1st year MBBS - Basic Sciences - paper IB - Internal Assessment January 2011

Numbers in the brackets indicate marks allocated.

SHORT ANSWER QUESTIONS

SECTION - A

1. Define shock. Enumerate types of shock. Describe briefly the stages of Septic shock. (1+1+3=5)

2. Define Neoplasia. What are the modes of spread of malignant tumors? Give one example each. (1.5+2+1.5=5)

3. Define Edema. Mention the pathophysiologic causes of edema. (2+3=5)

4. Define thrombus. What are the predisposing factors of thrombus formation? Enumerate the fates of a thrombus. (1+2+2=5)

5. Differentiate between dystrophic and metastatic calcification. (5)

6. Write short notes on: (5+5=10)
a. Type I hypersensitivity reaction
b. Autosomal dominant disease

SECTION - B

7. Write briefly on: (5*4=20)
a. Gram's Staining
b. Cultivation of Viruses
c. Genetic transfer of antimicrobial resistance among bacterial population
d. Common disinfectants used in  hospital

8. Draw a schematic diagram of Bacteriophage and mention its medical importance. (2.5+2.5=5)

9. Define nosocomial infection and briefly outline the approach to prevent this infection. (5)

10. Tabulate the differences between gram-positive and gram-negative bacteria. (5)

SECTION - C

11. Write briefly on the following with suitable examples: (5*6=30)
a. First pass metabolism
b. Topical routes of administration
c. Redistribution
d. Receptors antagonism
e. Tolerance
f. Cell cycle Kinetics

12. Define adverse drug reaction. Classify adverse drug reaction with examples. (5)

13. Write the mechanism of action, uses and adverse drug effects of the following: (5*4=20)
a. Amantadine
b. Amphotericin
c. Cloxacillin
d. Doxycycline

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Equality, Justice and Equity - World Bioethics Day 2017 Theme Essay Competition - Second Position

Equilibrium is the fundamental law of nature. Irrespective of the size and operating mechanism of any particular system of consideration, it is amazing to notice that it is in or at least it tries to be in equilibrium. In accordance with this simple rule, the stars stay at their specified place within a galaxy, planets stay on their orbits, the population of wild animals in an environment free from human interference remains nearly constant, the rivers flow, days and night occur, and the gases move from their higher concentration zones to those with their lower concentration,  which is fundamental for our survival as it is well known now that it is that simple process of diffusion of gases in alveoli which makes our life possible. Even within the cells and across them, the molecules diffuse from higher to lower concentration zones. From the smallest possible microcosm to the unimaginably vast universe, equilibrium tends to occur. As human beings realized, during the course of evolution, that equality is the ultimate state of stability, the concept of human rights, democracy, equality, and justice have emerged.

Equality, Justice and Equity, all these seemingly alike terms perplex almost everyone the first time they hear it. “I think they are similar, don’t they mean the same?”, even the purported pundits of our society gave this answer to me when they were asked about the subtle difference between these terms. Though they all are directed towards creating a better society and environment to live for everyone, ethical values, circumstances, and relativity may make these things a bit confusing, a bit paradoxical, and in some cases completely unreasonable.

Equality is the concept of providing the equal opportunity to everyone or distributing the available resources to each individual equally, irrespective of the backgrounds, needs, or any other special circumstances. From the time of the 14th-century English hero, Robin Hood, who supposedly used to steal from the rich and distribute to the poor, to modern-day communism, the concept of equality is implemented in various ways. However, equality doesn't always ensure justice and equity. Equality is like the blindfolded lady that is depicted in the symbol of justice. That blindfold has to be taken off and judgment should be done by seeing perspicaciously through the eyes of wisdom and compassion. Then only the justice is done and a state of equity is attained.

Let's make this more intelligible with some real-life situations. Implementing a rule that everyone should wait for their turns in a queue in a bill counter is equality. No matter whether someone is rich or poor, strong or weak, black or white, has to wait for their turns in a queue. This system for equality sounds perfect and desirable for each and every aspect of life. But, will it be justifiable to make a handicapped person who had already struggled so much just to reach the place wait for long hours in a queue along with other persons? Will it be a justice to make a pregnant lady in her third trimester of pregnancy wait in the queue? Who should be given more priority, the pregnant lady or the handicapped person? Now, there we seem to have reached an impasse of an ethical dilemma. The perfect system of equality suddenly seemed like a system where there is no place for compassion and empathy. Equality should always be tested for its accordance with justice. Equity is only attained when justice is considered for along with equality.

Similarly, in a classroom, a teacher should focus and give his attention differently to different students based on their individual needs. If on the premise of providing equality, the teacher gives equal focus to all students, the slightly slow learning student might never catch up with the speed of the class and the fast learning fellow may get bored. Also, what happens if every patient in the emergency unit of a hospital was given equal attention, time and resources? This will be a terrible mistake because it seems that we have practiced equality but the life of a critically injured patient may not be saved because unnecessary time and resources were wasted for a patient whose state was not as critical.

This insight into equality, justice and equity has to be implemented into every aspect of our lives be it social, economic or political. The act of budget planning and distribution, providing relief and compensation for the calamity struck population, providing healthcare facilities in a hospital, providing seats for the needy in public vehicles, providing reservation quotas for admission in a college or for a job, etc. all should have a consideration for justice whenever practicing equality. All the individuals should be well aware of the nuance between equality and equity and should be empathetic to incorporate in their own lives. Then only, we can make the society, the country and the world we live, a place where there is equality, justice and equity.

     -  Raman Dhungel
        BDS 2014
        BPKIHS

BDS Second Year CNS, MSK and Special Senses OSPE and VIVA Questions - Anatomy - July 2015

1. Key: Spinal cord
a. Identify the displayed specimen. (2)
b. Draw a well-labeled diagram showing the blood supply of it. (5)
c. Name the branches of typical spinal nerve. (2)

2. Key: Medulla Oblongata
a. Identify the displayed specimen. (2)
b. Name the cranial nerve arising from it. (4)
c. Write about the formation of facial colliculus. (4)

3. Key: Fourth Ventricle

a. Identify the flagged cavity. (2)

b. Draw a well-labeled diagram showing the floor of it. (5)

c. Write the three features of increased intracranial pressure. (3)

4. Key: Foramen Transversarium

a. Identify the flagged foramen. (2)

b. Name three structures passing from it. (3)

c. Write about the ossification of typical cervical vertebra.  (5)

5. Key: Superior Orbital Fissure

a. Identify the flagged foramen. (2)

b. Name three nerves passing through its middle part. (3)

c. Define diploic vein and name any three of it. (5)

6. Key: Hypoglossal Canal

a. Identify the flagged foramen. (2)

b. Name four muscles supplied by cranial nerve passing through it.  (4)

c. List 4 unpaired bones of skull. (4)

7. Key: Temporal Bone

a. Identify the displayed bone. (2)

b. Name different parts of it. (4)

c. List the boundaries and importance of suprameatal triangle.  (4)

8. Key: Orbicularis Oculi

a. Identify the flagged muscle. (2)

b. Name the different parts of this muscle and the nerve supplying it. (4)

c. Name any four other muscles of facial expression. (4) 

 

9. Key:  Parotid Gland

a. Identify the displayed specimen. (2)

b. List the structures within it. (4)

c. Give the anatomical explanation for Frey's syndrome.   (4) 

10. Key: Sternocleidomastoid muscle

a. Identify the flagged muscle. (2)

b. Write the functions and nerve supply of it. (4)

c. List the muscle forming the floor of posterior triangle. (4)

11. Key: Tentorium Cerebelli

a. Identify the flagged part of the displayed specimen. (2)

b. Name three dural venous sinuses related to it. (3)

c. List the structure lying in the lateral wall of the cavernous sinus. (5)

12. Key: tongue

a. Identify the flagged specimen. (2)

b. List any four muscles of it. (4)

c. List any four parts of the cervical fascia. (4) 

 

13. Key: Masseter

a. Identify the flagged muscle. (2)

b. Write the function and nerve supply of it. (4)

c. List any four contents of infratemporal fossa. (4)

14. Key: facial artery

a. Identify the tied vessel. (2)

b. List any four branches of it. (4)

c. List posterior and terminal branches of external carotid artery. (4) 

15. Key: Hyoid bone

a. Identify the displayed bone. (2)

b. Name the parts and developmental source of it. (5)

c. List any three content of carotid sheath. (3)

16. Key: Thyroid gland

a. Identify the displayed specimen. (2)

b. List five structures related with medial surface of it.  (5)

c. Name any three subarachnoid cisterns. (3)

17. Key: Eyeball

a. Identify the displayed specimen. (2)

b. Name six muscles attached to it. (6)

c. List two structures found within cavernous sinus. (2) 

18. Key: Middle meatus

a. Identify the flagged region. (2)

b. List the Paranasal air sinuses opening to this region. (4)

c. List four structures forming the nasal septum. (3)

19. Key: Lateral Rectus

a. Identify the flagged muscle. (2)

b. Write its action and nerve supply. (4)

c. Write the parts of internal ear containing endolymph. (4) 

20. Key: Vagus Nerve

a. Identify the tied structure. (2)

b. Name any four branches of it arising in the neck. (4)

c. List the nuclei of facial nerve. (4)

21. Key: Anterior cerebral artery

a. Identify the tied vessel. (2)

b. List the branches of basilar artery. (5)

c. List three characteristic features of cerebral veins. (3) 

22. Key: Stylomastoid foramen

a. Identify the flagged foramen. (2)

b. List two structures passing through it. (2)

c. With the help of diagram show the branches of the ophthalmic artery. (6)

VIVA Questions

1. What is Bell’s palsy? (2)

2. Why the infection behind the prevertebral fascia cannot extend below the superior mediastinum?  (2)

3. What is the most common cause of subarachnoid hemorrhage? (2)

4. What is Argyl-Robertson pupil? (2)

5. Tell two features of medial medullary syndrome. (2)

MCQs on Viral Infections - Oral Pathology

# The feature that distinguishes Herpes Zoster from other Vesiculobullous eruptions is :
A. Unilateral occurence
B. Severe burning pain
C. Prominent crusting vesicles
D. Subepidermal bullous formation

# A 3 year old child has a fever of 102 degrees F ; and following upper respiratory tract infection discrete vesicles and ulcers on the soft palate and pharynx are noted. The most probable diagnosis is :
A. Herpangina
B. Scarlet fever
C.Rubella
D. Herpetic gingivostomatitis

Regressive changes in Tooth : Attrition, Abrasion, Erosion and Abfraction

Regressive alterations are the group of degradative changes in the teeth which occur due to non-bacterial causes and result in wear and tear of the tooth structure with some impairment of function. Let's see some of the commonest regressive alterations of teeth one by one.

Firstly, Attrition. Attrition is a form of regressive change in teeth characterized by wear of tooth substance or restoration as a result of the tooth to tooth contact during occlusion, mastication or parafunction. Mostly, attrition is an age-related physiological process whose rate and severity depends on several factors like diet quality, dentition, masticatory force and chewing habits. So, older individuals often exhibit more attrition than the younger ones.

Attrition may also  be pathological which may be caused either due to:
a. Abnormal occlusion - leading to traumatic contact during chewing which causes more tooth wear
b. Premature extraction of teeth - which causes attrition of remaining teeth as the occlusal load on these teeth increase after the extraction of teeth because the masticatory force of an individual remains constant.

Also, pathological attrition may be due to parafunctional chewing habits like bruxism and habitual chewing of coarse and abrasive foods or other substances like tobacco and betel nut.

Abrasion: It is the pathological wearing of tooth structure or dental restorations by friction with foreign substances independent of occlusion. Toothbrush abrasion is the commonest type of abrasion caused by faulty toothbrushing technique, excessive force during tooth brushing and a dentrifice with strong abrasive. Abrasion may also be caused by habitual chewing of betel nut. tobacco and Pan (betel quid), and also by faulty clasp design in removable partial denture prosthesis. Tailors, carpenters, hairdressers, and shoemakers who use their teeth to hold nails and pins also develop abrasion.

Erosion: It is the progressive irreversible loss of hard dental tissues by some chemical process that doesn't involve bacterial action. It may be caused due to extrinsic factors such as acidic foods and beverages, medications ( Vitamin C and Hydrochloric acid preparations) and occupational exposure to acidic vapors. Intrinsic factors causing erosions are systemic diseases like Bulimia, GERD (Gastroesophageal reflux disease), etc. which cause increased vomiting and regurgitation of bowel contents into the mouth.

Abfraction: It is the pathological loss of tooth structure caused by biochemical loading forces. Excessive force during chewing or clenching cause repeated flexure of tooth and cause ultimate material fatigue and wearing off of tooth away from the point of loading.

MCQs on Growth and Development - Orthodontics

# Growth site of the mandible is in the :

A. Body
B. Condylar cartilage
C. Coronoid process
D. Ramus

# Maxilla develops by :
A. Endochondral bone formation
B. Intramembranous bone formation
C. cartilage replacement and intramembranous bone formation
D. mostly cartilage replacement and a little by intramembranous

MCQs on Etiology of Malocclusion - Orthodontics

# Malocclusion can be progressive in:
A. Class I
B. Class II
C. Class III
D. Combination of both class I and Class III

# Retained mandibular deciduous central incisors will result in:
A. Lingual eruption of mandibular permanent incisors
B. Labial eruption of mandibular permanent incisors
C. Impaction of mandibular permanent incisors
D. Ankylosis of mandibular permanent incisors