স্পেশাল বিসিএস (স্বাস্থ্য)

Insulin causes hypoglycemia by:
1.  Uptakes & oxidation of glucose by cells
2.  Uptake & storage of glucose as glycogen in muscle & liver.
3.  Uptake & utilization of glucose for lipogenesis & fat synthesis in adipocyte.
4.  Inhibition of gluconeogenesis & glycogenolysis

Circular folds are absent in proximal part of duodenum.

কোন ব্যাখ্যা যোগ হয় নি।

an analysis of the lever systems of the body depends on knowledge of the following:
(1) the point of muscle insertion;
(2) its distance from the fulcrum of the lever;
(3) the length of the lever arm;
and (4) the position of the lever.

Reference: Davidson 23rd; P-8(Fig-1.7).

Ref: Davidson 23rd; Box- 24.55

Reference: Davidson 23rd; P-137

Discontinuous capillaries (sinusoids) present in liver, spleen, Bone marrow.

• Infection by M. tuberculosis proceeds in steps, from initial infection of macrophages to a subsequent TH1 response that both contains the bacteria and causes tissue damage

Extreme cachexia in young female with history of diet control, heavy exercise and amenorrhea – anorexia nervosa.

Explanation :
Most effective cardiac biomarker in acute MI is serum trophonin I, which rise in 4-6 hours, peak at 12 hours and fall after 48-72 hours.

Others are secreted from follicular cell

Rabies virus is bullet shaped, enveloped, single-strand RNA virus of negative polarity. The first step in viral replication is synthesis of full-length copies (postive strands) of the viral genome.

Explanation: An ostium secondum defects is a large opening between the atria that can be caused either by excessive resorption of the septum primum or inadequate development of the septum secondum. Depending on the size of the defect, there can be shunting of blood between the atria.

Explanation:

Explanation: Humans are infected by eating food contaminated with mature ova. Ascaris larvae hatch in the duodenum, migrate through the lungs, ascend the bronchial tree, are swallowed and mature in the small intestine

Causes of acute pneumonias in the community include H. influenzae and M. catarrhalis (both associated with acute exacerbations of COPD), S. aureus (usually secondary to viral respiratory infections), K. pneumoniae (observed in patients who are chronic alcoholics), P. aeruginosa (seen in persons with cystic fibrosis, in burn victims, and in patients with neutropenia), and L. pneumophila, seen particularly in organ transplant recipients.

Explanation :
Changes in peripheral blood after acute blood loss :
Extravascular fluid pass into capillaries
Fluid may retain by kidneys
Hb% decreased
PCV decreased 
Reticulocyte count increase 5-15%
Thrombocytosis.

Ref: BD/7th/vol-2/ page 321

Defensin limits entry of microorganism into body

Autosomal dominant disorders: 
Skeletal
1. Marfan syndrome
2. Osteogenesis imperfect
3. Achondroplasia
4. Ehlar Danlos Syndrome
Nervous
1. Huntington’s disease
2. Neurofibromatosis
3. Myotonic dystrophy
4. Tuberous sclerosis
Urinary
1. Polycystic kidney disease
Metabolic
1. Familial hypercholesterolemia
2. Acute intermittent porphyria
Gastrointestinal
1. Familial adenomatous polyposis coli
Haematopoeitic
1. Von Willebrand disease
2. Hereditary spherocytosis

Pancoast's tumours are defined as tumours arising from the lung apex either on the left or right side. As the tumour grows it can compress structures such as the brachiocephalic vein, subclavian artery, recurrent laryngeal nerve (causing voice hoarseness (A), vagus nerve, phrenic nerve or compression of the sympathetic ganglion resulting in a group of symptoms known as Horner's syndrome (pupil constriction, enopthalmos sunken eye, ptosis (B) - drooping eyelid and ipsilateral anhydrosis (C) loss of sweating due to compression of sympathetic supply (thoracic outlet) to the face).

Smooth endoplasmic reticulum is abundant in cells involved in lipid synthesis-
• Liver cells
• Cells of adrenal cortex
• Leydig cells of testis
• SER also appears in a specialized form, called sarcoplasmic reticulum, found in the striated muscle cells.

Explanation : Optic tract is formed by uncrossed fibers of optic nerve on the same side and crossed fibers of optic nerve from the opposite side. Fibers from fovea do not enter superior colliculus. Supraoptic nucleus of hypothalamus: It is concerned with the retinal control of pituitary in animals. But in human, it does not play any important role. Fibers from lateral geniculate body pass through internal capsule and form optic radiation.
Ref : Sembulingam 6th edition (Page- 990,991)

Explanation :
Autosomal dominant inheritance -
At least one parent of a case is affected
Both male and female canbe equally affected.
Consecutive generations are affected
Presents in heterozygous state

Explanation: WBC & nitrite in urine is suggestive of UTI

Multiple doses of activated charcoal is effective against other substances.

Reference-langman’s medical embryology/13th/P-86

Reference: Davidson 23rd, Box-15.11

Ref: Davidson 23rd; P-946, box: 23.36

HGC prevents involution of corpus follicle.

In adult humans who are awake but at rest with the mind wandering and the eyes closed, the most prominent component of the EEG is a fairly regular pattern of waves at a frequency of 8–13 Hz.

This pattern is the alpha rhythm. It is most marked in the parietal and occipital lobes and is associated with decreased levels of attention. A similar rhythm has been observed in a wide variety of mammalian species.

Metformin is the first-line therapy for type 2 diabetes mellitus, as it reduces hepatic glucose production, improves insulin sensitivity, and is effective and well-tolerated. Insulin is used in type 1.

Beneficial effect of inflammation is control of infection

Explanation: P. falciparum infects all stages of RBC

Explanation : Nissl bodies or Nissl granules are small basophilic granules found in cytoplasm of neurons and are named after the discoverer. These bodies are present in soma and dendrite but not in axon and axon hillock. Nissl bodies are called tigroid substances.
Ref : Sembullingam 6th edition (Page- 760)

Hypoparathyroidism leads to hypocalcemia, by decreasing the resorption of calcium from bones. Hypocalcemia causes neuromuscular hyperexcitability, resulting in hypocalcemic tetany. Normally, tetany occurs when plasma calcium level falls below 6 mg/dL from its normal value of 9.4 mg/dL.

Stem Breakdown:

Abdominal pain, bloating, and altered bowel habits: These symptoms suggest a gastrointestinal disorder, possibly involving the colon.
Multiple polyps throughout the colon on colonoscopy: This finding is characteristic of familial adenomatous polyposis (FAP), a hereditary condition associated with numerous adenomatous polyps and a high risk of colorectal cancer.
Option Analysis:

A) Familial adenomatous polyposis (FAP): This is the correct diagnosis. Davidson and Harrison explain that FAP is an autosomal dominant disorder caused by mutations in the APC gene, leading to the development of hundreds to thousands of adenomatous polyps in the colon. If left untreated, FAP almost inevitably leads to colorectal cancer.
B) Peptic ulcer disease: Peptic ulcer disease causes epigastric pain, often related to meals, but it affects the stomach and duodenum, not the colon, and does not cause polyps.
Crohn’s disease: Crohn’s disease is an inflammatory bowel disease that can affect any part of the gastrointestinal tract, but it does not cause multiple polyps throughout the colon. It typically presents with skip lesions and transmural inflammation.
D) Diverticulosis: Diverticulosis involves the formation of small pouches (diverticula) in the colon, usually in the sigmoid colon, but it does not cause multiple polyps. It is often asymptomatic but can lead to diverticulitis (inflammation of diverticula).

Marasmus is a form of severe protein-energy malnutrition characterized by extreme wasting of muscle and fat, leading to a "skin and bones" appearance. It results from severe caloric deficiency. Unlike kwashiorkor, edema is absent or minimal, and appetite may be relatively preserved.

Special points Regarding blood supply of spinal cord
1. Anastomosis is least efficient at the region of lateral columns
2. Cervical and lumbar segments have rich vascular supply
3. T1 to T4 segments are most vulnerable to ischemia
4. Anterior spinal artery thrombosis causes ischemia of anterior 2/3rd of the cord, sparing the posterior column, hence leads to dissociated sensory loss.

Kayser-Fleischer rings are brown or green deposits of copper seen around the cornea in patients with Wilson’s disease. Davidson explains that Wilson’s disease is a genetic disorder characterised by the accumulation of copper in the liver, brain, and other tissues due to a defect in copper excretion. Harrison emphasises that Kayser-Fleischer rings are pathognomonic for Wilson’s disease, and treatment involves copper chelation therapy.

Explanation -
Premalignant condition of female genital tract :
Cervical dysplasia including CIN
LSIL,HSIL
Endometrial hyperplasia 
Leucoplakia
Dysplasia
Lichen sclerosus of vulva

Explanation -
Metastatic calcification :
Metastatic calcification may occur in normal tissues whenever there is hypercalcemia. Hypercalcemia also accentuates dystrophic calcification. There are four principal causes of hypercalcemia: (1) increased secretion of parathyroid hormone (PTH) with subsequent bone resorption, as in hyperparathyroidism due to parathyroid tumors, and ectopic secretion of PTH-related protein by malignant tumors  (2) resorption of bone tissue, secondary to primary tumors of bone marrow (e.g., multiple myeloma, leukemia) or diffuse skeletal metastasis (e.g., breast cancer), accelerated bone turnover (e.g., Paget disease), or immobilization; (3) vitamin D–related disorders, including vitamin D intoxication, sarcoidosis (in which macrophages activate a vitamin D precursor), and idiopathic hypercalcemia of infancy (Williams syndrome), characterized by abnormal sensitivity to vitamin D; and (4) renal failure, which causes retention of phosphate, leading to secondary hyperparathyroidism. Less common causes include aluminum intoxication, which occurs in patients on chronic renal dialysis, and milk-alkali syndrome, which is due to excessive ingestion of calcium and absorbable antacids such as milk or calcium carbonate.

Reference: Davidson 23rd, Box-4.4

Toxoplasma gondii is an intracellular parasite. The sexual phase of the parasite’s life cycle (Fig. 13.40) occurs in the small intestinal epithelium of the domestic cat. Oöcysts in cat faeces are spread to intermediate hosts (pigs, sheep and also humans) via soil contamination. Oöcysts may survive in moist conditions for weeks or months.

Melatonin is secreted from pineal gland

Ehlers danlos syndrome is a condition where there is poorly developed collagen,easy to hurt,poor healers,cigarette paper like skin known as rubber man or human pretzels. 

Reference: Davidson 23rd; P-634