hey friends i got 81 rank in nov.07aiims(65.667%),i expected 65% on the basis of disscusion on rxpg & i got very close to it.so u can expect a good deal of accuracy although nobody can give a cast iron guaraantee.i will b posting aippg08 Q & A with explanations,any diffrence in opinion are welcome.
Q.1which peptide antibiotic is an antitumor agent?
a)valinomycin
b)bleomycin
c)dactinomycin
Bleomycin is a glycopeptide antibiotic produced by the bacterium Streptomyces verticillus. Bleomycin refers to a family of structurally related compounds. When used as an anti-cancer agent, the chemotherapeutical forms are primarily bleomycin A2 and B2. Bleomycin A2 is shown in the image. The drug is used in the treatment of Hodgkin lymphoma (as a component of the ABVD regimen), squamous cell carcinomas, and testicular cancer, pleurodesis as well as plantar warts.
Q2most common cause of maternal mortality in India is
Haemorrhage
abortion
septicemia
obstructed labour
Q.3 MOST SENSITIVE TEST FOR ACUTE KNEE INJURY ?
LACHMAN
ANT DRAWER
PIVOT
ANTERIOR CRUCIATE LIGAMENT
Introduction
The incidence of ACL injuries has increased dramatically over the last 2 decades. More than 200,000 new ACL injuries occur in the United States annually. These injuries are important because of the extent of disability associated with ACL tears.
Normal ACL Torn ACL
Approximately 50% of patients with ACL tears also have meniscal tears. The lateral meniscus is torn more frequently than the medial meniscus in acute ACL injuries, but in chronic ACL tears the medial meniscus is more commonly torn.
Attempts to identify athletes at greatest risk for ACL injury have identified a few predisposing factors. Individuals with a narrow intercondylar notch of the femur appear to have a higher risk of non-contact ACL injuries. Women also appear to be more susceptible to non-contact ACL injuries compared to male counterparts. A two-fold increase in ACL injuries in women collegiate soccer players and a four-fold increase in basketball players. The cause of this gender difference is not clear.
Knee instability secondary to anterior cruciate tears is the most common cause of long-term disability of the knee. The ACL is the primary restraint to hyperextension and anterior translation of the tibia on the femur. It also protects against excessive varus valgus stress and internal and external rotation as a seconary restraint. As a result of this wide range of function , a variety of injury mechanisms , most of which are non-contact in nature, may damage this ligament.
History:
Patients with acute ACL injuries commonly report giving way of the knee with stopping, cutting, or jumping. A pop, immediate pain and swelling within several hours usually occurs with ACL injuries.
Physical Examination:
The examination of the knee with an acute ACL injury is often difficult because the pain and swelling cause muscular guarding by the patient. . Early examination prior to the onset of the guarding is advantageous and comparison to the normal knee is mandatory.
The Lachman test is the most accurate test for diagnosis of acute ACL tears.
The Lachman test and the varus-valgus tests often are the only tests that can be reliably performed in an acute knee injury. A positive pivot shift is diagnostic for ACL tears but it can only be elicited in 25% of acute ACL tears. Examination with a knee ligament arthrometer may be helpful in diagnosis of acute knee injuries, a side to side difference of 3 mm. or more is diagnostic of an ACL tear.
Diagnostic Imaging
Every knee suspected of ACL damage should be evaluated with plain X-rays. Osteochondral fracture can be visualized. The Segond’s fracture , which is seen at the lateral edge of the tibia on an AP view, is diagnostic of an ACL tear.
In the chronic setting , X-ray findings associated with anterior cruciate insufficiency include intercondylar spurring and intercondylar notch narrowing .
MRI can be useful with diagnosis of ACL injuries when the clinical exam is limited because of pain and swelling. This test can also identify associated injuries to the menisci, articular cartilage or bone. The accuracy of MRI in determining acute ACL injury is approximately 90%.
kavish, i found in the net that duuuuuuuuuuuying back neuropathy is also called uremic neuripathy. advanced glycation endproducts are known uremic toxins. can diabetes be the anser.
Q.4organism involved in crohn's disease?a)Mycobacterium avium subspecies paratuberculosis
Mycobacterium avium subspecies paratuberculosis is a pathogenic bacteria in the genus Mycobacteria.[1] It is often abbreviated Map, M. paratuberculosis, or M. avium sub. paratuberculosis. The type strain is ATCC 19698 (equivalent to CIP 103963 or DSM 44133).[2]
Contents [hide]
1 Pathophysiology
1.1 Crohn's disease
2 Genome
3 See also
4 References
[edit] Pathophysiology
Map causes Johne's disease in cattle and other ruminants, and it has long been suspected as a causative agent in Crohn's disease in humans; this connection is controversial.[3]
Recent studies have shown that Map present in milk can survive pasteurization, which has raised human health concerns due to the widespread nature of Map in modern dairy herds. Map is heat resistant and it is capable of sequestering itself inside white blood cells, which may contribute to its persistence in milk. It has also been reported to survive chlorination in municipal water supplies.
Even though Map is hardy, it is slow growing and fastidious, which means it is difficult to culture. Many negative studies for Map presence in living tissue, food, and water have used culture methods to determine whether the bacteria is present. Due to recent advances in our knowledge of the bacterium, some or all of these studies may need to be re-evaluated on the basis of culture methodology.
Map, like most mycobacteria, is difficult to treat. It is not susceptible to anti-tuberculosis drugs (which can generally kill Mycobacterium tuberculosis), but can only be treated with a combination of antibiotics such as Rifabutin and a macrolide such as Clarithromycin. Treatment regimes can last years.
[edit] Crohn's disease
MAP is recognized as a multi-host mycobacterial pathogen with a proven specific ability to initiate and maintain systemic infection and chronic inflammation of the intestine of a range of histopathological types in many animal species including primates.
On the assumption that Map is a causative agent in Crohn's, the Australian biotechnology company Giaconda is seeking to commercialise a combination of Rifabutin, clarithromycin and clofazimine as a potential drug therapy for Crohn's. As of April 2007, Giaconda received United States FDA IND approval for this medication, now called Myoconda
Pollicization is a plastic surgery technique in which a thumb is created from an existing finger. Typically this consists of surgically migrating the index finger to the position of the thumb in patients who are either born without a functional thumb (most common) or in patients who have lost their thumb traumatically and are not amenable to other preferred methods of thumb reconstruction such as toe-to-hand transfers.
During pollicization the index finger metacarpal bone is cut and the finger is rotated approximately 120 to 160 degrees and replaced at the base of the hand at the usual position of the thumb. The arteries and veins are left attached. If nerves and tendons are available from the previous thumb these are attached to provide sensation and movement to the new thumb ("neopollux"). If the thumb is congenitally absent other tendons from the migrated index finger may be shortened and rerouted to provide good movement.
The presence of an opposable thumb is considered important for manipulation of most objects in the physical world. Children born without thumbs often adapt to the condition very well with few limitations therefore the decision to proceed with pollicization lies with the child's parents with the recommendation of their surgeon. Persons who have grown to adulthood with functional thumbs and then lost a thumb find it highly beneficial to have a thumb reconstruction, not only from a functional but from a mental and emotional standpoint.
Retrieved from "http://en.wikipedia.org/wiki/Pollicization"
Q.cytogenetic abnormality in synovial sarcoma? ans: t(X;18) translocation
Synovial sarcoma constitutes 8-10% of all sarcomas and most commonly affects adults in the third to fifth decades of life. This malignancy usually involves the extremities, especially the lower extremities around the knees. Synovial sarcoma is frequently misdiagnosed as a benign condition because of its often small size, slow growth, and well-defined appearance.1, 2
Pathophysiology
Gross specimens are usually well-demarcated, pink, fleshy masses with a heterogeneous appearance and may display solid, hemorrhagic, or cystic components on sectioning. Calcification foci are occasionally noted; heavy calcification tends to indicate less aggressive lesions and offers a more favorable prognosis.
Synovial sarcoma is named for its resemblance to developing synovial tissue under light microscopy. It arises from the pluripotential mesenchymal cells near joint surfaces, tendons, tendon sheaths, juxta-articular membranes, and fascial aponeuroses. The histologic appearance is that of large polygonal cells (epithelioid) that secrete hyaluronic acid and show an organization that is suggestive of microscopic joint spaces. These cells are surrounded by spindle cells that simulate subsynovial mesenchymal cells.
The typical morphology is that of 2 strikingly distinct, well-differentiated cell populations. Depending on which cell type predominates, the overall histologic appearances can be described as biphasic (epithelioid and spindle cell), monophasic spindle cell, or monophasic epithelioid. Marked cellular pleomorphism and atypia are uncommon, but when they are present, their appearance overlaps with that of a high-grade malignant fibrous histiocytoma and fibrosarcoma.
Specific cytogenetic abnormalities have been identified. More than 90% of patients have a t(X;18) translocation mutation, which is not associated with other sarcomas. The translocation involves the SYT gene on chromosome 18 (at 18q11) and the SSX1 or SSX2 gene on the X chromosome (at Xp11).3, 4 These genes appear to be transcription regulators, whose functions occur primarily through protein-protein interactions. Subtypes of these translocations have been shown to correlate with distinct histologic subtypes.
Frequency
United States
Synovial sarcoma is the fourth most commonly occurring sarcoma,1 accounting for 8-10% of all sarcomas. Approximately 800 new cases of synovial sarcoma are diagnosed per year.
Mortality/Morbidity
Overall, survival rates are 36-76% at 5 years and 20-63% at 10 years.
Synovial sarcoma of the head and neck region has a better prognosis than that of sarcoma involving the extremities, with 5-year survival rates of 47-82%.
Sex
Although different studies have cited a slight male or female predominance, a study including 672 cases at the Armed Forces Institute of Pathology
(AFIP) demonstrated no significant sex or ethnic predilection for synovial sarcoma.1
Age
Synovial sarcoma can occur in patients with a wide age range, but it is most common in patients in the third to fifth decades of life. In a series of 121 cases, 83.6% of tumors occurred in patients aged 10-50 years, with a median age of 31.3 years. Another large study included patients with ages ranging from 5 to 87 years.5
Anatomy
Synovial sarcoma is the most common sarcoma that involves the upper extremity, hip, groin, and buttocks in patients aged 16-25 years. In patients aged 6-45 years, synovial sarcoma is the most common sarcoma in the foot and ankle.
Most synovial sarcomas are found within 5 cm of a joint. Despite the misnomer, only 10% of cases are intra-articular. The tumors are usually well circumscribed, but in unusual cases, they may interdigitate between muscles and tendons or encase neurovascular structures. Invasion of the adjacent bone is seen in 11-20% of patients, a feature that is uncommon in other sarcomas.
The region around the knee is the most common site of involvement. In a large study, 73% of synovial sarcomas occurred in the lower limb; 34% in the upper limb; and 16% in the chest/abdominal wall. Tumors that occur in the upper extremity tend to affect the distal extremity rather than the elbow or shoulder. Less common sites of involvement include the retroperitoneum, mediastinum, and head and neck regions. The most common site in the head and neck is the hypopharynx. Other head and neck locations include the cervical or parapharyngeal regions, masticator space, soft palate, tongue, suboccipital and infratemporal fossa regions, and sinonasal space.
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