Page 1 of 1: PGI JUNE 08 Q & A with explanation

kavish · Credits: 36315 My Scrapbook

hey friends

best wishes for result
let's disscuss Q & A with explanations

kavish · Credits: 36315 My Scrapbook

Q.1Duret haemorrhage found in?
a] lungs
b]kidney
c] endocardium of heart
d]Brain

ans is d]Brain
Duret haemorrhages (also spelled, Duret hemorrhages) are small areas of bleeding in the ventral and paramedian parts of the upper brainstem, (midbrain and pons). They are secondary to raised intracranial pressure with formation of a transtentorial pressure cone involving the cerebral peduncles (crus cerebri) and other midbrain structures caused by raised pressure above the tentorium. Kernohan’s notch is a groove in the cerebral peduncle that may be caused by this displacement of the brainstem against the incisura of the tentorium. The resulting ipsilateral hemiparesis is a false localising sign (Collier 1904), known as the Kernohan-Woltman syndrome. This may succeed or accompany temporal lobe (uncal) herniation and subfalcian herniation secondary to a supratentorial mass.

kavish · Credits: 36315 My Scrapbook

Q.2 Drugs used for smoking cessation?a)Varenicline
b)bupropion
c
d
e?

ans is a)Varenicline
b)bupropion

Varenicline is a nicotinic receptor partial agonist. In this respect, it is similar to cytisine and different from nicotinic antagonist, bupropion, and nicotine replacement therapies (NRTs) like nicotine patches (commonly, "the patch") and nicotine gum. As a partial agonist, it both reduces cravings for and decreases the pleasurable effects of cigarettes and other tobacco products, and through these mechanisms, it can assist some patients in stopping smokingIndications
Varenicline is indicated for (suggested for use in) smoking cessation. It is an alternative to NRTs and agonist medication and has demonstrated greater efficacy than them in comparable studies.

Bupropion (INN; previously known as amfebutamone,[1] Wellbutrin, Zyban) is an atypical antidepressant that acts as a norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist
Initially researched and marketed as an antidepressant, bupropion was subsequently found to be effective as a smoking cessation aid

kavish · Credits: 36315 My Scrapbook

Q.3."thumb print " sign seen in ?
a.acute epiglottitis
b.acute sinusitis
c.acute laryngitis

ans is a.acute epiglottitis

Epiglottitis
The term acute epiglottitis is used to describe a condition in which there is inflammation of the epiglottis and commonly the soft tissues surrounding the epiglottis. The condition is rare, but can be life threatening as inflammation of the epiglottis and surrounding tissues may lead to the complete obstruction of the upper respiratory tract.

Causes
Haemophilus influenzae type B (most common)
Pneumococci
Group A beta-haemolytic Streptococcus
Pseudomonas
Mycobacterium tuberculosis
Viruses
Local trauma e.g. following inhalation of foreign bodies or post intubation
Epidemiology
Acute epiglottitis is most common in children between the age of 2 and 8, although it can occur at any age
Males are more commonly affected than females with a ratio of 2.5:11
In adults, smoking and reduced levels of immunity appears to be risk factors, and there is some evidence to suggest an increased risk in diabetics2
Since the advent of vaccination against Haemophilus influenzae type b in children, the incidence of acute epiglottitis in children has reduced
Over the last few years the presence of epiglottitis in adults is being increasingly seen3,1
Presentation
Many of the signs and symptoms associated with acute epiglottitis are common, and may occur in many less serious disorders. Patients with epiglottitis may present with any of the following, and the symptoms may evolve very quickly over a period of a few hours.4

Commonest symptoms
Sore throat
Odynophagia
Muffled voice
Drooling
Fever
Anterior neck tenderness
Other features
Irritability
Cough
Ear pain
Cervical lymphadenopathy
The " rxpg sign" - patient leans forward on outstretched arms to move inflamed structures forward thereby easing the upper airway obstruction2
With more severe epiglottitis
Dyspnoea
Dysphagia
Dysphonia
Stridor (late finding-indicates airway obstruction)
Respiratory distress

Investigations
Patients who are suspected of having acute epiglottitis should not have their throat examined with the aid of a tongue depressor, due to the risk of laryngeal obstruction, but should be urgently referred for laryngoscopy.

Fibreoptic laryngoscopy remains the "gold standard" for diagnosing epiglottitis as the epiglottis can be seen directly. Laryngoscopy in these patients should only be performed in areas such as operating theatres which are prepared for intubation or tracheostomy in the event of upper airway obstruction.
Lateral neck X ray may be useful if laryngoscopy is not possible. Soft-tissue radiograph of the neck may show the "thumbprint sign".5
Throat swabs may be taken when the airway is secure, or when intubation/tracheostomy facilities are at hand. Streptococci are becoming the major pathogens in acute epiglottitis now.6
Blood cultures may be taken if the patient is systemically unwell.
CT or MRI scans may be performed if abscess formation is suspected.

kavish · Credits: 36315 My Scrapbook

Q.4drugs used in post-op nausea and vomitting ?
a.thiopnetone
b.ketamine
c.propofol?
d.Aprepitant
e.?

ans is d.Aprepitant

Aprepitant is a chemical compound that belongs to a class of drugs called substance P antagonists (SPA). It mediates its effect by acting on neurokinin 1 receptor

Aprepitant is manufactured by Merck & Co. under the brand name Emend for prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) and for prevention of postoperative nausea and vomiting. It was approved by the FDA in 2003.

Aprepitant may also be useful in the treatment of cyclic vomiting syndrome but there are few studies to date.

jayakrishnav55 · Credits: 12802 My Scrapbook

pl carry on the good work. what about the rezsults and toppers of pgi june 08

aryakid · Credits: 24727 My Scrapbook

great work kavish, what rank did u get? i'll be off network for a week, i got 333 rank, will be joining my pg at mysore and continue reading

lalwani · Credits: 501 My Scrapbook

GREAT WORK BUT WHY BIDNT U CONT IT

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