RRB Staff Nurse Previous Year Paper [Held on 20 July 2019 Shift II]

Explanation:

• Crude Death Rate: indicates the number of death per 1000 mid-year population.
• CDR is calculated as:
• CDR =   D x K  divided by P

1. D=total number of deaths registered during the calendar year
2. P= total mid-year estimated population or the total population of the middle of the year
3. K=a constant usually taken as1,000

Key Points

• Natural population growth happens because of the following

1. Birth Rate
2. Death Rate

• The natural increase in birth rate and death rate causes natural population growth.
• Basic components of population change-
• The fertility rate in women
• Mortality
• Migration
• Natural increase is the difference between the no. of births and deaths in the population.
• Crude Birth Rate - It is the total number of live births per 1,000 population divided by the length of the period in years. 
• current rate - 18.2births/1000
• Crude Death Rate - the ratio of deaths to the population of a particular area or during a particular period of time, usually calculated as the number of deaths per one thousand people per year.

Concept:

• Pulse deficit refers to the difference between a radial pulse and an apical pulse rate.
• The apical pulse is assessed through the stethoscope in a sitting or lying position of the patient.
• The radial pulse is assessed by palpating the radial artery.

Important PointsThe pulse deficit is seen in atrial fibrillation.

Explanation:

• Due to atrial fibrillation, there is electrical-mechanical disassociation.
• This leads to poor perfusion in the periphery arteries.
• It causes pulse deficit.

Concept:-

• Stimulus: it refers to an agent, or condition that elicits, accelerates or rouses physiological or psychological action, activity or responses.

Types of stimulus:

1. External stimulus: come from factors found in the environment.

e.g.- temperature, predators, presence of water or food, etc.

1. Internal stimulus: come from factors within an organism

e.g.- germs, dehydration, lack of energy, pain.

Stimulus control:

• Occurs when the rate, latency, duration, or amplitude of the response is altered in the presence of an antecedent stimulus.
• Is acquired when responses are reinforced only in the presence of a discriminative stimulus.
• And not in the presence of other stimuli.

Concept:-

In psychoanalytic theory, given by Sigmund Freud says that the defense mechanism is an unconscious psychological action that functions to protect a person from anxiety-producing thoughts and feelings related to internal conflicts and outer stressors. There are many defense mechanisms enlist which a person uses in his day to day life:

• Sublimation: It is similar to displacement, but takes place when a person manages to displace his unacceptable emotions into behaviors that are constructive and socially acceptable, rather than destructive activities.
• Sublimation is one of Freud's original defense mechanisms in which his deep sexual desires were turned into socially acceptable behavior by his writings and paintings.

Additional Information   1. Regression

• Regression is a defense mechanism proposed by Anna Freud whereby the ego reverts to an earlier stage of development usually in response to stressful situations. Regressions enable a person to psychologically go back in time to a period when the person felt safer.
• Example: When a person is troubled, he behaves most often childish or primitively to cope with the undesirable situation.

    2. Identification: 

• also known as Introjection. Is a defense mechanism when a person not only takes on a belief or voice of another person but also begins to identify with that individual. For example, a father tells his son that women do the household work and the son keeps this thought in his mind and acts in the same manner as his father does.

Concept:-

Examination of the newborn:

Complete physical examination should be done within 24 hours after birth. Including the following:

1. Vital signs
2. Physical examination
3. Neurological examination
4. Estimation of gestation age

Newborn examination:

Concept:-

• Virulence is a pathogen or microorganism's ability to cause damage to the host or in simple terms virulence is the degree of damage caused by microbe to its host.
• It is determined by the Virulence factor.
• Virulence factors (preferably known as pathogenicity factors or effectors in plant science) are cellular structures, molecules, and regulatory systems that enable microbial pathogens (bacteria, viruses, fungi, and protozoa) to achieve the following:

1. Colonization of a niche in the host (this includes movement towards and attachment to host cells)
2. immunoevasion, evasion of the host's immune response.
3. immunosuppression, inhibition of the host's immune response (this includes leukocidin-mediated cell death)
4. entry into and exit out of cells (if the pathogen is an intracellular one)
5. obtain nutrition from the host

Additional Information

• Infectivity: is the capacity of viruses to enter the host cell and then replicate and produce horizontal infection and then transmit to the subsequent human host.
• Pathogenicity: Pathogenicity refers to the ability of an organism to cause disease (ie, harm the host). This ability represents a genetic component of the pathogen and the overt damage done to the host is a property of the host-pathogen interactions.

The correct answer is Staphylococcus.

Key Points

• Staphylococcal food poisoning (SFP):-
• ​Staphylococcal food poisoning (SFP) is an intoxication that results from the consumption of foods containing sufficient amounts of one (or more) preformed enterotoxin.
• Staph food poisoning is a gastrointestinal illness caused by eating foods contaminated with toxins produced by the bacterium Staphylococcus aureus (Staph) bacteria.
• Symptoms of SFP have a rapid onset and include nausea, violent vomiting, abdominal cramping, with or without diarrhea.
• About 25% of people and animals have Staph on their skin and in their noses.
• It usually does not cause illness in healthy people, but Staph has the ability to make toxins that can cause food poisoning.

Additional Information

Botulism (or botulism poisoning) is a rare but very serious illness that transmits through food, contact with contaminated soil, or through an open wound.

• Without early treatment, botulism can lead to paralysis, breathing difficulties, and death.
• There are three main types of botulism:

1. infant botulism
2. foodborne botulism
3. wound botulism

Staphylococcal Poisoning

• The staphylococci bacteria grow in food, in which they produce toxins.
• Thus, staphylococcal food poisoning does not result from ingesting the bacteria but rather from ingesting the toxins made by the bacteria that are already present in the contaminated food.
• Typical contaminated foods include custard, cream-filled pastry, milk, processed meats, and fish.

Salmonella Poisoning

• Salmonella bacteria live in the intestinal tract of humans and animals and are excreted in feces.
• Poultry, beef, milk, and eggs all can contain Salmonella bacteria.
• Salmonella infection is a food-borne illness that occurs from the consumption of raw meats and eggs, contaminated dairy foods such as unpasteurized (raw) milk, or fruits and vegetables contaminated by food handlers.

Concept:-

Types of hospitals:

Concept:-

About plasma protein Albumin:

• It is the most abundant circulating plasma protein (40-60 % of the total).
• Playing important roles in the maintenance of the colloid osmotic pressure of the blood, in the transport of various ions, acids, and hormones.
• It is a globular protein with a molecular weight of approximately 66000 D and is unique among major plasma proteins in containing no carbohydrate.
• It has a relatively content of tryptophan and is an anion at 7.4.
• These properties have been exploited in the estimation of albumin in body fluids.

The function of albumin:

• Albumin has the ability to bind various ligands, thus acting as a transporter for various molecules. Such as-
• Free fatty acid
• Calcium
• Certain steroids hormones
• Bilirubin
• Copper
• A variety of drugs, including sulfonamides, penicillin G, Phenytoin, and Aspirin, are also bound to albumin.

Concept:-

1. Hirschprung Disease is the most common cause of lower intestinal obstruction in neonates. Also known as aganglionic megacolon which is a congenital anomaly caused by the migratory failure of neural crest cells leading to abnormal innervation of the bowl or also the absence of nerves in the part of the intestine.

• This condition occurs when the nerves in the intestine (enteric nerves) do not form properly in the embryonic development phase.
• This condition is usually diagnosed in the first two months of life but in some normal cases, it can be diagnosed in the later age groups also.
• Other names of Hirschprung Disease are:

1. Aganglionic Mega Colon
2. Congenital intestinal agangliosis
3. Congenital Megacolon

• Common clinical presentations of the disease are a swollen belly, Green or Brown substance vomiting, and delayed passage of Meconium.

​

Additional Information

       1. Intussusception: 

• is a form of bowel obstruction in which one segment of bowel telescopes inside the another. Although it can occur anywhere in the GI Tract, usually it occurs where the small and large intestine meet.
• The red Jelly stool is the most common feature of this condition along with nausea and vomiting.​  2. Hypertrophic Pyloric Stenosis
• In infants, it is the most common cause of gastric outlet obstruction and the most common surgical cause of vomiting.
• HPS causes a functional gastric outlet obstruction as a result of hypertrophy and hyperplasia of muscular layers of the pylorus.
• Projectile vomiting is the main significant feature of this condition.​   3. Meckel's Diverticulum  
• is the outpouring or bulge in the lower part of the small intestine. This pouch is congenital and leftover of the umbilical cord.​

Concept:-

• Choanal atresia is a congenital disorder where the back of the nasal passage (Choana) is blocked, usually by the bony or fibrous growth of tissues due to which failed hole development of the nasal fossae during the prenatal development phase.
• It can be:
• Unilateral Choanal Atresia (where only one side of the nose is blocked).
• Bilateral Choanal Atresia (Where both the sides of the nose are blocked)
• Sometimes this condition is considered an emergency condition because infants breathe almost exclusively through their nose, typically babies use their mouth for breathing only when they are crying.

Symptoms

• The chest retracts unless the baby is mouth breathing or crying.
• Difficulty breathing after birth, which can result in cyanosis (blue discoloration), unless the baby is crying.
• Inability to nurse and breathe at the same time.
• Inability to insert a catheter into the throat from either side of the nose.

Additional Information

• Congenital obstruction of the middle ear is known as Aural Atresia which involves some degree of failure of the development of the external auditory canal.

Concept:-

• Ghon focus is a primary lesion usually subpleural, often in the mid to lower zones, caused by Mycobacterium bacilli (tuberculosis) developed in the lung of a nonimmune host (usually a child).
• It is named by Anton Ghon (1866–1936), an Austrian pathologist.
• Ghon complex undergoes progressive fibrosis, often followed by radiologically detectable calcification known as Ranke complex.
• Ranke complex and Ghon complex are not synonymous. The Ranke complex is an evolution of the Ghon complex (resulting from further healing and calcification of the lesion).
• When the Mycobacterium enters the lungs, macrophages recognize the Mycobacterium as foreign and attempt to phagocytize them. Typically, a macrophage does this by engulfing the foreign material.
• When this mechanism of phagocytosis is affected then Mycobacterium produces a protein that inhibits this fusion, thereby allowing the Mycobacterium to survive, proliferate, and create a localized infection called primary tuberculosis.
• Approximately three weeks after the initial infection, more specific immune cells (e.g., T cells, B cells, and Neutrophils) surround the site of TB infection, creating a wall of immune cells known as a granuloma, which isolates the bacteria and prevents it from spreading.
• The tissue inside the granuloma then dies during a process referred to as caseous necrosis, or cheese-like necrosis. This necrotic area is known as a Ghon focus.

Additional Information 1. Goblet Cells

• Modified epithelial cells that secrete mucus on the surface of mucous membranes of intestines and airways.
• Location:

1. Respiratory epithelium
2. Intestinal epithelium

• The function of goblet cells is the Protection and lubrication of epithelial surfaces of the respiratory and digestive tracts by producing mucus.

   2. Caseous Focus

• Caseous necrosis or caseous degeneration is a unique form of cell death in which the tissue maintains a cheese-like appearance.
• Mainly occurs in the pulmonary cells.

The correct answer is Vitamin K.

Important Points

Some important Vitamins:

Key Points

• There are three types of blood corpuscles namely:
• Erythrocytes or red blood cells,
• Leucocytes or White blood cells.
• Thrombocytes or Blood platelets.
• Blood Platelets or Thrombocytes:
• They are only found in the blood of human beings & mammals in which nuclei are absent.
• These are composed of the cytoplasm of a larger nuclear cell of bone marrow.
• Its average life span is 7 days.
• Platelets are produced from very large bone marrow cells called Megakaryocytes.
• When the blood capillaries are cut, then blood platelets come at the point of damage and starts to accumulate by secreting a special type of chemical which helps in blood clotting.
• Blood Clotting:
• It is the conversion of normal viscous blood fluid into a jelly-like mass within 3-10 minutes after its exposure to air.
• The mechanism of blood clotting comprises of three steps which are the following:
• Stage I: The thromboplastin is released from the injured tissue.
• It changes into the prothrombinase enzyme.
• Stage II: Prothrombinase inactivates Heparin & catalyse the breakdown of prothrombin into thrombin.
• Stage III: Active thrombin converts blood soluble fibrinogen into fibrin.
• The thrombin acts as an enzyme to convert soluble fibrinogen of blood into insoluble fibrin threads in which RBCs get trapped.
• As a result, the clot is formed at the site of injury.

Additional Information

• Heparin is the anti-clotting substance that exists in blood & prevents it from clotting inside blood vessels by prohibiting catalytic activities of prothrombin.
• Basophils and mast cells produce heparin in all mammals.
• Disorders with low platelet counts are called Thrombocytopenia.

CONCEPT: 

• The umbilical cord is a flexible, tube-like structure that, during pregnancy, connects the fetus to the mother.
• The umbilical cord contains Wharton's jelly, a gelatinous substance made largely from mucopolysaccharides that protect the blood vessels inside.
• The umbilical cord is the baby's lifeline to the mother. It transports nutrients to the baby and also carries away the baby's waste products.

EXPLANATION:

• The umbilical cord is made up of three blood vessels.
• The cord has one large umbilical vein and two umbilical arteries.
• These vessels transport blood to and from the placenta, where exchange between the mother and fetus takes place.

The correct answer is sonorous.

Key Points

• A substance is said to be sonorous if it is capable of producing sound.
• The metals that produce a sound on striking a hard surface are called sonorous metals.
• When we strike these metals, a ringing sound is produced.​

Additional Information

• About Metal
• Metal is very strong and durable and therefore is used to make many things.
• These are used for making automobiles, satellites, cooking utensils, etc.
• Most metals are hard but some are not.
• Sodium and potassium are such metals that can be cut by knife whereas mercury is a liquid metal at room temperature.
• Iron is solid in nature.
• About Non-metals
• Non-metals are those which lack all the metallic attributes.
• They are good insulators of heat and electricity.
• They are mostly gases and sometimes liquid.
• Some of them are even solid at room temperatures like Carbon, sulphur, and phosphorus.

Concept:-

Concept:-

• Grounded theory: it is a systematic, qualitative procedure used to generate a theory that explains, at a broad conceptual level, a process, an action or an interaction about a substantive topic.
• It originated in 1967 with Barney Glaser and Anselm Strauss as a contrast to the a priori theoretical orientations in sociology.
• The area of inquiry in the grounded theory approach is Social structural process within social setting.

Purpose of grounded theory:

• To develop new concepts and theories of related phenomena, where these concepts and theories are firmly grounded in qualitative data.
• It allows for the emergence of original and rich findings that are closely tied to the data.

Grounded theory steps:

1. Data collection
2. Coding and tagging
3. Theoretical sampling
4. Theory building

Explanation:-

• Effacement: This is a process of Cervix thinning, as the labor is about to complete, the cervix stretches and completely opens and dilates. The process of effacement mainly prepares the cervix for the passage of the baby through the birth canal.
• As the baby's head drops down into the pelvic region it gives back pressure on the cervix and causes the cervix to become thin.
• During the pregnancy, the cervix is plugged by the mucus to prevent pregnancy. But during the first stage of labor, this mucus plug passes out of the vagina and the secretion is sometimes mucus tinged the process is known as "Show"
• After the cervix fully effaces then the next phase comes and the phase is known as Cervical Dilatation. In which the cervix dilates from 0 to 10 centimeters.

The 4 Stages of Labor are as follows

Stage 1: from Onset of true labor to full dilation of the cervix

• Latent Phase
• Cervix dilates 3-4cm
• Mild and short contractions
• Active Phase
• The cervix dilates to 4-7cm
• Moderate to strong contractions (5min apart)
• Bloody show
• Transition Phase
• Cervix dilates 7-10cm
• Strong contractions (1-2min apart)
• Leg tremors, perspiration, and flushed faces

Stage 2: from full dilatation of cervix (up to 10cm) to birth of Newborn (Option 2 is correct)

• Latent Phase
• last up to 1 hour
• Contractions: decreased frequency and increased strength
• Active Phase
• Urge to push
• Stronger and closer contractions
• Transition Phase
• The appearance of fetal head on the perineum
• Perineal bulge
• A head emerges at the opening of the vagina called 'crowning'
• Leg cramps

# Episiotomy is given if needed.

Stage 3: from the birth of Newborn to Delivery of the placenta

• Occur between 5-30min of childbirth
• Contractions begin again facilitate separation of the placenta

Stage 4: From Expulsion of Placenta until 2 hours after birth

• Fundus on the midline and lightly above the umbilicus
• The appearance of lochia rubra
• Fatigue and thirst

Additional Information

• Formation of Retraction Ring: also known as Bandl's Ring or the Pathological Retraction Ring.
• It is the abnormal Junction between the two segments of the uterus, it is mainly associated with the late sign of Obstructed Labor.

Concept: 

• Inheritance of any disease, condition, or trait from parents to the offspring depends upon the type of chromosome that is affected.
• There are two types of chromosomes that are autosomal chromosomes and sex chromosomes. Based upon the presence of mutated genes that trait can either be dominant or recessive.
• The autosomal recessive disorder is when parents are carriers that is when a mutated gene is present in both the mother and the father (i.e. parents are carriers).
• These mutated genes are passed on to the offspring. In this the probability of inheriting or becoming a carrier of the disease are as follows:

Explanations: 

The different types of autosomal recessive disorders: 

• Cystic fibrosis
• Sickle cell anemia
• Tay-Sachs disease

Cystic Fibrosis

• It is an autosomal recessive inherited disorder. In this, the fluid secreting cells like sweat, digestive secretions, and mucus cells are impacted.
• The inheritance of defective genes leads to the abnormal production of thick and sticky fluids. Such secretions block the passageways tubes and ducts.
• Commonly affected systems are the lungs, digestive system, and pancreas.

Hemophilia

• It is a bleeding disorder linked to a recessive gene on the X-chromosome (sex-linked chromosomes), hence almost exclusively affecting males. In this, the blood clotting is slowed due to the absence of certain blood clotting factors.

Craniofacial disorders

• It is a broad group of disorders, described as malformation of the head or facial skull bones that may be congenital, the result of disease or trauma caused during birth. Hence not essentially a genetic disorder e.g. cleft palate and deformational plagiocephaly.

Concept:-

• Bran Bath: It is also known as Colloid Bath, basically a medicated bath mainly used to treat or to resolve the skin conditions like rashes and itching, etc. In the bath soothing agents like gelatin, starch or bran are added which gives a soothing effect to the skin.
• It is an ancient process to prevent sensitive skin from irritation.
• A colloid bath is a medicated bath prepared by adding soothing agents such as gelatin, starch, or bran to bathwater to relieve skin irritation and itching. The patient is patted dry instead of rubbing the skin.

Additional Information

• Sitz Bath: It is the immersion of the hip and the buttocks to relieve discomfort, pain, and muscle relaxation.
• The temperature for Sitz Bath at the start is 95 Degree F and gradually increased up to 104 to 110 degrees F.

Concept:-

• Torticollis: it is a symptom related to turning or bending of the neck. Many different causes are possible. In newborns, torticollis usually results from Sternocleidomastoid Muscle injury during labor and delivery or the infant’s position in the womb. Less often, it is caused by birth defects. In older children, torticollis may result from injuries to the neck muscles, common infections, or other causes.

Explanation:

• Sternocleidomastoid Muscle: it divides the neck into anterior and posterior triangles. Its anterior border covers carotid arteries, internal jugular veins,s, and deep cervical lymph nodes; it also overlaps the thyroid gland.
• Origin: manubrium sterni (sternal head) and medial third of clavicle (clavicular head)
• Insertion: the mastoid process of the temporal bone and occipital bone.
• Action: two muscles acting together flex neck draw head forward; one muscle rotates, face to the opposite side.
• Nerve supply: spinal part of accessory nerve and anterior rami of C2 and C3.

Explanation:

Oxytocin plays a major role during Parturition in human beings.

• The posterior part of the pituitary gland also called Neurohypophysis (pars nervosa) releases oxytocin.
• Oxytocin is synthesized by the hypothalamus and is transported axonally to the neurohypophysis.
• Oxytocin acts on the smooth muscles of our body and stimulates their contraction. In females, it stimulates a vigorous contraction of the uterus at the time of childbirth, and milk ejection from the mammary gland. For this reason, it is also called the birth hormone.

Process of Parturition:

• Parturition is induced by a complex neuroendocrine mechanism.
• The signals for parturition originate from the fully developed fetus and the placenta which induce mild uterine contractions called fetal ejection reflex.
• This triggers the release of oxytocin from the maternal pituitary.
• Oxytocin acts on the uterine muscle and causes stronger uterine contractions, which in turn stimulates the further secretion of oxytocin.
• The stimulatory reflex between the uterine contraction and oxytocin secretion continues resulting in stronger and stronger contractions.
• This leads to the expulsion of the baby out of the uterus through the birth canal – parturition

​

Additional Information

• Prolactin: is released by the pituitary glands. It mainly causes the breast to prepare for the delivery and production of milk after birth.
• Vasopressin: is an anti-diuretic hormone that plays an important role in balancing the water level in the body.
• Progesterone: is the hormone released by the ovaries and helps to regulate the menstrual cycle.
• It is an important hormone for the implantation of the fertilized egg in the uterus and managing the pregnancy.

Concept:-

• Neuroleptic drugs: it is also known as antipsychotics or major tranquilizers are a class of medications primarily used to manage psychosis principally in schizophrenia and bipolar disorder.
• First generation antipsychotics known as typical antipsychotics were discovered in the 1950s.
• Second generation drugs known as atypical antipsychotics, first atypical antipsychotics was discovered inn 1960s and introduced clinically in the 1970s.

Uses of neuroleptic drugs:

1. Treatment of schizophrenia

• Reduce some of the positive symptoms

1. Hyperactivity
2. Bizarre behavior
3. Hallucinations and delusions

• Facilitate functioning in both out and inpatient environments.

Additional Information

• Antidepressants:  used in patients with major depression who have inadequate responses or intolerable side effects during first line treatment with selective serotonin reuptake.
• Hypnotics: It effects involve more pronounced depression of the central nervous system than sedation.
• Antiepileptics: it decreases the frequency and severity of seizures in people with epilepsy.

Concept:

Mantoux test

• Mantoux test (Purified Protein Derivative) or TB skin test: A standard dose of 5 tuberculin units is injected intradermally.
• The reaction is read (48-72 hours later) by measuring the diameter of erythema (palpable raised, hardened area) 15 mm or more millimetres is considered positive.

Important Points

Erythema measurement

• Erythema measurement of  5 or more millimetres is considered positive in People living with HIV
• Erythema measurement of 10 mm or more is positive in
• Client with clinical conditions that put them at higher risk.
• Mycobacteriology lab worker.
• People who abuse drugs.
• Erythema measurement of 15 or more millimetres is considered positive in People with no known risk factors for TB
• TB Vaccination with Basil Calmette-Guerin (BCG) Vaccine.

Concept:-

• Dialysis: separation of suspended colloidal particles from dissolved ions or molecules of small dimensions (crystalloids) by means of their unequal rates of diffusion through the pores of semipermeable membranes.
• This process was first employed in 1861 by a British chemist, Thomas Graham.

General principles:

• The separation between solutes is obtained as a result of differences in diffusion rates.
• These are arising from differences in molecular size and solubility.
• This means that the resistance increases with increasing molecular weight.

Additional Information

• Diffusion:  the movement of particles in a solid from an area of high concentration to an area of low concentration, resulting in the uniform distribution of the substance.
• Osmosis: the passive transport of water across a selectively permeable membrane is called osmosis.
• Viscosity: it is a quantity that describes a fluid’s resistance to flow.

Concept:-

• Protein: it is one of the most important nutrients in our food because it is the chief constituent of the body cell, of body tissues, and of body fluids.
• Proteins are made of chains of amino acids. Amino acids are the chemical building blocks from which new proteins are made.

Explanation:

• Protective proteins: it is the glycoprotein that forms a complex with the lysosomal enzymes B-galactosidase and neuraminidase.
• Its deficiency in man leads to the metabolic storage disorder galactosialidosis. Both human and mouse mature protective proteins covalently bind radiolabeled diisopropyl fluorophosphate.

The function of protective proteins:

• These proteins have a protective defense function. These proteins combine with foreign protein and other substances and fight against certain diseases.
• It is produced in the spleen and lymphatic cells in response to foreign substances called antigens.
• Fibrin present in the blood is also a protective protein.

Concept:-

• Myocardial ischemia: it is defined as a disease condition that is caused by reduced blood flow in a coronary artery due to atherosclerosis and occlusion of an artery by an embolus or thrombus.

Causes of myocardial ischemia:

• Coronary atherosclerosis
• Coronary artery spasm
• Coronary embolism
• Dissection into the coronary artery
• Congenital abnormalities of coronary circulation
• Coronary trauma

Inverted and larger 'T' wave means in ECG: It appears as a manifestation of ventricular repolarization abnormalities, and are associated with various clinical conditions such as myocardial ischemia, pericarditis, hypertrophic cardiomyopathy, central nervous disuses.

Concept:-

• Hypoglossal nerve: it is the twelfth cranial nerve (XII), leading to the tongue.
• The nerve arises from the hypoglossal nucleus and emerges from the medulla oblongata in the preolivary sulcus separating the olive and the pyramid. It then passes through the hypoglossal canal.

Branches of hypoglossal nerve:

1. Meningeal branch
2. Descending branch
3. Nerve to thyrohyoid
4. Nerve to geniohyoid
5. Muscular branches of the tongue

The function of the hypoglossal nerve:

• Helps to speak, and swallow. It is the main function of the hypoglossal nerve.
• It controls the hyoglossus, intrinsic, genioglossus, and styloglossus muscles.
• It enables tongue movements.
• It helps move substances around in the mouth.

Concept:-

• Sampling: the process of selecting a small number of elements from a larger defined target group of elements
• The information gathered from the small group will allow judgments to be made about the larger groups

Types of sampling:

Additional Information

• Triangulation:  Triangulation is an approach to research that uses a combination of more than one research strategy in a single investigation.
• Random Allocation: the participants in the study population are randomly allocated into two groups using random number tables, or computers to avoid selection and confounding biases.

Concept:-

About  Antitoxin:

• antitoxins act like vaccines in preventing disease. Antitoxins fight bacteria that produce substances that are toxic to the body. e.g. anascorp, antivenin, anavip.
• Antitoxins are given through a shot, by injecting a safe amount of a specific toxin, which stimulates the immune system to produce antibodies. The antibodies are then used to make antitoxin.

Explanation:

• Sensitivity test: it is a test that determines the “sensitivity” of bacteria to an antibiotic. It also determines the ability of the drug to kill the bacteria.
• The results from the test can help your doctor determine which drugs are likely to be most effective in treating your infection.

Why others are incorrect:

• Urine test: Not related to serum reactions.
• Blood test: Not used to predict immediate hypersensitivity.
• CSF test: Unrelated to antiserum administration.

Concept:-

• Reservoir: it is the place where microorganisms live and reproduce, e.g.- in humans and animals, in soils, food, plants, air, or water.
• Human reservoirs include patients, healthcare personnel, household members, and other visitors.
• The endogenous flora of patients (e.g.- bacteria residing in the respiratory or gastrointestinal tract) also is the source of HAIs.
• The means of escape is how the microorganisms leave the reservoir. These portals can be:
• Respiratory- viruses that cause the common cold, Mycobacterium. tuberculosis and Hemophilus influenza utilizes this means of exit from the reservoir.
• Genitourinary- sexually transmitted diseases such as syphilis or HIV.
• Alimentary - salmonella, rotavirus, C. difficile, Giardia.
• Skin - scabies, impetigo.
• Blood and body fluids - HIV, Hepatitis B, and C.

Explanation:

• The chain of infection includes six points.
• Infectious agent
• Reservoir
• Portal of exit
• Mode of transmission
• Portal of entry
• Susceptible host
• The chain of infection can be broken through the following steps:
• Hand hygiene
• Vaccination
• Using masks and gloves
• Isolation, if and when necessary
• Cleaning and disinfecting the environment
• Using sterile medical equipment.

Concept:-

• Otitis externa: it is a condition that causes inflammation of the external ear.
• Otitis externa is sometimes called swimmer’s ear or tropical ear or Temporal bone osteomyelitis.
• This is because it can sometimes be caused by getting water inside your ear canal and it is often more common in humid conditions.

Divided into:

1. Localized otitis externa: it is an infection of a hair follicle in your ear canal caused by staphylococcus aureus.
2. acute diffuse otitis externa: it is a more widespread inflammation of the ear canal, which causes a skin rash that can extend to the pinna and the tympanic membrane.
3. chronic otitis externa: it is defined as chronic when the duration of infection lasts for more than 4 weeks.

Concept:-

• pregnancy: it is the term used to describe the period in which a fetus develops inside a woman's womb or uterus.
• pregnancy usually lasts about 40 weeks or just over 9 months, as measured from the last menstrual period to delivery.

explanation: 

• The iron requirement during pregnancy is as follows:
• Basal iron = 280mg
• Expansion of red cell mass = 570mg
• Fetal transfer = 200-350mg
• Placental development = 50-150mg
• Blood loss at delivery = 100-250 mg
• After deducting iron conserved by amenorrhea (240-480) additional 500-600 mg iron is required in pregnancy.
• If the patient is chronically anemic, then her iron stores also stand to be depleted.
• This necessitates an extra supplementation of 500 mg is needed.
• Thus, total iron supplementation stands at 1000mg.

Concept:-

Effleurage: it is a form of massage involving a repeated circular stroking movement made with the palm of the hand.

• Stroking of the skin
• Performed with the palm of the hand:

                Stimulates deep tissues.

• Performed with fingertips:

                Stimulates sensory nerves

• Superficial, rhythmic stroking:

                Contours the body or relates to direction muscles

• Deep stroking:

                Follows of vein and lymph vessel

• Performed in a rhythmic manner.

Additional Information

• Circular Massage: applied using the tips of fingers or thumbs using some pressure and some circular stationary manipulation.
• Kneading: it is circular manipulation performed so that the skin and subcutaneous tissues are moved in a circular manner on the underlying structures.
• Friction Massage: it is a localized manipulation applied at the injury point aiming to give stretching across the fibers to separate them and restore mobility.

Concept:-

• Tripod position: a position assumed to relieve orthopnea (difficulty breathing except when in an upright position)
• The patient assumes an upright or semi-vertical position by using pillows to support the head and chest or sits upright in a chair.

Contraindications:

Should not be used when the following medical problems exist:

• Appendicitis
• Intestinal blockage
• Ulcerative colitis
• Heart disease
• Kidney disease

Children: not recommended for infants under 6 months of age.

Additional Information

• Trendelenburg position:  patient lying in supine position with knees over the lower break of the table.
• Fowler's position: it is a sitting position in which the head is elevated at 45° to 60° and the client's knees are slightly elevated, avoiding pressure on the popliteal vessels.
• Lithotomy position: patients lie in supine position with buttocks at the lower break of the table.

Correct Answer: Serotonin

Rationale:

• When platelets are activated during the inflammatory process, they release several substances, including serotonin. Serotonin is a vasoconstrictor and also increases the permeability of blood vessels, contributing to the inflammatory response.

Explanation of Other Options:

Histamine

• Rationale: Histamine is released by mast cells and basophils, not platelets. It plays a crucial role in the inflammatory response by causing vasodilation and increasing vascular permeability.

Heparin

• Rationale: Heparin is an anticoagulant released by mast cells and basophils. It prevents the formation of clots but is not typically released by platelets.

Bradykinin

• Rationale: Bradykinin is a peptide that causes blood vessels to dilate and contributes to pain during inflammation. It is not specifically released by platelets but is a key mediator in the inflammatory process.

Conclusion:

• Serotonin is the correct answer as it is released by platelets during the inflammatory process, playing a role in vasoconstriction and increasing vascular permeability.

Concept:

• Bhore Committee was established in 1943 headed by Sir Joseph Bhore. The committee submitted its report in 1946.
• Aim: "Health Planning and Development Committee"

Key Points

• Important Recommendations of the committee:
• Integration of preventive and curative services at all administrative levels.
• The minimum required ratio is 567 hospital beds, 62 doctors, and 151 nurses per one lakh population.
• In the short terms program, each Primary health care (PHC) center in a rural area caters to a population of 40,000.
• The PHC is to consist of 2 medical officers, 4 public health nurses, one nurse, 4 midwives, 4 trained dais, and 15 class IV employees.
• Secondary health care centers to serve as supervisory, coordinating, and referral institutions.
• A long terms program also called the 3 million plan of setting up primary health units with 75 bedded hospitals for each 10,000 to 20,000 population (Hence option 1 is correct).
• Major changes in medical education include 3 months of training in preventive and social medicine to prepare 'social physician'.

Explanation:

• Injury to the skin is followed by a series of actions and events for the healing of injured skin and this process is also known as Cascade of Healing. Which mainly occurs in further four phases and these phases work one by one:
• Hemostasis
• Inflammatory
• Proliferative
• Maturation

 Hemostasis Phase

• First Phase of wound healing once the injury occurs. This phase activates the body's emergency repair system or the blood clotting mechanism.
• In this phase platelets come in contact with collagen and activates and aggregation of platelets occurs.
• Thrombin enzyme plays a vital role by forming fibrin mesh that helps to clump the platelets at the site of injury. Clot formation at the injury site is the basic process in this phase.
• Duration is 4 to 10 minutes after injury.

 Defensive/Inflammatory Phase

• In this phase engulfment of bacteria and other microorganisms takes place from the site of injury. This phase is the key step to growing new tissues at the site of the injury by removing the damaged tissues and debris from the site of the injury.
• Neutrophils play a vital role in phagocytosis. Duration is 24 to 48 hours after the injury.
• As white cells leave the site after 3 days Macrophages remove the damaged cells and debris from the site.
• This phase is characterized by the development of redness, edema, and warmness at the injured site.​

. Proliferative Phase

• Fibroblastic Phase is another well-known name of this phase, this phase would covers fill and repairing the injured site.
• The Proliferative phase features three distinct stages:
• filling the wound
• contraction of the wound margins
• covering the wound (epithelialization)
• In this stage, the epithelial layer of the injured site is formed by the aggregation of the connective tissues.
• It lasts for 5 days to 24 days​

 Maturation Phase

• In this phase new tissue growth takes place and collagen fibers play an important role in the molding of the tissues and helping the body to gain its actual strength.
• This phase lasts from a few days to a few years.

Concept:

Phobia is defined as an irrational and excessive fear of an object or situation. In most cases, phobia involves a sense of endangerment or fear of harm.

Important Points

• Symptoms of Phobias:
• Nausea; a sense of unreality; fear of dying; terror; Obsessive thoughts and desire to flee; anticipatory anxiety i.e. persistent worrying about the upcoming events that involve the phobic object.
• Physical symptoms include dizziness; shaking; palpitations and breathlessness.
• Treatment for Phobias: 
• In exposure treatment - in this, the patient is exposed to the fear object in order to help them overcome their fear e.g. flooding.
• Counter conditioning- in its the patient is taught a new response to the fear object.

Key Points

Types of Phobias:

• Social phobias: fear of social situations
• Agoraphobia: fear of being trapped in an inescapable place or situation
• Specific phobias include fear of animal, medical or situational phobias
• Claustrophobia-  fear of confined places / closed spaces (Hence option 3 is correct)

Additional Information

• Gamophobia - Fear of Marriage
• Acrophobia - Fear of Heights
• Hamartophobia - fear of sinning or error

Concept:

• Dementia is characterized by the progressive and persistent deterioration of cognitive functions, which leads to an overall decline in the intellect, memory, personality, and thining skills that reduce a person's ability to perform everyday activities (Hence option 3 is correct).

Important Points

• Common signs and symptoms:
• Memory loss, impaired judgment, loss of communication skills, faulty reasoning, Gait, motor, and balance problem,
• Hallucination, paranoia, and agitation
• Difficulty in abstract thinking
• Inappropriate behavior
• Risk factors include:
• Age (>65 years of age); Co-morbidities like diabetes; Obesity; Depression and stress; Head injury; and Poor physical activity.
• Types of Dementia:
• Alzheimer's disease - (most common) occurs due to nerve cells damage or the death of never cells.
• Cerebrovascular dementia - the second most common is characterized by impaired judgment.
• Neurodegenerative dementia - is caused by underlying disease conditions such as Parkinson's disease and is characterized by problems with movement.
• Dementia is caused by infection such as HIV infection that leads to impaired memory.
• Diagnosis:
• Imaging such as MRI, CT-Scan, and PET
• Lab studies like CBC, ESR, and HIV test
• Confirmation by autopsy
• Management:
• ​Anti-psychotics and anti-depressants

Additional Information

• Delirium 
• It is described as an abrupt change in the brain that caused mental confusion and emotional disruption. It is also called an acute confusional state. It is characterized by disturbances in attention, consciousness, and cognition. Delirium is usually temporary and can be treated effectively.
• Schizophrenia: 
• It is a chronic, serve mental disorder that impacts individuals' ability to think, act, express emotions, reality perception. It is one of the most disabling and chronic disorders.
• Depression
• It is a mood disorder described as feelings of sadness, loss, or anger that interfere with a person's everyday activities.

Concept:

• Infertility is defined as lack of conception following one year of frequent unprotected sex.

Key Points

The main causes of male infertility are:

• Sperm disorders such as Oligospermia and Azoospermia.
• Testicular dysfunction such as:
• infection of the testes is known as Orchitis result of bacterial infection.
• Inability to maintain a normal temperature that is 33-35 degrees celsius. this leads to low spermatogenesis and hence infertility.
• Testicular cancer
• Undescended testes
• Testicular failure: it is described as primary hypogonadism leading to the inability of the testicles to produce sperm and androgen.
• Hormonal imbalance
• Medication such as anti-depressants or antibiotics
• Retrograde ejaculation is when semen goes backward in the body such as the bladder.
• Immunogenic infertility is when the body starts to make antibodies that attack the sperms of the body.
• Varicocele i.e. swollen veins in the scrotum.
• Obstruction

Concept:

The placenta is a circular disc that attaches to the uterine wall.

• Measurement: about 15-20cm thick at its center and weigh around 500gm.
• It has two surfaces: 
• Fetal surface: it is covered by a smooth glistening amnion with an umbilical cord attached to its center.
• The maternal surface: is rough and spongy and has dull red color due to maternal blood.
• Placenta also had 15-20cm convex polygons called the lobes or cotyledons.
• The volume of blood in the placenta is around 500ml.

Key Points

• Cord Abnormalities
• Battledore placenta is one in which the placental cord is attached to the margin.
• Velamentous insertion of the cord is one in which the cord inserts into the fetal membranes i.e. Chorioamnotic membrane, and then travels into the membranes of the placenta (Hence option 4 is correct).
• Succenturiate placental lobe is a condition in which one or more accessory Lobes develop in the membranes at distance from the placenta. Its complication is Vasa Previa and PPost Partum Hemorrhage.
• Abnormalities of placenta and cord:
• Placenta Extrachorialis is described as a morphological abnormality in the placenta, which is defined as a condition in which transition from the membranous to villous chorion does not occur at the placenta edge but at some variable distance with the circumference of the placenta.
• It is of two types:
• Circummeginate placenta: the margin of the chorionic plate appear as raised, the thin and fibrous rim at the margin of the chorionic plate where the fetal vessel appears to terminate.
• Circumvallate placenta:  in the fetal membranes 'double back' on the fetal side around the edges of the placenta.

Concept:

• The fight-or-flight response is a physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival.

 Key Points

• Mechanism of the Fight-or-flight response :
• As soon as the threat is perceived, the sympathetic nerve fibers of the autonomic nervous system are activated. This leads to the release of certain hormones from the endocrine system. Which in turn causes the release of certain hormones from the endocrine system, hence certain physiological reactions occur in the body.
• The sympathetic nervous system stimulates the adrenal glands triggering the release of catecholamines i.e. adrenaline and noradrenaline by the adrenal medulla (Hence option 1 is correct).
• The tissue response to catecholamines depends upon the type of receptors, there are two major types of adrenergic receptors on the surface of target organs: alpha-adrenergic receptors and beta-adrenergic receptors. While the former leads to constriction of the blood vessels, contraction of uterine muscles, relaxation of intestinal muscles, and dilation of the pupils. whereas the latter leads to an increase in the heart rate, stimulates cardiac contraction, dilates the bronchi, blood vessels, and relaxes the uterus.
• The adrenal cortex releases hormone called cortisol and corticotropin during the Fight-or-flight response. It increases the blood glucose level through gluconeogenesis, suppress the immune system, and aid in the metabolism of fat, protein, and carbohydrate.

Important Points

The hypothalamus is a small region of the brain which is located at the base of the brain, near the pituitary.

• The posterior part of the hypothalamus releases oxytocin and vasopressin and is released into the posterior pituitary. The posterior pituitary does not produce hormone rather it stores and secretes a hormone that is produced by the hypothalamus.
• While oxytocin stimulates the uterine contraction and dilatation of the cervix. the Vasopressin or ADH maintains the solute concentration in the blood by reabsorbing blood from the filtrate in the kidney.
• The anterior part of the hypothalamus secretes hormones including Corticotropin-releasing hormone; Gonadotropin-releasing hormone; Thyrotropin-releasing hormone and Somatostatin.

Concept:

• It is defined as the interaction between an antibody and a particulate antigen that results in clumping. The antibodies that produce such reactions are called agglutinins and the particulate antigen aggregated are called agglutinogens.

Key Points

• The surface structures of the bacteria have considerable antigenic heterogeneity. Based on these variations, the serological classification system of the bacteria include the following:
• H antigen or flagellar antigen made of Proteinacous. This antigen induces antibody formation with high titers. The agglutination takes place rapidly and the reaction produces cottony, fluffy precipitates.

 Additional Information

• O Antigen is also called as Somatic antigen or Boivin antigen. This antigen is part of the cell wall lipopolysaccharide and is heat stable. The agglutination reaction produces compact, chalky, and granular clumps. Also, the reaction occurs slowly.
• D Antigen is a protein found on the surface of RBCs. The D antigen is also known as the 'Rh factor.
• F Antigen is a compound antigen in the Rh blood group system. The F antigen is present when the person inherits an allele of the RHCE gene.

Explanation:

• ​A reflex is an involuntary and instantaneous movement in response to a stimulus without conscious thought.

Key Points

• Ferguson reflex
• ​It is a neuroendocrine reflex characterized by fetal distension of the cervix that stimulates a series of neuroendocrine responses resulting in a surge of oxytocin. This in turn leads to increased contractions as the presenting part of the fetus stimulates the nerve receptors in the pelvic floor, the cervix, and upper portion of the vagina. Following this, the other mother experiences an urge to push.
• The Ferguson reflex = fetal ejection reflex is the neuroendocrine reflex comprising the self-sustaining cycle of uterine contractions initiated by pressure at the cervix, more precisely, the internal end of cervix, or vaginal walls.
• Urge reflex
• ​Urge urinary incontinence is caused by an overactive bladder. Normally, the strong muscles are called sphincters to regulate the flow of urine from the bladder.
• However, in urge incontinence**, the muscles of the bladder contract with such strong force that they are able to override the sphincter muscles of the urethra.** Hence, leads to involuntary passing of the urine. It may be the result of spinal cord lesions, CNS disorders like Alzheimer's disease, and multiple sclerosis.
• Pelvic reflex
• ​The pelvic and perineal somatic and autonomic reflex muscle activity is termed as genito-pelvic reflexes and it is an important constituent of female sexual response.
• Chaddock reflex
• ​It is a diagnostic reflex to test for the dysfunctions along the corticospinal tract. It is performed by stroking the lateral malleolus which causes extension of the great toe which indicates damage to the corticospinal tract.

Concept:

• Disulfiram therapy is indicated in chronic alcoholism.
• It is an alcohol deterrent therapy.
• Deterrent agents help to maintain abstinence.

Explanation:

• Disulfiram provokes an unpleasant reaction if taken with alcohol.
• The unpleasant reaction helps to maintain abstInence.
• The common drugs used are tetraethyl thiuram disulfide or Antabuse.

Additional Information

• Disulfiram is an aldehyde dehydrogenase inhibitor that increases acetaldehyde more than 10 times from normal metabolism.
• It causes a disulfiram-ethanol reaction (DER) characterized by nausea and vomiting, headache, hypotension, sweating, dyspnea, tachycardia, chest pain, blurred vision, and a sense of impending doom associated with severe anxiety.

Concept:-

• In service, education is the Planned learning experience rendered by the employing agency for its employees. As Nursing is a dynamic profession that is subject to rapid change in health care protocols, in-service education plays an important role in Quality Nursing Care.

Types of In-service Education:

1. ​Workshops
2. Demonstrations or Hand on Practice Sessions
3. Lectures

Components of In services Education 

• Staff Development Programs: It helps to meet the educational needs of the Nursing staff which helps in delivering Evidence-based care to the patients.
• Scope of In-Service Education in nursing practice is very significant and nurses are committed to long-life, learning practice and it needs to be continued throughout the professional life.
• If the nurses lack motivation in Learning the new concepts and practices they will continue the practicing of old trends which are to be changed as per the social needs and scientific advancements.

Additional Information

How we learn Auditory, Visual and Kinesthetic

• We remember 1% through taste, 10% of what we read, 1.5% of what we touch, 20% of what we hear, 3.5% of what we smell, 30% of what we see, and 80% of what we say, and what we react.

Concept:

The nervous system can be divided into two major regions: The central nervous system (CNS) and the Peripheral nervous system (PNS).

Key Points 

• The nervous tissues are present in both the CNS and PNS, contain two basic types of cells: Neuron and glial cells.
• While the glial cell is one of a variety of cells that provide a framework of tissue that supports the neurons and their activities.
• The neurons are the core components of the nervous system, which includes the brain, spinal cord, and peripheral ganglia. In other words, Neurons are the building blocks of the nervous system. (Hence option 1 is correct)
• The human brain comprises tens of billions of neurons, each linked to thousands of other neurons via the chemical channels called synapses.
• The neurons consist of three main parts the cell body, dendrites, and axons. The cell body is the central region which is the most important part of the neuron containing the nucleus of the cell. Neurons receive and transmit signals from the brain to the body and vice versa.

Additional Information 

• Mucus - is an aqueous gelatinous material that is produced by the mucous membrane in the nose and sinuses. It is main function is to trap bacteria, viruses, and allergens like dust and pollen and hence prevent them from entering the body.
• Enzymes - are proteins that act as a catalyst to expedite the chemical reaction in the body.
• Nephrons - is the structural and functional unit of the kidney that performs the functions of filtration, reabsorption and secretion in the body.

Concept:-

• Broca's area is responsible for the speech. Speech is controlled by the largest part of the brain known as the Cerebrum.
• Typically the speech is governed by the left part of the Cerebrum.
• Each portion of the Cerebrum is further divided into regions known as the lobes of the Cerebrum, which mainly called as

1. Frontal Lobe
2. Parietal Lobe
3. Temporal Lobe
4. Occipital Lobe

• Broca's area is mainly situated in the front portion of the left hemisphere. It plays an important role in turning ideas and thought into Spoken Words. Broca's area becomes more active before the speech.
• It also helps in passing the signals to another part of the brain known as the Motor Cortex., which plays an important role in controlling the movement of the mouth while speaking.
• Broca's area is named after French Doctor Pierre Paul Broca in 1861.

Additional Information:

Hypothalmic Area: It is a Small Brain area but plays an important role in Hormone production like

• Antidiuretic Hormone
• Corticotrophin releasing hormone
• gonadotropin-releasing hormone
• Oxytocin
• Prolactin Controlling Hormone
• Thyrotrophin releasing hormone

​Hippocampus: It is a complex brain structure located in the temporal lobe of the brain, it plays an important role in Learning and Memory.

Concept:

• Administration refers to interpreting policies and making them operational. It is the process of designing and maintaining an environment where individuals working together in groups, meet specific goals.

Key Points

• Philosophies of administration are based on the flowing key points that are:
• Cost-effectiveness
• Execution and control of work plan
• Delegation of responsibility
• Human relation and good moral
• Effective Communation
• Flexibility in certain situations

Important Points

• Cost-effectiveness - is referred to the extent to which an organization or program produces particular outputs. It is aimed at maximizing the level of benefit in relation to resource availability.
• Effective communication -  refers to the ability to convey information to the subordinate and supervisor accurately and clearly. It constitutes the foundation of an effective administration.
• Delegation of responsibility -  It refers to entrusting part of a superior's work to his subordinates. It is characterized by a subordinate act within the limits prescribed by delegation Delegation can be partial or in entirety. The principles include planned and systematic and planned delegation of authority. Delegation should be succeeded by an appraisal of the task so delegated.

Concept:-

• Transdermal route of the Drug Administration wherein the active ingredients of drugs are delivered across the skin and then to the systemic circulation.
• Methods: Most commonly via patches. TDD is a painless method of drug delivery system by applying the drug formulation to healthy and intact skin.
• The drug initially penetrates through the Stratum corneum layer of the skin.
• Then drug passes to the deeper Epidermis and Dermis layer of the skin without penetrating into the dermal layer of the skin.
• Examples of Drugs given via the Transdermal Route are

1. Fentanyl
2. Testosterone
3. Nicotine etc.

Advantages of TDD

• Controlled absorption of the drug.
• More uniform Plasma Level
• Lesser side-effects, painless administration
• Flexibility of terminating the drug administration by simply removing the patch from the skin.

Additional Information

• Transmucosal Route: It is non-invasive route of drug administration including intra nasal, sub lingual, rectal and buccal routes.
• Intra Spinal Roue: It is a route of drug administration where a drug is directly injected into the site of its action. These site receptors are located within the spinal cord and drugs are directly injected to spinal fluid or to intrathecal space.

Concept:

Peritonitis is described as an inflammation of the peritoneum, the tissue that lines the inner wall of the abdomen (Hence option 3 is correct).

• Symptoms of peritonitis - poor appetite; nausea; abdominal ache; abdominal tenderness; fever and chills; fluid in the abdomen.
• Causes of peritonitis - bacterial infection; secondary peritonitis which usually develops due to injury and infection.
• Treatment - antibiotics and antifungal medications to treat the infection.

Additional Information 

• Duodenitis: is an intestinal condition characterized by inflammation of the duodenum lining. The most common bacterium that causes duodenitis is called Helicobacter pylori.
• Colitis: is inflammation of the colon that is part of the large intestine, caused by infection, loss of blood supply, or chronic disease and allergic reaction.
• Gastritis: is an inflammation of the stomach. The most common bacterium that causes duodenitis is called Helicobacter pylori.

Concept:

Pineal Gland:

• Also called Epiphysis Cerebri.
• It is a pine cone-shaped gland of the endocrine system.
• It is composed of cells called pinealocytes and cells of the nervous system called glial cells.
• The pineal gland connects the endocrine system with the nervous system in that it covers nerve signals from the sympathetic system to the peripheral nervous system into hormone signals.

Key Points

• Functions:
• Secretion of the hormone melatonin
• ​The hormone melatonin plays a key role in the regulation of circadian rhythm (Hence option 2 is correct).
• Regulation of endocrine functions
• Conversion of nervous system signals to endocrine signals
• causes the feeling of sleepiness
• Influences sexual development

Additional Information

• Thyroxine: also called tetraiodothyronine or T₄ is one of the two major hormones secreted by the thyroid gland. The principal function is to stimulate the consumption of oxygen and thus the metabolism of all cells and tissues in the body.
• Androgens: are a group of sex hormones that primarily influence the growth and development of the male reproductive system. The most active androgen is testosterone.
• Parathyroid hormone: is secreted by the parathyroid gland, which is located behind the thyroid gland. Parathyroid hormone regulates calcium levels in the blood, by increasing the levels when the level is too low.

Concept:

• The hypothesis is described as an assumption about a situation or a population that can be represented and tested via any or a combination of statistical methods. The research study of any particular phenomenon begins with writing a hypothesis.

Key Points 

Hypothesis testing refers to a formal process of investigating a supposition or a statement to either accept or reject it.

Steps of Hypothesis testing:

• Stating the Hypotheses
• This involves positioning the null and alternative hypotheses.
• Formulating an analysis plan
• It involves deciding the test which is to be carried out to test the hypotheses.
• Investigating or analyzing the sample data
• At this stage, sample data is examined by applying methods to drive mean values, normal distribution, t distribution, etc.
• Interpreting the results
• It involves making the decision to either reject the null hypothesis in favor of the alternative hypothesis or not to reject the null hypothesis.

Hence the process followed as :

State --> Formulate --> Investigate --> Interpret

(Hence option 1 is correct)

Concept:

• Sigmond Freud put forward psychoanalytic theory. According to him the human personality is complex and has more than a single component. He stated that human personality is made of three elements i.e. Id, Ego, and Superego.

Key Points

• Id
• ​According to Freud id is a primary component of personality as it is the source of all psychic energy.
• The Id is the only component of individual personality that is present from birth hence responsible for primitive behaviors.
• The Id is driven by the pleasure principle, which demands immediate gratification of all desires, wants, and needs.
• Ego
• ​This component develops from the id and ensures that the impulse of the id is expressed in a socially acceptable manner.
• It functions in the conscious, preconscious, and unconscious mind.
• The ego operates on the reality principle. Feud compared if to a horse and ego to the horse rider.
• Superego
• ​It holds the internalized moral standards and ideals that are acquired from parents and society.
• The superego tried to perfect and civilize individuals' behavior. In other words, it suppresses all unacceptable urges to id and makes the ego to act upon the idealistic standard rather than realistic principles (Hence option 3 is correct).

Explanation:

Key Points

• Delusion
• ​Delusion is a false, unshakeable belief that conflicts with reality (Hence option 1 is correct). Despite the contrary evidence, a person in a delusional state can't let go of convictions. Delusions are reinforced by misinterpretation of events. For instance, the patient might contend that the government is spying on every move via radio waves despite repeated negation and contrary evidence.
• Delusions are symptoms of psychotic disorders that may be accompanied by hallucination.
• Illusion
• ​It is described as a misinterpretation of a "real" sensory stimulus -  that is interpretation of an object that contradicts reality. For instance, a child perceives tree branches at night as if they are goblins.
• Hallucination
• ​It is a perception disorder that involves sensing things such as sounds, smells, and visions that may seem real but are not and created by the mind. It arises due to mental illnesses such as schizophrenia, physical illnesses such as epilepsy, and alcohol use disorder.
• Delirium
• ​It is described as an abrupt change in the brain that causes mental confusion and emotional disruption. This impacts the person's ability to think, remember, sleep and pay attention. However, it is usually temporary and can be managed effectiviely.

Concept:

Vitamin D is a group of fat-soluble prohormones which is produced in the skin on exposure to sunlight.

Important Points

• Functions of Vitamin D
• Regulates the calcium and phosphorous levels in the blood by promoting absorption from the food in the intestines.
• Promotes bone formation and mineralization.
• Affects the immune system by promoting immunosuppression, phagocytosis and anti-tumor activity.
• Some Important Source of Vitamin D:
• Fatty fish, like mackerel, salmon, tuna.
• Foods fortified with vitamin D, for example, some dairy products, orange juice.
• Cheese
• Egg yolks

Key Points

• Deficiency of Vitamin D leads to:
• learning disability
• Impaired work capacity
• Increased susceptibility to infection
• In children: Rickets (Hence option 2 is correct)
• Rickets: characterized by the softening and weakening of the bones. Rickets is a result of nutritional malabsorption, renal disease, etc.
• In adults: Ostomalacia i.e. bone thinning and bone fragility and osteoporosis i.e. decrease bone mineralization and increased bone fragility.

Additional Information

• Muscular dystrophy
• ​It is a group of diseases that causes progressive weakness and loss of muscle mass. It is a result of abnormal genes that interfere with the production of proteins needed to form healthy muscle. It is characterized by frequent falls, trouble running, and a waddling gait.
• Hemolysis:
• ​It is described as a rupture of red blood cells which leads to the release of hemoglobin into the bloodstream. It can be a result of a number of reasons such as infection, autoimmune disorder, and G6PD deficiency.

Concept:

• The serous membrane or serosal membrane is a thin membrane that lines the internal body cavities and organs such as the heart, lungs, and abdominal cavity.

Important Points

• The membrane is made of mesothelium tissue which originates from the mesoderm. The serous membrane allows for frictionless movement in the number of vital organs.
• There are various serous membranes in the body such as the pericardium that surrounds the heart and the blood vessels; the pleural membrane that surrounds the lungs; and the peritoneal membrane that surrounds the abdominal cavity and related organs.

Key Points

• Peritoneal membrane is present in the abdominopelvic cavity. It is the largest serous membrane in the body. The membrane expands from the internal surface of the abdominal wall to completely or partially surround organs of the abdominopelvic cavity.
• Peritoneum cosist of 2 layers: parietal peritoneum and visceral peritonum. The parietal peritoneum lines the internal walls of the abdominal cavity. In males, it is present as a closed sac. But in the female, the peritoneum is not a closed sac, since the free ends of the uterine tubes open directly into the peritoneal cavity.

Additional Information

• The mucous membrane is a membrane lining of body cavities and canals such as respiratory, digestive, and urogenital tracts. It varies in structures, but all have a surface layer of epithelial cells over the deeper later of connective tissue.
• Submucosa also called tela submucosa is a thin layer of tissue in various organs of the gastrointestinal, respiratory, and genitourinary tracts. It is made of irregular dense connective tissue that supports the mucosa and joins it to the muscular layer.

Concept:

• The Whipple procedure is also called a pancreaticoduodenectomy. It is surgical management indicated for pancreatic cancer that occurs within the head of the pancreatic gland (Hence option 4 is correct).

Important Points 

• Within this procedure, the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct, the gall bladder, and associated lymph nodes are removed.

Additional Information 

• Billroth - I
• ​The Billroth I procedure is also called a gastroduodenostomy in which the pylorus is removed and the distal stomach is anastomosed directly to the duodenum.

• Billroth - II
• ​It is a surgical procedure in which a partial gastrectomy is performed and the cut end of the stomach is closed. Additionally, the loop of the jejunum is sewed to the gastric remnant (gastrojejunostomy).
• Pancreatectomy
• ​It is a surgical procedure that involves the removal of the entire pancreas, as well as the gallbladder and common bile duct, the portions of the small intestine, and often the spleen.

Concept:

• Obstructive sleep apnea is a sleep disorder that involves the cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep.

Important Points

• Obstructive sleep apnea is caused by soft tissue collapse in the pharynx.
• Etiology: 
• Nasal obstruction - polyps, septal deviation, tumors, trauma, and stenosis
• Retropalatal obstruction - elongated, posteriorly places palate and uvula, tonsils, and adenoid hypertrophy.
• Retroglossal obstruction- - macroglossia and tumor

Key Points

• Sign and symptoms of Obstructive sleep apnea:
• Loud Snoring (Hence option 3 is correct)
• Gasping/choking at night
• Excessive daytime sleepiness is not explained by other factors
• Nocturia
• Morning headaches
• Decreased concentration
• Memory loss
• Mode changes, such as irritability and depressions

Additional Information

• Narcolepsy is a chronic sleep disorder and a neurological disorder that is characterized by overwhelming daytime drowsiness and sudden attacks of sleep.
• Hypersomnia is a symptom which is characterized by excessive daytime sleepiness

Concept-

• It is a phase of the bacterial growth curve.
• It is the second phase of the bacterial growth curve.
• it is also called Exponential and sometimes logarithmic phases.

Important Points

• in this phase the cell gets double in number
• In this, the growth of new bacteria is proportional to the current population of bacteria (per unit time).
• it  can not be continued indefinitely due to nutrients and being enriched with wastes

Additional Information

• The growth of bacteria mainly happens with the help of binary fission
• There are some phrases that occur during the growth of bacteria
• There are some important phases :
• Growth cycle (also called a growth curve )
• Synchronous growth
• 3 ​biphasic growth

The growth curve consists of 4 stages:

• Lag phase
• Log phase
• Stationary phase
• Decline phase

Concept:-

• t is a sudden rupture of the esophagus due to an increase in intraluminal pressure, retching.
• it may occur due to intake of alcohol and heavy food
• it was described by Herman Borhave

Causes-

• Infection to esophagus
• Insertion of NG tube
• During endoscopic procedure
• Trauma to esophagus
• Foreign body
• Esophageal diseases
• Surgery to neck and abdomen
• Endoscopy

Clinical Manifestation-

• Difficulty in breathing (DYSAPNEA)
• Vomiting
• Loss of appetite
• Fever
• Dysphagia
• Nausea
• Pain
• Difficulty in swallowing

Additional Information

It can be achieved mainly by surgical methods 

1. Thoracotomy
2. Esophagectomy
3. Endoclip application
4. Esophageal stenting

The spoilage from the rupture should be prevented 

Hygiene should be maintained 

Antibiotics should be administered

Concept:-

it is also called Montgomery tubercles 

• it is a small gland that presents near the areola of the nipples
• it is visible only in the pregnant women

Important Points

During pregnancy, the Mongomery glands are enlarged

• It shows a little bump around the areola
• It produces antimicrobial oil for protecting the nipples by getting infected
• This oil helps in cleaning up the nipples during the breastfeeding
• After delivery of the baby, the oil smells the same as amniotic fluid for helping the baby to find the nipples

Additional Information

• It is also called as sebaceous glands
• It helps to hydrates the nipples and prevents irritation.

Concept:-

• LITHO - means Stone
• TRIPSY -means to break.
• it is a procedure used to break the stones present in the ureter, bladder, kidney

Important Points

INDICATIONS: IT is done for the kidney stones which are less than 2cm in the kidney and in ureter less than 1 cm 

CONTRAINDICATION: it should not be done in -

• Pregnant lady
• lactating mother
• coagulation problems
• sepsis ​

Additional Information

• In this, there is no surgical incision done to remove the stones
• the stones will be broken into tiny pieces and then the broken stones come out of the body through the urination

There are many types of lithotripsy that are used in different aspects.

1. Extracorporeal shock wave lithotripsy (used to break the stones of the ureter and kidney ) in this R-wave  Of ECG  will initiate as a shock wave which is a refractory period of the cardiac cycle
2. Shock wave lithotripsy 

Laser lithotripsy (it is done in case of low ureteral stones in the ureter and can not be broken with the help of ESWL)

percutaneous lithotripsy (PCNL)( mainly used to remove kidney stones )

Concept:-

• It is a drug that is an anticonvulsant used to treat seizures.
• Mainly it is used to treat status epilepticus which is a type of seizure.

Important Points

• it is from the class of anticonvulsant
• In this, the common dose for adults is: 10 - 15 mg /kg should be infused under 50mg /min
• there are some contraindications of these drugs: bradycardia, heart block, hypoglycemia:
• it works by blocking the Na (sodium)  channels of neurons.
• And by blocking the Na channels the action potential will be more difficult to occur
• it also shortens repolarization

Additional Information

• The brand name of it is DILANTIN.
• IT is an anti seizures medication.
• it is also used for PREVENTION OF TONIC CLONIC SEIZURES AND PARTIAL SEIZURES :
• IT is not used for absence seizures.
• it is also used for HEART ARRHYTHMIAS AND NEUROPATHIC PAIN
• ROUTE OF ADMINISTRATION: IV (INTRAVENOUS ) AND ORAL

Side effects

• There is some common side effects  Loss of appetite, Nausea, Vomiting, Insomnia, Hair growth, Liver diseases, Decreased blood pressure.
• Souvenirs to Remember Side Effects: Hot Malika
• H-  Hypertrophy of gums (it is an abnormal growth of gingival tissues of gums )
• O - Osteomalacia (it is a softening of bones )
• T - Teratogenicity ( during pregnancy may cause deformity to the fetus )
• M - Megaloblastic anemia (vitamin b12 deficiency can lead to megaloblastic anemia )
• A - Ataxia (loss of control on body movements )
• L - Lymphadenopathy(affects, especially lymph nodes )
• I - Inhibits insulin release
• V - Vitamin k deficiency

The concepts of id, ego, and superego are proposed by 'Sigmund Freud' in his 'Psychoanalytic Theory of Personality.

• Freud used these three concepts to describe the three parts of the human personality and to explain the way a human mind works.
• According to Freud, the human personality is made up of three major systems: the id, ego, and superego.
• These three systems work together cooperatively and constitute a well-organized personality in a person and enable the person to interact with the external environment.

Key Points

Let's Understand in Brief:

The ID:

• It is the unconscious part of the human personality that works to fulfill basic desires.
• It is based on the pleasure principle which aspires for the satisfaction of antisocial desires.
• It is the basic personality component that is present since birth and seeks to satisfy sexual wishes.

The Ego:

• It looks for rules and morals and resides in the unconscious mind.
• The Ego always postpones the desire and discharges the tension until it gets the desired object.
• It is that aspect of personality, which strives to be logical and reasonable and to cope with the world of reality.

The Super-Ego:

• It is the moral part of the personality, which is known as conscience too. It stands for perfection, rather than pleasure.
• It acts as a balance between id and super-ego, it tries to figure the solution which does not hurt either id or super-ego.
• The Super-Ego develops in the child’s mind as a result of its response to the rewards and punishment adopted by the parents.

Hence, we can conclude that Sigmund Freud propounded psychoanalysis.

Additional Information

• Carl Gustav Jung, a Swiss psychologist, has proposed the concepts of "introvert" and "extrovert" in his 'theory of personality.
• Alfred Adler was an Austrian medical doctor, psychotherapist, and founder of the school of individual psychology.
• Hans Eysenck (1916-1997): British psychologist Hans Eysenck developed a model of personality basic upon just three universal traits; Introversion/Extroversion, Neuroticism/Emotional stability, and Psychoticism.

The correct answer is Chinese.

Key Points

• The first vaccination against smallpox was practiced over 2000 years ago in China and India and is introduced by a British physician, Edward Jenner is generally credited with ushering in the modern concept of vaccination.
• In the era of 1798, Edward Jenner introduced inoculation with cowpox (smallpox vaccine), a much safer procedure.
• This procedure, referred to as vaccination, gradually replaced smallpox inoculation, now in present terms called variolation to distinguish it from vaccination.

Schools create a unique opportunity to improve both the education and health status of learners throughout the nation. The School Health Programme under AYUSHMAN BHARAT is a joint collaborative program between the Ministry of Health and Family Welfare and the Ministry of Human Resource & Development. The health of children is a reflection of the future. Good education is possible only when the child is in good health.

Key Points

• With the world’s largest youth population, India represents an inspiring demographic dividend that can have a lasting impact on the social and economic development of the country. Therefore, investing in the health and wellbeing of children is a critical priority in nation-building efforts.
• The school environment is a natural entry point for reaching children and adolescents with health education, health promotion, and health services.
• Schools present the ideal ecosystem for students to imbibe from peers and learn from role models, such as teachers and heads of school.
• Students can be effective advocates for creating a healthy school and can become change agents for community health initiatives.
• Health and education are strongly connected-healthy children achieve better results at school, which in turn are associated with improved health later in life.
• Setting up a positive and healthy school environment, then, plays an important role in improving health, well-being, overall academic achievement.

Important Points

• According to the school health committee of India, the minimum land area for elementary school education is 10 Acre.

The correct answer is Dmitri Ivanovsky.

Explanation:

• A Virus is an infectious agent that replicates only inside the living cells of an organism.
• The virus was discovered by Dmitri Ivanovsky.
• The tobacco mosaic virus is the first discovered virus.
• The study of viruses is known as virology.
• Virology is a subfield of microbiology.
• Important diseases caused by the virus are:
• Smallpox
• Chickenpox
• SARS
• Polio
• Rabies
• Dengue fever
• Measles
• Common cold

Additional Information

• The smallpox vaccine was discovered by 'Edward Jenner' in 1796.
• Small Pox is caused due to Variola Virus.
• Robert Koch gave a great contribution to the field of microbiology.​
• Tuberculosis was first discovered in the year 1882 by Dr Robert Koch.
• He discovered cholera's livelihoods in 1883 after which he was awarded the Nobel Prize in 1905.
• Robert Koch is considered the 'father of microbiology due to studies on microbes.
• Robert Hooke discovered the cell.
• Robert Hooke also discovered the law of elasticity.

Continuing education refers to a continuation of basic literacy for withholding and stabilization of literacy skills acquired by the students either through the total literacy campaigns or non-formal education programs. Continuing education guides the learners from guided learning to a self-learning program.

• Kothari Commission suggested adult and continuing education.

Key Points The main purposes of Adult Education and Continuing education are-

• Strengthening the literacy skills
• Bringing the students and adults from dependence learning to self-learning.
• Improve different aspects of personal, occupational, and social life by applying knowledge that they have learned from education.
• Provide more learning opportunities and encourage more reading habits.
• Creating a learning society that helps in society and nation development

Hence, we can conclude that Kothari Commission suggested adult and continuing education.

Additional Information.Adult and Continuing Education Programmes:

• To impart literacy, functionality, and awareness to non-literates, Adult and Continuing Education Centers are being organized in rural areas.
• These courses include programs of short-term training.
• These courses could be skill-based, for example, skills for income generation, entrepreneurship development, family life education, value education or can be based on social issues.
• Students of adult education can organize adult and continuing education centers for farmers, women, and artisans. Certainly, students can be of immense help to the rural community in the fields of new technology, education, health and sanitation, childcare and nutrition, family planning, etc.

Hint

• Mudaliar Commission: The Secondary Education; commission known as Mudaliar Commission was appointed by the government of India in terms of their Resolution to bring changes in the present education system and make it better for the Nation. Dr. A. Lakshmanswami Mudaliar was the Vice-Chancellor of Madras University.
• Chadha Committee, 1963. This committee was appointed under the chairmanship of Dr. M.S. Chadha, the then Director-General of Health Services, to advise about the necessary arrangements for the maintenance phase of the National Malaria Eradication Programme.
• Bhore Committee: The concept of primary health care was recommended by the ''; Bhore committee''.  This committee was set up in 1943 with Sir Joseph Bhore as its Chairman. It is also known by the name Health Survey & Development Committee.  It made comprehensive recommendations for the remodeling of health services in India. Some of the important recommendations were the Integration of preventive and curative services of all administrative levels. Development of Primary Health Centres in 2 stages Long term & Short term stage Major changes in medical education include 3-month training in preventive and social medicine to prepare ''social physicians''​

The correct answer is P = 1/f.

Explanation:

Power of a lens

• The power of a lens is defined as the reciprocal of its focal length.
• It is represented by the letter P.
• The power (P) of a lens of focal length (f) is given by \(P=\frac{1}{f}\)P=1fP=1f
• The SI unit of power of a lens is ‘dioptre’. It is denoted by the letter D.
• f is expressed in metres, and power is expressed in dioptres.
• Thus, 1 dioptre is the power of a lens whose focal length is 1 metre i.e., 1 D = 1 m^–1.

Additional InformationConcave Lens

• A concave lens is known as a diverging lens.
• The rays of light passing through the concave lens appears to be coming from a point known as focus.

Convex lens

• The convex lens is a converging lens that converges the ray of light to point.
• The ray of light converges at a point after refraction which is called the focus.

Sign convention

• Sign convention for a convex lens is as shown. It is also applicable for a concave lens in terms of sides.

The correct answer is Isobars.

Explanation:

Isobars 

• Isobars are the atoms with same mass number but different atomic numbers.
• Example, ₆C¹⁴ and ₇N¹⁴.
• Carbon and nitrogen have atomic numbers of 6 and 7, respectively. Carbon-14, an isotope of carbon, has the same mass number as nitrogen-14.
• Thus, carbon and nitrogen are isobars.

Additional InformationIsotopes

• Atoms with identical atomic numbers but different atomic mass numbers are known as Isotopes.

Isotherm

• An isotherm is a relationship between the concentrations of a solid and a fluid that is used to describe no-change states in the sorption process.

Isohyets 

• Isohyets is a line drawn on a map or chart that connects areas with equal rainfall.

The correct answer is Br.

Explanation:

Bromine

• Bromine is a chemical element with symbol Br and atomic number 35.
• Carl Jacob Löwig and Antoine Balard, two chemists, independently discovered bromine in 1825 and 1826, respectively.

Additional InformationBeryllium

• Beryllium is a chemical element with atomic number 4 and the symbol Be.
• It is a steel-grey alkaline earth metal that is strong, lightweight, and brittle.

Boron 

• Boron is a chemical element with the atomic number 5 and the symbol B.
• It is a brittle, dark, lustrous metalloid in its crystalline form and a brown powder in its amorphous form.

Bismuth 

• Bismuth is a chemical element with atomic number 83 and symbol Bi.
• Bismuth is a brittle metal with a dark silver-pink colour.

Shortcut Trick

Time difference between crossing platform and man = 42 − 26 = 16 seconds.

This time difference is the time taken by the train to cover its own length plus platform, effectively covering the platform length alone in this extra time.

Platform Length = Speed × Time Difference

Platform Length = 29 m/s × 16 s = 464 m.

∴ The correct answer is 464 m.

Alternate Method

Given: Speed of train = 29 m/s, Time to cross man = 26 s, Time to cross platform = 42 s.

Formula Used: Distance = Speed × Time

⇒ Length of Train (L) = Speed × Time to cross man

⇒ L = 29 × 26 = 754 m

⇒ Total Distance to cross platform = Length of Train + Length of Platform (P)

⇒ L + P = Speed × Time to cross platform

⇒ 754 + P = 29 × 42

⇒ 754 + P = 1218

⇒ P = 1218 − 754 = 464 m

∴ The correct answer is 464 m.

Additional Information

Train Crossing Stationary Object

When a train crosses a point object (man/pole), distance = length of train. When it crosses a platform/bridge, distance = length of train + length of platform.

Unit Conversion

To convert kmph to m/s, multiply by 5/18. To convert m/s to kmph, multiply by 18/5.

Relative Speed

If two trains move in same direction, Relative Speed = S₁ − S₂. If in opposite directions, Relative Speed = S₁ + S₂.

One of the challenges, while doing research is to remain objective and free from biases. Most of your ideas and beliefs are probably linked with certain biases because they are influenced by your opinions or values. A variety of biases have been found to distort people’s impressions of collected data.

Key Points

• Procedural is a type of research bias. It happens when the participants are not given enough time to complete their responses.
• For example:- Employees are asked to fill out the feedback form during lunchtime, they will haphazardly without reading the questions properly. They are under unfair pressure that can affect the validity of their answers.

Thus, it is concluded that Applying an unfair amount of pressure to subjects to complete the responses quickly is called Procedural bias.

Additional Information

• Measurement bias is that bias or a random error that occurs in the collection of the data.
• Inclusion bias is popular in quantitative research and it happens when you select participants to represent your research population while ignoring groups that have alternative experiences.
• Selection bias: Any bias in selecting a group can undermine internal validity. Selection bias indicates the problem that occurs as a result of its existence at the pre-test differences between groups, may interact with the independent variable and thus influence the observed outcome and creates problems; examples would be gender, personality, mental capabilities, and physical abilities, motivation level and willingness to participate.

The correct answer is Municipal Corporation.

Key Points

• A municipal corporation is a type of local government in India that administers urban areas or big cities with a population of more than one million.
• The Mayor is the head of the Municipal Corporation.
• The office of the Mayor combines a functional role of chairing the Corporation meeting as well as a ceremonial role associated with being the First Citizen of the city.
• Municipal corporations are established for the administration of big cities like Delhi, Mumbai, Bangalore, etc.

Additional Information

• Municipal Corporation
• Municipal corporations are established by acts of the concerned state legislatures, and in the union territories by acts of the Parliament of India, for the management of large cities such as Delhi, Mumbai, Kolkata, Hyderabad, Bangalore, and others.
• A single act may apply to all municipal corporations in a state, or each municipal corporation may have its own act.
• Authorities of a municipal corporation.
• The council
• Deliberative and legislative wing
• Consists of the directly elected councillors as well as a few nominated persons having knowledge or experience of municipal administration.
• The Council is headed by a mayor, having a one-year term.
• Mayor is elected by a majority.
• Mayor basically acts as an ornamental figure and a formal head of the corporation.
• Mayor's main role is to preside over the meetings of the Council.
• The standing committees
• To facilitate the working of the council, which is too large in size.
• They deal with public works, education, health, taxation, finance and so on.
• They take decisions in their fields.
• The commissioner
• The municipal commissioner is in charge of putting the council's and standing committees' decisions into action.
• As a result, he is the corporation's chief executive officer.
• He is a member of the IAS and is appointed by the state government.

The correct answer is 1929.

Key Points

• The Child Marriage Restraint Act, 1929 was also known as Sarda Act.
• The act was passed on 28 September 1929.
• As per the act the age of marriage for girls was fixed at 14 years and for boys it was 18 years.
• Later through an amended it was changed to 18 for girls and 21 for boys.
• The name Sarda was derived from its sponsor Harbilas Sarda.

Shortcut Trick

To find the simultaneous ringing time, calculate the Least Common Multiple (LCM) of the given intervals.

Intervals: 78 seconds and 46 seconds.

LCM(78, 46) = 2 × 39 × 23 = 1794.

The bells will ring together again after 1794 seconds.

∴ The correct answer is 1794 sec.

Alternate Method

Given: Time intervals of two bells are 78 sec and 46 sec. They ring together at 10:00 AM.

Formula: Time after which periodic events coincide = LCM of individual time intervals.

Finding LCM using Prime Factorization:

⇒ Factors of 78 = 2 × 3 × 13

⇒ Factors of 46 = 2 × 23

⇒ LCM = 2¹ × 3¹ × 13¹ × 23¹

⇒ LCM = 6 × 13 × 23

⇒ LCM = 78 × 23

⇒ LCM = 1794

∴ The correct answer is 1794 sec.

Additional Information

LCM (Least Common Multiple)

The smallest positive integer that is divisible by all numbers in a set. It is widely used to solve problems involving circular tracks, traffic lights, and bell intervals.

HCF (Highest Common Factor)

The largest number that divides two or more numbers without leaving a remainder. It is also known as GCF (Greatest Common Factor).

Product Rule

For any two positive integers A and B: A × B = HCF(A, B) × LCM(A, B). This property is useful for finding one value when the other three are known.

The given series is:

3, 7, 16, 35, 74, ?

The pattern follows here is:

Hence the correct answer is 153.

The correct answer is Uttar Pradesh.

Key Points

• Fatehpur Sikri is a town in Agra District (UP).
• Agra used to be the capital of the Mughal Empire in 1571.
• Agra is on the banks of the Yamuna river.
• Agra is a major tourist destination because of its many Mughal-era buildings, notably the Taj Mahal, Agra Fort and Fatehpur Sikri, all of which are UNESCO World Heritage Sites.
• Fatehpur Sikri was built by the Mughal emperor "Akbar" in 1569.
• Fatehpur Sikri is the best example of Muslim architecture.

Given:

Total boys are examined in a test = 1350

Total girls are examined in a test = 900

42% of the boys and 36% of the girls pass the test.

Formula used:

The percentage of the total who failed = (Total number of failed in test/Total examined in test) × 100

Calculation:

Total boys are examined in a test = 1350

Percentage of boys passed in test = 42%

∴ Number of boys passed in test = 1350 × (42/100) = 56700/100 = 567

Total girls are examined in a test = 900

Percentage of girls passed in test = 36%

∴ Number of girls passed in test = 900 × (36/100) = 32400/100 = 324

Total number of boys and girls are examined in test = (1350 + 900) = 2250

Total number of boys and girls are passed in test = (567 + 324) = 891

∴ Total number of failed in test = (2250 - 891) = 1359

The percentage of the total who failed = (1359/2250) × 100 = 60.4%

∴ The percentage of the total who failed = 60.4%

The correct answer is Foreign investment.

Key Points

• Worldwide investment in multinational companies (MNC) is called foreign investment.
• It is an investment made by a company or individual from one country to the business of another country.
• It is also called foreign direct investment.
• It is an important factor in economic growth in the country.
• In Foreign direct investment, a foreign entity acquires shares or ownership in the company and can influence day-to-day businesses and operations.
• It is not an only inflow of money but also technology, skills and expertise.
• It is one of the major ways of capital transfer internationally and how well it is working will depend upon the host country’s system and infrastructure.
• FDI in India improved after the LPG reforms of 1991.
• The government opened the economy for investment and improved FDI norms.

Additional Information

The correct answer is Music.

• Bhupen Hazarika, who received the Bharat Ratna award in 2019, is famous in the music field.

Key Points

• Assamese singer Bhupen Hazarika was most popular in Bengal and Bangladesh and was responsible for introducing the culture and folk music of Assam and northeast India to Hindi cinema.
• Popularly known as Sudhakantha, meaning the nightingale.
• He had received:
• The National Film Award, Padmashri, Dada Saheb Phalke Award, Padma Vibhushan, and many other prestigious honours.
• He was known for his baritone voice and for making music on themes ranging from romance to social and political commentary. Some of his renowned works in Assamese music which audiences still enjoy includes "Bistirno Parore", "Moi Eti Jajabo", "Ganga Mor Maa", and "Bimurto Mur Nixati Jen".

Additional Information

• Bharat Ratna is the highest civilian honour in India.
• Any person without distinction of race, occupation, position, or sex is eligible for these awards.
• Bharat Ratna was instituted in the year 1954.
• It is not mandatory that Bharat Ratna be awarded every year.
• The first three recipients of Bharat Ratna are:
• C. Rajagopalachari.
• Sarvepalli Radhakrishnan.
• CV Raman.
• Lal Bahadur Shastri was the first person to be awarded Bharat Ratna posthumously.
• Khan Abdul Ghaffar Khan was the first foreigner to get Bharat Ratna.
• Indira Gandhi was the first woman to get Bharat Ratna.
• Sachin Tendulkar is the first sportsperson to get Bharat Ratna.
• There is no Bharat Ratna for the year 2021.

The correct answer is Swimming.

Key Points

• Ian Thorpe :
• Ian James Thorpe is an Australian retired swimmer who specialized in freestyle.
• But also competed in backstroke and the individual medley.
• He has won five Olympic gold medals, the most won by any Australian.
• Medals:
• Swimming at the 2004 Summer Olympics – Men's 4 × 200-meter freestyle relay.

The correct answer is 18.

Key Points

• Minimum age for marriage:
• The term refers to the age before which no man or woman can marry.
• In India, the legal marriage age has gone through several changes.
• But since 1978, the legal age for marriage for boys and girls are respectively 21 and 18 years.
• However, recently in Dec 2021, the Central government raised the legal marriage age for women from the current 18 to 21, at par with men.
• Due to the below reasons, the minimum age for marriage is set for the following reasons:
• To prevent child marriage.
• To empower girls and prevent them from pre-mature sex.
• A person should be mature enough to get married.

Important Points

• Prohibition of Child Marriage Amendment Bill introduced in Lok Sabha referred to Standing Committee
• The Prohibition of Child Marriage (Amendment) Bill 2021, which seeks to enhance the legal minimum age of marriage of a girl from 18 to 21 across all religions was introduced in the Lok Sabha amid protests by the Opposition members on 21 Dec 2021.
• After the introduction of the Bill, it was sent to the Standing Committee of the Parliament for further discussion and scrutiny.
• Introducing the Bill in the House, the Women and Child Development Minister, Smriti Zubin Irani said that the Legislation will provide the right of equality to women across all religions and castes in marriages.
• based on the recommendation of a four-member task force led by former Samata Party chief Jaya Jaitly.

The correct answer is the President.

Important Points

• The  President is the head of the Indian state and the first citizen and acts as a symbol of Unity Integrity and Solidarity of the nation.
• Our President is called the first citizen of India because he/ she represents our country and he/she is the head of the Executive, Legislature, Judiciary, the three arms of our government and also the head of our armed forces.
• All the executive actions are taken in his/her name.
• All the treaties or International agreements are carried out by his/her name and all diplomatic relations are maintained by his name.​

Additional Information 

• The President comes under Articles 52 to 62 in part V of the Indian Constitution.
• The President is elected by the:
• Elected members of both houses of parliament.
• Elected members of the legislative assemblies of the states
• The elected members of the legislative assemblies of the union territories of Delhi and Puducherry.
• Qualifications of the President are:
• He should be an Indian Citizen.
• His age should be a minimum of 35 years.
• He should qualify the conditions to be elected as a member of the Lok Sabha.
• He should not hold any office of profit under the central government, state government, or any public authority.
• Once President is elected, he holds office for five years.
• He can also be re-elected and there is no cap on his re-election.

The arithmetic average which is obtained by summing up all the observations and dividing the total by the number of observations is called Mean.

Formula to find the mean (\(\bar x\)) of a given data is,

Mean (\(\bar x\)) = Sum of all observations/Total number of observation