স্পেশাল বিসিএস (স্বাস্থ্য)

Explanation :
Causes of fine tremor :
Hyperthyroidism
Heavy metal poisoning
Drugs ( Beta agonist,Theophylline,Caffine,Sodium valproate,TCA,Amphetamine) 

Resting tremor :
Parkinson's syndrome

RBC increases in CSF in SAH

About one-third of those who develop an acute schizophrenic episode have a good outcome. One-third develop chronic, incapacitating schizophrenia, and the remainder largely recover after each episode but suffer relapses. Most affected patients cannot work or live independently. Schizophrenia is associated with suicide and up to 10% of patients take their own lives

Explanation: Osteoarthritis (OA) is by far the most common form of arthritis and is a major cause of pain and disability in older people. It is characterised by focal loss of articular cartilage, subchondral osteosclerosis, osteophyte formation at the joint margin, and remodelling of joint contour with enlargement of affected joints.

Explanation :
Glomerular syndrome :
Nephritic syndrome
Rapidly progressive glomerulonephritis 
Nephrotic syndrome 
Chronic renal failure
Isolated urinary abnormalities

Less common sign in hypothyroidism
Goitre with bruit
Atrial fibrillation
Systolic hypertension/increased
pulse pressure
Cardiac failure
Hyper-reexia
Ill-sustained clonus
Proximal myopathy
Bulbar myopathy

Less common sign in hyperthyroidism
Hoarse voice
Facial features:
Purplish lips
Malar flush
Periorbital oedema
Loss of lateral eyebrows
Anaemia
Carotenaemia
Erythema ab igne
Bradycardia hypertension
Delayed relaxation of reexes
Dermal myxoedema

Quartan malaria is caued by P. Malariae

Reference: Davidson 23rd; P-825

Diagnosis of hereditary angioedema can be confirmed by measurement of level of C1 inhibitor.

Explanation :
Site of traumatic fat necrosis -
Mostly breast
Then- salivary gland 
Pancreas
Neonates after delivery. 

Diabetic nephropathy is the leading cause of CKD globally, driven by the high prevalence of diabetes. The others are less common causes.

IV drug use-associated endocarditis often involves the tricuspid valve

• Oligoarthritis is more common,
• Systemic disease is more frequent,
• Large joints are affected more often than small joints,
• Rheumatoid nodules and rheumatoid factor are usually absent, and
• Antinuclear antibody (ANA) seropositivity is common.

Reference: Davidson 23rd; P-569
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

The capillaries are exchange vessel

Elastic work 65%

Ganong 26,Page 620

Reference: Davidson 23rd; P-496

Bronchodilation is stimulated by sympathetic nerve impulses, adrenalin & noradrenalin. Bronchoconstriction triggered by parasympathetic nerve impulses.

Diagnosis requires patient history, neurological examination and medical imaging
Magnetic resonance imaging is considered the best imaging modality for Chiari malformation
Diagnosis of Chiari type II malformation can be made prenatally through ultrasound (J Neurosurg Pediatr 2015;16:159)

Reference: Davidson 23rd; P-612

The low-dose dexamethasone suppression test is the best screening test for Cushing’s syndrome. Davidson explains that in Cushing’s syndrome, cortisol secretion fails to be suppressed by dexamethasone, indicating autonomous cortisol production. Harrison adds that a 24-hour urine cortisol measurement can also be used to confirm the diagnosis, but the dexamethasone suppression test is more sensitive for detecting mild hypercortisolism.

The fibrous skeleton is a dense framework of collagen within the heart that keeps the orifices of the atrioventricular (AV) valves and semilunar valve patent, provides an attachment site of the valve leaflets and cusps, serves as the origin and insertion sites of cardiac myocytes, and forms an electrical “barrier” between the atria and ventricles so that they contract independently.

Inhibition of Na+,K+-adenosine triphosphatase (ATPase) leads to an increase in intracellular Na+ concentration. Increased intracellular Na+ concentration decreases the Na+ gradient across the cell membrane, thereby inhibiting Na+–Ca2+ exchange and causing an increase in intracellular Ca2+ concentration. Increased intracellular Na+ concentration also inhibits Na+–glucose cotransport.

Lactulose reduces ammonia absorption via colonic acidification.

Explanation :
H.pylori associated gastritis -
Inflammatory infiltrate - Neutrophil, plasma cell
Location - Antrum
Acid production - Increased to slightly decreased 
Gastrin - Normal to drcreased
Sequelae - Peptic ulcer,Adenocarcinoma,MALToma

Explanation: A positive tuberculin test signifies T-cell–mediated immunity to mycobacterial antigens but does not differentiate between infection and active disease.

Explanation: Tularaemia and spores of bacillus used as bioterrorism

Davidson 23rd; P-1118

Parathyroid & pancreas are not under pituitary control.

All other are diabetogenic

Explanation :
Mycobacterium -
Rigid cell wall contain mycolic acid
M.fortuitum is rapid growing
Causes growth primarily in lungs

Explanation: Haemangiomas are the most common benign liver tumours and are present in 1–20% of the population

Main source of TNF is macrophage

Criteria of a substance, the plasma clearance of which is used for measurement of GFR are:
a) Freely filtered (not albumin bound),
b) Neither reabsorbed nor secreted by tubules
c) Not metabolized or produced by kidney
d) Non toxic

Ref: Davidson 23rd; P-992 , box : 24.10

IBS is a functional disorder with abdominal discomfort that improves post-defecation. No alarm features like bleeding or weight loss.

Reference: Davidson 23rd; P-563

Explanation :
CD4 + T helper cells may initiate the autoimmune response in RA by reacting arthritogenic agent.

Myxomas are the most common type of primary cardiac tumor in all age groups, most commonly in third to sixth decade, with a female predilection.

Langerhans’ cells have the primary function of antigen presentation to lymphocytes.

Type-1 respiratory failure occurs in lobar collapse

Western blot is confirmatory for HIV, if it is indeterminate, we will repeat this after one month.

Explanation: Syphilis is caused by T.pallidum

Leukemia is a group of cancers affecting the blood-forming tissues, primarily the bone marrow. It is characterized by the uncontrolled proliferation of abnormal, immature white blood cells (blasts) that accumulate in the bone marrow, peripheral blood, and sometimes other organs, impairing the production of normal blood cells.

There are three foramina present in the greater wing -
a.the foramen rotundum,
b. foramen ovale
c. foramen spinosum.
They conduct the maxillary nerve, mandibular nerve and middle meningeal vessels respectively.

Reference: Davidson 23rd Fig. 21.19 most common cause of Upper GIT bleeding is PUD

Broca’s motor speech area (Broadman area)-44, 45

( Ref : Davidson 23rd ,p – 700 )

Explanation : Coordination of movement (synergy) is the function of the cerebellum. Lesions of the cerebellum cause ataxia, lack of coordination, poor execution of movement, delay in initiation of movement, and inability to perform rapidly alternating movements. The premotor and motor cortices plan and execute movements. Lesions of the substantia nigra, a component of the basal ganglia, result in tremors, lead-pipe rigidity, and poor muscle tone (Parkinson disease).
Ref : BRS Physiology 7th edition

A) Retinal artery occlusion: This is the correct diagnosis. Davidson and Harrison explain that central retinal artery occlusion is caused by an embolus or thrombus blocking blood flow to the retina, leading to sudden, painless vision loss. The pale retina and "cherry red spot" are classic fundoscopic findings.
B) Retinal vein occlusion: Retinal vein occlusion causes painless vision loss, but the fundoscopy would show "blood and thunder" appearance with dilated veins, hemorrhages, and cotton-wool spots, not a pale retina with a cherry red spot.
C) Diabetic retinopathy: Diabetic retinopathy causes vision loss over time due to microvascular damage from diabetes. Fundoscopy reveals microaneurysms, hemorrhages, and neovascularization, not the findings described here.
D) Acute glaucoma: Acute glaucoma causes sudden, painful vision loss due to increased intraocular pressure. It is associated with a red, painful eye and a hazy cornea, not the fundoscopic findings described.