1. AFMC 2011 – MCQ 3
2. AFMC 2011 – MCQ 14
3. AFMC 2011 – MCQ 23

1. Forensic medicine – MCQ 3 – Burtonian line is seen with poisoning of?
2. AIIMS May 2011 – MCQ 56
3. Forensic medicine – MCQ 4 – Mercury will affect which part of the renal tubule ?

• 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

1. Pathology – MCQ 38 – Peripheral smear with increased neutrophils, basophils, eosinophils, and platelet
2. Clinical signs in allergic rhinitis – nasal, ocular, otologic, pharyngeal, laryngeal
3. Alpha-2 adrenergic receptor – Location, Actions, Agonist, Antagonists

Ballooning degeneration of hepatocytes

(Click on image for an enlarged view – Image by Nephron)

• Type of hepatocyte death
• Form of apoptosis
• Seen in hepatocytes infected with certain viruses
• characterised by increase in cell size (ballooning) with wispy/cobweb like cytoplasm, cytoplasmic vacuolation, pyknotic nucleus

1. AIIMS May 2011 – MCQ 35
2. Physiology MCQ 1
3. NEET PG / USMLE – MCQ 36

1. Causes of renal papillary necrosis – Medical mnemonic
2. AIPGMEE 2011 – MCQ 8 – Autoimmune disease
3. AIIMS May 2011 – MCQ 160 – Methotrexate

Also called:

• Nickerson Kveim reaction
• Kveim Nickerson skin test

1. RGUHS Karnataka PGET 2011 – MCQ 166
2. SPM – MCQ 26 – Analytical test of choice
3. SPM – MCQ 34 – Best method to compare new test and gold standard test

1. Basic Fuchsin
2. AIIMS November 2011 – MCQ 42
3. NEET PG / USMLE – MCQ 42

1. Fatty change
2. Pharmacology – MCQ 90 – Ionized drug
3. Physiology – MCQ 63 – Regulation of blood flow distribution

1. AIIMS November 2011 – MCQ 37
2. Biochemistry – MCQ 39 – Anticoagulant used for glucose estimation
3. AIIMS November 2011 – MCQ 133

1. Medicine – MCQ 137 – Pathogens implicated in infective endocarditis
2. Types of Shock – Medical mnemonic
3. Physiology – MCQ 73 – Conversion of heme to bilirubin

Fat metabolism in the liver

Lipids absorbed in the intestine are transported to the liver by the portal circulation where they are taken up by the hepatocytes. These fatty acids can be 1) oxidized to ketone bodies 2) used for the synthesis of cholesterol 3) used for synthesis of triglycerides.

1. Lipoprotein lipase
2. Mechanism of action of fibrates
3. Hyaline change

In MDS, there is decreased normal hemopoetic stem cells, proliferation of dyspoetic marrow cells, selective outgrowth of MDS cells and malignant transformation.

Most patients with MDS die of cytopenias than of leukemia. Transfusion dependence is also an important prognostic factor in MDS. Those who need more transfusions have a poorer prognosis.

5q deletion (5q minus) syndrome has been identified as an important factor in MDS, but this group does not go in for a malignant transformation.

Classifications: FAB (1982) and WHO (2001) classifications

IPSS risk score for de novo MDS is based on marrow blasts, karyotype and cytopenias. Refractory anemia sub group has a lower risk.

Treatment of myelodysplastic syndrome:

Packed cells – but this can cause iron overload, which occurs when you give more than 40 transfusions. Desferrioxamine has to be given to prevent hemochromatosis due to iron overload.

Erythopoetin is a worth a try, even though the response rates are only 20 – 30%. Darbepoetin is a syntetic analogue, which is not freely available. Thrombopoetin in addition to platelet transfusion can be used.

Lenalidomide, a congener of thalidomide and induces an erythroid response in about 50%. Response to lenalidomide is better in 5q minus syndrome.

Hypomethylating agent 5-Azactytidine is also useful. Time to AML or death is increased with this drug.

1. Pathology – MCQ 93 – Cytogenetic abnormality in adult myelodysplastic syndrome
2. Reye syndrome
3. Secondary myelofibrosis – Etiology, Pathogenesis, Investigations and Management

1. Pathology – MCQ 23 – Function of Natural killer cells
2. Haller’s cells (infraorbital ethmoid cells)
3. Pathology – MCQ 25 – Why adult cells stop division?

Haemophilus influenzae in blood agar

Haemophilus influenzae meningitis

1. Pfeiffer’s bacillus
2. Microbiology – MCQ 73 – 20 year old male with genital ulcer
3. Diseases caused by Haemophilus influenzae

1. Constrictions of oesophagus
2. Surgery – MCQ 44 – Early postoperative complication of ileostomy
3. Waldeyer’s lymphatic ring

1. Hemoglobinemia
2. Pathology – MCQ 73
3. AIIMS May 2011 – MCQ 7

1. AIIMS November 2011 – MCQ 198
2. Hemolysis
3. AIIMS November 2011 – MCQ 73