QBank Fortnightly Newsletter

VOLUME 1, ISSUE 4

We are back with the fourth issue of our newsletter. This time we bring you a mixed-bag of Qbank updates.

Take a look at the various updates and the new and revised MCQs.

1. Fragile X-associated primary ovarian failure (MCQ id- MC2220)

CGG premutation in FMR 1 gene is seen in Fragile X-associated primary ovarian failure, as well as Fragile X-ataxia(progressive neurodegenerative syndrome).

Women affected with fragile X–associated primary ovarian failure have menstrual irregularities and decreased fertility. 

FSH levels are elevated, and antimüllerian hormone levels are decreased—both are markers of declining ovarian function. 

Reference- Robbins and Cotran Pathologic Basis of Disease, 10th edition, page no 177.

2. Ferroptosis (MCQ id- MD4614)

Ferroptosis is a new mechanism of cell death that has been introduced in the latest edition of Robbins. It is a distinct form of cell death that is triggered when excessive intracellular levels of iron or reactive oxygen species cause unchecked membrane lipid peroxidation. The process can be prevented by reducing iron levels.

Ferroptosis has been linked to cell death in a variety of human pathologies, including cancer, neurodegenerative diseases, and stroke.

Reference- Robbins and Cotran Pathologic Basis of Disease 10th edition, page no 47

3. Osteomalacia and paraneoplastic syndrome (MCQ id: MD4606)

As per the recent edition of Robbins, Osteomalacia occurs as a paraneoplastic syndrome due to phosphaturic mesenchymal tumour. The gene mutation responsible for the disease is FGF-23 gene.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th edition, page no 329.

4. Antibiotics as the most common anaphylactic agent (MCQ id:MA6987)

As per the recent edition of Miller’s, the most common anaphylactic agent during anesthesia is antibiotics followed by neuromuscular blocking agents. 

Among the antibiotics, penicillins and cephalosporins are most commonly implicated in deaths due to anaphylaxis.

Ref: Miller’s Anesthesiology, 9th edition, pane no. 980

5. Routine antenatal anti-D prophylaxis (RAADP) (MCQ id: MB1404, MC9526, MB9714)

NICE now recommends a single dose of 1500 IU (300 mcg) of anti-D at 28 – 30 weeks as the Routine Antenatal Anti-D Prophylaxis (RAADP). As per the earlier guidelines, 2 doses (at least 500 units each) at 28 and 34 weeks of gestation were recommended. Now only a single dose is required as prophylaxis.

Also, 1500 IU is the minimum dose of Anti D which is used for alloimmunization as per the recent NICE guidelines.

Reference: https://www.nice.org.uk/guidance/dg25/resources/clinical-guideline-rhesus-rhd-negative-antenatal-management-bristol-university-hospital-pdf-4368966308  https://www.nice.org.uk/guidance/dg25/resources/guidelines-for-the-use-of-antid-taunton-and-somerset-nhs-ft-pdf-4368966307, page 6.

6. Medical management of induced abortion (latest WHO guideline) (MCQ ID: MB9780)

This recommendation has been updated from the WHO 2012 safe abortion guidance and presents recommendations related to medical management of induced abortion at < 12 weeks and at ≥ 12 weeks. 

Recommendation for induced abortion for < 12 weeks of gestation:

  • Combined Regimen (Recommended): 200 mg of oral Mifepristone followed 1-2 days later by 800 mcg of buccal, vaginal or sublingual Misoprostol
  • Misoprostol only regimen (Alternative): 800 mcg misoprostol administered vaginal, sublingual, or buccal routes.

This updated recommendation applies to pregnancies up to 12 weeks of gestation, whereas, in the previous guidelines, different regimens were recommended for pregnancies up to 7 weeks, 9 weeks, and 12 weeks. 

For the recommended misoprostol-only regimen, the buccal route of administration has been added and the maximum number of doses has been removed. 

Recommendation for induced abortion for >12 weeks of gestation:

  • Recommended Combined Regimen: 200 mg of oral Mifepristone followed 1-2 days later by 400 mcg of buccal, vaginal, or sublingual Misoprostol, every 3 hours.
  • Misoprostol only regimen (Alternative): 400 mcg misoprostol administered vaginally, sublingually or buccally, every 3 hours.

In pregnancies, more than 12 weeks of gestation the combined regimen (mifepristone and misoprostol) does not have the loading dose of 800 mcg misoprostol as in the prior guidance. 

For both the combination regimen and the misoprostol-only regimen, the buccal route has been added as an option. The maximum number of doses has been removed and the time period between mifepristone and misoprostol dosing is given in days.

Ref: https://apps.who.int/iris/bitstream/handle/10665/278968/9789241550406-eng.pdf?ua=1

7. C3 convertase controversy (re-solved) (MCQ ID: MC2954)

Clearing the confusion, in accordance with the latest update, C3 convertase in the classical complement pathway and lectin complement pathway is C4b2a.

C3 convertase in the alternate complement pathway is C3bBb.

Ref: Kuby’s Immunology – 8th edition, Page no. 364.

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87 Responses

  1. Dr ram yadav says:

    Very good for pregnant Lady to single dose anti D prophylaxis, new update for MTP.

  2. Akshata says:

    How can I save these newsletter for later review???

  3. SARITA says:

    i love all the features of marrow

  4. Sana says:

    Amazing! Thank you Team Marrow ♥️

  5. Kailash Kumar says:

    Can you make update column in marrow app ,segregated subject wise.

  6. Sunil says:

    Marrow is Continuously improving itself

  7. SUSHMITA says:

    Thank you very much for such updates

  8. Vinay says:

    How can i save

  9. Dr.Mukesh kumar jatav says:

    👍👍👍

  10. Dr.Mukesh kumar jatav says:

    Nice vedios

  11. Dr S. Das says:

    Nice gesture from Marrow…. But please send it as an email format so that we can review it later.

  12. Paramita Saha says:

    Can I get link of the previous 3 issues please?. I have missed them.

  13. Paramita Saha says:

    Can I get link of the previous 3 issues please?. I have missed them.

  14. Vikas Adikenavar says:

    How can I save these newsletter for later review???

  15. Arunkumar says:

    Thank you

  16. Arun says:

    Thank you

  17. Dr Lalita says:

    Okay

  18. sellakannu says:

    Please compile those updates into pdf format so that we can download and review this

  19. Shree says:

    Good, how can we review this later?

  20. M.Harika says:

    Useful

  21. Dr. Jitendra says:

    Superub.

  22. Gargi says:

    Thankyou marrow team for the amazing effort

  23. Sridharan Srivasudevan says:

    Dear sir/mam, How can I save these updates for last minute reading?

  24. R.sudheer says:

    How can we save the newsletter

  25. Snigdha says:

    How can i save this newsletter for later review?? Nd how can I see those previous 3 edition??

  26. Snigdha says:

    how can I see those previous 3 editions of newsletter?? Nd how can we save it

  27. Debasis Dash says:

    Thank u marrow

  28. SATYA NARAYAN DAS says:

    Thank you

  29. Dr ranjeet singh says:

    👍

  30. Phoebe says:

    Thankyou marrow

  31. Rcd Rvg says:

    Thank u marrow

  32. Twinkle Mukherjee says:

    Where will I get the previous 2 issues?? I missed somehow.. Can anybody share??

  33. Aditi Singh thakur says:

    Where can I find the issue 1,2,3??

  34. Gopikrishna says:

    Vera maari ,Vera maari

  35. Kuruva Kuruva Janakiramudu says:

    Fantastic. Iam very happy with this. Thank u very much

  36. PD says:

    Thank you team!

  37. Ravi kumar says:

    How many Doses for misoprostol and mifepristone??

  38. Archana says:

    Thank you

  39. Dr.Sujeet Agrahari says:

    Thank you for for this update.please always remind us, like this update because didn’t know about 1,2,3.🙏

  40. Mushtaq ahmed says:

    nice effort

  41. Dr.Sujeet Agrahari says:

    👍

  42. Arpit Agrawal says:

    Great and helpful updates. Thank you.

  43. Arjun says:

    Where can we get previous newsletters?

  44. Anubhav says:

    Thank you

  45. Dheeraj says:

    Thank you Marrow team

  46. Neha says:

    Thank you marrow for being up to date.

  47. Au says:

    Thanks marrow

  48. Varsha varghese says:

    Thank you marrow team doctors

  49. Pratima Kumar Eluri says:

    Thank you Marrow for your amazing effort

  50. Swapnil bansod says:

    Can we get previous 3 issues ??

  51. Swapnil bansod says:

    How can we get previous 3 issues ??

  52. Dr masood says:

    Thanks for this

  53. Khyati says:

    Is there any update or changes in Robbins 10th addition..other than these..??

  54. Khyati says:

    Is there any update or changes in Robbins patho 10th addition..other than these??

  55. Khyati Jotangiya says:

    Is there any other update or changes in Robbins 10th addition??

  56. pariii says:

    thank you

  57. Mathivaanane says:

    Sir can you brief me about ferroptosis and its association with tumorogenesis

  58. Sujata Subedar says:

    Much needed.. thanks a lot

  59. ayushi says:

    i missed last fortnight issues how vl i get those??

  60. Valli says:

    This s a great oppurtunity since i am working and trying to get this pg …and you people are making it happy..thank you all

  61. VALIYA (MISS)BHOOMI MANJIBHAI says:

    ..

  62. Merlin says:

    Thank you

  63. J yazhisai venba says:

    👍

  64. Db says:

    Thank you for ur support

  65. Suganya says:

    Thank you Marrow

  66. Krishna deo prasad says:

    Thanks a lot sir…..

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