Download MBBS 4th Year WBUHS General Medicine Paper II 2024 April New Regulation Question Paper

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The West Bengal University of Health Sciences

MBBS 3rd Professional Part-II Examination (New Regulation)

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March - April 2024

Subject: General Medicine Full Marks: 100

Paper: II Time: 3 hours

Attempt all questions. The figures in the margin indicate full marks.

1. a) A 18 year old boy was brought to the emergency department with history of fever, impaired consciousness and convulsion. What are the possibilities of this case? How will you investigate to reach a diagnosis? Write the treatment outline in brief. 5+5+5

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2. b) A 40 year old patient with shortness of breath, heaviness of the right side of the chest and low grade fever for last three weeks. There was stony dullness on percussion of right side of thorax.
   1. What is the probable diagnosis? 2+3+4+6
   2. What other clinical findings do you expect to find in this patient?
   3. What are the differential diagnosis in this condition?
   4. What investigations will you do to confirm the diagnosis?

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3. a) A 20 year old lady attends medical OPD with fever for 7 days along with gum bleeding, severe pallor and purpuric spots. What is your provisional diagnosis? How will you investigate and manage the case? 2+4+4
4. b) What is Thyrotoxicosis? What are the different causes? Discuss briefly clinical features and management of myxoedema coma. 2+2+2+4
5. c) Define anemia. Enumerate the clinical features in patients with haemolytic anemia. Discuss the essential laboratory investigations in a case of haemolytic anemia. 2+4+4
6. Write short notes on the following: 2 x 5
   1. Obsessive compulsive disorder.
   2. Toxic epidermal necrolysis.

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7. Explain the following statements: 5 x 4
   1. Clinical classification of leprosy is necessary for planning treatment.
   2. Some drugs to be used with caution in psychiatric illness patients to avoid risk of serotonin syndrome.
   3. Impaired glucose tolerant people do not routinely need anti-diabetic drugs.
   4. Steven Johnson Syndrome and DRESS (drug reaction with eosinophilia and systemic symptoms) are not synonymous.

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   5. Bone marrow examination is necessary in pancytopenia.

P.T.O

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5. Choose the correct option for each www.FirstRanker.com www.FirstRanker.com
   1. In the CURB-65 scoring system for pneumonia, which is not included?
      1. Blood urea nitrogen (BUN)

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      2. Respiratory Rate
      3. Cyanosis
      4. Age
   2. A 55 year old man presents with early satiety, weight loss and abdominal fullness. Physical examination reveals splenomegaly. Peripheral blood smear shows increased basophils and the presence of the Philadephaia chromosome. What is the most likely diagnosis?
      1. Acute myeloid leukemia (AML)

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      2. Chronic lymphocytic leukemia (CLL)
      3. Chronic myeloid leukemia (CML)
      4. Hodgkin lymphoma
   3. 'Row of tombstones' appearance is seen in:
      1. Herpes Zoster

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      2. Pemphigus
      3. Pemphigoid
      4. Irritant dermatitis
   4. Which anti-tubercular drug is contraindicative in pregnancy?
      1. Ethambutol

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      2. Streptomycin
      3. Rifampicin
      4. INH
   5. Elderly man presented to OPD with gradual onset of weakness of all four limbs, he also has florid fasciculation of both upper arm, most likely diagnosis is:
      1. Amyotrophic lateral sclerosis

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      2. GB syndrome
      3. Myasthenia Gravis
      4. Chronic inflammatory demyelinating polyneuropathy
   6. Weight gain occurs in all except:
      1. Pheochromocytoma

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      2. Cushing's syndrome
      3. Hypothyroidism
      4. Insulinoma
   7. Right 12th cranial nerve damage leads to:
      1. Tongue deviation toward left on protrusion

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      2. Tongue deviation to right on protrusion
      3. Nasal tonation of voice
      4. Scanning of speech
   8. Conversion disorder is treated by:
      1. Psychotherapy

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      2. Electroconvulsive therapy
      3. Lithium
      4. Venlafexine
   9. Beevor's sign is seen in:
      1. Abdominal muscle

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      2. Facial muscle
      3. Respiratory muscle
      4. Tongue muscle
   10. What is primary defect of Thalassemia major?
       1. Impaired iron absorption

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       2. Increased red blood cell production
       3. Decreased synthesis of one of the globin chains of hemoglobin
       4. Abnormal clotting factors

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