Q.P. Code: 321001
Reg. no.: .....................
Third Professional MBBS Part II Degree Supplementary Examinations
October 2025
General Medicine I
Time: 3 Hours
Total Marks: 100
Answer all questions to the point neatly and legibly ? Do not leave any blank pages between answers
Indicate the question number correctly for the answer in the margin space
Draw table/diagrams/flow charts wherever necessary
1. Multiple Choice Questions
(20x1=20)
The MCQ questions (Q.No. i to Q.No. xx) shall be answered only in the OMR sheet provided at page
marked in any other part/page of the answer book will not be valued. For marking the correct responses
use X mark only
Question numbers i-v case scenario-based questions
A 45 year old woman presents with symptoms of unexplained weight loss, increased appetite and persistent
has diffuse goiter, thyroid eye disease and tremor in hands. Laboratory tests reveal serum TSH < 0.01 Mu/L
(low); free T4 2.5mg / dl (elevated); free T3 6.0 pg/ml (elevated)
i. What is the most likely diagnosis for this patient based on her clinical presentation and laboratory
findings.
b) Grave`s disease
c) Hashimoto's thyroiditis
d) Thyroid carcinoma
ii. What is the most likely thyroid uptake pattern in this patient
c) Homogeneous diffuse thyroid uptake
b) Heterogeneous diffuse uptake in the thyroid
d) Decreased uptake
iii. Dermatological manifestation of this disease include
c) Erythema nodosum
b) Pretibial myxedema
d) Acanthosis nigricans
iv. Which factor is strongly associated with the development of `thyroid eye disease'
c) Uncontrolled blood sugar
b) Alcohol abuse
d) Vitamin B12 deficiency
v. What will be the treatment of choice if the patient is eight weeks pregnant
b) Methimazole
c) Propyl thiouracil
d) Radio iodine
Question numbers vi-x consist of two statements - Assertion (A) and Reason (R). Answer these
a) Both A and R are true, R is the correct explanation of A
c) A is true but R is false
b) Both A and R are true, R is not the correct explanation of A
vi. Assertion: Patient with chronic heart failure benefit from the use of angiotensin receptor blocker (ARB)
Reason: Angiotensin receptor blockers, compared to angiotensin converting enzyme inhibitors are
better tolerated and have similar efficacy in reducing cardiovascular events.
vii. Assertion: Thiazolidinediones activate peroxisome proliferator activated receptor- and enhance the
Reason: Pioglitazone should be given in combination with insulin in cardiac failure as it is decreases
the insulin resistance
viii. Assertion: Hypoglycemia does not occur in well controlled insulin-treated diabetics during exercise.
Reason: Learning to recognize the early onset of hypoglycemia is an important aspect of the diabetic
ix. Assertion: H. pylori and NSAIDS are independent risk factors for peptic ulcer disease.
Reason: Compared to ulcer healing lungs, H. pylori eradication therapy is superior for healing duodenal
ulcer.
x. Assertion: Acute fatty liver of pregnancy is more common in multiparous women.
Question numbers xi-xv are multiple-response type questions. Read the statements & mark the
answers appropriately.
xi. Which of the following are the most likely cause of non megaloblastic macrocytic anaemia (select two)
1) Hypothyroidism
3) Thiamine deficiency
4) Vitamin B12 deficiency
a) 1 & 2 are correct b) 1 & 3 are correct
c) 3 & 4 are correct
(PTO)
xii. 1) Generalized tonic colonic seizure
-
2) Absence seizure
-
Ethosuximide
3) Myoclonic seizure
Phenytoin
4) Secondary tonic colonic seizure
-
Acetazolamide
c) 3 & 4 are correct
d) 2 & 4 are correct
xiii. 1) TICS
- Tourette syndrome
Parkinsonism
3) Chorea
-
Huntingtons disease
Wilson's disease
a) 1 & 2 are correct b) 1 & 3 are correct
c) 3 & 4 are correct
d) 2 & 4 are correct
Parkinson's disease
2) Waddling gait
-
Proximal muscle weakness
-
Upper motor neuron lesion
4) High-stepping gait -
Lower motor neuron lesion
c) 3 & 4 are correct
d) 2 & 4 are correct
xv. Which of the following are the cause of high anion gap acidosis (select two)
1) Diabetic ketoacidosis
3) Diuretic use
4) Pneumonia
a) 1 & 2 are correct b) 1 & 3 are correct
c) 3 & 4 are correct
Question numbers xvi-xx are single-response type questions
xvi. A 35 year old female is brought to the emergency room. She is suffering from schizophrenia and is on
haloperidol. She presents with symptoms of fever, sweating, disorientation and rigidity for one day. Her
blood pressure is high and on investigation CPK level is increased and there is leukocytosis. What is
a) Acute dystonia
c) Viral encephalitis
b) Neuroleptic malignant syndrome
d) Tardive dyskinesia
a) Propranolol
b) Glucocorticoids
c) Metoclopramide
d) Levothyroxine
a) Steroids
b) Calcium gluconate
c) Salbutamol
d) Dextrose insulin infusion
a) Severe mitral stenosis
c) Para aortic regurgitation
b) Acute rheumatic carditis
d) Severe pulmonary hypertension
arrhythmia is most likely
a) Ventricular fibrillation
c) Atrial flutter
b) Ventricular premature contraction
Long Essays:
(2x10=20)
2. Write about etiology, clinical features, complications, investigations and treatment of Crohn's disease
(2+2+2+2+2)
a) Enumerate the causes of acute renal failure
b) Enumerate the mechanism of anemia in chronic kidney disease
c) Mention three systemic diseases that can lead to chronic kidney disease
d) What are the techniques of renal replacement therapy
Short Essays:
(6x6=36)
4. Management of Acute bacterial meningitis
5. Management of hypertensive emergencies
7. Migraine headache
8. Portal hypertension
9. Clinical manifestations and diagnosis of multiple myeloma
Short Answers:
10. Central nervous system (CNS) manifestations of HIV
11. Diagnosis and management of acute pancreatitis
12. Antiplatelet drugs
13. Communicate the therapeutic options to a patient with acute coronary syndrome
15. Clinical features of pheochromocytoma
**********************
Reg. no.: .....................
Third Professional MBBS Part II Degree Supplementary Examinations
October 2025
General Medicine I
--- Content provided by FirstRanker.com ---
(2019 Scheme)Time: 3 Hours
Total Marks: 100
Answer all questions to the point neatly and legibly ? Do not leave any blank pages between answers
Indicate the question number correctly for the answer in the margin space
--- Content provided by FirstRanker.com ---
Answer all parts of a single question together ? Leave sufficient space between answersDraw table/diagrams/flow charts wherever necessary
1. Multiple Choice Questions
(20x1=20)
The MCQ questions (Q.No. i to Q.No. xx) shall be answered only in the OMR sheet provided at page
--- Content provided by FirstRanker.com ---
No. 51 of the answer book (the inner portion of the back cover page (PART III)). Responses for MCQsmarked in any other part/page of the answer book will not be valued. For marking the correct responses
use X mark only
Question numbers i-v case scenario-based questions
A 45 year old woman presents with symptoms of unexplained weight loss, increased appetite and persistent
--- Content provided by FirstRanker.com ---
diarrhea. She also reports feeling unusually hot and sweating excessively. On physical examination, shehas diffuse goiter, thyroid eye disease and tremor in hands. Laboratory tests reveal serum TSH < 0.01 Mu/L
(low); free T4 2.5mg / dl (elevated); free T3 6.0 pg/ml (elevated)
i. What is the most likely diagnosis for this patient based on her clinical presentation and laboratory
findings.
--- Content provided by FirstRanker.com ---
a) Hypothyroidismb) Grave`s disease
c) Hashimoto's thyroiditis
d) Thyroid carcinoma
ii. What is the most likely thyroid uptake pattern in this patient
--- Content provided by FirstRanker.com ---
a) Focal uptakec) Homogeneous diffuse thyroid uptake
b) Heterogeneous diffuse uptake in the thyroid
d) Decreased uptake
iii. Dermatological manifestation of this disease include
--- Content provided by FirstRanker.com ---
a) Erythema multiformec) Erythema nodosum
b) Pretibial myxedema
d) Acanthosis nigricans
iv. Which factor is strongly associated with the development of `thyroid eye disease'
--- Content provided by FirstRanker.com ---
a) Smokingc) Uncontrolled blood sugar
b) Alcohol abuse
d) Vitamin B12 deficiency
v. What will be the treatment of choice if the patient is eight weeks pregnant
--- Content provided by FirstRanker.com ---
a) Carbimazoleb) Methimazole
c) Propyl thiouracil
d) Radio iodine
Question numbers vi-x consist of two statements - Assertion (A) and Reason (R). Answer these
--- Content provided by FirstRanker.com ---
questions by selecting the appropriate options given below.a) Both A and R are true, R is the correct explanation of A
c) A is true but R is false
b) Both A and R are true, R is not the correct explanation of A
--- Content provided by FirstRanker.com ---
d) A is false but R is truevi. Assertion: Patient with chronic heart failure benefit from the use of angiotensin receptor blocker (ARB)
Reason: Angiotensin receptor blockers, compared to angiotensin converting enzyme inhibitors are
better tolerated and have similar efficacy in reducing cardiovascular events.
vii. Assertion: Thiazolidinediones activate peroxisome proliferator activated receptor- and enhance the
--- Content provided by FirstRanker.com ---
actions of endogenous insulinReason: Pioglitazone should be given in combination with insulin in cardiac failure as it is decreases
the insulin resistance
viii. Assertion: Hypoglycemia does not occur in well controlled insulin-treated diabetics during exercise.
Reason: Learning to recognize the early onset of hypoglycemia is an important aspect of the diabetic
--- Content provided by FirstRanker.com ---
patient's education.ix. Assertion: H. pylori and NSAIDS are independent risk factors for peptic ulcer disease.
Reason: Compared to ulcer healing lungs, H. pylori eradication therapy is superior for healing duodenal
ulcer.
x. Assertion: Acute fatty liver of pregnancy is more common in multiparous women.
--- Content provided by FirstRanker.com ---
Reason: Acute fatty liver is characteristic of a defect in beta oxidation of fatty acid in the mitochondria.Question numbers xi-xv are multiple-response type questions. Read the statements & mark the
answers appropriately.
xi. Which of the following are the most likely cause of non megaloblastic macrocytic anaemia (select two)
1) Hypothyroidism
--- Content provided by FirstRanker.com ---
2) Alcohol abuse3) Thiamine deficiency
4) Vitamin B12 deficiency
a) 1 & 2 are correct b) 1 & 3 are correct
c) 3 & 4 are correct
--- Content provided by FirstRanker.com ---
d) 2 & 4 are correct(PTO)
xii. 1) Generalized tonic colonic seizure
-
--- Content provided by FirstRanker.com ---
Levetiracetam2) Absence seizure
-
Ethosuximide
3) Myoclonic seizure
--- Content provided by FirstRanker.com ---
-Phenytoin
4) Secondary tonic colonic seizure
-
Acetazolamide
--- Content provided by FirstRanker.com ---
a) 1 & 2 are correct b) 1 & 3 are correctc) 3 & 4 are correct
d) 2 & 4 are correct
xiii. 1) TICS
- Tourette syndrome
--- Content provided by FirstRanker.com ---
2) Myoclonus -Parkinsonism
3) Chorea
-
Huntingtons disease
--- Content provided by FirstRanker.com ---
4) Essential tremor -Wilson's disease
a) 1 & 2 are correct b) 1 & 3 are correct
c) 3 & 4 are correct
d) 2 & 4 are correct
--- Content provided by FirstRanker.com ---
xiv. 1) Circumduction gait -Parkinson's disease
2) Waddling gait
-
Proximal muscle weakness
--- Content provided by FirstRanker.com ---
3) Ataxic gait-
Upper motor neuron lesion
4) High-stepping gait -
Lower motor neuron lesion
--- Content provided by FirstRanker.com ---
a) 1 & 2 are correct b) 1 & 3 are correctc) 3 & 4 are correct
d) 2 & 4 are correct
xv. Which of the following are the cause of high anion gap acidosis (select two)
1) Diabetic ketoacidosis
--- Content provided by FirstRanker.com ---
2) Lactic acidosis3) Diuretic use
4) Pneumonia
a) 1 & 2 are correct b) 1 & 3 are correct
c) 3 & 4 are correct
--- Content provided by FirstRanker.com ---
d) 2 & 4 are correctQuestion numbers xvi-xx are single-response type questions
xvi. A 35 year old female is brought to the emergency room. She is suffering from schizophrenia and is on
haloperidol. She presents with symptoms of fever, sweating, disorientation and rigidity for one day. Her
blood pressure is high and on investigation CPK level is increased and there is leukocytosis. What is
--- Content provided by FirstRanker.com ---
the likely diagnosisa) Acute dystonia
c) Viral encephalitis
b) Neuroleptic malignant syndrome
d) Tardive dyskinesia
--- Content provided by FirstRanker.com ---
xvii. Which of the following medication can cause hyperprolactinemiaa) Propranolol
b) Glucocorticoids
c) Metoclopramide
d) Levothyroxine
--- Content provided by FirstRanker.com ---
xviii. All the following drugs are used to treat hyperkalemia EXCEPTa) Steroids
b) Calcium gluconate
c) Salbutamol
d) Dextrose insulin infusion
--- Content provided by FirstRanker.com ---
xix. Carey Coombs murmur is seen ina) Severe mitral stenosis
c) Para aortic regurgitation
b) Acute rheumatic carditis
d) Severe pulmonary hypertension
--- Content provided by FirstRanker.com ---
xx. A chronic alcoholic develops palpitation suddenly after an alcohol binge. Which of the followingarrhythmia is most likely
a) Ventricular fibrillation
c) Atrial flutter
b) Ventricular premature contraction
--- Content provided by FirstRanker.com ---
d) Atrial fibrillationLong Essays:
(2x10=20)
2. Write about etiology, clinical features, complications, investigations and treatment of Crohn's disease
(2+2+2+2+2)
--- Content provided by FirstRanker.com ---
3. A 30-year old male patient comes with blood urea level of 380 and creatinine of 8 mg/dLa) Enumerate the causes of acute renal failure
b) Enumerate the mechanism of anemia in chronic kidney disease
c) Mention three systemic diseases that can lead to chronic kidney disease
d) What are the techniques of renal replacement therapy
--- Content provided by FirstRanker.com ---
(3+3+2+2)Short Essays:
(6x6=36)
4. Management of Acute bacterial meningitis
5. Management of hypertensive emergencies
--- Content provided by FirstRanker.com ---
6. Nephrotic syndrome7. Migraine headache
8. Portal hypertension
9. Clinical manifestations and diagnosis of multiple myeloma
Short Answers:
--- Content provided by FirstRanker.com ---
(6x4=24)10. Central nervous system (CNS) manifestations of HIV
11. Diagnosis and management of acute pancreatitis
12. Antiplatelet drugs
13. Communicate the therapeutic options to a patient with acute coronary syndrome
--- Content provided by FirstRanker.com ---
14. Inheritance and genetic counselling of hemophilia15. Clinical features of pheochromocytoma
**********************
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