স্পেশাল বিসিএস (স্বাস্থ্য)

Some major endocrine glands are not controlled by the pituitary. These include the parathyroid glands (regulated by calcium concentrations), the adrenal zona glomerulosa (regulated by the renin–angiotensin system) and the endocrine Pancreas

Explanation- Distension of the stomach by food initiates contractions of the rectum and, frequently, a desire to defecate. The response is called the gastrocolic reflex, and may be amplified by an action of gastrin on the colon. Because of the response, defecation after meals is frequent in children. In adults, habit and cultural factors play a large role in determining when defecation occurs.
Reference-Ganong physiology/26th/P-494

Explanation -
Antibody raised in SLE :
ANA
Anti Ds DNA
Anti phospholipid antibody
Anti Sm antibody 

ACPA is anti citrullinated peptide antibodies raised in rheumatoid arthritis. 

Krukenbegre tumor is metastatise to ovary from stomach

Criteria of ovum at the time of ovulation:
• Ovum at the stage of secondary oocyte arrested at Metaphase of Meiosis-II 
• 120-150um in diameter
• Surrounded by cumulous oophorus/granulosa cell
• Completes 1st meiotic division 3 hours before ovulation
• Expulsion of 1st polar body just occurred
• Completes 2nd meiotic division after fertilization
• Ovulation process may last 12-48 hours
• Ovulation occurs after 36 hours of LH peak
• Inj. HCG causes ovulation after 38-40 hours

Abnormal sites of implantation:
1. Ampullary region of the tube (80%, most common site of ectopic pregnancy)
2. Tubal implantation (12%)
3. Abdominal cavity (commonly in pouch of Douglas)
4. Internal os of uterus
5. Ovary
6. Mesentary

Explanation -
Benign childhood tumor -
Haemangioma
Lymphangioma
Benign fibrous tumor
Mature teratoma

Explanation: The accumulation of serous fluid within the pleural space is termed pleural effusion. The accumulation of frank pus is termed empyema (that of blood is haemothorax, and that of chyle is a chylothorax

ABM 475

Most characteristic feature of apoptosis is chromatin condensation

Shrinkage in size of cell by loss of cell substance is called atrophy

Transport processes for macromolecules:
this process also called- Functional system of cell
1.Exocytosis(Neurotransmitters,Hormones,Enzymes,Proteins)
2. Endocytosis
◆ Pinocytosis(cell drinking)-proteins,vitamins
◆ Phagocytosis(cell eating)-bacteria,dead cell, tissue debris.

Explanation :
Cytokine of acute inflammation :
TNF, IL-1, IL-6, Chemokines
Cytokine of chronic inflammation :
IL-12, Gumma interferon, IL-17, All mediators of acute inflammation 

Reference: Davidson 23rd; P-814

 The "steeple sign" refers to the narrowing of the subglottic trachea, resembling a church steeple, and is characteristic of croup (laryngotracheobronchitis). Davidson explains that croup is a viral respiratory illness, most often caused by parainfluenza viruses, and commonly affects young children. Harrison adds that the steeple sign is an important radiographic finding, though clinical diagnosis is usually sufficient.

Reference: Davidson 23rd; P-133

Explanation: Acute lymphoblastic leukaemia shows a peak of incidence in children aged 1–5 years.

Explanation :
Complications of pneumonia-
Para- pneumonic effusion ( most common)
Empyema
Lung abscess
Lober collapse
Hepatitis,pericarditis
DVT
ARDS
Pneumothorax

Explanation: Ascaris lumbricoides causes ascariasis.

White infarct occurs in spleen

Reference: Davidson 23rd; P-133

Explanation-
Spleen - intraperitoneal

Secondary Polycythemia
Whenever the tissues become hypoxic because of too little oxygen in the breathed air, such as at high altitudes, or because of failure of oxy- gen delivery to the tissues, such as in cardiac failure, the blood-forming organs automatically produce large quantities of extra RBCs. This condition is called secondary polycythemia, and the RBC count commonly rises to 6 to 7 million/mm³, about 30% above normal.

A common type of secondary polycythemia, called phys iological polycythemia, occurs in those who live at altitudes of 14,000 to 17,000 feet, where the atmospheric oxygen is very low. The blood count is generally 6 to 7 million/mm³, which allows these people to perform reasonably high lev- els of continuous work, even in a rarefied atmosphere.

Ovarian cortex is covered by the germinal epithelium which is made up of a single layer of cuboidal cells in younger age. 

Explanation -
Symptoms of rheumatic carditis -
Dyspnoea 
Syncope
Chest pain,palpitation
Swelling of the legs.

Reference: Davidson 23rd; P-482

Explanation: CT is first line for stroke diagnosis

ß-1,3-D-glucan levels are characteristically elevated in P. jirovecii pneumonia.

Explanation :
Pathogenesis of osteoporosis -
Postmenopausal due to low peak bone mass
Genetic cause
Hypogonadism
Inflammatory bowel disease
Hyperparathyroidism
Cushing syndrome 
Corticosteroid 
GnRH agonist therapy
Alcohol excess
Heparin therapy

Renal angle is Angle between 12th rib and edge of erector spinae muscle

Explanation: Adenocarcinoma of the colon is the most common malignancy of the GI tract and is a major cause of morbidity and mortality worldwide

Explanation: Tricuspid regurgitation produces giant v waves that coincide with ventricular systole. Davidson 23rd, P-443

Reference: Davidson 23rd , Page : 1233
Explanation : Acrallentiginous or palmoplantar melanoma is more common in dark-skinned people.

Reference: Davidson 23rd, Page: 736 , Box : 20.15

Lateral horn of spinal cord refers to a lateral sideways extension of the lateral intermediate substance (lamina VII). It can be found only in the thoracic and upper lumbar spinal segments (T1 to L2) and therefore does not extend throughout the length of the spinal cord.

Pyogenic liver abscesses are often polymicrobial, with E. coli and Klebsiella among the most common.

Age estimation in adults is best done by examining morphological changes in the pubic symphysis. (Ref: Nandy, Age Determination)
The pubic symphysis is indeed a primary tool for age estimation in adults, as its morphology undergoes significant changes throughout life. The most widely used method is the Suchey-Brooks method, which classifies these changes into six phases. This method, along with others like McKern and Stewart, provides a reliable way to estimate age-at-death by examining the symphyseal face.

Digestion of proteins does not occur in mouth, since saliva does not contain any proteolytic enzymes. So, the digestion of proteins starts only in stomach.

Reference: Practical Manual in Clinical Medicine by Professor ABM Abdullah; P-320

Based on differences in the resting tone in muscles and the limbs involved, CP is classified into different groups.
The most prevalent type is spastic CP that is characterized by spasticity, hyperreflexia, clonus, and a positive Babinski sign.
These are all signs of damage to the corticospinal tract .
Dyskinetic CP is characterized by abnormal involuntary movements (chorea and athetosis) and may reflect damage to extrapyramidal motor areas. It is not uncommon to have signs of both types of CP.
The rarest type is hypotonic CP that presents with truncal and extremity hypotonia, hyperreflexia, and persistent primitive reflexes.

Unauthorized public disclosure of private medical information like HIV status can lead to defamation under Section 500, as it harms the patient's reputation.

Explanation: Bronchodilator therapy is central to the management of breathlessness

Neurotransmitter of Fast pain- Glutamate & Substance P for slow pain.

Primary hypothyroidism is diagnosed by a high TSH (from pituitary stimulation) and low free T4 (due to thyroid failure). Low TSH and low T4 suggest secondary hypothyroidism, while high TSH and high T4 or low TSH and high T4 are seen in hyperthyroid states.

Function of brainstem
1. Control of respiration
2. Control of the cardiovascular system
3. Partial control of gastrointestinal function
4. Control of many stereotyped movements of the body
5. Control of equilibrium
6. Control of eye movements

Reference: Junqueira’s Basic Histology; 14th Edition; Page-236

Explanation :
AGN -
Age group : 6-12 years
Haematuria : Present
Hypertension : Present
Mild to moderate proteiniurea

Normal site of Implantation- Anterior or posterior wall of body of uterus

Reference: Davidson 23rd Fig. 21.24

Reference: Davidson 23rd, Page: 733 , Box : 20.9

Testosterone, the principal hormone of the testes, is a C19 steroid with a hydroxyl group in the 17 position . It is synthesized from cholesterol in the Leydig cells and is also formed from androstenedione secreted by the adrenal cortex. 

Pituitary apoplexy ( characterized by a sudden headache, vomiting,visual disturbances and hormonal dysfunction. The cause is most commonly
due to the abrupt growth of a pituitary adenoma or pituitary infarction.The headache in apoplexy is usually very abrupt and can be mistaken for
a subarachnoid haemorrhage, although usually not as severe. Thepresentation can be unilateral or generalized. Visual defects are most
commonly of the superior quadrant bitemporally. Visual disturbances,such as loss of vision and opthalmoplegia affecting cranial nerves III, IV
and VI, help differentiate apoplexy from other intracranial pathology.Hypopituitarism can also follow an apoplexy although this is dependent
on degree of damage and often patients present feeling very tired ornauseous. Kallman syndrome (A) is characterized by gonadotrophin
deficiency and congenital anosmia. Septo-optic dysplasia (B) is a congenitaldisorder characterized by the triad of optic nerve hypoplasia, hypopituitarism
and forebrain abnormalities. The empty sella syndrome (D) is theobservation of absent pituitary tissue within the sella turcica observed on
imaging, however pituitary function is normal due to ectopic or unusual position of pituitary tissue within the sella fossa. Sheehan syndrome (C) is
also called postpartum hypopituitarism and is most commonly a rare complication of pregnancy. Patient's present with agalactorrhoea,
amenorrhoea and hypothyroidism after pregnancy.

Chromatid is formed during Prophase

Reference: Davidson 23rd; P-841

Explanation -
Transmission through Feco-oral route :
Hepatiris A & E
Polio
Rota
Coxsackie
Echo
Nowwalk virus

Explanation: H. pylori is Gram-negative and spiral, and has multiple flagella at one end, which make it motile, allowing it to burrow and live beneath the mucus layer adherent to the epithelial surface.

Explanation: HBV infection is the most common risk factor for developing hepatocellular carcinoma.

Valves prevent blood in veins from flowing away from the heart, while contracting skeletal muscle compresses the veins and this pushes blood through them towards the heart (as the valves prevent blood from being pushed in the other direction.

Cytoplasmic organelles Involved in Protein Synthesis (Translation):
1. Ribosome
2. RER
3. Mitochondria

Post-translational Modification of Protein Occurs in:
1. Golgi apparatus
2. Ribosome
3. RER