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20.HH
Merkel cells or Merkel-Ranvier cells are oval receptor cells found in the skin that have synaptic contacts with somatosensory afferents. They are associated with the sense of light touch discrimination of shapes and textures. They can turn malignant and form the skin tumor known as Merkel cell carcinoma.
There is evidence that they are derived from neural crest
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21.CC
common causes of meningitis-
0-6 month
1-GBS
2-E-coli
3-listeria
6mths - 6 yrs
1-strep pneumonaie
2-neisseria meningitis
3-H-influenza B
4-enterovirus
6-60 yrs
1-N -meningitidis
2-enterovirus
3-S-pneumonniae
4-HSV
above 60 yrs
strepo pneumoniae
gram neg rods
listeria.
posted by drona99
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22.CC
Chronic bronchitis
Airway clearance indications associated with chronic bronchitis include:
Mucus hypersecretion: In the normal lung, ciliated cells line the epithelium from the bronchioles to the trachea. A thin mucus blanket covers the cilia, which beat in a coordinated fashion, propelling mucus toward the pharynx. This mucociliary escalator serves as the primary defense mechanism for the lung, trapping inhaled particles, transporting them out of the lung, and maintaining a sterile environment. Mucus hypersecretion overwhelms the mucociliary apparatus and results in secretion retention.
Impaired mucociliary apparatus: If the mucociliary escalator is impaired, inhaled particles and bacteria are not adequately cleared from the lung. The resulting irritation can lead to additional secretion production initiating a vicious cycle of mucus obstruction, recurrent pulmonary infection, bacterial colonization, and progressive pulmonary compromise.
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23-B- Alveolar ventilation=(Tidal volume-Dead space)xbreath per min
(550ml-150ml)x10=4000ml=4 litres/min
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Hi alco,thank you for posting the answer
24.BB
Spherocytosis is an auto-hemolytic anemia (a disease of the blood) characterized by the production of red blood cells (RBCs), or erythrocytes, that are sphere-shaped, rather than bi-concave disk shaped. Spherocytes are found in hereditary spherocytosis and autoimmune hemolytic anemia.
It almost always refers to hereditary spherocytosis. This is caused by a molecular defect in one or more of the proteins of the red blood cell cytoskeleton, including, spectrin, ankyrin.
Spherocytes have a high osmotic fragility--when placed into water, they are more likely to burst than normal red blood cells. These cells are more prone to physical degradation
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@drlove,Thank you
25.CC
Papilledema (or papilloedema) is optic disc swelling that is caused by increased intracranial pressure. The swelling is usually bilateral and can occur over a period of hours to weeks. Unilateral presentation is extremely rare.
Papilledema may be asymptomatic or present with headache in the early stages. However it may progress to enlargement of the blind spot, blurring of vision, visual obscurations (inability to see in a particular part of the visual field for a period of time) and ultimately total loss of vision may occur.
The signs of papilledema that are seen using an ophthalmoscope include:
venous engorgement (usually the first signs)
loss of venous pulsation
hemorrhages over and / or adjacent to the optic disc
blurring of optic margins
elevation of optic disc
Paton's lines = radial retinal lines cascading from the optic disc
Checking the eyes for signs of papilledema should be carried out whenever there is a clinical suspicion of raised intracranial pressure, and is recommended in newly onset headaches. This may be done by ophthalmoscopy or slit lamp examination.
Causes:
Raised intracranial pressure: brain tumor, pseudotumor cerebri or cerebral venous sinus thrombosis, Intracerebral hemorrhage
Respiratory failure[1]
Hypotonia
Accutane (Isotretinoin), which is a powerful derivative of Vitamin A, rarely causes Papilledema.
Hypervitaminosis A, in some people who take megadoses of nutritional supplements and vitamins.
Hyperammonemia, elevated level of ammonia in blood (including cerebral edema/intracranial pressure)
Guillain-Barré syndrome due to elevated protein levels
Foster Kennedy syndrome (FKS)
Chiari Malformation
Tumors of the frontal lobe
Acute Mountain Sickness and High Altitude Cerebral Oedema
Lyme disease (Lyme meningitis specifically, when the bacterial infection is in the central nervous system, causing increased intracranial pressure).
Malignant Hypertension
Medulloblastoma
Pathophysiology:
As the optic nerve sheath is continuous with the subarachnoid space of the brain (and is regarded as an extension of the central nervous system), increased pressure is transmitted through to the optic nerve. The brain itself is relatively spared from pathological consequences of high pressure. However, the anterior end of the optic nerve stops abruptly at the eye. Hence the pressure is asymmetrical and this causes a pinching and protrusion of the optic nerve at its head. The fibers of the retinal ganglion cells of the optic disc become engorged and bulge anteriorly. Persistent and extensive optic nerve head swelling, or optic disc edema, can lead to loss of these fibers and permanent visual impairment
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26.DD
Rh antigen transferred through placenta in the maternal circulation during the process of delivery is neutralised by passive iso-immunization (anti-rh antibody) and prevents sensitization by mother to Rh antigen., resulting in no complications in her future pregnancies due to incompatibility!
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27.BB
ALPHA AND BETA RECEPTOR SITES:
Alpha-receptors are associated mainly with increased contractibility of vascular smooth muscle and intestinal relaxation.
Alpha-receptorshave been classified into two types:
Alpha1. receptors are located at the postsynaptic effector sites to stimulate transmitter release in smooth muscle (that is, contracts smooth muscle of peripheral blood vessels.
Alpha2. receptors are located presynaptic on axon terminals to inhibit release of transmitter (norepinephrine).
Beta Receptors.
Beta-receptors are associated with vasodilation and relaxation of nonintestinal smooth muscle and cardiac stimulation.
Beta-receptors aredivided into two types (example: bronchial dilation).
Beta1 receptors cause cardiac stimulation and lipolysis
Beta2 receptors cause bronchodilatation, relaxation of bloodvessels (usually skeletal muscles), and muscle glycogenolysis
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