 Hello everyone, I am Dr. Anand Kumar Sharma, rank 62 CSE 2018, optional medical science and my score was 316 in 2018 CSE. As we discussed in the last video regarding the sources and the strategy of medical science. So, we will be continuing in this video with the answer writing strategy and also the last year's paper. We will be going section wise like anatomy, biochemistry, physiology and discuss the question as well as how to approach the questions with respect to each section. So, let us start with the first section that is anatomy. Anatomy has three portion, general anatomy, embryology and neuroanatomy. Each portion has to be subdivided into three part while writing the answers like the headings as demanded in the question. Each heading has to be supported by a diagram and clinical anatomy with respect to it. Similarly, in embryology, headings, diagram and clinical embryology, a neuroanatomy also headings, diagram and clinical neuroanatomy. So, let us start with the question like first question is discuss the functional component nucleus, cores and distribution of fourth cranial nerve at a node on its clinical significance. So, in this question about the trigeminal nerve, you have to write the headings like functional components, then the nucleus, the cores and distribution. For each headings like for the functional component, you have to draw the diagram. For the nucleus also, you can draw a diagram or schematically show that which is the general sensory afferent, the special sensory afferent, special visceral afferent that you have to schematically can show by drawing the boxes. So, for the cores, the cores you have to draw the diagram, better to draw the diagram for the cores rather than writing the cores. If you can draw a diagram showing that from where it originates and how it goes and how it supplies to the various aspects, then you can do it by that. And also the distribution which part if it is supplying, suppose if it is supplying the phase, then you could show the part of the phase, which part of the phase it is supplying. So, for that you can go the diagrammatic. And what generally happens is, sometimes they do ask the question, add a note on its clinical significance, they have already asked in this question, sometimes they do not ask. So, even if they are not asking on the clinical significance, you have to write it without even asking. So, if there is now they have specifically asked, you could write about the clinical significance. But if they have not asked, then also you have to write about the clinical significance of the specific nerve or any other part. Suppose there is a question on ventricles, then you have to write about the hydrocephalus, how the ventricles or suppose there is a question about the CSF flow, then what is the diseases caused by the obstruction of the CSF flow or what can happen when there is a change in the CSF morphology or anatomy. So, that is how the neuroanatomy part you have to approach. Then similarly there is a question on classify arches of foot, write in details about the medial longitudinal arch. So, for classification you can draw a simple box and write about what are the medial longitudinal arch, lateral longitudinal arch or the transverse arches, the arches you can draw and similarly that details about medial longitudinal arch. For details you have to draw the diagram, without diagram you cannot explain it. Let us start with it like the force, this is the foot, this is the medial aspect of the foot, this is the medial longitudinal arch. Then how is it formed, what are the structures which comprises the medial longitudinal arch, what are the structures which has formed. Then similarly here it is not asked that what is the clinical significance, but you have to write. You have to write in the sense that if the medial longitudinal arch then there is a concept of flat foot, that how flat foot happens, there is a formality in the medial longitudinal arch, then flat foot can happen. So, in this way you have to mention about the clinical anatomy of the arches of foot and the medial longitudinal arch. This is one question on neuroanatomy and general anatomy. Then similarly there is a question on embryology regarding the placenta. So, the question is write the development of placenta, discuss the functions and anomalies of it. So, question number 4C part 1. So, write down the development of placenta, discuss the functions and anomalies of it. So, in this question there is a two approach. One some people write in a flowchart manner that how to approach the development of pressure step by step writing about the flowchart or some write in a theoretical manner. I think the better approach is to go by the flowchart and each step of the flowchart has to be supported by a diagram, so that you can explain that how the developmental is happening. Draw a flowchart only of diagram that will suffice, but diagram is necessary. Write about the functions of placenta, there are five functions given that a help in exchange to provide immunity. So, write all the four five functions which is given and then the third portion is anomalies. So, anomalies if they have specifically asked even if they haven't asked then you have to write about it. Anomalies don't have to explain every anomaly. Write just draw a diagram of the anomaly and write which type of anomaly it is. Suppose there is a placenta preview, then just draw the diagram. Then there is a placenta section area, then draw the diagram. So, just draw the diagram and that will suffice because the seven mark question. Had it been a 20 marks question, then you would have to explain each anomaly and then draw the diagram. So, when marks only two pages will be there, you won't have sufficient space. Just draw the diagram and that will suffice. Similarly, the next question on is about describe the coronary arteries and add a note on cardiac dominance. So, for this the coronary arteries for start with it first write all the coronary arteries which are there. After you have written the coronary arteries, write about each coronary artery which supplies to which area and then draw a diagram of heart showing that which coronary artery is supplying to which area and which area. Similarly, then add a note on cardiac dominance. Write a note on cardiac dominance, simple and show it by the diagram and here it is not mentioned about the clinical part, but you have to write about the clinical part. The coronary artery disease you have to write about then you can write about the angina just two three lines. So, that this will fetch you extra marks. The knowledge which you have that should show on your copy. It should not remain in your mind only. That should reflect on your copy so that examiner knows that you know the thing and then only you will be able to gather marks on that. Then there is a question describe the hip joint. Question number 2A. So, there are headings given I have told you that the question can be in the form of headings or you have to make the headings. It has to be in the headings to describe the hip joint under the following headings Articular surfaces and types, ligaments, relations, blood supply and movement. So, for that the articular surfaces you have to show the with the diagram that what are the articular surfaces of the hip bone and what are the surfaces of the femur. Then they when the type then you have to mention about the type is a ball and socket joint type. Then ligaments either you what can do in the form of ligament just enumerate all the ligaments whatever are there and then draw the diagram that which ligament is going from which area. So, there is a diagram given in your standard books only that there are two three diagrams are given when it comes to ligaments. So, draw all the ligaments and one more thing is that while you are drawing the diagram do the specific color coding like for muscles we use the brown for ligaments we use yellow for artery we use red for vein we use blue. So, that specific color coding has to be done then only you will be able to gather good marks. So, what I am saying is focus on color coding. Color coding should be there because you know while in the first year also we used to do the color coding while drawing the diagrams. Then third portion is relations relations you do not have to write just draw the diagram which is given in the book of the relations. So, that is more important. So, and then there is a question on describe the external internal features part of cerebellum add a node on constitution of cerebellar peduncles. So, now we will discuss the question number 3C describe the external internal features part of cerebellum and add a note on the constitution of cerebellar peduncles. See I have been mentioning about it that headings has to be there in the question three parts are there external features write the external features and then draw the diagram then is internal features then write about the internal features and then draw the diagram and then parts of cerebellum that are also be has to be in the diagram. So, each heading has to be in a specific manner and each heading has to be supported by a diagram and then it is given add a note on the constitution of cerebellar peduncles. For note you do not have to write you can what you can do is just draw a diagram with the help of a note and the cerebellar peduncles you can show that how the cerebellar peduncles are formed. Here they have not asked about the clinical part but since it is a 15 mark question there will be space also. So, you will have to write two three lines on the about the cerebellar atexia you can write about about the nystagmus is there then what type of tremors are there when there is a cerebellar disorder. So, you have to write about the clinical aspect of the cerebellum. Okay and regarding the answer writing of anatomy these were the questions we discussed but other than that what you have to focus on is while if the question suppose directly comes that write a short note on placenta sometimes the questions have come on write a short note on placenta then in such questions you remember the heading in which we used to study about it placenta its formation its functions it defects and its diagram these four five headings write down in the form of a heading so that you can get more marks. So, that is how about the answer writing of the anatomy portion. Now, we will doing the another part that is the biochemistry. Biochemistry is a very important portion because there are seven topics and generally three to four topics get repeated every year. So, you have to give a more specific focus on it. For example, this year's question is for question number one C. What is the regulatory mechanism of absorption at level of intestine? Role of Ti, BC and iron metabolism how does the body conserve iron? So, it's a very simple question you just write about the theory which is behind the iron absorption and you have seen there is a diagram given in the theory. So, that you can write about the diagram also that how the iron absorption help from the intestine which are the proteins involved in the iron absorption ferritin, apopheritin, then transferrin, then hemocytrin all these you can write about this also. Then what is the role of Ti, BC, write the role of Ti, BC. How does body conserve iron? That is simple, but more important in this is about this. They haven't asked anything. Just write a two line note about the clinical anatomy of clinical part that is iron deficiency anemia, that how does this absorption leads to anemia? This failure in absorption or how this absorption can be affected and this leads to anemia or if there is more absorption, then there is a deposition of iron. Then how does this that causes? So, you have to write about two, three lines on those also. Don't miss that because that will give you extra half marks. So, that is more important. Then the second question is given characteristics of hormone. Then give the characteristics hormone it is specific, it is ductless, it goes directly into a small, it is required in small amount, it is regulated. Then give about the characteristics and they have given the hormone regulation of calcium in level in the blood. So, for this you might be confused that how to go for is there are multiple levels of calcium regulation and how do is. So, what we have to do is just simply draw a table. Vitamin D is important, then your parathyroid hormone is there and third is calcitonin and write its impact on serum, on blood and on excretion. So, what is it causes increases the serum level, decreases the serum level, increases the C-bill level and draw a tabular form so that you can have a easy to do. Examiner will be able to understand it will save your time and give you more marks. Just draw a table that vitamin D, parathyroid and calcitonin these three hormones are involved and how they are affecting the serum level, how they are affecting the excretion and how they are affecting on the bone. And this way that simply hardly it will take two, three minutes, you will save your time also and get good marks also. Then there is a question, question number 2C part 1. Role of PCR in diagnosis and management of mycobacterium tuberculosis. So, just mention about what are the PCR strategies involved in the mycobacterium, mention about the gene expert, mention about the ADA, mention about all the identification techniques in the mycobacterium tuberculosis. This is more important 2C second question. That role of iodine in synthesis and function of thyroid hormone. So, there is a diagram given of the thyroid synthesis. So, just draw the diagram and mark where iodine is playing a role like step one or step three or step four. Wherever is iodine is playing this mark those areas that iodine is playing a role in these areas during the synthesis and this is how the thyroid hormone is formed with the help of iodine. Then it gives what is Grave's disease. So, then mention about the Grave's disease. Then there are the clinical features of Grave's disease. For that you have to draw the diagram. That exopthalmos is there, ptosis is there and whatever other features are there you can draw a diagram showing that these are the features of the Grave's disease. And then mention about a short note and how to treat this Grave's disease. Similarly, for biochemistry the question is 3B1. Discuss the principle of radio amino assay. What are the main advantages and disadvantages of RIA technique? So, for biochemistry the strategy is simple. For all the questions there are diagrams. You cannot explain PCR, RIA, RFLP every four. There are very, very, very long notes on that. If you start writing it you will not be able to summarize in short notes. So, better is go a flow chart diagrammatic approach. That this is the step one, this is what we are doing in step one, then we are doing in step two, step three, step four, seven state at safe with diagram. So, that will suffice. You don't have to write two, three paragraphs on that that after this what is we are doing, after this this is we are doing. Just draw a flow chart with diagram that will suffice for you in all the biochemistry questions. I'm not talking about only RIA but also PCR, RFLP or maybe a vitamin D absorption, vitamin D regulation, how they are synthesized. All the questions can be done in the flow chart manner or in the manner if you're drawing diagrams. That is more than enough. You don't have to write the whole paragraph for it. The question number four A, describe the structure of tRNA in detail. So, this question is of 10 marks. So, for this question you have to draw a diagram as well as describe the diagram because this give you the 10 mark question. So, first draw the diagram and then draw the diagram goes is T-size C-arm, D-arm and then other arms three S-hand, five S-hand. Describe each end each arm, how they are functioning, what are the role of each arm and each hand. You have to mention about this, okay. Then the next part is what is the energetics of synthesis of one peptide bond. So, for this there are equations given. You don't have to explain, just write down the equations and how the synthesis of each bond is done. Mention about the equations and then is what are the inhibitors of protein synthesis. For inhibitors of protein synthesis we can follow the tabular form on. Write about the inhibitor, write at what step it is causing inhibition. Write about the inhibitor, write at what step it is causing inhibition. Or other approach is there are three step of protein synthesis, initiation, translocation and release. So, you can mention about what are the inhibitors of initiation, what are the inhibitors of translocation and what are the inhibitors of release. So, now we will move to the physiology section. This section is more time demanding as also more scoring also because there are absolute answers to it and you can simply write or draw diagrams for it and get good marks. For example, we will do it by question wise. For example, for question number 1B, what are extra pyramidal tracks? Describe their function. How do they differ from pyramidal tracks? So, write down point wise. Just tell about what are extra pyramidal tracks? Enumerate them. Then write their functions. Write down 1, 2, 3 functions, 4 functions which is given in there. Then draw the diagram. That what are extra pyramidal tracks? That those which are not passing through the medullary deaccession is not happening in the pyramidal tracks. And now the question is how do they differ from pyramidal tracks? For such questions, difference just draw a table. Write extra pyramidal, write pyramidal tracks. And then write about the three, four points which are there in the difference. Don't go paragraph wise. Just write point wise. That these are the four differences of the pyramidal and extra pyramidal tracks. Again, also in the physiology, the clinical aspect you have to mention about. Since the question is on extra pyramidal tracks, you have to mention that what will happen if there is a damage to extra pyramidal tracks? You have to mention about it. Write 2, 3 diseases about the extra pyramidal tracks so that the examiner knows that you have a better understanding of the extra pyramidal tracks. Question number two, B1. So for such questions, like explain the regulation of mega karyocytopoiesis. For such question, you don't have to write theory. There's a well-governed diagram as a flowchart where it is mentioned that how, at what step the mega karyocytopoiesis has been regulated and you can mention about this. And then if there is space left, then you can explain it. But start with the diagrammatic and flowchart approach first. Just mention about the mega karyocytopoiesis, GMCSF factor is playing in it, then the size of the mega karyocytopoiesis, then the interleukins playing role in it, then the other factors which are playing role in it, then you can go by that. And then draw the diagram of mega karyocytopoiesis, that there are three, four steps, that there are first the pro mega karyocytite, then granular mega karyocytite, then the bits which are removed from it, which forms the platelets. Then 2B2, define the term cardiac reserve, explain how it is controlled, governed. This question is totally out of slabs. This was not in the slabs. So there is something which I would like to mention in every paper, there will be 10% marks paper, which will be out of slabs, or which will be not in there mentioned in the slabs. And my advice is not to worry about that. So that has to be a luck based question. If you know that question, then it is good for you. If you don't that, don't panic. Because for every optional 10, 15% marks question, that has to be from out of slabs. And for that 10%, you cannot cover the whole medical sciences. So don't worry about that. Know as much as what you know about it, write as much as you can write. If you don't know, draw a diagram, whatever you remotely related diagram, like for cardiac reserve, just mention the, just draw the diagram of hard and share how the cardiac reserve is controlled. If you don't know in detail about it. For any question which is out of slabs, just write anything remotely you know about it. Because you cannot cover the rest of the medical sciences slabs just for 10%. So focus on your slabs first. And then the rest 10% question, you have to base on your luck only. So you don't have to worry about it. Then the question 3A first. That is explain the changes which takes place during the luteal phase of menstrual cycle. This question has to be a very heading based question. Like the luteal phase changes happening in the menstrual cycle. So you have to mention about all the changes. The changes happening in the uterus, the changes happening in the vagina, the changes happening in the ovum and the hormonal changes taking place. So there has to be four different addings for that. Write in each heading and then draw the diagram and the, for example, there is a diagram given for the vaginal changes and the diagram given for the, there's a graph for hormonal changes, which are the hormones during the luteal phase which gives a peak. So draw all these map diagrams and also the graphs and write it in the four headings rather than writing just these is the changes are happening. Just schematically write the answer. So this will help you out in getting good marks because that will attract the attention of examiner and also send out your answer from the others. Now the next question is third day two. What are the modes of contraction and skeletal muscle? Give suitable examples and explain length tension relationship in skeletal muscle. So there are modes of contraction you are aware about it. There what they are asking is basically the isotonic and isometric contraction. Write two lines about isotonic contraction, write about two lines on isometric contraction. Then there is a graph given for isotonic contraction, graph given for isometric contraction. Draw these two graphs. Examples for two or for both the things give one one example of isotonic exercise and give one example of isometric exercise. Then the question is explain length tension relationship. So length tension relationship can be explained either writing about it or there is a two graph and one diagram for it. I would suggest you to draw that one graph and two diagram about that what happens if there is a tension length and tension active tension passive tension graph. This diagram is there, this flow chart is there and this map is this graph is there. You can draw this graph and also focus on that part. Similarly, the next question is about 4B1. Given account of monophylactic theory of hemopoiesies. So monophylactic theory, this is a bit odd question but you could score full marks in this question if you have studied about it. Then there is a flow chart given that there is a common predecessor and from that predecessor all the blood cells are formed. So you give three, four steps that from here the leukocytes are formed then monocytes, lymphocytes and all platelets and thrombocytes, RBCs. All the structure there is a flow chart given. There's a one page diagram and there's hardly this is a seven marks question. One page was given. If you would have drawn that diagram with the flow chart you would have get seven out of seven. It's a very elaborate diagram and very elaborate flow chart given in the book. Just simply have to copy paste that flow chart and diagram. So in physiology one more thing is I would like to suggest is that there's a book called GANONG. I have mentioned about the sources. So try to remember all the flow charts which are there given in that because directly they have been asking question on the flow charts of the GANONG. For example, last to last year there was a question on sleep cycle and they mentioned about asked about the regulation of sleep cycle and there's a very well depicted flow chart given in GANONG for regulation of sleep cycle. So you can write about it. Similarly, for the menstrual cycle hormone regulation there's a flow chart given out. So basically just write down at one place all the flow chart of syllabus related flow charts at one place and remember them because whenever a question comes on that you don't have to spend much time on writing anything else just draw that flow chart. That is more than sufficient. You'll get good marks in that. So for anatomy we have covered questions for physiology and biochemistry. We have covered almost all the question except one question 3B2. What is folate trap? What are the methods of assessment of B12 deficiency? So this is a question related to vitamin in biochemistry. So for folate trap you don't have to explain there is a you can just write about the flow chart which is there about the folate trap that there is a step of folate formation and how the folate trap happens and what are the consequences of the folate trap. And then methods of assessment enumerate 10-12 methods which are there mention about 3-4 methods which are more prominent most commonly used. You can, you can tell them a little elaborately enumerate the rest of them. There are different methods and enumerate the rest of them because these are the other methods also but these are the most commonly methods used for the vitamin B12 assessment. So now we'll move to microbiology. So microbiology is just like biochemistry where there are limited topics and each topic, each and every topic gets repeated also. And microbiology has to be a very organized answer. Answer in the sense, suppose the question comes on lab diagnosis. So it has to be in the way that what are the sample you're going to take then what are you going to take about the transport medium and third is direct microscopy then you mentioned about the culture part then you mention about the biochemical test and then you mention about the PCR or other techniques which are there used for the identification of or the lab diagnosis of any organism. So for example, there's a question on fifth B2, discuss the pathogenesis and lab diagnosis of diageal hemorrhagic fever. So in this question, pathogenesis you can easily mention about it and the lab diagnosis you have to mention in this way only. Sample, transport medium, direct test, direct microscopy, culture, biochemistry and PCR. For direct microscopy, you have to draw the diagram like if there is a gram positive bacteria or gram positive organism then you have to draw the gram positive. If there's a gram negative, draw about the gram negative. Similarly, if there is a capsule in it then show the capsule. If there is any about the microscopic found in that swelling is there or the how is the structure of that virus then draw that diagram. For example, there's a question on AIDS virus then you have to draw the HIV virus also. So this was about fifth B2 that in this manner only. Sample, transport medium, direct microscopy, culture, biochemical tests and the PCR. In this honor, you have to write about the each organism here. Then similarly, the question number 5B1, discuss the strategic plan laid down by the NACO for diagnosis of individuals with AIDS indicative disease symptoms. This is a very simple question where there is a table given in your book about all the strategies of the NACO while it comes to the diagnosis. Strategy 1, 1A, 2A, 2B, this type of strategies is given in the table and you just have to draw that table here only. Which must I, why Mark's question? Draw that table and that is more than enough for this question. Don't have to waste much time on this. Then 6C1, write the laboratory diagnosis and complication of plasmodium, phylsiporum infection. So then in the lab diagnosis, the same manner it will go. Sample, transport medium, direct microscopy, culture, biochemistry, PCR and or other tests. But what here you have to do in direct microscope, you know how the plasmodium, phylsiporum can be seen as a sickle shape. Then how the plasmodium oval can be seen. All the organism, how they are seen in the microscope. There is a diagram given for it. It's a sickle shape or there's a ring form or is there or a coal form is there. All these forms you have to draw the diagram for that with a particular color only. Same with the 6C2, enumerate the species of aspergillus, infection caused in lab diagnosis. So enumerate the species of aspergillus. The three species are there, infection it causes. Infection you have to give by system-wise. System-wise in the sense if there is a respiratory infection, mention about the respiratory infection. If there is a CNS infection, mention about the CNS infection. If there is a skin infection, then mention about the skin infection. All the infections caused by the aspergillus, you have to write system-wise. Then only it will look good. And then again the lab diagnosis, same approach for aspergillus is there. And in the aspergillus, there is a diagram of all the mycelia diagram is there where the conidias and all the conidiospores or all these are given that you have to draw that diagram also. Same question is 8A1. 8A1 is about the epidemiology, pathogenesis and laboratory diagnosis of patient presenting with basically dysentery. So epidemiology, you know epidemiology, there are three portion of epidemiology. That there is a triangle of it. That host, what are the host factor in organism? What are the organism factor involved in the epidemiology of best? And what are the environment factor involved? All these factors, all the three factors you have to write in the epidemiology about any organism. Pathogenesis, you know about it simple that how does it causes the dysentery. And the laboratory diagnosis, same order you have to follow. Microbiology, one simple format is there and that applies for all the questions in microbiology. That format will apply for all the question. Easy, just remember this format and write in this format with this heading only. You'll get good marks in microbiology. So this was about microbiology. Now we will move to forensics. So forensics, the first question which is there is about the 5E1, define head injury, write the mechanism of coup and counter group brain damage. These are technical. So forensics is much more about law and technicalities. So what is important in forensics is you write the exact definition what is there in the book. You cannot have a definition of your own. The exact definition which is provided in the law or in the book. So remember the definitions of forensics, heart to heart, so that you can write the exact words. Similarly in forensics injuries, there is one more important is there. For injuries you have to draw the diagram of body. Suppose there is a head injury. Draw the diagram, it happens the cow injury and here it happens the counter group injury. Along with this, you have to draw the diagram of the instrument which is being used for the injury. Suppose there is an abrasion or suppose there is a bruise. The abrasion is caused by a pointed object. Just draw the pointed object which can cause this diagram. Or if there is a contusion, then you can use a rod which can cause contusion for it. So you have to draw the diagram of that instrument. If there is a bullet injury, draw the diagram of bullet. If there is a stab injury, then you have to draw the diagram of knife also. Similarly 5E2, discuss briefly the formula for calculating the total body surface area involved in bunts in adult and child. Very simple it is there. You just have to copy paste the formula and also draw the diagram that there is a 9% rule in it. Just draw the 9% rule that 9% burn here, draw the human body show which part shows 9%, which part shows 1%. It's a simple copycat question. You don't have to do anything else in this question. Now the question number 7A. These type of question are very important. One thing I have to mention in about my previous video also. For these questions, what you have to do is, like there is a defined rape as per a criminal law amendment act 2013. So first thing is you have to write the exact definition which is given in the act. You cannot have the definition of your own. Second thing I mentioned about that the government of India has provided the whole protocol for the sexual harassment or sexual abuse patients which is there in your gynecology department. Go to your department. There is a whole 10, 15 pages protocol. The sheet is there. They will tell about that protocol tells you about what steps you need to take, what are the samples you need to take, what are the advice you need to give and what are the management protocols also. So bring that protocol and just copy paste that. That is not given in any other book. Only the government of India, the protocol of 15 pages, bring that and just copy paste that of the identified pages. For example, they have asked, define rape as per criminal law amendment act in a 11 year old girl, discuss the medical legal examination. That protocol gives about the medical legal examination and including the samples that are to be collected. So that is given in the protocol simply keep what samples you need to take and whatever the medical legal examination. There are seven, eight samples which you need to take, seven, eight steps for the medical legal examination. You just have to write to, you have to copy paste that. This question has been coming for last four years, repeatedly. So this can come again also prepare that protocol only. Now comes the question of poisoning in foreign sex. So for all the poisoning, there is a simple format, how to write the answer of poisoning. For example, first in poisoning, you have to write the mechanism of action. So then second is mechanism of action, then second is the fatal dose. Third is fatal period. Fourth is clinical features. Fifth is post-mortem finding. And sixth is medical legal aspect of that poisoning. For example, the question number 7B1, write a short note on management of a case of aluminum phosphide. So now this question is just about the management. So you write about the management portion only. You don't write about anything else. But if the question is write a short note on aluminum phosphide poisoning, then you have to write the mechanism of action, fatal dose, fatal period, clinical examination, post-mortem finding and if there is a medical legal aspect associated with it. In this question they have just asked the management portion so you just have to write about the management because question is of 7.5 marks. But if the question is write a short note on aluminum phosphide poisoning, then you have to write in this order. Mechanism of action, fatal dose, fatal period, clinical post-mortem, medical legal aspect and management. In this order you have to write. So now we have covered forensics and microbiology. Now we'll move to pharmacology. So in pharmacology there are generally two types of question. One is the reasoning-based question and other is the questions which are direct. Direct in the sense, mechanism of action, adverse effects and third is clinical indication or uses of that drug. So reasoning, in pharmacology there is nothing more very specific answer writing approach. There are direct questions and direct answers are there. You just have to remember and cram this. For example, the reasoning is there that why this drug is happening. For example, what are the indication? For example, question number 7C. So there are three questions directly based on the reasoning. Aspirin should not be administered concurrently with warfarin. So you just tell about it that aspirin and warfarin both causes bleeding tendencies. Therefore that should not be given. For example, patient chronically administered morphine remain constipated. Then you can talk about it that morphine causes smooth muscle relaxation which decreases the intestinal motility and therefore this causes constipation. Then similarly, imipinum or beta-lactam is used in combination with celestin. Then you can also tell about there is celestin reduces the excretion of imipinum and therefore it reduces the metabolism which is caused by other substance. So therefore there is a direct reasoning-based question. There is a question, there is a reason, there is a question, there is a reason. Nothing specific is required. Then similarly, there are questions like on this. Question number 8A2 and 8A3, there is also direct question. Monoclonal antibody, write about the mechanism of action, then its application. Similarly, interferon and their uses. Direct question is there. You don't have to focus on anything else. Similarly, question number 8C1 and 2. They've asked specifically the mechanism of action, clinical uses and side effects. Mechanism of action, adverse effects and clinical uses of spinonelectron and metformin. So these are the direct questions in pharmacology. There is no different approach required for pharmacology. Just have to remember and directly approach it. Every drug, prepare in this manner only. Mechanism of action, adverse effect clinical. Mechanism of action, adverse effect clinical. Other than that, there can be one type of question also. Like for example, these are related to drug. Sometimes they give related to disease. Like for example, what are the treatment protocols for angina? What are the treatment drugs used for hypertension? What are the drug used for diabetes? What are the drug used for malaria? So for example, there is a question. Question number 6B. So what are the different classes of drug used in treatment of hypertension? So you mention about all the different classes of the drug. For example, calcium canal blockers, beta blockers, nitrates and other all the newer drugs. You mention about all the drugs. And the other part is discuss the mechanism of action, clinical use and adverse effect. Mechanism of action, adverse effect and clinical use of sodium nitroproside. Nitrates they were asked directly on the question. So basically pharmacology, these three headings, you have to prepare each and every drug. Or other than you can also prepare disease wise also. Direct questions, no specific requirement of any answer. Just prepare, remember and revise. So this was about pharmacology. Now comes the pathology portion. Pathology portion is very important because it requires the art how to write pathology answers. Because they require different approach other than other questions. Then the other topics like micro or this. Pathology, there are two, three types of questions coming. So first I will tell you about the general way of writing the pathology answer. Then we will discuss about the questions. So general way of pathology answer writing is, suppose there is some question on cancer. Right, so for cancer you have to write three, four things you have to prepare. First is the pathogenesis of that cancer. Then the gross morphology of that cancer. Then histopathology of that disease. Fourth, there is any immunofluorescence finding. Fifth, if there is any electron microscopic finding. Pathogenesis, gross morphology, histopathogenesis, histopathology, then immunofluorescence and then electron microscopy. For every disease in pathology, you have to write in this format. And each thing has to be supported by a diagram. For example, if there are pathogenesis of diagram, diagram of pathogenesis, you have to write the diagram of pathogenesis. Gross morphology you cannot draw a diagram so you can leave that. But for histopathology, HND diagram. Using the HND pencils, you have to draw that diagram using the HND pencils. Similarly for immunofluorescence and electron microscopy. We'll go question wise, then it will be easier to identify. First question is define impaired glucose tolerance. This is a direct fifth A question. Define impaired glucose intolerance. So there is a direct question. You just have to write the definition. But next part is discuss the pathogenesis of type 1 diabetes. So the question is the pathogenesis. Write the pathogenesis and draw the diagram of type 1 diabetes. That you have to mention about the pathogenesis. There are two parts. They can be risk factors or causative factors. So you have to prepare both the things. The risk factors of that pathogenesis as well as the causative factors. Sometime they ask directly questions on this only. The risk factors of the causative factors and they might not ask what is the pathogenesis. For example, question number 5D1. Describe the risk factors identified for the breast carcinoma or breast cancer. Similarly, then discuss molecular subtypes of invasive breast carcinoma. This is 5D2. So this is the part of pathogenesis only. So you can write about the pathogenesis also. Molecular subtypes or the microscopic subtypes of invasive breast carcinoma. So all the topics you have to prepare in this heading. Either they will ask all the topics or any sub portion of this. They might ask the electroscopic funding. They might ask the pathogenesis only. Or maybe they can ask enough for 20 marks all the questions only. Like for example, question number 6A1. Define nephrotic syndrome and enumerated component. It's a direct question. Now the next part is discuss pathogenesis, histopathology, electron microscopy, immunofluorescence, findings of membranous nephropathy. So directly they have asked all the things. Pathogenesis, histological, electron microscopy and immunofluorescence. All the things they have asked in a 10 marks question. So for every disease you have to write in this manner only. Similarly for 6A2, they have asked the same way. Discuss the pathogenesis of gramometers, immune response and tuberculosis. Discuss the gross and histomorphological features of CNSTB. This is also the same thing. Pathogenesis, gross morphology, histopathology. The same thing for every disease you have to prepare in this manner only. Prepare from the starting only this manner so that you can write it. Okay and for histopathology as I have told that you have to diagram with HND pencil. Don't draw by pen or normal pencil. HND pencil only, not other than that. Then there's a question, 8B1 and 8B2. So 8B is a question on carcinoma. Define metastasis, what are the different pathways for spread of cancer? Draw a flow chart describing a sequential stop involved in the hematogenesis spread of a tumor. So this is a very direct question. First you define metastasis, then enumerate all the pathways and then the hematogenesis flow chart. They have directly asked, I was about to tell if they would have to ask draw a flow chart. So you don't have to write theory. You just have to draw a flow chart with the diagram. So here also just draw a flow chart. If they haven't asked directly also then also you should have drawn a flow chart only. So just draw the flow chart of the diagram which is given. There's a copy paste question. You just have to copy and copy paste it here. Now 8B2, the similar question. Discuss the pathogenesis of CML. Discuss the clinical pathological features of CML chronic phase. So that is what about I asked. Pathogenesis, gross morphology, histopathology, immunology, electromychroscopy. The same question they have been asking if you have realized that all the diseases, the same pattern is there in asking the question. So better to prepare the diseases in the same manner only. Pathogenesis, gross morphology, histopathology, immunophonosis and you will be able to solve all the questions of pathology. You will not find any difficulty in solving the questions of pathology. 7B2 is there. So this is again the 10% question but luckily this is an easy question. Enumerate six major blood groups give the Mendes law of inheritance of blood group and their role in disputed paternity testing. So it's an easy one. You can easily write about all mention about all the blood group A, A, B, A, B, O, all the A, B, all the blood groups, positive, negative, R, H factors ke saath dono ko mention karna hai. And the Mendes law of inheritance also you can mention about it. Ki kisey hota, konsa dominant factor hai, konsa recessive factor hai. So it's a direct question. It's a, luckily this question is out of syllabus but it's an easy one so you can write it easily. 5C is, this is a question of pharmacology, 5C. So, but again I told you in pharmacology I have told you about three things to be done. Three things is that mechanism of action, adverse effects and clinical uses. This question is a direct question. Discuss the adverse effects associated with use of antimicrobial. So either they ask one single drug, use of antimicrobial agent, they have generalized us about the antimicrobial agent. So what you can do is, first write the general side effects of all the antimicrobials. Then two, three major, major side effects like for beta-lactam, what are the side effects? Then for streptomycin, what are the side effects? Then for azithromycin, what is the side effects? Macrolites, so individual specific side effects also. Then antitubercular drugs, then anti-HIV drugs, all these specific side effects also you can write about because the 10 marks question, you'll have around two pages for this. So write the general side effects first and then write the specific side effects. That will help you out. But again I told you in pharmacology, three points, mechanism of action, adverse effect and clinical uses. These are the three type of questions that can come from any drug. Same have they been asked, just ask about the adverse effect. So this was medical science paper one, answer writing and paper discussion. In our next segments we'll be doing the paper two, the answer writing and the paper discussion. 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