স্পেশাল বিসিএস (স্বাস্থ্য)

Reference: Davidson 23rd; P-429

All other are lesion in neurosyphilis

Reference: Davidson 23rd; P-546

Explanations:
Reticulocyte is otherwise known as immature RBC. It is slightly larger than matured RBC. The cytoplasm contains the reticular network or reticulum, which is formed by remnants of disintegrated organelles. Due to the reticular network, the cell is called reticulocyte. The reticulum of reticulocyte stains with supravital stain.

Explanation -
Chlamydia trachomatis causes -
Uretheritis,
Pneumonia
Conjunctivitis
Lymphogranuloma venereum
Trachoma.

Explanation: Barrett’s oesophagus is a pre-malignant condition, in which the normal squamous lining of the lower oesophagus is replaced by columnar mucosa

Explanation: The combination of absent breath sounds and a resonant percussion note is diagnostic of pneumothorax

Explanation: Treatment duration of abdominal Tuberculosis- 6 months

Explanation-
★ The insulin receptor in target tissues is a tetramer. The two β subunits have tyrosine kinase activity and autophosphorylate the receptor when stimulated by insulin.
Reference-Ganong physiology/26th/P-424 &BRS physiology/6th/P-249/Fig-7.3

Composition of HDL
Apoprotein 50 %
Apo A
Apo C
Apo E

Lipid 50%


ABC of Biochemistry 6th - P: 218

Reference: Guyton 14th; P- 547

Reference: Davidson 23rd; P-518
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Explanations:
Most of plasma protein is synthesized from liver except gamma globulin from plasma cells.

Explanation :
Acute inflammatory exudates :
Contains neutrophil
Rich in Fibrinogen 
Have protective function
Due to change in blood vessels

1^st four clotting factor are essential

Explanation :
Ankylosing spondylitis involve mostly sacroiliac joint and vertebra.

Reference: Davidson 23rd; P-429

Explanation: Walking barefooted on soil predisposes to infection. An important public health measure was requiring children to wear shoes to school.

Explanation: Membranous nephropathy-Middle-aged to older patient, minimal change disease- Children, Primary Focal segmental glomerulosclerosis -Young adults

Faecal elastase is a sensitive non-invasive test for pancreatic enzyme output. Low values indicate exocrine insufficiency.

Reference: Davidson 23rd; P-593

The most abundant type of cortical neurons are the pyramidal cells. About two thirds of all cortical neurons are pyramidal. Their cell bodies are triangular, with the apex generally directed towards the surface of the cortex.

•Pancytopenia is common.
•Moderate to severe anaemia develops  rapidly and can cause cardiac failure.
•Thrombocytopenia, often compounded by  hepatic dysfunction, may result in bleeding  from the retina, gastrointestinal tract and  nose.
•In advanced illness, hypoalbuminemia may  manifest as pedal oedema, ascites and  anasarca (gross generalized oedema and  swelling).

Explanation:

Central artery of the retina is a true end artery

Malignant disease
 Breast cancer  Bronchogenic cancer
 Leukaemia  Lymphoma

Explanation : EPSP is confined only to the synapse. It is a graded potential. It is similar to receptor potential and endplate potential. EPSP has two properties: 1. It is nonpropagated 2. It does not obey all or none law. EPSP is not transmitted into the axon of postsynaptic neuron. However, it causes development of action potential in the axon.
Ref : Sembulingam 6th edition (Page- 783)

Explanation: mechanism of developing nephritic syndrome are: Inflammation, Reactive cell proliferation, Breaks in GBM, Crescent formation

An ECG is the most critical initial investigation in suspected ACS to identify ST-elevation myocardial infarction (STEMI) or ischemic changes (e.g., ST depression, T-wave inversion) that guide urgent management (e.g., percutaneous coronary intervention).

Events of cell cycle:
1. Mitosis (M phase)
2. Interphase: The long period between two mitosis division (the G1, S, and G2 phases) is  called interphase.
• G1 phase (pre-synthetic phase)
• S phase
• G­­­2 phase (post-synthetic phase)

G1 Phase:
- The period between mitosis and the beginning of DNA replication.
- The G1 phase, usually the longest and most variable part of the cycle.
- It is a period of active RNA and protein synthesis (RNA & regulatory proteins essential for DNA replication)
- Also in G1, the cell volume, reduced by half during mitosis, returns to its previous size.

S Phase:
- The S phase is characterized by DNA replication, histone synthesis, and the beginning of centrosome duplication.
- The cell now contains twice the normal amount of its DNA, that is - the (2n) amount of DNA is doubled (4n) in preparation for cell division.

G2 Phase:
- In the relatively short G2 phase, RNA and proteins essential for cell division are synthesized.

Oesophagus & vagus nerves passes through oesophageal opening.

Phase III RCTs are often used to determine whether a treatment should be licenced for clinical use. Patients are randomised to each arm, sometimes with stratification to ensure equal allocation of patient subgroups. RCTs may be double-blinded, as is the case here, single-blinded or ‘open-label’. The control arm should be the current clinical standard treatment. In this example, a placebo is used in place of observation only to ensure blinding and avoid potential bias of results. Patients may be divided in alternative ratios. This is sometimes the case when earlier studies suggest large differences between the investigational and current treatment.

Myasthenia gravis is an autoimmune disease, most commonly (80% of cases) caused by antibodies to acetylcholine receptors in the post-junctional membrane of the neuromuscular junction. The resultant blockage of neuromuscular transmission and complement-mediated inflammatory response reduces the number of acetylcholine receptors and damages the end plate (Fig. 28.50). Other antibodies can produce a similar clinical picture, most notably autoantibodies to muscle-specific kinase (MuSK), which is involved in the regulation and maintenance of acetylcholine receptors.

Explanation :
Indications of renal replacement therapy -
K+ level >6 mmol/L
Fluid overload
Pulmonary oedema
S.creatinine >6.8 mg/dl
Plasma urea level >30 mmol/L
Metabolic acidosis

Hyperpigmentation (skin and mucous membranes) is a hallmark of Addison’s disease, caused by elevated ACTH stimulating melanocytes. Weight loss (not gain), weakness, and hypotension (not tachycardia) are typical; moon face is seen in Cushing’s.

Explanation :

Ref : Sembulingam 6th edition (Table- 141.1)

Explanation :
Psoriatic arthritis is a type of arthritis linked with psoriasis, a chronic skin and nail disease. Psoriasis causes red, scaly rashes and thick, pitted fingernails.
Mostly distal interphaleangeal joint involved

o   Explanation: Consent must be given freely with adequate information. (Ref: Reddy, Consent Chapter)

Explanation : Center for taste sensation is in opercular insular cortex, i.e. in the lower part of postcentral gyrus, which receives cutaneous sensations from face. Thus, the taste fibers do not have an independent cortical projection.
Ref : Sembulingam 6th edition (Page- 1025)

Explanation :
Examples of illnesses resulting from type IV hypersensitivity reactions include contact dermatitis
drug hypersensitivity
GVHD
Tuberculin test
Lepromin test
Tumor immunity
Type I DM
Hashimoto thyroiditis
Erythema multiforme

Vermiform appendix is most common site Carcinoid tumour

Explanation :
Purulent inflammation is characterized by the production of pus, an exudate consisting of neutrophils, the liquefied debris of necrotic cells, and edema fluid. The most frequent cause of purulent (also called suppurative) inflammation is infection with bacteria that cause liquefactive tissue necrosis, such as staphylococci; these pathogens are referred to as pyogenic (pus-producing) bacteria.
A common example of an acute suppurative inflammation is acute appendicitis.

Reference: Davidson 23rd; P-608
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

 The JVP provides clinicians with information regarding right atrial pressures and filling. It mainly consists of five wave forms:
1 a wave - representing atrial systole;
2 c wave - representing closure of the tricuspid valve (this wave is not usually visible);
3 x descent - representing a fall in atrial pressure during ventricular systole;
4 v wave - representing atrial filling against a closed tricuspid valve;
5 y descent - representing the opening of the tricuspid valve.

In atrial fibrillation, the 'a waves' are absent (D) due to dysfunctional atrial systole. A raised JVP with normal waveform pattern (A) is usually seen in fluid overload and right heart failure. Large v waves (B) are usually seen in patients with tricuspid regurgitation. Cannon 'a waves' (C) are seen in patients with complete heart block, single chamber ventricular pacing, ventricular arrhythmias and ventricular ectopics. Large 'a waves' (E) can be seen in pulmonary hypertension and pulmonary stenosis.

Reference: Davidson 23rd; P-428

Other than intervertebral disc all are hyaline cartilage

o   Explanation: Cross-examination tests the accuracy and reliability of the expert’s statement. (Ref: Nandy, Legal Procedure)

[Robbins 9th 35]

Explanation:
About 10% of the total blood volume can be removed with almost no effect on arterial pressure or cardiac output, but greater blood loss usually diminishes the cardiac output first and falls to zero when about 40% to 45% of the total blood volume has been removed.

Reference: Davidson 23rd; P-358

The Penal Code, 1860
( ACT NO. XLV OF 1860 )
Act of a person of unsound mind
84. Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law.

Reference: Davidson 23rd; P-588

Intrinsic factor of Castle, secreted by parietal cells of gastric glands plays an important role in erythropoiesis. It is necessary for the absorption of vitamin B12 (which is called extrinsic factor) from GI tract into the blood. Vitamin B12 is an important maturation factor during erythropoiesis. Absence of intrinsic factor in gastric juice causes deficiency of vitamin B12, leading to pernicious anaemia.

Although heart function is obviously crucial in

determining cardiac output, the various factors of the  peripheral circulation that affect flow of blood into the heart  from the veins, called venous return, are normally the  primary controllers of cardiac output.

(Ref. Guyton & Hall-14th, P-245