Fourteenth Edition

MedicalSubjects
 Contents

From Authors’ Desk—Why ROAMS is Impotrant?....................................................................................................................................................i.x..............

Acknowledgements..................................................................................................................................................................................................x..i....................
From Publisher’s Desk..............................................................................................................................................................................................x..i.ii....................
How to Prepare for PGMEE?.....................................................................................................................................................................................x..v...................

Chapter 1 Anatomy 1
Historical Aspects Parts of Brain 34
Blood Vessels 2 White Matter of Cerebrum 37 Thalamus 38
Source of Hemorrhage/Bleeding in 2 Preferred Vascular Sites
Arteries
2 of Brain & Effects of Lesion 38
Veins: Important Points 4 Orbit 39
Anatomical Values 5 Spine 39
Anatomy Basics 6 End Arteries 6 Capillaries 6 Anastomosis Face
6 40
Dangerous Areas in the Body 7 Structures forming Various Oral
Bed Cavity
7 40

PR
Osteology (Bones & Joints) 7 Bones 7 Palatine/ FaucialTonsil 40
Structure of Bone 10 Cartilage 10 Teeth 40
Joints 11 Tongue 41
Shoulder (Glenohumeral) Joint 13 Joints of the foot 14 Palate 42
Arches of the Foot 14 Neck 42

EVI
Lymphatic Drainage 15 Lymphatics 15 Lymphatic Drainage Triangles
of 15 of Neck 42 Thyroid Gland 42
Fascia 16 Thymus 43
Glands & Ganglia 17 Salivary Glands 17 Ganglia of Head &Esophagus
Neck 17 43
Nerves 18 Lungs/Thorax 43

EW
Nerves in Relation to Humerus 18 Named Nerves 20 Ribs & Intercostal Spaces 44 Trachea 44
Imp Sensory Nerves 21 Cranial Nerves (CN) 24 Diaphragm 45
Some Important Mononeuropathies 26 Heart 45
Ligaments,Tendons,Triangles, Angles 26 Ligaments 26 Arterial Supply of heart 47 Venous Drainage of Heart 47 Aorta 48
Tendons 27 Upper Limb 48
Triangles (r) 27 GIT & Abdomen 50 Peritoneum 51 Mesentery 51 Stomach 52 Duodenum 52 Liver 53
Angles 28 Portal Venous System 53 Gall Bladder 54
Muscles 28 Spleen 54
Terminology in Muscles 29 Attachment over Bones 32 Pancreas 54
Foramina/Canals 33 Appendix 55
Head and Neck 34 Rectum 55
Anal Canal 56
Umbilicus 57
Inguinal Region 57
Kub Region 58 Kidney 58
 Adrenal Glands 59 Important Histological Structures 67
Ureter 59 G.I.T. 67
Urinary Bladder 60 Skin Glands 68
Prostate 60 Embryology 68 NeuralTube (NT) 70 Notochord 70 Development of CVS 71
Urethra 60 Derivatives of Mesentery of Foregut 73 Development of Kidney 74
Perineal Region 61 Perineal Body 61 Derivatives of Undifferentiated Gonads /Related Structures 74
Perineal Pouch/Spaces 61 Derivatives of Urogenital Primordia 75 IMP. Derivatives of 3 Germ Layers 76 Branchial/ Pharyngeal Apparatus 77 Branchial/Pharyngeal Arches 77
Vagina 62 Laryngeal Cartilages 79
Uterus 62 Procedures 79
Fallopian Tube (UterineTubes/ Oviducts) 62
Vertebral
Important
LevelsHistological
81 Structures 63 Testes 64
Gluteal Region 64
Lower Limb 64
Histology 65 Epithelium 65
3 Germ Layers & DevelopmentalTree 66

Chapter 2 Physiology 87
Cellular Physiology 88 Cell Cycle 88 Laws related to Sensory Physiology 112 Reflexes 113
Cell Division 88 CVS 115
Cell Membrane 89 Cardiac Fibres 115
Intercellular Connections 89 Extracellular Matrix (ECM) 89 Cytoskeleton ofCardiac
a Cell 90
Cycle
Cellular
116 N/s
Organelles
of Heart92
117
General Physiology 93 ESR and BMR 93 Feedback Mechanisms 93 Fluid Types Jugular
94Venous Pulse (JVP) 117 Cardiac Cycle 118
Transport across Cell Membrane 95 Distribution of Body Water 96 Buffers inBlood
the Body
Pressure
96 (BP) 118 CardiacVariables 119
To Summarize 97 JVP 120
Plasma 97 Heart Sounds 120
Plasma Proteins 97 Exercise Physiology 121
Acute Phase Proteins 98 Blood Vessels & Haemodynamics 122 Viscocity 122
Neuro Physiology 98 Voltage Gated Channels 98 Blood Flow 122
Muscle Physiology 100 M/S Proteins 100 Cerebral Blood Flow (CBF) 123
Reflexes on the Basis of No. of Synapse 103 Muscle Spindle 103 Respiratory System 124
Nervous System 104 Characteristic of Pulmonary Circulation 124 Surfactant 125
Blood Brain Barrier (BBB) 104 Important Barriers 104 Lung Volumes and Spirometry 125 Airflow/Airway Resistance 126
Sensory SpinalTracts (AscendingTracts) 105 Motor Tracts (DescendingTracts)Oxygen105Therapy
SleepWaves
127 106
Motor Disorders 106 Hypoxia 128
Basal Ganglia (Basal Nuclei) 107 Hypothalamus 108 Oxygen Hb Dissociation Curve (ODC) 129 Nitrogen Narcosis 130
Autonomic Nervous System 109 Neurotransmitters (NT) 109 Types of Inhibition
CO2 Narcosis
110 Receptors
130 110
Pain Pathway 112 Decompression Sickness/Caisson's d/s 130
Changes seen in Acclimatization to High Altitude 131 Brainstem/Neural Respiratory Centres 131
Non-respiratory Function of Lung 132
GIT and Liver 132 Appetite 132 Absorption 132 Gastric Emptying 134 Factors Affecting 135 Bile 135
Bile Salts 135
Hormones Control of G.I.T. 136

xviii
 Personality Disorders 1041 Sexual Paraphilia 1045
Adjustment Disorder 1042 Alcoholism 1045
Dissociative Disorders 1042 Opioid Abuse 1047
Post-Traumatic Stress Disorder (Ptsd) 1042 Phobic Disorders Or Phobia Drug
1043Dependence 1047
Impulse 1043 Serotonin Syndrome 1048
Obsession 1043 Anticholinergic Syndrome 1048
Affective Types 1043 Defense Mechanisms 1048 Acts & Laws 1049
Anxiety Disorders 1044 International Classification Of Diseases (Icd) 1050 Dsm IV Classification 1050
Somatoform Disorders 1044 Some CommonTerms In Psychiatry 1050
Psycho-Somatic Disorders 1044

Chapter 28
Oncology 1053

General Oncology 1054 28.9 Skin Cancers 1069 Melanoma 1069 Nevi 1071
Kaposi
Staging and Grading Of Tumours 1054 Various Plasia in Oncology Sarcoma
1055 1072
Prognostic Factors In Cancers 1055 Screening 1056
Biopsy For Neoplasms 1057 Retinoblastoma 1074
Onco-Pathology 1057 Tumour Markers 1058 Tumours of Head & Neck Region 1074 Salivary Gland Neoplasms 1075 Zollinger Elision Syndrome (Zes) 1084 Insulinoma 1084
Oncogenesis 1059 Gist 1084
Vipoma
Radiation Induced Cancers 1059 Chemical Carcinogenes & Cancers 1084
1059
Carcinoids 1084 1061
Tumours A/W Supressor Gene Inactivation 1060 Cytogenetics &Translocations
Proto-Oncogenes & Gi/Colonic Polyps 1085
Their Expression In Neoplasms 1061 Carcinoma Colon 1085 Ca Anal Canal 1086
Tumours: Common Points 1062 Ca Head of Pancreas 1086 Hepatocellular Cancer (Hcc) 1087 Carcinoma Gb 1087 Cholangiocarcinoma

PR
(Bile Duct Cancer) 1088
Pnet (Primitive Neuro Ectodermal Tumours) 1063 Net (Neuro EndocrinalTumours) 1063 Klatskin Tumour 1088
Gist 1063 28.24 Tumours Of Kidney & Urinary Tract 1088 Wilm'sTumour 1088
CarcinoidTumours 1063 Neuroblastoma 1089
Bladder
Pre-Malignant Conditions Of Cancers 1063 Inherited Predisposition To Cancer 1090
Cancer 1064
Prostate Cancer 1090

EVI
Cancer Radiotherapy 1064 Imp. Form Of Radiation 1065
Testicualr
Cancer Chemotheray 1065 Adjuvant Chemotherapy 1065 Anti-Cancer Cancer
Drugs 10661091
Other Modes of CancerT/T 1068 Malignant BoneTumours 1092
Benign BoneTumours 1094
Paraneoplastic Syndromes & Cancers 1097

EW
Some Points of Special Mention 1098

Chapter 29 Hematology1101

Hematology Basics 1102 Fanconi Anemia 1109

Microcytic Hypochromic Anemia 1103 Iron Deficiency Anemia (IDA) 1103 Thalassemia 1105Sideroblastic Anemia 1109
Hemolytic Anemia 1105 Disorder of Bleeding And Coagulation 1109
Micro-Angiopathic Hemolytic Anemias 1106 Hereditary Spherocytosis (Hs) 1106 Platelets Disorders 1111
Megaloblastic Anemias 1107 Coagulation Disorders 1112 ALL 1115
Other Anemias 1107 AML 1115
Sickle Cell Disease (SCD) 1107 CLL 1116
CML 1116
Hairy Cell Leukemia (HCL) 1117
xxxi
 Mycosis Fungoides 1117 Hodgkin's Disease (Hd Or Hl)Multiple
1117 Myeloma (Mm) 1120 Blood Transfusion (Bt) 1121 Clotting Factors 1123
Blood Groups
Non-Hodgkin's Lymphomas (NHL) 1118 Burkitt ’s Lymphoma 1118 1123
Langerhans Cell Histiocytosis 1119

Chapter 30 Syndromes 1127

Brain Stem Syndromes A/W Hemiplegia 1128 Spinal CordTransection Syndromes 1128ClinicalVignettes 1136
30.1 Some Impt. Negative Points 1136 Recent Points 1136

Chapter 31 Miscellaneous1137

Useful Mnemonics 1138 Fathers 1150

Latest Updates 1148 Newer Drugs 1148 Indications of MRI of Mother During Pregnancy 1150 Indications of Fetal Surgery 1150
Who
Changes In National Immunisation Program 2015- 2016 Theme 1150 In The News 1150
1149
Some Other Imp. Updates 1149 Some Surgical Instruments 1151 Pediatric Rescucitation Equipments 1151 Pedigree Symbols 1152
Scientists 1149
Miscellaneous 1149
Nobel Prize In Medicine/Physiology 1149

xxxii
 ARTERIALSUPPLY OF HEART
A
N
A
T
O
M

A
Y

N
A
T PR
EVI
O VENOUSDRAINAGEOFHEART

EW
M
Y

47
 Exam Oriented Prototype IBQs ((IInncclluuddiinngg ))
7. Find out the abnormality: 10. X-ray neck. (Lateral view). structure marked by the arrow is:-
A A
N 1. Identify the artery marked with the arrow: 4. Below given CT scan of Brain The structure marked is:- N
A A
T T
O O
M M
Y Y

a. Vertebral artery b. MCA

a. Cricoid b. Thyroid
c. Basilar artery d. ICA a. Cerebellum b. Basal ganglia a. Brachymelia b. Arachnodactyly c. Hyoid d. Epiglottis
c. Corpus callosum d. 4th ventricle c. Rhizomelia d. Floating thumb
2. Arrow marked in the diagram indicates which artery: 11. CT scan of abdomen at T8-T10 level. Identify the
5. Area 4 marked in the picture is pointing to which structure: 8. Identify the abnormality shown in the image:marked structure:-

PR
EVI
EW
Perforating femoral
Ans. Ans.
Popliteal artery a. IVC b. Abdominal aorta
c d
Superior lateral genicular c. Thoracic duct d. Duodenum a
b a. Polydactyly b. Macrodactyly
Anterior tibial artery Cribriform plate
b c. Floating thumb d. Syndactyly d
3. Arrow marked in image indicates Frontal sinus
a
Lesser wing of sphenoid 12. Triangle shown below in the picture is also known as 10. c
c
Crista galli 9. X-ray showing left border of heart. Identify the structure marked with the arrow:- b
b :- b
6. Marked structure in the image below indicates

Superior angle of scapula

82 Coracoid process 83
Acromion process
Glenoid cavity a. Root of aorta b. Pulmonary artery a. Callots triangle b. Passaros triangle
a. Caudate b. Putamen c. Left atrial appendage d. Aortic knuckle c. Petit triangle d. Mac’evan triangle
c. Globus pallidus d. Hypothalamus
 SURGERY

S
U
R PR
G EVI
E EW

Duodenal Ulcer versusGastricUlcers

R
Y
DU GU
ŸMost DU are found in first part of duodenum usually just post- ŸGU are found predominantly along the lesser curvature in
pyloric & more commonly on anterior wall than posterior pyloric antral region more commonly on posterior than
anterior wall
ŸIn DU perforation usually occurs from ant. wall ŸPerforation is rare.
ŸBleeding is the m/c complication & also m/c cause of ŸGUs bleed more commonly than DUs
death.Occurs from post wall d/to involvement of ŸBleeding is due to erosion of Lt gastric a..> splenic artery.
gastroduodenal artery
ŸPain relieved by food ŸPain aggravated by food & relieved by antacids
ŸWeight gain ŸWeight loss
ŸNever turns malignant ŸUlcers along lesser curvature are benign & along greater
curvature are more malignant
ŸBlood gp O association ŸBlood gp A association [‘a’ in Gastric & also in gastric carcinoma]
[‘o’ in duo]
ŸIncreased BAO & MAO ŸNormal to i BAO & MAO 661
 EExxaammOOrireinetnetdePdroPtrootytpoe )
S
tyIBpQesI((IIBnncclluQuddiinnsgg PPGGMMEEEE 22001166--1177 IIBBQQss
1. Image shown below indicates:- 4. “Bird’s beak sign” as shown in the image is U
characteristic of:R
GERY

Gastric outlet obstruction

Small intestinal obstruction Achalasia cardia
Colonic obstruction Barret’s esophagus
CHPS Diffuse esophageal spasm
2. Image shown below indicates:- Ca esophagus
5. Tense non tender cystic swelling as shown over wrist is most likely:

PR
EVI
EW
Lipoma
Implantation dermoids Ans.
Gastric outlet obstruction
Ganglion c
Small intestinal obstruction
Dermofibroma b
Colonic obstruction b
CHPS
6. A mother brings her 12 days old baby with umbilicus 4. a
3. By looking at X-ray and ultrasonogram image identify the most probable gall bladder pathology:
as shown in the image. What will you advice? c
c

Urgent surgery
GB stone Apply local Framycetin
Pellets due to gunshot Apply silver nitrate stick
Pancreatic calcification Cleaning with spirit
Cholesterolosis

707
SURGERY
7. Image shown
9. A patient
below ispresent
of:- with uneasiness and aching sensation in his left testicle. On examination there is feel of bag of worms on palpation. Likely diagnosis is:-

a. Spermatocoele b. Hydrocoele
c. Ureterocele d. Varicocoele
a. Urtereocele b. Ectopic ureter
c. Double ureter d. Vesico ureteric reflux
8. Image shown below is:-

Ans.
a
a
d

a. PUJ obstruction b. Bladder stones

c. Ureterocele d. Ectopic ureter

708
 A4 size
27 cm PR
EVI
EW

21.5 cm

ROAMS: Review of All Medical Subjects | 14th edition | YOP: 2017 | Pages:
1200 By VD Agrawal, Reetu Agrawal | Color: | ISBN: 9789386827449

Available on EduLanche.com