Download MUHS MBBS Final Year Year General_Medicine_II_Winter2023 Question Paper

PAPER CODE: 01304B

Third (II) M.B.B.S. (2019) Examination, Winter - 2023 (Phase - III)

GENERAL MEDICINE II

Total Duration: Section A+B+C = 3 Hours Section B & C Marks: 80

SECTION - B & SECTION - C

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Instructions:

1. Use black ball point pen only.
2. Do not write anything on the blank portion of the question paper.
3. All questions are compulsory.
4. The number to the right indicates full marks.

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5. Draw diagrams wherever necessary.
6. Distribution of syllabus in Question Paper is only meant to cover entire syllabus within the stipulated frame. The Question paper pattern is a mere guideline. Questions can be asked from any papers syllabus into any question paper. Students cannot claim that the Question is out of syllabus.
7. Use a common answer book for section B & C.

SECTION - B (21 Marks)

SECTION - B (40 Marks)

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2. Short Answer Questions (Any five out of six): [5 x 4 = 20]

1. Your grandfather who is 80-year-old is forgetting many things of daily routine activities. How will you evaluate him and what lifestyle modifications will you implement in his habits of daily living? [2+2]
2. Enumerate biologicals used in Rheumatology practice. Briefly outline the mechanism of action and complications of Rituximab. [2+1+1]
3. Write the nursing instructions/prescription for a 72 year old male, a known case of diabetes on irregular therapy admitted to the ICU with chest tightness. [4]
4. Enumerate the steps in the management in a 18-year-old girl presenting to the emergency ward with acute breathlessness diagnosed as severe asthma exacerbation. [4]

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5. Enumerate types of headache. Enumerate various drugs prescribed in a case of Migraine with doses. [2+2]
6. Enumerate clinical features and the treatment of a case of generalised anxiety disorder. [2+2]

3. Long Answer Questions (Any two out of three): [2 x 10 = 20]

1. A 56-year-old male patient presents with hematemesis since 4 hours and melena since 2 days. He consumes alcohol daily for last 25 years. On examination he has icterus and abdominal distension. What are the causes of hematemesis in this case and how will you treat this case? Enumerate the other complications you can expect in this case. [2+4+4]
2. A 45-year-old male had developed acute onset left sided hemiparesis. Draw the blood (arterial and venous) supply of brain with proper labelling. Enumerate the risk factors for development of ischemic stroke in this patient. Discuss in brief the management of this patient. [3+3+4]

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3. A 20-year-old female was referred for evaluation of persistent haematuria and proteinuria. She had a history of fever and sore throat lasting 1 week and dark urine. She did not receive any antimicrobial agents. Significant finding on physical examination at that time included a BP of 140/90 mmHg and pedal edema extending upto the knees.
   1. Enumerate the differential diagnosis in this case.
   2. Discuss in brief the any 2 histopathological variants of acute glomerulonephritis.
   3. Discuss the management of acute post infectious glomerulonephritis. [3+4+3]

SECTION - C (24 Marks)

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SECTION - C (40 Marks)

4. Short Answer Questions (Any five out of six): [5 x 4 = 20]

1. A child develops itchy rashes in the intertriginous regions. What is the most probable diagnosis and how would you manage such a case (write a prescription for the same). [1+3]
2. Kindly provide various steps and key issues you will cover while counseling a HIV patients spouse in a sero-discordant couple. [2+2]
3. Write a prescription of a newly diagnosed sputum positive pulmonary tuberculosis weighing 60kg including the drug dosages and therapy. [4]

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4. Enumerate the various types of renal replacement therapy (RRT). Briefly be about the peritoneal dialysis. [2+2]
5. Enumerate clinical features of Acromegaly and draw the algorithm for evaluation of a case of acromegaly. [2+2]
6. Enumerate microvascular complications of diabetes mellitus. Describe the frequency of evaluation for identifying each of these complications. [2+2]

5. Long Answer Questions (Any two out of three): [2 x 10 = 20]

1. A 21-year-old male was diagnosed as a case of amyotrophic lateral sclerosis by the Neurologist. Enumerate the clinical features in such a case. Describe the various tests to diagnose such a disorder with pathognomic findings on these investigations. How would you manage such a case. [3+4+3]

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2. A 30-year-male gets a call from blood bank where he recently donated blood for his friend. The blood bank officer informed him that he has come positive for hepatitis B surface antigen (HbSAg) and advised to take physician opinion. He comes to your office and asks about his disease. Answer the following queries of his
   1. What are the modes of transmission of hepatitis B, how could I have developed this?
   2. How would I be further investigated to know if I am suffering from anything grave?
   3. What are the dos and donts for me and my family members? [3+4+3]
3. A 25-year-old married female presented to the emergency department with sudden onset pain on the right side of the chest with sudden onset breathlessness. On examination she had RR=44/min, BP=90/60 mmHg, PR=120/min and was afebrile. On RS examination she has trachea shifted to left side with absent breath sounds. Enumerate the differential diagnosis for this patient. Discuss in brief the investigations and emergency treatment of this case. [3+3+4]

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