Download MUHS MBBS Final Year Year General_Medicine_I_Winter2023 Question Paper

PAPER CODE: 01304A

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

GENERAL MEDICINE I

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. A 66-year-old lady was diagnosed to be suffering from urosepsis with blood and urine culture growing pseudomonas. Enumerate your antibiotic choice in such a case. Write a comprehensive prescription for this patient. [2+2]
   2. A 64-year-old male was diagnosed as a case of Community Acquired Pneumonia (CAP). Kindly enumerate the different scoring systems to grade the severity of the CAP. Also mention the clinical relevance of each of these scoring systems. [2+2]
   3. A 22-year-old male had Hb-10.4 g/dL with a MCV of 60.4 fL. Outline the diagnostic approach to such a case. [4]
   4. A 20-year-old friend of yours on a beach vacation was bitten by a scorpion. What are the clinical features expected in this case and how will you manage the patient? [2+2]
   5. An individual was diagnosed as a case of Metabolic syndrome. Enumerate the dietary advice for such a case. [4]

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   6. A 52-year-old male had acute Myocardial infarction (MI) post LAD and LCx obstruction. What are the acute and long term complications post-acute MI in this patient? [2+2]

SECTION - C (40 Marks)

SECTION - C (21 Marks)

3. Long Answer Questions (Any two out of three): [2 x 10 = 20]
   1. A 27-year-old male IV drug abuser and history of multiple sexual partners presents with weight loss of 6 Kg in last 2 months. What is your likely diagnosis? What opportunistic infections can occur in this condition? Enumerate the clinical features, investigations and treatment of any one of these opportunistic infections. [1+3+2+2+2]

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   2. A 18 year old individual after a rave party was mad as hatter, dry as a bone, red as a beet, blind as a bat. Identify the type of toxidrome the individual is suffering from. Define toxidrome and classify the type of toxidromes. Briefly outline the management in this individual. [2+1+1+4+3]
   3. A 54-year-old male presents with heaviness in the head, tongue and arm along with breathlessness since 3 hours. On examination his blood pressure was 190/120mm Hg. What is the acute management and long term treatment you will offer to this patient? Also mention what lifestyle modification you will advise to this patient? [3+3+4]

4. Short Answer Questions (Any five out of six): [5 x 4 = 20]
   1. How will you counsel adolescent students in a college to quit smoking? [4]
   2. You are a famous physician in your city. A corporate hospital marketing executive approaches you to offer 40% of revenue generated for every radiological and blood investigation you refer to them. What decision will you take considering the Ethical guidelines laid down by the Medical Commission? [4]

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   3. A 60-year-old female was found to have 20% EF on 2D Echocardiography. Outline the medical management of such patient of heart failure with decreased ejection fraction. [4]
   4. A 28-year-old male has increased frequency of defaecation (6-8 episodes per day) with weight loss of 4-5kg in 6 months. Enumerate the differential diagnoses and the algorithm for evaluation of such a case. [2+2]
   5. A 60-year-old male was found to have Myocardial infarction post LAD & LCx obstruction. Outline acute & long term management. [2+2]
   6. A 28-year-old patient was diagnosed with hyperchondriac pain with vomiting. He has history of passing blood and mucus in stools 15 days back for which he took herbal medications and later deteriorated. On examination his liver was tender hepatomegaly. What is the differential diagnosis in this patient? How would you evaluate this patient further? Describe the diagnosis in such a case. Also enumerate two complications of this condition. [1+4+1+1]

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5. Long Answer Questions (Any two out of three): [2 x 10 = 20]
   1. A 22-year-old female presents with history of palpitations since 2 months. Enumerate all the causes of palpitations in a young female. Later during routine evaluation, she was found to have occasional episodes of irregularly irregular pulse. How would you investigate this patient with this new clinical finding? Also briefly outline the management of atrial fibrillation. [3+3+4]
   2. A 55-year-old male, weighing 72 kg, a known hypertensive and diabetic was diagnosed to have acute onset chest pain associated with early angina. Clinically he had hypotension with bradycardia. He was labelled as a case of acute inferior myocardial infarct by the cardiologist. Mention three ECG findings you would expect in this case. Write a nursing summary and prescription for the hospital admission. Also list the investigations to be done before thrombolysis in case local Cath lab was non-functional. Provide a checklist for absolute/relative contraindications you would double check before thrombolysis. [3+3+4]

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