Download VNSGU MBBS 2306000104010101 S General Medicine I Level1 MarchApril2024 Question Paper

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2306000104010101-S

EXAMINATION MARCH - APRIL 2024

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THIRD YEAR MBBS PART-2

GENERAL MEDICINE – I(NEW) – LEVEL 1

Instructions:

1. Fill up strictly the following details on your answer book
   1. Name of the Examination : THIRD MBBS PART-2
   2. Name of the Subject : GENERAL MEDICINE – I(NEW) LEVEL 1

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   3. Subject Code No : 2306000104010101-S
2. Sketch neat and labelled diagram wherever necessary.
3. Figures to the right indicate full marks of the question.
4. All questions are compulsory.

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SECTION - I

Q.1 LONG ESSAY TYPE QUESTIONS (Clinical problem based) (Any 2 out of 3) 20

1. A 72 years male patient has history of headache, giddiness and breathlessness since 1 month. There was no significant past illness. His systolic blood pressure was more than 180 mmHg and diastolic blood pressure was more than 100 mmHg on different days. Other clinical parameters are normal. Chest X ray shows cardiomegaly and ECG shows left ventricular hypertrophy. Discuss diagnosis, management and follow up for his presenting illness.
2. Describe clinical features, etiopathogenesis and management of chronic obstructive pulmonary disease with severe pulmonary hypertension.
3. Discuss etiology, clinical features and management of severe rheumatic mitral stenosis.

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Q.2 SHORT NOTES (Any 3 out of 4) 12

1. A 48 years old patient admitted in emergency room with acute ST elevation anterior wall myocardial infarction, has survived after cardiopulmonary resuscitation. Discuss way of counselling for informing diagnosis, prognosis and therapeutic options to patient's relatives.
2. Disease modifying anti rheumatic drugs and newer biologics in treatment of rheumatoid arthritis.
3. Clinical presentations of patient with SLE.
4. Discuss cardiac causes of cyanosis.

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Q.3 REASONING TYPE QUESTIONS / SHORT NOTES / APPLIED ASPECTS (Any 9 out of 10) 18

1. Discuss any 4 extra articular manifestations of rheumatoid arthritis.
2. Discuss 2 causes of absent tactile vocal fremitus (TVF).
3. Discuss any 4 causes of chronic inflammatory arthritis.
4. Discuss any 4 complications of scleroderma.

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5. ECG manifestations of acute inferior wall myocardial infarction.
6. Components of Fallot's Tetrology (TOF).
7. Discuss common side effects of Prednisolone.
8. Describe any 4 causes of secondary hypertension in young adult.
9. Findings of auscultation in patients of pleural effusion.

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10. Why diuretics are given in patients of acute heart failure?

SECTION – II

Q.4 LONG ESSAY TYPE QUESTIONS (Clinical problem based) (Any 2 out of 3) 20

1. Describe in detail about clinical features, investigations, complications and treatment of a patient having history of organo phosphorus poisoning with acute respiratory failure.
2. Classify hemolytic anemias. Discuss clinical features, investigations, treatment and prognosis of sickle cell disease.

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3. A 34 years old male patient has history of high grade fever with rigor and headache since 5 days. He has developed tachypnoea and hypoxia since 2 days. Routine investigations suggest low Hb, high reticulocyte count, thrombocytopenia and presence of +4 P. falciparum malaria. His renal and liver profile is normal at present. ABG shows low PaO2 and SPO2. Describe in detail about complete diagnosis of presenting illness. How will you monitor remaining investigation profile. Discuss in detail about his complete management and prognosis.

Q.5 SHORT NOTES (Any 3 out of 4) 12

1. Clinical presentation of hypothyroidism.
2. Clinical presentation and investigation profile in CML (chronic myeloid leukemia).
3. Management of neurotoxic snake bite.

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4. Follow up screening in diabetic patients.

Q.6 REASONING TYPE QUESTIONS/SHORT NOTES/APPLIED ASPECTS (9 out of 10) 18

1. Explain any 2 conditions associated with acute fall of hemoglobin.
2. Investigations in Dengue shock syndrome.
3. Describe important pathogens causing diarrhea in HIV patients.

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4. Why diabetic patients with CKD are presented with frequent episodes of hypoglycemia?
5. Explain significance of pancytopenia in febrile illness.
6. Compare clinical use of Chloroquine and Artesunate in malaria.
7. Discuss vital parameters in hyperthyroidism.
8. Why stool examination is important in patient of Iron deficiency anemia?

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9. Discuss any 4 drugs used to treat gram negative septicemia.
10. Describe importance of urine examination in diabetic patients.