RETINA DIGEST Blood

Aa¨vq: 04 gvbe kvixiZË¡ : i³ I mÂvjb

 G Aa¨vq †_‡K Aek¨B hv Rvb‡Z n‡e-

 i³ I i‡³i Dcv`vb [M.19-20, 18-19, 17-18,15-16,12-13,11-12,09-10,02-03, D.17-18]
 i³ ZÂb I jwmKv [M. 09-10,08-09,03-04,D.17-18]
 ürwc‡Ûi MVb Ges KvwW©qvK P‡µi NUbvejx [M.15-16,13-14,09-10,07-08,D. 17-18, M: 18-19]
 gvbe †`‡ni i³ msenb; agbx I wkiv [M.08-09,05-06,01-02, D. 10-11,07-08]
 ürwc‡Ûi gv‡qv‡RwbK wbqš¿‡bi welqmg~n [M.19-20, 10-11,09-10,07-08,04-05,03-04]
 i³Pvc [M.18-19]
 ürwcÛRwbZ mgm¨v, KviY, j¶Y I cÖwZKvi| [M.17-18,08-09]

Key words
d¨v‡MvmvB‡Uvwmm : ¶Yc` cÖmviY K‡i f¶Y cÖwµqv|
G‡Ûv‡_wjqvg : AšÍtAveiYx|
‡nvwgI÷¨vwmm : †`‡ni Af¨šÍixb ¯^vfvweK Ae¯’v eRvq ivLvi Rb¨ †`‡ni wbR¯^ cÖ‡Póv|
wn‡gv÷¨vwUK cø¨vM : ¶Z¯’v‡b AYyPwµKv¸‡jv ci¯ú‡ii mv‡_ hy³ n‡q i³cvZ cÖwZ‡iv‡ai D‡Ï‡k¨ †h †`qvj ˆZwi K‡i|
Serology : wmivg welqK covïbv|
A¨v‡Wb‡qW : Mjwe‡ji cðvr cÖvPx‡i Aew¯’Z Ubwmj m`„k A½|
wf‡mivj : †Kvb A‡½i AveiYxi †mB ¯Íi hv A½wUi Mv‡q Rwo‡q _v‡K|
c¨vivBUvj : wf‡mivj ¯Í‡ii evwn‡i †h ¯Íi _v‡K|
gv‡qv‡RwbK : ‡ckx‡ZB DrcwË jvf K‡i‡Q Ggb|
e¨v‡ivwi‡mÞi : PvcMÖvnK
KvwW©qvK : ü`wcÛ m¤úwK©Z
cvj‡gvbvix : dzmdzmxq/dzmdzm m¤úwK©Z
gv‡qvKvwW©qvj BbdvK©kb : O2 ¯^íZvi Kvi‡Y gv‡qvKvwW©qv‡gi †ckxi cPb ev bó nIqv|
wn‡gv‡÷wmm : i³ RgvU euvav/i³ZÂb cÖwµqv
jy‡gb : bvjxi gv‡S duvcv Ask|
e¨v‡ivwi‡d¬· : e¨v‡ivwi‡mÞi KZ©„K i³Pvc wbqš¿b|
A¨v‡_‡ivgv : †h Kvi‡Y K‡ivbvwi agbx miæ n‡q hvq|
_ª‡¤^vwmm : i³evwnKvi Af¨šÍ‡i i³ZÂb|
nvU©eøK : ü`¯ú›`b wgwb‡U 30-40 ev‡i †b‡g Avm‡j Zv‡K nvU© eøK e‡j|
‡ngv‡UvjwR : i‡³i MVb, i³ m„wó cÖwµqv, i³ msµvšÍ ‡ivM wb‡q wPwKrmv weÁv‡bi kvLv‡K †ngv‡UvjwR e‡j|

 GKUzLvwb BwZnvm
 cÖ_g i³ msen‡bi eY©bv †`bÑDBwjqvg nv‡f©
 cÖ_g ürwc‡Ûi eY©bv †`bцigÛ wW wfD‡mÝ
 cÖ_g i³Pvc cwigvc K‡ibÑw÷‡db †njm
 cÖ_g †÷‡_v‡¯‹vc Avwe®‹vi K‡ibцib wj‡bK
 cÖ_g I‡cb nvU© mvR©vwi K‡ibÑwµw÷qvb evb©vW
 cÖ_g K…wÎg ürwcÛ ˆZwi K‡ibÑievU© RviwfK
 cÖ_g K…wÎg ürwcÛ ms¯’vcb K‡ibÑDB‡jg wW wåm [m~Î: Avjxg m¨vi]

1
RETINA DIGEST Blood
i³
➥ i³ Zij †hvRK Kjv ➥ i‡³i cwigvY 5-6 wjUvi ev 4.5-5.5L [m~Î: Avjxg m¨vi] hv †`‡ni ‡gvU IR‡bi 8%
➥ i‡³i pH: 7.35-7.45 (Mo-7.4) ➥ i‡³i ZvcgvÎv: 36 0-380 C
➥ i‡³i Av‡cw¶K ¸iæZ¡ 1.065 ➥ A‰Re je‡Yi Dcw¯’wZi Rb¨ i³ jeYv³ ¯^v`wewkó
➥ i³ wbDU‡bi mv›`ªZv m~Î †g‡b P‡j bv ➥ i‡³i NbZ¡ 1060kg/m3
➥ i³ mvgvb¨ ¶vixq ➥ e„wUk weÁvbx DBwjqvg nv‡f© 1628 mv‡j i³ msenb cÖwµqvi eY©bv †`b
➥ i³ msenbZš¿ 3wU Ask wb‡q MwVZ|
†hgb-
 i³  i³ evwnKv  ürwcÛ [m~Î: MvRx AvRgj,Avjxg I †gNbv` m¨vi]
 i‡³i KvRÑ
➥ k¦mb M¨vm cwienb ➥wewea e¯‘ cwienb Ñ †iPb eR©¨, ni‡gvb, A¨vw›UewW, LwbR jeY, GbRvBg, cøvRgv‡cÖvwUb
➥ Lv`¨e¯‘ cwienb/cywói evnK ➥ eR©¨ c`v_© wb®‹vkb
➥ Zvcmvg¨Zv iÿv/DòZv mgZv iÿv ➥ †ivM RxevYy cÖwZ‡iva
➥ i³cvZ cÖwZ‡iva ➥ ﮋZv cÖwZ‡iva
➥ †nvwgI÷¨vwmm iÿv ➥ pH wbqš¿Y
➥ cvwb mvg¨Zv iÿv ➥ ÿZ wbivgq
➥ Avq‡bi mgZv iÿv [m~Î: gv‡R`v g¨vg, Avjxg I †gNbv` m¨vi]
 †U÷wUD‡e i³ wb‡q †mw›UªwdDMvj h‡š¿ wgwb‡U 3000 evi K‡i 30 evi Nyiv‡j i³ 2wU ¯Í‡i fvM nq|
 Dc‡i nvjKv (njy` ) e‡Y©i cøvRgv, wb‡P Mvp Ask n‡jv i³KwYKv|

i³ i‡³i Ask †`L‡Z †KvWwU ¯‹¨vb K‡iv


 
i³im/cøvRgv (55%) i³KwYKv/Kicvmj (45%)
 
    
cvwb (90-92%) KwVb c`v_© (8-10%) †jvwnZ KwYKv †k¦Z-i³KwYKv AYyPwµKv
 
   
A‰Re (0.9%) ‰Re (7-8%) A`vbv`vi `vbv`vi
→ †mvwWqvg  
→ cUvwmqvg - wbD‡Uªvwdj
→ K¨vjwmqvg - wj‡ùvmvBU - BIwm‡bvwdj
→ g¨vM‡bwmqvg - g‡bvmvBU - †e‡mvwdj
→ dmdivm
→ Zvgv I †jvnv BZ¨vw`|

  
†cÖvwUb †cÖvwUb wenxb Ab¨vb¨ ˆRee¯‘
bvB‡Uªv‡Rb NwUZ c`v_©

A¨vjeywgb, †MøvweDwjb, nvB‡cvR¨vbw_b, BDwiqv, A¨v‡gvwbqv, Mø‡y KvR, cÖkwgZ †mœn `ªe¨, A¨vwg‡bv GwmW,
‡cÖv_ªw¤^b, dvBweª‡bv‡Rb BDwiK A¨vwmW, wµ‡qwUwbb, R¨vbw_b ‡Kv‡j‡÷ij, ni‡gvb, wfUvwgb, †jwmw_b,
GbRvBg, wewjiæweb, wewjfvwW©b BZ¨vw`
[m~Î: MvRx AvRgj I †gNbv` m¨vi]
2
RETINA DIGEST Blood

 cøvRgv †cÖvwUb: G P A 5

†MøvweDwjb †cÖv_ªw¤^b A¨vjeywgb dvBweª‡bv‡Rb

 †cÖvwUbwenxb N2 NwUZ †iPb c`v_©: wK †n Rv Avgv B

wµ‡qwUwbb nvB‡cvR¨vbw_bb R¨vbw_b A¨v‡gvwbqv BDwiqv, BDwiK GwmW

 A‰Re Dcv`vbÑ †m w`j dvjZz Avg

†mvwWqvg †K¬vivBW (NaCl) dmdivm †jvnv Zvgv Av‡qvwWb g¨vM‡bwkqvg cUvwkqvg K¨vjwmqvg
†mvwWqvg evBKve©‡bU (NaHCO3) (P) (Fe) (Cu) (I) (Mg) (K) (Ca)

i³im

 nvjKv njy` e‡Y©i, Clr ÿviag©x, A‡Kvlx Zij Ask

 i³i‡m †cÖvwU‡bi NbgvÎv : 6-8 gm/dl
 i³i‡mi NbZ¡ 1.025 g/mL
 i³i‡mi pH-7.4
 GKRb my¯’ c~Y©eq¯‹ gvby‡li †`‡n cÖvq 3L cøvRgv _v‡K hv †`‡ni †gvU IR‡bi 5%| (m~Î: Av: Avjxg m¨vi)
†iPb c`v_©-BDwiqv, BDwiK GwmW, wµ‡qwUwbb BZ¨vw`|
cÖwZi¶vg~jK `ªe¨vw`t A¨vw›UUw·b, A¨vMøywUwbb|
Dcv`vb
`ªexf~Z M¨vmmg~nt O2, CO2, N2.
i³ Avwgl 4wU| h_v: A¨vjeywgb, †MøvweDwjb, dvBweª‡bv‡Rb, †cÖv_ªw¤^b|
1. i‡³i ZijZv eRvq iv‡L| cvwbi mvg¨Zv iÿv K‡i|
2. cwicvKK…Z Lv`¨mvi wewfbœ wUmy¨ I A‡½ enb|
3. wUmy¨ †_‡K eR©¨ c`v_© †iP‡bi Rb¨ e„‡° cwienb|
4. AwaKvsk CO2 Ges Aí cwigv‡Y O2 cwienb|
5. ni‡gvb, GbRvBg, wjwcW, A¨vw›UewW cÖf„wZ wewfbœ A‡½ enb|
6. i‡³i A¤ø-¶v‡ii fvimvg¨ i¶v (H+ Gi mgZv i¶v)
KvR 7. cøvRgv †cÖvwU‡bi mvnv‡h¨ i‡³i AwfmªewYK i³Pvc eRvq iv‡L|
8. i³KwYKv aviY K‡i|
9. ‡`‡ni Zvc mvg¨Zv i¶v|
10. Gi dvBweª‡bv‡Rb I †cÖv_ªw¤^b i³Z‡b fywgKv iv‡L|
11. ‡ivM cÖwZ‡iv‡a mvnvh¨ K‡i|
12. ‡`‡ni ‡cÖvwUb Avavi wn‡m‡e KvR K‡i| †cÖvwU‡bi mÂq fvÛvi wn‡m‡e KvR K‡i|
(m~Î: MvRx AvRgj I Avãyj Avjxg m¨vi)

 AvšÍt †Kvlxq AvqwbK mvg¨Zv iÿvi gva¨‡g †`n‡K wewfbœ ai‡bi msµgY I †iv‡Mi nvZ †_‡K myiÿv `vb K‡i|

wmgy‡j‡UW ewW d¬zBW (Simulated Body Fluid SBF) GKwU we‡kl ai‡bi `ªeY hvi AvqwbK Dcv`vb A‡bKUv i³i‡mi gZ|
[m~Î: Avjxg m¨vi]
3
RETINA DIGEST Blood

01. i‡³i pH KZ?

A. 7.2 – 7.4 B. 7.35 – 7.45 C. 7.25 – 7.5 D. 7.1 – 7.4
02. wb‡Pi †Kvb Z_¨wU mwVK??
A. mRxe i‡³i ZvcgvÎv (36-38)F B. i³i‡m ˆSe Dcv`vb 7-9%
C. i³i‡m cvwbi cwigvY 55% D. my¯’‡`‡n cøvRgvi cwigvY 5-6 wjUvi
03. i³ Avwgl bq †KvbwU?
A. A¨vjeywgb B. †MøvweDwjb C. dvBweªbv‡Rb D. _ªw¤^b
04. i³i‡mi KvR †KvbwU?
A. AwaKvsk O2 I Aí cwigvY CO2 cwienb B. eøvW MÖæwcs‡q mvnvh¨ K‡i
C. H+ Gi mgZv iÿv D. i‡³i mv›`ªZv eRvq ivLv
DËigvjvt 1. B, 2. B, 3. D, 4. C

i³KwYKv
 i³KwYKv ¯^wefvwRZ nq bv ZvB G‡`i‡K †Kvl bv e‡j KwYKv e‡j [m~Î: gv‡R`v g¨vg]
 wewfbœ †Kvlxq A½vby bv _vKvq G‡`i mvKvi Dcv`vbI e‡j
 i³KwYKv cÖavbZ 3 ai‡Yi| h_vÑ Rvb‡Z n‡e mKj bvg
1| †jvwnZ i³ KwYKv/Red Blood cell (RBC) /Erythrocyte
2| †k¦Z i³KwYKv/wjD‡KvmvBU/White Blood Cell/(WBC)
3| AYyPwµKv/_ª‡¤^vmvBU/Platelet

†jvwnZ i³ KwYKv/Erythrocyte/wngvwUW
 MVb ˆewkó¨:
◉ †`L‡Z †Kgb? wKbviv A‡cÿv ga¨fvM A‡bK cvZjv
¯’~jZ¡ 2.2 m

wØ AeZj PvKwZi gZ,

jvj e‡Y©i e„ËvKvi/†Mvj

wbDwK¬qvmwenxb

e¨vm 7.3 m
◉ RBC †Z Kx Kx _v‡K bv?
 cwiYZ RBC †Z wbDwK¬qvm, RNA, MjwM ewW, gvB‡UvKwÛªqv, G‡ÛvcøvRwgK †iwUKzjvg _v‡K bv| [m~Î: Avjxg m¨vi]

◉ RBC †Z Kx _v‡K?
 RBC †Z wn‡gv‡Møvweb we`¨gvb|
Note: wn‡gv‡Møvweb: GwU 2wU wRwb‡mi mgš^‡q MwVZÑ
1. wng bvgK O2 evnx Fe mg„× iÄK
2. †Møvweb bvgK †cÖvwUb
* GKwU RBC Gi IR‡bi 33% wn‡gv‡Møvweb
4
RETINA DIGEST Blood

◉ KZUzKz Hb _v‡K?
 GKwU RBC †Z Hb = 29 wc‡KvMÖvg
 100mL i‡³ Hb = 16gm

◉ msL¨v (Must to Know)

 eqm‡f‡` cÖwZ Nb wgwjwgUvi i‡³ †jvwnZ KwYKvi msL¨v wbgœiƒct
åƒY †`‡nt 80-90 j¶
wkïi †`‡nt 60-70 j¶
c~Y© eq¯‹ cyiæ‡lt 54 j¶
¯^vfvweK c~Y© eq¯‹ ¯¿x‡`‡nt 48 j¶
cyiæl †`‡n KwYKvi msL¨vt 5.4 wgwjqb/mm3 blood
¯¿x †`‡n †jvwnZ KwYKvi msL¨vt 4.8 wgwjqb/mm3 blood [m~Î: Av: Avjxg m¨vi]
i‡³ RBC-Gi AvqZ‡bi kZKiv cwigvc‡K †ngv‡UvwµU e‡j| hv cyiæ‡li †ÿ‡Î 45%, ¯¿x‡`i 40%|

ESR (Erythrocyte Sedimentation Rate): cÖ_g N›Uvq 5mm Ges wØZxq N›Uvq 10mm nq|
➥ cwjmvBw_wgqv: †jvwnZ i³ KwYKvi msL¨v e„w× cvIqv| K‡jiv I D`ivgq †iv‡M †`Lv hvq|
➥ Awj‡MvmvBw_wgqv: i‡³ †jvwnZ KwYKvi msL¨v ¯^vfvweK A‡cÿv AwaK K‡g hvIqv|
➥ A¨vwbwgqv: kix‡i wn‡gv‡Møvwe‡bi Afve n‡j i³k~b¨Zv ev A¨vwbwgqv †`Lv †`q|
➥ _¨vjv‡mwgqv: wn‡gv‡Møvweb ms‡kø‡li ÎæwURwbZ GK ai‡bi eskMZ †ivM, †h‡ÿ‡Î wn‡gvjvBwUK A¨vwbwgqv nq|

◉ †jvwnZ i³ KwYKvi m„wói Drm

1. åæ‡Yi Kzmyg _‡j †_‡K (Giv wbDwK¬qvmhy³)
2. R‡b¥i GKgvm c~‡e©-hK…Z I cøxnv †_‡K|
3. R‡b¥i ci cÖavbZ †jvwnZ Aw¯’g¾v, wdgvi I wnD‡giv‡mi g¯ÍK, K‡kiæKv, cky©Kv I K‡ivwUi P¨vÞv Aw¯’Ñ †hgbÑ ¯‹¨vcyjv, ÷vY©vg,
K‡ivwUKvi d«›Uvj I c¨vivBUvj cÖf…wZ †_‡K Drcbœ nq| [m~Î: †gNbv` m¨vi]
◉ RBC KZw`b euv‡P  120 w`b/4 gvm
◉ †Kv_vq aŸsm nq  hK…r I cøxnv
◉ RBC Gi Kei¯’vb †Kv_vqcøxnvq [m~Î: Avjxg m¨vi]
◉ aŸs‡mi c‡i wK ˆZix nq?
01. †jŠn Ask †dwiwUb wn‡m‡e hK…‡Z Rgv nq|
02. iÄK Ask  wewjiæweb I wewjfvwW©b iƒ‡c †iP cÖwµqvi gva¨‡g wb®‹vwkZ nq|

 D‡Ui RBC †Z wbDwK¬qvm _v‡K Z_¨wU fzj

 AcwibZ Ae¯’vq RBC †Z wbDwK¬qvm _v‡K|
 e„° †_‡K ÿwiZ Gwi‡_ªvc‡qwUb ni‡gv‡bi cÖfv‡e jvj Aw¯’g¾vi †÷g‡Kvl †_‡K RBC m„wó nq|

1
Gwi‡_ªvc‡qwUb 
O2
A_©vr, i‡³ O2 gvÎv evo‡j Gwi‡_ªvc‡qwUb K‡g i‡³ O2 gvÎv Kg‡j Gwi‡_ªvc‡qwUb ev‡o
we:`ª: gvbe‡`‡n RBC cÖwZ wgwbU GKevi mgMÖ‡`‡n cwiågY K‡i|

5
RETINA DIGEST Blood
 †jvwnZ KwYKvi KvR
1. AwaKvsk O 2 I mvgvb¨ CO2 cwienb|
2. i‡³i NbZ¡ I mv›`ªZv eRvq ivLv|
3. A¤ø-¶v‡ii fvimvg¨ i¶v Kiv A_©vr evdvi wn‡m‡e KvR K‡i|
4. †jvwnZ KwYKvi cøvRgv †gg‡eª‡b Dcw¯’Z A¨vw›U‡Rb eøvW MÖæwcs‡q mvnvh¨ K‡i|
5. i‡³ wewjiæweb I wewjfvwW©b bvgK eY©KwYKv Drcbœ K‡i|
[m~Î: AvRgj m¨vi]
6. Giv cUvwmqvg evBKve©‡bU wn‡m‡e †Kvl-Kjv †_‡K dzmdz‡m mvgvb¨ cwigv‡Y CO2 cwienb K‡i|
7. bvBwUªK A·vBW Drcv`b Ki‡Z cv‡i hv G‡Ûv‡_wjqvj †Kv‡li L-arginine Gi g‡Zv e¨eüZ nq|
8. nvB‡Wªv‡Rb mvjdvBW M¨vm Drcv`b Ki‡Z cv‡i hv i³bvwji m‡¼vPb K‡i| [m~Î: gv‡R`v g¨vg]
9. †`‡ni Abvµg¨Zvq mvov cÖ`vb (immune response) K‡i| [m~Î: Avjxg m¨vi]

†k¦Z i³KwYKv ev wjD‡KvmvBU t åvg¨gvb cÖwZiÿvKvix GKK (Mobile Defensive Unit)

 ‰ewkó¨ t
A. †`L‡Z †Kgb? A¨vwge‡qW, `vbv`vi ev A`vbv`vi I AwbqZvKvi
B. WBC †Z wK Av‡Q?wbDwK¬qvm we`¨gvb G‡Z
C. msL¨v KZ? c~Y©eq¯‹ gvbe‡`‡n t 4000-10000/mL [M‡o 7000]
6000-8000/mL [m~Î: Avjxg m¨vi]
2 eQ‡ii Kg eqmx †`‡n t 6200-17000/mL
beRvZ‡Ki †`‡n t 9000-30000/mL
D. RBC: WBC = 700 t 1 ev, 600 t 1 [m~Î: Avjxg m¨vi]
* cwiYZ my¯’ gvby‡li i‡³i 1% WBC

➥ wjD‡Kwgqv → †k¦Z i³KwYKv A¯^vfvweK nv‡i ev‡o Ges †jvwnZ i³ KwYKv aŸsm cÖvß nq|
→ G‡K †k¦Z i³ KwYKvi K¨vÝviI e‡j|
➥ gvq‡jvc‡qwmm → WBC m„wó nevi cÖwµqv|
➥ wjD‡KvmvB‡Uvwmm → WBC Gi msL¨v ¯^vfvwe‡Ki †P‡q †ewk n‡j| †hgb: wbD‡gvwbqv, ûwcs Kvwk‡Z ev‡o|
➥ wjD‡Kv‡cwbqv → WBC Gi msL¨v Kg _vK‡j| [m~Î: MvRx AvRgj I Av: Avjxg m¨vi]

 cÖKvi‡f`
 AvK…wZ I MVbMZfv‡e †k¦Z KwYKv cÖavbZ `yB cÖKvi| h_v-
1) A`vbv`vi/Agranulocyte †gvU †k¦Z i³KwYKvi 28%
2) `vbv`vi/Granulocyte/Polymorphonuclear leucocyte †gvU †k¦Z i³KwYKvi 72%

we:`ª: A`vvbv`vi KwYKv¸‡jv eY©nxb, `vbv`vi KwYKv¸‡jv eY©h³

y | †hgbÑ
* wbD‡UªvwdjÑeY©wbi‡cÿ * BDwm‡bvwdjÑjvj * †e‡mvwdjÑbxj [m~Î: MvRx AvRgj m¨vi]

†hme KYv `vbv w`‡q ÔwdjÕ ZvivB `vbv`vi WBC| †hgbÑ

wbD‡Uªvwdj| BIwm‡bvwdj| †e‡mwdj

6
RETINA DIGEST Blood
 cÖKvi‡f` I ZzjbvgyjK Av‡jvPbv
`vbv`vi A`vbv`vi
‰ewkó¨ 1. wj‡çvmvBU 2. g‡bvmvBU 1. wbD‡Uªvwdj 2. †e‡mvwdj 3. BIwm‡bvwdj
kZKiv (%) 24%-25% 4% 60%-70% 0%-1%/0.5% 1.5%
cÖwZ Nb 1500- 4000 280 3000-6000/4900 0-400 150-300
wgwg.G msL¨v
RxebKvj 7 w`b 2-5 w`b 2-5 w`b 12-15 w`b 3-5 w`b
wbDwK¬qvm ‡Mvj,LÛwenxb e„°vKvi ev 2-5 LÛ/ 2-7 LÛhy³ 2 LÛ
Ak^LyivK…wZi (Avjxg)
mvB‡UvcøvRg Kg ‡ewk AmsL¨ eY© wbi‡cÿ AmsL¨ I wewfbœ `vbv A‡cÿvK…Z eo
`vbv hy³ AvK…wZi `vbv hy³ jvj‡P Kgjv i‡Oi
DrcwË †jvwnZ Aw¯’g¾v hK…Z, †jvwnZ Aw¯’g¾v †jvwnZ Aw¯’g¾v †jvwnZ Aw¯’g¾v †jvwnZ Aw¯’g¾v
jwmKv hK…Z, cøxnv
i. ewnivMZ RxevYy‡K i) cÖvK…wZK av½i i) d¨v‡MvmvBwU‡mmi i) wn÷vwgb I i) A¨vjvwR©RwbZ
A¨vw›UewW w`‡q aŸsm Kiv (Scavenger) gva¨‡g RxevYy MÖvm †ncvwib ÿiY Kiv cÖwZwµqv MÖnY I Zvi
ii. GKB ai‡bi AYyRxe wn‡m‡e KvR K‡i K‡i ii) †ncvwib gvÎv wbqš¿Y
fwel¨‡Z †`‡n cÖ‡ek Ki‡j ii) wKQz A¨vw›U‡Rb‡K ii) wjwcWRvZ i³evwnKvi †fZi ii) nvB‡WªvjvBwUK
¯§„wZ  †Kvl mn‡RB Kv‡R jvwM‡q ivmvqwbK c`v_© ÿiY i³RgvU cÖwZ‡iva GbRvBg I
kbv³ I aŸsm K‡i BwgDbZ‡š¿ f~wgKv K‡i hv i³evwnKv‡K K‡i| cÖwZwµqvkxj O2
KvR iii. T †Kvl fvBivm iv‡L| AviI †f`¨ K‡i| [M 18-19] Z¨vM K‡i
AvµvšÍ †Kvl, †`n †Kvl, iii) d¨v‡MvmvB‡Uvwmm iii) †`‡n Schistosoma,
K¨vÝvi AvµvšÍ †Kvl cÖwµqv Ae¨vnZ †i‡L Abyc‡Ö ekKvix m¤ú‡K© Trichinella
aŸsm K‡i| cÖv_wgK cÖwZiÿv ¯Íi ivvqwbK evZ©v †cÖiY ciRxexi g„Zz¨
iv. weK…Z T †Kv‡l †`‡n wn‡m‡e KvR K‡i| K‡i| NUv‡bv|
K¨vÝvi ev A‡UvBwgDb
e¨vwai m„wó K‡i|

wPÎ

[m~Î: AvRgj I Avjxg m¨vi]

➥ BIwm‡bvw©dj: i³evwnKv A‡cÿv †cŠwóKbvjx‡Z †ekx cvIqv hvq|

➥ g‡bvmvBU: * me‡P‡q eo WBC
* Aci bvgÑ ‘Rubbish Collecting’ †Kvl [m~Î: gv‡R`v g¨vg]
* g‡bveøv÷ bvgK †Kvl †_‡K DcwË
➥ wj‡çvmvBU: * wØZxq eo †k¦Z KwYKv|
* me‡P‡q †ewk cvIqv hvqÑwjç‡qW wUmy¨‡Z h_vÑcøxnv, †cŠwóKbvjxi mvewgD‡Kvmv, _vBgvm, Ubwmj, A¨v‡Wb‡qW G|
 cÖKvi‡f`: * 2 cÖKvi| h_vÑ 1. B-wj‡çvmvBU; 2. T- wj‡çvmvBU [m~Î: AvRgj m¨vi]
* 3 cÖKvi| h_vÑ 1. B-wj‡çvmvBU; 2. T- wj‡çvmvBU, 3. NK- †Kvl [m~Î: Avjxg m¨vi]
➥ B-wj‡çmvBU:
* Aw¯’g¾v (Bone Marrow) †Z m„wó nq|
* A¨vw›UewW ˆZix K‡i| [M 19-20] [m~Î: gv‡R`v g¨vg]
* i³ gva¨g Abvµg¨Zvq (Humoral immunity) †Z f~wgKv iv‡L|
➥ T-wj‡çmvBU
* _vBgvm (Thymus) MÖwš’i _vB‡gvmvBUm †_‡K m„wó nq|
* †Kvl gva¨g Abvµg¨Zvq (Cell mediated immunity) †Z f~wgKv iv‡L|
7
RETINA DIGEST Blood
➥ NK- †Kvl
* Natural killer †Kvl GK we‡kl ai‡Yi †k¦Z KwYKv|
* fvBiv‡mi AvµgY `ªæe mvov cÖ`vb K‡i|
†k¦Zi³KwYKv

 
`vbv`vi A`vbv`vi
 
    
wbD‡Uªvwdj BIwm‡bvwdj †e‡mvwdj wj‡çvmvBU g‡bvmvBU

 
B-wj‡çvmvBU T-wj‡çvmvBU
 
   
cøvRgv †Kvl †g‡gvwi †Kvl mvB‡UvUw·K-T †njcvi-T

 †k¦Z KwYKvi KvR

01. g‡bvmvBU I wbD‡Uªvwdj d¨v‡MvmvB‡Uvwmm cÖwµqvq RxevYy f¶Y K‡i|
02. wj‡ùvmvBU A¨vw›UewW m„wó K‡i †ivM cÖwZ‡iva K‡i| ZvB G‡`i‡K †`‡ni AvYyex¶wYK ˆmwbK e‡j|
03. ‡e‡mvwdj †ncvwib ˆZwi I wbtmiY K‡i hvi i³ bvjxi wfZ‡i i³RgvU †iva K‡i| [M: 18-19]
04. `vbv`vi wjD‡KvmvBU A_©vr wbD‡Uªvwdj, †e‡mvwdj I BIwm‡bvwdj wn÷vwgb ¶iY K‡i|
05. BIwm‡bvwdj i‡³ cÖ‡ekK…Z K…wgi jvf©v Ges GjvwR©K Gw›UewW aŸsm K‡i|
06. wbD‡Uªvwd‡ji welv³ `vbv RxevYy aŸsm K‡i|
07. wj‡ùvmvBU cÖ`vn A‡j dvB‡eªveøv‡÷ cwiYZ n‡q ¶Z wbivgq K‡i|
08. wUª‡dvb ms‡kølY: †k^ZKwYKv wUª‡dvb ms‡køl K‡i †`‡ni cywó , e„w× I Kjvi ÿq c~iY K‡i|
[m~Î: MvRx AvRgj I †gNbv` m¨vi]

AbyPwµKv/Thrombocyte/Platelet
 ‰ewkó¨
➥ G¸‡jv ¶z`ªZg i³ KwYKv, †MvjvKvi, wW¤^vKvi ev `ÛvKvi (i‡Wi gZ)
➥ wbDwK¬qvmwenxb| wefvwRZ n‡Z cv‡i bv|
➥ cÖwZ Nb wgwjwgUvi i‡³i G‡`i msL¨v 1.5-3 j¶/ 2.5-5 jÿ [Avjxg m¨vi]| Amy¯’ †`‡n msL¨v †e‡o hvq|
➥ G‡Z †cÖvwUb I cÖPzi cwigv‡Y †mdvwjb bvgK dm‡dvwjwcW we`¨gvb|
➥ †jvwnZ Aw¯’g¾vi eo †gMvK¨vwiImvBU †_‡K G‡`i DrcwË|
➥ Mo Avqy 8-12 w`b| Avqy †kl n‡j cøxnv I Ab¨vb¨ †iwUKz‡jv G‡Ûv‡_wjqvj †Kv‡l webó nq|
➥ cøxnv e¨ZxZ †Kv_vI AYyPwµKv mwÂZ nq bv|
➥ i³ Z‡bi Rb¨ cÖ‡qvRbxq _ª‡¤^vKvB‡bR GbRvBg m„wó K‡i| [Av:Avjxg]

 AYyPwµKvi KvR
01. ¶Z¯’v‡b i³ZÂb NUvq Ges A¯’vqx †cøBU‡jU cøvM MVb K‡i i³¶iY eÜ K‡i|
[wn‡gv÷¨vwUK cøvM=blood platelet+ plasma protein]
02. i³bvjxi ¶wZMÖ¯Í G‡Ûv‡_wjqvj AveiY cybM©Vb K‡i|
03. ‡m‡iv‡Uvwbb ¶iY K‡i hv i³bvjxi ms‡KvPb NUvq|

8
RETINA DIGEST Blood
04. d¨v‡MvmvB‡Uvwmm c×wZ‡Z Kve©b KYv, BwgDb Kg‡cø· I fvBivm‡K f¶Y K‡i|
05. Giv wn÷vwgb I 5-Hydroxytryptamine (5HT) mÂq K‡i| [m~Î: Av:Avjxg m¨vi]
[Note: 5HT gv‡b †miv‡Uvwbb]
06. ¯^vfvwe‡Ki †P‡q †ewk AYyPwµKv A`iKvix i³RgvU m„wó, †÷ªvK I nvU© A¨vUv‡Ki m¤¢vebv evwo‡q †`q|
[Note: 5HT gv‡b †miv‡Uvwbb]

01. †Kvb i³ KwYKv A¨vw›UewW ˆZwi K‡i? [M:19-20]

A) g‡bvmvBU B) †e‡mvwdj C) -wj‡çvmvBU D) T- wj‡çvmvBU
02. †ncvwib ˆZix I wbtmiY Kiv †Kvb †Kv‡li KvR? [M:18-19]
A) Lymphocyte B) Basophil C) Monocyte D) Neutrophil
03. wb‡Pi †KvbwUi ˆZixi cÖµxqv‡K Gwi‡_ªv‡cv‡qwmm e‡j? [M:17-18]
A) ‡jvwnZ i³KwYKv B) AYyPwµKv C) cøvRgv D) ‡k^Z i³KwYKv
04. A¨vMÖvby‡jvmvBU †KvbwU? [M:17-18]
A) wbD‡Uªvwdj B) g‡bvmvBU C) BIwm‡bvwdj D) ‡e‡mvwdj
05. wbDwK¬qvm wenxb †Kvl n‡jvÑ [M.16-17]
A) ü`‡Kvl B) ¯œvqy‡Kvl C) †k^Z i³ KwYKv D) †jvwnZ i³ KwYKv
06. †KvbwU A`vbv`vi †k^Z KwYKv? [M:15-16]
A) BDwm‡bvwdj B) wbD‡Uªvwdj C) †e‡mvwdj D) g‡bvmvBU
07. wb‡¤œi †Kvb A‡½ †jvwnZ KwYKv aŸsm nq? [M:11-12]
A) cøxnv B) hK…Z C) cvK¯’jx D) e„°
08. wb‡¤œi †Kvb †KvlwU †ncvwib wb:miY K‡i? [D: 09-10]
A) wbD‡Uªvwdj B) †e‡mvwdj C) BDwm‡bvwdj D) wj‡çvmvBU
09. wb‡¤œi †KvbwU kix‡i AYycÖ‡ewkZ RxevYy‡K aŸsm Kivi cÖwµqv? [M:09-10]
A) A‡Uvd¨vwM B) A‡UvjvBwmm C) d¨v‡MvmvB‡Uvwmm D) wc‡bvmvB‡Uvwmm
10. wb‡¤œi †Kvb †k^ZKwYKvi wbDwK¬qvmwU `yB †jve wewkó? [D:09-10]
A) wbD‡Uªvwdj B) BDwm‡bvwdj C) g‡bvmvBU D) wj‡çvmvBU
11. wb‡¤œi †KvbwU cøvRgv †cÖvwUb bq? [M:09-10]
A) UvB‡ivwmb B) wdweª‡bv‡Rb C) †cÖv‡_ªvw¤^b D) A¨vjeywgb
12. †KvbwU i³ RgvU n‡Z †`q bv? [D:05-06]
A) wewjiæweb B) A¨v‡Wªbvwjb C) †ncvwib D) Bbmywjb
13. wkï‡`i i‡³ wj‡çvmvB‡Ui msL¨v eq¯‹‡`i ZzjbvqÑ [M:01-02]
A) Kg B) †ekx C) mgvb D) A‡a©K
Ans: 1.C 2.B 3.A 4.B 5.D 6.D 7.A+B, 8.B, 9.C, 10.B, 11.A, 12.C, 13.B.

01. wb‡Pi †KvbwU ˆZwii cÖwµqv‡K Gwi‡_ªv‡cv‡qwmm e‡j?

A) †jvwnZ i³KwYKv B) AbyPwµKv C) cøvRgv D) †k¦Zi³KwYKv
02. wb‡Pi †Kvb A‡½ †jvwnZ i³KwYKv aŸsm nq? [M: 12-13]
A) cøxnv B) Aš¿ C) cvK¯’jx D) e„°
03. †`‡ni ÒAvYyexÿwYK ˆmwbKÓ ejv nq Kv‡j?
A) †jvwnZ KwYKv B) wj‡çvmvBU C) wbD‡Uªvwdj D) g‡bvmvBU
04. wb‡Pi †Kvb Z_¨wU mwVK bq?
A) AYyPwµKvq cÖPzi cwigv‡Y †mdvwjb we`¨gvb B) Amy¯’ †`‡n AYyPwµKv †e‡o hvq
C) BIwm‡bvwdj eY©wbi‡cÿ D) `vbv`vi wjD‡KvmvBU wn÷vwgb ÿiY K‡i
DËigvjvt 1. A, 2. B, 3. B, 4. C
9
RETINA DIGEST Blood

 i³ZÂb (wn‡gv‡÷wmm/Blood Coagulation)

 i³Z‡b †gvU 13wU d¨v±i ev Dcv`vb cÖ‡qvRb|
 AZ¨vek¨Kxq Dcv`vb 4wUÑ
Factor I: Fibrinogen dzj c‡o Uzc K‡i
Factor II: Prothrombin    
Factor III: Thromboplastin dvBweª‡bv‡Rb †cÖv_ªw¤^b _ª‡¤^vcøvw÷b K¨vjwmqvg
Factor IV: Ca++
 Gi g‡a¨ Thromboplastin ¯^vfvweK Ae¯’vq i³i‡m Abycw¯’Z, AYyPwµKvq _v‡K|
 i³ Z‡bi GK ev GKvwaK d¨v±i Abycw¯’Z _vK‡j i³ RgvU euv‡a bv| G Ae¯’v‡K wn‡gvwdwjqv e‡j|
 RgvU euvav i³ wcÛ †_‡K wb:m„Z ¯^”Q Lo e‡Y©i Rjxq Ask‡K wmivg e‡j| Z‡e G‡Z dvBweª‡bv‡Rb I d¨v±i II, V, VIII _v‡K
bv| Z‡e †m‡iv‡Uvwb‡bi Nb‡Z¡ †ekx|
 wmivg wb‡q Aa¨vq‡bi welq‡K Serology ejv nq|
 eøvW e¨vs‡K i³ msiÿ‡Y mvB‡UªU‡K cÖavb i³ZÂb †ivaK c`v_© e‡j we‡ePbv Kiv nq|
 gvby‡li ¯^vfvweK i³ ¶iYKvj 1-4 wgwbU|
 gvby‡li i³Z‡bi ¯^vfvweK mgq 4-5 min (Av: Avjxg)/3-8 min (‡gNbv`)

 i³ cÖev‡ni mgq †`nvf¨šÍ‡i i³ RgvU euv‡a bv|

◉ KviY-
01. ‡ncvwib (GK ai‡bi Protein) Gi Dcw¯’wZ|
02. gvby‡li i³ I Ab¨vb¨ Kjv‡Z cÖvq 50 ai‡bi Dcv`vb ev d¨v±i Av‡Q †h¸‡jv i³ZÂb cÖwµqv‡K cÖfvweZ K‡i| G‡`i‡K `yB
K¨vUvMwi‡Z fvM Kiv nq, h_vÑ
K) †cÖv‡Kvqv¸‡j›U d¨v±iÑGiv i³ZÂb‡K DÏxß K‡i Ges
L) A¨vw›U‡Kvqv¸‡j›U d¨v±i: Giv i³ZÂb‡K cÖwZ‡iva K‡i|
03. i‡³i `ªæZMwZi cÖevn|
04. i³bvjxi Af¨šÍi Mv‡Îi gm„YZv|
05. mwµq Coagulant Factor ¸‡jv hK…Z KZ…©K me©`v AcmvwiZ nIqv| [m~Î: Av: Avjxg m¨vi]

 i³ZÂb †KŠk‡ji ch©vqµwgK avc:

01. webó Kjv I wegy³ i‡³i _ª‡¤^vmvBU
evZv‡mi ms¯ú‡k© G‡m _ª‡¤^vcøvw÷b→†ncvwib‡K A‡K‡RvKiY
02. _ª‡¤^vmvBU 
vRgv GbRvBg (d¨v±i VII, VIII, IX, X) Ca2+ †_ªvw¤^b
03. _ª‡¤^vcøvw÷b+†cÖv‡_ªvw¤^b cø
04. †_ªvw¤^b+dvBweª‡bv‡Rb→dvBweªb g‡bvgvi
05. dvBweªb g‡bvgvi (A‡bK¸‡jv)→dvBweªb cwjgvi→dvBweªb RvjK|
06. WdvBweªb RvjK+Ave× †jvwnZ I †k^Z i³KwYKv→i³ZÂb|

➥ _ª‡¤^vmvB‡Uvwmm: i‡³ AbyPwµKvi cwigvY ¯^vfvweK A‡cÿv e„w× cvIqv|

➥ _ª‡¤^vmvB‡Uwcwbqv: i‡³ AbyPwµKvi cwigvY ¯^vfvweK A‡cÿv K‡g hvIqv|
➥ BT Ges CT: i³ÿiY ïiæ †_‡K ZwÂZ nIqvi mgqKvj‡K ZÂbKvj ev CT (Clotting Time) e‡j| Acic‡ÿ, i³ÿiY ïiæ
nIqv †_‡K i³ÿiY eÜ nIqv ch©šÍ mgqKvj‡K i³ †gvÿYKvj ev BT (Bleeding time) e‡j| CT = 4–5 wgwbU Ges BT = 2–5
wgwbU|]

10
RETINA DIGEST
 i³ZÂb d¨v±i¸‡jvi bvg t
d¨v±i
01. Fator I ev dvBweª ‡bv‡Rb
02. Fator II ev †cÖv_ªw¤^b
03. Fator III ev _ª‡¤^vcøvw÷b
04. Fator IV ev K¨vjwmhvg Avqb
05. Fator V ev j¨vevBj d¨v±i ev †cÖvA¨vK‡mjvwib
06. Fator VI ev A¨vK‡mjvwib (Avb‡÷ej d¨v±i)
07. Fator VII ev ‡cÖvKbfviwUb (‡÷ej d¨v±i)
08. Fator VIII ev A¨vw›Uwn‡gvwdwjK d¨v±i A
09. Fator IX ev wµ÷gvm d¨v±i
10. Fator X ev ÷zqvU© d¨v±i/A¨vw›Uwn‡gvwdwjK d¨v±i B
11. Fator XI ev cøvRgv _ª‡¤^vcøvw÷b A¨vw›Uwm‡W›U
12. Fator XII ev n¨vMgvb d¨v±i/Møvm d¨v±i
/A¨vw›Uwn‡gvwdwjK d¨v±i C
13. Fator XIII ev dvBweªb †÷wejvBwRs d¨v±i
Blood
Z‡b f~wgKv
GwU †MøvweDwjb †cÖvwUb|
GwU cøvRgv †cÖvwUb| wfUvwgb K-i Dcw¯’wZ‡Z hK…‡Z ms‡køwlZ nq|
GwU webó Kjv‡Kvl ev fvOv AbyPwµKv †_‡K wbtm„Z nq|
K¨vjwmqvg Avqb GKvav‡i _ª‡¤^vcøvw÷b Drcv`‡b mvnvh¨ K‡i Ges Ab¨w`‡K
†cÖv_w¤^b‡K _ªw¤^‡b cwiYZ K‡i|
cøvRgvq Aew¯’Z †cÖvwUb RvZxq G c`v_©wU †cÖv_w¤^b‡K _ªw¤^‡b cwiYZ K‡i|
GwU cÖKwíZ (A_©vr Does not exist)
cøvRgvq Aew¯’Z GB †cÖvwUbwU _ª‡¤^vcøvw÷b Drcv`‡b mvnvh¨ K‡i
Gi ivmvqwbK Dcv`vb d¨v±i VII-Gi g‡Zv| Gi Afv‡e i³ZÂb e¨vnZ nq|
i³i‡m Aew¯’Z †cÖvwUb _ª‡¤^vcøvw÷b MV‡b Ask †bq|
K¨vwj‡µBb‡K (kallikrein) mwµq K‡i Ges cøvRgvKvBwbb
(plasmakinin) bvgK c`v_© m„wó K‡i i³bvwji †f`¨Zv I
m¤úªmviYkxjZv evovq|
GwU K¨vjwmqvg Avq‡bi mn‡hvwMZvq i‡³i big ZÂb wcÛ‡K A`ªeYxq
KwVb Zš‘‡Z iƒcvšÍwiZ K‡i|

01. gvby‡li i³ RgvU euvavi g~j Dcv`vb bq †KvbwU? [D 17-18]

A) K¨vjwmqvg Avqb B) jwmKv im C) dvBweª‡bv‡Rb D) cÖ‡_ªvw¤^b
02. gvby‡li ¯^vfvweK i³ ÿiYKvjÑ[M 16-17]
A) 5-7 wgwbU B) 12-14 wgwbU C) 1-4 wgwbU D) 45-55 †m‡KÛ
03. †KvbwU gvbe †`‡ni i³ RgvU euvavi Kv‡R mn‡hvwMZv K‡i bv? [D 16-17]
A) dvBweª‡bv‡Rb B) †cÖv_ªvw¤^b C) _ª‡¤^vcøvw÷b D) BIwm‡bvwdj
04. i³ cÖev‡ni mgq i³ RgvU bv euvavi KviY wb‡¤œi †KvbwU? [M 09-10]
A) PjvP‡ji ¯ø_MwZ B) cvwbi Dcw¯’wZ C) bvjxi Agm„Y MvÎ D) †ncvwi‡bi Dcw¯’wZ
05. wb‡¤œi †KvbwU i³ RgvU euvavi g~j Dcv`vb bq? [M 08-09]
A) wdweª‡bv‡Rb B) †cÖv_ªw¤^b C) A¨vjeywgb D) Ca++

Ans: 1.B 2.C, 3.D, 4.D, 5. C.

jwmKv Zš¿
 †Wwbk weÁvbx Olaus Rudbeck Ges Thomas Bartholin 1760 wLª÷v‡ã me©cÖ_g jwmKvZ‡š¿i eY©bv †`b|
 jwmKvMÖwš’i msL¨v 400-700
 cøxnv, Ubwmj, A¨vWb‡qW BZ¨vw` D‡jøL‡hvM¨ jwmKvMÖwš’
 gvbe †`‡ni Nv‡o, eM‡j I KzuPwK‡Z AwaK msL¨K jwmKvMÖwš’ _v‡K|
 gvbe ‡`‡n wj‡çi cwigvb cÖvq i‡³i wظY 10-12 wjUvi|
 jwmKvi pH 7.4-9 Av‡cwÿK ¸iæZ¡; 1.01-1.016|
 cÖwZ Nb wgwg. jwmKvq 500-7500 wj‡çvmvBU _v‡K|
 A‡š¿i weKwkZ jwmKv bvjx‡K j¨vKwU‡qj e‡j|
 AwaK Pwe©h³y Lvevi †L‡j jwmKvq d¨v‡Ui cwigvY †e‡o hvq Ges jwmKv‡K `y‡ai gZ mv`v †`Lvq| GK KvBj e‡j|
 jwmKv MVb cÖwµqv‡K wj‡çv‡R‡bwmm e‡j| [m~Î: AvRgj I Avjxg m¨vi]
11
RETINA DIGEST Blood
jwmKvi Dcv`vb
jwmKvZš¿

  
jwmKv jwmKv bvjx wjç‡qW A½
 
   cøxnv
Wvb jwmKvbvjx †_vivwmK jwmKvbvjx  Ubwmj
   A¨v‡Wb‡qW
Wvb mve‡K¬wfqvb I Wvb AšÍ:Ry¸jvi evg mve‡K¬wfqvb I evg AšÍ:Ry¸jvi
wkivi ms‡hvM¯’‡j wkivZ‡š¿i mv‡_ hy³ wkivi ms‡hvM¯’‡j wkivZ‡š¿i mv‡_ hy³

 
†Kvlxq Dcv`vb A‡Kvlxq Dcv`vb
(wj‡çvmvBU) 
 
cvwb/Zij (94%) KwVb (6%)

 
ˆRe A‰Re
†cÖvwUb, wjwcW,kK©iv, BDwiqv, BDwiK GwmW, wµ‡qwUwbb, A¨vw›UewW, A¨vjweDwgb, (120- K¨vjwmqvg, dmdivm,
132 gm/100mL) †MøvweDwjb, dvBweª‡bv‡Rb, mvgvb¨ †cÖv_ªw¤^b RvZxq †cÖvwUb _v‡K †K¬vivBW BZ¨vw`
[m~Î: MvRx AvRgj m¨vi]
 wKQz Z_¨:
 W.bancrofti Z_v dvB‡jwiqv K…wg w`‡q gvbyl AvµvšÍ n‡j jwmKv cÖevn evavMÖ¯’ nq| G‡K †Mv` †ivM ev dvB‡jwiqv ev
Gwjd¨vbw_qvwmm e‡j|
➥ cøxnvÑ
 eo jwmKvMÖwš’
 i‡³i wiRvf©vi ev eøvW e¨vsK bv‡g cwiwPZ
 †jvwnZ i³ KwYKvi Kei¯’vb
 RxevYy aŸsm K‡i cÖwZ‡iv‡a Ask †bq|
➥ UbwmjÑ
 GK ai‡bi jwmKv MÖwš’ hv gy‡Li †fZ‡i Aew¯’Z
 RxevYyi weiæ‡× cÖ_g mvwii cÖwZ‡iva M‡o †Zv‡j
 cÖPzi wj‡çvmvBU m„wó K‡i
 e¨vK‡Uwiqv fvBivm Øviv AvµvšÍ n‡j UbwmjvBwUm Z_v Ubwm‡ji cÖ`vn nq| [m~Î: Avjxg m¨vi]
 gvby‡li i³ I jwmKvÑGi g‡a¨ cv_©K¨
cv_©‡K¨i welq i³ jwmKv
1| eY© jvj e‡Y©i eY©nxb ev nvjKv njy`
2| KwYKv †jvwnZ KwYKv, †k¦ZKwYKv Ges AbyPwµKv _v‡K| †Kej wj‡çvmvBU bvgK †k¦ZKwYKv _v‡K|
3| wn‡gv‡Møvweb Dcw¯’Z| Abycw¯’Z|
4| dvBweª‡bv‡Rb i‡³ AwaK cwigv‡Y _v‡K| jwmKvq Kg cwigv‡Y _v‡K|
5| cwienb i³evn‡Ki gva¨‡g msevwnZ nq| jwmKvev‡ni gva¨‡g msevwnZ nq|
6| †hvMv‡hvM i‡³i mv‡_ Kjv‡Kv‡li mivmwi †hvMv‡hvM _v‡K bv| jwmKvi mv‡_ Kjv‡Kv‡li mivmwi †hvMv‡hvM _v‡K|
7| †cÖvwUb jwmKv A‡cÿv †ewk| i³ A‡cÿv A‡bK Kg|
8| KvR i‡³i gva¨‡g k¦mb M¨vm I Lv`¨KYv (kK©iv I Avwgl) jwmKvi gva¨‡g eR©¨ c`v_© I Lv`¨mvi (wjwcW)
cwievwnZ nq| cwievwnZ nq|
[m~Î: gv‡R`v g¨vg]
12
RETINA DIGEST Blood
* ‰KwkK Rvwj‡Ki i³ Kjvi‡mi cÖvq 90% Awf¯ªeY cÖwµqvq cybivq MÖnY K‡i †bq| [m~Î: Av: Avjxg m¨vi]
* wUmy¨ †_‡K wUmy¨i‡mi 10% Ask jwmKvi gva¨‡g wb®‹vwkZ nq|

 cøvRgv I jwmKvi cv_©K¨

cøvRgv (i³im)
1| GwU i‡³i †Kvlwenxb Zij hv‡Z LwbR je‡Yi Avqb, `ªexf~Z
†cÖvwUb I Rxe‡bi cÖ‡qvRbxq Ab¨vb¨ me Dcv`vb we`¨gvb _v‡K
2| i³ evwnKvi gva¨‡g cÖevwnZ nq|
3| RgvU eva‡Z cv‡i
4| wewfbœ e¯‘ cwien‡bi gva¨‡g cywó, †iPb I k¦mb Kv‡R Ges
A¨vw›UewW Drcv`‡bi gv`¨‡g cÖwZiÿv Kv‡R AskMÖnY K‡i|
jwmKv
1| jwmKv mv`v e‡Y©i Zij hv‡Z †k¦Z i³KwYKv, LwbR je‡Yi
Avqb, mvgvb¨ †cÖvwUb, eR©¨ c`v_© I wjwcW KYv _v‡K|
2| jwmKv bvwjKvi gva¨‡g cÖevwnZ nq|
3| RgvU eva‡Z cv‡i bv|
4| †`‡ni †hme Kjvq i³ †cŠuQv‡Z Aÿg jwmKv †mme Kjvq cywó
I Aw·‡Rb mieivn K‡i, Pwe© †kvlY K‡i Ges †`‡ni cÖwZiÿv
Kv‡R AskMÖnY K‡i|
[m~Î: Av: Avjxg m¨vi]

 jwmKv RvjK I i³Rvj‡Ki g‡a¨ cv_©K¨

jwmKv RvjK i³RvjK
1| GwU eY©nxb nIqvq ch©‡eÿY Kiv KwVb 1| jvj‡P i‡Oi nIqvq mn‡RB ch©‡eÿY Kiv hvq|
2| AMÖfvM eÜ| 2| GKcÖvšÍ Dcagwbi (arterioles) m‡½ Ges AcicÖvšÍ Dcwkivi
(venules) m‡½ hy³ _v‡K|
3| i³RvjK A‡cÿv cÖk¯Í| 3| jwmKv Rvj‡Ki Zzjbvq miæ|
4| cyiæZ¡ me ¯’v‡b mgvb bq| 4| cyiæZ¡ me ¯’v‡bB mgvb|
5| cÖvPxi cvZjv G‡Ûv‡_wjqvg wb‡q MwVZ Ges wfwËc`©v Lye `ye©j| 5| cÖvPxi mvaviY G‡Ûv‡_wjqvg I wfwËc`©v w`‡q MwVZ|
6| eY©nxb jwmKv aviY K‡i| 6| jvj i³ aviY K‡i|
[m~Î: gv‡R`v g¨vg]
 jwmKvi KvR
1. †cÖvwUb cwienb 2. †mœn cwienb 3. cywó
4. †mœ‡ni cwi‡kvlY 5. cÖwZi¶v 6. cÖwZ‡iva
7. †`ni‡mi cybe©›Ub 8. Kjvi MvVwbK ALÛZv i¶v
9. †hme Kjvq i³ †cuŠQv‡Z A¶g †mLv‡b O2 I cywó mieivn| [m~Î: †gNbv`+AvRgj m¨vi]

 Kjvim t
 †`‡ni AvšÍt †Kvlxq duv‡K we`¨gvb Zij‡K Kjvim ev Tissue Fluid e‡j|
 †`‡ni Af¨šÍixY cwi‡ek MVb K‡i|
 we:`ª: Kjvi‡m RBC, †cøU‡jU, cøvRgv †cÖvwUb _v‡K bv|
 Kjvi‡mi KvR
➥ †Kvl Kjvim †_‡K Aw·‡Rb I cywó c`v_© MÖnY K‡i Ges mKj wecvKxq eR©¨ G‡Z Z¨vM K‡i|
➥ cvwb, jeY I cywó c`v‡_©i e„nr fvÛvi|
➥ i‡³i cwigv‡Yi mvg¨Zv iÿv K‡i|
➥ †`‡ni ZvcgvÎv wbqš¿‡Y|
[m~Î: gv‡R`v g¨vg]
 Kjvim I jwmKvÑGi g‡a¨ cv_©K¨
cv_©‡K¨i welq Kjvim jwmKv
1| DrcwË i‡³i cøvRgv †_‡K Drcbœ nq| Kjvim †_‡K Drcbœ nq|
2| Ae¯’vb AvšÍt †Kvlxq ¯’v‡b| jwmKvev‡n|
3| †cÖvwUb Abycw¯’Z Dcw¯’Z
4| †k¦Z KwYKv Abycw¯’Z Dcw¯’Z (wj‡çvmvBU)
[m~Î: gv‡R`v g¨vg]
13
RETINA DIGEST Blood

01. wb‡¤œi †Kvb Z_¨wU jwmKvZš¿ m¤ú‡K© mZ¨ bq? [M: 08-09]
A) cÖK…Zc‡ÿ jwmKv GK ai‡bi cwiewZ©Z Kjvim B) Kjv †_‡K Kjvi‡mi cÖvq 10 % jwmKv Øviv Acm„Z nq
C) jwmKvq A‡bK AbyPwµKv _v‡K D) jwmKvMÖwš’ A¨vw›UewW ˆZwi K‡i
02. jwmKv m¤^‡Ü †KvbwU mwVK bq? [D: 05-06]
A) †jvwnZ KwYKv _v‡K bv B) jwmKv bvjx‡Z PjvPj K‡i
C) jwmKv ¯^”Q D) jwmKv‡Z AbyPwµKv Av‡Q
03. jwmKvi Av‡cwÿK ¸iæZ¡Ñ [M: 03-04]
A) 1.022 B) 1.013 C) 1.014 D) 1.015
04. jwmKv wb‡¤œv³ †Kvb KwVb c`v_© _v‡K bv? [D: 03-04]
A) dmdivm B) bvB‡Uªv‡Rbhy³ c`v_© C) g¨vM‡bwmqvg D) †cÖvwUb

Ans: 1.C 2.D, 3.D, 4.C.

ü`wcÛ
 gvby‡li ü`wc‡Û wØeZ©bx msenb N‡U|
 ürwc‡Ûi IRb cyiæ‡l 250-390gm| ¯¿x‡jv‡K Zv cyiæ‡li †P‡q GK-Z…Zxqvsk Kg| ¯¿x †jv‡K IRb 200-275gm|
 GwU jvj‡P e‡Y©i w·KvYvKvi A½| Gi ˆ`N©¨ 12 cm, cÖ¯’ 8 cm|
 ürwcÛ Wvb w`‡Ki 2q cï©Kv †_‡K evg w`‡Ki 5g cï©Kv ch©šÍ Zxh©Kfv‡e we¯Í…Z|
 G‡c· Gi Ae¯’vbt evg w`‡Ki 5g cuvR‡ii duv‡K|
 ürwcÛ †cwiKvwW©qvg bvgK AveiYx Øviv †ewóZ| †cwiKvwW©qvg wدÍix| Z_vÑ 1. dvBeªvm †cwiKvwW©qvg (evB‡i), 2. †mivm †cwiKvwW©qvg
(†fZ‡i)| †mivm †cwiKvwW©qvg Avevi 2 fv‡M wef³Ñ1. c¨vivBUvj ¯Íi (evB‡i), 2. wf‡mivj ¯Íi (wfZ‡i)| wf‡mivj I c¨vivBUvj GB
`yB ¯Í‡ii gvSLv‡b †cwiKvwW©qvj d¬zBW _v‡K|
 †cwiKvW©vBwUm: ürwc‡Ûi wSwjøi cÖ`vn; ey‡K Zxeª e¨_v I Kvwk|

we.`ª.: cyiæl I gwnjvi ürwc‡Ûi IRb †`n IR‡bi h_vµ‡g 0.45% I 30.40% [m~Î: gv‡R`v g¨vg]

◙ ü` LvR: ü`wc‡Ûi evwn‡ii Z‡j 2wU LuvR _v‡K| h_vÑ K) K‡ivbvix mvjKvm L) AvšÍtwbjq LvR [m~Î: Av: Avjxg m¨vi]

 †cwiKvwW©qvj d¬zBW Gi KvR

1. ürwcÛ‡K Pvc, Zvc, Nl©Y RwbZ AvNvZ [ürwc‡Ûi MVb
n‡Z i¶v| I i³ mÂvjb †`L‡Z
2. ürwc‡Ûi ms‡KvPb mnRmva¨ Kiv| cv‡ki †KvWwU
3. ür¯ú›`b wbqš¿b| scan K‡iv]
4. ürwcÛ‡K wm³ ivLv|

 ürwc‡Ûi cÖvPxi 3 ¯Íi wewkót

 GwcKvwW©qvg t ewnt¯’ ¯Íi| Gi mv‡_ wew¶ßfv‡e Pwe©hy³ _v‡K| †hvRKKjv wbwg©Z|
 gv‡qvKwW©qvg t gv‡Si ¯Íi| ms‡KvPb cÖmvi‡Y mwµq f~wgKv cvjb K‡i| ür†ckx Øviv MwVZ|
 G‡ÛvKvwW©qvg t AšÍt¯’ ¯Íi| AšÍtcÖvPxi MVb K‡i Ges KcvwUKv¸‡jv †X‡K iv‡L| AvuBkvKvi AveiYx Kjvq MwVZ|
 gvbe ürwcÛ Pvi cÖ‡Kvô wewkó| Awj‡›`i †P‡q wbj‡qi cÖvPxi cyiæ nq| Avevi, Wvb wbj‡qi †P‡q evg wbj‡qi cÖvPxi 3 ¸Y †ewk cyiæ|
 ürwc‡Ûi KcvwUKv¸‡jv wbjq-cÖvPx‡ii Awf‡¶ciƒcx c¨vwcjvwi †ckxi mv‡_ KwW© †UwÛwb w`‡q hy³ _v‡K|

14
RETINA DIGEST Blood
 ür†ckxi ˆewkó¨
01. Q›`gq ms‡KvPb cÖmviY 02. m¤ú~Y© A‰bw”QK|
03. †K‡›`ª 1wU bDwK¬qvm 04. AcÖK…Z wmbmvBwmqvg
05. B›Uvi K¨v‡j‡UW wW¯‹
06. gvB‡UvKwÛªqvi AvwaK¨Zv †`Lv hvq hv †Kv‡li Aweivg AevZ k¦m‡bi my‡hvM cÖ`vb K‡i|
07. AwbqwgZfv‡e hy³ †_‡K Rv‡ji gZ MVb ˆZwi|
08. G‡`i †Kv‡li mvi‡KvcøvR‡g mgvšÍiv‡j mw¾Z gv‡qvdvBweªj bvgK m~² Zš‘ _v‡K|
09. ür‡ckx‡Z ch©vß Aw·‡Rb mieiv‡ni cÖ‡qvRb nq| (m~Î: AvRgj, Avjxg I gv‡R`v g¨vg)
 gvby‡li ürwc‡Ûi wewfbœ KcvwUKvi bvg,Ae¯’vb, ˆewkó¨ I KvR
KcvwUKv Ae¯’vb
evBKvmwcW ev gvBUªvj KcvwUKv (wØcÎx) evg Awj›` I evg wbj‡qi ms‡hvM¯’‡j
UªvBKvmwcW KcvwUKv (wÎcÎx) Wvb Awj›` I Wvb wbj‡qi ms‡hvM¯’‡j
BD‡÷wkqvb KcvwUKv Bbwdwiqi †fbvK¨vfv I Wvb Awj‡›`i ms‡hvM¯’‡j
w_‡ewmqvb KcvwUKv K‡ivbvwi mvBbvm I Wvb Awj‡›`i ms‡hvM¯’‡j
cvj‡gvbvwi (†mwgjybvi) KcvwUKv cvj‡gvbvwi agbx I Wvb wbj‡qi ms‡hvM¯’‡j
A¨vIwU©K (†mwgjybvi) KcvwUKv A¨vIU©v (gnvagbx) I evg wbj‡qi ms‡hvM¯’‡j|
[m~Î: ‡gNbv` I AvRgj m¨vi]

 G‡ÛvKvwW©qvg fuvR n‡q KcvwUKv ˆZwi K‡i| Wvb Awj‡›` Db¥y³ mywcwiqi †fbvK¨vfv Ges evg Awj‡›` Db¥y³ cvj‡gvbvwi wkivi gy‡L
†Kvb KcvwUKv _v‡K bv|
 wbjq cÖvPx‡ii †fZ‡i KZ¸‡jv gvsmj †ckx Awf‡ÿwcZ Ae¯’q _v‡K| G‡`i Kjvgwb KwY© e‡j|

 A¨vwUªI †fw›UªKzjvi KcvwUKv I †mwgjybvi KcvwUKvi g‡a¨ cv_©K¨

A¨vwUªI †fw›UªKzjvi KcvwUKv †mwgjybvi KcvwUKv
1| A¨vwUªqvg I †fw›UªK‡ji wQ`ª c‡_ Aew¯’Z| 1| A¨vIU©v I cvj‡gvbvwi agwbi DrcwË ¯’‡j Aew¯’Z|
2| A¨vwUªqvg †_‡K †fw›UªK‡j GKgyLx i³cÖev‡n mvnvh¨ 2| †fw›UªKj †_‡K agwb‡Z GKgyLx i³cÖev‡n mvnvh¨ K‡i|
K‡i|
3| `yB ev wZb d¬vchy³ 3| Aa©P›`ªvK…wZ| G‡`i‡K c‡KU fvj¦ e‡j|
4| KcvwUKv¸‡jv KwW© †UwÛwbi mv‡_ hy³ 4| KwW© †UwÛwbi mv‡_ hy³ bq| KcvwUKv¸‡jv i³bvwji cÖvPx‡ii mv‡_
mshy³|
[m~Î: gv‡R`v g¨vg]
 iæB gvQ Ges gvby‡li ürwc‡Ûi g‡a¨ cv_©K¨
iæB gv‡Qi ü`wcÛ gvby‡li ürwcÛ
01. `yB cÖ‡Kvôwewkó 01. Pvi cÖ‡Kvôwewkó
02. 1wU A¨vwUªqvg I 1wU †fw›UªKj 02. 2wU A¨vwUªqvg I 2wU †fw›UªKj
03. mvBbvm- †f‡bvmvm bvgK DccÖ‡Kvô Av‡Q 03. mvBbvm- †f‡bvmvm †bB
04. †Kej CO2- mg„× i³ cwienb K‡i 04. O2-mg„× I CO2-mg„× Dfq ai‡bi i³ cwienb K‡i|
05. GKPµx i³ msenb N‡U 05. wØPµx msenb N‡U
[m~Î: AvRgj m¨vi]

01. ü`wc‡Ûi †Kvb KcvwUKvq wZbwU Kv¯ú (Cusp) _v‡K bv? [M 18-19]
A) Wvb GwUªI‡fw›UªKzjvi KcvwUKv B) evg GwUªI †fw›UªKzjvi KcvwUKv
C) A¨vIwU©K KcvwUKv D) cvj‡gvbvwi KcvwUKv
02. ü`wc‡Ûi Wvb Awj›` I Wvb wbj‡qi ms‡hvM¯’‡ji KcvwUKvi bvgÑ [M:13-14]
A) gvBUªvj KcvwUKv B) UªvBKvmwcW KcvwUKv C) cvj‡gvbvwi KcvwUKv D) A¨vIwU©K KcvwUKv

15
RETINA DIGEST Blood
03. †dvmv Ifvwjm ü`wc‡Ûi †Kv_vq _v‡K? [D: 09-10]
A) åæ‡Yi ü`wc‡Ûi AvšÍ:Awj›` c`©vi Mv‡Î B) ü`wc‡Ûi AšÍtwbjq c`©vi Mv‡Î
C) Awj›` Ñwbjq c`©vi Mv‡Î D) Wvb wbj‡qi Af¨šÍi Mv‡Î
04. wb‡¤œi †KvbwU ürwcÛ‡K wewfbœ cÖ‡Kv‡ô wef³ K‡i? [D:09-10]
A) GwcKvwW©qvg B) †cwiKvwW©qvg C) G‡ÛvKvwW©qvg D) gv‡qvKvwW©qvg
05. gvBUªvj KcvwUKv wb‡¤œ D‡jø Z ?
wLZ †Kv_vq Aew¯’ [M:09-10]
A) Wvb I evg wbj‡qi †Mvovq B) Wvb Awj›`Ñwbjq wQ`ª gyL
C) evg Awj›`Ñwbjq wQ`ªg‡y L D) GIU©vi wQ`ª gy‡L Ans: C

Ans: 1.B, 2.B, 3.A, 4.C, 5.C.

KvwW©qvK Pµ
 cÖvß eq¯‹ my¯’ e¨w³ ür¯ú›`‡bi nvi cÖwZ wgwb‡U 70-80 evi| M‡o 72-75 evi|
 ¯ú›`bnvi cÖwZwgwb‡U 75 evi n‡j, KvwW©qvK P‡µi w¯’wZKvj 0.8 †m‡KÛ|
 ürwc‡Ûi ms‡KvPb‡K wm‡÷vj I cÖmviY‡K Wvqv‡÷vj e‡j|
 wm‡÷j + Wvqv‡÷vj  nvU© weU

 KvwW©qvK P‡µi wewfbœ `kv [vvi]

A¨vwUªqv‡gi - ¯’vwqZ¡t 0.7 †m‡KÛ
Wvqv‡÷vjt - evB I UªvBKvmwcW eÜ|
- ¯’vwqZ¡t 0.1 †m‡KÛ
- cÖ_g 0.05s WvqbvwgK ch©vq|
A¨vwUªqv‡gi wm‡÷vjt
- cieZ©x 0.05s A¨vWvqbvwgK ch©vq|
- evB I UªvBKvmwcW †Lvjv|
- ¯’vwqZ¡t 0.3 †m‡KÛ
†fw›UªK‡ji wm‡÷vjt - evB I UªvBKvmwcW eÜ, †mwgjybvi †Lvjv|
- GB `kvi ïiæ‡Z UªvBKvmwcW I evBKvmwcW KcwUKv m‡Rv‡i eÜ nIqvi mgq Òjve (Lub)Ó m`„k kã nq|
- ¯’vwqZ¡t 0.5 †m‡KÛ
†fw›UªK‡ji
- evB I UªvBKvmwcW †Lvjv, †mwgjybvi eÜ|
Wvqv‡÷vjt
- GB `kvi ïiæ‡Z †mwgjybvi KcvwUKv m‡Rv‡i eÜ nIqvi mgq ÒWve (Dub)Ó m`„k kã nq|
[m~Î: MvRx AvRgj m¨vi]

 Awj‡›`i wm‡÷vjt evB I UªvBKvmwcW †Lvjv|

 Awj‡›`i Wvqv‡÷vjt evB I UªvBKvmwcW eÜ|
 wbj‡qi wm‡÷vjt evB I UªvBvmwcW eÜ, †mwgjybvi †Lvjv|
 wbj‡qi Wvqv‡÷vjt evB I UªvBKvmwcW †Lvjv, †mwgjybvi eÜ| [m~Î: Avjxg m¨vi]

01. ürwc‡Ûi Awj‡›`i wm‡÷v‡ji mgqKvj KZ? [M: 04-05]

A. 0.7 †m‡KÛ B. 0.8 †m‡KÛ C. 0.3 †m‡KÛ D. 0.1 †m‡KÛ
02. jwmKvi †ÿ‡Î mZ¨ bq †KvbwU?
A. cwiewZ©Z Kjvim B. pH = 4.9–7
C. kZKiv 94 fvM cvwb _v‡K D. AwaK cwigv‡b CO2 `ªexf~Z _v‡K
03. ürwc‡Ûi Awj‡›`i wm‡÷v‡ji mgqKvjÑ [M: 03-04, 07-08, 10-11]
A. 0.7 †m‡KÛ B. 0.8 †m‡KÛ C. 0.3 †m‡KÛ D. 0.1 †m‡KÛ
16
RETINA DIGEST Blood
04. wbj‡qi Wvqv‡÷v‡ji mgq wb‡Pi KZ †m‡KÛ? [M: 09-10]
A. 0.7 B. 0.5 C. 0.3 D. 0.1
05. ürP‡µi w¯’wZKvj KZ?
A. 0.7 †m‡KÛ B. 0.8 †m‡KÛ C. 0.3 †m‡KÛ D. 0.1 †m‡KÛ
DËigvjvt 1. D, 2. B, 3. A, 4.B, 5.B

nvU© weU Gi gv‡qv‡RwbK wbqš¿Y

ürwc‡Û wKQz we‡kl wUmy¨ _v‡K †h¸‡jv ür¯ú›`b m„wó I DÏxcbv enb K‡i| G¸‡jv‡K Junctional Tissues of Heart ev ürwc‡Ûi
mn‡hvMKvix Kjv ev ms‡hvMx wUmy¨ e‡j| G¸‡jv nj-
i. Sino-Atrial Node (SAN)
ii. Atrio-Ventricular Node (AVN)
iii. Bundle of His (BH)
iv. Bundle of His Gi Wvb I evg kvLv
v. Purkinje fiber ms‡hvMKvix wUmy¨ †`L‡Z [m~Î: Av: Avjxg m¨vi]
Dc‡ii †KvWwU scan K‡iv|
 mvB‡bv-A¨vwUªqvj †bvW (Sino-Atrial Node)
 Avwe®‹viKÑgvwU©b d¬K
 Ave„wZÑKjv AvK…wZ (Banana shaped)
 Wvb Awj‡›`i cÖvPx‡i, Wvb Awj›` I mywcwiqi †fbvK¨vfvi ms‡hvM¯’‡j Aew¯’Z|
 10-15 mm j¤^v, 3 mm PIov I 1 mm cyiæ|
 SAN-G m„ó ÔA¨vKkb c‡UbwkqvjÕ Gi gva¨‡g B‡jKwUªK wmMb¨vj m„wó nq hv Øviv nvU© we‡Ui m~Pbv N‡U|
 G Rb¨ Sino-Atrial Node †K †cm †gKvi ev cÖv_wgK MwZ Drcv`K/Q›` wbqvgK [M: 19-20] ejv nq|
 SAN-Gi Kvh©KvwiZv K‡g †M‡j K¬vwšÍ I k¦vmKó Abyf~Z nq| G‡K B‡k‡Kwgqv (Ischemia) e‡j|
 A¨vwUªI-‡fw›UªKzjvi †bvW (Atrio-Ventricular Node)
 Wvj Awj›`-wbjq cÖvPx‡i Aew¯’Z|
 Awj›` †_‡K wbj‡q ü`DÏxcbv †cuŠQvq|
 SAN ‡_‡K AVN G DÏxcbv cwien‡b 0.15 †m‡KÛ †`ix nq|
 Bundle of His B›Uvi‡fw›UªKzjvi †mÞv‡g Aew¯’Z| Bundle of His †_‡K m~² Purkinje fiber m„wó nq|
 ürwc‡Ûi wbgœ‡`k †_‡K ms‡KvPb ïiæ n‡q Dc‡ii w`‡K we¯Ívi jvf K‡i|
 †Kvb ¯Íb¨cvqx cÖvwYi ürwcÛ Zvi †`n †_‡K wew”Qbœ K‡i O2 mg„× jeY `ªe ‡Y 370 ‡m. ZvcgvÎvq †i‡L w`‡j Zv‡Z evB‡ii DÏxcbv
QvovB †ek wKQz¶Y ü`¤ú›`b Pj‡Z _v‡K|
 G‡K msiwÿZ †cm‡gKvi e‡j| [m~Î: Av: Avjxg m¨vi]
 SA †bvW I AV †bv‡Wi g‡a¨ cv_©K¨:
SA Node (SAN) AV Node (AVN)
1| GwU Wvb A¨vwUªqv‡gi mywcwiqi †fbvK¨vfvi wQ‡`ªi wbK‡U Aew¯’Z| 1| GwU Wvb A¨vwUªqv‡gi AvšÍtA¨vwUªqvg c`©vi g~j‡`‡k Aew¯’Z|
2| Gi Q›`gqZv Lye †ewk| 2| Gi Q›`gqZv Lye Kg|
3| GwU ¯ú›`bcÖevn m„ wó K‡i| 3| GwU SA Node †_‡K Drcbœ ¯ú›`bcÖevn MÖnY K‡i|
4| G‡K †cm‡gKvi ev Q›`-wbqvgK e‡j| 4| G‡K msiÿx Q›`-wbqvgK e‡j|
 Bullet Information:
 cÖvK…wZK †cm‡gKvi→ SA node
 wiRvf© †cm‡gKvi ev msiw¶Z Q›` wbqvgK → AV node
 SA node Gi ¯ú›`b nvit 70-80 weU/wgwbU (m‡e©v”P 100 weU/wgwbU)
 AV node Gi ¯^vfvweK ev ¯ú›`b nvi wgwb‡U 40-60 (M‡o 50)
 evÛj Ae wnR → cÖwZ wgwb‡U 36 evi|
 cviwKbwR Zš‘ → cÖwZ wgwb‡U 30-35 evi| [m~Î: †gNbv` m¨vi]
ürwc‡Ûi gv‡qv‡RwbK wbqš¿‡Yi MwZc_:
SAN→AVN→Bundle of His→Purkinje fibers
17
RETINA DIGEST Blood

01. ürwc‡Û Aew¯’Z †Kvb ms‡hvMKvix Kjv‡K †cm‡gKvi ejv nq? [M: 19-20]
A. mvB‡bv A¨vwUªqvj †bvW B. evÛj Ae wnm C. cviwKwÄ Zš‘ D. A-V †bvW
02. GKwU ü`wc‡Û cÖwZ wgwb‡U 80 evi ü`K¤úb nq, Zvn‡j ü` P‡µi ¯’vqxZ¡ KZ? [D:16-17]
A) 0.60 †m‡KÛ B) 0.75 †m‡KÛ C) 7.50 †m‡KÛ D) 0.80 †m‡KÛ
03. Awj‡›`i Wvqv‡÷vj `kvi mgqKvj wb‡¤œi †KvbwU?[M:10-11]
A) 0.3 B) 0.7 C) 0.1 D) 0.5
04. wb‡¤œi †KvbwU ürwc‡Ûi msenbZ‡š¿i Ask bq? [D:09-10]
A) †cm †gKvi B) gv‡qvKvwW©qvg C) ev‡Ûj Ae wnR D) cviwKbwR Zš‘
05. wbj‡qi Wvqv‡÷v‡ji mgq wb‡¤œi KZ †m‡KÛ? [M:09-10]
A) 0.7 B) 0.5 C) 0.3 D) 0.1
06. Wvb Awj›` cÖmvwiZ n‡j AMÖ‡`kxq gnvwkivi gva¨‡g‡`‡ni mvg‡bi AÂj †_‡K Kve©bÑWvB ·vBW mg„× i³ wb‡¤œi †Kvb Awj‡›`
wd‡i Av‡m? [M:09-10]
A) Wvb wbjq B) Wvb Awj›` C) evg wbjq D) evg Awj›`
07. wb‡¤œi †Kvb Dw³wU mwVK bq? [M:07-08]
A) Awj‡›` AvMZ wkiv¸wji cÖ‡ek c_ KcvwUKvwenxb B) Wvb wbjq †_‡K cvj‡gvbvix agbx ïiæ nq
C) gvBUªvj KcvwUKv Wvb Awj›` I Wvb wbj‡qi ms‡hvM¯’‡j _v‡K D) mvB‡bvÑA¨vw&Uªqvj †bvW (SAN) Wvb Awj‡›`i cÖvPx‡i _v‡K
08. ürwc‡Ûi Awj‡›`i wm‡÷v‡ji mgqKvj KZ? [M:04-05]
A) 0.7 †m‡KÛ B) 0.8 †m‡KÛ C) 0.3 †m‡KÛ D) 0.1 †m‡KÛ
Ans: 1.A, 2.B, 3.B, 4.B, 5.B, 6.B, 7.C, 8.D.

e¨v‡ivwi‡mÞi

* e¨v‡ivwi‡mÞi nj gvby‡li i³ evwnKvq Pvc-ms‡e`x mœvqy cÖvšÍ

* e¨v‡ivwi‡mÞi 2 cÖKvi| h_v-
K. D”P i³Pvc e¨v‡ivwi‡mÞi (High pressure baroreceptor) ev AvU©vwiqvj e¨v‡ivwi‡mÞi|
L. wbgœPvc e¨v‡ivwi‡mÞi (Low Pressure Barorecptor) ev KvwW©Icvj‡gvbvwi e¨v‡ivwi‡mÞi ev fwjDg wi‡mÞi|

K. D”P i³ Pvc e¨v‡ivwi‡mÞi :

 D”P i³Pvc e¨v‡ivwi‡mÞi A¨vIwU©K AvP© I K¨v‡ivwUW mvBbv‡m Aew¯’Z|
 A¨vIwU©K Av‡P© Aew¯’Z e¨v‡ivwi‡mÞi wm‡÷wgK msen‡b Avmv i‡³i Pvc gwbUi K‡i|
 K¨v‡ivwUW mvBbv‡mi wi‡mÞi gw¯Í¯‹gyLx i‡³i Pvc gwbUi K‡i|
 K¨v‡ivwUW e¨v‡ivwi‡mÞi †_‡K ms‡KZ Mø‡mvd¨vwiwÄqvj mœvqyi gva¨‡g †cÖwiZ nq| A¨vIwU©K e¨v‡ivwi‡mÞi †_‡K ms‡KZ †fMvm mœvqyi
gva¨‡g †cÖwiZ nq|
L. wbgœPvc ev fwjDg wi‡mÞi ev AvqZb wi‡mÞi ev KvwW©I cvj‡gvbvix e¨v‡ivwi‡mÞi [M 18-19]
 eo wm‡÷wgK wkiv, cvj‡gvbvwi wkiv, Wvb Awj›` I wbj‡qi cÖvPx‡i Aew¯’Z|
 Giv i‡³i AvqZb wbqš¿Y K‡i|
 A¨vwUªqv‡gi †fZi i³Pvc wba©viY K‡i|
 i³msenb I †iPb G `yBwU Z‡š¿i Dc‡iB KvR K‡i
 Angiotensin II i³Pvc evov‡bvi cÖavb G‡R›U wn‡m‡e KvR K‡i| [m~Î: AvRgj I Avjxg m¨vi]

g‡b ivLvi †KŠkjÑ

(D P S)

Wvb Awj›` I wbjq cvj‡gvbvwi i³evwnKv wm‡÷wgK wkiv

18
RETINA DIGEST Blood
i³Pvc
 cÖevngvb i³ agbxi cÖvPx‡i ‡h cvk¦©Pvc m„wó K‡i Zv‡K i³Pvc e‡j|
 ‡`‡ni i‡³i cwigvY, ü`wcÛ †_‡K wb®‹Z … i‡³i cwigvY, i‡³i mv›`ªZv Ges agbxi w¯’wZ¯’vcKZv i³ Pvc‡K cÖfvweZ K‡i|
 ¯^vfvweK wm‡÷vwjK Pvc 110-140 mmHg| M‡o 120 mmHg| ¯^vfvweK Wvqv‡÷vwjK Pvc 60-90mmHg| M‡o 80 mmHg|
 wm‡÷vwjK I Wvqv‡÷vwjK Pv‡ci cv_©K¨‡K cvjm& †cÖmvi ev bvox Pvc ev ¯ú›`b Pvc e‡j| GwU M‡o 40 mmHg|
 140/90 mmHg Gi †ewk n‡j D”P i³Pvc ev nvBcvi‡Ubkb e‡j|
 100/50 mmHg Gi Kg n‡j Zv‡K wbgœ i³Pvc ev nvB‡cv‡Ubkb e‡j|
 i³Pvc cwigvcK hš¿ wùM‡gvg¨v‡bvwgUvi| [m~Î: Avjxg m¨vi]

i³ msenbZš¿
 i³bvjx 3 ai‡bi| h_v- agbx, wkiv I ˆKwkK RvwjKv|
 agbx I wkivi cÖvPxi 3 ¯Íi wewkót
 ewnt¯’ †hvRK Kjvq MwVZ wUDwbKv G·UvY©v/wUDwbKv A¨vW‡fbwUwkqv|
 ga¨t¯’ †ckxZš‘ wbwg©Z wUDwbKv wgwWqv|
 AšÍt¯’ G‡Ûv‡_wjqv‡g MwVZ wUDwbKv B›UvY©v ev wUDwbKv Bw›Ugv|
 ‰KwkK RvwjKvi cÖvPxi ïaygvÎ wUDwbKv B›Uvb©v Z_v GK ¯Íi wewkó AvuBkvKvi G‡Ûv‡_wjqvg Øviv MwVZ| [m~Î: gv‡R`v m¨vi]

 agbx I wkivi ZzjbvgyjK Av‡jvPbvÑ

welq agbx wkiv
1. DrcwË I mgvwß DrcwË-ürwc‡Û; mgvwß †`‡ni ˆKwkKbvjx‡Z DrcwË-‰KwkKbvjx †_‡K; mgvwß ürwc‡Û
2. i³ cÖev‡ni w`K ürwcÛ †_‡K †`‡ni w`‡K cwienb K‡i ‡`n †_‡K ürwc‡Ûi w`‡K cwienb K‡i
cvj‡gvbvwi agbx Qvov Ab¨ agbx¸‡jv O2 mg„× i³ cvj‡gvbvix wkiv Qvov Ab¨ wkiv¸‡jv CO2 mg„× i³
3. i‡³i cÖK…wZ
cwienb K‡i| i³ D¾¡j jvj e‡Y©i| cwienb K‡i| i³ Kvj‡P e‡Y©i|
4. cÖvPxi ‡ek cyiæ I w¯’wZ¯’vcK Kg cyiæ I Aw¯’wZ¯’vcK
5. jy‡gb (MnŸi) †QvU †ek eo
6. KcvwUKv KcvwUKv _v‡K bv ‡mwgjybvi KcvwUKvi g‡Zv KcvwUKv _v‡K
7. Ae¯’vb cÖavbZ †`‡ni Mfxi As‡k we¯Í…Z _v‡K ‡`‡ni cwiwa As‡k we¯ÍZ
… _v‡K
8. i³ Pvc D”P i³ Pv‡c i³ cwienb K‡i Kg Pv‡c i³ cwienb K‡i
9. ¯ú›`b Av‡Q bvB
10. †K‡U †M‡j wdbwK w`‡q i³ †ei nq PzB‡q i³ †ei nq
11. eR©¨ c`v_© Kg _v‡K †ekx _v‡K

cvj‡gvbvwi agwb I cvj‡gvbvwi wkivi g‡a¨ cv_©K¨

cv_©‡K¨i welq cvj‡gvbvwi agwb cvj‡gvbvwi wkiv
01. Drcw˯’j ürwc‡Ûi Wvb wbjq ev Wvb †fw›UªKj dzmdz‡mi ˆKwkK RvjK
02. cwimgvwß dzmdz‡mi ˆKwkK RvjK ürwc‡Ûi evg Awj›` ev evg A¨vwUªqvg
03. cÖvPxi cyiæ Ges w¯’wZ¯’vcK cvZjv Ges Aw¯’wZ¯’vcK
04. ürwc‡Ûi ms‡hvM¯’‡j KcvwUKv _v‡K _v‡K bv
05. i³Pvc †ewk Kg
CO2 mg„× i³ O2 mg„× nIqvi Rb¨ ürwc‡Ûi O2 mg„× i³ dzmdzm †_‡K †`‡n mieiv‡ni
06. KvR
Wvb wbjq †_‡K dzmdz‡m wb‡q hvq| Rb¨ ürwc‡Ûi evg Awj‡›` wb‡q hvq|

19
RETINA DIGEST Blood
 gvbe‡`‡n Pvi c×wZ‡Z i³ msenb msNwUZ nq
01. wm‡÷wgK msenb : evg wbjqgnvagbxA½-Zš¿ gnvwkivWvb Awj›`Wvb wbjq|
02. cvj‡gvbvwi msenb: Wvb wbjqcvj‡gvbvwi agwbdzmdzmcvj‡gvbvwi wkivevg Awj›`evg wbjq
03. †ncvwUK †cvU©vj msenb: †cŠwóK A½vw`‡ncvwUK †cvU©vj wkivhK…Z‡ncvwUK wkivwb¤œgnvwkivü`wcÛ
04. K‡ivbvwi msenb: wm‡÷wgK agbxK‡ivbvwi agbxü`cÖvPxiK‡ivbvwi wkivWvb Awj›`

 †cvU©v‡ji cÖ‡qvRbxqZv:
1. AwZwi³ Møy‡KvR MøvB‡Kv‡R‡b cwiYZ n‡q fwel¨‡Zi Rb¨ mwÂZ nq| †`n‡Kv‡l Møy‡Kv‡Ri Afve NU‡j MøvB‡Kv‡Rb cybivq Møy‡Kv‡R
cwiYZ n‡q i‡³ cÖevwnZ nq|
2. A¨v‡gvwbqv hK…‡Z BDwiqvq cwiYZ n‡q e„‡°i gva¨‡g †`‡ni evB‡i wbM©Z nq| d‡j i³ cwiï× nq|
3. hK…Z i‡³ †cÖvwUb Drcv`b K‡i|

 LywUbvwU Z_¨:
 wm‡÷wgK msen‡bi mgq jv‡M 25-30 †m‡KÛ
 †giæ`Ûx cÖvwY‡Z `yai‡bi †cvU©vj cvIqv hvq|
h_v- 1. hK…Z/†ncvwUK
2. e„°xq/†ibvj
 D‡jøL¨, †ibvj †cvU©vj gvby‡l Abycw¯’Z|
[m~Î: AvRgj m¨vi]

1. †Kvb RvZxq e¨v‡ivwi‡mÞi i‡³i AvqZb wbqš¿‡b f~wgKv iv‡L? [M:18-19]

A) D”PPvc e¨v‡ivwi‡mÞi B) K¨v‡ivwUW e¨v‡ivwi‡mÞi C) wb¤œPvc e¨v‡ivwi‡mÞi D) A¨vIwU©K e¨v‡ivwi‡mÞi DËi: C
2. wb‡¤œi †KvbwU cvj‡gvbvwi msen‡bi Ask bq? [M:15-16]
A) dzmdzm B) Wvb wbjq C) gnvagbx D) evg Awj›` DËi: C
3. wb‡¤œi †KvbwU mwVK bq? [M:09-10]
A) wkivq i³Pvc Kg _v‡K B) jwmKv †`‡ni wKQz wKQz ¯’v‡b i‡³i cwieZ© wnmv‡e KvR K‡i
C) ‰KwkK RvjK †_‡K wkivi DrcwË D) KvwW©qvK P‡µi mgqKvj, ürwc‡Ûi ¯ú›`‡bi mgvbycvwZK DËi: D
4. wm‡÷vwjK Ges Wvqv‡÷vwjK Pv‡ci AšÍidj‡K ejv nqÑ[M:09-10]
A) cwi¯ªveb †cÖmvi B) †emvj †cÖmvi C) wgb †cÖmvi D) cvjm&& †cÖmvi DËi: D
5. wb‡¤œi †Kvb Z_¨wU mwVK bq? [M:08-09]
A) ürwc‡Ûi evg Awj›` †_‡K cvj‡gvbvix agbx Drcbœ nq
B) cvj‡gvbvix agbxi cÖ‡ek gy‡L GKUv Aa©P›`ªvKw…Z KcvwUKv _v‡K
C) cvj‡gvbvix wkiv dzmdzm †_‡K Aw·‡Rbhy³ i³ wb‡q ürwc‡Ûwd‡i Av‡m
D) gvby‡li i³msenbZ‡š¿ wØPµxq msenb ‡`Lv hvq DËi: A
6. wmwjqvK agbx wb‡¤œi †Kvb A‡½ i³ mieivn K‡i bv? [M:08-09]
A) cvK¯’jx B) e„° C) cøxnv D) hK…Z DËi: B
7. wkivi Rb¨ †Kvb Z_¨wU mwVK bq? [M:05-06]
A) jy‡gb eo B) mvaviYZ Kve©b WvB A·vBW mg„× i³ †`‡ni wewfbœ Ask †_‡K ü`wc‡Û enb K‡i wb‡q Av‡m|
C) wkivcÖvPxi wZb ¯Í‡i MwVZ D) cÖvPxi w¯’wZ¯’vcK DËi: D

20
RETINA DIGEST Blood
8. AvP© Ae A¨vIU©v †_‡K †ei nq bv †Kvb agbx? [D:04-05]
A) B‡bvwg‡bU ev eªvwKI‡mdvwjK B) eªvwKqvj agbx
C) evg mvaviY K¨v‡ivwUW agbx D) evg mve‡K¬wfqvb agbx DËi:B
9. agbxi †ÿ‡Î bx‡Pi †KvbwU cÖ‡hvR¨? [D:02-03]
A) Drm¯’j ˆKwkK RvwjKv B) mgvw߯’j ürwcÛ C) KcvwUKv Av‡Q
D) i³ mvaviYZ ürwcÛ †_‡K ‡`‡ni wewfbœ As‡k cwievwnZ nq DËi:D
10. ‡h `y‡Uv wkiv wgwjZ n‡q ÒBbœwg‡bU wkivÓ MwVZ nq Zvi g‡a¨ GKwU n‡jvÑ[M:01-02]
A) Gw·jvix wkiv B) mve‡K¬wfqvb wkiv C) ‡mdvwjK wkiv D) GRvBMvm wkiv DËi:B

ü`‡iv‡Mi wewfbœ Ae¯’v

eZ©gvb c„w_ex‡Z †gvU g„Zz¨i 30% n‡q _v‡K ü`‡ivM RwbZ Kvi‡Y| ZvB G‡K we‡k¦i GK b¤^i NvZK e¨vwa ejv nq|
* wPwKrmvweÁv‡bi †h kvLvq ürwc‡Ûi †ivM wb‡q Av‡jvPbv nq→KvwW©IjwR
 D‡jøL‡hvM¨ ü`‡ivM:
 K‡ivbvwi ü`‡ivM (Coronary heart disease)
 wiDg¨vwUK ü`‡ivM (Rheumatic heart disease: evZR¡iRwbZ ür‡cwk I KcvwUKvi KvR eÜ nIqvi Rb¨ †ivM)
 D”P i³Pvc (Hpertension)
 Rb¥MZ ü`‡ivM (Congenetal heart disease: Rb¥MZfv‡e ürwc‡Ûi ÎæwU)
 KvwW©I‡gMvwj (Cardiomegaly: ürwcÐ eo n‡q hvIqv)
 KvwW©Igv‡qvc¨vw_ (Cardiomopahy: ür‡cwki †ivM) BZ¨vw`|
[m~Î: gv‡R`v g¨vg]
A¨vbRvBbv/ü`k~j

 GwU ürwcÛRwbZ eyK e¨v_v|

 G‡K A¨vbRvBbv †cK‡UvwimI e‡j|
 A¨vbRvBbv‡K mvaviYZ nvU© A¨vUv‡Ki c~e©m~ix g‡b Kiv nq|
- K‡ivbvwi agbx‡Z D”P gvÎvq †Kv‡j‡÷ij Rgvi d‡j jy‡gb miæ n‡q hvIqv|
- O2 K‡g †M‡j ür†cwk‡Z AevZ k¦mb nq| G‡Z j¨vKwUK GwmW m„wó nq hv R‡g e¨_v m„wó K‡i|
- ü`wc‡Ði KcvwUKvi mgm¨v
KviY
- A¨vwbwgqv AvµvšÍ †ivMx
- ch©vß O2 Gi Afve
- AwZwi³ cyiæ ü`wc‡Ði cÖvPxi
- A¨vbvRvBbvi e¨v_v 5-30 wgwbU ¯’vqx nq|
- Ditdj‡Ki †cQ‡b, ey‡K e¨v_v nIqv|
- e¨v_v Mjv, Kuva, †Pvqvj, `uv‡Z, evû‡Z I wc‡V Qwo‡q †h‡Z cv‡i|
jÿY
- Nb Nb k¦vm-cÖk¦vm
- Kuva I evû fvix n‡q Avmv
- Nvg nIqv, gv_v wSgwSg Kiv, kixi d¨vKv‡k nIqv
1. myw¯’Z/w¯’i A¨vRvBbv
cÖKvi‡f` 2. Aw¯’Z/Aw¯’i A¨vRvBbv
3. wcÖbR‡gUvj A¨vRvBbv (VvÛvi Kvi‡Y n‡Z cv‡i)
1. eqm 40 Gi †ewk
2. a~gcvqx
3. D”P i³Pv‡ci †ivMx
Kviv AvµvšÍ n‡Z cv‡i
4. Wvqv‡ewU‡mi †ivMx
5. hviv KvwqK kÖg K‡i bv
6. hv‡`i i‡³ D”P gvÎvq †Kv‡j÷ij Av‡Q
21
RETINA DIGEST Blood
nvU© A¨vUvK
➥ ch©vß Aw·‡Rb mg„× i³ mieiv‡ni Afv‡e KvwW©qvK †ckx aŸsm nIqv ev g‡i hvIqv‡K nvU© A¨vUvK e‡j|
➥ Gi Aci bvg gv‡qvKwW©qvj BbdvK©kb| ev GgAvB [MI]
➥ †Kb nq?:
 K‡ivbvwi agbxi AšÍM©v‡Î D”P gvÎvi †Kv‡j‡÷ij Rg‡j O2 mieivn eÜ nq|
 i‡³ AbyPwµKvi Kvh©KvwiZv †e‡o †M‡j, i‡³ dvBweª‡bv‡Rb I d¨v±i VIII †e‡o †M‡j|
➥ i‡³ †Kv‡j‡÷i‡ji ¯^vfvweK gvÎv cÖwZ 100 wg.wj‡Z 150-200 wg.wj. MÖvg|
➥ KLb nq?:
 ‡kl iv‡Z I mKvj 9Uvi Av‡M nvU© A¨vUv‡Ki nvi me‡P‡q †ewk|
➥ nvU© A¨vUv‡Ki e¨_v n‡Z cv‡i cyiæ‡li evg evû‡Z Ges bvix‡`i `yB evû‡Z|

❑ j¶Y:
➥ nvU© A¨vUv‡Ki-
 cÖv_wgK jÿY nj ey‡K Zxeª I Amnbxq e¨v_¨v|
 mvaviY jÿY nj cÖPzi Nvg ev kxZjNvg nIqv|
➥ nvU© A¨vUvK wbY©‡qi Rb¨ wewfbœ cix¶v- [VI]
K. ECG L. B‡KvKvwW©IMÖvwd M. KvwW©qvK MRI N. K‡ivbvwi GbwRIMÖvg O. ey‡Ki G·‡i (†iwWIMÖvd)
➥ SuywKc~Y© eqm: cyiæl → 45 eQ‡ii †ewk,
bvix → 55 eQ‡ii AwaK|
❑ nvU© A¨vUv‡Ki cÖavb KviY n‡jv 5wU| h_v:
1. a~gcvb 2. D”P i³Pvc 3. Wvqv‡ewUm 4. i‡³ Pwe© AvwaK¨ 5. cwRwUf †dwgwj wnw÷ª

❑ nvU© A¨vUv‡Ki cÖwZKvi I cÖwZ‡iva:

nvU© A¨vUv‡Ki cÖwZKvi:
 wPwKrmvi cÖavb cQ›` n‡jv A¨vbwRIcøvw÷|
 i³bvwjKvi †fZ‡ii i³ RgvU fv½‡Z †ivMx‡K Ilya †meb Kiv‡K _ª‡¤^vjvBwUK †_ivwc (thrombolytic therapy) e‡j|
 A‡bK‡ÿ‡Î †ivMxi evBcvm I‡cb nvU© mvR©vwii cÖ‡qvRb|

nvU© A¨vUvK cÖwZ‡iva:

wbqwgZ Ilya †meb I Rxeb-hvcb c×wZi cwieZ©b K‡i nvU© A¨vUvK †iva Kiv hvq| Rxeb-hvcb c×wZi cwieZ©‡bi we‡kl w`K n‡jv:
 ürevÜe ¯^v¯’¨Ki Lv`¨ MÖnY Kiv  gvbwmK Pvc I welbœZv cwinvi Kiv
 i‡³i †Kv‡j‡÷ij gvÎv wVK ivLv  ¯’‚jZv wbqš¿Y Kiv
 wbqwgZ e¨vqvg Kiv  A¨vj‡Kvnj I g`¨cvb †_‡K weiZ _vKv
 a~gcvb cwiZ¨vM Kiv  cÖdzjø-Avb›`gq Rxeb hvcb Kiv
 Wvq‡ewUKm I D”P i³Pvc wbqš¿‡Y ivLv  Pwe©hy³ Lvevi cwinvi Kiv [m~Î: Avjxg m¨vi]
❑ KiYxq:
 nvU© A¨vUvK n‡q‡Q g‡b n‡j Zvr¶wYKfv‡e wRnŸvi wb‡P A¨vbwRmW (Angised) U¨ve‡jU w`‡Z n‡e|
 ¸iæZi n‡j 300mg (75mg Gi 4wU U¨ve‡jU) A¨vmwcwib †L‡Z n‡e| A¨vmwcwib i³‡K Zij iv‡L Ges RgvU euva‡Z †`q bv|
 GQvov weUv eøKvi, A¨vw›U‡Kvqv¸‡j›U ‡hgb: A¨vmwcwib, †K¬vwc‡Wv‡MÖj, A¨vwU‡bv‡jvj, †cÖvcv‡bv‡jvj e¨envi Kiv hvq|
 Avav‡kvqv Ae¯’vq nvmcvZv‡j wb‡Z n‡e|

22
RETINA DIGEST Blood
†÷ªvK I nvU© A¨vUvK
gw¯Í‡®‹ i³ PjvP‡j weNœ NU‡j †÷ªvK (†ivMx AÁvb n‡q hvq, †`‡ni GK w`‡K c¨vivjvBRW n‡q hvq)
ürwc‡Ûi i³ PjvP‡j weNœ NU‡j nvU© A¨vUvK (†ivMx AÁvb n‡q hvq bv, †`‡ni GK w`‡K c¨vivjvBRW nq bv
[m~Î: Avjxg]
nvU© †dBwjDi
➥ ürwcÛ hLb †`‡ni Pvwn`v Abyhvqx ch©vß i‡³i †hvMvb w`‡Z cv‡i bv ZLb G Ae¯’v‡K nvU© †dBwjDi e‡j|

❑ KviY:
i.AwZwi³ †Kv‡j‡÷ij ii. Wvqv‡ewUm
iii. AwZwi³ a~gcvb I g`¨cvb iv. Bk‡KwgK nvU© wWwRR I nvU© A¨vUvK
v. ürwc‡Ûi Q›`cZb vi. AšÍt¶iv MÖwš’i A¯^vfvweKZv
vii. `xN©¯’vqx D”P i³Pvc viii. ¯’~jZv
ix. KcvwUKvi †ivM x. KvwW©I-gv‡qvc¨vw_
xi.eskMZ xii. AwZgvÎvi i³ k~b¨Zv (Gwbwgqv)
xiii. msµgbRwbZ xiv. AwZwi³ KvR
[m~Î: AvRgj m¨vi, Av: Avjxg m¨vi, †gNbv` m¨vi]
❑ j¶Ymg~n:
 nvU© †dBwjD‡ii jÿY: nvU© †dBwjDi ürwc‡Ûi evg cv‡k n‡j GKiKg Ges Wvb cv‡k n‡j Ab¨iKg jÿY cÖKvk cvq|
 nvU© †dBwjDi evg cv‡k n‡jÑ
i) k^vmÑcÖk^v‡mi MwZ I mgq K‡g hvq
ii) †Kv‡bv KvwqK cwikÖ‡g k^vm Kó nq|
iii) ﮋ K‡di m„wó nq hv †ei Kiv hvq bv|
iv) K¬vwšÍ I Aemv`MÖ¯’ Abyfe Kiv|
v) †cwki `ye©jZv
vi) †`‡ni IRb K‡g hvq|
 nvU© †dBwiDi Wvb cv‡k n‡jÑ
i) cv‡qi dz‡j hvIqv (B‡Wgv):
ii) cv‡qi wb‡Pi As‡ki Z¡K ﮋ n‡q hvq:
iii)cv‡q GKwRgvi g‡Zv jvj `vM cv‡o hv c‡i RwUj Nv G cwiYZ nq|
iv) D`i MnŸi Ges Z`w¯’Z A½¸‡jv‡Z Zij c`v_© R‡gwe‡kl K‡i dzmdzm I hK„‡Z Zij R‡g dz‡j hvq|
[m~Î: Avjxg m¨vi]
❑ wPwKrmv 3 ai‡bi t
1. Rxebhvcb c×wZ cwieZ©b
2. Jla (Angiotensin Converting enzyme inhibitor, Angiotensin Receptor blocker,  blocker)
3. mvR©vwi: cÖ‡qvR‡bi †cÖwÿ‡Z nvU© †dBwjD‡ii Kej †_‡K iÿvi Rb¨ mvR©vwi Kiv jvM‡Z cv‡iÑ
i. K‡ivbvwi evBcvm mvR©vwi
ii. ürwc‡Ûi KcvwUKvi †givgZ ev wis emv‡bv
iii. †fw›UªKzjvi †cwms/‡cm †gKvi emv‡bv|
[m~Î: †gNbv` mvnv m¨vi]
ü`‡ivM wbY©q
➥ wPwKrmKMY nvU© we‡Ui nvi e„w×, ürwc‡Ûi A¯^vfvweK kã, cv dz‡j hvIqv, Nv‡oi wkiv dz‡j hvIqv, hK…Z eo nIqv BZ¨vw` jÿY¸‡jv
†`‡L ür‡ivM mn‡RB wbY©q Ki‡Z cv‡ib|
➥ ey‡Ki X-ray Kiv‡bvi gva¨‡g ürwc‡Ûi Ae¯’v Rvbv hvq|
➥ ECG (Electrocardiogram) ü`wc‡Ûi cÖv_wgKfv‡e ‡ivM wbY©‡q e¨eüZ nq|
➥ K‡ivbvix GbwRIMÖvg: ü`wc‡Ûi i³bvjx‡Z †Kvb eøK Av‡Q wKbv Zv wbY©‡qi Rb¨|
23
RETINA DIGEST Blood
➥ MRI (Magnetic resonance imaging) ürwc‡Ûi †cwk Ae¯’v Rvbvi Rb¨ cixÿvwU Kiv nq|
➥ BNP (Brain Natriuretic peptide) cixÿvwUi gva¨‡g nvU© †dBwjDi m¤ú‡K© wbwðZ nIqv hvq|
➥ ETT (Exercise tolerance test ) Gi mvnv‡h¨ ürwc‡Ûi Ae¯’v ev Kvh©ÿgZv fv‡jvfv‡e Rvbv hvq|
➥ D”P i³Pvc Av‡Q wKbv Zv cixÿv Kiv|
➥ i‡³ kK©iv I Pwe©i cwigvY wbY©‡qi cixÿv Kiv|
➥ KvwW©qvK GbRvBg: Uª‡cvwbb, CKMB (Creatine Kinases Muscle and Brain) G‡`i cwigvY ev gvÎv
[m~Î: Av: Avjxg]
we.`ª.: K‡ivbvwi GbwRIMÖvg I †_wjqvg Avcv‡UK †U÷ ev gv‡qvKvwW©qvj cviwdDkb BgvwRs (MPG) cixÿv `ywU SzuwKc~Y© I e¨qeûj|
[m~Î: gv‡R`v g¨vg]
❑ wPwKrmv 3 ai‡bi t
1. Rxebhvcb c×wZ cwieZ©b
2. Jla (Angiotensin Converting enzyme inhibitor, Angiotensin Receptor blocker,  blocker)
3. Ab¨vb¨ wPwKrmv Pvwj‡q hvIqv|
 ü`‡iv‡Mi cÖPwjZ wPwKrmv:
 cÖ_gZ, e¨v_v Kgv‡bvi Ilya-bvB‡UªvwMømvwib, Nitroglycerin|
 wØZxqZ, i³ RgvUe×Zv †iv‡ai Rb¨ A¨vw›U‡cøU‡jU Ilya| †hgb: A¨vmwcwib, †K¬vwcW‡MÖj BZ¨vw`|
 Z…ZxqZ, i‡³ †Kv‡j÷ij gvÎv Kgv‡bvi Ilya| †hgb: ÷¨vwUb, dvB‡eªU BZ¨vw`|
 eø‡K‡Ri cwigvY †ewk n‡j cÖ‡qvRb nq B›Uvi‡fbkb I mvwR©K¨vj wPwKrmvi| B›Uvi‡fbkb n‡jv GbwRIcøvw÷ (†ejywbs I †÷w›Us ev
avZe wis civ‡bv) Avi mvwR©K¨vj wPwKrmv n‡”Q evBcvm Acv‡ikb|
[m~Î: gv‡R`v g¨vg]
ü`‡iv‡Mi wPwKrmvi aviYv

†cm‡gKvi

➥ ü`¯ú›`b A¯^vfvweK n‡j Zv‡K A¨vwi_wgqv e‡j|

➥ ü`¯ú›`b ¯^vfvwe‡Ki †P‡q `ªæZ n‡j (160-200 beat/min)- Tachycardia e‡j|
➥ ü`¯ú›`b ¯^vfvwe‡Ki †P‡q gš’i n‡j (60 ev Gi Kg beat/min) Bradycardia e‡j|
➥ William Chardack Ges Wislon Greabatch 1969 mv‡j †`‡n ¯’vcb‡hvM¨ †cm‡gKvi Avwe®‹vi K‡ib|
➥ GKwU wjw_qvg e¨vUvwi, Kw¤úDUvivBR †Rbv‡iUi, †PZbv ev †eva ea©K (Amplifier) I kx‡l© †mÝihy³
➥ ‡cm‡gKv‡i Acwievnx AveiYhy³ 1-3wU Zvi _v‡K| †cm‡gKv‡ii Zvi‡K †cwms wjW e‡j|
➥ ‡cm‡gKvi 3 iKgt
K) GK cÖ‡Kvô t Wvb A¨vwUªqvg ev Wvb wbj‡q wjWhy³ _v‡K|
L) wØ cÖ‡Kvô †cm‡gKvi t Wvb A¨vwUªqvg I Wvb wbj‡q wjW hy³ _v‡K|
M) wÎ-cÖ‡Kvô †cm‡gKvi t Wvb A¨vwUªqvg, Wvb wbjq I evg wbj‡q wjW hy³ _v‡K|
➥ ‡cm‡gKv‡ii e¨vUvwii †gqv` _v‡K 5-10 eQi|
➥ GwU UvB‡Uwbqvg (Ti) Øviv ˆZwi nq|
➥ ¯’vwcZ nq evg K¬¨vwfKj Gi wb‡Pi Z¡‡Ki wbgœvs‡k, †ckxi Dcwifv‡M|

I‡cb nvU© mvR©vwi

➥ U‡i‡›Uv wek¦we`¨vj‡qi Aa¨vcK Dr. Wilfred G. Bigelow 1950 mv‡j cÖ_g I‡cb nvU© mvR©vwi cÖ‡qvM K‡ib|
➥ ürwc‡Û i³ mieivnKvix †Kvb ¶wZMÖ¯’ agbxi cwie‡Z© Ab¨ RvqMv †_‡K wkiv ev agbxi Ask G‡b ürwc‡Û ¯’vcb K‡i bZzb i³ evwnKv
m„wói cÖwµqv‡K K‡ivbvwi evBcvm ev K‡ivbvwi AvU©vwi evBcvm MÖvdU (CABG) e‡j|

24
RETINA DIGEST Blood
 †hme †ÿ‡Î I‡cb nvU© mvR©vwi Kiv nq-
1. K‡ivbvwi i³bvjx‡Z eøK n‡j Zv Ab¨ †Kv‡bv i³bvjx w`‡q i³cÖevn ¯^vfvweK Ki‡Z
2. ü`wc‡Ûi †Kv‡bv KcvwUKvi †givgZ ev cÖwZ¯’vcb Ki‡Z|
3. ü`cÖvPx‡ii †Kv‡bv bó ev ÿwZMÖ¯’ Ask †givgZ ev cÖwZ¯’vcb Ki‡Z|
4. ü`wc‡Ð †Kv‡bv hš¿ emv‡Z|
5. ü`wcÐ cÖwZ¯’vcb Ki‡Z|
➥ I‡cb nvU© mvR©vwi wZb Dcv‡q Kiv nq-
i. Abcv¤ú mvR©vwit Heart Lung †gwkb ev ü`dymdzm †gwkb e¨envi Kiv nq| G cÖwµqvq ürwc‡Û i³I _v‡K bv, ür¯ú›`bI nq bv|
GwU cÖPwjZ cÖwµqv|
ii. Adcv¤ú mvR©vwi t ü`-dymdzm †gwkb e¨eüZ nq bv| mwµq ¯ú›`biZ ürwc‡ÛB A‡¯¿vcPvi Kiv nq| ür¯ú›`b gš’i K‡i ivLv nq|
iii. †iveU mn‡hvMx mvR©vwi t m~² I mwVK| Av‡iKwU Dcvq nj Minimally invasive Surgery
 ü`dzmdzm †gwk‡bi Ab¨ bvg=KvwW©I-cvj‡gvbvwi evBcvm|

K‡ivbvwi evBcvm mvR©vwi (CABG)

➥ K‡ivbvwi agbx‡Z †Kv‡j‡÷ij RvZxq njy` Pwe©-c`v_© mwÂZ n‡Z cv‡i| Gme c`v‡_© Zš‘ Rgv n‡q k³ nq Ges Pzbgq c`v‡_© cwiYZ
nq| G cÖwµqv‡K AvU©vwiI‡¯‹¬‡ivwmm e‡j| cywÄf~Z c`v_©‡K A¨v‡_‡ivg¨vUvm cøvK e‡j|
➥ 45 eQ‡ii eo cyiæll I 55 eQ‡ii eo bvixi †ÿ‡Î K‡ivbvix evBcv‡mi SzwK †`Lv w`‡Z cv‡i|
➥ K‡ivbvwi agbx 50-70% msKxY© n‡j O2 mg„× i‡³i cÖevn ü†ckx‡Z K‡g hvq Ges ey‡K e¨v_v Abyf~Z nq|
➥ jy‡gb 90-99% msKxY© n‡j Aw¯’i A¨vbRvBbv (Unstable Angina) Z¡ivwš^Z nq|
➥ mvaviYZ K‡ivbvwi evBcvm mvR©vwi‡Z 3-5 N›Uv mgq jv‡M| K‡ivbvwi evBcvm mvR©vwii AwaKvsk †ÿ‡Î nvU©-jvs †gwkb e¨eüZ nq|
➥ OPCAB (Off Pump Coronary Artery Bypass): nvU© jvs †gwkb QvovB nvU© ¯úw›`Z Ae¯’vq wm.G.we.wR mvR©vwi|
➥ MIDCAB: evg cv‡k †QvU wQ`ª K‡i †K‡U wm.G.we.wR mvR©vwi|

➥ iæ× K‡ivbvwi agbx Gwo‡q wfbœ c_ wbg©vY Ki‡Z eyK, nvZ, cv I Zj‡cU †_‡K agbx msMÖn Kiv nq|
‡hgbt 1. cv‡qi m¨v‡dbvm wkiv 2. B›Uvi‡Kv÷vj g¨vgvwi agbx 3. Kwâi †iwWqvj agbx|

GbwRIcøvw÷ (Angioplasty)
➥ Aci bvg PCI→Percutancous Coronary Intervention
➥ 1977 mv‡j myBRvij¨v‡Ûi Wv: A¨vb‡WªK MÖ‡qb wRM me©cÖ_g G c×wZ cÖ‡hvM K‡ib|
➥ GbwRIcøvw÷ Pvi ai‡Yit
K) †ejyb GbwRIcøvw÷
L) †jRvi GwbRIcøvw÷t †jRvi iwk¥ ¯Í‡i ¯Í‡i cøvK aŸsm K‡i Ges ev®úxf~Z K‡i †`q|
M) K‡ivbvwi A¨v‡_‡iKUwg
N) K‡ivbvwi †÷bwUst hv‡`i K‡ivbvwi agbx bvRyK Zv‡`i †¶‡Î AZ¨šÍ Dc‡hvMx|
➥ ‡ejyb I †÷›U c×wZ GKB mv‡_ e¨envi Ki‡j cøvK Gi cybivwe©fv‡ei m¤¢vebv K‡g hvq|
➥ GKwU ¯’v‡b GbwRIcøvw÷ Kiv‡Z 30-40 wgwbU mgq jvM‡Z cv‡i|

25
RETINA DIGEST Blood

➥ †÷‡›Ui gva¨‡g GbwRIcøvwU‡K wis civ‡bv e‡j|

➥ wis 2 ai‡Yi: h_v-
1| †gwW‡K‡UW †÷›U: wis Gi Mv‡q Ilya †`qv _v‡K hv cybteø‡KR cÖwZ‡iva K‡i
2| bb †gwW‡K‡UW †÷›U
➥ hv‡`i 2wU K‡ivbvix agbx‡Z 50-60% I 80% eøK| Zv‡`i ïay 80% eøKW agbx‡Z †÷w›Us Kiv n‡e

[m~Î: gv‡R`v g¨vg]

➥ cÖwZ 60 †m‡K‡Û †`‡ni mg¯Í i³ GKevi mgMÖ gvbe‡`‡n cwiågY K‡i|

➥ gvbe‡`‡ni mKj agwb wkiv I ˆKwkK RvwjKvi me©‡gvU ˆ`N©¨ 60,000 gvB‡ji AwaK hv w`‡q c„w_ex‡K `yBevi cu¨vPv‡bv hv‡e|
➥ gvby‡li GK‡dvUv i‡³i A‡a©K †dvUv cøvRgv, 5 wgwjqb †jvwnZ i³ KwbKv, 10 nvRvi †k¦Z i³KwYKv Ges 250 nvRvi AYyPwµKv|
➥ cÖwZ wgwb‡U gvbe ür¯ú›`b N‡U 72 evi hv mvivw`‡b 100,000 evi, eQ‡i 3,600,000 evi Ges 70 eQi eq¯‹ GKRb gvby‡li
mvivRxe‡b 2.5 wewjqb evi|
➥ ürwcÛ mwµq ivL‡Z cÖwZ wgwb‡U 1-5 IqvU we`y¨r mgcwigvY kw³i cÖ‡qvRb nq|
➥ GKRb my¯’ gvby‡li ürwcÛ w`‡q cÖwZw`b M‡o 2000 M¨vjb i³ cÖevwnZ nq|
➥ Mf©avi‡Yi Pvi mßvn ci †_‡K ür¯ú›`b ïiæ nq Ges g„Zz¨i c~e© ch©šÍ GwU Aweivg Pj‡Z _v‡K| GKwU m‡`¨vcÖm~Z wkïi †`‡n 90
wgwjwjUvi/†KwR gvÎvq i³ _v‡K|
➥ ICD-Inplantable cardioverter defibrillator
➥ ICU-Intensive Care Unit
➥ PCI-Percutaneous coronory intervention
➥ CABG-Coronary Artery Bypass Graft

[m~Î: Avt Avjxg m¨vi]

1. ü`-dzmdzm hš¿ †Kvb Kv‡R e¨eüZ nq? [M.17-18]

A) A¨vbwRIcøvwó‡Z B) ü`wc‡Ûi evBcvm mvR©vix‡Z C) i³Pvc wbqš¿b K‡iZ D) ‡cm‡gKvi emv‡Z
2. GKB mv‡_ kix‡i i‡³ Aw·‡R‡bi NbZ¡ I ü`¯ú›`‡bi cwigvcK h‡š¿i bvg Kx? [M.16-17]
A) _v‡g©vwgUvi B) wùM‡gvg¨v‡bvwgUvi C) cvj&&mAw·wgUvi D) e¨v‡ivwgUvi
3. ü`h‡š¿i †ivM wbY©‡q cÖv_wgK cixÿv †KvbwU? [M.16-17]
A) GbwRIMÖvg B) wjwcW †cÖvdvBj C) BwmwR D) BwUwU
4. K‡ivbvwi agbx miæ n‡q hvIqv wbY©‡q e¨eüZ nq †Kvb cixÿv? [D: 16-17]
A) B‡KvKvwW©IMÖvg B) GbwRIMÖvg C) BwUwU D) BwmwR
5. wek^e¨vcx i³k~b¨Zvi cÖavbZgKviY Kx? [D:16-17]
A) wfUwgb wm NvUwZ RwbZ B) †jŠn NvUwZ RwbZ C) Rb¥MZ i³k~b¨Zv D) wfUvwgb we-12 NvUwZ RwbZ
6. wb‡¤œi †KvbwU K‡ivbvix nvU© wWwR‡Ri AšÍf³ z© bq? [M:08-09]
A) GbRvBbv †cK‡Uvwim B) gv‡qvKwW©qvj BbdvK©kb C) Avb‡÷ej GbRvBbv D) †÷ªvK
Ans: 1.B, 2.C, 3.C, 4.B, 5.B, 6.B.

26
RETINA DIGEST Blood

1. †jvwnZ KwYKvi Avqy KZw`b?

A) 150 w`b B) 20-30 w`b C) 120 w`b D) 100 w`b
2. †Kvb ms‡hvMx wUmy¨wU Kjv AvK… w Zi?
A) SAN B) AVN C) evÛj Ae wnR D) cvwK©bwR Zš‘
3. †jvwnZ KwYKvi Kei¯’vb †K?
A) hK…Z B) cøxnv C) Ubwmj D) Aw¯’g¾v
4. wb‡Pi †KvbwU‡K åvg¨gvb cÖwZiÿvKvix GKK ejv nq?
A) †jvwnZ i³KwYKv B) †k^Z i³KwYKv C) AbyPwµKv D) jwmKv
5. wb‡Pi †Kvb KwYKvi wbDwK¬qvm e„°vKvi?
A) g‡bvmvBU B) †e‡mvwdj C) wj‡çvmvBU D) wbD‡Uªvwdj
6. A¨vw›UewW ˆZix K‡i †Kvb KwYKv?
A) g‡bvmvBU B) BDwm‡bvwdj C) wj‡çvmvBU D) †e‡mvwdj
7. K¬wUs d¨v±i KqwU?
A) 4wU B) 10wU C) 13wU D) 8wU
8. K‡ivbvix mvBbvm I Wvb Awj‡›`i ms‡hvM¯’‡j _v‡K wb‡Pi †Kvb KcvwUKv?
A) w_‡ewmqvb KcvwUKv B) A¨vIwU©K KcvwUKv C) gvBUªvj KcvwUKv D) UªvBKvmwcW KcvwUKv
9. cvj&m †cÖmvi KZ?
A) 40 mmHg B) 80 mmHg C) 120 mmHg D) 140 mmHg
10. A¨vIU©vi D™¢e N‡U †Kv_v †_‡K?
A) evg wbjq B) Wvb wbjq C) Wvb A¨vwUªqvg D) wm‡÷wgK agbx
11. gvby‡li wb‡Pi †Kvb †cvU©vjZš¿ Abycw¯’Z?
A) wm‡÷wgK B) ‡ibvj C) †ncvwUK D) cvj‡gvbvix
12. nvU© A¨vUv‡Ki c~e©ve¯’v ejv nq †KvbwU‡K?
A) A¨vbRvBbv B) nvU© †dBwjDi C) gv‡qvKvwW©qvj BbdvK©kb D) †÷ªvK
13. nvU© A¨vU‡Ki jÿY bq wb‡Pi †KvbwU?
A) ewg ewg fve B) Ny‡g e¨vNvZ C) gv_v e¨v_v D) ey‡K A¯^w¯’
14. ü`¯ú›`b ¯^vfvwe‡Ki †P‡q ax‡i n‡j Zv‡K wK e‡j?
A) U¨vwKKvwW©qv B) eªvwWKvwW©qv C) A¨vwi_wgqv D) †KvbwUB bq
15. ‡cm‡gKv‡i e¨vUvixi †gqv` KZ eQi?
A) 3-10 eQi B) 8-10 eQi C) 3-5 eQi D) 5-10 eQi
16. I‡cb nvU© mvR©vixi cÖPwjZ c×wZ †KvbwU?
A) Ad cv¤ú mvR©vix B) †iveU mn‡hvMx mvR©vix C) Ab cv¤ú mvR©vix D) me¸‡jvB
17. Aw¯’i A¨vbRvBbv‡Z agbxi jy‡gb KZUzKz msKxY© nq?
A) 90-100% B) 90-95% C) 50-70% D) 90-99%
18. GbwRIcøvw÷ Kq ai‡bi?
A) 2 B) 3 C) 4 D) 5
19. ü`wc‡Ûi i³bvjx‡Z †Kvb eøK Av‡Q wKbv Zv Rvbvi Rb¨ wK cixÿv Kiv nq?
A) B.wm.wR B) BwUwU C) ey‡Ki G·-‡i D) K‡ivbvix GbwRIMÖvg
20. wb‡Pi †KvbwU mwUK bq?
A) ECG=Electrocardiograph B) ETT=Exercise Tolerance Test
C) MRI=Magnetic Resonance Imaging D) ICU= Intensive Care Unit

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RETINA DIGEST Blood

21. A¨vbRvBbvi e¨v_v KZ wgwbU ¯’vqx nq?

A) 5-30 wgwbU B) 5-20 wgwbU C) 5-10 wgwbU D) 3-10 wgwbU
22. nvU©weU wgwb‡U KZevi nq?
A) 14-18 evi B) 60-90 evi C) 70-75 evi D) 70-80 evi
23. i³ MÖæwcs‡qi Rb¨ `vqx †Kvb KwYKv?
A) †jvwnZ KwYKv B) †k^Z KwYKv C) AbyPwµKv D) g‡bvmvBU
24. wb‡Pi †KvbwU A`vbv`vi KwYKv?
A) †e‡mvwdj B) wj‡çvmvBU C) BDwm‡bvwdj D) wbD‡Uªvwdj
25. ‡ncvwib ˆZix K‡i wb‡Pi †KvbwU?
A) †e‡mvwdj B) BDwm‡bvwdj C) wj‡çvmvBU D) g‡bvmvBU

Answer:
01.C 02.A 03.B 04.B 05.A
06.C 07.C 08.A 09.A 10.A
11.B 12.A 13.C 14.B 15.D
16.C 17.D 18.C 19.D 20.A
21.A 22.D 23.A 24.B 25.A

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