disease by sensitizing

1Q: Nucleolus

 LARGE AMOUNT OF RNA

nucleolus, a long ribosomal RNA (rRNA) precursor molecule is Fibrillar centers contain large amounts of RNA polymerase I, which tr cribes rRNA

1Q: Submandibular ganglion location bounded by

 MANDIBLE, ANTERIOR AND POSTERIOR BELLY OF DIGASTRIC

The submandibular triangle, also known as the digastric triangle, is bounded anteriorly by the anterior belly of the digastric muscle, posteriorly by the posterior belly of the digastric muscle, superiorly by the mandible, and inferiorly by the mylohyoid and hypoglossus muscles

1Q: Stress predisposes to

 CVS AND PSYCHIATRIC DISORDERS

psychiatric co-morbidity and efficacy of mirtazapine treatment in young subjects with chronic or cyclic vomiting syndromes

1Q: Risk of malignant melanoma increased.

 XERODERMA PIGMENTOSUM

Frequent mutation of the nucleotide excision repair (NER) system in both malignant melanoma and the inherited skin disease Xeroderma pigmentosum (XP) has led to

speculation about whether XP may influence melanoma risk 1Q: Repolarization carried out by

 POTASSIUM EFFLUX

Potassium - Biological functions. Potassium plays a determining role in the cellular repolarization. Depolarization caused by sodium and calcium influx is followed by repolarization caused by potassium efflux. The return of the cell to the state of initial or resting equilibrium is achieved by membrane Na+/K+-ATPASE

1Q: Characteristic about fat embolism

 MANIFEST AFTER 12 HOURS OF INJURY

manifestation of fat embolism syndrome (FES) can start from 12 hours to 3 days after diagnosis of the underlying clinical disease. The three most characteristic

1Q: Structure located 2 feet away from ileocecal valve

 MECKELS DIVERTICULUM

The solitary diverticulum lies on the antimesenteric border of the ileum (opposite to the mesenteric attachment) and extends into the umbilical cord of the embryo.Meckel's diverticulum is located in the distal ileum, usually within 60–100 cm (2 feet) of the ileocecal valve

1Q: Purine endproduct in human

 URIC ACID

Gout is common painful rheumatic disease, resulting from the deposition of monosodium urate monohydrate microcrystals or uric acid in various parts of the body, primarily in joints and surrounding tissues due to overproduction or underexcretion of poorly soluble uric acid which is the end product of endogenous

1Q: DNA coiling gets melted easily by abundance of which sequences

 C-T OR C-G

DNA replication, a major source of inheritance.The base–pairs in DNA are adenine- thymine (A-T) and cytosine-guanine (C-G)

1Q: Bonemarrow carry out of differentiation of undifferentiated stem cells under the influence of

 GROWTH FACTORS

such as the gut and bone marrow, stem cells factors that are typically produced by undifferentiated cells system and scientists can observe growth and differentiation of damaged heart, can have beneficial effects

1Q: Respiratory distress

 DIABETIC MOTHER

respiratory distress syndrome was present in five infants (0.95%) all were less than 34 weeks' gestational age most cases of respiratory distress in the infants of diabetic mothers were unrelated to surfactant deficiency

1Q: GFR

 10% DECREASE BY 10% DECREASE IN BP

arterial blood pressure coupled Overall the constriction of the afferent arteriole decreases both blood flow is very high the renal blood flow could be reduced to 10-30% of normal

1Q: Drugs alter GFR by

 ALTERING GLOMERULAR COEFFICIENT

Glomerular filtration rate (GFR) is defined as the volume of plasma that is filtered .The filterability factor significantly decreases as the molecular weight Altered Clearance of Renally Cleared Drugs in Patients With Kidney Disease

1Q: Sodium and water reabsorption

 ALDOSTERONE

If decreased blood pressure is detected, the adrenal gland is stimulated by these stretch receptors to release aldosterone, which increases sodium reabsorption from the urine, sweat, and the gut. This causes increased osmolarity in the extracellular fluid, which will eventually return blood pressure toward normal

1Q: Burns opportunistic infection

 CANDIDA

Burn patients are ideal hosts for opportunistic infections. Candida infection in burn patients has a reported mortality ranging from 14% to 90%

1Q: Orofecal route

 HEPATITIS E

Men who have sex with men (MSM) have an increased incidence of pathogens tr mitted by the oro-fecal route. Hepatitis E virus (HEV) is an emerging cause of acute hepatitis and fecal shedding is observed during primary infection

1Q: ADH stored in

 POSTERIOR PITUITARY

The posterior pituitary (or neurohypophysis) comprises the posterior lobe of the pituitary gland and is part of the endocrine system. Hormones known as posterior pituitary hormones are synthesized by the hypothalamus, and include oxytocin and antidiuretic hormone.

1Q: Typical sweating 2L wala scenario

 ICF OSMOLARITY INCREASE

Sweating causes hypotonic fluid loss ICF, ECF both and the total volume of water in the body has remained at a normal level

1Q: Important in maintaining GFR

 TUBULOGLOMERULAR FEEDBACK

The drop in GFR causes a tubuloglomerular feedback—mediated arteriolar dilation, restoring GFR and also increasing renal blood flow. Consequently, the regulation of GFR also results in the autoregulation of renal blood flow

1Q: Right sided weakness and diplopia on seeing left, lesion in

 MIDBRAIN OR CEREBRAL CORTEX

The lesion is on the opposite side of the hemiparesis Rarely, but this will occur if there is a lesion of the cerebral peduncle in the midbrain

1Q: Benign tumor and hyperplasia

 BENIGN TUMOR IS ENCAPSULATED

If a tumor lacks the ability to invade adjacent tissues or spread to distant sites by metastasizing then it is benign, whereas invasive or metastatic tumours are

malignant,Benign tumors will grow in a contained area usually encapsulated in a fibrous connective tissue capsule

1Q: Fetal HB

 LOWER AFFINITY FOR 2,3 BPG

fetal hemoglobin (HbF) exhibits a low affinity for 2,3-BPG, resulting in a higher binding affinity for oxygen

1Q: H antigen

 BLOOD GROUP OH

H antigen deficiency is known as the "Bombay phenotype" (h/h, also known as Oh) and is found in 1 of 10,000 individuals in India and 1 in a million people in Europe.Because the H antigen is the precursor of the ABO blood group antigens, if it is not produced, the ABO blood group antigens are also not produced

1Q: Patient has dyspnea on lying down.

 RETROSTERNAL GOITER

Retrosternal goitre is usually referred to as enlarged thyroid gland with greater than began to experience more difficulty in breathing even when lying down.The majority of patients present with shortness of breath or asthma

1Q: Treatment of pseudomembrane colitis.

 VANCOMYCIN

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