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Name:........................................
Reg. No:........................................
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THIRD PROFESSIONAL M.B.B.S. DEGREE EXAMINATION, FEBRUARY 2009
Part II
GENERAL MEDICINE-Paper I
Time: Three Hours
Maximum: 60 Marks
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Answer Sections A and B in separate answer-books.
Draw diagrams wherever necessary.
Response Sheet for MCQs to be provided
Section A
I. Multiple Choice Questions. Single response type-20 (separate sheet attached).
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(20 x ½ = 10 marks)
II. Match the following. Single response type-6 (separate sheet attached).
(6 x ½ = 3 marks)
III. Draw and label:
- Fundus in diabetes retinopathy.
- Nephron.
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(2 x 1 = 2 marks)
IV. Write briefly on:
- Ascites in cirrhosis.
- Peripheral signs of aortic regurgitation.
- Lateral medullary syndrome.
- Criteria for diagnosis of diabetes mellitus.
- Clinical features of nephrotic syndrome.
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(5 x 1 = 5 marks)
V. Write short notes on:
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- Hypertrophic cardiomyopathy.
- Statins.
- Multiple sclerosis.
- Hemophilia A.
- Hyponatremia.
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(5 x 2 = 10 marks)
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Section B
VI. Read the paragraph and answer the following questions :-
A 64-year old hypertensive male wakes up in the morning with inability to move his right upper
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and lower limbs and deviation of angle of mouth to the left side.
- What is the provisional diagnosis ?
- What are the differential diagnosis?
- What are the risk factors?
- How will you investigate the patient?
- Outline the treatment?
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(1+2+2+2+3 = 10 marks)
VII. Write briefly on:
- Diagnosis of multiple myeloma.
- Wernicke - Korsakoff syndrome.
- Prinzmetal angina.
- Hashimoto's thyroiditis.
- Laboratory features of hemolytic anemia.
- Antidiuretic hormone.
- Drugs for chronic hepatitis B infection
- Sickle cell anemia.
- Acute pyelonephritis.
- Classification of seizure disorders.
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(10 x 1 = 10 marks)
VIII. Write short notes on:
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- Cardiac arrest.
- Difference between Crohn's disease and ulcerative colitis.
- Alcoholic hepatitis.
- Cluster headache.
- Clinical features of Cushing's syndrome.
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(5 x 2 = 10 marks)
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D 52915
GENERAL MEDICINE-Paper 1
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I. MULTIPLE CHOICE QUESTIONS
Note.-(1) Do not write anything on the question paper.
(2) Write your register number on the answer-sheet provided.
(3) Select one most appropriate response and encircle the corresponding alphabet against
each question in the answer-sheet provided.
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(4) In the answer-sheet enter the local number of your answers in the appropriate box
provided.
(5) Each question carries ½ mark.
1. Which of the following is not a cause for clubbing?
(A) Eisenmenger syndrome.
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(B) Infective endocarditis.
(C) Atrial myxoma.
(D) Myocarditis.
2. Oral ulcers are not seen in:
(A) SLE.
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(B) Ulcerative colitis.
(C) Leukemia.
(D) Pemphigus
3. The target HbA1C is less than:
(A) 1%
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(B) 5%
(C) 7%
(D) 10%.
4 Atrial fibrillation does not occur commonly in:
(A) Thyrotoxicosis.
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(B) Odollum poisoning
(C) Alcohol intoxication.
(D) Myocardial infarction.
5. Commonest organism causing spontaneous bacterial peritonitis in cirrhosis is :
(A) E.Coli.
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(B) Pseudomonas.
(C) Pneumococcus.
(D) Klebsiella.
6. Atrial natriuretic peptide acts in which segment of the kidney?
(A) PCT
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(B) Loop of Henle.
(C) DCT.
(D) Collecting duct.
7. Conn's syndrome is:
(A) Primary hyperaldosteronism.
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(B) Secondary hyperaldosteronism
(C) Primary hyperparathyroidism.
(D) Secondary hyperparathyroidism.
8. The early management of ischemic stroke is aimed at preserving:
(A) Infarcted tissue.
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(B) Ischemic penumbra.
(C) Broca's area.
(D) Brainstem.
9. Itching is a prominent feature in:
(A) Autoimmune cirrhosis.
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(B) Primary biliary cirrhosis.
(C) Alcohol related cirrhosis.
(D) Wilson's disease.
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10. Endocrine hypertension occurs in all conditions except :
(A) Acromegaly.
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(B) Hypoparathyroidism.
(C) Hypothyroidism.
(D) Hyperthyroidism.
11. Serositis is seen in all except:
(A) Dengue fever.
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(B) SLE.
(C) Hypothyroidism.
(D) Cushing's syndrome.
12. Acute endocarditis is commonly caused by:
(A) Staphylococcus aureus.
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(B) Streptococcus viridans.
(C) Gram negative bacilli.
(D) Coagulase negative staphylococci.
13. Hemodialysis is associated with the following complication except
(A) Hypotension.
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(B) Peritonitis.
(C) Cardiac Arrhythmias.
(D) Air embolism
14. One and a half syndrome occurs due to involvement of
(A) MLF.
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(B) PPRF.
(C) MLF and PPRF.
(D) None of the above.
15 Macrocytic RBCs are seen in circulation in:
(A) Sideroblastic anaemia.
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(B) Alcoholism.
(C) Hemolytic uremic syndrome.
(D) Lead poisoning,
16. What is true about KF ring?
(A) Almost always seen in neurological Wilson's disease.
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(B) Does not disappear with treatment.
(C) Seen best by fluorescent staining.
(D) Deposition of copper in corneal endothelium.
17. Which of the following will result in a normal anion gap metabolic acidosis ?
(A) Acute renal failure.
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(B) Tissue hypoperfusion.
(C) Uretero sigmoidostomy.
(D) Salicylate overdose.
18. Which of the following signs indicate insulin resistance?
(A) Acanthosis nigricans.
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(B) Alopecia
(C) Necrobiosis lipoidica.
(D) Kryle's lesion
19. Which antiepileptic causes osteomalacia ?
(A) Clonazepam.
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(B) Carbamazepine.
(C) Valproate
(D) Phenytoin.
20. Beck's triad is seen in:
(A) Aortic dissection.
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(B) Constrictive pericarditis.
(C) Pericardial tamponade.
(D) Hypertrophic cardiomyopathy.
(20 x ½ = 10 marks)
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D 52915
GENERAL MEDICINE-Paper I
II. Match the following:
1 S3 gallop
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2 Phasic ejection click
3 Left ventricular S4
4 Pulsus dicroticus
5 Diffuse apex
6 Prominent v waves
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(a) Myocardial infarction.
(b) Dilated cardiomyopathy.
(c) Tetralogy of fallot.
(d) Tricuspid regurgitation.
(e) Typhoid fever.
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(f) Pulmonary stenosis.
(g) Left ventricular failure.
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