DNB CET REVIEW 4TH ED ERRATA VOLUME 1, 2013 SESSION 2, PAGE 359, Q 646 Q 646 Buschke’s ollendorf sign is seen in? (A) Gonorrhoea (B) Congenital Syphilis (C) Secondary Syphilis (D) Herpes genitalis ANSWER: (C) Secondary Syphilis REF: Text book of sexually transmitted diseases 2nd ed P-205 Explanation is correct VOLUME 1, 2013 SESSION 2, PAGE 207, Q 281 Q281 Sumatriptan is agonist of? (A) 5-HT 1A (B) 5-HT 1D (C) 5-HT 2A (D) 5-HT 4 ANSWER: (B) 5-HT 1D REF: KDT 6th ed page 164-171, Harrison’s 18th ed ch: 14 Indirect Repeat Pharmacology 2012 Session 1 (See for explanation) See APPENDIX- 106 "SEROTONIN RECEPTORS" VOLUME 1, 2013 SESSION 2, PAGE 129, Q 94 Q94 Free water clearance of 1.3 ml/min signifies? (A) (B) (C) (D) No secretion of vassopressin Urine is hypotonic to plasma Urine is hypertonic to plasma Urine is isosmotic to plasma ANSWER: (B) Urine is hypotonic to plasma REF: Guyton 12th ed page 354 Explanation is correct VOLUME 1, 2013 SESSION 2, PAGE 13, Q 105 Q105 Calcitonin causes all EXCEPT: (A) Decrease new osteoclasts formation (B) Reduce plasma Ca2+ concentration (C) Decreases bone mineralization (D) Reduces absorption of calcium ANSWER: (C) Decreases bone mineralization REF: Guyton’s physiology 12th Ed page 966 Explanation is correct PAGE 894-895 VOLUME 1 Missing color plates PLATE O-19 PLATE O-19 KEY HYPERTENSIVE RETINOPATHY The appearance of the fundus in hypertensive retinopathy is determined by the degree of elevation of the blood pressure and the state of the retinal arterioles. In mild to moderate systemic hypertension, the retinal signs may be subtle. Focal attenuation of a major retinal arteriole is one of the earliest signs. Keith and Wegner classification of hypertensive retinopathy Stage Description Hemorrhage Exudate Disc edema Grade I Subtle broadening of the arteriolar light reflex, mild (A) generalized arteriolar attenuation, particularly of small branches, and vein concealment. Grade II It comprises marked generalized narrowing and focal (B) attenuation of arterioles (increased light reflection) associated with deflection of veins at arteriovenous crossings (Salus’ sign- in boxes). Grade III This consists of Grade II changes plus copper-wiring (C) (insat) of arterioles, banking of veins distal to arteriovenous crossings (Bonnet sign), tapering of veins on either side of the crossings (Gunn sign) and right-angle deflection of veins (Salus sign). Flame-shaped hemorrhages (white arrow), dot blot hemorrhages (blue arrow), and hard exudates (black arrow) may be present Grade IV This consists of all changes of Grade III and papilloedema. (D) Plus silver-wiring of arterioles can be seen (insat). Sometimes star shaped hard exudate around macula (macular star in circle) + PLATE O-20 PLATE O-20 KEY + + + + + Vernal keratoconjunctivitis is characterized by giant papillae (diameter > 1 mm) on the superior tarsal conjunctiva, giving a cobblestone appearance. The papillae causing cobblestones in vernal keratoconjuctivitis have eosinophil. More common in summer; hence the name spring catarrh looks a misnomer. Recently it is being labelled as 'Warm weather conjunctivitis' Palpebral form The typical lesion is characterized by the presence of hard, flat topped, papillae arranged in a 'cobble-stone' or 'pavement stone', fashion         Bulbar form Dusky red triangular congestion of bulbar conjunctiva in palpebral area Gelatinous thickened accumulation of tissue around the limbus; and Presence of discrete whitish raised dots along the limbus (Horner Tranta's spots) Treatment is purely symptomatic. The irritation is best relieved by cold compresses, antihistaminic eye drops & the topical instillation of steroid drops 4-6 hrly. After a few days, the acute irritation usually subsides & thereafter, a maintenance dose 3 or 4 times a day along with topcal mast cell stabilizing agents during the seasonal period of activity generally keeps the symptoms in check. Mast cell stabilizers such as sodium cromoglycate (2%) drops 4-5 times a day are quite effective in controlling VKC, especially atopic cases. Olopatadine is a new mast cell stabilizer that is prescribed twice daily. Subtarsal injection of triamnicolone in severe cases may be helpful. As the symptoms & signs subside, topical steroids can be tapered off & discontinued, & mast cell stabilizers continued. Chronic steroid usage may lead to the patient silently developing steroid-induced glaucoma, or bacterial or fungal corneal superinfections which are all potentially blinding conditions. Hence steroids should be always for short periods, & hence should always be under the guidance of the ophthalmologist. Antibiotics are likely to cause an allergic reaction. Acetyl cysteine 20% can be used for the treatment of sticky mucus production. Cold compresses & tinted glasses are of help. Cryotherapy of lesions may be considered