স্পেশাল বিসিএস (স্বাস্থ্য)

Reference: Davidson 23rd; P-746

Orthotolidine test is used to detect blood in urine.

Explanation : Trigeminal nerve acts as afferent nerve in case of corneal,conjunctival & nasal superficial mucous membrane reflexes. Glossopharyngeal nerve acts as afferent nerve in case of uvular & pharyngeal reflex.
Ref : Sembulingam 6th edition (Table- 142.1)

Explanation: After incubation period, there is diarrhoea, abdominal pain, weakness, anorexia, nausea and vomiting. On examination, there may be abdominal distension and tenderness, Chronic diarrhea and malabsorption may occur, with bulky

Reference: Davidson 23rd; P-565

Others are classical sites of insulin receptor.

Septum transversum gives rise to central tendon of the diaphragm & fibrous pericardium.

Ref: Davidson 23rd; P-982

Transitional epithelium prevents urine from leaking of the bladder due to Tight junction

Receptors are those in the rods and cones in the retina that respond to light are- photoreceptors

Reference: Davidson 23rd; P-133

Explanation :
Target organ damage by hypertension -
Blood vessels
Central nervous system 
Retina
Heart
Kidneys

Thyroxine is not teratogenic. Thyroxine replacement is given during pregnancy if there is hypothyroidism.

In obstructive (post-hepatic) jaundice, conjugated bilirubin cannot reach the intestine, leading to pale stools and is excreted in urine, causing dark discoloration.

Nestin is found in some stem and embryonic cells. Rests of them are true.

*** The corpus callosum is the largest commissure of the brain. It connects the two cerebral hemispheres. It is 10 cm in length in man.

45XO- Turner's syndrome
47 XXY- Klinefelter's syndrome
47 XX/XY+18- Edward's syndrome (Trisomy 18)
47 XX/XY+13- Patau's syndrome (Trisomy 13)

Down's syndrome:
Also known as Trisomy 21 is the most common numerical chromosomal abnormality.

Cause :
- Non disjunction (94%)- 47 XX/XY+21 (Trisomy 21)
- Mosaicism (2%)
- Transloation (4%)

Explanation :
Cells implicated tumor immunity -
Natural killer cell
Macrophage
Cytotoxic T cell

Intrinsic factor is secreted by the parietal cells of the gastric fundus (as is HCl). It is absorbed, with vitamin B12, in the ileum.

Explanation: Metformin is used as first-line therapy for type 2 diabetes, irrespective of body weight

Effects of insulin on various tissues
Adipose tissue
Increased glucose entry Increased fatty acid
Increased glycerol phosphate synthesis Increased triglyceride deposition Activation of lipoprotein lipase Inhibition of hormone sensitive lipase Increased K+ uptake
Muscle
Increased glucose entry Increased glycogen synthesis Increased amino acid uptake
Increased protein synthesis in ribosomes Decreased protein catabolism
Decreased release of gluconeogenic amino acids Increased ketone uptake
Increased K+ uptake

Explanations:
In response to hypoxia kidney release erythropoietin that acts on bone marrow & stimulate erythropoiesis.

Cl- activates salivary alpha amylase.

Euthanasia is illegal in Bangladesh; ethical practice emphasizes palliative care and pain management.

• Intrapleural space: -8 mm Hg
• Joint synovial spaces: -4 to -6 mm Hg
• Epidural space: -4 to -6 mm Hg

Reference: Davidson 23rd; P-644

Reference: Davidson 23rd; P-825

Microtubule, microfilament & intermediate tubule are cytoskeleton of cell

Explanation :
Liver failure -
Hyperacute : <7  days
Acute : 8-28 days
Subacute : 29 days - 12 weeks.

Reference: Davidson 23rd; P-617

Explanations:
The principal haemostatic mechanism is believed to be via extrinsic pathway which is assessed by PT.

The centromeres also move away from the centre, pulling along the remainder of the chromosome during Anaphase.

Explanation: Metformin- is an oral anti diabetic drug

sinensis is liver fluke

Explanation: Night sweats is common in TB & infective endocarditis

Investigations
1 to 5 days of fever : CBC, NS1 antigen, SGOT and SGPT (Not mandatory but helpful)
• After day7: IgM and IgG Antibodies (Day 5-7 window period)
• Follow up testing may be done on 1st afebrile day, but should be done daily when DHF is suspected
Haematocrit:
-A regular haematocrit is more important for management than the thrombocytopenia
-In severe dengue especially with shock hourly haematocrit is crucial for management

Soft-tissue swelling that most frequently affects the face (Fig. 4.15) but can also affect the extremities and genitalia characterizes angioedema. Involvement of the larynx or tongue may cause life-threatening respiratory tract obstruction, and oedema of the intestinal mucosa may cause abdominal pain and distension.

Foul smelling dark colored sputum: lung abscess
Rusty sputum: pneumococcal pneumonia.
Productive cough with frothy sputum occurs in pulmonary edema.
Barking cough: acute epiglottitis.

Reference: Davidson 23rd; P-818

* The basic structural unit of chromatin is the nucleosome.
Nucleosomes are composed of  DNA wrapped around a set of eight histone proteins. 

* Gene, the functional unit of DNA, is the unit of inheritance.

* The nucleotides are the basic structural units of the DNA.
• Nitrogen base + sugar = Nucleoside
• Nucleoside + phosphate group = Nucleotide
• Nucleotide polymer = Nucleic acid (DNA/RNA)

Explanation :
Major neurodegenerative disorder :
Alzheimer’s disese
Parkinson disese
Huntington disese
Spinocerebellar ataxia

Davidson P852

Ultrasound scanning can confirm the diagnosis, although in the earlier stages the gland may not be grossly swollen. An ultrasound scan is also useful because it may show gallstones, biliary obstruction or pseudocyst formation.

Contrast-enhanced pancreatic CT performed at least 3 days after
admission can be useful in assessing viability of the pancreas if persisting organ failure, sepsis or clinical deterioration is present, since these features may indicate that pancreatic necrosis has occurred.

Explanation -
IDDM -
Age <40 years
Duration : Weeks
Body weight : Normal or low
Ketonuria, Hypoglycemia, complications : Present
Family history : Absent
Othet autoimmune disease : Present

Explanation: The hallmark of SLE is the production of autoantibodies Antibodies to double-stranded DNA and the so-called Smith (Sm) antigen are virtually diagnostic of SLE.

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.

Transposition of the great arteries (TGA) causes severe cyanosis at birth due to parallel pulmonary and systemic circulations. Mixing of blood (e.g., via a patent ductus arteriosus) is required for survival until corrective surgery.

Explanation : Superior semicircular canal gives response to rotation in anteroposterior plane (transverse axis). Horizontal semicircular canal gives response to rotation in horizontal plane (vertical axis). Semicircular canals are concerned with angular (rotatory) acceleration. Otolith organ is concerned with linear acceleration and detects acceleration in both horizontal and vertical planes. Utricle responds during horizontal acceleration and saccule responds during vertical acceleration.
Ref : Sembulingam 6th edition (Page- 924, 926)

Reference: Davidson 23rd; P-547

Reference: Davidson 23rd; P-816

When RBCs are delivered from the bone marrow into the circulatory system, they normally circulate an average of 120 days before being destroyed. Even though mature RBCs do not have a nucleus, mitochondria, or endoplasmic reticulum, they do have cytoplasmic enzymes that are capa- ble of metabolizing glucose and forming small amounts of adenosine triphosphate.
These enzymes also do the following:
(1) maintain pliability of the cell membrane;
(2) maintain membrane transport of ions;
(3) keep the iron of the cells' hemoglobin in the ferrous form rather than the ferric form;
(4) prevent oxidation of the proteins in the RBCs.
Even so, the metabolic systems of old RBCs become progressively less active, and the cells become more and more fragile, presumably because their life processes wear out.

Explanation -
Urine R/M (Urine Routine & Microscopy) test involves gross, chemical, and microscopic evaluation of the urine sample.
Include physical appearence, urine protein, sugar, ketone body level,osmolarity,pH.

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

Dilated bronchi parallel to adjacent vessels create tram-tracks signs

Leptin produces satiety

Explanation: Acute tubular necrosis (ATN) is most commonly caused by ischemia due to sepsis. Davidson explains that systemic hypotension and renal hypoperfusion in sepsis lead to tubular cell injury and necrosis. Harrison adds that nephrotoxic drugs (e.g., aminoglycosides) and rhabdomyolysis are also significant causes of ATN.

Circulating level of Leptin is responsible for food intake regulation. Leptin decreases food intake.
Reference-Ganong/26th/P-481/Figure-26.9

The presence of leucocytes and nitrites in urine is indicative of renal tract infection. Urine pH can provide diagnostic information in the assessment of renal tubular acidosis and urinary tract stones (p. 562).

Explanation: Features of Patau’s syndrome are Early lethality, cleft lip and palate, polydactyly, small head, frequent congenital heart disease