স্পেশাল বিসিএস (স্বাস্থ্য)

Reference: Davidson 23rd , Page : 473 , Box : 16.24

Explanation: IgG distributed equally between blood and extracellular fluid and transported across placenta.

Explanation :
Causes of -
Osteoblastic metastasis following carcinoma :
Prostate 
Breast ( Mixed)
Osteolytic metastasis following carcinoma :
Kidney
Thyroid
Lung
Breast

It will be cold intolerance , Reference: Davidson 23rd, Box-18.7

E E Explanation: The most important steps are to make a positive diagnosis and reassure the patient

Blood pressure regulation is the most important Which is regulated by negative feedback mechanism.

Chronic inflammation leads to fibrosis and calcification. Pain is chronic and may lead to exocrine and endocrine insufficiency

Exuberant scars that recur after excision are called desmoids

Trachea is lined by Ciliated pseudostratified columnar epithelium

a₁-antitrypsin deficiency is an autosomal recessive disorder (C), which results from single amino acid substitutions at positions 264 and 342 on chromosome 14. ₁-antitrypsin is a serine protease, synthesized in the liver, required in controlling inflammatory cascades. The lack of this serine protease results in emphysema (75 per cent), chronic liver disease and hepatocellular carcinoma, asthma, pancreatitis, gallstones, Wegener's granulomatosis.
Patients with liver disease secondary to d₁-antitrypsin deficiency usually present with dyspnoea (from emphysema), liver cirrhosis, cholestatic jaundice. Investigations include: serum a₁-antitrypsin levels, liver biopsy, genetic phenotyping and DNA analysis at prenatal diagnosis. Management involves quitting smoking, augmentation therapy with α₁-antitrypsin pooled from human plasma and liver transplantation is the treatment of choice in decompensated cirrhosis.

Reference: Davidson 23rd, Page : 646

Erythropoietin is produced by interstitial cells in the peritubular capillary bed of the kidneys and by perivenous hepatocytes in the liver.

Explanation: Uric acid stone is radio opaque

HAP is defined as pneumonia occurring ≥48 hours after admission, not incubating at admission. It is commonly caused by Gram-negative organisms like Pseudomonas, Klebsiella, and MRSA. These infections are often more resistant to antibiotics and carry higher morbidity. Management requires empiric broad-spectrum antibiotics, adjusted based on culture results.

Graves’ disease
Definition: It is an autoimmune disease in which circulating antibodies are formed against the TSH receptor and activates the thyroid gland hyperactive, resulting in development of goiter and hypersecretion of T3 & T4
More common in women

Clinical features:
1.  Goiter with bruit
2.  Exophthalmos-protrusion of the eye ball (it is the hallmark of Graves' disease)
3.  Retraction of upper eye lid, lid lag
4.  Corneal ulceration
5.  Diplopia
6.  Ophthalmoplegia
7.  Papilledema
8.  Loss of visual acuity
9.  Vitiligo
10.  Digital clubbing
11.  Pretibial myxedema

 

Explanation-
Post translational modification occurs in-ribosome, RER and Golgi complex.

Answer: A
Explanation: Radioactive iodine therapy is the most common treatment for Graves’ disease. Davidson explains that radioactive iodine selectively destroys thyroid tissue, leading to reduced thyroid hormone production. Harrison notes that this therapy is particularly effective in older patients and those with contraindications to surgery. Methimazole and beta-blockers are often used as adjunctive therapies but are not definitive treatments.

There is strong clinical trial evidence for the other four classes of drugs (A-D), although it is not clear how long the duration of therapy should be in each case. This benefit is applicable to normotensive patients with 'normal' LDL levels, although what constitutes normal in this case is controversial. Targets are likely to be reduced in the near future. One clinical trial did appear to shown additional benefit for the omega-3 fatty acids  this was in a population where few were receiving statins. Subsequent data have not supported their routine use.

Explanation -
Class I - Present in all nucleated cell and platelet
Class II - Present in antigen presenting cell ( Macrophage,B- cell,Dendritic cell) 
Class III - Remains free in plasma.

Neutropenia leaves patients vulnerable to severe bacterial and fungal infections.

Most common cause of thrombosis is endothelial injury

Zonulae occludens is another name of Gap junctions

Volume, which cannot be measured by spirometry, is the residual volume. Capacities, which include residual volume also cannot be measured. Capacities that include residual volume are functional residual capacity and total lung capacity.

Reference: Davidson 23rd , Page : 1200
Explanation : Lithium carbonate is the drug of first choice for bipolar disorder.

HOCM is the most common cause of sudden cardiac death in the young. 
Always consider HOCM in sudden death & unusual collapse in young person

p24 antigen appears earlier than antibodies and is used in fourth-generation HIV tests

Antigen testing of blood and cerebrospinal fluid is most useful in the diagnosis of cryptococcosis.

Guyton  13th-501-502

-Nucleus is situated at the periphery in case of yellow fat.
-Yellow fat is unilocular. Brown fat is multilocular.

Anus below the pectinate line develops from proctoderm

Reference: Guyton 14th; P- 495

Explanation : M. Leprae has tropism for Schwann cells & skin macrophages.

Reference: Davidson 23rd; P-861
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-581

Explanation :
Superantigen -
Enterotoxin of staphylococcus
Toxic shock syndrome toxin of s.aureus
All toxin of steptococcus
Enterotoxin of bacillus
Enterotoxin of clostridium.

Raynaud’s phenomenon is digital ischaemia induced by cold and emotion. It has three phases 
•     pallor: due to digital artery spasm and/or obstruction
•     cyanosis: due to deoxygenation of static venous blood
(this phase may be absent)
•    redness: due to reactive hyperaemia.

Reference: Guyton 14th; P- 533

♣ The AV node is situated in the lower and dorsal part of the atrial septum just above the opening of the coronary sinus (within the Koch’s triangle)
♣ The SA node is situated in the wall of the right atrium in the upper part of sulcus terminalis just below the opening of superior vena cava

  Nonspecific laboratory findings associated with hypothyroidism.
Ø  Increased serum total cholesterol and LDL-C

Ø  Increased TAG (Triacyl glycerol)

Ø  Hyponatremia (due to free water retention)

Ø  Increased CPK (due to myopathy)

Listeria monocytogenes most frequently causes Meningitis

Reference: BD Chourasia’s human anatomy/7th/vol-4/P-129

How to perform an oral glucose tolerance test (OGTT)
Preparation before the test
·       Unrestricted carbohydrate diet for 3 days
·       Fasted overnight for at least 8 hrs
·       Rest for 30 mins
·       Remain seated for the duration of the test, with no smoking

Reference: Acute upper gastrointestinal haemorrhage is the most common gastrointestinal emergency

Under BPC (Bangladeshi Penal Code) Section 375, sexual intercourse with a girl under 16 years of age is considered rape, regardless of whether the girl consents. The law clearly states that if a girl is under the age of 16, any sexual intercourse with her, whether or not she consents, constitutes rape. 

The larger lateral striate branch of middle cerebral artery is called ‘Charcot’s artery of cerebral haemorrhage.

It supplies the posterior limb of the internal capsule which transmits corticospinal (pyramidal tract) fibres for the upper limb, lower limb and trunk. Hemorrhagic stroke at this region results in contralateral spastic hemiparesis. 

The bronchial veins carry deoxygenated blood from the bronchial arteries that supply large bronchi. Right bronchial veins drain into the azygos vein. Left bronchial veins drain into the accessory hemiazygos vein.

Explanation: Iodine is required for synthesis of thyroid hormones

Reference: Davidson 23rd; P-626
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Explanation -
Pneumothorax -
Inspection - Restricted chest movement
Palpation - Trachea and apex beat shifted to opposite side
Percussion - Resonant percussion note
Auscultation - 
Breath sound absent
No added sound

For acute dissection, parenteral beta-adrenergic blockers (IV propranolol, metoprolol, labetalol or esmolol) should be administered to achieve a heart rate of ~60 beats/min. Sodium nitroprusside infusion is used to lower SBP to <120 mmHg. Verapamil, diltiazem or enalaprilat may be used parenterally. Isolated use of direct vasodilators like diazoxide and hydralazine is contraindicated because these agents can increase hydraulic shear and may propagate dissection.

Explanation: 12-lead ECG is the initial investigation for acute onset chest pain.

Foetal skeleton is a hyaline cartilage

Reference: Guyton 14th; P- 526

Explanation: Acromegaly is caused by growth hormone (GH) secretion from a pituitary tumour, usually a macroadenoma, and carries an approximate twofold excess mortality when untreated.

Chest pain on exertion suggests angina pectoris. The reproducibility, predictability and relationship to physical exertion (and occasionally emotion) of the chest pain are the most important features.

Adenocarcinoma is common carcinoma of gallbladder