1 Radiodiagnosis
Ophthalmology
Psychiatry
Orthopaedics
Eighth Edition
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Not only this book, my whole life is dedicated to
Bhagwan Ratneshwar, my Mother and Father
Preface to the Eighth Edition
We are thankful for your reviews that has given us a fresh impetus to completely change this book in a more systematic way.
In this edition, the entire book has been revised, with a view to eliminating errors, incorporating suggestion of readers,
updating concepts and discarding material that is no longer relevant. Our aim was to update all subjects according to recent
available text. For convenient reading subject has been divided into theory and MCQ portion and further subdivided into
chapters and sub-chapters; according to their topics. In this way the book has been kept concise while remaining as up to date
and accurate as possible. Our major goal was to make this book more interesting and user-friendly, with a substantial reduction
in overall size of the subject. To achieve this goal the book has been rigorously edited involving their amalgamation, division,
or deletion. This has been put to effect without loss of crucial information but with gain in conciseness and clarity. We have kept
the book succinct and to the point. The job that was no mean feat has become possible only because of the best endeavours of
our team.
Many MBBS students do not have a good background in these subjects. This examination-oriented book is written with
these students in mind. The language is simple, explanations clear and presentation very systematic. Our commitment to
simplicity is total! This book will help you overcome the fear of these subjects. Topics, which usually confuse the students,
are explained in greater detail. This text will help you learn faster and enjoy it more! Stress is on understanding as well as
memorization. It is intended that every topic should be approached in a pragmatic and flexible manner.
This book is an important text for Postgraduate Entrance Exams. Your choice of a book can mean success or failure. Because
today you need a book, that can help you streak ahead of competition and succeed. No one knows more about your needs than
us. It is a tall claim, but it is true!
I think the time has come to make you realize the importance of the phenomenon of contradiction (POC) in medical preparatory
exams. You all must understand, that medical science is a dynamic (ever changing) and relative science which is made-up of
innumerable number of research papers from different part of world (some of them contradicting each other and with their
own most common, most preferred and best, etc). And each topic has been explained in books of various specialties (like a topic
about kidney is explained in books of nephrology, urology, radiodiagnosis, genitourinary imaging, nuclear medicine, oncology,
radiotherapy, medicine, surgery, anatomy, physiology and so on) giving their own shades to the topic focusing more on their
aspect of that topic; and not to mention about numerous authors of each subject.
So when a book by an author (many times even Harrison) says anything, it is not always an absolute truth, if it is against
the basic broad concept of that topic. So be very cautious before blatantly remarking any answer wrong on the basis of single
line written in one book. And try to avoid amending answers on the basis, of one British/American/French research paper until
and unless it is a ground breaking/Nobel prized research paper because most of the times you even do not know the statistical
significance of that paper.
Your standard reference/textbooks tell you the extract of statistically significant research papers (most of which are paid
review papers comparing the contradictory papers about that topic and few new statistically significant research papers). So
leave this cumbersome responsibility of which paper to include/believe or exclude/not to believe on reference books.
In nut shell, never try to believe an answer on the basis of journals (freely available on internet) when you are getting a
logical answer in your reference textbooks. Because most of the PGMEE questions are concept (not research) based.
We have elaborately explained this phenomenon in few selected answers, which were controversial/wrong according to
some reviews. In last 12 years (initial 6 years in CROSS) we have explained few of these questions at least 6 times but the answer
always remained same. It is not always possible to elaborate all answers to such a huge extent but believe us research done to
find a perfect fitting answer is always far more extensive and exhaustive and many times include reading hundreds of pages
and spending weeks of time for getting one perfect line.
Knowledge without purpose is only a useless collection of words. So before attempting any question, always follow the
algorithm of why, how, and what, i.e. why this question has been asked?, how it is going to make me a better clinician? and
Preface to the Eighth Edition
what have I learnt while finding the correct answer? After following this approach you would realize that most questions are
based on very basic concepts of medical science used to differentiate various diseases. And this process of giving purpose to
your learning would never allow you to forget the concept, making your remembering easy.
Never restrict your imagination by thinking that only purpose of reading is to pass PGMEE. Instead, always think that how
this information makes me a better, safer clinician. Believe me, a student who approaches the exams in this way always gets
success, whatever the pattern of examination maybe because purpose of all examinations is only and only this.
This book has helped students to secure good ranks in various patterns of entrance exams including AI, AIIMS, PGI, DNB,
JIPMER, CMC, AFMC, AMU and various state PGME exams for last 14 years. So, do not worry about the pattern of NEET and
its conducting body (presently DNB) because this book incorporates the latest text and 20 year questions about most important
topics in a sequential manner.
Saumya Shukla
v
Acknowledgments
"To Bhagvan Ratneshwar"
At the very outset, I fail to find adequate words, with limited vocabulary at my command, to express my emotions to 'Dear God',
whose eternal blessings, divine presence, and masterly guidance helps us to fulfill all our goals.
It is very difficult to find a true Guru in this materialistic world. But I am lucky and I fail to find words to express my
emotions to "Swami Swayambodhanand Sarawasati" (Swami Ji) for his colossal and beatific spiritual cosseting, without which
I would never have been like this.
I will always remain obliged and grateful to my teachers Prof OP Singh, MS, FICS, MAMS; Prof VD Sharma, MS,
FICS, Prof Vineet Sharma, MS, FICS, Dr Ashish Mahendra, MS, MCh, FRCS, Orthopaedics Department, KGMC, Lucknow,
Prof KD Khare Retd HOD, AFMC, Pune and Dr RK Singh, MS, D Orth for their inspiration and encouragement, which gave
succour and strength to my thoughts and mapped my way to find a modus operandi for myself.
Sometimes it is not easy to express your emotions in words especially when you have to say thanks to your parents for
their constant undemanding love, dedication, sacrifice, inspiring guidance, affectionate encouragement and never ending
enthusiasm; without which this book would not have seen the light of the day.
An ostentatious use of word will not be sufficient to express my heartiest thanks to Dr SK Dikshit, Mr LN Dikshit,
Dr (Mrs) Arti Shukla (MD, Obs and Gynae), Dr Smita (RIMS) and Dr Sneha Dikshit (AMU), Dr Harish Dikshit, Dr VN Shukla,
Dr Shraddha Shukla, Smt Kamla Devi, Mr PS Shukla and Mr Dev S Shukla, Mr Sujit Kumar Mishra, Aditi and Kriti Tripathi
for their meticulous efforts during the making of this book. Their valuable and critical suggestions, constant inspiration and
encouragement, instinctive corrective measures, tireless efforts, unstinted cooperation and sentimental support throughout
have made this marathan task a smooth journey.
It is hard to envisage how it could have happened without the assiduously deligent and ingenious editing effort and proof
reading of Dr Monika, Mrs Vibha Shukla, Mr VS Shukla. And infact this book would never have been like this without the expert
technical consultations and dexterous work of Mr Sayeed and Mr Saleem and their team at Compsphere.
It would be a sacrilege if I do not mention the names of my friends, whom I always find with me in every filed of life.
- Dr Sunil Kumar Paltan (Asst Prof Ortho, Safai) - Dr Gopal Singh, MS Ortho, KGMC
- Dr Sachin Awasthi, MS Ortho, KGMC - Dr Pradeep Pandey, MS Ortho, KGMC
- Dr Saurabh Agarwal, MS Ortho, KGMC - Dr Rudra Pratap Singh, SR Orthopaedics, GTB, Delhi
- Dr Mukul Singh, MD Ortho, KGMC - Dr Atul Jain, MS Orthopaedics, KGMC
- Dr Harish Ghoota, MS Orthopaedics, KGMC - Dr Shaleen Verma, MS Orthopaedics, KGMC
- Dr Ankur Das, MS Orthopaedics, KGMC - Dr Abhishek Manu
- Dr Nitin Joshi, MS ENT, KGMC - Dr Sandeep Buratodi, MD Radiology, KGMC
- Dr Sandeep Tripathi, MD Pediatrics, LHMC, New Delhi - Dr Sandeep Rai, MS Gen Surgery, GSVM
- Dr Suneel Chamoli, MD Psychiatry, KGMC - Dr Ashish Gupta, MD Radiology, KGMC
- Dr Sharad Chandra, DM Cardiology, AIIMS - Dr Vipin Gupta, MS Gen. Surgery
- Dr Anil Kumar Singh, MD, Medicine MAMC, New Delhi - Dr Nasir Ahmed, BRDMC, Gorakhpur
- Dr Jai Jag Tambe, SR, Pediatrics, LHMC, New Delhi - Dr Gunjan Das Agarwal, MD Radiology, KGMC
- Dr Chitwan Dubey, MS Obs and Gyne, Grants, Mumbai - Dr Anubhav Pandey, MD Microbiology, AIIMS
- Dr Ambuj, MS General Surgery (Pune) - Dr Sandhya Mishra, DNB, Obs and Gynae, Mumbai
- Dr Chander Shekher Kumar, MS, Ophtha, AIIMS - Dr Vikas Mathur, NRSMC
- Dr Parul Kakkar, Dr Gaurav Mittal - Dr Arijit Mitra, NRSMC
- Dr Rohit Jain, MD Patho, Ahmedabad - Dr Gunjan Raghuvanshi, MD Patho, Agra
- Dr Vineet Kumar, MD Psychiatry, PGI Chandigarh - Dr Nilanjana Gosh
- Dr Prajna Latika - Dr Avneet, KGMC, Dr Gopal Singh, GSVM
- Dr Anurag Yadav, MD Pediatrics - Dr Athar Mohammad, KGMC
Acknowledgments
vii
Contents
I. Dermatology (Skin and Veneral Diseases) S.1-S.200
1. General Anatomy and Appendageal Disorders 3
2. Disorders of Pigmentation 23
3. Allergic Disorders and Dermatitis (Eczema) 35
4. Papulosquamous Disorders 48
5. Papulo-Vesicular/Vesico-Bullous Disorder and Immunologically Mediated Disease 65
6. Systemic Disease with Prominent Cutaneous Features, Photosensitivity and Cutaneous Drug Erruptions 92
7. Leprosy (Hensen's Disease) 118
8. Skin Tuberculosis and Other Bacterial Infections 132
9. Fungal Infections 141
10. Scabies 151
11. Pediculosis 156
12. Veneral (Sexually Transmitted) Disease 157
13. Genodermatoses and Deficiency Diseases 177
14. Malignant Skin Disease 190
V. Radiodiagnosis RD.437-RD.616
1. Physics and Technique 439
2. Systemic Radiodiagnosis I: Neurology and Nephrology 456
3. Systemic Radiology II: Others 502
4. Diagnostic Features and Specific Signs 579
5. Investigation of Choice 597
ix
A Complete Review of Short Subjects (Vol-1)