Congratulations on securing a top rank in AIIMS and PGIMER – PG entrance November 2011 ! What is the secret of your success?

secret of my success… work hard n work focused.. read whats needed..

i’m from a middle class family in calicut, kerala.. did ma schooling in jnv calicut.. graduated from govt med college calicut.. i was an average student.. never wid in first 5 in my batch.. iwas in d team that won all kerala anatomy quiz.. and has represented college in iap quiz.. state level..

d exams i wrote…
upsc jan10.. rank 94
aiims nov 10.. not in list
aipg 2011.. rank 4404
kerala 2011.. rank 326
aiims may11.. rank 333
aiims nov11.. rank 29
pgi nov11.. rank 21
joined for md medicine at pgi.. it was not even in my dreams to get this..

i didnt make much changes to my study strategy after these exams..

strategy..i read only mcq books.. i followed aaa n mk.. went thru d referances given by them if i needed clarification.. read only d first volumes.. ie from 2005.. but i read it thrice.. with heart..

it needs 18 months preparation.. point is that u’ve to be in touch wid aaa n mk during d first 6 months..and intense reading next 12 months..

during intrnship i targetted 10-15 qns a day.. but i was never able to.. i was able to cover only 4 or 5 qn papers during that time.. i enjoyed my internship well.. i started preparing seriously after aiims nov 10..jineesh v ,my batch mate got d first rank in that.. it boosted us a lot.. i selected a remote tribal village to do my rural service.. i was free by 2pm everyday.. i read 7-8 hrs a day during my service.. i took leav from mid august.. started fullday preps.. read 14-15 hrs a day since then.. for 3 months..

as all others i too prepared a time table.. but never able to follow.. i divided my day in to two.. a 2 hr n a 5hr.. in 5hr part i read aaa n mk.. in two hr part i read my class notes n selected subjects from across n sparsh guptha..

internet helped me a lot..used it wisely…only for academics… i opened an fb account only after i got in to d ranklist..

as everyother i had breakdowns.. my roommates sreesanth n dhanin helped a lot.. i kept anoop mk as my target.. to keep in pace wid him was hard.. n i was never able to.. all of us got in to list of pgi n aiims.. all my frens helped me a lot.. my parents were always wid me..

i went for sunday coaching at ma college cme.. that was d only off day we had while doing rural service..it helped me a lot.. it helped me to make a timetable.. to revise d qns.. to clarify doubts.. to keep in touch wid my frens..

i took grand test series by bhatia.. it helped me a lot.. to assess my self.. to form my exam strategy.. to tackle exam tension.. and for a revision… i targeted 55-60% in those series n i got it.. that boosted my confidence..

whole my preparation was based on aaa n mk.. i gave some time extra for biochem, anaesthesia,psychiatry,forensic n pharmac.. i read across for these subjects n sparsh guptha for pharmac..

i hadnt much time to read theory.. read topics that i needed clarification.. i referred
anatomy- chourasya
biochem-vasudevan
physio-ganong
patho-robbins(son)
micro-panikkar
pharmac-tdt
then harrison
obg sheela
sx bailey… i focussed on mcqs.. and got very little time to read theory..

for mcq..
aaa n mk..
psych dermat forensic biochem.. across
pharmac sparsh guptha
rachna chourasya for micro
then my class notes..
i was planning to read aa for sx… and notes in patho.. but i didnt get time..

for pgi i read manoj choudhary.. iread d explanations.. went thru d charts.. not d answers… i didnt get much time to read it as i focussed mainly on aipg.. i think it’ll be d case wid all..

in d last two wks i revised aaa n mk n my special notes.. in d last two days i jst read only d answers no xplanations..i used to mark all d qns that i go wrong.. last day i read those qns n answers which i was frequently going wrong….

in exam..i used to have three readings.. in first i mark those rpt qns n those qns i’m so sure.. i leav all lengthy qns wid out even reading.. in second i mark those doubtful qns n lengthy ones.. in third those qns in which i can rule out atleast two options… i avoid marking qns dat i cannot rule out atleast two options..

i attempted 190 in aiims.. n around 230 in pgi…

dont know how many went wrong..

my suggestions.. read aa n mk even if pattern changes.. they r our bible..
preparing for may pgi is more rewarding than for aiims may.. especially for those who have resrvation.. read focussed.. keep targets.. reading aaa n mk at first is very tiring… but keep reading.. refer wen needed.. its not who have big brains but who work hard gets d ranks.. take one grand test series.. manage to read even during internship.. eventhough its difficult..
all d best.. my wishes n prayers…

the will to win is important ;but the will to prepare is vital…

pg blazer rocks.. keep going.. help to identify wat to read.. help to enhance confidence..

If you would like to ask something specific to Dr. Adarsh, just leave a comment below!

1. Interview with Dr. Jineesh V – 1st rank holder – AIIMS PG entrance – November 2010
2. Interview with Dr. Jagadeesh Menon – 23rd rank holder – PGIMER PG entrance May 2011
3. Interview with Dr. Pavan Rasalkar – 11th rank holder – AIIMS PG entrance May 2011

Congratulations on securing a top rank in AIIMS and PGIMER – PG entrance November 2011 ! What is the secret of your success?
Thank you! May be CONTINUOS HARD WORK AND DEDICATION, best wishes from my loved ones – my parents , my brother ,teachers, friends , and GOD  ALMIGHTY ….and lastly THE LUCK FACTOR….

Could you tell us something about yourself? (Where you are from, where you did your MBBS, your previous academic achievements etc…)
I am from Vidyangar , Kasaragod…. Northern most district of KERALA …
Did my schooling ( till 12 th std ) : kendriya vidyalaya no .2 at kasaragod
Passed out 10 th : 482 / 500 ..96.40 % marks in 2002…( AI Rank – 01 )
Passed out 12 th : 481 / 500 …96.20 % marks in 2004…( AI Rank – 04 )
Sought admission in the prestigious CALICUT MEDICAL COLLEGE in all India quota ( rank 505) in 2004.. I fear if seats would be available at calicut at this rank these days… Thank GOD.. I was born earlier….

What were the various entrance exams you wrote? What were the ranks you obtained?
This time around I wrote only two…

PGI CHANDIGARH Nov 2011– rank 25( obc rank 03) with 99.700 percentile marks…
AIIMS Nov 2011 – rank 12 (obc rank 03)

Was this your first attempt at this exam? If not, what rank did you obtain previously? What changes did you make to your preparation after your last attempt?
no…was writing AIIMS for the 3rd time and PGI for the 2nd time…
did not see my name in the aims rank list in the last 2 occassions…may be GOD wanted me to wait…
wrote MAY 2011 PGI – combined rank was around 300 ( obc rank 68 ) with 94.126 percentile marks..
ranks for the exams written previously…
all India 2010 – rank 16882 ( obc 4844 ) with 46.33 % marks..
kerala entrance2010 – rank 588
jipmer 2010 –rank 344
these HUGE numbers might remind you of the numbers written on the PRICE TAGS of branded shirts and suits….but take it from me. ….: .unless you prepare well you are not gonna get through…once you are up to the mark…YOU WILL CLEAR ALL THE EXAMS YOU WRITE…..

What was your study strategy? (read mcq and look the corresponding part in the textbook / read a topic in the text and read the corresponding mcq’s etc… )
mainly concentrated in solving MCQ s from January 2010….did not spend more than 20 % of my total preparation time reading theory text books….solving maximum MCQs matter specially when you target AIIMS or ALL INDIA….had touched upon the theory text books during my UG days…

When did you seriously start preparing for the entrance exam?
started in mid January 2010..started with PG HUNT book meant for KERALA entrance and JIPMER…..boost for preparations came every now and then when exam results came..and you come to know …ENTRANCE is HIGHLY COMPETITIVE….and YOU ARE IN THE RACE…….

In your opinion, how much time does a student require for preparing for this exam?
slightly depends on how he has worked during UG days and his PREPARATIONS for entrance…
on an average I would say around 9 to 12 months…….

How many hours did you study each day?
started initially with 5 to 6hrs a day…gradually increased it …worked for around 12 to 14 hrs a day for last 3 months from AIIMS and PGI….
REQUEST : please don’t compromise SLEEP and FOOD for “studying”….it will decline your performance…DAMN SURE…..

What role did the internet play in your preparation?
Did not have a direct access to it..
friends helped me out : DR.DWIDEEP .C….DR.ASHIK….DR.MUHD.AFSAL…

its good when you have to find answers to certain questions …say eg : Rasmussen aneurysm from bronchial artery or pulmonary artery….most common extra intestinal manifestation of AD PCKD..hepatic cysts or colonic diverticulosis…..mizou phenonmenon is seen in oguchi disease…
it also keeps you informed about the new advancements..say for eg : LETROZOLE aromatase inhibitor has been banned recently……new strain of KLEBSIELLA has arrived…..NOBEL PRIZE winners in MEDICINE for the year…

and to look into the RANK LIST of model exams you have been writing ..( eg : BHATIA GRAND TEST RESULTS…)
sites like ..PG BLAZER and RXPG where you would find lot more questions…discussions…can get your doubts cleared…information about various exams….solutions to controversial questions…so on….

Did you have a timetable for preparation? Were you able to stick to it?
EVERY PG aspirant must have his / her own….i too had one….
short time tables….max for a week….the material I put up for study is usually double the amount I could cover…but used to categorise it into category 01(most imp ) ……02…. …03(less imp ) ……04(least imp )…always started to read from cat 01 to 04…always completed cat 01..sometimes cat 02…but could never touch cat 04….

Did you ever doubt your ability to get selected in this entrance exam? If so, how did you overcome your fears?
Ya…it would be behind every ones mind…sure…
prayers to GOD , my parents , friends specially DR.ABDUL SHAMEER ( 47th batch) and DR.ANOOP A (48th batch) were of immense help…
we , in a group of three ( DR.ADAI and DR.TUSHAR VP : room mates ) , every now and then used to discuss our ambitions…..our chances…..our fears….those were real TENSION RELIEVERS………thank you my friends…

Were you able to prepare well during the internship period?

No….not much….mainly because I did not take much effort I should say…THEN motto was : WORK ..SLEEP ..and ENJOY …PLEASE don’t use this motto any more my dear friends who are doing internship…work hard during internship you will get through…

Did you attend any coaching? Was it useful?
weekly classes at trissur medical college ..by trissur medical college alumni association (TMCAA)…best faculty….50 to 55 sessions…..1600 students….3 aiims mock test and 4 all India model tests…
weekly test papers separately…. Those were absolutely useful…..

Did you attend any test series other than that conducted by your coaching centre? If so, did you find it useful?
DR.BHATIA – joined grand test series and subject wise series……
Used variety of techniques in writing those test papers….
And selected the BEST POSSIBLE one for the REAL ONE…..

What were the subjects you focused upon?
All have got equal importance…….
Do not leave behind the short subjects..: skin .. anaesthesia..radiology…psychiatry…those are HIGH YIELDING ONES……..and these are the ones which are untouched during UG days….

What books did you read for theory?
Anatomy – chaurasia
Physiology – ganong
Biochemistry – vasudevan
Pathology – robbins grandfather
Microbiology – ananthanarayanan
Pharmacology – kd tripati
Forensic medicine – vv pillai
Ophthalmology –khurana..parson…
ENT – dhingra
Community medicine – park…
Medicine – Harrison…davidson…
Surgery – bailey .. SRB…
Obstetrics and Gynaecology – shaws….. Sheila balakrishnan…
Peadiatrics – o.p.ghai….
Anesthesia – nil…
Psychiatry – Davidson…
Radiology – nil…

What books did you read for MCQ’s?
QUESTION PAPERS
1 ) Ashish gupta……… 2 volumes …from 2000 to 2010

2 ) Mudit khanna …….2005 to 2010

3 ) Manoj chaudhary ( PGI ) …2006 to 2010…it’s a misconception that its going to be useful only for PGI exams ….no every pg aspirant aiming all India rank within first 100 to 150 must read this book…

Students preparing for KERALA entrance : your preparation is complete only when you have gone through the last 4 year papers from manoj chaudhary…

4 ) PG HUNT 2006 to 2011….book meant to tackle KERALA entrance and JIPMER PG entrance….(stress upon it only after all India entrance…will have a GAP of around ONE MONTH between all India and KERALA entrance…

5 ) RAPID REVIEW ..book from edulanche….fully solved question paper of all India 2011….

SUBJECT MCQs…

6 ) ACROSS volume 01…skin . anaesthesia… radiology…radoitherapy….psychiatry….ophthamology…ortho ( selected topics…only upper limb trauma and upper limb nerve injuries + bone tumours )

7 ) RACHANA CHAURASIA – microbiology…read it thoroughly….THE BEST BOOK among those for a particular subject.….

8 ) sparsh gupta – DO NOT GO INTO THE THEORY GIVEN…. Just solve the MCQs……..+ class notes DR.SUNIL KUMAR…

9 ) antomy : class notes by DR.ARIVUSELVAN…..

Read this much thoroughly with proper revision you will be assured of an AVERAGE rank within 1000 to 1200 in all India…

Attain completeness in preparations…..

9 ) aravind arora –spm : epidemiology…..health programmes….commitees……statistics (with formulas)…nutrition……vaccines…….

10 ) ACROSS volume 02…physiology ( endocrine , cell physio, resp , git ).. forensic …biochemistry ( questionsand ans ..just like a revision ..90 % biochemistry questions can be solved by reading previous papers…)

11 ) aravind arora – pathology…read topics : exclusive to pathology SUBJECT like inflammation …repair…cytokines ..interleukins …immunity .. + connective tissue diseases…rest of them will overlap in medicine .. surgery … gynaecology

An average to good student will be able to give correct answers to 80 to 85 % questions in medicine , surgery , paediatrics ( except certain AIIMS papers ) , and OBG …

ATTAIN PERFECTION…
12 ) ashish gupta medicine……. 2 volumes
13 ) ashish gupta surgery single volume

Have not read any subject book for both paediatrics and OBG….
For OBG : previous quest papers enough
For paediatrics : I read class notes by DR.KISHORE CHANDRA VARIER and previous question papers..

Is there anything specific to keep in mind while preparing for AIIMS? (when compared to AIPGMEE and other state exams) Regarding books for preparation, topics to focus on etc)

NO……… I don’t feel so…
ONLY the exam strategy is different….
AIIMS :..+3 and -1 correct and incorrect responses…
all India : +4 and -1 for correct and incorrect responses…
but I would recommend you to attempt the maximum ……only then you would have at least the chance of getting those right…

How did you tackle the PGIMER entrance exam? (as it is very different from the other exams)

PGI CHANDIGARH exam is different from the rest….
less number of pure repeats…but the topic will be repeatedly asked…only that matters actually…
250 questions …5 options each….1250 options in total…and you have THREE hrs….
I feel …NOV 2011 was quite different from MAY 2011…NOV 2011 had very few topic repeats as well when compared to MAY 2011…
There is more chance of success in PGI exams for those who have in depth knowledge of the UG subjects…
Those might not need any special preparations for PGI exams…( background ashish gupta and mudit khanna knowledge is enough )….say for eg : DR.ADARSH MB (rank 21- gc rank 19 ) 99.746 percentile

NOTE : all these entrance exams are cracked most often by AVERAGE to GOOD students than by VERY GOOD to EXCELLENT ONES…not only because the “average to good student” community is larger…

Rest who have PASSION of joining PGI ….take this…..
Read MANOJ CHAUDHARY :

june 2006 to may 2011 question papers….at least twice during your preparation….
Start reading from the latest paper always….( THE GOLDEN RULE )
Need to revise at least FIVE latest papers the week before exam….
I read 3 papers after writing aims exams…( nov 14 to nov 17)..
Nov 18 th took for the journey to chandigarh..( flipped through 100 questions: may 2011 )
DAY BEFORE THE EXAM REVISED : may 2011 ( rest 100 )..nov 2010…may 2010…
(nov 19) All these quickly…….
Morning before exam : had a short hand book with around 30 to 40 IMPORTANT
TABLES and their corresponding page no. in manoj chaudhary
book……. .REVISED IT……….

STRATEGY I USED WHILE PGI EXAMS :
MAY 2011 : was writing such an exam for the first time….
No mock test was written before…
Read only TWO question papers from manoj chaudhary that too not the latest….
Friends advised :” try reading at least the complete paper in THREE hrs.….”
I answered at such pace that leaving around 15 to 20 questions I finished exam before 40
minutes…it indirectly told me that YOU WILL HAVE TIME ….. DISTRIBUTE OR DIVIDE IT
EQUALLY and in the correct manner……

NOV 2011 : STRATEGY I USED ………
Took the exam with an open mind….
Started answering questions taking each in its own merit….
After answering first 60 questions..looked into the time…took 35 minutes…
Roughly calculated the time for answering 300 questions ( total no of questions in the paper is 250 ) to be 175 minutes approx. 3 hrs….
Then decided to go at the same pace….
By GOD S GRACE … could complete reading the entire paper in 2.30 hrs….
Had left around 10 to 13 BIG / LONG questions unattended……
Answered it in the next 10 to 15 minutes…
Had marked around 30 to 40 options in the question paper . the DOUBTFUL ONES…if to mark it or not…..
Last 15 to 20 minutes ..decided to go for few ..and left few of them unmarked in the answersheet…

NOTE : YOUR DIGITAL PHOTO AND FINGERPRINTING would be done during the exam….
It takes less than 02 minutes…..
But you will be provided extra 10 minutes for that …

“ It means PGI exam DURATION IS THREE HOURS AND TEN MINUTES……….”.
( this wont be mentioned in your hall ticket )

That 10 minutes means a lot….

…. I marked 494 response in total …DR. ADARSH MB( rank 21- general rank 19…..99.746 percentile ) said he too marked around 480 to 500…..

PGI MOCK EXAMS :

these are conducted by ADRPLEXUS in two to three centres in kerala…
Write at least 01 or 02 mock exams ..so that you can assess your speed ..and formulate your strategy for the exam………
SELECT THE ONE THAT SUITS YOU MOST……….

What was your plan for the week before the exam?
PGI have already discussed….

THE WEEK BEFORE AIIMS : revised only the previous exam papers

ashish gupta may 2006 to nov2010…
mudit kahanna…2007 to 2010…
had marked few questions to look through in the last week in ashish gupta vol 02 ..2000 to 2005( not more than 20 to 25 questions from each paper )…could cover only less than 30 % of these ( 2000 to 2005 )…….
Previousday (nov 12 ): I read ashish gupta..may 2011…
Rapid review all India 2011…

What was your strategy for taking the exam?
PGI have been discussed earlier……
For AIIMS : Never had the problem of time limitation in solving aims or all india mock exams……
so the time factor was out…
answered 144 questions in first two hours…
tackled the rest by coming three to four rounds…
this time CHANGE IN ANSWERING PATTERN : need to write the no of UNATTEMPTED questions in the answer sheet both in numerals and in words….

MANAGING THE TIME FACTOR …..
Either you assess the question paper first by just going solving around 20 to 30 questions..and then decide whether to slow down or to accelerate…..roughly assess the standard of the paper…
OR…
set up a target of around 25 to 30questions in 20 minutes…
Always better that you set up short targets…

NEVER SET TARGETS say for eg..one and half hours 100 questions..next 100 in next 1.5 hrs….
The RISK IN IT …sometimes you might end up solving around 120 to 140 questions in first half…or end up solving only 75 questions … both will be bad…both will create tension in the hall..
ITS ALWAYS BETTER TO GIVE equal time for each question….as each one would fetch you the SAME MARKS……I FEEL SHORT TARGETS would be most beneficial in exams like ALL INDIA ..300 questions.and 3.5 hrs…..

Always BETTER stick to your OWN STYLE of answering…
…
How many questions did you attempt?
PGI :
I attempted around 246 to 248 …….it includes questions without response too….

RULE : cant go with a pre determined mind that you will attempt all… you will attempt only 240….or 235…
needs to decide accordingly in the hall……no of attempted questions does not count….
actually THE no of responses counts…..i marked 494…..

AIIMS –
i attempted all 200 …I too asked the same to all….how many should I attempt ?…

DR.JINEESH V (NOV 2010 aiims ..first rank..MD RADIO DIAGNOSIS)… “ between 197 to 200 wud be better…”

DR. PADMARAJ ( KERALA entrance 2010 rank 07 MD GENERAL MEDICINE CALICUT MEDICAL COLLEGE –“ if you want some rank and you are to satisfy with a nonclinical seat ..go conservartively….if you want medicine .….JUST GO FOR IT…..HAVE A BLAST….. attempt 200………”

DR.A ANOOP (all India 2011 rank130 MD RADIO DIAGNOSIS ..PGIMER , CALCUTTA…. – “ decide it according to the paper…anyway…196 is required…..”

How many do you think you got correct?
No one would attempt a question feeling that it would fetch me NEGATIVES……anyway how easy or how tough the paper is….…the top most rank would have got around 72 to 74 %maximum….

What is your advice to future aspirants?
Put up a time table …work accordingly….
Do not go behind CONTROVERSIAL questions …. Its enough that you read THE RELATED TOPICS….…
Revise the topics you have read AT REGULAR INTERVALS…
Never compromise SLEEP and FOOD…..
PRAY TO GOD CONTINUOUSLY …….
WORK HARD …..SUCCESS WILL BE YOURS………….
wish you all the very best…….

Please give your suggestions / comments regarding PG Blazer. (What you think about the service and how to improve it.)
You have been doing a great job …..
thanks for the latest updates…
discussions and solved papers all are very useful…
controversial and NEW questions need to be solved with proper references….
Wish you the best…..do continue the GREAT WORK……

That brings us to the conclusion of the interview. Best of luck for your future endeavors!
Thank you……..

If you would like to ask something specific to Dr. Anoop, just leave a comment below!

1. Interview with Dr. Jineesh V – 1st rank holder – AIIMS PG entrance – November 2010
2. Interview with Dr. Pavan Rasalkar – 11th rank holder – AIIMS PG entrance May 2011
3. Interview with Dr. Adarsh MB, – 21st rank holder – PGIMER PG entrance November 2011

Entrance examination for admission to All India Institute of Medical Sciences (AIIMS) Post Graduate courses – January 2012 session was conducted on 13th November 2011. We have collected all the 200 questions asked in the exam and published them in our website. You can  visit our AIIMS November 2011 MCQ section to view them! You can also join our  AIIMS PG Entrance – November 2011 – Discussion group to discuss the questions. We are now making required updates to the questions based on the feedback received. We are also trying to find the answers to all the questions. The answers will be updated regularly. We need your help in making the discussion a success. Please contribute to the discussion by posting the answer where ever possible and pointing out any mistakes in the question. Thanks in advance!

1. AIIMS PG entrance – November 2011 – Questions and Answers – Discussion
2. AIIMS PG entrance – May 2011 – Questions and Answers – Discussion
3. PGIMER PG entrance – November 2011 – Questions & Answers Recall and Discussion

Dr. Pavan Rasalkar

• Congratulations on securing a top rank in AIIMS PG entrance May 2011! What is the secret of your success?
  • Concentrated and well directed hardwork
• Could you tell us something about yourself? (Where you are from, where you did your MBBS, your previous academic achievements etc…
  • I am from Gulbarga, Karnataka. I did my MBBS from MRMC, Gulbarga. Previous achievements include topping my school in SSLC, Rank 61 in UG Karnataka CET, Rank 27 UG Comedk, Overall topper of my college during MBBS.
• Did you write any other entrance exams? What rank did you obtain in them?
  • AIPGMEE 2011 – Rank 749, Comedk – Rank 120, Jipmer – Rank 350, KCET – Rank 277, AIIMS May 2011 – Rank 11, PGIMER May 2011 – Rank 90
• What was your study strategy?
  • Ten hours of directed harwork daily, with concentration on repeated topics
• When did you seriously start preparing for the entrance exam?
  • After internship
• In your opinion, how much time does a student require for preparing for this exam?
  • One year
• How many hours did you study each day?
  • 10 to 12 hours
• What role did the internet play in your preparation?
  • I had joined few online discussion groups which helped me and as a stress buster
• Did you have a timetable for preparation? Were you able to stick to it?
  • Yes, I had and most of the times I sticked to it
• Did you ever doubt your ability to get selected in this entrance exam? If so, how did you overcome your fears?
  • I never doubted myself
• Were you able to prepare well during the internship period?
  • Read well in the time I could find during internship
• Did you attend any coaching? Was it useful?
  • Yes. Speed Bangalore. Yes, sort of helpful
• Did you attend any test series other than that conducted by your coaching centre? If so, did you find it useful?
  • Yes. Bhatia. it was very useful
• What were the subjects you focused upon?
  • First and second year subjects and sarp
• What books did you read for theory?
  • I read the following books for theory and mcqs
    • Anatomy – BDC, Across
    • Physiology – Ganong cover to cover , Across
    • Biochemistry – Satyanarayan, Across
    • Pathology – Robbins first 7 chapters plus hematology and kidney, Aravind Arora
    • Microbiology – Anantanarayan, Aravind Arora
    • Pharmacology – Govind Garg
    • Forensic medicine – Across
    • Ophthalmology – Khurana, Across
    • ENT – Dhingra, Sakshi arora
    • Community medicine – Park, Aravind Arora
    • Medicine – Harrison, Aravind Arora
    • Surgery – Schwartz, Aravind Arora
    • Obstetrics and Gynaecology – Dutta, Shaws, Sakshi Arora
    • Peadiatrics – OP Ghai,SPAN
    • Anesthesia – Ajay Yadav, Across
    • Psychiatry – Niraj Ahuja, Across
    • Radiology – Across
• Is there anything specific to keep in mind while preparing for AIIMS? (when compared to AIPGMEE and other state exams) Regarding books for preparation, topics to focus on etc
  • Nothing specific, aipgme and aiims touch same topics. aiims gives more time so u can think well before answering
• What was your plan for the week before the exam?
  • Previous papers and most importantly good sleep which i couldnt have during aipgme and performed below par
• What was your strategy for taking the exam?
  • Most important stategy was DO NOT MISS REPEATS AND REPEAT RELATED QUESTIONS
• How many questions did you attempt?
  • 196
• How many do you think you got correct?
  • 155 to 160
• What is your advice to future aspirants?
  • Figure out which branch you are interested in and plan your strategy accordingly. Work hard, very hard, but more importantly work smart. In ambiguous questions with uncertain answers in guides do not answer against the guide answers unless the error in guide is very visibly gross. Better to lose a mark with the mass than mark something else and lose a mark alone.
• Please give your suggestions / comments regarding PG Blazer. (What you think about the service and how to improve it.)
  • I should thank PG Blazer for the online group as it proved out to be very useful for my preparations and also I could interact with people from all over country and figure out how others are preparing. You are doing a great job. Hope you continue serving pg aspirants
• That brings us to the conclusion of the interview. Best of luck for your future endeavors!
  • Thanks a lot

1. Interview with Dr. Jineesh V – 1st rank holder – AIIMS PG entrance – November 2010
2. Interview with Dr. Anoop MK, – 12th rank holder – AIIMS PG entrance November 2011
3. Interview with Dr. Adarsh MB, – 21st rank holder – PGIMER PG entrance November 2011

• Congratulations on securing a top rank in PGIMER PG entrance May 2011! What is the secret of your success?
  • Thank you very much. Read theory from Harrison, Robbins and Ganong. And surely, with the support of my parents, dear ones and above all, the Almighty.
• What was your study strategy?
  • I mainly read theory from Harrison, Robbins, Nelson (systems) and Ganong and did the corresponding mcq’s.
• When did you seriously start preparing for this exam?
  • Mainly after my internship.
• In your opinion, how much time does a student require for preparing for this exam?
  • I think, may be 1.5 to 2 years for the theory basics and then going through the mcq’s. After internship, it depends.
• How many hours did you study each day?
  • During my 2nd and final year, about 4 to 5 hours per day, not much during internship, after that about 3 to 4 hours a day.
• Did you have a timetable for preparation? Were you able to stick to it?
  • No, I did not have any timetable.
• Were you able to prepare well during the internship period?
  • No, I felt a bit difficult to read during internship except during some free postings.
• Did you attend any coaching? Was it useful?
  • Yes, the alumni coaching classes of Calicut Medical College. It was really helpful.
• What were the subjects you focused upon?
  • Mainly Hematology, Oncology, Ophtalmology, Radiodiagnosis, Pharmacology, Anesthesia and PSM
• What books did you read for theory?
  • Anatomy – Chaurasia, K L moore
  • Physiology – Ganong and its mcq’s
  • Biochemistry – Harper
  • Pathology – Robbins
  • Microbiology – Ananthanarayan
  • Pharmacology – KDT, Katzung
  • Forensic medicine – Pillay
  • Ophthalmology – Parsons
  • ENT – Dhingra
  • Community medicine – Park
  • Medicine – Harrison
  • Surgery – Bailey and Sabiston
  • Obgyn – Shiela B, Jeffcot
  • Peadiatrics – O P Ghai, Nelson (systems)
  • Anesthesia - Ajay Yadav
  • Psychiatry – Niraj Ahuja and Pre-test
  • Radiology – Sumer K Sethi
• Is there anything specific to keep in mind while preparing for PGIMER? (when compared to AIIMS, AIPGMEE and other state exams) – regarding books for preparation, topics to focus on etc…
  • Yes. Mainly because it’s a multiple response examination. The probability of choices becoming right is more. So each of the 250×5=1250 choices are to be assessed and so, I think, time is the limiting factor. For each question, on an average, 2/3 of 5 options would be right. A guide by manoj chaudhari is helpful in understanding the pattern of examination. Some important topics stressed are: Nerves of upper and lower limbs + visceral supply, Cardiac dynamics, Genetics and biotechnology(lippincot), Antibiotics and chemotherapy (katzung), Posterior segment of the eye, Anatomy of ear, nose and throat, Metabolic disorders, Accidents and trauma care, Gynecological malingnancies and contraception, Growth and development, Hematology and Oncology(Robbins and Harrison), Anesthetic equipments, Radiation physics, Tuberculosis
• What was your plan for the week before the exam?
  • After going through the basics before, I did the previous years question papers from Manoj Chaudhari during the final week.
• What was your strategy for taking the exam?
  • Exam was of 3 hrs duration with 250 questions. I attempted each question, both easy and difficult ones in the same order since time was limited for a review. Some tricky ones I left for the 2nd round for which about 10 min was left.
• How many questions did you attempt?
  • 247 questions and about 600 options.
• How many do you think you got correct?
  • Since answer key and especially marks are not published, its difficult to predict.
• What is your advice to future aspirants?
  • I don’t know whether my strategies are suitable for all since each of us would be having different methods of preparation. But 4 books will help us all: Harrison, Robbins, Nelson(systems) and Ganong. Retrospectively thinking I feel that the ideal time to start preparing is from 3rd semester onwards with Robbins PBD and to start reading Harrison from 6th semester onwards and then doing the mcq’s.
• That brings us to the conclusion of the interview. Best of luck for your future endeavours!
  • Thank you very much

If you would like to ask Dr. Jagadeesh any specific questions regarding preparation, please leave a comment below.

1. Interview with Dr. Adarsh MB, – 21st rank holder – PGIMER PG entrance November 2011
2. Interview with Dr. Jineesh V – 1st rank holder – AIIMS PG entrance – November 2010
3. Interview with Dr. Pavan Rasalkar – 11th rank holder – AIIMS PG entrance May 2011

‘Rapid Review, AIPGMEE, 2011‘ is a recently published book containing the questions and answers of AIPGMEE 2011. The authors Rahul K.R. and Nishant B. have certainly done an excellent work in compiling the questions and answers in a easy to read format. All 300 questions, answers and explanations with suitable references are provided in a clear and concise manner. Controversial questions are discussed in more detail. Related questions asked in previous question papers are also added for easy reference. Although the clarity of the pictures need a bit more improvement, this is definitely a book that is worth having while preparing for AIPGMEE.

You can use the following contact form to get in touch with the authors:

1. AIPGMEE 2011 Guide E-book – FREE Download
2. AIPGMEE 2011 – Questions and Answers – Discussion
3. AIPGMEE 2012 – Questions and Answers – Recall and Discussion

POSTGRADUATE INSTITUTE OF MEDICAL EDUCATION & RESEARCH CHANDIGARH

LAST DATE FOR RECEIPT OF APPLICATION: 09.04.2011 (up to 2.00 PM)

Application on the prescribed  form are invited for the following Postdoctoral/ Postgraduate courses and PhD programme for the  academic session starting from 1^st July, 2011. INCOMPLETE APPLICATIONS WILL NOT BE ENTERTAINED AND NO CORRESPONDENCE WILL BE MADE IN THIS REGARD.

1. First Year Junior Resident (for MD/MS courses)

2. a) Master of Dental Surgery (MDS)

• Pedodontics & Preventive Dentistry (Gen-1, SC-1, OBC-1)
• Orthodontics (Gen-1, ST-1, OBC-1)

b) First Year Junior Residents (House Job) for Oral Health Sciences (Gen-5, SC-1, ST-1, OBC-2)

3.            Master of Hospital Administration (MHA) (Gen-1, OBC-1)

4. DM/M.Ch

5. PhD Programme

Anaesthesia, Biochemistry, Biophysics, Com Medicine, Exp. Medicine & Biotechnology, Forensic Medicine, ENT, Gastroenterology, Hepatology, Haematology, Histopathology, Immunopathology, Internal Medicine, Medical Microbiology, Nephrology, Neurology, Neuro Surgery, Nuclear Medicine, Ophthalmology, Orthosurgery, Psychiatry (Cl. Psycology), Parasitology, Pharmacology, Pediatrics, Radiodiagnosis, General Surgery, Urology.

6. Master of Public Health (MPH) (Gen-5, SC-3, ST-1, OBC-3, Spon-4)

7. M.Sc/ M.Sc MLT courses

i.) M.Sc Medical Technology Immunopathology-2               xi.) M.Sc Medical Technology Radiodiagnosis-2

ii.) M.Sc Medical Technology Cytopathology-1                     xii.) M.Sc Medical Technology Radiotherapy-2

iii.) M.Sc Medical Technology Haematology-2                       xiii.) M.Sc Medical Technology Transfusion Medicine-1

iv.) M.Sc Medical Technology Histopathology-1                 xiv.) M.Sc Respiratory Care-2

v.) M.Sc Medical Technology Bacteriology & Mycology-2 xv.) M.Sc Biochemistry-(Gen-4, SC-2, ST-1, OBC-2)

vi.) M.Sc Medical Technology Parasitology-2                      xvi.) M.Sc Medical Biotechnology-(Gen-4, SC-2, ST-1, OBC-3)

vii.) M.Sc Medical Technology Virology-2                            xvii.) M.Sc Pharmacology-(Gen-5, SC-1, ST-1, OBC-2)

viii.) M.Sc Medical Technology Pharmacology-1              xviii.).M.Sc Anatomy- (Gen-1, SC-1, OBC-1)

ix.) M.Sc Medical Technology Biochemistry-2

x.) M.Sc Medical Technology Biotechnology-2

8. Certificate Courses

1. Certificate course in Immunopathology (Spon-2)

2. Post MD Certificate course in Cytopathology (Gen-1, Spon-1)

3. Post Doctoral Certificate Course in Vascular Neurosurgery (Spon-2)

4. Post MD Certificate Course in Medical Biotechnology (Spon-5)

GENERAL INFORMATION

1. For all courses, where MBBS/BDS is an eligibility requirement, the candidates who have made more than one attempt (i.e. have more than one failure, compartment or reappear) during their MBBS/BDS career, are not eligible. For DM/M.Ch courses, the candidates who have made more than one attempt in MBBS and MD/MS career are not eligible. However, those belonging to Sch. Caste/Tribes with upto two attempts in their MBBS/BDS career will be eligible for MD/MS/MDS and  House Job in Oral Health Sciences.

2.        The candidates completing internship after 30.06.2011 are not eligible for course NO. 1, 2 and 3

3.        The number of seats wherever indicated are provisional and may increase/decrease without any prior notice.

4.        The courses at Sr. No. 7, ( i – xiv) are only for sponsored/deputed candidates.

5.        A candidate applying for more than one subject/course except Sr. No. � 1, 2, 3, 6 & 8 is required to submit separate application complete in all respect for each subject/course.

6.        The candidates applying for DM/M.Ch courses can apply maximum upto two subjects in separate application form.

7.        The candidates may apply in the form downloadable (for Sr.No. 1 to 5) at http://pgimer.nic.in together with requisite fee by Demand Draft in the name of Director, PGI. The prescribed application forms along with prospectus (Brochure of information) are also available from the office of the undersigned either personally on payment of Rs.1000/- for GENERAL/OBC/OPH category and Rs.800/- for SC/ST at the counter (Kairon Block, Room No.309) from 10.30 AM to 12.30 P.M and from 2.30 PM to 3.30PM on all working days except Saturdays  (On Saturdays, forms will be available from 10.30 AM to 12.00 Noon) or by post for which the request must be accompanied with a self addressed thick envelope of size 12 X 10 cm bearing postage stamps of Rs. 50/- and Bank Draft preferably from any SBI branch  payable at SBI Medical Institute Branch (Code No.1524) Chandigarh for GENERAL/ OBC/OPH Rs.1000/- and for SC/ST Rs.800/- (indicating category i.e. General or SC/ST) drawn in favour of the Director, PGI, Chandigarh. However, prospectus for DM/M.Ch will be available for Rs.1000/- only as there is no reservation for the same.

TENTATIVE DATES OF EXAMINATIONS

Note:

1) It is in the interest of the candidate to send the application through Registered/Speed Post.

2) No request for the supply of form by post will be entertained after 02.04.2011.

3) Fee once paid will not be refunded.

4) Numbers of seats in sponsored category for MD/MS courses may be increased with the approval of Director of the Institute.

5) Prospectus on cash payment shall be available from 14.03.2011. However, the prospectus  cum application form can be downloaded from the PGI website w.e.f. 11.03.2011

Source : pgimer.nic.in

Ready to fast track your preparation? Join PGIMER PG entrance May 2011 Discussion page and blaze your way towards a PG seat!

1. PGIMER PG entrance exam November 2011 (January 2012 session) – Important dates
2. PGIMER PG entrance – November 2011 – Questions & Answers Recall and Discussion
3. AIIMS PG entrance – May 2011 – Notification

• Entrance examination for admission to All India Institute of Medical Sciences (AIIMS) Post Graduate courses – July 2011 session will be conducted on 8th May 2011
• You can apply online at www.aiimsexams.org from 28th March 2011 to 15th April 2011
• Since the exam is fast approaching, we have created a facebook page for discussing the important questions and topics
• Previously asked questions should form an important part of our preparation
• Recent advances in medicine should also be looked into
• After the exam is over, we can recollect the questions asked and discuss the answers!
• So what are you waiting for? Join AIIMS PG Entrance – May 2011 – Discussion group and blaze towards a AIIMS PG seat!
• Want to know the secrets of toppers? Read what Dr.Jineesh V, the topper of AIIMS PG entrance November 2010 has to share with us!

Update : AIIMS May 2011 Question and Answer discussion has started! Please post all the questions you can remember @ the AIIMS PG Entrance – May 2011 – Discussion group and we can discuss the answers.

1. AIIMS PG entrance – November 2011 – Questions and Answers – Discussion
2. AFMC 2011 – PG entrance – Questions recall with answers discussion
3. NIMHAHNS PG entrance 2011 – Questions and Answers – Discussion

UPDATE : We have temporarily stopped this service. We hope to restart it soon.

We are pleased to announce that PG Blazer is starting a SMS based service. You can receive PG Medical entrance MCQ’s  and updates delivered to your mobile daily for FREE! The MCQ’s will be based on questions previously asked in the various PG entrance exams – AIPGMEE, AIIMS, PGIMER, JIPMER, AFMC, NIMHANS and other state entrance exams. This service is available only for subscribers in India. If you have any comments / suggestions, please post them in the comments section below. And don’t forget to tell your friends about this service!

To subscribe, send one of the following smses from your mobile:

‘JOIN pgblazer’ to 567678 – SMS GupShup

OR

‘ON pgblazer’ to 09870807070 – Google SMS Channels

You can also subscribe online by going to SMS GupShup or Google SMS Channels

Note: Both of these groups have the same content. So there is no need to subscribe to both. First try subscribing via SMS GupShup. If you do not get a confirmation sms, then you can try subscribing via Google SMS Channels. If you do not get a confirmation sms with any of them, please check your Do Not Disturb Status. If DND is enabled, you will not be able to receive any sms. You can check this by calling 1909 from your mobile.

Subscribe using Twitter to get extra MCQ’s and tips via SMS!

Advantages of subscribing via twitter:

1. Get more MCQ’s and tips (SMS Gupshup and Google SMS channels have a limit of 3 sms per day)
2. Better SMS delivery compared to SMS GupShup and Google SMS Channels

How to subscribe via twitter:

1. Signup for Twitter (www.twitter.com) if you havent already done so
2. Add your mobile (only available for Airtel / Reliance / Videocon users) to your twitter account by going to the ‘Mobile’ section in your ‘Account settings’
3. After you have successfully connected your mobile to your twitter account, go to the PG Blazer page on twitter – www.twitter.com/pgblazer
4. Click on the ‘Follow’ button. After you click the ‘Follow’ button, a small icon of a mobile will appear on the right side
5. When you move your mouse to the icon, it will read : ‘Tweets from this user are not sent to your mobile phone’. Click on the icon and you will get any future updates delivered to your mobile!

1. Free Online PG Medical Entrance Coaching
2. RGUHS PGET 2011 – Karnataka Medical PG entrance – MCQ Questions and answers – Discussion
3. List of upcoming medical PG entrance exams

• We are discussing the questions asked in PGET 2011 – Karnataka PG medical entrance 2011
• Rajiv Gandhi University of Health Sciences (RGUHS), Bangalore conducted the entrance test on 30.01.2011 for admission to Post Graduate Degree/Diploma courses in Government Medical/Dental colleges and Government seats in Private Medical / Dental colleges of Karnataka for the academic year 2011‐2012
• Total questions – 200
• The answer keys have been released
• The questions and answers will be posted under the category of Karnataka PG entrance

Click here to access all the 200 Questions and answers of PGET 2011

1. KCET (Karnataka Medical PG) 2011 – Questions and Answers – Discussion
2. RGUHS – Karnataka PGET 2011 – Answer key – Version M1
3. RGUHS – Karnataka PGET 2011 – Answer key – Version M5

• NIMHANS PG Entrance Examination 2011 will be held in Bangalore on 27th February 2011
• We have created a facebook page for discussing the possible questions and important topics for the exam
• Studying the questions asked previously is an important aspect of NIMHANS PG entrance preparation
• Once the exam is over, we can recall the questions and discuss their answers
• Click here to join NIMHANS PG entrance 2011 Discussion group

1. AIIMS PG entrance – May 2011 – Questions and Answers – Discussion
2. AIIMS PG entrance – November 2011 – Questions and Answers – Discussion
3. AIPGMEE 2011 – Questions and Answers – Discussion

AFMC PG entrance 2011 was conducted on 16th January 2011. We are going to discuss the various questions asked in AFMC 2011. We have created a facebook forum for this purpose. Please go PG Blazer – AFMC 2011 Discussion to access the questions and answers. Also please recollect any questions that you can remember so that we can find out their answers.

1. DNB entrance – June 2011 – Questions and Answers – Discussion
2. PGIMER PG entrance – November 2011 – Questions & Answers Recall and Discussion
3. NIMHAHNS PG entrance 2011 – Questions and Answers – Discussion

• Congratulations on securing a top rank in AIIMS November 2010! What is the secret of your success?
  • I was able to prepare well during internship period, studied Ashish Gupta and Mudhit Khanna, An element of luck was also involved
• What was your study strategy?
  • I used to do previous year mcq’s and read the corresponding topic from standard textbooks
• When did you seriously start preparing for this exam?
  • During 8th semester
• In your opinion, how much time does a student require for preparing for this exam?
  • Approximately 1.5 years
• How many hours did you study each day?
  • About 4 hours a day during internship period
• Did you have a timetable for preparation? Were you able to stick to it?
  • I hand a monthly time table of topics I intended to finish. But most of the time, I was not able to adhere to it
• Were you able to prepare well during the internship period?
  • During certain posting, there is a shortage of time, otherwise it was OK
• Did you attend any coaching? Was it useful?
  • Yes, I attended the coaching conducted at Calicut Medical College by the Alumni Association. It played an important part in my success
• What were the subjects you focused upon?
  • I focused mainly on Anesthesia, Radiology, Hemato oncology, Pharmacology and Community Medicine
• What books did you read for theory?
  • Anatomy – Notes
  • Physiology – Ganong
  • Biochemistry – Harper
  • Pathology – Robbins
  • Microbiology – Rachana Chaurasia
  • Pharmacology – Sparsh Guptha
  • Forensic medicine – Across
  • Ophthalmology – Parsons
  • ENT – Dhingra
  • Community medicine – Park
  • Medicine – Harrison
  • Surgery – Ashish gupta
  • Obgyn – Sheila
  • Peadiatrics – Notes
  • Anesthesia - Ajay Yadav
  • Psychiatry – Niraj Ahuja
• What was your plan for the week before the exam?
  • I revised Ashish Guptha and Mudith Khanna
• What was your strategy for taking the exam?
  • I took the exam in 2 rounds
  • First round – about 2.5 hours – did the easy questions
  • Second round – remaining 30 minutes – tackled the difficult ones – attempted all questions in which I was able to eliminate atleast 2 of the options
• How many questions did you attempt?
  • 196
• How many do you think you got correct?
  • 150-160 I guess
• What is your advice to future aspirants?
  • Read the questions carefully, try to attempt maximum questions
  • The November AIIMS exam usually contains new questions, whereas the one conducted in May usually has more repeat questions
• That brings us to the conclusion of the interview. Best of luck for your future endeavours!
  • Thank you very much

1. Interview with Dr. Anoop MK, – 12th rank holder – AIIMS PG entrance November 2011
2. Interview with Dr. Pavan Rasalkar – 11th rank holder – AIIMS PG entrance May 2011
3. Interview with Dr. Jagadeesh Menon – 23rd rank holder – PGIMER PG entrance May 2011

• All India Post Graduate Medical Entrance Examination 2011 will be conducted on 9th January 2011
• We have created a facebook page for discussing the possible questions and important topics for the exam
• Learning the previously asked questions is an important part of AIPGMEE preparation
• But repeat questions are decreasing over the years
• Still, there are certain important topics from which more questions are being asked
• After the exam is over, we can discuss the answers of the questions asked in the 2011 exam
• So please do join Aipgmee 2011 Discussion group

UPDATE (9/1/2011):

Click here to go to AIGPMEE 2011 - All 300 questions recalled!

1. AIPGMEE 2012 – Questions and Answers – Recall and Discussion
2. NIMHAHNS PG entrance 2011 – Questions and Answers – Discussion
3. AIIMS PG entrance – May 2011 – Questions and Answers – Discussion

• Nephrotic syndrome is characterised by albuminuria, hypoalbuminemia, oedema, hyperlipidemia and lipiduria
• The increased loss of proteins in urine stimulates the liver to increase synthesis of proteins
• Apolipoporteins are synthesised in increased quantities – especially apo B, apo C-II, and apo E which are used VLDL and LDL formation
• Apoproteins associated with HDL synthesis – apo A-I and apo A-II usually remains normal
• In addition to this, there is decreased lipid catabolism due to decreased activity of lipoprotein lipase
• All these factors together contribute to the hyperlipidemic state in nephrotic syndrome

Image source

1. Indications for renal biopsy in nephrotic syndrome
2. Pathology – MCQ 18 – Most common gene defect in Idiopathic Steroid Resistant Nephrotic Syndrome
3. Pathology – MCQ 30 – Most common gene defect in idiopathic steroid resistant nephrotic syndrome

Scoliosis is a deformity of the spine which is characterised by lateral curvature of the spine in upright position in the coronal plane

Problems due to scoliosis:

• Cosmetic
• Deranged force and load transmission through spine
• Impairment of functioning of vital organs like heart and lungs
• Difficult to treat

Types of scoliosis:

• Structural
  • Fixed curvature
  • Non flexible
  • Does not get corrected by side bending
• Non structural
  • Flexible curvature
  • Gets corrected by side bending

Mechanism of non structural scoliosis

• Compensatory – to compensate for leg length deformities / fixed flexion deformities of hip
• Sciatic – due to inflammation / irritation due to lumbar disc disease
• Postural – due to bad posturing

1. Tension band principle
2. Mass lesion – Left lungs – X-ray
3. Dermatology – MCQ 23 – 27 year old male with vesiculobullous lesion

• X-ray chest anteroposterior view showing massive pleural effusion on left side and mediastinal shift to right
• Patient presented with symptoms of dyspnoea, cough and fever for 1 week duration
• On examination, breath sounds were absent on left side with stony dullness on percussion
• Patient’s spouse was an active case of tuberculosis, hence tuberculous pleural effusion was suspected

1. Pleural effusion – left
2. Minimal pleural effusion
3. Urinothorax – Etiology, Clinical features and Management

Aortic stenosis – rheumatic
Click on image for an enlarged view

In the following conditions, aortic stenosis can coexist with aortic regurgitation (aortic incompetence).

• Rheumatic
• Congenital bicuspid aortic valve
• Calcific degeneration of aortic valve
• Atherosclerotic degeneration of aortic valve
• Infective endocarditis in a case of aortic stenosis

H0w aortic stenosis and regurgitation can coexist?

• It can be explained by the following analogy
• Consider a normal aortic valve to be a door
• It closes and opens completely during each cardiac cycle
• Now consider the door to be stuck in the mid position
• It neither closes completely nor opens completely
• Similarly, when the aortic valve is deformed, both stenosis and regurgitation can coexist

1. Medicine – MCQ 53 – Water hammer pulse
2. Medicine – MCQ 151 – 59 year old man with severe myxomatous mitral regurgitation
3. Ross procedure (aortopulmonary translocation)

Electrical activity of heart in atrial fibrillation

• Progressive fibrosis of the atria is the underlying pathologic change that results in atrial fibrillation
• Fibrosis of atria can occur due to:
  • Atrial dilatation (most common)
  • Inflammation
  • Genetic causes
• In valvular heart diseases that cause increase in atrial pressure (mitral stenosis, mitral regurgitation, tricuspid regurgitation), there is progressive dilatation of the atria
• Dilatation can also occur due to hypertension or heart failure

How atrial dilatation causes atrial fibrosis?

• Atrial dilatation results in activation of Renin Angiotensin Aldosterone system
• This induces rise in matrix metalloproteinases and disintegrin, which promotes atrial remodelling and fibrosis

How fibrosis of atria results in atrial fibrillation?

• Fibrosis not only involves the muscle mass of the atria, but also involves the conduction system of the heart
• SA node and AV node are affected
• The conduction speed is decreased and multiple foci of electrical activity occur in the atria
• Multiple re-entry loops are setup which results in irregular activation of atrial musculature and atrial fibrillation

1. Mechanism of development of atrial fibrillation in chest infections
2. Medicine – MCQ 17 – A person with mitral regurgitation and atrial fibrillation presents with syncope
3. Atrial fibrillation with bigeminal rhythm

Components of a joint

• Enthesis refers to the point where a tendon / ligament is attached to bone
• The collagen fibers are calcified at this region and integrated into bone tissue

Types

• Fibrous enthesis
• Fibrocartilagenous enthesis

Clinical importance:

• Enthesitis (inflammation of the enthesis) is the common pathology responsible for spondyloarthropathies

Image credits: Madhero88

1. Secondary myelofibrosis – Etiology, Pathogenesis, Investigations and Management
2. Microbiology – MCQ 19 – Pseudomembranous colitis
3. Sequestrum

• Defective vision is one of the important symptoms of acute iridocyclitis
• Initially there is slight blurring of vision with progressive deterioration
• There are multiple causes of defective vision in acute iridocyclitis
• They are: (from anterior to posterior of eyeball)
  • corneal oedema and keratic precipitates
  • Aqueous humour turbidity
  • Exudates in pupillary area
  • Myopia as a result of ciliary spasm
  • Complicated cataract
  • Cyclitic membrane
  • Vitreous haze
  • Macular oedema
  • Papillitis
  • Secondary glaucoma

Image credits: The eyes have it

1. Ophthalmology – MCQ 42 – 25 year old male with sudden painless loss of vision
2. Vision 2020 – The right to sight
3. SPM – MCQ 47 – Vision 2020 “The right to sight”

Rat flea (Xenopsylla cheopis)

• Rat flea (Xenopsylla cheopis) is a parasite of rodents primarily of the genus Rattus
• It is responsible for the transmission of many diseases like plague and rickettsial diseases
• These diseases can be controlled by utilising flea control measures
  • Insecticides
    • DDT is the most commonly used insecticide against rat fleas
    • It is sprayed as powder form in areas frequented by rats and their burrows
    • Spraying should be done on the floor and on the walls up to a height of 1 foot
    • The DDT powder gets adhered to the fur coat of rats and kill the fleas
    • In areas where plague is endemic, fleas have acquired resistance to DDT and BHC
    • In these areas, malathion or carbaryl can be used
    • Other host animals like cats and dogs and their premises should also be treated with insecticide dusts or sprays
  • Repellants
    • Diethyl toluamide is a good flea repellent
    • Clothes treated with it repel fleas up to 1 week
    • Benzyl benzoate can also be used as repellent
  • Rodent control measures
    • Rodent control measures should be used along with flea control measures to get maximum benefit

1. Anti rodent measures – Sanitation, Traps, Poisons, Fumigation, Chemosterilants
2. National vector borne disease control programme (NVBDCP)
3. SPM – MCQ 98 – Antilarval measures

Genetic counselling is the utilisation of knowledge of genetics to predict the probability of genetic disorders. It is of 2 types:

• Prospective genetic counselling
  • In this the genetic disorder has not yet expressed itself
  • It is done is heterozygotic individuals to assess the probability of having a child with genetic disorders
  • If a person is identified as heterozygotic for a genetic condition, he/she should be advised against marrying another heterozygotic individual as there is increased risk of the trait expressing itself in the phenotype
• Retrospective genetic counselling
  • In this, the disease has already occurred in the family
  • This is more commonly done compared to prospective genetic counselling
  • This is because, people usually come for genetic counselling only after having a child with congenital anomalies / mental retardation / inborn errors of metabolism
  • The interventions as a part of retrospective genetic counselling are:
    • Contraception
    • Sterilization
    • Termination of pregnancy

1. AIIMS May 2011 – MCQ 37
2. Biochemistry – MCQ 91 – Genetic defect of fructose 1,6 – biphosphatase
3. Surgery – MCQ 37 – Familial polyposis coli (FPC) screening test

Mansonia egg – microscopic view
Click on image for an enlarged view

• Mansonia mosquitoes are vectors of malayan (brugian) filariasis and chikungunya fever
• Eggs are laid in star (rosette) shaped clusters glued to underside of aquatic vegetation
• The eggs are brown or black, cylindrical shape with a tube like extension which is darker than the rest of the egg
• Eggs cannot survive dessication
• The eggs hatch to form larvae which remain attached to aquatic plants

Mansonia Egg attached to leaf of aquatic plant – microscopic view – video

1. Vitreous humor anatomy
2. Double lumen endotracheal tube
3. Anatomy – MCQ 24 – Trigone of bladder

Fundus picture – Papilledema
Image by The eyes have it

• Papilledema is usually bilateral (See Why papilledema occurs bilaterally? )
• Under certain special circumstances, papilledema can be unilateral. They are:
  • Foster Kennedy syndrome
    • Intracranial lesions that exert pressure on one optic nerve often leads to unilateral optic atrophy
    • If these lesions are large enough, they may cause increased intracranial tension and papilledema in the opposite eye
    • Seen in :
      • olfactory groove meningiomas
      • frontal lobe tumours
  • Pseudo Foster Kennedy syndrome
    • Increased intracranial pressure with preexisting unilateral optic atrophy (due to any cause) again results in unilateral papilledema of opposite eye

Frontal lobe tumour – MRI. (Frontal lobe tumours can cause unilateral papilledema)
Image courtesy of Radiopaedia.org (the whole case can be seen here)”

1. Etiology of papilledema
2. Why papilledema occurs bilaterally?
3. Ophthalmology – MCQ 47 – Von Hippel Lindau Syndrome

Anterior view of skull – pyriform aperture is highlighted
Click on image for an enlarged view

• Pyriform aperture is the anterior most and narrowest area of the bony part of nose
• Boundaries of pyriform aperture:
  • Superior – Nasal bone
  • Lateral – Frontal (nasal) process of maxilla
  • Inferior – Premaxilla, anterior nasal spine of maxilla
• Clinical importance:
  • Congenital Nasal Pyriform Aperture Stenosis
    • stenosis of pyriform aperture resulting in significantly increased nasal airway resistance

1. CNPAS – Acronym
2. Anatomy – MCQ 39 – Structures passing through the superior aperture of thorax
3. Denis’ three column concept of spine stability

Click on image for an enlarged view
Based on illustration created by Patrick J. Lynch

Mnemonic – “Live Frankly To See Absolutely No Insult”

The nerves passing through superior orbital fissure are (from top to bottom) :

• Lacrimal nerve
• Frontal nerve
• Trochlear nerve
• Superior division of oculomotor nerve
• Abducens nerve
• Nasociliary nerve (branch of ophthalmic nerve)
• Inferior division of oculomotor nerve

1. Anatomy – MCQ 22 – Characteristics of oculomotor nerve
2. Annulus of Zinn
3. Anatomy – MCQ 39 – Structures passing through the superior aperture of thorax

Antrochoanal polyp Click on image for an enlarged view

• Antrochoanal polyp arises from the maxillary sinus.
• It usually grows posteriorly towards the nasopharynx

The reasons for growing posteriorly are as follows:

• Mucociliary flow is directed posteriorly
• Accessory ostium, through which the antrochoanal polyp comes out is located more posterior in the nasal cavity
• Effect of gravity when lying down
• Inspiratory airflow is stronger compared to expiratory flow
• Broetz anatomical variation theory
• Bernoulli effect

Image credits:

Antrochoanal polyp – Otolaryngology Houston
Antrochoanal polyp – endoscopic view – Otolaryngology Houston
Antrochoanal polyp CT scan – Radiopaedia. Original image can be viewed here

1. Nasal polyp – Differential diagnosis
2. How to differentiate nasal polyp from turbinate hypertrophy?
3. ENT – MCQ 15 – Area of maximum air flow in nasal cavity

Sulfonylureas – Presentation Transcript

1. Sulfonylureas
2. Introduction – Sulfonylureas • Lower blood glucose in normal persons and type 2 diabetics • Not effective in type 1 diabetics
3. Mechanism of action – Sulfonylureas SUR1 receptors on pancreatic β cell membrane Binding to receptor Reduced conductance of ATP sensitive K+ channels Depolarization of membrane Enhanced Ca2+ influx Degranulation of insulin vesicles
4. Mechanism of action – Sulfonylureas • Augment 2nd phase of insulin secretion • At least 30% functional β cells required
5. Extrapancreatic action – Sulfonylureas • Chronic administration – downregulation of sulphonylurea receptors – Insulin release decreased • But control of blood sugar is maintained • Tissues are sensitized to insulin – By Increase in insulin receptors and/or postreceptor action
6. Pharmacokinetics – Sulfonylureas • Well absorbed orally • High plasma protein binding – 90% • Low volume of distribution – 0.2-0.4 L/kg
7. Interactions – Sulfonylureas • Increasing sulfonylurea action – Displacement from plasma proteins – Decrease metabolism – Synergistic action • Decreasing sulfonylurea action – Increase metabolism – Antagonistic action
8. Interactions – Sulfonylureas • Increasing sulfonylurea action – Displacement from plasma proteins • Phenylbutazone • Sulphinpyrazone • Salicylates • Sulfonamides • PAS – Decrease metabolism – Synergistic action • Decreasing sulfonylurea action – Increase metabolism – Antagonistic action
9. Interactions – Sulfonylureas • Increasing sulfonylurea action – Displacement from plasma proteins – Decrease metabolism • Cimetidine • Sulfonamides • Warfarin • Chloramphenicol • Acute alcohol intake – Synergistic action • Decreasing sulfonylurea action – Increase metabolism – Antagonistic action
10. Interactions – Sulfonylureas • Increasing sulfonylurea action – Displacement from plasma proteins – Decrease metabolism – Synergistic action • Salicylates • Propranolol • Sympatholytic antihypertensives • Lithium • Theophylline • Alcohol (inhibits gluconeogenesis) • Decreasing sulfonylurea action – Increase metabolism – Antagonistic action
11. Interactions – Sulfonylureas • Increasing sulfonylurea action – Displacement from plasma proteins – Decrease metabolism – Synergistic action • Decreasing sulfonylurea action – Increase metabolism • Phenobarbitone • Phenytoin • Rifampicin • Chronic alcoholism – Antagonistic action
12. Interactions – Sulfonylureas • Increasing sulfonylurea action – Displacement from plasma proteins – Decrease metabolism – Synergistic action • Decreasing sulfonylurea action – Increase metabolism – Antagonistic action • Corticosteroids • Diazoxide • Thiazides • Furosemide • Oral contraceptives
13. Adverse Effects – Sulfonylureas • Hypoglycemia – Commonest – More in elderly, liver+kidney disease – More with Chlorpropamide – long action – Least with Tolbutamide – low potency, short action • Non specific side effects • Hypersensitivity
14. Adverse Effects – Sulfonylureas • Hypoglycemia • Non specific side effects – Nausea – Vomiting – Flatulence – Diarrhoea/constipation – Headache – Paresthesias – Weight gain • Hypersensitivity
15. Adverse Effects – Sulfonylureas • Hypoglycemia • Non specific side effects • Hypersensitivity – Rashes – Photosensitivity – Prupura – Transient leukopenia – Agranulocytosis (rare)
16. Adverse Effects – Sulfonylureas • Chlorpropamide – Cholestatic jaundice – Dilutional hyponatremia (sensitise kidney to ADH) – Disulfuram like reactions • Tolbutamide – Reduce iodine uptake by thyroid • Does not cause hypothyroidism • Should changeover to insulin during pregnancy!

1. Physiology – MCQ 12 – Which of the following adaptations will be apt to increase the work capacity at high altitude?
2. Supplementary action of proteins
3. Metronidazole

1. Mid day meal program (School lunch program)
2. Maternal and Child health problems in India
3. SPM – MCQ 90 – Child with a history of cough and fever for 4 days