be iteY sh ewes Sere, PUee KY NOVEMBER- 2012 © cqurarayss of cranial rot of accessory nerve affects all except ‘A. Cricopharyngeus B. Salpingopharyngeus .Palatopharyngeus D, Stylopharyngens Ans. D. Stylopharyngeus olateglassus is supplied by the cranial ‘ofthe accessory nerve via. the al plexus, and is therefore unlike ‘ibe ote muscles of the tongue, which are supplied by the hypoglossal nerve. ‘actions polatoglossus elevates the root of the \Salpinepharyngeus is innervated through the cranial part of the accessory nerve from the pharyngeal plexus Actions Salpingopharyngens clevates the pharynx, and may. also assist tensor veli palatini to open the cartilaginous end of Stylopharyngewsis innervated by the glossopharyngeal nerve. Actions Stylopharyngeus elevates the pharynx and Aarynx. References: “GRAYS ANATOMY ,S0% edition” ZL0z “AON SWIIY toogie aid aPOTONIMAles the | the pharyngoompanic be daring palatoglossal arch 10 its contralateral | swallowing, fellow, this shutting off the oral cavity from the oropharyms EXGEFT, WHICH ISSUPPLIED BY Pharyngeal plexus. Stylopharyngeus ‘Glossopharyngeus 1X2X And symphathetic = 1x ane Palate Pharyngeal plexus Tensor vei plating ‘Neve fo medial prenygoid IX.X And symphathetic i) Toagve Hiypostossal Palatogiossux Pharyageal plexus XIL IX.X And symphathetic Focal expression | Facial Vit Tevator palpebac superiors | Osculomoter “Mastication Mandibular division of tigeminal | Buccinator Facial CVI} Tare “Recarentlayngeal neve Cricothyroid Enterial braich of superior laryngeal nerve (X), Q2.Direct and consensual light reflex lost In which merve palsy Trigeminal B, Occulomotor Cone Ans, B.Oceulomotor on one side: (Ex Leftaculomotor lesion) ‘The ipsilateral direct reflex is lost (Example: when the left. ‘eye is stimulated, only the right pupil constricts) The ipsilateral consensual reflexis lost (Example: when the right eye ts stimulated, only the right pupil consoricts) ‘The contralateral direct reflex is intact (because light shone {nto both eyes ean still signal to the beain, and the pupil on the undamaged side will still be able to constrict via its ‘normal oculomotor nerve) ‘The contralateral consensual reflex is intact (because light direct reflex is ost (Example: when the left tod, neither pupil constricis, as no signals ‘from the left eye due to its damaged opticLEN ej pa ee ‘The coniatitera direc reflex is intattbecause ight sbooe nto dhe right eye can signal to the ‘bevin, CHEERS ‘enstrcton of both pupite via the normal ocalomatar nerves) . ‘The contralateral consensual reflex it lost (because Pee shane into the eye on the dag se ane signal to ‘brainy, therefore, despite the right palhway (optic nerve} ofthe Kft eye) ‘A. Direct and Consensual Light Reflexes : tag shone ao one, pop ob femal coneric T eNO ap shooe is called the direct igh ffl: the enstiston ofthe opposite pop, even though no Tigh consenaul ight reflex The alfeent inmpolss travel though the ope serve, optic chisems ang gu umber of fibers leave the optic ict and synapse on nerve cells ithe pretectal nicleas, which 25 ‘colliculus. The npulies ar pasied by axons ofthe pretctal nerve, ces 10 the auele) of etn eras nerve, on both sides. Hers the fibers syzupse and the thi cranial’ nerve, othe liar ginglon inthe orbit. Filly. postganlioni parasympathenic ciliary nerves a the eyeball andthe constrictor pupils muscle ofthe irk. Both pupils constrict in the consensual light reflex becatse the geetectal nuctens sets fibers to tv, ‘om both sides af the mirain Theft ht ese mein lie le he irr pa commissure me 1B, Accommodation Reflex + Wen the evek are deected from a diane & nedr object contraction -of the medial rect! brings aboag earns she fens hen fo rete i refractive power by eotiraction of the elias: and gh, Pg restrict the light waves to the thicket central part ofthe lens Prt cst Q3:The nerve supply of tenser-vell palstini 6? Sy A. Pharyigeal plexus BINH None © Von Nerve D. Vit Nerve Amc vag | Vescar swept Tenercstin! ~The blood sony of eso vel palatal is derived fim the | + "The motor tnertion of tensor vel pate ‘seznding plane banc f he fal acy ad tbe | from the mandibular nerve via te as td greater palatine branch of tho maxillary artery, ei uhh branch of TRUCE anos ‘Gran antiom the enatomiea Bass of linke prac dh | the development ofthe muscle from the rat ne a j “A thin, fibrous palatine aiponeuross Jeppors the tates sergthons the sf late: ie x tached tthe poser bode by inferion sfc ofthe hard peta behind be palate crest; ris thick nthe anterior 23rd of che if uate bor Very thin forthe ak composed of the expanited tendons of the tensor vel palate” Soft patate has 2 parts : Anterior & Posterior A). Anterior part Posterdor part: = Ismore horizanial in postion id Mee mote ~ Less mobile Palatine aponeursis: = Made mainly of palatine aponeurosis - Lsmrcotiqa’y = 415 the chief area acted upon by the jensor vel palatine ~ Abundant mucous glands Has abundant mocous glands Blood Soppty >vcampete denture sould sully be extn ty coey area ~ Greater palatine branch of of macllary artery vst cae : Acc palatine ranch of facial artery 4 palatic > Palating branch of ascending pharyngeal artery evaor vei pli N eg ‘Velns: pass to plerygoid & tonsilfer plewus of veins. i palalonharyngels Lytmphatics: drain into upper deep cervical and ‘etrpharyngel nodes. pnervation of palates | ‘General sensory + greater palatine. (hard 1 Case palin (900 plat) ay Nasonatine (Region ofan ule) \ nadia, fila loepharyageal nso gen enor arch | Sensory branches to soft palate i (seerelomotor) : Lexscr pala es i + Lenser palatine nerves, fottmay ¢ Superiore salivary nucleus ——->Nervais ‘Prerygopalatinc ganglion ———sLessey Eicine > Greaicr petrosal nerve ({heial nerve) ‘ Se saan: fated we an ‘nenielate ganglion) ahwy Noes mbigous —> Coe nea eieas rey retina eee mandibular news) igi —— Pharyngeal plexus ACCESEOHY Nerve — Pharyngea! branch of vaneres palate: All re bracts of ehtemalearoid artery) a) Manillary a. : i) Facial. ), Ascending pharyngeal a. venous drainage: 0 plengsid plexus of wens, ZL0z ‘AON SIV pa anpser crease at Pest Gala lar as? ip syylomandibular ligament 'B, Masseteric Fascia G Deep envi D. Fascia ata ‘Ans. B Masseterie Fascia. parotid gland The ween the angle of innble abd te tp of sntoid proces the investing ayer song ad ps 1) enclose the tends to the base inp exten superiorly a the parotidomassetric faein and reaches iio the zygomatic arch. The desp Pa of hull between the styloid process and the ungle of mandi it is thickened asthe stylonsanlibular liga . Refie AUIMS May 2013 paper for more exptanations engrssve bulbar alt set, ith invovement of Nucleus Ambiguous whch wll ot be afte ‘k-Coadiae angio B. Parotid Clotinse muscles of aye D, Muscles of pharynx Ans. B, Parotid «The nysls ambi is. group of large mor newones stated dsp the medllay reticular formation. y Frestenda romaly sf up upper end ofthe vagal nucleus wile ent Kt eoaiquous with the nucleus of the spinal sccessory nerve. «= Fibes emerging from it pass dorsomedial, thon cuve laterally, Rosa res join the gleasopharynigeal nerve | Gata le in the wasn earl aceon nerve andar lib Yo he ‘pharyngeal constrictors, intrinsic laryngeal sruactes and strated muses of ve pause and upper esophagux(apten © & D) eal arynesl maeles are anervaed by elavely ree wows of els ners an Ales 5 Feones dat terrae he pharyax. He inthe imtenmediate ata, al pores tha nner the oesophagus end sof palate are ara ft eeivesconeobulb fibres basally and ix connected many Kin emt eas ‘Avis upper end, a small rtroacial ‘cleus intervenes between tnd the facial nucleus. 4+ Although the nucleus ambiguns bs generally rparded asa speci ‘einceral efferent nicleus, Hs also a repuled source of gener ‘vicera efferent fibres fo the Vagus. a2012 AIMS NOV. j (Genial somatic |Glossopharyngeal [To tigeminall ii [Glossoparyngea! |afeent femetia ce © [General veers [Glossophunrigeal ft nucleus ke [Glassopbaryngea! afferent jeanelia olicrias | || Spas vkerl|Glossopymgcal [To miele paca afferent feanelia olin [Inferior salivatory [From olfactory ‘nucleus reas, nueleus Hee] fi) Tilere [Rapudar i [Brachial Nucleus ambiguus [From procentral 1X |Glassopharyngenl (special visceral) gyrus © _fetterent lee eur & controls the Read rate. lx excitation reduces the heart vat: (Option A). A lrd Nerve B.IVih Nerve © Vth Nerve D. Vilth Nerve 50 siceus ambiguous WF nat eta FOOD ganda W weed wo floor ali6g) aOR Opa [srenumonay pathway second onder pltamergic neon the NTS exile the cholinergic meron nthe ew ambiguous hts ends projections te cada angio. This cardiac ganglion projets, a (Q6.Crdine dysrrythmis may be exused daring denial ertraction de to stimulation of Cranial Nervez olinersialy ty‘Function Opening in Skull [Silt penings ik cil ate of eel sion eel [Rites pper eyelid, tums eyeball upward ownward, ond medially; comtricty pupil [pccomnmodates eye Seri ori ise |Assst in turning eySball dewrpvant and laterally japerior orbital ware also. mucous enembrane of paranasi simises. ans pasal cavity ISkin of face over manila, wath Of wpper jan Yacous meinbrane of nose, the maxilary winu, fd palate icles oF mastication, mylohyoid, anerir belly i gaan, tensor vel palin, and tengor tyenpan} ‘of forehead slp, eels, and qr Tisure FForamen rolupdun Hrormen ovate kin of cheek, skin over mandible wnd side of Iv, teth of Bower jaw and. temporomandibutay jm; teens membrane of mouth and ante of tongue Lateral eetas tunel warns eyeball laterally jparioe abil frst IMusdies of face and iealp, sapedian rite fsb of dc and oye maces mira acount meatus, ecial canal} i foramen ctl gland, and glands of nose and palit Hine rom anterior twoathids of tongue, fo vor of mouth and palate jubaanndibular and sublingual salivary ylands, [From uircle and siccule nd vemiewcularcanals—finermal _scouste an and miovenient of head featus gan of Cont hearing Svlopharyngca maicle— Gute awallowing [gular foramen @ Parotid salivary gland ZOz “AON SIAIIY(encept tensor vel pati) Puglr formes es of a recs). and. ler roel domastold and trapezius muscles ies of tongue (except palaloglossis)Hypoglossa cay ing its shape and movement ‘Grays anatomy the anatomical basis of ctiteel proce ty jMuscl Qa) Facial nervels cated? ; 'A.Above SMAS and below paroidomassciric fscid 'B. Below SMAS and below parotidomassetric fascia (©. Above SMAS ond above pirotidomassetric fascia parcidomaneiic fascia Dae Ans. B. Below SMAS and below parotidomaset fag QA, (b) Facial nerve is located? ‘A. Above SMAS and below parcidomassetic fascia B, Below SMAS and below parotidomssetricfascis Above SMAS and above parotidamasstric fascia 1D, Between SMAS and buccal pad of fat ‘Ans. D, Between SMAS and buccal pad eit ‘In most ateas of the face, a disti plyin ate uickyng mening ys nM ein deep to SMA ts continous with the pan ewe! tho SMAS is fy ened wih ge ve in the nek However, where it overties the parotid gland tical oa impose, a dtine inthe ego of re, eee Yes, which means that clear sub-SMAS ple rnc URE branch le wader the parotdsmaseeic ae hich a whichis “The facil nerve ics dep tothe sxpctofte maja” ° NSMAS td isu he mee my below the SMAS, mScls Of the forehead and mid-fuce from the vein! Puotid Sapsule appears (9 component of the $ 10 Be continuous it ‘i ene psy I my be meal geen ie ‘with the fascia layerthe deep cervical fascia}, separated Fam ‘om i a itbyaceth ue stologcally, Shepard sai iy = ‘the lower part of the parotid capsule. Although ik evel rmcroscopleally theres litle evidence tigi on te bass of ros dnsection anid complementary hy pasar tele eso he ple of efi ac cee PR is, ort Sane pas ae epi faye of ibo-adipve ss: the supeteialm tes Fn saperiil odeep. thes ayers are the akin a subetaneoes ussuloraponeiotic system (SMAS); and the parotid masseteric fase plingual space fs separated from submandity i lar space 85 ngs an evihyoid Bhan stapayad (¢ submandibular space ‘D. Body of mandible a Ans. B. Fibres of mylohyoid = aa = a The a ‘$RN855 Af located below the Inferior borer of the rib beneath mylotyoi, in the G sapenbyoid spon he nek: The subnet pace lies beneath theca inte midi, between hemylohyold nels and z | the imag et Of sp evil sci 1s bounded ltcaly bythe vo errs othe digste maces The Y= ssbmentl ne commits ponerory wih wo sebmanifla spaces, = = The aba see Site beveen te ator and postr lie of he dg acl and communicates sve sobingl pce around the poseior ie horde myn 3 mf Grays anatomy the anatomical basis of clinical practice, 40th edition => The subline space lies ft Nao the ou above the ylohiyoid msc, and in somtigwous aro te edie: i semimunicates with the submandibular spaces. over the pobetor free bots of the siglahyokd muscles. helped by the sqbnandbvlarlrs stight extension ver this edge (aap) — I ee citrine | CS ix nfl welling he ehin eyioe. Surgical drags ~ This kind of rwsting ean also occur inthe localized | + Antibiotic therapy snovodontogeaic infections. + Treatment ofthe offending tooth. Boundary Gintea! Fearures ea ‘Anieforly he midline: vof | Mandibular anterior eth | + Painful swelling to the’) > Anubiouc Wecapy, raandible, posteriorly the submental aes + Eniniction of eidodoatie sajesior border of the + Occasionally dyspnea’ and’ | therapy to the offending tooth scb’maiey space und ysphagi, inferiorly by the myelohyoid mule Treatment SUBMANDIBULAR SPACE INFECTION SUBLINGUAL SPACE INFECTION Howndary: Subrassibular ot sulunitlisy ypace js bordered by thelowndary: Sublisyual space is situated above the foowiog sets jwbmandibular space. and. it ts bordered by. the edt) —Vyoplosus and diganuie musclen [ttowingstrctres ‘aratt—Supericial fusln and si Siperionb— cos ofthe floor ofthe mouth. $Sipeor'y—Rosterioc portion of hyoplowuy muscle. ferdorly—Mylobyoi muscle Conta Sbmandblarsalivary sland wn yop oe [Aner lareraly=Body of he ane Seureof nection: Infecse mandala ola Posteriory—ttyoid bone Clinica! Feanares |Medall»—Nedin raphe of the tongue © Sibenindibular ¥pace infection is the’ ion” coemén of all epace|Sourve of tfection infections inthe otofiacia gion. © Mandibular eth except second ad third molars © Fever, chilland anorexia, Jo Sublingual infections iy be transported from the ‘© Pain with swing near the angle ofthe mandible, submandibular spuce.‘ ¢ > a E i Submandibalar space infeston often results in iyeph denis submandibular Iymph node and. sialadenitis in the salivary gland ‘and submental spaces, and rarely to the fateral pharyngeal spaces. dysphagia. ‘im infections of the cmnial fossa oro the mediastinum. Treatment Surgical drainage Antibiotic therapy Treatment ofthe offending tooth Tracheotomy may be required in cases of airway obstruction. LATERAL PHARYNGEAL SPACE INFECTION © ° Infections trom the submandibular space may extend to the sublingl Involvement of the pharynx and the Inrynx may cause dyspnea and) Distant spread of infection from the Sutmandibular space may resull fn the| Clinical Features jo Swelling ofthe locr of the; lo. Airway obstructions in sey oe jo Dysphagia ae [o Infections can spread to [Treatment oad a jo Drainage lo. Antibiotic therapy REINO THARINCEAAE Cerra Lateral pharyngeal o parapharyngeal space is situated deep inthe neck and foundary ‘nfestion of thi space ofen trina fly Boundary Anterioriy-—Buccopharyngeal aponeurosis, Paro gland and pterygoid muses Posteriorly—Prevenebral fascia, Laterally-—Carotid sheath. Medially—Lateral wall of the pharynx. Source of Infection © Mandiblarhird mobs © Infection ofthe palatine tosis mastoid air cells and parotid glands © Infection may also come from the retromandibular space. Clinical Features: © Pain, tismus with fever and chill, © Dysphagia and dyspnea dao ivolvemce ofthe phar and arya © Infection from lateral pharyngeal space may spread to the} mediastinum via the prevebal asia Complications 2 Septcemia Respiratory paralysis © Thrombosis the intemal jar ein 2 Erosion of the intemal carotid ater. Treatment © Serpial deinage Antibiotic therapy Elimination of the primary source of infections: LAnteriorly Wal ofthe pharynx. |Pasteriorly—Prevertebral fascia, [lateraly—Laterl pharyngeal space ay [sheath [Source of Infection ey ‘© Maintenince of airway patency. Q.10.A1DS virus discavered in which years A. 1969 ©. 1994 B1976 D. 1983 ‘Ans D190 > In May 1963, doctors ot the Lnstitute Pasteur In France reported that they had isolaied a new vines, whic they suxgecstd me the cause of AIDS, Gallo's greatest triumph was the notorious press conference in April 1983 when be and the Seeretary of Hal = ———_—erovacan that a scientific hypothesis of j =, , ees i Le tpieonen ie aithy Calne mye ee sequences would be nationally accepts 2 ‘atthe sitme time to file together with his (eee ee ak e ‘with his employer the National Inte of Heal, fora Iuerave AIDS a sex outt Howe? 1983, Since Mi Sequence analyses proved Gallo'syinis from 1984 to be the same as the virus discov fy bi Nom 1 ONS Sis Meinl a8 sc is Virals jn. 1963 appeared tat Calo bod rediscovered os z Mpa heroes PO) * clency vis binds 19 macrophages having — Cd CCRS molec > va motecule (COMEDK 08) 2 ary to icon = Western blot test, (RCET 04) 4 j 2 Cor fecon, dfse bmaphedenopaity ina person whois eloncally wells wala sign of - POL Perssent Generlized at 1 sent) (COMEDK 09 rane ofimed ad detsed by—Revere ransrptane PCR (APG 0) and pi is the Be (beneen Infection and appearance of antibodies in AIDS (I isthe sero-ve injective stage) (AP? 7) eesmal none parttclae protel, Feading fo enhanced replication of HBV ax well ax HIVis —HibtAg (CBT 071 © salvar rote which prevents transmission of human inamuradeficiency virus via saliva is — Salivary leukocyte proteinase inhibitor (COMEDK 09 Clinical manifestations of AIDS may be clssifiedas follows — Grape Acie Infections | Growp-1l: Chronic Asympromatc Tfections Group-ill: Persistent Generalized fwesoosmononisTeosis. | It is the potentially most dangerous group and | Lymphadenopathy (PGL) ett. ‘eropositive individuals who are apparently healthy but | Unexplained lymphadsnopathy in 2 oF seis: ‘capable of infecting others. Patcot may have enlarged | more extringuinal sites persisting for Meningocncepbalits axillary glands as well ashematolegical and | more than 3months in the absence of any immunological abnormalities, concurrent illness or causative drugs. Group Opportunistic infections: = Mucocutancous infections: | ‘A Comitational diseases (AIDS-related Pneumonia or sinusitis: + Hepes simplex sampler: tis characterized by prolonged +Paeunioeystis carn’ preumonia + Herpes zoster inexlainedpyrena, chronic persistent + Crypiococcosis + Candidiasis anes, weightloss more than 10% ofthe + Mucoraycosis + Stapiylocoesus aureus. ervious normal body weight. + Toxoplasmosis + Histoplasmos B.Nawelie elses: + Pseudomonas aeruginosa &. Meningitis and encephalitis: sProgessive dementia, + Tubsrsulosis + JC-vieus (Jamestown Canyon + eningoencepaiis. + Suaphslecoccus aureus virus) + Sreplecoceus pneumoniae + Toxoplasmosis. + Haemophilaxigtuencae «Disseminated infections: , Gastrointestinal infections “Atypical mycobacteriass (diarritea): > Cryplococeosis + Crypiosporidiosis * Histoplusmosis “Tsosporiais: Giardia Oral candidiasis ‘Viral infections of oral mucosa + fiytiemaious, hyperplastic and | + Herpes simplex and herpes zoster-causing PPewlomembranoas (the last one | atypical and chromic leet, ‘© most common, among | + Epsicinbarr —virus—Cuusing hairy Bilder, Jeukoplakia * Esophageal candidiasis ‘+ Papilloma virus—Causing’ proliferative * Angular cheilitis fesions, eg Veruca vulgaris, condyloina Neurological disorders + Facial palsy ‘+ Trigeminal neuropathy + Paresthesia and hyperesthesia ‘Autoimmane disease + Thrombocytopenie purpura Systemic lupus erythematosus ‘Zh0Z “AON SWIIVthe follwing statements aT = Fragalis from clisical samples “QeL1 With reference to hacteriodes eae “a fncinaly een rom conventions A.B figs the most frequent EBB: Raps fe oF ‘Befragills's DIC are common in SE ee Sea a isis roca bacteriodet Brats eee ‘Ans. D. Shock a The tipopliaccharibe 1D. Shock asd DIC are common in bactsioxes| [ile resistant non spore forming slender gram negative + (Often inlaid in int-abominal efoto, usally Interleukin (IL) 8, 1L-10- the cytokine inhibits of abucess formation, desruction! 7“ by acral may ebotes ee disrbeal disease “An enterotoxin hs been cae sae om ; . Sadan) that ae 10-100 toes Tess Bley potest dan Gautier sue snd purpura 2. jasc posses ipopoysaccharies (LPS, bacterieloner SS Se ‘in Bk x bacteremia -Q.12.Which part of bacteria not destroyed by distnfecion or sotsep Ned Pion D. Coccidia CC. Mycobacterium ‘Ans. Bri ver feat seco Prin pore> elie i> Pongo mire rg (Myebactr?Gmt ~pegatve bacteria Lipophille vi Grom pstve ctr”pons re fesisance to lost ll disinfectants excep high dose of sum eorite Cam (+ ve) baceraare most uscepable io alnox all discus {fevachlorophene ba ery weak disinfectant. Amos al the organisms arc resin ‘Sodium poco i he best isnt. fe guia al organism ineloding prions > 75 4s ] Paste Swath, Liquid paratin older Method-—— 63C for 10 Mines Ftand great, Alllassyringes Dusting powder [+ Flash nethod-—— 72 For 1S:20scennds Forceps blades “> il poorporing, -patbogems ch mysobacteria,brucela, smlmonetia are ‘Calin medi, Surgical struments except stamp | dosroyed Coxiella burnett rlatively heat resistant and insmuments, may arvve the holder method! 2 Peseta oa “Amoop he net rsan eels are spores of elastridhama botulism Also reevembers> (Asked in AIPG 2013) + Sterlization isa process by which wricle surfice or medium is fred of all living microorganism sither im vegetative or spore ‘nic —— Complete absence of micro-organisma > Disiatectae oc removal of all the pathogenic ongmisns capable of-gving se 19 jnfestion —— Recilom tn the. f tnkeroorgais osu a level ich deemed nofonger harmful heath a + Oven feat used To Menfize glassware and meal objec: | | open the seo cine microorganisms ‘Spores of clostridium tetani are used for testing the efficacy of dry beat ‘alocaving seize matin, Bandages, and any Kinds hospital aa istoratory equipment no damaged by heat and ‘moisture; pressure cooking sterlizes canned foods ‘Kills pathogens its milk, dairy products, and beer. Used to preserve some fults and vegetables; sotetmes wed with smoke to preserve sausages and fisti —— rule Denatures prone —aace whe tuner oF mcToRpan, ing oom iranstertd, es “sina go sterilize Plat preserve foods Removes water from Tac v9 pve TONE Se and plait age, ia! ‘ ‘animal rooms, and Sans of ood ach ap ao aie oan Pmreena vranufacruring Nascins, el 7 Mechanically removes alcathol, Benzatkonim | or henachlroptene 8) 7 are used Kill cicr0Ora in the form oF Thos erteotive i ‘Holding tempersture i Bacillus Holding 1emperatre | carbonate | clevate the boli pa “All uure material except catsut Rubber gloves, surgical instrume! Fad eificient vethod 20 min. under LSI pressere “| 1347C for 3 mio Spores ae not led by Bowie water even tn Soa {heir sharpness by repeating bo | instruments IO8E Feissorm needles Pinaableyingss 55 Fentibioties sokutions pes/Serum! ‘Operation theatres: Preparation ofthe atin a Filtration Fumigation wit formaldehyle re avon and Chlorestsive = ml I Fatah sere oF Coss baud pierilizer 5 assim te working lade: quickly through n aime: jeveral imi seca followed by double swath ‘with inetare of ther “sorbent pots, brooches, HES ‘Cotson pliers, cewie! Swabbing the ‘surface: Fi woo ype K silerifizer for 5326 sins by conslation id dentuaiy rearothermaphilus is used a control rite for Irtin, Followed by Fins Flame for 34 ties or bylnspissator. Tyadillaana Hintchets, “Corrosion sensitive you Or intermittent senieeation ios Gai Hes a je Foe 1% Seven ae = Soaking it Eyal 7 oly npression materials [71% Ghat << A$} ee Polyslphide, “Conlesstion and) a Sodas = Cree jeone apres materi cet ee Boonen to a ‘ube, Endoscopes, PE Cidex (295 Ghitaralachyiey Sai sO _ Fractional Setization pctaess eral Ray Ps pal ele Gata ays PRI Seale hypochionie a ARE “poculton oop of wirpibe tip of forceps and searing spatula Tag ana lah anal cateaies dnd pathological mod Tasco Gasmarssninges aides tabs Tasks surge insane Taurean fos care ei Atosirving of rabnnne Hite Sep Sectes0l oF hot ait oven is wero Savion jprocchossopesand oiler endoscopes.comuated Aber anesthe bea Gee | Glutaaldctyde eras eodtracheal tubes Fae aa Ee CU atocaving cat Toning radiation Tressnsaronk glows catheles area asramens eqcep aarp TENN ‘Autoclaving | conae wel cei Sein omar "Tyndaltation Frepucced items suoh as syringes and catheters Tnfraved radiation fieat sensitive cathetarsjwards fumigation laboratis.s1ck room operator heatures Formaldheyde gas or UV rays (qin At-cati.at pains viet inected cet ty? ‘A Expression of MHC Ln cell surface recepion {8 Non Expression of MHC Lon cell surface receptor (C-Expressin of MHC If om cell surface receptor 1D.Noo Expression of MIC lon cell ure reseptor ‘Ani. 8. Nom Expression of MHC on cell surface receptor ‘Groton T cells act mainly op virally tnfected cells, whereag NK cellcact mainly on tumor cell cells G7 tansplanied lseues, and osbty on cells infected wih intracellular agents such wt chess ar! chamnydins. Each kindof Miles eal acts by 8 iteeat nechanism, CyoticT cells bind to antigen preseted by macrophage andthe attack virus-ndsted cell, fa contrast, NK ces iad dtetly to malignant oF cher target eels without the help of mactophages. Ifo target cell Tacks certain proteins, (major ‘isoconpatbilty Comples— MHC I), the NK cell will auomticalty tack and kil [NK cats ave unique specificity, To avoid atacking normal oat Cells, NK cclls expteda inhibitory eseplots thst recognize vel list MHC molecules, wtih are expressed of all healthy cells; enaement ofthese inhibitory receptors typically overrides the scivaing receplors and thus prevents actvaton of the NK. cells. Infections. especially: viral infections) aid stress ‘re associated ‘wih os of expression of class MHC molecules. When thi happens, the NK cells are released ftom tit ibibition and are able to ‘espn othe activating ligands that were ndiced bythe seas and ultimately dest the unbealty bost cls, ‘References:Robbins Pathology Reerencencttottine Patnotony TT aoe nowsmn D &EYES i rT fintry preset in ens ak for marmal amt o iby? nel: "y ‘B Anchidonis aed “© Linoleaie acid D, Decaishernni 8 ic ac ig found inhuman ile and bea ipl 208 required for nerves system and visuay ‘ ical the auibitic Piperaclin all are trae EXCERT? wa q Ans, C. Not effected of destroy, oe in (PIPRACIL) ext = SRT ROA AF a lctamase-producing), many Bacteroides spp and Efoeesls eS combination with a Aactamase inhibitor (prin tazobscam, ZOSYN), It BAS the broadey properties are reminiscent ofthe other sureidopenicilfins. High biliary concentrations are achieyey, “THERAPEUTIC INDICATIONS Piperacitn and relied agents ar important das for the ream of FIO infections caused By gram infections ccna inte hos tg | Petypentides like Polymycin B aid Cols ia “et Colitin is mare poteot aint Selune Bein sabato nce: Same ‘a Partial agaist llc arectly 9 ¢ Aneonist peste {adie to sctivie then ke Inet ponige dont 3 Chemica Cat Binds ys ey Ass AY rurally Occuring Substance, C0 cel ad iggen sy a locks the act Mook by that ei, y ee abe cls eee gs Amis fen mime the sein of a : ere ant 5 Ein same ese Pill cay wt enn efroceptons Hnverse Agonists exert the sat bindings as satis eran pelaalie era Pst hires elo expen reverses cet ace) acing fo 0 SHE he aeons wig, Dich susie) “ome: Mark aswer ANTAGONISM ANTAGONISM Antgoniom describes the sition, when ‘ne drug decreases or inhibits the action of COMPETITIVE ANTAGONISM fn competitive antagoniem, tht | The effects. of competitive smgonst bcd withthe sare receptor | artagoniss ean Be evereme by asagonat. If the fog dose response curve opposite tbose of the-agonis A classo example vw agonist is obtained in the presence + the functional antagonism by episephrne 10. of aniagoaist, it sill be found that fisamine, induced troochocoosition anagonist bas 90 effect of it own, and Hissenne binds Yo H histamine rvepies oa there is parallel rightward sift inthe | or with very high afiniy to the | tmonchinl soot muscle, casing contraction, ose response cane of agonist wth no| aetive site of the reeepior reversible ammagooist), This ineverbility in binding wo the setive se reduces the amit of receptors avaiable setnely ein This funcional anagorisa s also known as *Shysiologe etagonism.~ A chemica} satagonsmn are: tobe agonist snags prevent heats ofan ages by = Aceycholine (a3 spins) — rmodivingorsooestenng the ago 0 that ts cs satigie incapable of binging wo aad actnatng a2 sate reel. 1 soprenline— propanolTARGET MDS AlIMS blood train barrier? B:Neiimice D. Ceftazidime Q.17 Drug which docs not crosses A Penicillin ©. Clindamycin The penicitiny and metronidazole have che sAYS80E a Clindomyein, on che other hand, does RO! om metronidazole or ampicilstbactem when there is Few cephalpoporins ae abe to eoss the blow In addition, veftndizime is effective against the Nitropisside cts by releasing activates the yuan eyelasa-eyelle-GMP-PRG patie leading to vasodilation. ‘The mechanism of release cf NO! likely. 1m ‘enymatic and nonenzymatic pathways. Tolerance does not develop io nitropusside Nitroprustide diltes both, arterioles: and, venoles; the hemodynamic response results from 4 combination of venous pooling and reduced arterial impedance. In subjects with ‘normal left ventric function, veneas pooling afecs eartise ouput more than does the redictin ff aftertoad; cardiac ontput thus tends to fall. la patents with severely impsired lefi veninculae function and ‘diatolic ventricular distention, the redction off arts ittipedaaiee leads 10 a rise in cardiac output « “Sodium nitroprusside is used primarily to weet hypertensive emergencies but can also be used ix many situations when short-term reduction of cantie,pretoud andlor aflerload is desired Goodman And Gillman Page 574 AIIMS NOV. 2012 wolves boi QU9.Antl-Diabetic drug to be stopped prior to surgery under GA: ‘A. Metformin B, Piogl © Glibenclamide one Hond-braia bar a Bh ofan adage fee” the renal ang PM, ec ant en mi AE Sag “a rain barrier when the meninrey Therefore, ib approprice gk thd enero eopbalsperins sachs etapa, TA S (0.14, Drug most commonly associated te treat bypertest® ri B Hydralazing A te sf eee hypertension anc Per A no ai Diapenide + piatoxide (HVPERSTAT IV) is used in the tees Prpetnave emereccies only icant lage 3 arent valabe ander lose monitoring agp 2 DOPAMINE Dopamine bas United wiley in he eames of ma patients with cardiogenic circulatory Giilure. AL low doses (& igky Sean body mas per minute) DA coum vasodilation by maltingGLP is wally secieted when food eilers stomach dt ‘essa ty DP ahd a be wad in treatment of DM ; “ ‘gan Set re aboat Metformin: A. Excreted unchanged in. une Decreases hepatic wlacove formation this cellar respiration specially on mitochondria 1, Case ven inpatient with detompersated hen dseae ‘Ans. , Can be given ia patient wth decompensated heart disease ‘Metformdg, tori i ibyperglyeemic, not hypoghycemic. I ews ln release fom the pancreas ant gene 6c no case hypoglycemia, even io Lge doves: Metformin reduecy gluco levels primarily by decreadng. hepatle glacore production and by iacreabing inulin action in missle atid fat These aedans are ited at least partly by activation of -atPacthated protein kinase (AMP kinase The mechan by which wetformin rics pale glace producto I controversial, burl most data support an effect on reducing glucomeogencsts. - Goodin ond Gillman page 1053. Pa wi al pire Nou ho Teceive metformin Olher eanimindieaions ache hepatic disease: x Nstory of lacie ‘sido, cada fjlre regaining dr thesapy, or chron hypatic ang discus, These condivons al predpese ao the potentially ‘nit complication of Ince acidosis. Metforinin should be discontinue temporarily poy to the administration of | cox ee id pre any sara proved. ‘The drug hou not be reds ny oct than 48 hour fer such pds id ald be hed wen ution bs deemed ta be socal ofa ta Remeber: + Medormin docs not promt weight pun ab en edie pbaima goes by 1-0 > Meri the oy dru that has been demonstrated to redce macrovascular evens bh type 2 DAI. —_ Mecforinit can be administered in combination with sulforjluréis, thinmlitinediones, and/or insula: ZL0Z ‘AON SINIIV21 Antibiotic associate with Collis? ‘ (O71 Antibac wit ease ©. Chindaesyeiy pM = Ae ne apes of aserbic Na jg Clindaiyein and it sete bile metabolite, Name} ena r persis n the stool for 5 day. BM ‘Aor Complications. antibiotic aoe cli Anianrobial CLINDAMY CIN ven AR a Ft ac asad ess pres 111i Tichtor-Fateneyliaconycin, « semiynititic Jers = ocernycin. We inti most of the jam pokive cect = Streporcece), sciphylocecci and paewimcacci, C. diphtheria ‘Aciionyoes, Neca ad Toop. ‘1 is wsed in the eatnent of vevete anaerobic infbctoen cased ‘by bacteroides and enher anaevobee. I alia uned in combination inisopyeoide ibe sine of abdomen si GT aioe? ‘wounds. infections of emule genital inst ple sbicesies, eae ‘opition pore nd sp sbortiok Fenty Te ai wed for propbysi Sole oa an long wi plate in Paewicyath Ea peal Shai . ADS fle pn eas Incr th DNA, tracy ‘Geal abscopton 4 poo Mt i largely messbolied an metabolites stk ou tidevading, is AIIMS NOV, 2012 ae crete i tine nd le ‘Mets effet inhi pai tintin aie somali, oni m seen me chewy sem kes, veri, mtan, whe | 7) Avdietablite Sein, Ausoia: Hypotension and eandise arrest aller api 1V. wwe INH, ethambutot, Avofesa, metic wits, ccxpbap shania pit Prtimethimin. (0:22. Hepatit is ayociared with 2 ‘A. Chrone lve fire BCs Ava ive tare Acute et lise Te eas a6 Ge toa 5h aT ec he ae Rr ea ee iti Re sone marta vag ies Scat fli: peat wor, eapeealy set he Meee, Sue an vad ay fri dat oreo Hepatitn E is usally self aiding tout msiy develo inte Femina cute live fhitung) Z a