What Is Liver Cirrhosis ? Symptoms, Treatment & Causes

What Is Liver Cirrhosis ? Symptoms, Treatment & Causes

What is Liver Cirrhosis?

Cirrhosis is a type of chronic disease (slow processing) that’s relative to the liver. Cirrhosis is identified when the cells of the liver are getting replaced by fibrosis (i.e. fibrous thickening of tissue) or the replacement of normal tissue with scar tissue. Basically, cirrhosis leads to damage to our liver and their functions. The liver plays a significant role in metabolism, detoxifying harmful substances, purify the blood and also including bile production and excretion too. Mostly, cirrhosis caused in alcoholic person and also more chances in a patient of viral hepatitis (B and C).

By examing and performing various experiments the medical science finds out a way to limit the further effects of cirrhosis but still cannot be able to cure. The ultimate way to rescue from cirrhosis is liver transplantation.

Globally, At present, there are more than 1 million cases of liver cirrhosis are.

 

Symptoms of Liver Cirrhosis

  • Joint pain
  • Fever
  • Fatigue
  • Vomiting
  • Abnormal personality
  • Neurologically deprived
  • Hepatic encephalopathy
  • Peripheral neuropathy
  • Asterixis
  • Integumentary
  • Jaundice (icterus)
  • Spider angiomas
  • Palmar erythema
  • Purpura
  • Caput medusa
  • Itchy skin
  • Gastrointestinal
  • Dull abdomen pain
  • Dyspepsia
  • Fetor hepaticus
  • Flatulence
  • Varices
  • Gastritis
  • Gynecomastia’ testicular atrophy
  • Hematemesis
  • Feel like overeating
  • Hemorrhoidal varices
  • Digestion problem
  • Increase size of liver
  • Loss of appetite
  • Hematologic
  • Anemia
  • Thrombocytopenia
  • Leukopenia
  • Coagulation disorders
  • Splenomegaly
  • Metabolic
  • Hypokalemia
  • Hyponatremia
  • Hypoalbuminemia
  • Fluid retention
  • Peripheral edema
  • Ascites

 

Causes of Liver Cirrhosis

  • Hepatitis B
  • Hepatitis C
  • Biliary atresia
  • Wilson’s disease
  • Fat accumulated in the liver
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis
  • Infection (schistosomiasis, peritonitis)
  • Enlargement of the spleen (splenomegaly)
  • Portal hypertension
  • Esophageal varices
  • Malnutrition
  • Bone disease
  • Gallstones
  • Heart failure
  • Obstructed blood flow
  • Hormonal imbalance
  • Production of toxins
  • Prevent the functions of protein and drugs too
  • Non- alcoholic fatty liver disease (NAFLD)
  • Non- alcoholic steatohepatitis (NASH)
  • Greater chance of Liver cancer

 

Prevention of Liver Cirrhosis

  • Stop or reduce intake of alcohol
  • Focus on the balanced diet
  • Less intake of salt
  • Less intake of sugar too
  • Prevent from taking of non-veg and spices.

Tests to be Performed for Liver Cirrhosis

  • Blood test
  • Liver function test ( ALT, AST, ALP)
  • Creatinine
  • Hepatitis B And C
  • Imaging test (CT, MRI, ultrasound, MRE)
  • Biopsy
  • TREATMENT
  • Endoscopy
  • Medication
  • vaccination
  • Rehabilitation
  • Consume diet with low sodium content
  • Avoiding nonsteroidal anti-inflammatory drugs
  • Hemochromatosis (reduce the levels of iron)
  • By the excretion of copper in urine
  • Liver transplant

 

Conclusion

The liver is the most workable organ within our body, performs various functions relating to circulation too. The liver performs both functions like production and excretion too.

LIVER CIRRHOSIS is the most advanced form of liver disease that’s related to generally drinking alcohol and viral hepatitis B and C. Liver cirrhosis occurs when the liver cells are killed or injured, and after that when the inflammation occurs, the injured want to repair itself by forming scar tissue that consequences in forming new liver cells in clusters form that leads to regeneration of nodules of liver within the scar tissue.

The disease is a part of the progression. It may start with the fatty liver disease, then progress to alcoholic hepatitis, and then to liver cirrhosis.

Liver cirrhosis main identified by jaundice, loss of appetite and fatigue. There are various types of complications occur in liver cirrhosis including liver cancer.

Diagnosis of liver cirrhosis can be started firstly with examing patient history, family history also, the vital signs (physical examination), blood test, and we can also perform complete diagnosis by confirming liver cirrhosis by performing the liver biopsy.

Treatment of liver cirrhosis prevents further damage to the liver, liver cancer, other complications related to liver cirrhosis and other adjacent organs from any damage. By suppressing the immune system by prescribed medications like prednisone and azathioprine to prevent further inflammation related to the liver in such as autoimmune hepatitis.

We can’t cure liver cirrhosis, but we can provide treatment to the patient as medication and further types of test like endoscopy. The best recommendation for the liver cirrhosis patient is to liver transplant surgery, still, the medical science working on the curing of liver cirrhosis by medications and some other remedies.

 

Five Years of My MBBS Life

Five Years of My MBBS Life

I had joined the medical college with all the excitement that is humanly possible. Getting merit-based scholarship and not having to pay a single penny as a donation to college, I had made my parents proud. Not that I had always wanted to be a doctor. Being a doctor is the epitome of success academically in our society. The toppers of the country would choose to be a doctor. More than me, my parents were happy that I was studying Medicine. What more could I do than to make my parents proud. Not that I was forced to study medicine. Personally, I was indifferent. I wanted to go through the tough road that elites chose. Deep down inside, I still wanted to explore passion in life. But I was far too lucky (and thinking now maybe unlucky) that I got my name in the successful candidate name list in the MBBS entrance examination.

First year: Crushed euphoria

I was so happy to sign in the admission forms and submit all my certificates. More than that I was happy to see my dad’s smile while I was signing. Getting my hostel room key and filling a small sheet of paper for college identity card filled me with utmost pride.

As classes started, the happiness curve went down. All my expectation of med school became upside down with the reality. As happy I was to get the key to my hostel room, I was more disappointed to open the room of the hostel that was located 3 kilometers away from the hospital right next to the public bus park. Unlike the photos are shown on the website of the college, the hostel was a temporary rented hotel, with zero facilities. The hostel corridor had a leaking terrace and in the monsoon flooded our room if we opened our door for long. The soaked carpet smell mixed with our own sweat smell during the power cuts was in the air. Love definitely wasn’t in the air.

Second year: Exams

Literally, the second year was nothing but the exams. We had monthly big exams, and countless small posting examination. The syllabus was vast and time very limited. On top of that, we would hear about the terror of HODs of departments during practical Viva examinations. Our only aim was to pass every internal examination so that we would not be barred from giving board examination.

Third year: Honeymoon year

We were posted in the hospital. We had our first share of exposure to the patients. Only two subjects whose exam would be there. Taking history and learning physical examination. It was far different kind of learning compared to learning from the cadavers of first-year anatomy class. For the least, all we had to do was to maintain our attendance to 80 percent.

Fourth Year: Minors

We had already spent a year in the hospital wards and OPDs. The place felt familiar and we had been quite familiar with the history taking and physical examination. Watching POP casts and slabs in the Orthopedics OPD was exciting. Learning to use an Otoscope and be able to visualize the perforated eardrum gave all of us some happiness of sorts.

Final Year: The real exams

We were the same as the third year and our posting was the same. But the way our teachers treated was entirely different and that increased the fear. They would constantly remind of us being the ‘exam giving batch’ and that we had to cover each and every topic. Everyone was seriously studying except for the legends who still got time to flaunt the new bike they had bought.

Time passed in a blink of an eye. There was so much to study and so less of time. Nothing except the syllabus mattered. The frequency of mom and dad calling to ask about my whereabouts decreased. Going out for parties were almost nil. Birthday parties got postponed.

Internship: Three Ds

Dressing. Discharge. Daru (alcohol). The dressing of wounds and especially of the burn patients was really difficult and time-consuming. Making discharge sheets of patients who were admitted for delivery of babies was hectic as hell as the number many a time crossed half-century. And a chilled beer once in a while was the answer for releasing the frustration of doing ‘clerk-type’ work every day.

Right now, I am almost halfway through my internship. The days are so varied. Some days, we get all the time in the world to talk about all the things that are shitty in this country. Other days, we are so tired we fall asleep right as we close our eyes. The way we are treated also varies greatly. Some patients treat as if we are magicians wearing white gloves applying elixirs in their wounds and heal them. Other patients treat as if we don’t even exist there.

Final Note:

With all the free ‘no-need-to-read-compulsorily’ time that I have got in the internship, I get plenty of time to introspect. I think about the situation in the country. I talk with the residents and learn about the things I could do during my internship days to make the future a little bit easier when I would be working in a hospital far from cities. And some nights when I am alone in my room and it is raining outside, I wonder with one question on my mind:

Would I be a good doctor?

JOURNEY OF MY M.B.B.S

JOURNEY OF MY M.B.B.S

For starters, I want to share my experience with students who want to go on this route and with people who are just curious about what it’s all about – Becoming a doctor.
 I still remember the first day of landing to medical college; the cheerfulness, happy moment, excitement and dream that everybody carries to become a doctor.
Well, my journey was both sweet and sour. The first phase is one of the important years I believe, That is when students have to acclimatize to the new environment. Nevertheless, it’s the year when everyone is ready to get kick started to become a doctor. Everyone is usually more focused during the first phase and eventually, some people start drifting away from their goals. I can’t say that’s the worse thing in the world since that’s how most of us learn the major life lessons. However, I would say getting a good grip on the first phase subjects anatomy, pathology and physiology go a long way. They make the foundation for a smooth journey ahead. I must add, I am not saying that biochemistry isn’t important. Each and every subject carries its own importance. What I see, in the medical field seniors are the motivators, guides and helpers.there are so many books and every writer had their own opinion regarding the books. and they help us in choosing the finest book to read and pass an exam. I love to read ROBBINS PATHOLOGY and GUYTON’S physiology.these book changed the way what I saw in the entire medical field, Guyton telling the all the normal physiology that happens in our body where Robbins explained the detail possible cause where physiology goes wrong to cause disease. studying these books throughout the first phase of my basic science tells me the start from normal physiological cell to the concept of a necrosed cell.
The first year is very fast but at the same time its sort of slow. It might be because its hard to forget the memories made especially during this year. The big transition from school to college is difficult to forget for the most of us. Then comes the second year, which is 1 years long on TU. Well, my biggest mistake was to think “Oh no biggie, I have a lot of time to hit the books.” I was wrong. this year we have to study all system remaining after the first year. Pathology and Anatomy is a major subject of the second year and its best to get a head start rather than waiting until the end. In my opinion, the best case scenario will be a student who not only focuses on the second year subjects but also adds medicine to pathology. Worse case scenario would be waiting until the end to open books!! Well, this is also the year when students start planning trips and enjoying college life. Have fun but don’t overindulge to a point that you can’t come back.
The third year is the easiest year I think. But also because I studied decently throughout the year and it’s very feasible. The holy grail of M.b.b.s is the fourth and final year. Its the hardest I believe. Mostly because practicals weigh just as much as theory, and I was always terrified of vivas. So focus on both theory and practicals. Attend the clinical postings from the third year onwards and be well equipped with the history taking skills.
The internship is one year long. That’s when most of the students learn the basic procedures and get a good taste of the hospital life specifically being on call or night duties.
Moreover, I believe that my medical journey was both sweet and sour.W e are not alone in the journey there is a lot in the world who are with us on the journey. I want to share  a great word by ARISTOTLE
  -“NO GREAT MIND EVER EXISTED WITHOUT A TOUCH OF MADNESS”
ANATOMY 10 years (2018-2017) question papers of 1st prof MBBS WBUHS

ANATOMY 10 years (2018-2017) question papers of 1st prof MBBS WBUHS

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  Marks division

ANATOMY [Theory 140 + Practical 60 = Total 200 marks]

 THEORY (140 MARKS)

a) Written Exam (100) [paper I 50 + paper II 50]

 b) Oral (20)

  1. Bones 10 [axial 5 + appendicular 5]
  2. Viscera 10 [abdominal 5 + brain 5]

 c) Theory Internal Assessment (20)

[ Written exam + Oral + Internal assessment = 100+20+20 = 140 ]

PRACTICAL (60 MARKES)

a) Histology (15)

  1. Normal slide- 5
  2. Special slide- 4
  3. Notebook- 4
  4. cross section identification- 2

 b) Window dissection (10)

 c) Identification (8)

 d) Surface anatomy (4)

 e) Radiology (3)

 f) Practical Internal Assessment (20)

 

[ Histology + Window dissection + Identification + Surface anatomy + Radiology + Practical

Internal Assessment = 15+10+8+4+3+20 = 60 ]

 

 

                     Upper extremity

Group -A

  1. What are the palmar spaces? Describe the thenar muscles with their nerve supply and actions. (2017) P-1
    Enumerate the ligaments of shoulder joint. how the stability of the joint is maintained? Mention the nerve supply of the joint. Discuss the mechanism of elevation of arm above the hand. Which type of dislocation is common and why? (2016) P-1
  2. Describe the brachial plexus under the following heads: roots, trunks, divisions and chords. what do you mean by Erb’s point? Add a note on klumpke’s paralysis. (2015) P-1
  3. A 10 years old child had a fall on his out stretched hand and was diagnose to be suffering from supra condylar fracture of humerus. Describe the structures likely to be damaged what are the immediate and delay effect of said facture? (2015) P-1
  4. Describe the intrinsic muscle of hand. What is total claw hand? (2014) P-1
  5. Name the nerve involved in fracture of medial epicondyle of humerus. Describe course and distribution of the nerve beyond elbow. Mention motor and sensory distribution following its injury. (2013) P-1

Group-B

  1. A man presents with neuromuscular disability following fracture of surgical neck of Humerus. Give a brief account of the nerve affected because of its most close relation to that part of the bone. From your knowledge of anatomy add a note on the motor and sensory defects that may arise. (2010) P-1
  2. A factory worker present with acute pain and swelling of central part of the palm of his right hand following infection of web space between middle and ring finger. Using your anatomical knowledge explain this complication. Write a brief note on the palmer space affected. (2009) P-1
  3. Following a street accident, a young man develops fracture of mid shaft of humerus. Discuss the distribution of nerve related to this part of the bone, while it passes through the arm. Add a note on its lesion while it is in relation to the spiral groove of the bone. (2008) P-1

Short Note

  1. Anatomical snuff box of hand. (2014) P-1
  2. Cephalic vein. (2013) P-1
  3. Quadrangular and triangular space. (2012) P-1
  4. Clavipectoral Fascia. (2010) P-1
  5. carpal tunnel. (2009) P-1
    Carpal Tunnel syndrome. (2008) P-1

Explain why

  1. Upper end of Humerus 1s an example of compound epiphysis. (2010) P-1
  2. Fracture of shaft of humerus causes wrist drop. (2017) P-1
  3. Tear of medial semilunar cartilage (meniscus) is more frequent than lateral semilunar cartilage (meniscus). (2015) P-1
  4. Carcinoma of inferomedial quadrant of mammary gland main spread to ovary. (2015) P-1
  5. Painful arc syndrome. (2014) P-1
  6. Clavicle is a modified long bone. (2013) P-1
  7. Injury to radial nerve in cubital fossa will not cause wrist drop. (2012) P-1
  8. Injury to long thoracic nerve causes winging of scapula. (2012) P-1
  9. A palpable nodule in axilla of an elderly lady should be properly cared. (2009) P-1
  10. Clavicle is a modified long bone. (2009) P-1
  11. Metastasis from carcinoma of inferior medial quadrant of breast may take place in pelvic cavity. (2008) P-1

                     Lower extremity

Group -A

  1. Describe the formation of rectus sheath. Name the contents of the sheath. What is the function of tendinous intersection and at which level they are present? (2016) P-1
  2. Describe the shutter mechanism of inguinal canal and anatomical difference between oblique and direct hernia. (2015) P-1
  3. Name the bones forming the knee joint. Describe the locking and unlocking movement of knee joint. (2014) P-1
  4. What are the muscles exposed after cutting Gluteus maximus? Name the nerves supplying these muscles. What are the actions of these muscles on Hip joint. (2012) P-1
  5. Following an automobile injury, a person lost his adductor movements of the leg. What is the nerve supplying the adductor groups of muscles of leg? Describe the nerve under the following heading: i) Origin. ii) Branches. iii) Distribution. (2011) P-1

Group-B

  1. Describe the factors maintaining medial longitudinal Arch of foot. (2017) P-1
  2. Discuss the Tibialis posterior muscle. (2015) P-1
  3. Discuss different factors that maintain longitudinal arch of foot. What are the disadvantage of flat foot. (2013) P-1
  4. A bus conductor having prominent veins in his legs during standing position. What are the superficial veins present in the leg? What are the origin, termination and tributaries of short saphenous vein? What is varicosity of leg veins? (2011) P-1
  5. A factory worker presents with swollen painful Inguinal lymph nodes following an uncared wound at medial side of ankle. Explain this complication from your knowledge of anatomy. Write a brief note on Inguinal Lymph Nodes. (2010) P-1
  6. A child suffering from bilateral dislocation of hip joint. Mention the anatomical type of this location of hip state the factors mention the stability of hip joint. (2009) P-1
  7. An athlete while running, experienced severe clamps in his right thigh and was diagnosed as a case of Pulled hamstrings. Set the characteristics of Hamstrings. Mention the origin insertion nerve supply and actions of this group muscles. (2008) P-1

hort Note

  1. Short Saphenous vein. (2017) P-1
  2. Femoral sheath. (2013) P-1
  3. Deltoid ligament. (2011) P-1
  4. Popliteus muscle. (2010) P-1
  5. Deltoid ligament of Ankle. (2008) P-1

Explain why

  1. Sartorius is called as Tailors muscles. (2017) P-1
  2. Foot drop after fracture of neck of fibula. (2013) P-1
  3. Peroneus longus muscle has effect on both longitudinal as well as transvers arches of foot. (2010) P-1
  4. Injury of the superficial superior gluteal nerve shows posterior Trendelenburg sign. (2009) P-1
  5. Peroneus longus, while action along, has role on both transverse as well as longitudinal arches of foot. (2008) P-1

                              Abdomen

Group -A

  1. Give a brief amount of ureter. Mention its microscopic structure and development. Explain radiation of pain from loin to groin in ureteric colic. (2013) P-1
  2. A young married lady with a history of missed period, suddenly collapsed with sharp lower abdominal pain and was diagnosed having ruptured tubal pregnancy. What is the commonest site of tubal pregnancy and its fate. Mention the parts of this tube, blood supply, histological structure and development. (2012) P-1
  3. A 50 years old man was brought to the Out Patient Department (OPD) with a complaint of a swelling at the midline of anterior abdominal wall over an operative scar. Swelling was diagnosed to be incisional hernia through rectus sheath. i) Define the sheath. ii) Give its formations at different levels. iii) What are the contents of rectus sheath? Why is median incision not preferred over the anterior abdominal wall? (2011) P-1
  4. An old man suffering from carcinoma of Prostate presents with metastasis (secondary deposit) in vertebra. From your knowledge of anatomy explain this complication. Discuss briefly the capsules, lobes and relations of prostate gland. Add a note on interior of the organ. (2010) P-1
  5. Per vaginal examination of an elderly lady suffering from Pelvic Inflammatory Disease reveals collection of fluid in Pouch of Douglas. Write a note on this pouch with peritoneal as well as visceral relations of Uterus. Give a brief account of supports of the organ. (2010) P-1
  6. Young lady brought to the hospital emergency with acute pain in the lower abdomen and features of shock was diagnosed as a case of ruptured ectopic gestations. Mention the usual site of ectopic gestation discuss the gross anatomy development and micro anatomy of the organ involved. (2009) P-1
  7. During routine investigations, ultrasonography of whole abdomen of an adult healthy individual revealed incidence of horse-shoe shaped kidney. Explain the causes from your knowledge of embryology. Discuss briefly the development of kidney. Add a note on its clinical anatomy with congenital anomalies. (2008)P-1

Group-B

  1. Describe lymphatic drainage of stomach. Why does Virchow lymph nodes get enlarged in carcinoma of stomach? (2017) P-1
  2. Describe the cervix uteri. What is its clinical importance? (2016) P-1
  3. Describe the common bile duct. What is Calot’s Triangle? (2016) P-1
  4. Describe the interior of anal canal with its is histological structure. (2015) P-1
  5. Describe the common bile duct in short. Important of Calot’s triangle. (2014) P-1
  6. Mention the factors that prevent gastro-oesophageal regurgitation. Give and histological structure of oesophagus. (2013) P-1
  7. Give an account of uterine cervix. Mention its lymphatic drainage. (2013) P-1
  8. Why ischiorectal abscess is very painful when abscess is superficial. Write boundary and content of fossa. (2012) P-1
  9. Name the false ligaments of the liver. State within which mesogastrium, development of liver takes place and what are the remnants of it? Write from which part of the gut liver bud develops? (2011) P-1
  10. Name the parts of the large intestine with their corresponding lengths in the adults. Describe the structure of the large gut with diagram. (2011) P-1
  11. A teen aged girl suffering from Acute appendicitis got initial attack of pain around umbilicus which was finally localised at right iliac fossa. State anatomical reason of pain in both the areas. Give an account of positions of Vermiform appendix. (2010) P-1
  12. After splenectomy operation due to rupture of spleen following intra abdominal injury, a patient develop diabetic mellitus. Explain the reason form your Anatomical knowledge. Discuss briefly the ligaments of spleen cut during operation. (2009) P-1
  13. Bouts of hematemesis, following cirrhosis of liver of a patient was diagnosed to be due to obstruction of portal venous system. Explain the causes from your knowledge of anatomy. Give a brief account of the Portal Vein with a note on Porto-caval anastomosis. (2008) P-1

Short Note

  1. Hesselbach’s Triangle. (2017) P-1
  2. Prosthetic part male urethra. (2015) P-1
  3. Internal trigons of urinary bladder. (2014) P-1
  4. Broad ligament of uterus. (2014) P-1
  5. Ovarian fossa on lateral Pelvic wall. (2013) P-1
  6. Epiploic foramen. (2012) P-1
  7. Mackenrodt’s ligament. (2012) P-1
  8. Left Renal Vein. (2011) P-1
  9. Epiploic foramen. (2011) P-1
  10. Ischial spine. (2009) P-1
  11. Hesselbach’s triangle. (2009) P-1
  12. Porto-caval anastasis. (2009) P-1
  13. Relation of head of pancreas. (2008) P-1

Explain why

  1. Appendix of testis is embryologically different form appendix of epididymis. (2017) P-1
  2. Pleural sac may be accidentally opened during exposure of the kidney from back. (2017) P-1
  3. Pubic tubercle is important landmark for femoral and inguinal hernia. (2016) P-1
  4. In prostatic carcinoma X-ray of lumbosacral vertebra to be avoided. (2016) P-1
  5. Dropping of the kidney is not followed by suprarenal gland. (2016) P-1
  6. Caput medusae. (2015) P-1
  7. Inner layer of myometrium acts as a living ligature of uterus during menstruation and parturition. (2015) P-1
  8. Varicocele of left testes is common. (2014) P-1
  9. Carcinoma of the head of the pancreas may produce jaundice. (2014) P-1
  10. Pain around umbilicus in case of acute appendicitis. (2013) P-1
  11. Cholecystitis causes pain in right shoulder. (2011) P-1
  12. A patient of cirrhosis of liver presents with Caput Medusa. (2010) P-1
  13. Pectinate line is an important landmark of anal canal. (2009) P-1
  14. Rupture of membranes part of urethra may cause extravasation of union in anterior abdominal wall. (2008) P-1
  15. Incidence of inguinal hernia is normal healthy individual is prevented by Shutter mechanism. (2008) P-1

 

 

                               Thorax

Group -A

  1. Define pleura. Enumerate the parts of the pleura with their nerve supply. Describe the costomediatinal reflection of pleura. What is pleural effusion. (2015) P-2
  2. Describe the transverse pericardial sinus with development. What is the clinical importance of it? (2014) P-2
  3. Give an account of pleura. mention its nerve supply. What is the site of choice for insertion of needle to drain plural effusion and why? (2013) P-2

Group-B

  1. Describe the origin, course and distribution of left coronary artery. what is angina pectoris? enumerate the sources of development of internal system. (2017) P-2
  2. Describe the coronary sinus of the heart with its tributaries and development. (2015) P-2
  3. Give an account of usual pattern of coronary artery supply of heart. What is coronary dominance? (2012) P-2
  4. A young patient presents with repeated vomiting and reflux on examination which was diagnosed as Diaphragmatic Hernia. Explain the Condition from your knowledge of anatomy. Give the origin, insertion & nerve supply of the diaphragm. (2011) P-2
  5. A patient with history of cough, fever and breathlessness is diagnosed to be a case of Pleural effusion. Give a brief account on parts of pleura with its recesses and nerve supply. (2010) P-2

Short Note

  1. Central tendon of diaphragm. (2015) P-2
  2. Ligamentum arteriosum. (2014) P-2
  3. Nerve supply of apical pleura. (2014) P-2
  4. Inlet of Thorax. (2013) P-2
  5. 1st intercostal nerve. (2012) P-2
  6. Ansa cervicalis. (2012) P-2
  7. Oblique sinus. (2011) P-2
  8. Constrictions of oesophagus (2008) P-2

Explain why

  1. Fibrous pericardium is fused with central tendon of the diaphragm. (2016) P-2
  2. Recurrent laryngeal nerve is both side present different course. (2016) P-2
  3. Central tendon of the thoraco-abdominal diaphragm is blended with the basal part of the fibrous pericardium. (2014) P-2
  4. Type of respiration in children is abdominal, whereas it is thoraco-abdominal in adult. (2012) P-2
  5. Segment 2 and segment 6 of lung are the sites of lung abscess. (2011) P-1
  6. Inter costal nerves other than 3rd to 6th are atypical. (2010) P-2
  7. Type of respiration in infants is abdominal, weather thoracic in adult females and thoraco-abdominal in adult male. (2009) P-2
  8. Right recurrent laryngeal nerve hook round right subclavian artery, whereas the left does round the ligamentous arteriosum. (2008) P-2

                            Head-Neck

Group -A

  1. Describe the parotid gland under the following headings: i) Coverings ii) Relations of parotid gland iii) Nerve supply iv) Frey’s syndrome (2016) P-2
  2. A man suffering from hypertension bleeds from Little’s area of nose. Give an account of the formation, arterial supply, nerve supply & lining epithelium of nasal septum with a note on Little’s area. (2012) P-2
  3. Following thyroidectomy a patient may develop hoarseness of voice. Explain the statement. Give a brief account of intrinsic muscles of the larynx and their action on Rimaglottidis. (2012) P-2
  4. A child came to OPD with a complaint of injury to the external ear. On examination a perforation was found in the tympanic membrane. Discuss about the gross anatomy, arterial supply and nerve supply of the Tympanic membrane and the External auditory canal. (2011) P-2
  5. A person gives history of inability to close his mouth immediately after yawning. What is the anatomical basis behind it? Describe the muscles and ligaments related to the. anatomical site affected. (2011) P-2
  6. Following surgical operation of right sided parotid gland, a patient develops weakness of facial muscles of that side. State the relation of the affected cranial nerve with parotid gland. Give a brief account of functional components and intracranial course and distribution of the nerve. (2010) P-2
  7. Following operation on Thyroid gland, a patient developed hoarseness of voice. Give a brief note on muscle action on vocal cord and state from your knowledge of anatomy, what happened wrong with the patient. Discuss briefly the important relations and arterial supply as well as venous drainage of the thyroid gland. Mention what precautions, based on anatomical knowledge, are to be taken by a surgeon during operation on thyroid gland. (2008) P-2

Group-B

  1. Enumerate the extraocular muscles with their nerve supply and functions. (2017) P-2
  2. Enumerate the muscles of soft palate and their nerve supply. What are the different types of cleft palate and how they are formed? (2016) P-2
  3. Name the components forming the Nasal Septum with a suitable diagram. What is Little area? (2015) P-2
  4. Name the paranasal air sinuses. Mention the factor that helps to drain out the content of the maxillary sinus. Why these sinuses are developed around the nose? (2014) P-2
  5. Name the muscles of the pharynx. Give their nerve supply. What is killian’s dehiscence. (2014) P-2
  6. Enumerate paired Venous system sinuses in skull. Write brief note on cavernous sinus. (2013) P-2
  7. Mention the boundaries of Pyriform fossa of pharynx and its sensory supply. What is the clinical importance of the fossa. (2013) P-2
  8. An old man presents with an ulcer along the margin of the tongue which was diagnosed as carcinoma of the tongue (Cancer). Which group of lymph nodes are likely to be enlarged? Discuss briefly the lymphatic drainage of the tongue. (2011) P-2
  9. During surgical operation on thyroid gland a surgeon must be careful to avoid injury to some nerves. Mention the components, distribution and effect of lesion of these nerves. (2010) P-2
  10. A boy presents discharge of pus through ear following recurrent infection in throat. Explain the clinical complication from your knowledge of anatomy. Write a brief note on the structures connecting with throat. (2009) P-2

Short Note

  1. Maxillary sinus. (2017) P-2
  2. Danger area of scalp. (2016) P-2
  3. Rima glottidis. (2016) P-2
  4. Bronchopulmonary segments of left lung. (2016) P-2
  5. Nasolacrimal duct. (2016) P-2
  6. Ciliary body. (2016) P-2
  7. Structure and nerve supply of tympanic membrane. (2015) P-2
  8. Pyriform fossa with clinical importance. (2014) P-2
  9. Dangerous area of scalp. (2014) P-2
  10. Temporomandibular joint. (2013) P-2
  11. Dangerous area of face. (2013) P-2
  12. Lacrimal apparatus. (2012) P-2
  13. Tympanic membrane. (2012) P-2
  14. Inlet of the Larynx. (2011) P-2
  15. Middle meatus of nose. (2010) P-2
  16. Iris (2008) P-2
  17. Middle meatus of nose (2008) P-2
  18. Inferior constrictor muscles of pharynx (2008) P-2

 

Explain why

  1. Cricoarytenoid posterior muscle is the safety muscles of the larynx. (2017) P-2
  2. Increase pressure of CSF in subarachnoid space is easily diagnosed by ophthalmoscopic examination of the eye. (2017) P-2
  3. Parotitis is very painful. (2017) P-2
  4. A child suffering from repeated throat infection has discharge of pass through ear. (2017) P-2
  5. A child suffering from acute tonsillitis main complaint of pain in the ears. (2015) P-2
  6. Danger area of the face. (2015) P-2
  7. Posterior cricothyroid muscles act as safety muscles of larynx. (2015) P-2
  8. Pain in is referred to the middle ear in ulcer of the posterior part of the tongue. (2014) P-2
  9. In tonsillitis pain is referred to middle ear. (2013) P-2
  10. Superior parathyroid are inferior in position. (2013) P-2
  11. Optic disc in eye ball is known as blind spot. (2013) P-2
  12. Posterior inferior quadrant of tympanic membrane is chosen for myringotomy. (2013) P-2
  13. Superior Parathyroid are inferior in position. (2011) P-2
  14. Entry of foreign bodies is commoner to the right bronchus. (2011) P-2
  15. Layer of loose connective tissue is known as Dangerous layer of scalp. (2010) P-2
  16. Vocal cord is considered as water-shed line of larynx. (2009) P-2
  17. Layer of loose connective tissue is called Dangerous layer of scalp. (2008) P-2
  18. Throat infection in child, if neglected, may leads to Mastoiditis. (2008) P-2

 

                      Neuroanatomy

Group -A

  1. Describe cavernous sinus under following heading
    i) General information ii) Structure passing through sinus iii) Tributaries iv) Communications (2017) P-2
  2. Enumerate with fibres of the brain. Describe the internal capsule under the following heads. Parts with relations, fibres passing through different parts and blood supply. What is stroke? (2017) P-2
  3. What is atrial cycle of Willis? Describe the arterial supply of the superolateral surface of cerebral hemisphere. (2016) P-2
  4. Give an account of origin, course and distribution of oculomotor nerve. Explain the effects of oculomotor nerve lesion. (2015) P-2
  5. Give the arterial supply of supero-lateral surface of the brain. What is macular sparing. (2014) P-2
  6. Name the ventricle of brain. mention the boundaries and communications of third ventricle. What is hydrocephalus? (2013) P-2
  7. A patient is brought to physician presenting right sided ocular signs of ptosis, lateral strabismus, diplopia and loss of accommodation as well as light reflex with contralateral hemiplegia. From your knowledge of anatomy explain the lesion. Give a brief account of the cranial nerve affected. (2010) P-2
  8. Following ‘Stocks’ a man suffers from Weber’s syndrome with left right hemiplegia and ptosis, lateral strabismus and dilatation of pupil of right eye. Using your anatomical knowledge explain Weber syndrome and involvement of ocular muscles. Discuss briefly the extrinsic muscles of eyeball. (2009) P-2
  9. A person suffering from Parotid Tumour with malignant change gets complaints of Bell’s paralysis. Mention the anatomical change that occurred in Bell’s paralysis in this case. Discuss briefly the important relations structures in the interior and nerve supply of the Parotid Gland. (2008) P-2

Group-B

  1. Describe the floor of the fourth ventricle with diagram. (2017) P-2
  2. Describe the wall and communications of 3rd What is non-communicating type hydrocephalus? (2016) P-2
  3. What are the different parts of the cerebellum? mention its blood supply. What is cerebellar ataxia.(2015) P-2
  4. Write a note on Internal Capsule of brain with its blood supply. What is hemiplegia? (2012) P-2
  5. A patient with increased intracranial tension presents with medial squint/strabismus. Explain the reason for medial squint. Give a brief account of anatomy of the structure involved. (2011) P-2
  6. CT scan of brain of a patient suffering from cerebrovascular accident shows lesion in Internal capsule of brain. State why this part of brain is called ‘internal capsule’. Mention the different fibres passing through the internal capsule. Add a note on its blood supply. (2010) P-2
  7. A man about 60 years suffer from cerebral ataxia following ventricular damage mention arterial supply and phylogenetic subdivision of cerebellum. What do you mean by cerebellar ataxia from your knowledge of anatomy? (2009) P-2
  8. A patient with Argyll Robertson’s Pupil presence persistence of accommodation reflex, but loss of light reflex. Discuss briefly the accommodation reflex pathway. State how can you justify the specific neurological deficit in this case. (2008) P-2
  9. Neglected infection in dangerous area of face of a patient need to Cavernous Sinus Thrombosis. State the reasons from your knowledge of anatomy. Mention the communication and anatomical basis of complication arising from structures related to the thrombosed sinus. (2008) P-2

Short Note

  1. Blood supply of spinal cord. (2017) P-2
  2. Spinal accessory nerve. (2017) P-2
  3. Speech area of the brain. (2015) P-2
  4. Otic ganglion. (2013) P-2
  5. Ciliary ganglion. (2012) P-2
  6. Spine of the Sphenoid. (2011) P-2
  7. Thalamic Nuclei. (2011) P-2
  8. Left coronary artery. (2010) P-2
  9. Boundaries and communications of Third Ventricle of Brain. (2010) P-2
  10. Circulation of aqueous humour. (2010) P-2
  11. Motor neurone of spinal cord. (2009) P-2
  12. Superior cervical ganglion. (2009) P-2
  13. Blood Brain Barrier (2008) P-2

Explain why

  1. Syringing of external ear may sometimes causes vasovagal attack of the patients. (2016) P-2
  2. Obliquely the length of the spinal nerve root increase progressively from above downward. (2016) P-2
  3. A patient of pituitary tumor suffer from by temporal hemianopia. (2016) P-2
  4. Increased intracranial pressure may cause medial squint. (2015) P-2
  5. In anterior spinal artery syndrome there is bilateral loss of pain and temperature sensation but
  6. conscious proprioceptive sensations are preserved. (2015) P-2
  7. A pituitary tumour causes temporal hemianopia. (2014) P-2
  8. A patient having fracture of sphenoid sinus complain of loss of taste sensation at a later day. (2014) P-2
  9. Inflammation of parotid gland is very painful. (2014) P-2
  10. Macular vision is generally spared in lesion of posterior cerebral artery. (2012) P-2
  11. Optic nerve cannot regenerate after injury. (2012) P-2
  12. A patient of Pituitary tumour suffers from Bitemporal Hemianopia. (2010) P-2
  13. Lesions in pretectal nucleus of midbrain cause Argyll Robertson’s pupil. (2009) P-2
  14. Supranuclear type of Facial nerve lesion with two motors loss of lower part of face. (2009) P-2
  15. Visual defect due to occlusion of Posterior cerebral artery does not have effect on macular vision. (2008) P-2

                              Histology

Group-B

  1. Describe the histology of classical hepatic lobule. What is a liver acinus? (2012) P-1

 

Short Note

  1. Transitional epithelium. (2016) P-1
  2. Difference between transitional epithelium and stratified squamous epithelium. (2014) P-1
  3. plasma cell. (2009) P-1
  4. Respiratory epithelium. (2009) P-2
  5. Light microscopic structure of lymph node. (2009) P-2

 

                      General anatomy

Group-B

  1. Define long bone. Name the different part of young long bone. Describe the blood supply of the long bone. (2016) P-1
  2. What is metaphysis of a growing bone? Give its importance. (2014) P-1
  3. Mention the main structural characteristics of synovial joint. Classify synovial joint with example of each type (2012) P-1

 

Short Note

  1. (2017) P-1
  2. (2016) P-1
  3. (2016) P-1
  4. Cardiac muscles. (2015) P-1
  5. Turner’s syndrome. (2015) P-1
  6. Laws of ossification. (2015) P-1
  7. Non disjunction. (2013) P-1
  8. Epiphyseal cartilage. (2012) P-1
  9. Down’s syndrome. (2011) P-1
  10. (2011) P-1
  11. Klinefelter Syndrome. (2010) P-1
  12. Inter vertebral Disc. (2010) P-1
  13. Intervertebral disc. (2008) P-1

 

Explain why

  1. Spurt and shunt muscles. (2017) P-1
  2. (2014) P-1
  3. Barr body is present in Klinefelter syndrome. (2012) P-2
  4. Double Bar body in Klinefelter’s syndrome. (2011) P-1
  5. An elderly female (38 years) gave birth to a baby who is examined to be having a rounded face, epicanthic folds an a characteristic single palmar (simian) crease in the palm. Explain the genetic cause of the event. (2011) P-2

                           Embryology

Group -A

  1. Describe the internal features of anal canal with epithelial lining of each division. Why the pectinate line is called the watershed line of the anal canal? What is the importance of Hilton’s line? Mention the development of anal canal. Define internal haemorrhoids and mention their common sites. (2017) P-1
  2. A child presents leakage of urine throw umbilicus from urinary bladder. Using your anatomical knowledge explain the congenital anomaly with a note of development of urinary bladder. Give a brief amount of features with relations, ligaments and nerve supply of the organ. (2009) P-1
  3. A new-born baby was found to have cleft palate with nasal regurgitation of milk during breastfeeding. Explain the congenital defect from your knowledge of anatomy with a brief note on development of soft palate. Give a brief amount of muscles of soft palate with its movement during deglutition. (2009) P-2
  4. An anxious lady complaints to her doctor that right scrotal sac of her new-born male baby is found empty. The case of is diagnosed as one of the anomalies of descent of testes. Write a brief note on descent of testes. Discuss various anomalies of descent. Explain how the descent of female gonad differ from that of male. (2008) P-1
  5. An anxious lady complaints to her doctor that right scrotal sac of her new-born male baby is found empty. The case of is diagnosed as one of the anomalies of descent of testes. Write a brief note on descent of testes. Discuss various anomalies of descent. Explain how the descent of female gonad differ from that of male. (2008) P-1

Group-B

  1. Describe the derivatives of secondary mesoderm. (2017) P-1
  2. Classification of chromosomes on the basis of centrosomes. (2017) P-1
  3. Describe the derivatives of endothelial pharyngeal pouch. What is bronchial fistula? (2016) P-2
  4. Describe the development of placenta in short. What is placenta previa. (2014) P-1
  5. Give the development of atrioventricular septum. A pin pricked through the right side of the septum will reach which part of the heart? (2014) P-2
  6. What is primary defect in Fallot’s Tetralogy. Describe the development of interventricular septum. (2013) P-2
  7. Describe the development of tongue. Correlate the nerve supply of tongue with its development. (2012) P-2
  8. A child suffer from Fallot’s tetralogy. Mention anatomical features of this congenital anomaly. Write a brief note on development of Ventricular Septum. (2009) P-2
  9. A child, age 8 years with features of breathlessness on exertion and cyanosis since birth was diagnosed to be the case of Fallot’s Tetralogy. Explain the disorder from your knowledge of embryology. Write a note on development and blood supply of Inter ventricular septum. (2008) P-2

Short Note

  1. Anaphase Lag. (2017) P-1
  2. Meckel’s cartilage. (2017) P-2
  3. Bronchial cyst. (2017) P-2
  4. (2016) P-1
  5. Placenta previa. (2016) P-1
  6. Annular pancreas. (2016) P-1
  7. (2015) P-1
  8. Transposition of great vessels. (2015) P-2
  9. Meckel’s cartilage. (2015) P-2
  10. (2014) P-1
  11. Muscles of the first branchial arch with their nerve supply. (2014) P-2
  12. Styloid apparatus. (2014) P-2
  13. Placental barrier. (2013) P-1
  14. Bronchial cyst. (2013) P-2
  15. Umbilical Cord. (2012) P-1
  16. Development of the Soft Palate. (2011) P-2
  17. Physiological umbilical hernia. (2010) P-1
  18. Thyroglossal duct. (2010) P-2
  19. (2009) P-2
  20. Placenta previa. (2008) P-1

Explain why

  1. Transposition of great vessels. (2017) P-2
  2. New-born baby passes urine through umbilicus. (2016) P-1
  3. Imperforate anus. (2015) P-1
  4. A new-born baby presenting with imperforate anus. (2013) P-1
  5. Tracheo oesophageal fistula. (2012) P-1
  6. Monozygotic twins are identical whereas dizygotic twins are not identical. (2012) P-1
  7. Urinary fistula at the level of umbilicus in a new born baby. (2011) P-1
  8. Transposition of great vessels. (2011) P-2
  9. A patient is detected to have Horse shoe shaped kidney. (2010) P-1

 

Experience in first year MBBS final Anatomy practical exam

Experience in first year MBBS final Anatomy practical exam

A knowledge in anatomy is like a dead weight if we do not know how to apply the knowledge with successful skill. My experience in first year MBBS is quite good.Anatomy is really a hard subject for first year students because you never read about it like two other subjects like Physiology and Biochemistry. Our school teacher used to tell us that you have entered into a sea when we were in class eleven, But we are now really understanding what actually a sea is. The sea we were used to think are now like a small pond. Every wise person said that Practical part of the anatomy is more important than theory. I am sharing my experience in first year mbbs anatomy practical examination.

“I will turn human anatomy into roses and stars and sea. I will dissect the beloveds body in metaphor.” – Siri Hustvedt in The Summer Without Men

I know syllabus of human anatomy is like counting number of stars and amount of water in sea but if you love it like you love the beauty and smell of a  living rose – you are going to be a genius. I am writing another quotes which sounds funny.

“No man should marry until he has studied anatomy and dissected at least one woman.” – Honoré de Balzac

He had told like this to express that it is impossible to understand a woman. But if he really tried to learn anatomy- ever read the Grey’s anatomy, he would not said like this. If People have to study anatomy in order to get married – then – I like to hear your comment in this regard. It’s really a long debate.

So, I had the Anatomy practical exam. There was one day gap between two practical exam. Anatomy was next to Physiology practical exam. So, I had to focus on important chapters of anatomy and obviously my most favorite Atlas of anatomy utilizing most of the day. It was a amazing experience in first year mbbs anatomy practical examination.

The Day of Exam (experience in first year mbbs) 

Journey from Hostel room to Anatomy Hall – some unexpected moments 

Moments in the morning The day was luckily unlucky – Sometimes my luck favored but mostly luck was not with me. I was forced to wake up at 6:35 AM in the morning by me though alarm was set for 7 AM. And after some unorganized last minute view of Histology slides, I got ready and prepared my bag with with few  books, color pencils, pen etc. Then I see my white apron was staring at me curiously hanging from a overpopulated rope. I thanked myself for remembering that as I am a experienced and expert in forgetting.

Crisis in the road – It was 9:15 and I hurried for auto, taking a cake from canteen as usually I do. I was in hurry and there was auto but fully loaded there was no space for a single poor man. After few minutes a auto came and there was a space. But around ten people were struggling for  the single seat without showing any sympathy with this fighter. Waited for another 10 min with red face with anger in every cell like the Angry Bird and finally, I managed to get a seat and now I was the winner of the battle, feeling proud for myself. I traveled the 3/4th of the road very smoothly but suddenly paused but time was not paused. It’s cost was only 5 min, I had to pay. I started running, reached the college at 9:45. My heart was beating very fast as it wanted to come out from by body. I was feeling my apex beat like a novice drummer practicing with a hammer inside my chest.

The incidents that took place inside the anatomy hall – usual or unusual 

At last I entered the anatomy hall with gathering some confidence with in me. I was trying to charge mind but past experience was haunting my mind in the staircase. Head of the Department mam had already scolded me for the same reason.  It was my good luck for that day.

Histology exam experience – Histology exam started at 10:30 am, Histology notebooks were taken. I am telling seriously that I had some type of allergy in Histology notebook.  In Histology exam you have to identify 5 slides with two points and a special slide which you have to  draw only. Viva will be asked from the special slide . There was no problem in identifying the five slides and also the special slide. I was happy and did not hear any mishap from my fellow batch mates though 2 or 3 people mis-identified and later corrected with HOD’s solid snub.

Other six exam tables – After Histology, you have the freedom to choose any one of the following tables- Identification, Radiology & Surface Marking, Bones, Viscera and dissection window. Histology exam is conducted by fully internal team of Anatomy department but now it is the time for facing external.

My first choice Window – There was two cadavers one in supine and one in prone position. You have to give exam for one window. Normally you have to pick one card by lottery. The name of the window is written in the card. If you are lucky enough you get the chance to play with your luck again if the sir or mam conducting the lottery has some sympathy for you.

Luck didn’t favor this time – But actually what happened, the lottery was conducted by a really good and sympathetic mam. I was in a small queue behind two. They did no lottery just told what they want and mam gave the same card to them. My mind and heart was bouncing like a spring to get my most wanted, most practiced, most studied  Femoral triangle.  But, when my turn came another mam came to assist her. I told mam my choice. But mam was completely changed. The mam came like a negative inducer and I was ordered to choose from the bunch of cards. I choose a card and it was not for me, I have not done this before I told. The second mam started her mouth which I denied to hear and requested for another choice. First mam gave me the chance warning that it was my last chance. I did and and yes I got “Cubital fossa” a hot thing.

On spot preparation – I went for the cubital fossa there was no one for it. External sir was taking exam of a other fortunate who were first in the queue. I got the time as I required to prepare myself extra time to discuss with others who got the same.

We both enjoyed the Cubital Fossa – My turn came, Sir asked me to show roof, floor, boundaries, nerves, vessels everything and some clinical questions that I answered properly. I was happy to make sir happy but happiness came to anger when I came to know that sir gave 6.5 for good answers and 6 for moderate to bad answers. Actually they gave average number for experience in first year mbbs.

Identification, not a problem – Then I preferred to go for identification and waited for my turn sir pointed his forceps to  vessels, nerves, structures, viscera’s, muscles. I identified and answered carefully. Very good experience in first year mbbs practical exam.

Radiology and surface marking was my next choice I got a token of a line and a point frontal air sinus and 9th costal cartilage respectively. Examiner asked me few questions from occipito-mental view of skull.

V for Viscera – I gave the Viscera exam confidently. Brian, lung, tongue, cerebellum etc was given to me and I tried my best to satisfy the teacher. My total experience in first year mbbs dissection classes for viscera works fine.

Studying bones proved useless – The examination of bone was my last exam and the examiner’s too. We were three left for the exam. So as a team of three got confidence but he picked up the section of a bone. Giving half of the sectioned bone asked some definitions. He wanted us to tell “The exact definition written in the book” we failed to satisfy him. No anatomical position, no bony features, no attachment – studying these all things proved truly useless for the exam – a nice experience in first year mbbs.

It was my experience in first year mbbs and It was truly my last exam for anatomy, I successfully passed the first year and now trying to study the anatomy of second year that is Pharmacology.

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