|
| Author |
Message |
candyee
AIPPG Senior Member
Joined: 23 Jan 2003
Posts: 17
Location: Outer space!!
749 Credits
|
|
| Back to top |
|
|
|
 |
hemant garg
Guest
|
|
| Back to top |
|
hemant
Guest
|
|
| Back to top |
|
hemant garg
Guest
|
|
| Back to top |
|
candyee
AIPPG Senior Member
Joined: 23 Jan 2003
Posts: 17
Location: Outer space!!
749 Credits
|
|
| Back to top |
|
Bruno
AIPPG seven stars experienced member
Joined: 20 Jan 2003
Posts: 1923
Location: South India
63610 Credits
|
 Posted: Wed Feb 12, 2003 6:28 am Post subject: B - Lynch Suture |
|
|
This Explanation and brief discussion is by
NAVEEN K. KANSAL,
kansalnaveen@yahoo.co.in
Reg. No. MCI/22693,
569, SUBHASH NAGAR, LANE NO. 8,
MEERUT-250001 [UP], INDIA .
Ph. No. 0121-2666367.
The B-Lynch suture, also known as the “brace suture”, was described by Christopher B Lynch and co-workers in 1997 as an alternative surgical method of controlling postpartum haemorrhage due to uterine atony.(7) The method is simple and seems to be effective, although only case reports are available to evaluate the efficacy of the procedure thus far.
The technique can be summarised as follows:
General anaesthesia, urinary catheter in place and the patient in the Lloyd Davies position.
Pfannenstiel incision usually adequate.
Lower segment uterine incision (as for Caesarean Section) made after dissecting off the bladder.
Bimanual compression of the uterus to assess the potential chance of success of the B-Lynch suturing technique. If bimanual compression controls the bleeding as observed vaginally, the suture is placed.
A no.2 chromic suture on a round bodied needle is used to puncture the uterus about 3 cm below the right hand corner of the lower segment incision and brought out about 3 cm above the same corner (as one would place the first suture when closing this corner of the incision).
From this point the suture is passed over the right hand cornu of the uterus, approximately 3-4cm from the right corneal border, where it may be fixed to prevent it from slipping off the fundus, and then fed posteriorly and vertically down to the same level where the suture has previously left the uterine cavity from anterior.
The suture is then placed through the posterior uterine wall into the cavity under direct vision of the surgeon and back through the posterior wall about 4-5cm left of the previous entry site.
With the suture outside and posterior of the uterine cavity at this stage, it is now passed over the left hand cornu, approximate 3-4cm from the left corneal border, where again it may be fixed to the fundus, then fed anteriorly and vertically down to the level of the left corner of the lower segment incision.
The needle is then passed through the left corner in the same fashion as
on the right hand side, to emerge below the incision margin on the left side.
With the suture now in place, the assistant bimanually compresses the uterus while the surgeon pulls the chromic suture taught.
If a third person confirms that the bleeding is controlled (as observed vaginally), the surgeon ties the suture to keep it in position and closes the lower segment uterine incision.  _________________ Dr.J.Mariano Anto Bruno Mascarenhas. 98421 11725, 0461 2310725
Mnemonic of the month
Silica found in the ground affects the apex, but asbestos used for roof affects the base of lung  |
|
| Back to top |
|
kansalnk
AIPPG Fresher
Joined: 13 Feb 2003
Posts: 2
Location: meerut
150 Credits
|
| Posted: Wed Feb 26, 2003 11:34 am Post subject: |
|
|
some confusing questions of all india post-graduate medical entrance exam 2003: please guide through, THANKS.
1. The main enzyme responsible for activation of xenobiotics is:
1.Cytochrome P-450
2.Glutathione S-transferase.
3.NADPH cytochrome P-450-reductase.
4.Glucuronyl transferase.
2. The parameters of sensitivity and specificity are used for assessing:
1.Criterion validity.
2.Construct validity.
3.Discriminant validity.
4.Content validity.
3. Chi-square test is used to measure the degree of:
1. Causal relationship between exposure and effect.
2. Association between two variables.
3. Correlation between two variables.
4. Agreement between two observations.
4. A 55 year old lady presenting to out patent department (OPD) with postmenopausal bleding for 3 months has a 1x1 cm :?nodule  on the anterior lib of cervix. The most appropriate investigation to be done subsequently is:
1. Pap smear.
2. Punch biopsy.
3. Endocervical curettage.
4. Coloposcopy.
5. In actinomycosis of the spine, the abscess usually erodes:
1. Intervertebral disc.
2. Into the pleural cavity.
3. Into the reteroperitoneal space.
4. Towards the skin.
6. Central nervous system manifestations in chronic renal failure are a result of all of the following, except:
1. Hyperosmolarity.
2. Hypocalcemia.
3. Acidosis.
4. Hyponatremia.
7.Two students. Vineet and Kamlesh were asked to demonstrate in dogs the role of sinus nerve in hypovolemic shock. Vineet severed the sinus nerve when the mean blood pressure (MBP) was 85mm Hg and Kamlesh cut the sinus nerve when the mean blood pressure was 60mm Hg. On cutting the sinus nerve:
1. Vineet recorded an increase in MBP but Kamlesh recorded a decrease in MBP.
2. Vineet recorded a decrease in MBP but Kamlesh recorded an increase in MBP.
3. Both recorded an increase in MBP.
4. Both recorded in decrease in MBP.
8.As a part of space-research program, a physiologist was asked to investigate the effect of flight-induced stress on blood pressure. Accordingly, the blood pressure of the cosmonauts were to be measured twice: once before the take-off, and once after the spacecraft entered the designated orbit around the earth. For a proper comparison, the pre-flight blood pressure should be recorded in:
1. The lying down position.
2. The sitting position.
3. The standing position.
4. Any position, as long as the post-flight recording is made in the same position.
9.Most important epidemiological tool used for assessing disability in children is:
1.Activities of Daily living (ADL) scale.
2.Wing's Handicaps, Behavior and Skills (HBS) Schedule.
3.Binet and Simon IQ tests.
4.Physical Quality of Life Index (PQLI)
10. The response which is graded by an observer on an agree or disagree continuum is based on:
1.Visual analog scale.
2.Guttman Scale.
3.Likert Scale.
4.Adjectival scale.
11.For calculation of sample size for a prevalence study all of the following are necessary except:
1. Prevalence of the disease in population.
2. Power of the study.
3. Significance level.
4. Desired precision.
12.Troponin T is preferable to CPK-MB in the diagnosis of acute MI in all of the following situations except
1. bed side diagnosis of MI
2. Post operatively after CABG
3. Reinfarction after 4 days
4. Small Infarcts
13.Pulmonary hypertension may occur in all of the following conditions except:
1. Toxic oil syndrome.
2. Progressive systemic sclerosis.
3. Sickle cell anaemia.
4. Argemone mexicana poisoning.
14. Which of the following is the most common location of hypertensive hemorrhage?
1. Pons.
2. Thalamus.
3. Putamen/external capsule.
4. Subcortical white matter.
15. Type IV hypersensitivity to Mycobacterium tuberculosis antigen may manifest as:
1. Iridocylitis.
2. Polyarteritis nodosa.
3. Phlyctenular conjunctivitis.
4. Giant cell arteritis.
16.In a patient with AIDS chorioretinitis is typically caused by:
1. Cytomegalvirus.
2. Toxoplasma gondii.
3. Cryptococcus neoformans.
4. Histoplasma capsulatum.
17. The following are true for Bordetella perussis except.
1. It is a strict human pathogen.
2. It can be cultured from the patient during catarrhal stage.
3. It leads to invasion of the respiratory mucosa.
4. Infection can be prevented by a acellular vaccine.
18. laparotomy performed in a case of ovarian tumor revealed unilateral ovarian tumor with ascities positive for malignatn cells and positive pelvic lyjph nodes. All other structures were free of disease. what is stage of the disease:
1. Stage IIc.
2. Stage IIIa.
3. Stage IIIb.
4. Stage IIIc.
19.Cut-off value of cervical length at 24 weeks of gestation for prediction of preterm delivery is:
1. 0.5cm.
2. 1.5cm
3. 2.5cm
4. 3.5cm
20. A 50 Kg. man with severe metabolic acidosis has the following parameters:pH 7.05. pCO2 12mm Hg., pO2 108mm Hg. HCO3 5 meq/L. base excess-30 mEa/L. The approximate quantity of sodium bicarbonate that he should receive in half hour is:
1. 250mEq.
2. 350mEq.
3. 500mEq.
4. 750mEq.
21.All of the follwing are mechanisms of action of emergency contraception except:
1. Delaying ovulation.
2. Inhibiting fertilization.
3. Preventing implantation of the fertilized egg.
4. Interrupting an early pregnancy.
22. The blood gas parameters: pH 7.58, PCO2 23 mmHg PO2, 300 mmHg and oxygen saturation 60% are most consistent with:
1. Carbon monoxide poisoning.
2. Ventilatory malfunction.
3. Voluntary hyper ventilation.
4. Methyl alcohol poisoning.
23.Which one of the following tests will you adopt while examining a knee joint where you suspect an old tear of anterior cruciate ligament?
1. Posterior drawer test.
2. MC Murry test.
3. Lachman test.
4. Pivot shift test.
24. A 15 year old healthy boy with no major medical problem complaints that he breaks out with blocky areas of erthema that are pruritic over skin of his arm, leg and trunk every time within an hour of eating sea foods. The clinical features are suggestive of:
1. Localised immune-complex deposition.
2. Cell mediated hypersensitivity.
3. Locallized anaphylaxis.
4. Release of complement C3b.
25.Transient myeloproliferative disorder of the new born is seen in association with:
1. Turner syndrome.
2. Down syndrome.
3. Neurofibromatosis.
4. Ataxia telangiectasia.
26.A 1-moth old baby presents with frequent vomiting and failure to thrive. There are features of moderate dehydrtion. Blood sodium is 122mEa/l and potassium is 6.1 mEq/l. The most likely diagnosis is:
1. Gitelman syndrome.
2. Bartter syndrome.
3. 21-hydroxylase deficiency.
4. 11-b hydroxylase deficiency.
27. A 63-year-old man presented with massive splenomegaly, lymphadenopathy and a total leucocyte count of 17000 per mm3. The flowcytometery showed CD 19 positive, CD5 positive, DC 23 negative, monoclonal Bcells with bright kappa positivity comprising 80% of the peripheral blood lymphoid cells. The most likely diagnosis is:
1. Mantle cell lymphoma.
2. Splenic lymphoma with villous lymphocytes.
3. Follicular lymphoma.
4. Hairy cellleukemia.
28.Which of the following increases the susceptibility to coronary artery disease:
1. Type V hyperlipoproteinaemia.
2. Von will Brandt ’s disease.
3. Nephritic syndrome.
4. Systemic lupus erythematosus
29. The HLA class 3 rejection genes are important elements in :
1. Transplant rejection phenomenon.
2. Governing susceptibility of autoimmune diseases.
3. Immune surveillance.
4. Antigrn presentaion and elimination.
29. All of the following are useful intravenous therapy for hypertensicve emergencies except:
1. Fenoldopam.
2. Urapidil
3. Enalpril
4. Nifedipine.
30.Thiamine deficiency is known to occur in all of the following except:
1. Food faddist.
2. Homocstinemia
3. Chronic alcoholic.
4. chronic heart failure patient on diuretics.
31.Bostentan is a:
1. Serotonin uptake injibitor.
2. Endothelin receptor antagonist.
3. Leukotriene modifier.
4. Calciuim sensitizer.
32.Recurrent ischemic events following thrombolysis has been patho-physiologically linked to which of the following factors :
1. Antivodies to thrombolytic agents
2. fibrinopeptife A
3. Lipoprotein (a) [LP(a)]
4. Triglycerides.
33. Which of the following is pan - T laymphocyte marier?
1. CD 2.
2. CD 3.
3. CD 19.
4. CD 25.
34.Which of the following statements is true for excitat0ry postsynaptic potentials [EPSP];
1. Are self propagating.
2. Show all or none response.
3. Are proportional to the amount of transmitter released by the presynaptic neuron.
4. Are inhibitory at presynaptic terminal.
35. Synaptic conduction is mostly orthodromic because:
1 Dendrities cannot be depolarized.
2. Once repolariced, an area cannot be depolarized,
3. The strength of antidromic impulse is less
esynatic ter minal.
4. Chemical mediator is located only in the presynatic terminal.
36.A 55- year -old woman has recurrent urinary retention after a hysterectomy done for huge fibroid. The most likely cause is:
1. Atrophic and stenotic urethra.
2. Lumbar disc prolapse.
3. Injury to the bladder neck.
4. Injur to the hypogastric plexi.
37. Fraying and cupping of metaphyses of long bones in an child does not occur in:
1. Rickets.
2. Lead poisoning.
3. Metaphyseal dysplasia.
4. Hypophosphatasia.
38. A classical expansive lytic lesion in the transverse process of a vertebra is seen in:
1. Osteosarcoma.
2. Aneurysmal bone cyst.
3. Osteoblastoma.
4. Metastasis.
39.A child has got a congenital catract involving the visual axis which was detected by the parents right at birth. This child should be operated.
1. Immediately.
2. At 2 months of age.
3. At 1 year of age when the globe becomes normal sized.
4. After 4 year when entire ocular and orbital growth become normal.
40. Fasanella Servat operation is specififcally indicated in:
1 Congenital ptosis.
2. Steroid induced ptosis.
3. Myasthenia gravis.
4. Horner’s syndrome.
41. Which of the following lasers is used for treatment of bening prostatic hyperplasia as well as urinary calculi?
1. CO2 laser.
2. Excimer laser.
3. Ho: YAG laser.
4. Nd: YAG laser.
42.Semen analysis of a young man who presented with primay infertility revealed low volume, fructose negative ejaculate with azoospermia. Which of the following is the most useful imaging modality to evaluate the cause of his infertility?
1. Colour duplex ultrasonography of the scrotum.
2. Transrectal ultrasonography.
3. Retrograde urethrography.
4. Spermatic venography.
43.An eight-year-old boy presents with back pain and mild fever. His plain X-ray of the dorso-lumbar vertrbra with preserved disc spaces. There was no associated soft tissue shadow. The most likely diagnoisi is:
1. Ewing ’s sarcoma.
2. Tuberculosis.
3. Histiocytosis.
4. Metastasis.
44.Cardiac or central nervous system toxicity may result when standard lidocaine doses are administered to patients with circulatory failure. This may be due to the following reason:
1. Lidocaine concentration are initially higher in relatively well perfused tisseues such as brain and heart.
2. Histamine receptors in brain and heart gets suddenly activated in circulatory failure.
3. There is a sudden out-burst of release of adreneline, noradreneline and dopamine in brain and heart.
4. Lidocaine is converted into a toxic metabolite due to its longer stay in liver.
45.The best time for surgery of hypospadias is:
1. 1-4 months of age.
2. 6-10 months of age.
3. 12-18 months of age.
4. 2-4 years of age.
46. Which one of the following statements is false with regard in Xanthogranulomatous pyelonephritis in children.
1. Often affects those younger than 8 years of age.
2. It affects the kidney focally more frequently than diffusely.
3. Boys are affected more frequently.
4. Clinical presentation in children is same as in adults.
47. The Hunterian Ligature operation is performed for:
1. Varicose veins.
2. Arteriovenous fistulae.
3. Aneurysm.
4. Acute ischemiz.
47.Sympathectomy is indicated in all the following conditions except:
1. Ischaemic ulcers.
2. Intermittent claudication.
3. Anhidrosis.
4. Acrocyanosis.
49. Which one of the following statements is false with regard to pyaria in children?
1. Presence of more than 5 WBC/hpf (high power field) for girls and more than 3 WBC/hpf for boys.
2. Infection can occur without pyuria.
3. Pyuria may be present without Urinary tract infection.
4. Isolated pyuria is neither confirmatory nor diagnostic for Urinary tract infection.
50. A 45 year old female is having bilatertal ovarian mass, ascites and omental caking on CT scan, There is high possibility that patient is having .
1. Benign ovarian tumor.
2.Malignant epithelial ovarian tumor.
3. Dysgerminoma of ovary.
4. Lymphoma of ovary.
51.The renal plasma flow (RPF) of a patient was to be estimated through the measurement of Para Amino Hippuric acid (PAH) clearance. The technician observed the procedures correctly but due to an error in the weighing inadvertently used thrice the recommended does of PAH. The RPF estimated is likely to be:
1. False-high.
2. False-low
3. False-high or false-low depending on the GFR.
4. Correct and is unaffected by the PAH overdose.
52. All of the following are features of hallucinations, except:
1.It is independent of the will of the observer.
2.Sensory organs are not involved.
3.It is a vivid as that in a true sense perception.
4. It occurs in the absence of perceptual stimulus.
53. All of the following statements regarding bio availability of a drug are true except:
1. It is the proportion (fraction) of unchanged drug that reaches the systemic circulation.
2. Bioavailability of an orally administered drug can be calculated by comparing the Area Under Curve (0- ) after oral and intravenous (iv) administration.
3.Low oral bioavailability always and necessarily mean poor absorption.
4.Bioavailability can be determined from plasma concentration or urinary excretion data.
54. The extent to which ionisation of a drug takes place is dependent upon pKa of the drug and the pH of the solution in which the drug is dissolved. which of the following statements is not correct.
1.pKa of a drug is the pH at which the drug is 50% ionized.
2.Small changes of pH near the pKa of a weak acidic drug will not affect its degree of ionisation.
3.Knowledge of pKa of a drug is useful in predicting its behaviour in various body fluids.
4.Phenobarbitonewith a pKa of 7.2 is largely ionized at acid pH and will be about 40% non-ionised in plasma.
55. Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionisation of the drug in the stomach. Which of the following statements is not correct example:
1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorthiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.
NAVEEN K. KANSAL,
Reg. No. MCI/22693,
569, SUBHASH NAGAR, LANE NO. 8,
MEERUT-250001 [UP], INDIA .
Ph. No. 0121-2666367.
KANSALNAVEEN@YAHOO.CO.INB
|
|
| Back to top |
|
Bruno
AIPPG seven stars experienced member
Joined: 20 Jan 2003
Posts: 1923
Location: South India
63610 Credits
|
| Posted: Thu Feb 27, 2003 10:16 am Post subject: Few Answers |
|
|
Many of these answers are already explained by me in this same forum.......... Please see the old questions
1. The main enzyme responsible for activation of xenobiotics is:
1.Cytochrome P-450
2.Glutathione S-transferase.
3.NADPH cytochrome P-450-reductase.
4.Glucuronyl transferase.
Answer 1
----------------------
7.Two students. Vineet and Kamlesh were asked to demonstrate in dogs the role of sinus nerve in hypovolemic shock. Vineet severed the sinus nerve when the mean blood pressure (MBP) was 85mm Hg and Kamlesh cut the sinus nerve when the mean blood pressure was 60mm Hg. On cutting the sinus nerve:
1. Vineet recorded an increase in MBP but Kamlesh recorded a decrease in MBP.
2. Vineet recorded a decrease in MBP but Kamlesh recorded an increase in MBP.
3. Both recorded an increase in MBP.
4. Both recorded in decrease in MBP.
Answer 3
-----------------------------
8.As a part of space-research program, a physiologist was asked to investigate the effect of flight-induced stress on blood pressure. Accordingly, the blood pressure of the cosmonauts were to be measured twice: once before the take-off, and once after the spacecraft entered the designated orbit around the earth. For a proper comparison, the pre-flight blood pressure should be recorded in:
1. The lying down position.
2. The sitting position.
3. The standing position.
4. Any position, as long as the post-flight recording is made in the same position.
Answer 1
-----------------------
9.Most important epidemiological tool used for assessing disability in children is:
1.Activities of Daily living (ADL) scale.
2.Wing's Handicaps, Behavior and Skills (HBS) Schedule.
3.Binet and Simon IQ tests.
4.Physical Quality of Life Index (PQLI)
Probably 2
----------------------
10. The response which is graded by an observer on an agree or disagree continuum is based on:
1.Visual analog scale.
2.Guttman Scale.
3.Likert Scale.
4.Adjectival scale.
Answer 3
--------------------
12.Troponin T is preferable to CPK-MB in the diagnosis of acute MI in all of the following situations except
1. bed side diagnosis of MI
2. Post operatively after CABG
3. Reinfarction after 4 days
4. Small Infarcts
Answer 3
--------------------
14. Which of the following is the most common location of hypertensive hemorrhage?
1. Pons.
2. Thalamus.
3. Putamen/external capsule.
4. Subcortical white matter.
Answer 3
------------------
28.Which of the following increases the susceptibility to coronary artery disease:
1. Type V hyperlipoproteinaemia.
2. Von will Brandt ’s disease.
3. Nephritic syndrome.
4. Systemic lupus erythematosus
Answer 4_________________ Dr.J.Mariano Anto Bruno Mascarenhas. 98421 11725, 0461 2310725
Mnemonic of the month
Silica found in the ground affects the apex, but asbestos used for roof affects the base of lung |
|
| Back to top |
|
Candyee
Whoa 
