Thursday, December 8, 2016

Pearls of Renal System

*Pearls of Renal System*
*Important Points😊*
Increased osmolarity .... Tip of loop of henle
Decreased osmolarity ....... Early DCT & macula
Diluting segment .....Thick ascending limb
Concentrating segment...... CCD ( vasa recta)
Concentrating urine ..... function of.... *Vasa Recta*
Concentrating urine in summer or during fasting... *ADH*
DCT....Impermeable to water
Loop diuretics act on *Thick ascending limb*
Thiazide diuretics act on *Early DCT*
Both together act on... *DCT & CT*
Osmotic diuretics act on.... *PCT*
Renal columns contain... *Medullary rays / collecting ducts*
prone to ischemia....PCT
Maximum water & sodium absorption ....PCT
Maximum water & sodium absorption with any hormone ....PCT
Maximum potassium absorption....PCT
potassium loss due to dietry irregularities .... Distal tubules
H secretion in PCT is related to HCO³— reabsorption
After blood loss GFR & urine out put is increased by.... *Thick Ascending limb*
*Asthenuria* ... Decrease tubulointerstitial feedback
( increase plasma osmolarity / increased fixed sp. gravity )
Juxtamedullary nephrons....Vasa recta
Juxtamedullary nephrons... not supplied by peritubular capillaries
ADH...Acts on osmoreceptors / DCT
ADH....Increase Urea transport to DCT
ADH.... inhibited by alcohol
ADH... regulates plasma volume / urine osmolarity
ADH...V1 receptors cause vasoconstrictio
ADH...V2 receptors act on kidney
Highest tubular transport maximum....Lactate
Least Clearance...
Glucos
Threshold for Glucose....180
Glucose appears in urine.....250
Erythropoeitin secreted by peritubular capillaries
( mesengeal cells )
Amino Acid deficiency causes cell injury...Glycine
Amino acid cause injury to cell....choline
Amino Acid causing renal stones....Lysine
Amino acid in abnormal metabolism....Tryptophan
Isotonic loss...sodium remains same
Hypotonic loss.... Hyponatremia & ICF volume increases
Hypertonic loss.... hypernatremia , ICF volume contracts
Na/K/cl at basolateral membrane
ACE at luminal surface of endothelial cells
Kidney podocytes...at visceral layer of bowman capsule
Cresents formed by parietal cells linning bowman capsule
Paracetamol & sickle cell anemia... cause renal papillary necrosis
Renal calyses in normal VP.... 7
Renal segments....5
Capacity of renal pelvis... less than 5ml
Fanconi Anemia... BRCA 2 mutation
Na/H & Cl/HCO3.... Hypertonic cell volume regulation
K efflux from cell.... Hypotonic cell volume regulation
Smller system in B.P contro.... tubuloglomerular feed back
Long term B.p regulation.... Kidney
Normal Values for Acid base...
PCO2 : 5.3 KPa / 40mmHg
PO2 : 11 to 13 KPa / 75 to 100 mmHg
PH : 7.40
HCO3 : 22 to 26 meq
Maximum flow per gram.... Kidney
Maximum consumption of O2 ...Liver
Countercurrent multiplier require .... hypertonic medullary interstitium
Countercurrent multiplier require...maintaned by vasa recta
After 2 liter fluid loss , person drinks plain water ... increase ICF
1 liter blood loss in 5 min.... Increased venous tone
Lost 8 percent blood in 30 min, Volume significantly reduced...Capillary blood
PKD .. most common death id due to RENAL FAILURE
PKD... associated with Berry Aneurysm & Renal failre
Secreted from kidney... 1,25 dihydrocholecalciferol , Renin, Erythropoeitin
NOT secreted from kidney... Angiotensin 1
Angiotensin ... Increases extracellular K ( moving K out of cell)
Maintainance of ECF k... Na/ K pump
Most COMMON shift of K to ECF....Strenous Exercise
main action of Angiotensin 2... Vasoconstriction
Decrease Angiotensin.... Increases ECF volume
Dialysis pt are Prone to develop... Hepatitis B
GFR measure clinically / best estimated ... Creatinine clearance
GFR best Way to measure.... Inuline
Best way to measure RPF... PAH
Best test for renal failure... Creatinine clearance
Pyuria Culture negative... Poststreptococcal glomerulonephritis.
Persistent pyuria.... PKD & Urine at room temp. i. e. alkaline PH ( not cause by Poststreptococcal glomerulonephritis)
Renin... produced by JG cells
Renin...Long term B.P regulation
Renin...secretion may be stimulated by vasopressor secretion
Renin.. most potent stimulus for release is sympathetic outflow
Renin.. increased by ACE inhibitors, increase K, B1 receptors.
Renin...secretion INVERSLY related to Na & Cl in DCT
Immunoflorescence Granular... PSGN , SLE, Diffuse prolf. GN ,Membrane prolfi. GN
SubENDOthelial deposits...
SLE,
Diffuse prolf. GN,
Membrane prolfi. GN
Sub EPIthelial deposits...PSGN
Intramembranous Deposits...
Diffuse prolf. GN , Membrane prolfi. GN type 2
GB Thickening.... Membranous GN ( IC deposit ) ,
D.M ( type 4 Collagen)
Rapidly progressive GN associated with ...Good pasture, Micrscopic polyangitis (p ANCA)
Focal segmental Glomerulonephritis ... M.C.C of nephritis in Adults , associated with HCV > IV drug abusers , Bad prognosis , Leads to CRF
First sign of DM Nephropathy... Microalbuminuria
Medullary sponge kidney... swiss cheese appearance
Streptococcal infection ... Blood culture
Streptococcal infection COMPLICATIONS....ASO titer
Renal lesions in Wegner's Granulomatosis
Most common ...IgA nephropathy
Hyperaldosteronism.... INCREASED Na, DECREASED K & Renin , Muscle weakness, MET. Alkalosis, HTN.
Most potent stimulus Hypovolemia... Renin Angiotensin
Most potent stimulus Osmolarity....ADH
Most potent stimulus for Aldosteron... K >>> Renin
Mecula Densa sensitive to Na & osmolar load delivered to DCT
CNS manifestations in CRF DUE TO...
HYPOcalcemia,
HYPOnatremia
ACIDOSIS
( not due to hyperosmolarity)
Tetny occurs in REspiratory Alkalosis / HYpercapnia
BORN with PKD ... Autosomal Recessive
When ureteric bud doesn't grow towards metanephric cap.... *Absent ureter*
Sodium Absorption.... Aldosteron
Sodium excretion...ANP
Net SODIUM Absorption... Aldosteron & ANP
MOLE for MOLE Sodium Absorption... Aldosteron
SERUM osmolarity ....
300 m osm
GLOMERULAR capillary pressure increases due to ....... *short afferents*
MAJOR Buffers
Body / ECF.....HCO3
Renal Tubules....Phosphate
ICF...proteins
RBC....Hb
Acute Hemorrhage , sequence of replacement.... Plasma volue > Electrolytes > R.B.C
Plasma Osmolarity INCREASE in...Water deprivation
Plasma Osmolarity DECREASE in...SIDH
Plasma Osmolarity DECREASE by ...INjection of ADH
1 liter blood loss....Negative feedback
2 Liter blood loss ( stage 3 to 4) ....Decrease Stroke Volume
Renal excretion of drug... Affected by glomerular filteration

Saturday, October 3, 2015

Central Nervous system

CENTRAL NERVOUS SYSTEM


1.Spinal cord in children ends at L3

2.Spinal cord in adults ends at L1

3.middle meningeal artery arises from
 maxillary artery

4.csf is obtained from space b/w Arachnoid
 and piamater

5.3rd CN nuclei is Fiber for constrictor pupillae originate from edinger

6.Arterial supply to dura matter is frm all
 of the following Except basilary artery

7.artery supplying major part of superolateral surface of brain is middle cerebral artery

8.hypoglassal nerve is -12th CN

9.eye ball movements are controlled by all

of the following CN’s Except  optic nerve

10.largest CN is trigenimal nerve.

11.not a tributary of cavernous sinous 

superior petrosal sinus

12.nuclei deep with in the medial temporal
lobes of the brain amygdala

13.raphe nuclei are a modrate –size cluster
nuclei found in the brain stem

14.cross section of midbrain at the level of
 superior colliculus shows red nucleus 
 and occulomotor nerve nuleus

15.trochlear nerve nucleus @inferior colliculus

16.spinal part of accessory nerve supply

sternocleidomastoid muscle

17.primary auditory area is superior

temporal gyrus

18.primary visual area is occipital lobe

19.visual area[primary] is supplied by

posterior cerebral artery

20.a lesion involving UMN of facial nerve 
manifest as (upper half of the face
normal,lower half  affected UMN above the

facial nucleus in the pons)

21.nuleus ambigus is not ass/with which CN 7th

22.not involved in damage to cerebellum

 athenia *asthenia (weakness/lack of energy 

&strength/loss of strength.
  *it is prominent part of myasthenia gravis

23.loss of tactile localization &2point

 discrimination occurs in damage to somato sensory area 1

24.functions of limbic system 

emotions,memory&higher functions.

25.source of bleeding in extradural 

hemorrhage middle meningeal artery .

26.adductor pollicis is supplied by
 ulnar nerve.

27.teres minor &deltoid muscle is supplied 

by axillary nerve

28.nerve supply to gluteus maximus inferior gluteal nerve.

29.nerve supply hypothenar muscle is from 

ulnar nerve .

30.nerve passing deep to flexor retinaculum
 at wrist median nerve.


31.nerve related to spiral groove of
 humerus radial nerve .

32.nerve involved m/c ly in#of shaft of
 humerus  is median nerve.

33.nerve involved # of medial epicondyle of
 humerus is ulner nerve.

34.hansens disease 
ulnar nerve

35.cubital tunnel syndrome ulnar nerve.

36.nerve compressed in guyon’s canal
 is ulnar nerve.

37.ulnar nerve injury results in  clawing of
 fingers

38.#of fibular neck may involve common
 peroneal nerve.

39.nerve supply to the nail bed of middle
 finger median nerve.

40.tardy ulnar nerve palsy is commonly
 seen in cubitus valgus deformity.

41.palmar &dorsal interossei are supplied
 by ulnar nerve .

42.thenar eminence is supplied by median
 nerve .

43.lunate dislocation may injury to median
nerve.

44.ape thumb/pointing index/carpal tunnel

syndrome(median nerve injury.

45.parasympthetic secretomotor fibers to

submandibular gland is through(facial nerve.

46.nerve supply to platysma(facial nerve.

47.nerve supply to superior oblique
 muscle(trochlear(so4).

48.nerve supply to lateral rectus muscle
 is(abducens (LR6).

49.right phernic nerve passes through (vena
 caval opening.

50.vagus nerve pass through (esophageal
 opening

51.pain of CA base of tongue is refered to

the ear through (glossopharyngeal nerve .

52.circumvallate papillae of tongue are

supplied by(9th.(glossopharyngeal nerve).

53.forment’sign/book test/card test is done

for(ulnar nerve injury.

54.nerve of medial /adductor compartment

of thigh(obturator nerve.

55.gluteus medius ,gluteus minimus &tensor

fascia lata is supplied by (superior gluteal

nerve.

56.root value of pudendal nerve is(s2 s3

s4.

57.root value of obturator nerve is ( L2
 L3 L4.

58.root value of radial nerve (c5-t1.

59.artery crossing optic nerve is(opthalmic
 artery.

60.CN having longest intracranial
 cows(trochlear.

61.CN 3rd &4th have their nulei in (midbrain .

62.CN-9,10,11,12, have their nuclei

in (medulla.

63.CN emerging frm dorsal ascept of

brain (trochlear.

64.glands supplied by facial nerve

are(submandibular,lacrimal,nasal glands.

65.facial nerve dose not supply( parotid
 gland.

66.arterial supply to facial nerve (ascending
 pharyngeal artery.

67.all palatal muscles (except-tensor palati)
 supplied by( cranial part of accessory nerve.

68.right hypoglossal nerve palsy deviate the
 tongue to (right side.

69.paralysis of 3,4&6 CN’s indicates lesion
 of ( cavernous sinus.

70.afferent pathway of corneal
reflex(trigeminal nerve.

71.erbs palsy root value(c5c6.

72.partial claw hand(ulnar nerve .

73.total/true/complete claw hand (ulnar
 &median nerve.

74.Labourers nerve (median nerve.

75.nerve supply to adductor magnus is
 through(tibial part to sciatic nerve
 &obturator.

76.pudendal nerve is related to (ischial
 spine .

77.special somatic afferent nuclei (CN8.

78.4th&6th CN’s passes through ( superior
orbital fissurea.

79.muscle supplied by glossopharyngeal
 nerve(stylopharyngeus.

80.stadedius is supplied by(facial nerve.

81.motor supply to the muscles of the
 tongue is by (hypoglossal nerve.


82.the nerve that may get injured during
 the removal of 3rd molar is(lingual nerve.

83.Sensory nerve supply to angle of jaw is
 through (great auricular nerve.

84.the the muscle which is not supplied by
 recurrent laryngeal nerve is(cricothyroid.

          *cricothyroid is supplied by (
 external laryngeal nerve.

85.all the intrinsic muscles are supplied
 by (*recurrent laryngeal nerve .

86.auriculotemporal nerve does not
 supply (submandibular gland.


87.sensory nerve supply of the palatine
 tonsile is by(*glossopharyngeal nerve.

88.scala tympani is supplied
 by(*vestibulocochlear nerve.

89.occulomotor nerve supplies all muscles of
 the eye Except(LR&SO.

90.following spinal tracts are ipsilateral
 Except(anterior corticospinal.

91.synaptic transmission in autonomic
 ganglia is d/t(brain sten &scaral spinal cord.

92.sympathetic chain is(passes frm skull to
 coccys.

93.great vein of galen is formed by union
 of (two internal cerebral veins.

94.not a branch of basilar artery(posterior
 inferior cerebellar artery.

95.posterior cerebral artery is not a branch
 of(interal carotid artery.

96.true abt conus syndrome are all
 Except(knee&ankle jerk are abscent.


97.the papillary light reflex can be
 eliminated by cutting which of the following
 nerve (occulomotor ,short cilliry &optic
 nerve .

98.the taste pathway from palate goes
 through (greater petrosal nerve branch of
facial nerve

99.post superior alveolar nerve is a branch
 of( maxillary nerve.

100.left phernic nerve runs through
 (anterior to scalenus anterior.



101.rupture of the internal vertebral venous
 plexus results in an accumulation of blood inWhich of the following space (space b/w
 duramater &periosteum of vertebra.


102.the nerve innvoting  the four muscles
 in the suboccipital tringle emerges frm or
 b/w Which of the following (b/w the
 occipital bone &the atals(C1).

103.primary curvature of vertebral column
 are(thoracic &sacral.

104.branch frm the trunk of brachial
 plexus (suprascapular nerve.


105.function of basal ganglia
(programming
 of muscle movements.

106.intention tremers are seen
 in (cerebellar lesion .

107.main excitatory neurotransmitter in
cns(glutamate.

108.hypothalamic nuclei controlling thrist
 &water balance (supra optic.

109.broaca’s area is present in (inferior
 frontal gyrus.

110.impaired comprehension of spokes
 &written language is known as(wernickes Aphasia. 
                          

111.nightmares are seen in
(REM sleep.

112.pneumotoxic centre is present in (dorsal
 pons.

113.temperature regulation is done
 by(hypothalamus.

114.dreaming is common in which phase of
 sleep(REM .

115.neurotransmiter depleted in parkinson’s
 disease (dopamine.

116.law explaning phantom limb(law of
 projection.

117.tract involved in parkinson’s
 disease (nigro-striatal pathway.

118.Shivering is controlled
 by(posterior/lateral hypothalamus.

119.true for alpha waves are all
 Except(predominantly recorded frm
temporal region .

120.preganglionic neurotransmitter in
 sympathetic division of autonomic nervous
 system Is (actylcholine.


121.poaterior part of hypothalamus is
 concerned with (regulation of response to
 smell.

122.bipolar cells are seen in(retina.

123.all are carried through anterolateral
 system Except(propricoception .

124.propricoception is carried through(dorsal
 column medial lemniscal system .

125.all or non law is obeyed by (action
 potential.

126.sensory fiber with least conduction
 velocity (c-fiber (0.5-2m/sec).
                                    *fast conduction velocity (alpha fiber (70-
120m/sec).

127.all are primary colours Except 
(white.

128.true abt colour blindness(defect in one or more prime colour .

129.true abt semicircular canals is(arranged at 8angles to each other .

130.stretch reflex of urinary bladder is intergrated at (sacral portion of spinal cord.

131.function of neocerebellum is
(planing &programming of voluntary movements.

132.all of the following are concerned with spatial orientation (vistibular receptors,
                                                                                   Eyes,proprioceptors in joint capsule.

133.A cut/leasion above the pyramidal tract decussation results in (paralysis of opp.half Of the body.

134.which lies in the dorsal column of spinal cord (fasicular gracilis.

135.clasp knife rigidity is also known as (inverse stretch reflex < lengthening reaction .

136.neurotransmitter depleted in parkinson’s disease(dopamine.

137.function of flocunodular lobe of cerebellum is( equilibrium.

138.alpha wave in EEG are seen in (awake state .

139.delta wave are seen in (deep sleep.

140.features of occipital lobe of brain are all Except
(it’s the only area in the brain
                                                                                      Activated by visual stimuli.

141.neuroglial cells in the CNS (oligodendrocytes
                                         .microglia
                                        .astrocytes.

142.max no.of sodium channels per square micrometeris present in
(nodes of ranvir.

143.sweating is mediated by(cholinergic mediated sympathetic activity. *sympathetic postganglionic neurons innervating (sweat glands.

144.function
of muscle spindle is(maintain muscle length.

145.sensory organ for responding to texture is (meirsmer corpuscles.

146.acetylcholine receptors are decreased in 
(myasthenia gravies.

147.all of the following are cholinergic effects Except(tachycardia.

148.properties of alpha waves are seen in all Except(seen in rem sleep.

149.melatonin is ass/with all of the following Except(vomitings

150.all of the following effects can occur if vagus is stimulated Except(bronchial
                                                                                          Musculature relaxation.

151.when both vagal cut,respiration becomes (deep &slow.

152.influx of which of the following ion is responsible for IPSP
(chloride ions.
                                            (inhibitory postsynaptic potential).

153.vomitting centre is situated in the 
(medulla.

154.optic nerve is (2nd order neuron .

155.which of the following is not carried in dorsal column of spinal cord 
(heat sensation

156.not ass/with temporal lobe
(spatial relationship.

157.vagal stimulation causes (decreased depth of respiration .

158.complete apneusis will result if transaction is done at (lower pons.

159.intrafusal fibers of the striated skeletal muscles are inverted by one of the following
               
Type of motor neuron (gamma.*extrafusal fibers(alpha.

160.synaptic potential can be recorded by(microelectrode.

161.example of neurohormone (oxytocin (released frm –hypothalamus).

162.muscle weakness is seen in all Except(physostigmine therapy.

163.which ions helps in resting membrane potential in neurons(pottasium(k+).

164.magnitude of action potential is mainly affects by
(sodium(Na+).

165.type of exercise done to increase the muscle strength is(isotonic

166.nicotinic receptors are seen in all Except(bronchial smooth muscle..

167.size of the action potential decreased as a result of( lower extra cellular sodium.

168.fibrillation of skeletal muscle is ass/with all Except(strong stimulus.

169.most serous complication of measles is (mengio-encephalitis.

170.the absolute C/I to lithium is
(renal failure.

171.lithium toxicity is treated by following methods Except(acidification of urine.

172.antipsycotic drugs act through (dopamine 2 receptor blocked.

173.not used in bipolar disorder (phenytoin.

174.DOC for drug(phenothiazine)induced parkinsonism(benzhexol.

175.which anti-epileptic drug will cause hirsutism in a 30 years old women(phenytoin.

176.false statement regarding phenytoin is(follows zero order kinetics at lower doses.

177.true abt impramine is(anti depressant .

178.short acting neuromuscular blocking agent (mivacurium.

179.DOC for petitmal /absence seizures (valporate.

180.malignant neuroleptic syndrome is caused by (antagonist.

181.true regarding buspropion is(nicotinic receptor antagonist .

182.antidote for restyl/alprazolam is(flumazenil.

183.phenobarbitone and warfarin interaction results in(increased metabolism of
                                                                                      Warfarin .

184.an anxiolytic benzodiazepine  which is also anti depressant(alprazolam.

185.drug C/I in the pt of myasthenia gravis (tubocurare.

186.antidepressant drug that can cause neuroleptic malignant syndrome &tardive
                                                             Dyskinesia 
(amoxapine.

187.which of the following drug not given in acute maina (lamotrigine.

188.DOC for acute migraine is(sumatriptan.

189.TOC in attention deficit hyperactivity 
disorder (ADHD)(methylphenidate.

190.baclofen is used in(spasticity.

191.DOC for status epilepticus(lorazepam .

192.false statement regarding phenobarbitone (no significant interaction with warfarin.

193. site of action of vecuronium(myoneurol junction.
194.when the sympathetic nervous system is activated (norepinephrine is released Frm axon onto the anterior wall.

195.regarding suckling reflex ,which of the following is true (triggers the release of
                                                                      Oxytocin by stimulating the supraoptic nuclei

196.negri body is most commonly found in(hippocampus.

197.most frequent site of brain abscessis(frontall lobe.

198.glioma of optic nerve is usually pilocytic astrocytoma.

199.phagocytes in cns(microglia.

200.mcc of IC bleed (HTN.

201.celebellar ataxia is caused by(cytosine arabinoside.

202.wrong abt antiepileptics(valproate reduces t1/2 of lamotrigine.

203.m/c cause of acute pyogenic/bacterial meningitis in adolescents and young adults(N.meningitidis.
                                      *adults(streptococcus pneumonia.
                                              *neonates (E.coli and group B streptococci.

204.lisch nodules are seen in( neurofibromatosis.(NF1)*not found in NF2.

205.pathological changes /findings in rabies is (negri bodies.

206.parkinson’s traid(rigidity ,risting tremors,bradykinesia.

207.in myasthenia gravis antibodies are +nt against (nicotinic receotor proteins.

208.mcc of viral encephalitis(herpes simplex.(m/c entro virus).
*m/c complication after mumps.

209.m/c site of hypertensive intraparenchymal hemorrhage in brain (putamen.

210.in GBS( asending flaccid symmetrical paralysis is seen and histological Inflammation .

211.pathology of alzehimers disease is (accumulation of beta amyloid protein .

212.which of the following cancer metastasize to brain leastly(prostate cancer.

213.m/c cause of meningitis in aids (cryptococcus.

214.negri bodies are seen in (nerve cells.

215.carpal tunnel syndrome involves(median nerve.

216.trendenlenburg’s sign seen in(superior gluteal nerve injury.

217.m/c muscle complete paralysed in polio(tibialis anterior.

218.the commenest of spinal discprolapse  occurs in lumberspine at the level(L4-L5.

219.neuropathic joints are seen in (syphillis,DM,myelomeningocele.

220.fasciculation are most commonly seen with(motor neuron disease.

221.mcc of stroke in elderly is (embolic.

222.anti-actylcholine receptor antibodies are found in (myasthenia gravis.

223.wernicke’s encephalopathy is d/t deficiency of vit B1(thiamine).

224.winging of scapula is d/t (long thoracic nerve palsy.

225.mcc of dementia seen in elderly pt’s is (alzheimers disease.

226.feature of alpha rhythm in EEG (disapper when a pt opens eyes.

227.shivering is caused by(stimulation of fibers coming frm posterior hypothalamus.

228.in primary syphilis primary treatment used(inj.of benzathine pencilline 2.4
                                                                                        Million unit I/M single dose.

229.DOC for GTCS(sodium valporate.

230.in pathogenesis of Parkinson which play an important role(dopamine.

231.IOC in acute subarachnoid hemorrhage (CT-scan.

232.intracranial calcification are best diagnosed by(CT.

232.nesseria meningitis contain following virulent factors Except(beta-lactamase.

233.in cavernous sinus thrombosis 1st CN to be affected is (6th CN.

234.contre-coup injury to brain is more common in(moving head.

235.a pt with sinus infection develops chemosis B/L proptosis and fever most likely
Diagnosis( cavernous sinus thrombosis.

236.neck stiffness and kernig’s sign are seen in(meningitis.

237.target fibers are not seen in(dermatomyositis.

238.a pt  P/with h/o 2 episods of left eye blindness ,right hemiplegia&transient speech Difficulty ,which lasted 20mins each ,which is the most possible site of obstruction (left niddle cereberal artery.

239.tinel sign is suggestive of (nerve regeneration .

240.in anterior shoulder dislocation m/commonly involved nerve is (axillary nerve.

241.radial nerve mostly injured in fracture of(shaft of humurus.

242.cock-up splint is used in(radial nerve injury.

243.wrist drop is by(radial nerve injury.

244.foot drop is by(common peroneal nerve injury.

245.loss of conduction of nerve fiber or physiological paralysis of nerve fiber in (neuropraxia.

246.poliomyelitis(paralysis is asymmetrical,
m/c muscle affected is quadricepis femoris.
Where as complete paralysis is seen with tibialis anterior.

247.increased neuromuscular irritability is a feature of (hypocalcemia.

248.paradoxical breathing is seen in (diaphragmatic palsy.

249.pseudohypertrophy of muscle is a feature of(duchnne muscular dystrophy.(DMD).

250.sxcal procedure done in myasthenia gravis(thymectomy.

251.CSF findings in a pt with TB mengitis isincreased protein Decreased glucose,Increased lymphocytes
                              
252.all are true abt cluster head ache Except (seen B/L.

253.presence of hemiplegia with diminution of vision in the C/L eye suggests Occulussion of (internal carotid artery.

254.B/L facial palsy is seen in (GBS.

255.CN most commonly involved in posterior communting artery aneurysmIs(occulomotor.

256.fasiculations are seen in lesions of (LMN type of lesion.

257.parkinson’s disease and parkinsonism differs in all of the following
Except(symptomatology.

258.upper motor neuron lesion is characterized by(weakness &spasticity.

259.not seen in a case of hemorrhage in MCA territory(urinary incontinence.

260.brain death is defined as(loss of brain stem function .

261.characterstic of GBS is(loss of limb reflex.

262.spike and dome pattern is seen in (petitmal seizures.

263.an upper motor neuron lesion of facial will cause (Paralysis of half of the face on opposite side.
                                              264.argyll Robertson pupil is seen in (neurosyphilis.

265.mcc of SAH(saccular aneurysm repture/berry aneurysm.

266.initial IOC in SAH(CT-scan .

267.antibodies against actylcholine receptors are seen in (myasthenia grvis.

268.Flapping tremors seen in all Except(thyrotoxicosis.

269.B/L pin point pupil ,hyperpyrexia&loss of consciousness is suggestive of(pontine hemorrhage.
                                                                                       
279.in dominated parietal lobe head injury  all of the following are seen Except(Urinary incontinence.
                                           
280.m/c cause of intracranial bleed is(HTN.

281.which of the following sensation is preserved on the side of the lesion inbrownSequard syndrome(temperature.
                                                            

282.CN commonly involved in GBS(facial.

283.m/c causative agent for meningitis in the immonocompromised pt is(cryptococcus.

284.Not a component of thalamic syndrome(sexual alteration.

285.nissl substance is found in(neuron.

286.ragged red fibers is ass/with (MERRF syndrome .

287.correct statement regarding von reklinghausen disease (NF1)are all Except
                                                                                                
(neuron turns malignant.
288.a pt with head injury opens eyeson painful stimulus,uses inappropriate words and
 Localizes pain .what is his 
GCS(10.

289.a pt sustained RTA and endotracheal intubation was done most likely GCS of such aPt be(8.
                                   
290.what is not seen in head injury (GCS score 0.

291.minimum  GCS (3 (max-15).

292.GCS in a case of mild head injury
(14/15 with LOC
                                            Moderate(9-13.
                                            Sever(3-8.

293.which of the following is not a feature ofnormal pressure hydrocephalus(
                       
Lesion is blockage of csf pathology for the lateral to fourth ventricle.

294.raised intracranial pressure will cause(papilloedema.

295.lucid interval is ass/with(extradural hematoma.

296.source of chronic subdural hematoma is (venous.

297.epidural hemorrhage commonly occur from tearing of (middle meningeal artery.

298.feature of diffuse axonal injury(prolonged unconsciousness.

299.GCS(3.

300.ECG is least useful for diagnosing ischemic disease d/t which of the following (Left circumflex artery.
                                                                                           
301.diseases involving misfolded protein defect include the following Except(Multiple sclerosis.
                                                                                       302.features of wernike’s encephalopathy are all Except(parapresis.

303.most sensitive test for the diagnosis of myasthenia gravis is( elevated serumAch-receptor binding antibodies. 
                                                                                         
304.the hyperkinetic features of the huntington’s disease are d/t the loss of(             Intrastrisatal GABAergic and cholinergic system.
                                              
305.EEG is abnormal in the following Except(locked-in state

306.characteristic EEG pattern in absence seizures(3-Hz spike-and-waves.

307.all of the following are neurologic channelopathies Except
(spinocerebellar ataxia 

308.livedo reticularis is an adverse effect of which of the following anti-parkinsonismDrug(amantadine.
                                                                                                                

309.p-100 response in neurodiagnostics refers to (visual evoked potential .

310.defective proteins involved in the pathogenesis  of parkinsons disease are( Alpha synuclein,dardarin,parkin etc..
                    
311.correct definition of myoclonus(sudden ,brief {<100 ms},shocklike arrhythmic Muscle twitches.
                                                                                                               
312.the scaralspinal segments lie at what vertebral body levels(D12-L1

313.m/c clinical type of multiple sclerosis(RRMS(relapsing/remitting multiple sclerosis

314.treatment of Tic Douloureux (trigeminal nerve neurolagia) includes(Carbamazepine,baclofen,radiofrequency thermal rhizotomy.
                                        
315.vit-B12 deficiency can give rise to all of the following ,Except(myopathy.

316.which of the following is false regarding progressive multifocal leukoencephalopathy(indolent course.                                                                                                             
317.the following are supplied by posterior cereberal artery(PCA)Except(pons.

318.CN involved when the posterior laterocondylar space is compromised(9,10,11,12.

319.true abt pneumococcal meningitis include all Except(has it peak age incidenceIn childhood.
                                                                                                                     
320.20yrs/girl c/o headache while studying .her vision is found tobe normal.
       Which of the following you need not enquire to evaluate her headache.
(menstural history.
                                                                                  
321.a young 29yrs/m in casualty with sudden onset “thunderclap” headache and
        Unconsciousness .he has u/l dilated pupil.what is the most probable cause
(acute SAH.
                                                                                                 

322.horner’s syndrome can be caused by following Except(medial medullary syndrome.

323.60yrs/man with c/o progressive dementia for the past 6months P/with suddenly
              Developed diffuse jitterness of whole body .EEG showed sharp bipolar spikes In temporal lobes .diagnosis is
(creutzfeld jackob disease.

324. ‘onion bulb” changes in nerve are seen in (chronic inflammatory demyelinatingPolyneuropathy
                                                                                                               
325.left abducent nerve palsy causes(diplopia in left lateral gaze.

326.antidepressant also useful intreatment of Enuresis,ADHD,&chronc pain
(imipramin

327.correct regarding the treatment of a pt suffering frm amyotophic lateral Sclerosis(ASL
)(riluzole was FDA approved for ALS because it improves Survival rate.
                                                                                           
328.most common complication of mumps is(orchitis.(inchildhood-meningoencephlitis)

329.causes of “dying back neuropathy” include all Except
(GBS.

330.drugs used for prophylaxis of migraine are following Except
(levetriacetam.

331.the classic presentation of proximal arm/leg weakness with preservation of Distal strength ,the so-called “man in barrel”is feature of
(ACA occlusion

332.54yrs/man developed sudden monocular blindness with mild right sided hemiparesis
Most likely culprit vessel responsible for this is
( left internal carotid artery.

333.craniovertebral junction is likely to be affected in all the following Except OA.