Thoracentesis / Pleural Puncture - OSPE & OSCE for MBBS/CBME/NEXT -

What is this procedure? and why it should be avoided below the level of 6th or 7th intercostal space?Thoracentesis/pleural punctureIt’s usually done dorsolaterally on the posterior axillary line or scapular line . Puncture below the 6th or 7th intercostal space should be avoided prevent to the liver or spleen injury.

Simple MCQ's

SRQ: simple recall MCQ for FMGE/MCI screening 002

Q: All of the following viscera are supplied by a branch derived from the internal iliac artery except a.            The rectum b.            The testis c.             The urinary bladder d.            The cervix of the uterus   Answer : B. The testis is supplied by the testicular artery, which is a branch of the abdominal aorta. The cervix and the body of the uterus below the fundus are supplied by the uterine artery, which is a branch of the internal iliac artery. The rectum and anal canal are supplied by the superior rectal artery, which is the direct continuation of the inferior mesenteric artery, and by the middle rectal artery, which is a branch of the internal iliac artery. The anal canal is also supplied by the inferior rectal artery, which is a branch derived from the internal iliac artery. The upper part of the urinary bladder is supplied by the superior vesical artery, which is a branch of the internal iliac artery, The lower part of the urinary bladder is supplied by the inferior vesical artery in the male and the vaginal artery in the female; each of these arteries is a branch of the internal iliac artery. 

Case Based Questions

CBQ: Case based MCQ for FMGE/MCI screening - 002

You are asked to see a 52-year-old woman with no prior medical history admitted to the neurosurgery service with a nontraumatic subarachnoid bleed. She was just placed on a ventilator, and an urgent craniotomy is planned. Based on the above ECG done 2 hours earlier, what would be the next best step before proceeding to surgery? A. Echocardiogram to assess for right ventricular hypokinesisB. Repeat ECGC. Look at the chest x-ray to confirm a congenital heart abnormalityD. Stress test to assess for significant ischemiaThe answer is B: Repeat ECG. This ECG demonstrates sinus tachycardia with apparent right axis deviation. However, make note that the predominantly positive precordial P waves appear to support a sinus mechanism from the high right atrium, but the negative P waves in I and flat P waves in II do not. This suggests limb lead reversal. With right arm–left arm lead reversal, as in this case, lead I is inverted, leads II and III are reversed, leads aVR and aVL are reversed, and lead aVF is unchanged. Right arm left–arm lead reversal is one of the more common reasons for right axis deviation, and assessing the P wave morphology as explained helps distinguish this. This abnormality needs to be distinguished from rare dextrocardia, which can also produce these limb lead findings. However, the precordial leads would show a lack of normal R wave progression as the heart would be in the other side of the chest. A. Despite what appears to be right axis deviation at first, there is no evidence of right ventricular hypertrophy or enlargement on this ECG, and therefore echocardiogram is not indicated.C. As the ECG pattern is most consistent with limb lead reversal, the chest x-ray is unlikely to be helpful unless there was a lack of precordial R wave transition in which dextrocardia would be more likely.D. There is no role for a stress test in this patient who has an urgent noncardiac surgical indication.

Case Based Questions

CBQ: Case based MCQ for FMGE/MCI screening - 1

Dilip raj, a 44 years old man with a long history of chewing tobacco underwent a tonsillectomy procedure. Following the procedure, he is unable to detect taste on posterior one-third of his tongue. Which of the following nerves has most likely injured?a) Lingual nerveb) Glossopharyngeal nervec) Greater palantine nerved) Chorda tympaniAnswer= B• Posterior one-third of tongue receives both general and taste innervation from the lingual branch of glossopharyngeal nerve• General sensation of the anterior two-thirds of the tongue is due to lingual nerve• Taste sensation of the anterior two-thirds of the tongue is due to chorda tympani

Image Based Questions

IBQ: Image based MCQ for NEET

A child is taken to the doctor because of a 2-week bout of abdominal discomfort and diarrheic stools. A fecal concentration reveals scores of bipolar eggs like the one shown, indicating a heavy parasite burden. Which of the following complications might occur if the child is not treated for this parasite? (A) Asthmalike manifestations(B) Blockage of the duodenum(C) Extraintestinal infection(D) Prolapse of the rectum The answer is D: Prolapse of the rectum.  Oftentimes light infections of the human whipworm (Trichuris trichiura) are only treated palliatively; however, a child who is symptomatic and who harbors heavy parasite burdens should be aggressively managed. Failure to treat with an anthelminthic could theoretically result in rectal prolapse. Hypochromic anemia is a possibility, but pernicious anemia (the choice here) refers to the broad fish tapeworm, Diphyllobothrium latum. The human whipworm is small and resides in the large intestine, which would eliminate choice C. Intestinal obstruction anywhere in the intestinal tract would be highly unlikely. The juvenile worms have no pulmonary phase like Ascaris and hookworms. Again, the adult worm resides in the large intestine and occasionally the appendix.



The Poison of which snake family can elicit such a reaction when added to the blood sample?Viperidae (vipers)Hemotoxins (serine protease) called Batroxobin. Batroxobin is closely related in physiological function and molecular size to thrombin    therefore causes clotting of the blood.

Simple MCQ's

FMGE Simple MCQ of Day - 001

Structure passing through foramen spino­sum is ? a. Accessory meningeal artery b. Middle meningeal artery c. Mandibular nerve d .Maxillary nerve Incorrect The correct answer is: b.  Middle meningeal artery The foramen spinosum transmits following structures : Middle meningeal arteryMeningeal branch of mandibular nerve (nervus spinosus)Posterior trunk of middle meningeal vein.        (Ref.  Gray’s Anatomy, 40th Edition, Vol.  3, Pg.  414)