UPSC Ophthalmology (Recall) 2024 Questions

UPSC Ophthalmology (Recall) 2024

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  • Contralateral homonymous lower quadrantanopia is the type of visual loss seen when the lesion is located ataa which one  of the following anatomical locations?

(a) Frontal lobe
(b) Temporal lobe
(c) Parietal lobe ✅
(d) Occipital lobe

  • Which of the following correctly describes the primary position of the right eye in right third cranial nerve palsy?

(a) Downwards and outwards.✅
(b) Downwards and inwards
(c) Upwards and outwards
(d) Upwards and inwards

  • Which of the following findings are seen in Diabetic Retinopathy on fundus examination?

1. Microaneurysm
2. Dot and blot hemorrhage
3. Retinal thickening
4. Neovascularization
Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 1, 2 and 4✅
(c) 1, 3 and 4
(d) 2.3 and 4

  • Consider the following causes of visual loss:

1. Obstruction of the central retinal artery
2. Vitreous and retinal haeno.tlhage
3. Cataract
4. Retinal detachment
Which of the above causes are associated with acute visual loss in a patient?
(a) I, 2 and 3
(b) 1, 3 and 4
(c) 1, 2 and 4✅
(d) 2, 3 and 4

5 tips to control your gout: Does cold-compression help in acute gout flare up?

5 tips to control yout gout: Does cold compression help in acute gout flare up? 

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acute gout and joint involvement

Introduction of Gout

Gout is a acute inflammatory condition which involces joints and soft tissue. 

Use of cold for Gout

Cold compression can be helpful in managing acute gout attacks. During a gout flare-up, applying cold packs to the affected joint can reduce pain and inflammation. The cold helps by numbing the area and reducing blood flow, which in turn decreases swelling and inflammation. It is recommended to apply cold packs for 20 minutes at a time, with a protective barrier such as a towel between the cold pack and the skin, and to repeat as needed with intervals in between applications (Arthritis Society Canada).

When to use cold therapy?

Using cold therapy is most beneficial during an active gout attack, whereas heat should be avoided as it can exacerbate symptoms. After the initial acute phase, applying heat can help with general pain and stiffness but should not be used on inflamed joints (Cleveland Clinic) (Home).

Tips to control gout

  1. Manage your diet that is low in purine
  2. Keep check of your uric  acid level
  3. Do not consume alcohol and beer
  4. Do not stop medication without asking your doctor
  5. Seek treatment on time if one of your joint  is painful and swollen
  6. Reduce your weight if youre obese
  7. Stop smoking
  8. Treat comorbidities
  9. Exercise
  10. Do not connsume other medications that may increase uric acid level in blood
If you want ti knw about diet that good for uric acid please contact us.

Complications of Gout

Gout is acute painful condition which leads to severe pain of one or more joints. But this can last ofr several days if untreated prevennting use of the joint and dysfunction.
Repeated gout flare up and attacks can permanently damage the joint, goint membrane named synivium and the cartilage leading to permanent dysfunction.
High uric acid in blood can also lead to crystallization of it in kidneys leading to kidney stones.
Yes it will help. Get some ice, cover it with  a piece of clothe. and keep it in the affected joint for few minutes then keep it off. Do not keep it continuously. 
But remember this is not alternative to treatment but add on to it.
  1. Recurrent pain
  2. Joint dysfunction
  3. Permanent damage of joint
  4. Kidney stones
  5. Ongoing pain and multiple joints involvement

Treatment of Gout

Your doctor may use one or many of the following drug for treatment of gout
  1. NSAIDs like: Indomethacin, Naproxen, Etoricoxib, Diclofenac, Aceclofenac, Ketorolac
  2. Steroids: Prednisolone, Methylprednisolone
  3. Colchicine
  4. PPIs like: Pantoprazole, Esometrazole, Rabeprazole, Lansoprazole, Omeprazole
  5. Uric acid lowering drugs like: Allopurinol, Febuxostat, Probenecid , Benzbromarone , Sulfinpyrazone ,Uricase , Pegloticase, Rasburicase , topiroxostat

Now the big question: Does cold compression help?

Yes it will help. Get some ice, cover it with  a piece of clothe. and keep it in the affected joint for few minutes then keep it off. Do not keep it continuously. 
But remember this is not alternative to treatment but add on to it.

For more comprehensive information on managing gout, including the use of medications and lifestyle adjustments, you can refer to resources from the Arthritis Society Canada and the Cleveland Clinic.

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Diabetes drug classification according to machanism of action

Diabetes drugs are classification

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Introduction

Diabetes drugs are classified into several groups based on their mechanisms of action. Here are the main categories along with examples for each:

1. Biguanides

  • Example: Metformin (Glucophage)

2. Sulfonylureas

  • Examples:
    • Glipizide (Glucotrol)
    • Glyburide (Diabeta, Micronase)
    • Glimepiride (Amaryl)

3. Meglitinides

  • Examples:
    • Repaglinide (Prandin)
    • Nateglinide (Starlix)

4. Thiazolidinediones (TZDs)

  • Examples:
    • Pioglitazone (Actos)
    • Rosiglitazone (Avandia)

5. Dipeptidyl Peptidase-4 (DPP-4) Inhibitors

  • Examples:
    • Sitagliptin (Januvia)
    • Saxagliptin (Onglyza)
    • Linagliptin (Tradjenta)
    • Alogliptin (Nesina)

6. Glucagon-like Peptide-1 (GLP-1) Receptor Agonists

  • Examples:
    • Exenatide (Byetta, Bydureon)
    • Liraglutide (Victoza)
    • Dulaglutide (Trulicity)
    • Semaglutide (Ozempic)
    • Lixisenatide (Adlyxin)

7. Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors

  • Examples:
    • Canagliflozin (Invokana)
    • Dapagliflozin (Farxiga)
    • Empagliflozin (Jardiance)
    • Ertugliflozin (Steglatro)

8. Alpha-Glucosidase Inhibitors

  • Examples:
    • Acarbose (Precose)
    • Miglitol (Glyset)

9. Bile Acid Sequestrants

  • Example: Colesevelam (Welchol)

10. Dopamine-2 Agonists

  • Example: Bromocriptine (Cycloset)

11. Amylin Analogs

  • Example: Pramlintide (Symlin)

12. Insulins

  • Examples:
    • Rapid-acting: Insulin lispro (Humalog), Insulin aspart (NovoLog)
    • Short-acting: Regular insulin (Humulin R, Novolin R)
    • Intermediate-acting: Insulin NPH (Humulin N, Novolin N)
    • Long-acting: Insulin glargine (Lantus, Toujeo), Insulin detemir (Levemir)
    • Ultra long-acting: Insulin degludec (Tresiba)

These groups help manage blood glucose levels through different mechanisms, such as increasing insulin secretion, improving insulin sensitivity, decreasing glucose production in the liver, and enhancing glucose excretion in the urine.

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