UPSC Mains Medical Science Optional PYQs, 2016-2026

Describe the hip joint under the following headings: (i) Factors responsible for its stability (ti) Arterial supply of upper end of femur along with mechanism of avascular necrosis of femoral head

A 55-year-old male is operated for a lung tumour. During the postoperative stay, he develops shortness of breath. His examination shows paradoxical movement of right hemidiaphragm during inspiration and same was also recorded on MR imaging. In the above case— (i) explain the anatomical basis of his clinical findings; (ti) enumerate the major openings of diaphragm and their vertebral levels, along with all the structures passing through each of them.

A 55-year-old male presented in surgery OPD with yellow-coloured sclera and greasy stools. On detailed examination, he was diagnosed with carcinoma of head of pancreas. Based on these clinical findings, discuss the following: (i) Serum markers of cholestasis; (iti) Cause of greasy stools

Describe the phases of action potential in a neuron. State the difference in 'conduction' between benign and unmyelinated neuron.

With the help of a suitable well-labelled diagram, explain the principal connections of basal ganglia.

A 32-year-old male is brought to the emergency department following a road traffic accident. His clinical examination shows that his arm is adducted and medially rotated, elbow is extended and forearm is pronated. Sensory loss is also noted on lateral aspect of his forearm. His MR scan shows involvement of upper part of brachial plexus. Based on this clinical scenario, answer the following: (i) Identify the site of involvement of brachial plexus, using a diagram. (i) Explain the anatomical basis of motor and sensory loss.

5 marks

Describe the role of various proteins regulating the iron absorption, transport and storage in the body.

Explain the biochemical role of vitamin 86. Explain why the deficiency of vitamin B6 causes pellagra-like symptoms.

Describe the functions of growth hormone. Write a note on the regulation of secretion of growth hormone.

Discuss the mechanism of action of insulin at receptor level. 5 Name 3

Name the ligaments of ovary and their role in ovarian torsion and its complications.

Explain the surgical importance of anatomical relations of structures in ovarian fossa.

Describe the major anatomical sites of portosystemic anastomosis, listing the veins involved.

Define genetic code. What are the salient features of genetic code?

5 marks

What are posttranslational modifications? Discuss in brief the post- translational modifications involving various amino acids.

Describe any two methods to measure cardiac output. Explain the role of Frank-Starling law' in cardiac contraction.

Discuss the structure and function of Golgi tendon organ.

5 marks

Describe the cerebrospinal fluid (CSF) flow from site of production to its absorption. Write a note on the mechanism of its absorption.

5 marks

A 62-year-old hypertensive male is brought to medical OPD with the complaints of sudden onset of visual loss in both his eyes. His ophthalmologic examination reveals right homonymous hemianopia with macular sparing, and his MR scan shows cerebral hemorrhage involving left occipital lobe. Based on the above findings, explain the anatomical basis of visual loss in this patient using a diagram depicting the entire visual pathway.

Define glomerular filtration rate (GFR). Discuss the different clearance tests used to measure glomerular filtration rate.

Discuss briefly the different steps of polymerase chain reaction (PCR) technique. Write three applications of PCR technique.in clinical medicine.

Discuss in brief the functional divisions of cerebellum and state the role of each division.

5 marks

Discuss in brief the medial and lateral descending pathways and their functions.

5 marks

Discuss in brief the role of oxytocin in parturition and lactation.

5 marks

State the therapeutic indications, drug interactions and side effects of Methotrexate.

5 marks

State the therapeutic indications, drug interactions and side effects of Furosemide.

5 marks

Enumerate any four 'antigen-presenting cells (APCs)'. Describe in brief two major antigen processing pathways.

5 marks

Enumerate any two types of effector T cells. What are Treg cells?

A 6-year-old boy presented with fever, chills and malaise. On history, he revealed intense throbbing pain around the right knee. X-ray of the knee revealed a lytic focus of bone destruction surrounded by a zone of sclerosis. () What is the most probable diagnosis? (ti) Describe the pathogenesis of this condition. (iti) Enumerate four complications.

Describe the laboratory diagnosis and immunophenotypic classification of acute lymphoblastic leukaemia.

Classify 'thermal injuries'. How is the total body surface area involved in burns calculated in adults? Give the various causes of death in burns.

Define inflammation. Describe the cardinal features of acute inflammation.

Describe the pathogenesis of secondary tuberculosis. Enumerate five microscopic features of tuberculosis in AIDS.

Elaborate the mechanism of action of antimicrobial resistance.

5 marks

Name the third-generation Cephalosporins. State their therapeutic indications and side effects.

5 marks

Name five clinically important species of Candida.

Write the laboratory diagnosis of Candida infection.

Mention a seromarker for invasive candidiasis.

Describe in brief any five clinical manifestations of Aspergillus infection. Mention one specific antigen test used for its diagnosis.

Classify neurotoxic poisons. Discuss in brief the clinical features, treatment and postmortem findings in acute poisoning by 'opiates'.

Write a brief note on 'atypical drowning'.

5 marks

A 60-year-old male presented with an irregular plaque-like lesion at the base of tongue. Biopsy showed a proliferation of atypical cells displaying keratin pearls. l. What is the most probable diagnosis? 2. Describe the pathogenesis of this condition.

Enumerate five differences between benign and malignant tumours. Describe the mechanisms by which the tumour cells evade the immune system.

Briefly describe the advantages of Liposomal Amphotericin-B over conventional Amphotericin-B.

5 marks

Briefly describe the therapeutic indications and adverse effects of Thiazides.

Elaborate the therapeutic indications, mechanism of action and side effects of Metformin.

5 marks

Enumerate five agents of malaria in humans.

Describe in brief rapid diagnostic test (RDT) used for malaria and its advantages.

Mention the vaccine available for malaria.

Discuss the role of 'antibody-dependent enhancement' in pathogenesis of severe dengue. Write in brief the laboratory diagnosis of dengue.

Define injury as per Bharatiya Nyaya Sanhita. Enumerate the various ' mechanical injuries. Write a brief note on 'concealed punctured wound'.

What is identification? Describe in brief the primary and secondary characteristics of identification. Which is the surest test for identification of an individual?

Discuss the management of complicated Plasmodium falciparum malaria.

5 marks

Describe the therapeutic indications and side effects of Primaquine.

Discuss the various sputum-based tests for the diagnosis of tuberculosis under the National Programme in India, along with their advantages and disadvantages.

10 marks

Describe the management of a case of dog bite on the fingers associated with bleeding, as per the national guidelines of India.

10 marks

A 15-month-old child, weighing 8 kg, is brought to the District hospital with fever for 5 days, loose motions and vomiting for 2 days, and respiratory distress for 1 day and has not passed urine. (i) Assess and classify the child as per IMNCI guidelines and document the complete diagnosis. (ii) How will you manage this case as per the IMNCI guidelines?

10 marks

A 24-hour-old newborn has presented with jaundice extending to the palms and soles. (i) Classify and enumerate the possible causes of hyperbilirubinemia in this newborn. (ii) Outline the management for unconjugated hyperbilirubinemia at this age.

10 marks

What do you understand by a papulosquamous lesion in dermatology? Enumerate these disorders. (ii) Describe the clinical and histopathological clues for the differentiation between psoriasis and lichen planus.

10 marks

A 20-year-old medical student presents with fever, dry cough, and right-sided chest pain. She also has loss of weight and loss of appetite. The chest X-ray shows right-sided pleural effusion. Discuss the diagnostic investigations and management of this patient.

20 marks

A 2-year-old boy, weighing 8 kg, with a length of 72 cm, has presented at the hospital. (i) How does one assess and classify malnutrition in this boy? (ii) What are the clinical features of malnutrition and what are its complications? (iii) Outline the stepwise management of 'Severe Acute Malnutrition'. (iv) Explain the dietary management during the rehabilitation phase.

20 marks

A l-month-old infant has yellowish greasy scaling on the vertex and frontal area of the scalp. His retroauricular and nasolabial folds show erythema and scaling. (i) What is the diagnosis? (ii) What is the aetiology of this disorder? (iii) How do you manage this disorder?

What is the diagnosis? (ii) What is the aetiology of this disorder? (iii) How do you manage this disorder?

10 marks

An 18-year-old girl presents with episodic breathlessness, cough with sputum, chest tightness and wheezing for the last 4 years. She also complains of recurrent sneezing and nasal blockage. Discuss the evaluation and management of this patient.

25 marks

A 6-day-old newborn presents with cyanosis, respiratory distress,

Discuss the differential diagnosis of this newborn. (ii) Outline the diagnostic approach. (iii) Discuss the acute and long-term management of this newborn.

15 marks

Describe the clinical and histopathological features of acute, subacute and chronic eczema. (ii) What is Airborne Contact Dermatitis? Discuss its aetiology and clinical features.

10 marks

A 45-year-old hepatitis-C positive patient presents with icterus, oliguria, abdominal distention and blood in stools. Discuss the investigations and management of this patient.

25 marks

A 12-year-old girl, unvaccinated since the age of 1 year, reports to you for a 'catch-up vaccination'. (i) How would you draw her vaccination plan? Which vaccines should be administered to the girl and what should be their schedule? (ii) Describe the possible adverse events that may occur following vaccination (immunization). (iii) Discuss the clinical manifestations of acute anaphylaxis following vaccination and its management.

15 marks

Briefly discuss the management of the microvascular complications of

Enumerate the causes of lower gastrointestinal bleeding in an adult. Discuss the management of actively bleeding haemorrhoids.

10 marks

Briefly discuss the life cycle of the hydatid cyst. How will you manage a large hydatid cyst of the liver?

10 marks

Discuss the differences between 'abruptio placentae' and 'placenta praevia'. (ii) Outline the management of a 30-year-old G3P2L2 woman at 36 weeks of gestation with bleeding per vaginum due to abruptio placentae along with absent foetal heart sounds.

Outline the management of a 30-year-old G3P2L2 woman at 36 weeks of gestation with bleeding per vaginum due to abruptio placentae along with absent foetal heart sounds.

10 marks

Briefly discuss the differential diagnosis of "primary amenorrhea". (ii) How do you manage a 15-year-old girl presenting with abdominal pain and primary amenorrhea due to an imperforate hymen?

10 marks

In the context of treatment and disposal technologies for healthcare waste, comment upon the following: (i) The 'Process of Inertization' with its advantages and disadvantages (ii) Wet and dry thermal treatment

10 marks

Describe the causes of occipito-posterior position and different modes of delivery in the occipito-posterior position. (ii) Define 'Deep Transverse Arrest' and enumerate the maternal and foetal complications associated with it.

20 marks

Describe the clinical features, investigations and treatment of

In the context of HIV/AIDS Control and the National AIDS Control Programme in India, answer the following questions: (i) Define Post-Exposure Prophylaxis (PEP). (ii) How will you establish eligibility for Post-Exposure Prophylaxis (PEP) based on exposure and HIV source codes? (iii) What are the Post-Exposure Prophylaxis (PEP) drug regimens for healthcare personnel?

15 marks

Describe the various complications of acute pancreatitis. Discuss the role of surgery in acute pancreatitis.

20 marks

Under the National Rural Health Mission, explain the concept of Comprehensive Primary Health Care and outline the key strategic areas essential for its effective operationalization.

15 marks

Discuss the aetiopathogenesis, diagnosis and management of

Write briefly on the ovulation induction protocol in a Polycystic Ovarian Syndrome (PCOS) patient.

15 marks

What are the main objectives and key strategies of the National Strategic Plan (NSP) for Tuberculosis Elimination in India?

Discuss the indications and methods of second-trimester termination of pregnancy. (ii) Describe the medico-legal issues of mid-trimester medical termination of pregnancy in modern practice.

15 marks

Describe the aetiopathogenesis of carcinoma colon. (ii) Briefly mention the management of carcinoma of descending colon in a 65-year-old male who has presented with intestinal obstruction.

15 marks

Describe the formation, course and branches of ulnar nerve. Which muscles do each of the branches supply? Why is ulnar nerve called the "musician's nerve"?

Name the nerves and their branches that supply the sole of the foot stating the specific area of their distribution. Explain in brief what is

Classify jaundice according to its aetiology. Make a tabular representation of the blood, urinary and stool findings observed in different types of jaundice.

10 marks

Describe the process of generation and conduction of nerve impulses in humans. Add a note on saltatory conduction.

10 marks

With the help of a suitable diagram, explain the innervation and functions of muscle spindle.

10 marks

Using a well labelled diagram, trace the taste pathway from circumvallate papillae of tongue to the cerebral cortex.

15 marks

Enumerate any five tests for the assessment of renal tubular functions. Explain the underlying principle andtheir interpretation.

10 marks

Explain the role of biotin in intermediary metabolism with suitable examples. Add a note on the mechanism of action of any biotin-antagonist with its application in medicine.

10 marks

Define cardiac output and describe the regulation of cardiac output in normal adults. Add a note on Cardiac Index and Cardiac Reserve.

10 marks

Define Systemic Vascular Resistance and list its determinants. Briefly explain the role of its determinants.

5 marks

A 36-year-old cyclist suffered pelvic injury while riding into a pothole on the road. Following this incident, he has severe pelvic pain and is unable to pass urine. His retrograde urethrogram shows contrast limited to

What is the most likely structure and its site of involvement, which is responsible for his inability to pass urine? (ii) What are the parts of the principal structure involved? (iii) With the help of a labelled diagram, illustrate the difference in the contents of superficial perineal pouch in males and females.

20 marks

Be ala Fits Describe Selenium under the headings of 'its dietary sources', 'its biochemical roles' and 'its deficiency diseases' with their clinical manifestations.

10 marks

Restriction Fragment Length Polymorphism has a number of applications in clinical medicine. Briefly state any three. apiferent & Hat SHAT at stasare fares At Peace at E With the help of suitable examples explain the second messenger mechanisms that mediate the downstream actions of hormones inside the cell.

5 marks

Give a brief account of synthesis, storage, secretion and functions of the posterior pituitary hormones.

5 marks

A 55-year-old lady visits surgery OPD with a three month old history of a painless hard swelling in her left breast. On examination, it is found that the swelling is firm, immovable and is located in upper inner quadrant, along with retraction of nipple. She is advised to undergo pre-operative sentinel lymph node biopsy and surgery. Explain the anatomical basis of pre-operative sentinel node biopsy in this case.

5 marks

FIRST A 45-year-old man presents at orthopaedic OPD with swollen and painful right knee. He gives a history of fall while playing cricket two weeks ago. On examination, his right knee has tenderness, swelling, decreased range of mobility and anterior joint instability. His MRI scan reveals damage to one of the major knee joint stabilizers. (1) Name all the ligaments and write their specific roles in stabilization of the knee joint. (II) Name the most likely structure involved in the given case and write two points to support your viewpoint.

10 marks

Explain the principle of radioimmunoassay (RIA) and outline its role in the diagnosis of thyroid disorders. Add a note on the advantages and disadvantages of this technique.

10 marks

Enumerate haematopoietic vitamins. Explain the biochemical basis of the deficiency manifestations of any 'two' of them which lead to anaemia.

10 marks

Briefly describe the development of Cell-Mediated Immunity. List the cell types involved, along with their actions.

5 marks

Briefly describe the process of Phagocytosis.

5 marks

Give an account of the formation and function of thrombocytes.

5 marks

Enumerate the topical antifungal drugs along with their indication and side effects.

5 marks

Name antihelmintic drugs used in treatment of neurocysticercosis and also mention their side effects.

5 marks

Enumerate the cells of lymphoreticular system. Schematically represent the process of B-cell maturation.

Make a schematic flowchart of pathogenesis of Salmonella causing enteric fever. Mention two important categories of drug resistance in Salmonella typhi.

What are the risk factors for lung carcinoma? Describe the morphological features of three major histological types of lung carcinoma.

10 marks

Write a note on the role of Human papilloma virus in the pathogenesis of cervical carcinoma.

10 marks

Classify poisons based on the chief symptoms. Describe the legal duties of a medical practitioner in a case of suspected poisoning.

10 marks

Describe the approach to laboratory diagnosis of chronic myeloid leukemia — chronic phase.

10 marks

Describe the gross and light microscopic changes evolved over two weeks duration in myocardial infarction. Add a note on the role of serum cardiac biomarkers in the diagnosis of myocardial infarction.

10 marks

Explain why beta blockers should not be given to diabetes patients who are on oral hypoglycaemic agents.

Explain why folic acid is given with methotrexate.

5 marks

Fife Heat A aaa At ofshar (A) aT Ware Afar SATU ILS

A 12-year-old child developed fever with multiple crops of vesicular rash starting from the face spreading towards the trunk. (I) Mention the mode of transmission and spread of the probable viral agent. Prepare a flowchart of the course of the infection in humans. Mention three tests for laboratory diagnosis of the agent. (II) Discuss the post-exposure preventive strategies.

10 marks

Enumerate the malarial parasites prevalent in India. Of them, which species is notoriously associated with life-threatening complications? What are the different characteristic peripheral blood smear findings in different species of parasites that cause malaria?

10 marks

Define 'drowning'. Enumerate the different modes of death in a case of drowning. List the postmortem findings in a case of wet drowning.

10 marks

Describe Diatom Test and enumerate its limitations.

5 marks

Enumerate four major primary glomerulonephritides presenting with nephrotic syndrome. Describe pathogenesis, light microscopic, immunofluorescence microscopy and electron microscopic findings of post-infectious glomerulonephritis.

10 marks

Describe steps of wound healing by first intention. Enumerate factors that influence tissue repair.

10 marks

WHAT SAT ais LRAT Describe the role of nitrates, their route of administration and their side effects while being used in the management of angina pectoris.

5 marks

Discuss in brief the mechanism of action and the therapeutic uses

Enumerate the advantages of artemisinin-based combination therapies in the treatment of malaria.

5 marks

Describe the challenges of circulating Vaccine-Derived Poliovirus (VDPV). Add a note on the environmental surveillance and preventive strategies for effective maintenance of Polio elimination.

10 marks

Tat FIAT Describe the mode of infection and clinical manifestation of cryptococcosis. Discuss the role of the rapid diagnostic test in comparison to conventional techniques for identifying the infection.

10 marks

Define 'Injury', 'Hurt' and 'Grievous Hurt'. Add a note on the medicolegal aspects of contusion.

10 marks

Describe the various tests prescribed for blood and seminal stains obtained during the examination of a victim of rape and their role in the investigation.

10 marks

Enumerate the drugs used in the management of hypertensive crisis. Also describe the route of administration and their side effects.

Name the drugs, doses and duration of treatment after post-exposure prophylaxis of HIV.

5 marks

Briefly describe the role of lifestyle interventions in prevention of coronary artery disease.

Discuss the role of various imaging modalities in the diagnostic evaluation of pyelonephritis.

Write the criteria for diagnosing pneumonia in children according to the 'Acute Respiratory Infection (ARI) Control Programme' (WHO). Write the treatment strategies of different types of pneumonia according to the ARI Control Programme.

How will you treat hypothermia in a 3-year-old child with severe acute malnutrition (SAM)? How will you prevent hypothermia in an SAM child?

A joint family comprising of senior citizens, antenatal women and one-month- old infant is suffering from scabies. (i) Name the organism that causes scabies in humans. (ii) What factors are involved in the transmission of scabies in a family? (iti) How do you plan to treat scabies in this family?

A 23-year-old woman with type I diabetes mellitus presents with nausea, vomiting and altered sensorium. On examination, she is tachypneic and hypotensive. Her random blood sugar is 460 mg/dL, and routine examination of urine is positive (++) for ketone. Outline the stepwise approach to the diagnosis and management of this patient.

20 marks

Define acute diarrhoea in children. List its causes. How would you assess for dehydration in such a child?

Write the nutritional management of acute diarrhoea and the steps to be taken for prevention of acute diarrhoea.

How do you classify eczema?

Enumerate the differences between allergic contact dermatitis and irritant contact dermatitis.

Elaborate the indications for initiating antiviral therapy in a patient with chronic hepatitis B.

Write the first-line antivirus treatment regimen for the management of chronic hepatitis B along with the recommended monitoring strategy during therapy.

25 marks

Write the risk factors for respiratory distress syndrome (RDS)s in newborn. What is the differential diagnosis of RDS? How will you manage respiratory distress syndrome in newborn?

A 28-year-old female with a long history of psoriasis develops symmetrical, flexural and grouped pustules with high grade fever and severe constitutional symptoms in the third trimester. (i) What is your diagnosis? (ii) How do you manage the condition? (iti) What are the complications?

How do you differentiate between acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) based on peripheral smear and bone marrow findings?

Describe the current standard of care for acute lymphoblastic leukaemia (ALL) in adults and children.

25 marks

Enumerate the various types of vaccines available in National Immunization Schedule (NIS) in children. Define adverse events following immunization. State the adverse events of any three vaccines.

5 marks

Discuss the diagnostic approach to and curative management of renovascular hypertension.

Enumerate the advantages as well as the limitations of laparoscopic surgery.

Describe the different techniques of creating pneumoperitoneum during Describe surgery.

Describe the aetiology, clinical features and management of anal fissure.

Define maternal mortality rate (MMR) and enumerate the causes of maternal mortality in India.

What are the steps to be taken to reduce maternal mortality in India?

Discuss the clinical features, diagnosis and treatment of pelvic endometriosis.

Explain the significance of the 'Kilkari' initiative with reference to National Rural Health Mission. Who is it aimed at and how is it being implemented?

Classify hypertensive disorders in pregnancy.

Enumerate the types and complications of eclampsia.

Discuss the management of antepartum eclampsia in a 25-year-old primigravida with 32 weeks of pregnancy. 5+5+0=20 Describe 5 [P-T:0.

Describe the clinical features and management of ulcerative colitis.

Enlist the differences between ulcerative colitis and Crohn's disease.

5 marks

What are the major objectives of 'Home-based Newborn Care'? State the responsibilities that 'ASHA' is entrusted with to make the programme a success.

5 marks

Describe the clinical features and diagnostic workup of a suspected case of peritonitis.

Enumerate the principles of management of peritonitis.

Enlist the important complications of peritonitis.

20 marks

Anaemia Mukt Bharat Programme' employs a multipronged approach. What are the interventions it focuses on to achieve its goals? What are the specific measures being undertaken under this programme? Which are the specific population groups that this programme targets?

5 marks

Define infertility. How will you investigate the tubal factors of female infertility?

Enumerate the assisted reproductive technology (ART) procedures.

5 marks

Under the National Framework for Malaria Elimination in India, what are the targets set for the years 2027 and 2030 respectively? What are the key interventions recommended for States and UTs which require intensified control and fall under Category 3? Which are the parameters employed for maintaining epidemiological surveillance over malaria?

20 marks

Describe the WHO medical eligibility criteria for contraceptive use for women with medical conditions.

Discuss the complications of intrauterine contraceptive device (IUCD).

How will you manage a case of misplaced copper-T (Cu-T)?

5 marks

Describe the embryogenesis, clinical features and principles of management of cleft palate.

Describe the radial nerve under the following headings: (i) Origin and course (ii) Branches and muscles supplied (iii) Applied aspects

Describe the development of ventricles of the heart. Add a note on Fallot's tetralogy.

Explain the 'Mucosal Block Theory' for iron absorption. Discuss briefly the complications of excess of iron deposition in the body.

Give the sequence of events at the neuromuscular junction during the transmission of a nerve impulse. Name the muscles most commonly affected by Describe the

Describe the components of the nervous system which are concerned with 'conscious alert state' that makes perception possible.

A middle-aged female notices a lump in the midline of the neck. She notices it moves with swallowing. The surgeon gives a tentative diagnosis of goitre. Describe the thyroid gland under the following headings: (i) Gross anatomy and relations (ii) Blood supply and lymphatic drainage (iii) Surgical anatomy of thyroid gland

5 marks

Explain why vitamin 0 can be considered to be a 'hormone'. Describe the role of vitamin D in calcium homeostasis.

Discuss the sources and Recommended Daily Allowance (RDA) of vitamin Bl2. Briefly discuss the absorption of vitamin Bl2 in the GIT and the clinical manifestations of the disorder of absorption of vitamin B2.

Define the Frank-Starling law. State the significance and causes of shift of Frank-Starling curve to right and left.

What is the role of baroreceptors and chemoreceptors in the regulation of blood pressure?

5 marks

FITS / 3 [ P.T.O. Describe the uterus under the following headings: (i) Gross anatomy (ii) Ligaments and supports (iti) Relations of uterus (iv) Blood supply (v) Lymphatic drainage (vi) Applied aspects

20 marks

Which antibiotics and toxins inhibit protein synthesis in prokaryotes and eukaryotes? Briefly explain the mechanism of action of each of them.

What are ribozymes? Explain briefly the role of any one ribozyme in protein synthesis.

5 marks

Enumerate the major hormonal causes of dwarfism. Give their characteristic features.

Describe the principal events during oogenesis in brief.

5 marks

Describe the facial nerve under the following headings: l. Functional columns and nuclei of origin 2. Course and branches 3. Bell's palsy

Differentiate between indirect and direct inguinal hernia.

5 marks

Define renal clearance. What key features should be present in a compound for it to be considered as a 'gold standard' for measurement of renal clearance? Explain why urea is not considered as a 'gold standard' for this.

Briefly describe the role of Restriction Fragment Length Polymorphism (RFLP) in DNA fingerprinting.

Give the physiological basis of anaemia in kidney and liver disease.

5 marks

Describe the role of eosinophils in control of allergy reactions.

5 marks

Describe the role of platelets in haemostasis.

5 marks

Discuss the antiviral spectrum and therapeutic uses of acyclovir.

5 marks

Doxorubicin is an antibiotic. Enumerate its role in cancer chemotherapy and its adverse effects.

5 marks

What is hypersensitivity? Enumerate different hypersensitivity reactions along with examples. Define type I hypersensitivity reaction and write its role in health and disease.

Define cancer. Describe in detail the effects of cancer-related genes on cell growth.

/ 5 [ P.T.O. A 50-year-old male presented with a history of chest pain, polyuria and polydipsia since last 5 years. Investigations showed HbAlc level of 2%, cardiac enzymes were normal, while urinalysis showed proteinuria. (i) What is the most likely diagnosis? (ii) Describe the microscopic findings. (iti) What is the pathogenesis?

Define injury. Discuss the microscopic and histochemical methods which can determine the age of injury.

Describe the microscopic features of breast cancer. Enumerate any five major prognostic factors.

Enumerate any five differences between primary tuberculosis and secondary tuberculosis.

Explain why primaquine is used for radical cure of malaria.

5 marks

Explain why albendazole is termed as broad-spectrum oral antihelminthic.

5 marks

What is candidiasis? What are its different presentations and etiological causes? Give the laboratory diagnosis of a case of invasive candidiasis.

What is shigellosis? What are its causative organisms and their modes of pathogenicity? Give the laboratory diagnosis of a case.

Define death due to hanging. What are the probable causes of death in hanging?

What are the findings in a case of judicial hanging?

5 marks

A 55-year-old female presented with haematemesis. On physical examination, she was afebrile and pale. No organomegaly was noted. Serological tests for hepatitis B were positive. l. What is the most likely diagnosis? 2. Describe the microscopic findings. 3. What is the pathogenesis?

Describe the clinical features and microscopic findings in acute lymphoblastic leukaemia.

State the role of diuretics in the management of hypertension.

5 marks

Discuss how excess dose of paracetamol causes acute hepatocellular toxicity and how you will manage the condition.

5 marks

Elaborate the advantages and disadvantages of Sodium-Glucose Cotransporter-2 (SGLT-2) inhibitors in the management of diabetes mellitus.

5 marks

What is enteric fever? What are its causative agents? Give a detailed presentation of a case according to the time of the disease and the respective tests used for diagnosis.

Draw a diagram of HIV virion depicting the various antigens and proteins. Give the serological pattern in an HIV infection according to the time of presentation. List the various diseases associated with AIDS.

What is virtual autopsy? State its methodology. What are its merits?

Define brain death. Describe its medicolegal importance.

Discuss why infliximab is considered as an immunosuppressant. Mention its therapeutic uses.

5 marks

Describe briefly the pharmacological characteristics of natriuretic peptides and their clinical uses. 5 kkk / 8 25SS—672

Discuss in short the role of a Chest X-ray in the diagnosis of pulmonary tuberculosis.

10 marks

Describe the clinical features for diagnosing a case of Depression.

10 marks

What are the key differences between Kwashiorkor and Marasmus? Which is the easiest method which can help in the early detection of Protein Energy Malnutrition (PEM) in children?

10 marks

During the initial phase of stabilization in a severe acute malnourished child, map out the dietary plan. State the type, amount and frequency of feed that the child requires and for how long that would be necessary. In this phase, what is the vitamin and mineral supplementation given?

10 marks

In a confirmed case of scabies in an adult: (i) What are the primary manifestations of the disease and what is the pattern of distribution of lesions on the body? (ii) What are the complications seen in scabies?

10 marks

Discuss in short about the different modalities used in the diagnosis of Extra-Pulmonary Tuberculosis.

10 marks

Describe the clinical features of malabsorption syndrome.

10 marks

Write in brief the ten steps of Baby-friendly Hospital Initiative (revised 2018).

10 marks

Write the advantages of breast-feeding.

5 marks

A young adult female develops asymptomatic depigmented chalky white macules and patches with no sign of inflammation over face and around body orifices. (i) What is the diagnosis? (ii) What are the associated findings seen in this disorder? (iii) How is this disorder classified? (iv) Describe the clinical course of the disease.

15 marks

Describe the clinical features, diagnosis and treatment of Kala-azar.

20 marks

What are the types of vaccines currently in use against Pneumococcus organisms? State the National Immunization Schedule for administering Pneumococcal Vaccine in infants. Enumerate the diseases that the Pneumococcal Vaccine can safeguard against.

15 marks

A young female patient develops acute inflammatory papules and vesicles all over her scalp and tips of ears following repeated use of hair

What is the diagnosis? (ii) How can the diagnosis be confirmed? (iii) How will this condition be treated?

15 marks

A sixty-year-old male develops central chest pain while walking uphill. The pain is squeezing in character, radiating to left arm, that relieves on taking rest. Discuss in short about the evaluation and treatment of this case.

20 marks

Enumerate the causes of respiratory distress in a newborn. How would you differentiate between respiratory distress of respiratory origin and that of cardiac origin?

8 marks

Write the complications of cyanotic congenital heart diseases.

How will you manage a one-year five-month old child presenting with severe respiratory distress with a history of cough and fever for 5 days?

8 marks

What is the meaning of the term 'lichenoid'? (ii) Name the disease that is a prototype of lichenoid reaction. (iii) Describe the clinical features of the disease.

10 marks

Enlist conditions having an increased risk of malignant disease in bone and cartilage. (ii) Briefly mention classification of bone tumours.

10 marks

A 55-year-old male patient underwent subtotal gastrectomy for carcinoma stomach. Briefly describe early and late complications of this procedure.

10 marks

A 25-year-old infertile woman presents with menorrhagia. USG (Ultrasound) pelvis revealed multi-fibroid uterus, largest measuring 3 X 3 cm. Describe the evaluation and management of Fibroid Uterus in the above patient. (ii) Describe recent classification of Abnormal Uterine Bleeding (AUB). Briefly discuss the endometrial pattern in various types of Abnormal Uterine Bleeding.

10 marks

A young newly married couple wants advice on contraception.: Describe the various methods of contraception which are suitable for them. (ii) Enlist the various methods of female sterilization and complications

Describe the 'yellow' category of biomedical waste in terms of — types of waste, types of bags or containers to be used, and treatment and disposal options. (ii) Comment upon 'incineration' as a method of biomedical waste management.

10 marks

A 22-year-old Unbooked Primigravida at 38 weeks of gestation presents to Emergency with labour pains. How would you evaluate the patient for obstetric triaging and further management of labour? (ii) Discuss the clinical features, diagnosis and management of Rupture Uterus following obstructed labour.

Discuss the clinical features, diagnosis and management of Rupture Uterus following obstructed labour.

20 marks

Write the clinical features and diagnostic work-up in a case of carcinoma rectum. (ii) Briefly mention Dukes' staging for this condition. (iii) Enumerate surgical options for this disease.

15 marks

In the context of HIV/AIDS control and the National AIDS Control Programme in India, comment upon the following: (i) 95-95-95 targets (ii) Categorization of districts (iii) TB-HIV coordination to reduce mortality

15 marks

A 50-year-old male presented with a 3 cm nodule in the left lobe of thyroid gland with a hard left cervical lymph node. Fine Needle Aspiration Cytology (FNAC) from the thyroid nodule revealed orphan Annie-eyed nuclei. (i) What is the diagnosis in this case? How can this condition be managed surgically? (ii) Enumerate different prognostic scoring systems for this condition. (iii) What are the post-operative complications of total thyroidectomy?

List the various sources of health information. (ii) Describe the limitations of hospital records as a source of health information. (iii) Write in brief the use of pictograms for presenting health information data.

15 marks

What are the signs and symptoms of Pelvic Inflammatory Disease

What are the complications of PID? (iii) How do you manage a 28-year-old woman, P1L1 with unilateral

What are the different types of epidemiological studies? (ii) What are the possible sources of control in case-control studies? (iii) List the advantages of case-control studies as compared to cohort studies.

20 marks

Define Antenatal Care. What are its objectives? What is the schedule of antenatal clinic visits that a mother is expected to follow during the course of her pregnancy? What are the advantages and disadvantages of

Enumerate the causes of hematuria in a 60-year-old male. (ii) Briefly describe the management of carcinoma prostate in a 60-year-old male.

15 marks

Fret At fear 4 forer Ht after At caret Afar A 35-year-old male smoker with complaints of difficulty in swallowing and ulcer on tip of his tongue for last one month, visits an ENT surgeon. Based on his clinical examination and histopathological investigation of tongue lesion, he is diagnosed as a case of carcinoma of tongue with

Using a flowchart, show the principal lymph node involved and its further distribution. (ii) Explain the role of tongue in swallowing.

10 marks

Describe the following in the context of 'Auditory pathway': (i) Its course from internal ear to auditory cortex (ii) Blood supply of the auditory cortex

10 marks

Discuss the sources and Recommended Daily Allowance (RDA) of Folic Acid and the clinical manifestations of its deficiency in the body. Add a note on 'Folate Trap'.

10 marks

Describe the role of cerebellum in control of voluntary movement. Add a note on cerebellar dysfunction.

10 marks

Describe the genesis of Rapid Eye Movement (REM) sleep. Why is REM sleep called paradoxical sleep?

10 marks

A 56-year-old male visits a surgery OPD with complaints of difficulty in passage of urine especially on straining. Based on his clinical examination and ultrasound findings, he is diagnosed with Benign

What is the anatomical basis of his urinary problems? (ii) Describe the relations of Prostate gland. (iii) Describe the blood supply and lymphatic drainage of Prostate gland.

15 marks

Describe the biochemical role of copper in the body. Discuss briefly about Wilson disease and the biochemical investigations that will help in its diagnosis. 10 (ii) Define Genetic code and explain the Wobble Hypothesis. Discuss briefly the post-translational modifications of proteins.

10 marks

Explain the physiological changes that occur in a mother during pregnancy, under the following headings: (i) Genital organs (ii) Blood and its constituents (iii) Cardiovascular system

15 marks

Describe the following regarding the knee joint: (I) All movements including locking and unlocking with muscles responsible for each (II) Role of cruciate ligaments in movement and stability

10 marks

Describe Carpal Tunnel Syndrome under the following headings: (I) Causes and structure(s) involved (II) Clinical features

10 marks

Explain the principle and steps of Polymerase Chain Reaction (PCR). Write its clinical applications. 10 (ii) Discuss the serum biochemical markers of cholestasis.

5 marks

Describe the intrinsic regulation of cardiac output. 10 (ii) Discuss the factors regulating erythropoiesis.

5 marks

Describe the role of SRY (Sex-determining region on Y gene) transcription factors in testicular development. 10 (ii) Describe Vitelline duct abnormalities.

5 marks

Describe the role of iodine in the synthesis of thyroid hormones. investigations that will be done for its diagnosis. 15 (ii) Explain briefly the biochemical role of Vitamin-K in the body. What is the biochemical basis of using Warfarin as an anticoagulant drug?

Describe the functions of vasopressin and the regulation of

Describe the physiological effects of glucagon.

5 marks

Enumerate various classes of antihypertensive drugs. Briefly discuss the role of calcium channel blockers in the treatment of hypertension.

10 marks

Describe mechanism of T-cell mediated immune response in Type IV hypersensitivity reaction. Explain it by giving example of tuberculin testing. § (ii) List the clinical diseases caused by typhoidal and non-typhoidal Salmonellae. Discuss the Widal test and its interpretation.

List the clinical diseases caused by typhoidal and non-typhoidal Salmonellae. Discuss the Widal test and its interpretation.

5 marks

Enumerate four disturbances of growth. Describe the mechanism of Atrophy.

10 marks

A 25-year-old male presented to emergency with history of fever, neck stiffness, headache and vomiting. On examination, patient was in altered sensorium. Neck rigidity was present. CSF examination showed cobweb formation. Microscopy showed lymphocytosis. Biochemical examination showed decreased glucose and increased protein. (i) What is the likely diagnosis? (ii) Name the special stain on CSF useful in confirmation of diagnosis and write the finding. (iii) Describe the diagnostic gross pathology of likely affected organ.

10 marks

Enumerate types of Blood Group Systems used for identification and paternity testing.

10 marks

Enumerate any five risk factors for oral cancer. Describe its morphology. 5+5=10 (ii) Enumerate five causes of membranous glomerulonephritis. Describe its morphology.

10 marks

State the therapeutic indications, drug interactions and side effects of the following drugs: (i) Aspirin

5 marks

Discuss various stages in the asexual life cycle of Plasmodium falciparum. Describe the principle, advantages and disadvantages of non-microscopic Rapid Diagnostic Test (RDT) for diagnosis of malaria. 5+5=10 (ii) Enumerate Human Herpes Viruses (HHV) with their primary target cells. How will you approach to diagnose a case of HSV infection in the laboratory?

10 marks

Classify the various types of poisons. Enumerate the features of Plumbism. Discuss the tests which will show/establish the onset of early stages of Pb poisoning.

15 marks

A 29-year-old female presented with fever, multiple episodes of epistaxis and gum bleeding since one month. On examination, her temperature was 37-6°C. Skin showed multiple bruises. CBC showed

What is the most likely diagnosis? (II) Enumerate the cytochemical stains useful in this disease. (III) Write two cytogenetic abnormalities with favourable prognosis. (IV) Mention two cytogenetic abnormalities with unfavourable — prognosis. 2+4+24+2=10 (ii) Describe the aetiopathogenesis and microscopic findings in affected heart of rheumatic heart disease.

10 marks

Discuss the management of complicated Plasmodium falciparum malaria. 10 (ii) Discuss the therapeutic indications and adverse effects of Insulin.

5 marks

Describe the morphological characteristics of Cryptococcus neoformans on microscopic examination. Discuss the pathogenesis of Cryptococcosis. 6+655-709 (ii) Define meningococcaemia. Discuss laboratory diagnosis of acute meningococcal meningitis. Briefly write about the available meningococcal vaccines to prevent the disease.

Define meningococcaemia. Discuss laboratory diagnosis of acute meningococcal meningitis. Briefly write about the available meningococcal vaccines to prevent the disease.

10 marks

Define 'Injury', 'Hurt' and 'Grievous hurt' as per the Indian Penal Code. Write a short note on secondary markings on fired bullet. 6+4=10 (ii) Enumerate different types of finger impressions. Write a short note on DNA fingerprinting.

10 marks

Elaborate the mechanism of action of Potassium-sparing diuretics. 5 (ii) Briefly describe the therapeutic indications and adverse effects of

Enlist the clinical features of dengue fever. (ti) Outline the management of a patient with dengue haemorrhagic fever.

Write the symptoms of schizophrenia.

What is the full form of IMNCI and what are its objectives? (ii) What are the components of integrated care provided under IMNCI?

State the immunization schedule under the National Immunization Programme for infants and children.

A 40-year-old male presented with multiple itchy, violaceous, flat-topped papules over skin for last one year. He also complained of burning sensation in mouth. (i) Diagnose this condition. (ii) What are the oral findings which can be associated with this condition? (iii) Outline its management.

A 30-year-old female has been brought to medical emergency with a history of low-grade fever, headache, anorexia and weight loss for the last one month. She has also developed diplopia and altered sensorium for the last two days. (i) What is the most likely diagnosis? (i) Enumerate the investigations required to confirm the diagnosis. (ti) Differentiate between the CSF findings in pyogenic, tubercular and viral meningitis. (iv) Outline the treatment plan in this patient.

20 marks

A 2-year-old boy was brought to the emergency with the complaints of sudden onset of respiratory distress with irritability. On examination, the child is disoriented and he has both peripheral and central cyanosis. He has deep sighing respiration with 59902 < 65% at room air. On oxygen therapy, his SpO, is increased to 80%. He has no organomegaly or neurological deficit. (i) Write the complete diagnosis of this boy. How will you manage this case in emergency? (iti) Classify the congenital cyanotic heart diseases. 2+8+5=5 [?.7.0.

A 48-year-old male presented with yellowish, greasy scales and redness over the scalp. (i) What is the most likely diagnosis? (ti) Mention the sites of involvement in this disease. (ti) Name the organism responsible for the pathogenesis of this disease. (iv) Outline its treatment.

5 marks

Discuss in short the aetiology, clinical features, investigations and management of chronic renal failure.

20 marks

Write the causes of unconjugated hyperbilirubinemia in a newborn. (ti) What is the mechanism of action of phototherapy in the treatment of hyperbilirubinemia? (ii) What are the potential complications of the phototherapy?

5 marks

Mention the nail findings in psoriasis. (ti) Discuss the topical and systemic therapies in psoriasis.

5 marks

A 20-year-old male has presented to the medicine OPD. He has complaints of episodes of breathlessness associated with tightness of chest and wheezing since the childhood. These episodes occurred commonly during the change of season. (i) What is the most probable diagnosis? (ii) How will you confirm the diagnosis? (iii) Discuss in short the clinical features of the disease. (iv) Outline the stepwise approach to the management of the disease.

20 marks

What are the criteria for the identification of severe acute malnutrition (SAM) in children 6 months to 59 months of age? (ii) Enumerate the criteria for admission in the facility-based care for severe acute malnutrition. (iii) Write ten steps in the management of SAM.

20 marks

Discuss in short the role of X-ray imaging in diagnosing a case of acute abdomen.

A 65-year-old lady has progressively increasing dysphagia for last 6 months. She also has significant weight loss. How will you investigate her?

A 42-year-old male, known case of alcoholic liver disease with portal hypertension, is brought to casualty with severe haematemesis. Describe the management of this case. 0 [ P.T:O.

Name any five risk factors associated with pelvic organ prolapse. (i) Enlist the management options for a 60-year-old postmenopausal lady with procidentia with cystocoele with enterocoele with rectocoele.

Define chronic pelvic pain. What are the various causes of chronic pelvic pain in women?

The Janani-Shishu Suraksha Karyakram is a unique national initiative of the Government of India. State in brief the entitlements to pregnant women and neonates under this scheme.

Enumerate the causes for postpartum haemorrhage (PPH). (ti) Discuss the management of PPH.

20 marks

Enumerate the signs of lower limb arterial ischaemia. (i) Briefly outline the diagnostic workup in a 62-year-old male with atherosclerotic lower limb peripheral arterial disease. (iii) State the management of this case.

5 marks

The National Rural Health Mission is committed towards improving rural healthcare delivery system in the country. State the major initiatives that have been undertaken under this Mission to strengthen the healthcare infrastructure in rural areas.

5 marks

Enumerate the causes of radio-opacities on a plain abdominal radiograph. (ti) Enlist the causes of hydronephrosis in adults. (iii) How would you investigate an adult patient with unilateral right-sided hydronephrosis? (iv) State in brief the management of PUJ obstruction.

20 marks

What are essential amino acids? List any six. (ii) When is a protein said to be 'biologically complete'? What does the term 'supplementary action of proteins' mean? Explain this concept by citing an example from daily life.

5 marks

What are the methods for screening of cancer cervix? (ii) What are the risk factors for cervical cancer? (iti) Enlist the preventive strategies for cancer cervix.

5 marks

State the vision, goals and objectives of the National Framework for Malaria Elimination in India, 2016-2030. What are the milestones and targets to be met under this framework by the years 2024, 2027 and 2030? Outline the broad strategies of this national framework.

How do you grade anaemia in pregnancy based on the haemoglobin levels as per the World Health Organization? (ti) List the complications of anaemia in pregnancy. (ti) Briefly outline the management of a pregnant woman with severe anaemia in labour.

5 marks

Enumerate the therapeutic indications of splenectomy. (ii) Briefly mention the aetiopathogenesis and prophylaxis of 'overwhelming postsplenectomy infection (OPSI)' syndrome. 5+l0=5 xk SB24—606

Discuss the stomach under the following headings: (i) Peritoneal relations (ii) Blood supply (iti) Lymphatic drainage

5 marks

Discuss the regulation of secretion and physiological functions of growth hormone.

Define physiological jaundice of the newborn. What are the predisposing causes and effects of this condition?

Discuss in brief the developmental anomalies of the kidney and the ureters.

5 marks

Discuss the physiological functions of placental hormones in pregnancy.

Describe the anatomy of uterus under the following headings: (i) Gross features (ii) Relations of uterus (iii) Ligaments and supports (iv) Blood supply (v) Lymphatic drainage (vi) Applied aspects

5 marks

Discuss the physiological mechanism of short-term and long-term regulation of arterial blood pressure.

5 marks

Explain the process of initiation of protein synthesis in eukaryotes. Enumerate any four inhibitors of protein synthesis with their mechanism of action.

Explain the principle and applications of radioimmunoassay.

Discuss the functions of basal ganglia. Add a note on Parkinson's disease.

Discuss the mechanism of excitation-contraction coupling in the skeletal muscle.

Explain the biochemical role of the different derivatives of vitamin A. Add a note on the causes, clinical manifestations and management of vitamin A deficiency.

5 marks

Describe the functional components, course, branches and applied aspects of the facial nerve.

Discuss the attachments and applied aspects of rotator cuff muscles of the shoulder joint.

Explain the mechanism of iron absorption in the intestine. What are the factors regulating the process?

Explain the diagnostic role of thyroid function test (TFT) in the diagnosis of thyroid disorders.

5 marks

Draw a well-labelled diagram of stretch reflex.

5 marks

What are the functions and clinical applications of stretch reflex?

Discuss the lymphatic drainage of the mammary gland and its clinical significance.

5 marks

Describe the development of the interventricular septum and write briefly about the congenital anomaly of the heart related to this structure.

Describe the molecular mechanisms of carcinogenesis of breast carcinoma. Describe the salient histopathological features of invasive carcinoma of no special type.

Draw a diagram of IgA. What is its role in a disease?

5 marks

What are opportunistic infections? Enumerate the various bacterial, parasitic, viral and fungal opportunistic infections seen in a case of AIDS.

5 marks

Discuss about angiotensin II receptor blocker (ARB). How are they different from angiotensin converting enzyme (ACE) inhibitors? Write the pharmacotherapy of hypertensive emergency.

Define granulomatous inflammation. Describe in brief different types of granuloma.

What is a firearm? What are the features of a firearm ammunition entry wound that will help in determining the range and direction of fire?

Describe in brief the pathogenesis and histopathological features of rheumatic heart disease.

Enumerate two important causes of cirrhosis. Describe the key histopathological features of cirrhosis.

State the therapeutic indications, drug interactions and side effects of the following drugs: (i) Celecoxib (ii)

What is Giardia lamblia? Write the manifestations of the disease produced by infection with Giardia and give its laboratory diagnosis. 0 What 5

What are the different dengue viruses? Give the pathogenesis of the infections by them. How is the laboratory diagnosis done in a case of dengue haemorrhagic fever?

What are organophosphate compounds? Discuss briefly the clinical features, treatment and postmortem findings of a case of organophosphate poisoning.

5 marks

Enumerate four differentiating features between benign and malignant tumours. Describe in brief the pathogenesis of cancer cervix.

Describe in brief the pathogenesis of type I diabetes mellitus. Enumerate two important glomerular lesions of diabetic nephropathy.

Discuss the second line drugs used for the treatment of tuberculosis.

Discuss the role of aldosterone antagonists as vasodilators.

5 marks

Enumerate different species of Aspergillus and the infections caused by them. Give the laboratory diagnosis of a case of pulmonary aspergillosis.

What is dysentery? Give the differences between bacterial and amoebic dysentery. Describe the laboratory diagnosis of a case of amoebic dysentery.

What is drowning? Explain briefly the different types of drowning.

Draw a labelled diagram of the hyoid bone. Discuss briefly the various fractures of the hyoid bone.

Elaborate the mechanism of action of Metformin.

5 marks

Briefly describe the therapeutic indications and adverse effects of Thiazides. 5 kkk SS23—600

Enumerate the imaging modalities used in the diagnosis of cardiac diseases. List their specific indications in diagnosing cardiac illnesses.

10 marks

Outline the pharmacological and non-pharmacological management of anxiety disorders.

A 3 year old girl, who weighs 2 kg, presents with a history of loose stools mixed with blood and mucus, and fever for 3 days. On examination, she is active and feeling excessively thirsty. There is some loss of skin turgor. (i) Write your complete diagnosis. (ii) Name the most common micro-organism responsible for this condition. (iii) Write two most important life-threatening complications of this condition. (iv) Outline the management of the condition in this girl.

Give two examples for each of the following types of vaccines used in under-5 children: l. Capsular polysaccharide vaccines 2. Conjugate vaccines; 3. Recombinant vaccines (ii) Define the following terms: l. Herd effect 2. Vaccine efficacy

State the various modes of transmission of scabies. (ii) What is the mite burden in a classical case of scabies during l. an initial infection 2. in reinfection 3. in Norwegian scabies (iii) Describe the distribution of cutaneous findings in scabies.

Discuss in brief the etiology, clinical features, diagnosis and treatment of nephrotic syndrome in a 40 year old adult.

20 marks

A 2 year old unimmunized boy weighing 6 kg presented with fever, cough, and difficult breathing for 5 days. There was a history of fever with maculopapular rash lasting for 3 days around 7 days prior to this episode. The child is febrile, has a pulse rate 116/min, respiratory rate: 72/min, SpO, 88%. There is severe chest indrawing and nasal flaring. Auscultation revealed bronchial breath sounds on left side and bilateral crepitations. (i) State the complete diagnosis. (ii) Enumerate 3 most important complications associated with this condition. (iii) How would you assess the severity of illness in this child? (iv) Discuss in brief the management of this child.

What are the four 'P's used to describe clinical manifestation of lichen planus? (ii) What are the common sites of cutaneous involvement in lichen planus? (iii) Describe Koebner phenomena. List the disorders where this phenomena can be observed.

5 marks

Discuss in brief about the diet and exercise related advice given to a 35 year old male diagnosed with non-insulin dependent diabetes mellitus. (ii) Write the acute complications of Insulin dependent diabetes mellitus and outline their management.

20 marks

A 22 year old primi mother comes to you with complaint of "NOT ENOUGH MILK". Due to this, her baby remains hungry and is constantly biting at her nipples. She is feeling soreness in the nipples. (i) How will you assess the mother-child duo to identify the underlying etiology of "NOT ENOUGH MILK"? Discuss briefly. (ii) Outline the 4 criteria each for "correct positioning" and "correct attachment" of the baby for proper breastfeeding. (iii) Discuss in brief the management of sore nipples.

5 marks

Following an acute episode of diarrhoea a 3 month old infant wearing diaper daily develops rash on skin surfaces that are in direct contact with diaper. (i) What is your diagnosis? Describe clinical picture of this disorder. (ii) How do you treat skin condition of this child?

5 marks

A 25 year old female has presented to the medicine OPD with complaints of excessive tiredness, cold intolerance and menstrual irregularities. (i) Write the name of thyroid disorder that can lead to above manifestations. (ii) Tabulate the differentiating cardiovascular clinical manifestations in hypo- thyroidism and hyperthyroidism. (iii) Outline the pharmacological management of hypothyroidism and hyperthy- roidism. What are the blood investigations conducted to monitor the treatment of hypothyroidism and hyperthyroidism?

20 marks

A 6 week old sick looking young infant is brought to a primary health centre with suspicion of "Possible Bacterial Infection" as per Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy. (i) How will you assess this child, and classify as having "Possible Serious Bacterial Infection" or "Local Bacterial Infection"? (ii) State the treatments for "Possible Serious Bacterial Infection" and "Local Bacterial Infection", as per IMNCI strategy.

20 marks

A young epileptic patient was put on antiseizure drug Lamotrigine. Three weeks later he develops an eruption consisting of purpuric macules and bullae all over skin with involvement of lips, oral mucous membrane and eyes. Skin was tender to touch. (i) What is the differential diagnosis in this case? (ii) How will you manage this condition?

Name the clinical tests for checking sapheno-femoral junction competence and deep venous system patency. (ii) Enumerate the complications of varicose veins. (iii) Briefly discuss the management of venous ulcer.

A 65 year old male came to casualty with acute retention of urine. He also gave history of nocturia, urgency, dribbling and thin stream of urine for two years. (i) How will you manage acute retention of urine in this patient? (ii) Briefly outline the definitive management in this patient.

Outline the management of a 35 year old multigraveda patient who has presented to the emergency department in a state of shock. She has delivered a dead baby at home 2 hours back and the placenta has not delivered. She has a previous history of lower segment caesarean section.

10 marks

Enumerate the contraindications which limit the usage of oral contraceptive pills in a woman.; (ii) Discuss the causes for failure of sterilization procedure in males and in females.

State the National Guidelines on feeding of infant and young child. What are the goals which these guidelines strive to achieve?

Define 'pre-eclampsia'. Enumerate the risk factors which may lead to this condition. What are its clinical signs and what are its alarming symptoms? Outline in brief its management.

20 marks

Describe clinical features, diagnosis and management of ileo-caecal tuberculosis.

5 marks

What are the objectives of investigating an epidemic? (ii) Briefly state the various steps you would undertake while investigating an epidemic.

5 marks

A 40 year old lady came to casualty with pain in the right upper abdomen associated with vomitings for 5 days. On examination, she was found to be having tenderness in right hypochondrium; the rest of the abdomen was normal. Ultrasound abdomen revealed a thick walled gallbladder with gall stones and pericholecystic fluid. (i) What is the clinical diagnosis and how will you manage this condition? (ii) Enumerate the complications of gall stones. (iii) What is Mirizzi Syndrome? How would you investigate and manage it?

20 marks

What is the total content of iron in the human body? (ii) What are its bodily functions? (iii) State the interventions being undertaken under the 'Anaemia Mukt Bharat Strategy'.

What is the current consensus on prescribing Hormone replacement therapy (HRT) in post menopausal women? (ii) Discuss its merits and demerits.

5 marks

The 'End TB Strategy' is an evolution over the previous strategies to win over tuberculosis. (i) What are the key principles of the "End TB Strategy'? (ii) What are the 'pillars and components' of this strategy? (iii) What are the major barriers that have thwarted the progress in the battle against the disease?

20 marks

What has been the impact of HPV vaccination in India? (ii) Discuss the currently available Human Papilloma Virus (HPV) Vaccines and their schedules.

5 marks

A 60 year old lady comes to surgery OPD with 624 cm lump in her right breast with nipple discharge. (i) What will be the possible findings on clinical examination if this lump were to be malignant? (ii) How will you investigate this patient?. (iii) What are the important structures which are to be preserved during modified radical mastectomy?

5 marks

Describe the formation, course, tributaries and termination of coronary sinus.

Describe the role of cerebellum in maintenance of posture and equilibrium.

A 4-year-old girl presented with low-grade fever, loss of appetite and yellow discolouration of conjunctiva. The attending physician suggested evaluation of liver functions of the patient. () Define and classify jaundice. (i) Describe the laboratory tests for jaundice and their clinical interpretation.

Describe the typical intercostal space.

Compare and contrast the features of Rapid Eye Movement (REM) and non-REM sleep.

Describe the prostate under the following headings: () Gross features (ii) Lobes (iti) Capsules and ligaments (iv) Blood supply (v) Lymphatic drainage (vi) Age changes

Describe the key events occurring in the ovarian cycle with reference to their hormonal basis. Enumerate the diagnostic tests for ovulation.

5 marks

Discuss the principle and steps involved in Polymerase Chain Reaction (PCR). Mention any five of its applications in clinical medicine.

Write a note on different vitamers of vitamin Bg and write their biochemical role in cellular metabolism.

Elaborate on the hormonal regulation of blood glucose level. Explain in brief the signs and symptoms of hypoglycemia.

20 marks

Describe the sources, RDA and biochemical significance of vitamin C. Write a note on clinical manifestations of vitamin C deficiency.

5 marks

Discuss the formation, course and branches of ulnar nerve.

5 marks

Describe the formation and tributaries of portal vein. List the sites of portacaval anastomosis.

Explain in detail the absorption and hormonal regulation of blood calcium in body. Discuss in brief the clinical manifestations of hypocalcemia.

20 marks

Describe the key mechanisms for regulation of cardiac output. Comment on the changes observed in moderate isotonic exercise.

Write in brief about hepatic segments.

5 marks

Enumerate all cranial nerve nuclei with their functional components.

Define 'metastasis'. Enumerate the steps involved in metastasis. Write briefly about the role of stromal elements in metastasis.

Explain the functions of each class of immunoglobulins. Describe the subsets of T-lymphocytes.

5 marks

List the intestinal and extraintestinal manifestations of amoebiasis.

Discuss about the longer acting insulin analogues. How are they different from insulin preparations? Mention the therapeutic uses and adverse effects of insulin.

Define chronic inflammation. Enumerate the causes of chronic inflammation. What is the role of macrophages in chronic inflammation?

Enumerate the data of identification. Write a note on fingerprinting.

Define ischemic heart disease. Enumerate four ischemic syndromes. Discuss the pathogenesis of myocardial infarction. Briefly describe infarct modification by reperfusion.

20 marks

State the therapeutic indications, drug interactions and side effects of the following drugs: (i) Methotrexate (ii)

Discuss the importance of CD, cell count and viral load in HIV infection.

Describe the antigenic structure of Salmonella typhi with its implication in diagnosis of enteric fever cases and carriers.

Define poison and classify it. Describe the treatment of venomous snakebite. Write a note on 'designer drug'.

Enumerate predisposing conditions for oral cancer. Describe the pathogenesis, molecular basis and morphology of oral cancer.

Describe the pathologic responses of the glomerulus to injury and pathogenesis of glomerulonephritis.

Elaborate the mechanisms of antimicrobial resistance.

Name the third and fourth generation cephalosporins. Mention their therapeutic indications.

5 marks

Describe the uniqueness of Pulse Polio Programme in India.

A 28-year-old man with history of HIV antibody positive brought to the emergency with headache and fever for three days. He also has a history of forgetfulness, irritability and confusion for the last two weeks. His cerebrospinal fluid examination shows numerous WBCs predominantly lymphocytes and budding yeasts with a wide capsule in Indian Ink preparation. (7) Write the most probable diagnosis in this case. (2) Describe the laboratory diagnosis of the condition. (3) Mention the predisposing conditions. (4) What is the treatment to be given to the patient?

Define 'injury' and 'hurt'. Enumerate the ingredients of 'grievous hurt'. Briefly differentiate 'hurt' from 'grievous hurt'.

Describe signs of 'asphyxia'. Enumerate the types of 'violent asphyxial deaths'. Briefly discuss about 'sexual asphyxia'. Enumerate the tests for confirmation of semen. State the modus operandi of collection of samples for detection of semen in alleged case of rape victim.

Discuss the artemisinin-based combination therapies for the treatment of malaria.

5 marks

Briefly describe the advantages of liposomal amphotericin-B over conventional amphotericin-B. 5 wk kk / 7 SB22—384

Discuss in brief the role of ultrasound in the investigation of pain in

Outline the pharmacological and non-pharmacological treatment of depressive disorders.

10 marks

A neonate born at 30 weeks of gestation is found to have tachypnea, chest retractions and grunt within 30 minutes of birth. (i) What is the most likely diagnosis? Mention the basis of your diagnosis and state briefly the pathophysiology of the condition. (ii) Describe the management of this condition.

10 marks

A 6-month-old infant attending paediatrics OPD is found to have central

What is the most likely cardiovascular condition? State its cardiovascular examination findings and accompanying

Write about the clinical course and complications related to this condition.

10 marks

An adolescent girl fond of wearing artificial jewellery presented with itchy, papulo-vesicular skin lesions on the ears, wrists and neck. (i) What is the likely diagnosis? (ii) Name the gold standard test which you would use for the confirmation of diagnosis. (iii) How would you interpret the test results? (iv) State the complications of this test.

10 marks

A sixty-year-old diabetic male presented to the emergency department with acute onset, central squeezing type of chest pain, which is severe in intensity and not relieving even after taking rest. (i) What is the most probable diagnosis? (ii) How will you investigate the case to reach the diagnosis? (iii) Outline the steps in the management of the case.

20 marks

A 12-month-old infant with history of delayed initiation of complementary feeding and few diarrhoeal episodes was found to have length of 72 cm, weight of 5 kg, mid arm circumference of 10 cm and loss of subcutaneous fat. (i). State the diagnosis. Under what severity of condition would you place this infant? (ii) Enumerate the complications associated with the condition. (iii) Describe the steps and phases of treatment.

15 marks

Write the atypical presentations of scabies. (ii) Describe the management of scabies in a neonate, in a child less than 2 years of age, an adult and a pregnant female. (iii) State the causes which can lead to persistent itching following the administration of scabicide therapy.

15 marks

A 40-year-old male who was bedridden for the last two months following a fracture in the lower limb developed sudden breathlessness. (i) What is the most probable diagnosis? (ii) How will you investigate the case? (iii) How will you manage the case?

20 marks

A term neonate born to 'O' negative blood group mother was found to have deep jaundice involving palms and soles, excessive crying and convulsions at 20 hours of life. (i) How would you assess the clinical severity of jaundice in this neonate? (ii) List the key investigations to arrive at the diagnosis. (iii) Describe the management of this neonate.

Give the clinical findings of lichen planus at the following sites

State the histopathological findings of oral lichen planus. (iii) Discuss the management of oral lichen planus.

15 marks

Discuss in short the etiology, diagnosis, treatment and complications of cirrhosis of liver.

20 marks

A 15-month-old child brought by the mother with history of 6 episodes of vomiting and 4 episodes of watery diarrhoea was found to have lethargy and is unable to drink. The child weighed 10 kg before this event of illness. (i) How would you assess the severity of the illness in this child? (ii) Write the fluid management in the first 3 hours. (iii) Write the treatment guidelines after 3 hours if the child still exhibits signs of dehydration. (iv) Write the composition and preparation of the WHO Oral

What is the differential diagnosis of psoriatic arthritis? How would you distinguish psoriatic arthritis from other conditions? (ii) Discuss the management of psoriatic arthritis.

10 marks

Briefly describe the clinical features, diagnostic workup and management of a patient of choledochal cyst.

10 marks

A 60-year-old lady presents to the casualty after a fall on her right outstretched hand. X-ray image is suggestive of Colles' fracture. (i) Briefly write the clinical features of this condition. (ii) Enumerate five complications of this fracture.

10 marks

Define Foetal Growth Restriction (FGR). (ii) List the common causes of FGR. (iii) Outline the strategy for managing a severely growth restricted pregnancy diagnosed at 26 weeks of gestation. This female has no living issues and has a past history of undergoing Caesarean

Define menopause. (ii) List the medical indications for prescribing Hormone Replacement

State briefly the controversies that have demerited the concept of

Dengue has become a major health problem for the country. The number of cases and disease severity have worsened over the years. Keeping this in context, answer the following questions: (i) What are the reasons which have led to a major shift in the geographic extent of dengue in the country? (ii) How is climatic change impacting the disease?

10 marks

Write in brief the reasons for rising Caesarean Section rates globally and in India. (ii) Discuss briefly the advantages and disadvantages of Vaginal birth and Caesarean Section. (iii) What measures can be adopted to reduce Caesarean Section rates? (iv) How will you counsel a patient who had previous Caesarean

A 55-year-old male, tobacco chewer, presents to OPD with difficulty in opening mouth for one month. On examination, he is found to be having poor oral hygiene and a white patch on right buccal mucosa. (i) Briefly describe leukoplakia and its significance. (ii) What are the premalignant conditions for oral cavity cancer? (iii) What are the different cervical lymph nodes which can get involved in a patient with oral cavity cancer?

15 marks

When is a protein said to be "biologically complete"? (ii) How do vegetable proteins compare and compete with animal proteins? (iii) What are proteins needed for in the body?

15 marks

A 60-year-old male presents with progressively increasing jaundice for 2 months. He is having clay coloured stools and pruritus. On examination, he is having a palpable and distended gall bladder. (i) How will you investigate this patient? (ii) Briefly mention Courvoisier's law and its exceptions. (iii) What are the treatment options for this patient?

20 marks

The Mother and Child Tracking System (MCTS) is a significant initiative of the government. (i) Briefly explain what is MCTS. (ii) What are its objectives? (iii) How is it being put into operation?

15 marks

How will you investigate a couple; wife 35 years, husband 37 years, married for 3 years, but trying for conception since 6 months? (ii) What are the major factors affecting fertility? (iii) Outline the treatment options available for unexplained infertility.

15 marks

Summarise the spectrum of Iodine Deficiency Disorders. (ii) State the goal, objectives and salient features of Iodine Deficiency Disorder Control Programme.

20 marks

What are the major changes that have been introduced under the

What are the different contraceptive methods employed by people in India? List them in the order of their usage stating the statistics of how commonly they are used. (iii) What measures can help increase the use of contraceptives in India?

15 marks

A 47-year-old female presents to the surgery OPD with a solitary nodule in the right lobe of thyroid gland. (i) How will you investigate this case? (ii) What is the ideal treatment if investigations are suggestive of follicular neoplasm? (iii) How will you follow-up a patient who has undergone total thyroidectomy for papillary carcinoma thyroid 5 days back?

How will you follow-up a patient who has undergone total thyroidectomy for papillary carcinoma thyroid 5 days back?

15 marks

Describe otic ganglion under following headings: (i) Location (ii) Roots (iii) Branches (iv) Role of its fibers in Frey's syndrome

With the help of a schematic diagram describe the process of excitation-contraction coupling in skeletal muscles. Add a note on Rigor mortis.

A 15 year old boy from city slum presented with complaints of low grade fever, vomiting and yellowish discoloration of eyes. The liver function test was done and the report is as follows: Total Bilirubin = 7-5 mg/dl (0-l - l-2 mg/dl) Direct Bilirubin = 3 mg/dl (0-] - 0-3 mg/dl) Indirect Bilirubin = 4-5 mg/dl (0- - -0 mg/dl) Alanine Transaminase (ALT) = 500 (< 35 IU/L) Aspartate Transaminase (AST) = 300 (< 40 IU/L) Alkaline phosphatase (ALP) = 250 (40 — 30 IU/L) (i) Write the most likely diagnosis and justify it with the findings. (ii) Classify jaundice on the basis of aetiopathology and write their main biochemical findings.

Describe the developmental causes of "primum" and "secundum" types of Atrial septal defects.

5 marks

Name the structures that constitute the placental membrane. (b) List the changes taking place in placental membrane in the later stages of pregnancy, which makes it more efficient.,

5 marks

Describe indirect inguinal hernia under the following headings: (i) Coverings and course of complete hernia (ii) Anatomical safety mechanism of inguinal canal (iii) Clinical features 0 3

Describe the anatomy of the Mammary gland under the following headings: (i) Extent — vertical and horizontal (ii) Blood supply (iii) Anatomical basis of metastatic dissemination to abdomen and cranium (iv) Sentinel lymph node mapping method and its role in breast surgery.

20 marks

Give an account of the factors that affect the formation and maturation of erythrocytes.

Describe the hormonal regulation of the development of breast and lactation. Draw a schematic labelled diagram of the milk ejection reflex.

Discuss the principle and the steps involved in Restriction Fragment Length Polymorphism (RFLP). Write any three applications of RFLP in clinical medicine.

Explain the role of vitamin-B, (Niacin) in biochemical processes. Write a note on its three main deficiency manifestations and the line of management.

5 marks

With the help of a neatly-labelled diagram describe the cortico-spinal tract from its origin to termination. Add a note on Upper Motor Neuron paralysis.

10 marks

Describe the pathophysiology and clinical features of Parkinson's disease. Give a brief account of the physiological basis of its treatment.

10 marks

Define blood pressure and describe the Neuro-endocrine regulation of blood pressure with the help of flow charts.

15 marks

Describe shoulder joint under the following headings: (i) Type and articulating surfaces (ii) Movements and muscles responsible for each (iii) Painful arc syndrome

5 marks

Describe the synthesis and functions of Vitamin-D in the body. Write a note on the deficiency disorders along with relevant laboratory investigations and line of management.

15 marks

Illustrate the structure of t-RNA with a suitable diagram and its role in protein synthesis.

5 marks

Describe the functional significance of atrio-ventricular nodal delay and add a note on Wolff-Parkinson-White syndrome.

5 marks

Give an account of the synthesis, release, regulation and functions of the hormones of the posterior pituitary.

10 marks

Describe Erb's palsy under the following headings: (i) Causes (ii) Structures involved (iii) Attitude of limb

Describe the embryological basis of Horse-shoe kidney.

Define cancer. Describe the four most important investigations for lab diagnosis of cancer.

A 20 year old man was admitted with fever, nausea, vomiting, headache, neck stiffness and confusion. CSF showed intracellular Gram negative diplococci. Write the most probable diagnosis in this case. Describe the processing of CSF sample to identify the aetiological agent.

Enumerate various oral antidiabetic drugs. Discuss the mechanism of action, therapeutic uses and adverse effects of Glibenclamide.

Define Diabetes mellitus. Describe the morphological changes that occur due to its complications in the following: e Vascular system e Kidney e Eye e Peripheral nerves

Classify burns and discuss its pathophysiology in detail. Discuss the injuries in the victims in a shopping mall fire and medicolegal formalities to be done by the district administration.

Define cirrhosis. Enumerate four common causes of cirrhosis.

Describe the aetiopathogenesis and morphological features (gross and microscopy) of Bronchogenic carcinoma.

Enumerate various non-selective cycloxygenase inhibitors. Discuss the mechanism of action, therapeutic uses and adverse effects of Aspirin.

15 marks

A 30 year old woman presented with step-ladder type fever for 7 days. On examina- tion, there was relative bradycardia, rose-spot rashes and hepatosplenomegaly. She was managed with probable diagnosis of enteric fever. Give details of tests to confirm the diagnosis of enteric fever in this patient.

15 marks

What are 'rave parties'? Discuss the magnitude of drug menace in younger generation in our country. What is NDPS Act?

20 marks

What are the ABO and Rh blood group systems? Discuss the various tests for blood and seminal stains in a rape victim.

15 marks

Discuss the general toxicities of anticancer drugs.

5 marks

Discuss the therapeutic uses and adverse effects of clonidine.

5 marks

Discuss the management of acute myocardial infarction.

Describe the laboratory diagnosis of intestinal amoebiasis. Enumerate the differences between amoebic and bacillary dysentery.

Describe the laboratory diagnosis of cryptococcal meningitis..

Discuss the tests you would perform for the diagnosis of HIV in the window period.

5 marks

Write the clinical features and lab diagnosis of chronic myeloid leukaemia.

20 marks

Discuss the mechanism of action and the therapeutic uses of

As per ICD-10 classification, describe briefly the types of schizophrenia. (ii) Enumerate the various catatonic Symptoms observed in schizophrenia and describe each in one line.

10 marks

Enumerate the various primary haemostatic disorders. (ii) Discuss the treatment of severe haemarthrosis of right knee in a 50 kg male suffering with Haemophilia A.

10 marks

An 18-month-old child weighing 7 kg has presented with history of diarrhoea, vomiting, rapid breathing and dehydration. How will you manage the child as per IMNCI protocol?

10 marks

A 12-month-old child has presented with cough, respiratory distress and noisy respiration. Enumerate their causes and the management.

10 marks

Parents of a 7-year-old girl noticed milky white macules on her upper eyelids and hands. Her mother had been recently diagnosed as a case of

What is the diagnosis for her skin lesions? Enlist the differential diagnosis of this clinical entity. (ii) Enumerate the disorders associated with this condition. (iii) How would you classify this disorder?

10 marks

What are the causes of "neonatal jaundice"? (ii) Outline the algorithm for its work-up. (iii) How will you manage a 34 weeks newborn at 7 days of life weighing 600 gm with hyperbilirubinemia? (iv) Enumerate the indications of exchange transfusion and outline the procedure.

Enumerate the indications of exchange transfusion and outline the procedure.

20 marks

What are the various causes of pleural effusion? (ii) How can we differentiate between transudative and exudative pleural effusion based on 'Light's criteria'? (iii) What is parapneumonic effusion? Enlist factors which indicate towards inserting a chest tube to manage a case of parapneumonic effusion.

15 marks

A 30-year-old male presented with well-demarcated erythematous plaques with silvery white scales on the knees and elbows. Grattage test was positive. (i) Enlist the differential diagnosis for various clinical forms of this disorder. (ii) State briefly the treatment options for this disorder, for mild, moderate and severe presentation. (iii) What are the various disease modifying factors for this skin disorder?

A 4-month-old infant presented with severe itching disturbing her sleep. On examination she had redness, papules and excoriations on the cheeks. Family history revealed asthma in mother since childhood. (i) What is the most likely diagnosis? (ii) What is the clinical presentation in different age groups? (iii) State its diagnostic criteria. (iv) Discuss first, second and third line of management and the non-medical measures for this condition.

20 marks

Enumerate the causes of cyanotic congenital heart disease and the ages of their presentation. (ii) How will you manage a 6 weeks infant presenting with cyanosis and congestive heart failure? (ii) How will you manage a 2-year-old child weighing 10 kg in a

Enumerate the commonly encountered serological patterns of Hepatitis-B infection along with the interpretation of each., (ii) Discuss the role of Tenofovir in the treatment of chronic

A 22-year-old male is bitten by a stray dog on his right leg. The bite was an unprovoked bite. (i) What are the immediate dos and don'ts for such a wound? (ii) As per the national guidelines on rabies prophylaxis, what are the categories of dog bite in humans and what are the recommended post-exposure prophylaxis in each? (iii) What are the clinical manifestations of rabies in humans? (iv) What are the intramuscular and intradermal regimens of anti-rabies vaccine as per national guidelines?

20 marks

An elderly female developed itchy, firm, shiny, violet, polygonal, flat topped papules on her wrists and ankles. (i) What could be the associated environmental factors for this disorder? (ii) What are its clinical variants? (iii) State its histopathology findings.

15 marks

Enumerate the common causes of under-5 mortality. (ii) Enumerate the vaccines preventing CNS infections in children and their schedule. (iii) What are the adverse events and contraindications of DPT vaccine?

15 marks

Describe in brief the clinical features, diagnostic work-up and management of a case of pheochromocytoma.

10 marks

Describe in brief the etiopathogenesis, clinical features and management of a case of amoebic liver abscess.

10 marks

A 35-year-old unmarried female presents with heavy menstrual bleeding since two years with severe anaemia. (i) Write the causes for this condition. (ii) Outline the management protocol of this patient.

10 marks

What are the advantages of vaginal births over caesarean section? (ii) What are the current caesarean section rates globally and in India? (iii) What, according to you, is the reason behind rising caesarean (iv) What are the implications of caesarean sections on future pregnancies?

10 marks

What is the significance of birth weight for an infant? (ii) Under the international standards, what is the definition of low birth weight? (ii) From the perspective of causation, how are low birth weight babies broadly grouped?

10 marks

Define Premature Ovarian Insufficiency (POD. (ii) How do you diagnose POI? (iii) Outline management for a 27-year-old woman with history of primary infertility presenting with POI.

20 marks

Write briefly about the medical management of peptic ulcer disease. (ii) Enumerate various surgeries for duodenal ulcer. (iii) Discuss in brief about the sequelae of peptic ulcer surgery.

15 marks

Name the States in India which continue to be heavily infected with

Under the National Filaria Control Programme, what is the strategy being adopted to achieve the elimination of lymphatic

Define the criteria which must be met to state that elimination of lymphatic filariasis has been achieved.

15 marks

A 35-year-old male is brought to casualty after suffering from blunt trauma chest. He is having significant hemothorax. (i) What will be the clinical picture of this patient? (ii) Write boundaries of triangle of safety. What is the rationale of underwater seal in intercostal drainage? (iii) What is 'Flail chest' and what is its significance? How will you manage it?

20 marks

State in brief how the National Rural Health Mission aims to fulfil the goals of Janani Suraksha Yojana at the community level. (ii) List the key areas of action proposed under the National Rural Health Mission which aim to make primary healthcare comprehensive and universal.

15 marks

Enumerate non-contraceptive usage of oral contraceptive pills. Gi) What are long-acting reversible contraceptives? Mention briefly their advantages over oral contraceptives. (ii) Define "Emergency contraception". What is their mechanism of action? (iv) Enumerate any two "Emergency contraceptives". How should they be prescribed for their maximum effectiveness?

15 marks

State in brief how dietary factors may influence the cardio-vascular health in adults highlighting the specific cause-effect relationship. (ii) Explain why vegans are more at risk to develop Vitamin By9 deficiency. State the ill-effects of Vitamin By deficiency on human health.

20 marks

Gs faster Ser ara Bet

SIT veda Ate A 30-year-old PjL,; woman presents to casualty with 7 month amenorrhoea and gives history of off and on bleeding per vaginum since 2 days. She has had one myomectomy three years back and has undergone one lower segment caesarean section one year back. (i) How will you evaluate her and what are your concerns? Gi) Outline the management protocol to optimize her outcome.

15 marks

A 45-year-old male is having pain and pus discharging wound near anus. On examination, he is found to be having fistula-in-ano. (i) What is 'Goodsall rule'? (ii) Briefly describe Park's classification system of fistula-in-ano. (iii) Outline the management of this condition.

15 marks

Discuss the Functional Components, Nucleus, Course, Distribution of Seventh Cranial Nerve.

A 52 year old chronic alcoholic man: has difficulty in his gait with imbalance and tendency to fall. Elaborate the underlying physiology of motor coordination and features of cerebellar dysfunction.

A 35 year old man presented with complaints of generalised weakness, loss of appetite and yellowish discolouration of eyes. The liver function test was done and ae the report is as follows: Total bilirubin: 0 mg/dL (0-l—-2 mg/dL) - Direct bilirubin: 9 mg/dL (< 0-3 mg/dL) Alanine transaminase (ALT): 3] IU/L (< 35 IU/L) Aspartate transaminase (AST): 33 IU/L (< 40 IU/L) Alkaline phosphatase (ALP): 800 IU/L (45—50 IU/L) (i) What is the most likely diagnosis and why? (ii) What will be the expected findings in urine and stool?

Enumerate palmar spaces of Hand.

Enumerate the Developmental Components of thoraco Abdominal Diaphragm.

Describe Bronchopulmonary segment of lungs. Add a note on the importance of organ transplantation.

Describe the knee joint under the following headings: l. Types, Articular surface 2. Ligaments 3. Relations 4. Blood supply and nerve supply 5. Movements

20 marks

Enumerate various hormones secreted by pituitary gland with their cell types.

5 marks

A 28 year old man noticed marked enlargement of bones of his hands and feet along with coarsening of facial features and prognathism. He was diagnosed as a case of pituitary adenoma. What ailment he is suffering from and its features? Describe physiological status of anterior pituitary hormones of this patient and its control mechanism. 10 3 SDF-U*MDCS

Discuss the principle and the steps involved in real time PCR. Enlist any five applications of PCR in medicine.

Explain the significance of selenium in biochemical processes.

5 marks

Describe the physiological mechanism involved in control and maintenance of tone, posture and equilibrium and its various anatomical structures and pathways.

Elaborate types and stages of sleep along with EEG findings. Describe neuronal and neurohumoral mechanism causing sleep with possible role of serotonin in it.

Discuss in detail the hormonal regulation of calcium and phosphate homeostasis. Add a note on the causes and clinical manifestations of hypocalcemia.

5 marks

Describe stomach under the following headings: 2. Gross features 3. Peritoneal and visceral relation 4. Blood supply and lymphatic drainage 5. Clinical anatomy

5 marks

Explain in detail the absorption and biochemical role of vitamin K in the body. Add a note on the deficiency manifestations of vitamin K along with relevant laboratory investigations for confirmation.

10 marks

Define clearance. Explain its significance and enumerate the methods available for its determination.

Illustrate a diagram of Neuromuscular function elaborating neuromuscular transmission and muscular contraction.

5 marks

Describe various Cardiovascular changes during physical exercises.

10 marks

Describe the gross anatomy, blood supply and applied importance of Thyroid gland.

8 marks

Enumerate the different types of myelineted fibers in the cerebral white matter.

Enumerate the Developmental Components of Inferior vena cava.

What are the major cell derived mediators of Inflammation? Describe their role in acute Inflammation.

Discuss the laboratory diagnosis of acute meningococcal meningitis.

Discuss the laboratory diagnosis of HIV in an asymptomatic individual.

Discuss general toxicity associated with the use of cytotoxic drugs.

What are the growth factors involved in Regeneration and repair of tissues?

Explain violent asphyxial death. Write about various types of violent asphyxial death.

Give the laboratory findings in a case of Acute Myeloid leukemia (PML/RARA): fusion gene type.

Give the etiopathogenesis, Gross and microscopic picture of Acute bacterial osteomyelitis.

What are different classes of oral hypoglycaemic drugs used in the management of diabetes mellitus? Discuss the mechanism of action, side effects and clinical uses of Discuss urea.

Discuss epidemiology, pathogenesis and laboratory diagnosis of Polio virus infection.

Enumerate infections caused by candida species. Suggest a laboratory approach for the diagnosis of invasive candidial infections.

What is DNA finger printing? What precautions should be taken while collecting various samples from living human being for this test? What is DNA Bill?

20 marks

Discuss the process of wound healing. What is the significance of stages of wound healing in Medico-legal cases?

5 marks

Fungal infections have been on the rise over the past few decades.

5 marks

Sudden withdrawal of Clonidine causes rebound hypertension.

5 marks

Artemether-Lumefantrine combination for treatment of malaria should be administered with fatty food.

5 marks

Briefly describe the pathogenesis and laboratory diagnosis of enteric fever.

10 marks

Describe in brief the life-cycle of Plasmodium vivax. How will you make a laboratory. diagnosis of malaria?

Give the pathogenesis, Urinary findings and Immunoflorescence picture in Acute; Post infection glomerulonephritis.

20 marks

Discuss precisely the mechanism of action, side effects and medical uses of the following

What are the investigations done to diagnose a case of Dengue fever? How are they useful on different days of illness? (ii) Write about the haematological tests done to monitor a case of uncomplicated Dengue fever between 3 — 7 days of illness. (iii) What are the indications of different blood components in the

Discuss in brief about the role of USG in the management of Liver abscess. (ii) Discuss in brief about the non-pharmacological management of Anxiety disorder.

10 marks

A 4-year-old girl is brought to you with fever and noisy respiration for last two days. Examination reveals a febrile, dyspnoeic child with a low-pitched sound heard during inspiration. Chest examination reveals conducted sounds. (i) What is the most likely diagnosis and differential diagnoses? (ii) Name the micro-organisms that can be considered in the etiology of this condition. (iii) Outline three major principles of management of this child, after hospitalization.

10 marks

A 2-year-old boy is brought with complaints of loose stools for 7 days, lethargy and inability to feed. Anthropometry of the child is as follows

Length 66 cm (expected weight for length 7:5 kg); Mid-upper arm circumference 10-0 cm.,] On examination, the child is having severe pallor and peripheral pulses were poorly palpable. (i) Identify four major problems (diagnoses) in this child and provide points in favour for each diagnosis. (ii) Outline the management of this child in first two hours after immediate hospitalization.

10 marks

An Asian HIV patient suffering from haematologic malignancy was put on carbamazepine for epilepsy/convulsions. After 3 weeks of therapy, he developed influenza like symptoms lasting 3 days followed by development of large number of bullae on skin and mucous membranes of mouth, eyes and genitalia. On examination, skin involvement was } extensive and very painful. Nikolsky sign was positive. (i) What is your diagnosis? Justify in points. (ii) What are the possible risk factors in this patient?: (iii) How will you assess the severity of the disease?

10 marks

Discuss in brief about the utility of GeneXpert in the management of Tuberculosis. (ii) What is the limitation of GeneXpert in the treatment of Pulmonary

What advice would you give to a 50-year-old diabetic male for prevention of Ischaemic heart disease?

20 marks

A 3-year-old child presents with history of loose stools for last 20 days, that started as an acute infective diarrheal episode. On examination, the child appeared sick looking, irritable, undernourished, and having some dehydration. There was marked perianal excoriation. Systemic examination is essentially within normal limits. (i) What is your complete diagnosis? Justify the same. (ii) Discuss the probable etiopathogenesis leading to the present

Outline the principles of stepwise management of this child, in brief.

15 marks

Describe pointwise management of a case of Stevens-Johnson

What is the mortality rate in SJS and Toxic Epidermal Necrolysis.

What is the risk of development of Cirrhosis of liver in the course of

Discuss four common acute complications of Cirrhosis of liver. (iii) A 30-year-old male, known case of Bronchial Asthma, presented to the emergency with the complaints of breathlessness for the past one day and is not in a position to even speak out a sentence. Outline the management of this patient.

20 marks

A 2-year-old boy was hospitalized with episodes of excessive crying and extreme bluishness of the body during these episodes. There is a history of 4 such episodes in the last 6 months. Examination reveals cyanosis, clubbing and conjunctival suffusion. Oxygen saturation was 75% in all four limbs. After stabilization, examination revealed normal S,; and single So. There was a grade 3 ejection systolic murmur at left upper parasternal border. (i) What is the likely diagnosis? Justify. (ii) Outline the principles of management of acute episode of extreme bluishness, precipitated by excessive crying, in this child. (iii) Describe the palliative surgical options available to treat this condition.

What is the likely diagnosis? Justify. (ii) Outline the principles of management of acute episode of extreme bluishness, precipitated by excessive crying, in this child. (iii) Describe the palliative surgical options available to treat this condition.

20 marks

A patient develops an acute vesicular reaction on scalp after using 'Henna' as black dye for colouring his hair. (i) What is your diagnosis? Describe the gold standard test done to confirm this condition. (ii) What all chemicals in Henna can cause this condition? (iii) How will you treat it?

10 marks

Describe in brief about prevention, investigation and treatment of

Discuss in brief about the indications of Electro Convulsive

A 32-week-old boy (birth weight 1300 grams) was delivered by caesarean 18 hours before delivery. The newborn developed tachypnea, soon after birth with chest retraction and grunting. (i) What is the likely diagnosis in this newborn? Also give 2 differential diagnoses. (ii) Outline the steps of diagnostic work-up required to establish the diagnosis. (iii) Describe the principles of management of this child.

15 marks

Enumerate various major clinical forms of Psoriasis. (ii) What are the clinical patterns of joint involvement in Psoriatic Arthritis? (iii) What are the systemic co-morbidities with Psoriasis? (iv) Describe classic histopathology findings in Psoriasis.

15 marks

A 60-year-old male presented to OPD with pus discharging ulcer over his right great toe for the last 1 month. He is suffering from uncontrolled diabetes for 10 years. (i) How will you investigate this patient? _(ii) Briefly describe the management of this condition. (iii) How will you differentiate between arterial ulcer and venous ulcer?

Describe causes, clinical features and management of pelvi-ureteric junction (PUJ) obstruction in a 12-year-old male child.

10 marks

What are the maternal risks in breech presentation? (ii) Does external cephalic version reduce the incidence of breech and caesarean delivery and perinatal mortality? (iii) Why is external cephalic version recommended at 37 weeks of gestation and not before?

What is gestational hypertension?

What is the role of antihypertensives in pre-eclampsia?

10 marks

Home Based Newborn Care (HBNC) is a strategy which aims at improving newborn survival. In the context of this strategy, answer the following questions: (i) What are the major responsibilities of ASHA in delivery of HBNC? (ii) What is the specified schedule under which ASHA is expected to visit the newborn in a case of home delivery?

10 marks

What is physiological anaemia of pregnancy? (ii) Do all pregnant women need additional iron? Explain in brief. (iii) What is the diagnostic test of iron-deficiency anaemia in pregnancy and why? |, (iv) How much total additional iron is required during pregnancy and what is its distribution in the mother's body?.

20 marks

A 23-year-old lady presented to OPD with diffusely enlarged thyroid for last 3 years. She also has a history of heat intolerance and increased appetite. (i) How will you work up this patient? (ii) Enumerate the eye signs in Graves' disease. (iii) Briefly describe the medical management of this condition.

15 marks

What do you understand by the term "Antenatal Pediatrics"? What are the various measures that can be undertaken to accomplish its primary objectives? (ii) Define "Low Birth Weight" (LBW). Enumerate the public health measures that can help to reduce the burden of LBW babies in the community.

15 marks

An 18-year-old male presented to casualty with massive upper GI bleed. On examination, he is found to be having ascites and enlarged spleen. (i) Briefly describe the management of this case. (ii) Enumerate the causes of portal hypertension. (iii) What is "OPSI" and how can it be prevented?

20 marks

In reference to human nutrition, various Expert Committees of WHO have made recommendations regarding dietary goals. On the basis of these recommendations, what constitutes a 'prudent' or ideal' diet in a normal person? (ii) In reference to pediatric nutrition, define the term "Stunting". What is it indicative of? What are its causes?

15 marks

Why do women become less fertile after the age of 35 years? (ii) Why are two semen samples collected 3 months apart. in the investigation of infertility? |, (iii) What points in a woman's history would suggest a tubal problem causing infertility?

15 marks

Drug-resistant tuberculosis has emerged as a major public health - challenge before the country. Keeping this in context, answer the following questions: (i) What are the major culpable factors which have led to this situation? (ii) To limit the burden of multi-drug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in the community, public health experts have drawn a 7-point plan of action. State those 7 points in brief. (iii) List the subgroups of tuberculosis patients currently eligible for receiving treatment with a Bedaquiline containing regimen.

20 marks

(i) A woman forgot to take her pill last night and is worried about the risk of pregnancy. She is on combined oral contraceptives. If she seeks your advice, what will it be? (ii) What is meant by the "Pearl Index"? (iii) Which contraceptive methods have lowest "Pearl Index"? (iv) What are the criteria for an ideal contraceptive?

15 marks

A 50-year-old male presented with fluctuating jaundice and melaena for last 3 months. He is also giving history of itching and clay coloured stools. (i) How will you investigate this patient? (ii) What is the differential diagnoses in this case?

Discuss the Functional components, Nucleus, course and distribution of 4th cranial nerve. Add a note on its clinical significance.

10 marks

What are extra pyramidal tracts? Describe their functions. How do they differ from pyramidal tracts?

10 marks

What is the regulatory mechanism of iron absorption at the level of intestine? What is the role of TIBC in iron metabolism? How does the body conserve iron?

Classify Arches of foot, Write in details about medial longitudinal Arch.

10 marks

Give an account of characteristics of a hormone. Describe the hormonal regulation of calcium level in the blood.

10 marks

Describe Hip Joint under the following headings: 20 Articular surface and Types

Blood supply and Nerve supply

Explain regulation of megakaryocytopoiesis.

5 marks

Define the term "cardiac reserve". Explain how is its control governed?

10 marks

Describe briefly

Role of PCR (Polymerase Chain Reaction) in the diagnosis and management of Mycobacterium tuberculosis.

Flat #? Role of iodine in synthesis and function of thyroid hormone, What is Graves Disease?

5 marks

Explain the changes which takes place during luteal phase of menstrual cycle.

10 marks

What are modes of contraction in a skeletal muscle? Give suitable examples. Explain length-tension relationship in skeletal muscle.

10 marks

Describe the principle of Radio Immuno Assay (RIA). What are the main advantages and disadvantages of RIA technique.

8 marks

What is folate trap? What are the methods of assessment of vitamin B), deficiency,

Describe the External, Internal features, parts of cerebellum. Add a note on the

Describe the structure of tRNA in detail, What is the energetics of synthesis of one peptide bond? What are the mhibitors of protein synthesis?

Give an account of monophylactic theory of haemopoiesis.

8 marks

List growth promoting hormones. Explain their contribution to growth after birth.

Write down the Development of placenta, discuss the functions and anomalies of it.

Describe the Coronary Arteries. Add a note on cardiac dominance.

8 marks

Define impaired glucose tolerance. Discuss the pathogenesis of Typel diabetes mellitus.

Discuss the strategic plans laid down by NACO for diagnosis of individuals with AIDS indicative disease symptoms.

5 marks

Discuss the adverse effects associated with the use of antimicrobial agents.

10 marks

Describe risk factors identified for breast carcinoma.

5 marks

Discuss molecular subtypes of invasive breast carcinoma.

5 marks

Define 'Head Injury', What ts the mechanism of 'Coup' and "Contre Coup' brain damage.

Discuss briefly the formula used for calculating the "Total Body Surface Area' involved in burns in an adult and a child.

5 marks

Define nephrotic syndrome and enumerate its components. Discuss pathogenesis, histopathological, electron microscopic and immunofluorescence findings of

Describe the pathogenesis of granulomatous immune response in tuberculosis. Discuss gross and histomorphological features of central nervous system (CNS) tuberculosis.

10 marks

What are different classes of drugs used in the treatment of hypertension? Discuss the mechanism of action, clinical uses and adverse effects of Sodium nitro

Write the laboratory diagnosis and complication of Plasmodium falciparum infection.

Enumerate species of Aspergillus, infections caused and laboratory diagnosis of

Define 'Rape' as per Criminal Law Amendment Act, 2013. An 11 yr old girl is brought to casualty with alleged history of rape 2 hours ago. Discuss the medico-legal examination in detail, including the samples that are to be collected.

Write a short note on the management of a case of aluminium phosphide poisoning.

Enumerate 6 major Blood Groups. Give the Mendel's laws of inheritance of the blood groups and their role in disputed paternity testing.

Aspirin should not be administered concurrently with warfarin

5 marks

Patients chronically administered morphine remain constipated.

5 marks

Discuss the epidemiology, pathogenesis and laboratory diagnosis of a patient presenting with bacillary dysentery.

Write short note on

Interferons and their uses arm & cart ere 4 nite sepals sei at quit are wes ware are aagT Define metastasis. What are the different pathways for the spread of cancer? Draw a flowchart describing the sequential steps involved in the hematogenous spread of a tumor. pathological features of CML-chronic phase.

5 marks

Discuss precisely the mechanism of action, clinical uses and side effects of the following ¢

10 marks

Enumerate the causes of acute hepatitis.; (ii) What are the natural history and clinical manifestations of chronic hepatitis-C infection? (iii) What are the direct acting antiviral agents for hepatitis-C infection?

What are the direct acting antiviral agents for hepatitis-C infection?

10 marks

A 10-month-old infant with "Tetralogy of Fallot" is brought to the paediatric emergency ward with history of excessive crying and then becoming dyspneic, drowsy and bluish. (i) What is the likely diagnosis in this infant? Mention the basis for diagnosis. (ii) Describe the management of this condition.

10 marks

Describe the aetio-pathogenesis, clinical features and management of "Bipolar Disorder". (ii) Enumerate the side effects of commonly used anti-psychotic drugs.

A 16-month-old child attending Paediatrics OPD with past history of diarrhoea and respiratory infections was found to have loss of subcutaneous fat and weight of 5-5 kilograms. (i) Which physical examination findings would help you to arrive at diagnosis in this child? (ii) Describe the two phases of treatment for this condition.

10 marks

How does Classical scabies differ from "Crusted" scabies infection? (ii) How do you treat "Crusted" scabies infection in an institution?

A middle-aged hypothyroid woman on irregular medication became drowsy two days ago following an episode of fever. (i) What could be the causes of drowsiness in this patient? (ii) How will you diagnose and manage the patient? (iii) State cardio-vascular manifestations in hypothyroidism.

15 marks

A 10-month-old infant having watery nasal discharge for the last 2 days developed rapid breathing, chest retraction and decreased feeding over the last one day. (i) What is the likely diagnosis in this patient 7 (ii) Enumerate the microbiological agents for this condition. (iii) Discuss the investigations and management of this condition.

15 marks

Describe various theories which have been proposed to explain the

How do you assess the severity of vitiligo? (iti) Deseribe the lines of treatment of various grades of the disease. eet fates fem ere?

A young male patient carne to the medical emergency department with fever, headache and recurrent vomiting. He was also having some skin lesions on both lower limbs and abdomen. On clinical examination, he was drowsy and having neck rigidity. (i) What is his differential diagnosis? (ii) Discuss in brief the clinical manifestations, diagnosis and management of acute meningitis. (iii) What are the causes of recurrent meningitis?

15 marks

A 32-week preterm neonate born by a Caesarian section is found to have a respiratory rate of 70/minute, grunting and cyanosis within half an hour of birth, Gi) What is the most likely diagnosis in this neonate? (ii) Describe the management of this condition. (iii) Write about its important complications.

20 marks

A young woman presented to the emergency department with a history of pesticide intake, She has massive frothing from the mouth and nose, (i) Which is the pesticide she is likely to have consumed? Gi) State what would be the clinical features and management in this patient. (ii) Define the "Intermediate Syndrome" which may occur in this setting and its management.

A 13-month-old boy was brought by his mother with six episodes of loose stools and persistent vomiting to the emergency ward, He was found to be lethargic and his pulse rate was 160 per minute. Gi) What are the danger signs you would ask for and look for in this child to assess the severity of his illness? (ti) Ifyou find severe dehydration, how will you treat the child? (ui) If the child is fit to be discharged, yet has 2 — 3 episodes of loose stools, what advice would you give to the mother?

15 marks

What are the current guidelines regarding the classification of hypertension? (ii) Enumerate the causes of secondary hypertension. (ii) Enumerate the various anti-hypertensive drugs based on their mechanism of action.

20 marks

A 70-year-old male, bed-ridden for the last 2 weeks following a fracture of the femoral neck, presented to the medical emergency department with sudden breathlessness and hypotension, Gi) What is the likely diagnosis? (ii) How would you diagnose this patient? (iii) What would be the management for this patient?

15 marks

A 40-year-old lady presents in the OPD with complaint of right breast lump for the last one year which is progressively increasing in size. Gi) How will you evaluate this patient? (ii) Briefly outline the treatment of "early breast cancer".

10 marks

A 25-year-old young patient is presented to the emergency department with severe pain in abdomen for the last 3 hours. On clinical examination, the patient is oriented, but is dehydrated, having tachycardia with a blood pressure of 90/60 mm Hg. (i) Discuss the differential diagnosis of this patient. Gi) How will you investigate the case? (iii) Briefly outline the management of peptic ulcer perforation peritonitis.

Diseuss the differential diagnosis of this patient. Gi) How will you investigate the case? (iii) Briefly outline the management of peptic ulcer perforation peritonitis.

10 marks

How do combined oral contraceptives (COC) work? (ii) How long can a woman stay on COC? (ii) What effect do the COC have on the menstrual cycle? (iv) What is meant by "breakthrough bleeding"? What are its common causes?

10 marks

What are the possible reasons for "unexplained" infertility?

Discuss in brief the epidemiological factors which have led to the spread of dengue in different parts of the country. (i) Discuss in brief the guidelines laid down by the Directorate of National Vector Borne Diseases Control Programme for the prevention and control of dengue.

10 marks

Write notes on issues you would raise in counselling a woman about to be delivered at 28 weeks gestation after placental abruption.

20 marks

A 40-year-old male patient is presented with hematuria off and on for the last 4 months. (i) Enumerate the causes of hematuria. (ui) How will you investigate the patient to reach the diagnosis? (iii) Discuss the treatment of renal stones.

As per the National Family Health Survey-4, how grave is the situation in India with regard to Nutritional Anaemia. Give statistics substantiating your statement. (ii) Under the "National Iron+ Initiative', which are the specific groups being specially targeted? (i) What specific interventions are being employed for different target groups under the National Iron+ Initiative? (iv) What are the mechanisms of service delivery being employed to implement the National Iron+ Initiative?

Describe the aetio-pathogenesis, clinical features, investigations and management of varicose veins of lower limbs.

20 marks

Briefly state the basis which led to setting up of the programme "Mission Indradhanush". What are its targets and eventual pfoals? (ii) More recently, the government has launched "Intensified Mission Indradhanush". Discuss the thoughtline, specific focus, and operative strategy which govern its implementation.

More recently, the government has launched "Intensified Mission Indradhanush". Discuss the thoughtline, specific focus, and operative strategy which govern its implementation.

A 45-year-old multiparous woman presenta with a 2-year history of heavy, irregular periods and increasing tiredness. On clinical examination, she appears pale. The uterus is enlarged to 12 weeks in size. The cervix and adnexae are unremarkable. Describe, giving reasons, how you would manage the case.

15 marks

A high maternal mortality rate continues to be a major public health challenge before the country, Keeping that in context, answer the following questions: (i) How is "Maternal Mortality Rate" (MMR) defined? State the major causes of maternal mortality in the country. (i) The recent data indicates a major decline in MMR in the country, Briefly state, with due reasons, the various governmental initiatives which have led to this favourable decline in maternal mortality rate in India. (ii) The government has grouped the different states in the country in a specific manner to obtain a greater understanding of the ground situation and to map the changes following its initiatives, Briefly outline this strategy, and its benefits.

20 marks

How does the pattern of rise in human chorionic gonadotropin (HCG) differ between a normal and abnormal pregnancy? (ii) How accurate are most home pregnancy tests? (i) What are the most common causes of false positive and false negative pregnancy tests?

15 marks

Enumerate the indications and complications of colonoscopy. (ui) Outline the principle of primary survey in trauma. (ili) Enumerate the advantages and disadvantages of "laparoscopic surgery'.

15 marks

Write in short about Embalming.

10 marks

Describe microscopically, the cellular components of lungs. Add a note on fetal distress syndrome.

10 marks

Describe the developmental component and nerve supply of the tongue.

10 marks

Describe the functions of spinocerebellum.

10 marks

Tabulate the findings of various biochemical tests in blood and urine of patients of pre-hepatic, hepatic and post-hepatic jaundice.

10 marks

Describe how iron is absorbed, transported and stored in our body. Give the different tests done to assess status of iron in the body.

20 marks

Enumerate the sites for formation of erythrocytes in the embryo, foetus and adults.

5 marks

Describe the characteristic changes in the cytoplasm and nucleus during erythropoiesis.

Describe in detail about hepatic spaces in relation to peritoneal reflection. Add a note on its applied importance.

10 marks

Describe blood supply of brain stem and add a note on its applied importance.

Describe the functions of basal ganglia in voluntary actions.

10 marks

Compare the functions of basal ganglia with primary cortex.

10 marks

Describe the gross anatomy, innervation and applied importance of the urinary bladder. Add a note on autonomous bladder.

15 marks

Discuss the principle of 'Polymerase Chain Reaction (PCR)' technology - and outline the steps involved. Write its clinical application.

15 marks

Describe the shoulder joint under the following headings

15 marks

Give the anatomic basis of black eye.

Show the sucking reflex through a diagram. Describe positive and negative feedback actions of estrogen.

8 marks

Describe baroreceptor reflex mechanism in the regulation of blood. pressure.

Justify the statement 'Vitamin D is a hormone'. Describe the synthesis, mechanism of action and physiological functions of vitamin D.

15 marks

Define neoplasm. List five differences between benign and malignant

Explain the challenges in epidemiology and control measures in malaria. Discuss its laboratory diagnosis.

10 marks

Discuss acute paracetamol poisoning emphasizing on mechanism of toxicity and its treatment.

10 marks

Describe the gross and microscopic appearance of post-primary tuberculosis of lung.

10 marks

How will you assess that the injury is 'Grievous Hurt' as per Section 320 of the Indian Penal Code? Illustrate with examples.

10 marks

Describe the gross and microscopic features of acute proliferative glomerulonephritis.

Describe in brief the etiopathogenesis of squamous cell carcinoma of cervix.

10 marks

Describe the mechanism of action of sulfonamides. Also describe which methods bacteria employ to develop resistance to it.

15 marks

What are the factors responsible for invasive candida infection. Briefly describe the laboratory diagnosis of bloodstream candida F infection.

Name opportunistic fungal (two) and parasitic (two) agents causing infections in an HIV patient. Describe the laboratory, diagnosis of any one of them.

5 marks

A 16-year-old girl has been brought for medical examination to the hospital by the police with alleged history of rape. How will the medical officer proceed to examine her? Describe the possible findings. What are the specimens preserved to establish the alleged crime?

20 marks

Discuss the clinical features, management and post-mortem findings in a case of cyanide poisoning.

15 marks

Explain the reasons for the following

Beta blockers should not be given with Verapamil.

5 marks

Discuss the pathogenesis of enteric fever. What are the different. mechanisms by which salmonella acquires antimicrobial resistance?

10 marks

Define immunological tolerance and discuss its role in autoimmunity, with one example.

10 marks

A 40-year-old chronic alcoholic male presents himself with ascites, splenomegaly, jaundice and hematemesis.

What is the likely disease in the liver?

What is the reason for hematemesis?

Describe the gross and microscopic features of the liver in this case.

10 marks

Discuss briefly the mechanism of action, uses and side effects of the following

15 marks

A young 23-year-old lady had attempted suicide thrice in last one year. What is the cause of her condition? How do you diagnose and manage Major Depressive Disorder?

A 40-year-old man gives history of gradual loss of weight and altered bowel habits for last two years. What differential diagnosis would you consider? How will you manage Idiopathic Tropical Malabsorption Syndrome?

What are the principles of Echocardiography? What is its diagnostic significance?

A baby is delivered at 34 weeks of gestation; develops respiratory distress soon after birth. (i) List the important causes of respiratory distress in this baby. (ti) Mention the pathogenesis of Respiratory Distress Syndrome. (ti) Outline the management of the baby.

Mention the important causes of mortality in children under 5 years of age.

Enlist the vaccines which can reduce the incidence of Acute Respiratory Infection in children.

Mention the measures to reduce mother to child transmission of HIV (Human Immunodeficiency Virus) infection.

A 70-year-old man was found comatose on the road by a passerby. There were no external injuries. He was brought to the casualty. What are the common medical conditions in his case? How will you manage Diabetic 2-month-old

20 marks

A 2-month-old infant presents with Central Cyanosis. He had two episodes of cyanotic spells. () Enlist the differential diagnosis of Congenital Cyanotic Heart Diseases with reduced pulmonary blood flow. (ii) Mention the complications of Congenital Cyanotic Heart Diseases. (iii) Outline the management of a cyanotic spell.

5 marks

A 45-year-old gentleman, agriculturist by occupation, presents with recurrent itchy scaly lesions over face and limbs of one year duration. Examination revealed hyperpigmented scaly lesions over face, neck and upper and lower limbs. There were involvement of skin creases, eyelids, retroauricular areas and nasolabial folds. He gave history of photosensitivity. (i) What is your likely diagnosis? (ii) What tests will you perform to establish the cause of his condition? Describe in brief. (iii) How will you treat this gentleman? 5+5+5=5 ST Ih-B-JNBCS/37 3

A 30-year-old labourer, with high fever of three days duration, was brought to emergency in hospital in semiconscious state. (i) What are the likely causes for it? (ii) How will you diagnose and manage Japanese Encephalitis? (iii) What are the bad prognostic indicators for it?

20 marks

A 4-year-old child presents with stunted growth and moderate pallor. The child had history of intermittent diarrhoea. (i) Mention the differential diagnosis. (ii) Mention the investigations required for diagnosis of celiac diseases. (ii) Outline the management of celiac diseases in children.

5 marks

A 30-year-old female presents with itchy lesions over upper and lower limbs of one month duration. On examination, multiple discrete flat-topped skin- coloured and violaceous papules were present around ankles, wrist and forearms. (i) Which other areas will you examine to arrive at a clinical diagnosis? (ii) What are the tests will you perform to confirm the diagnosis? (iii) How will you treat this lady?

5 marks

A 20-year-old young man was brought to the casualty with severe headache. His blood pressure was 220/30 mm of Hg. On previous two occasions also his BP was recorded very high. = What is the differential diagnosis? How will you investigate and manage him?

20 marks

A 3-year-old child presents with generalized oedema. (i) Enlist the differential diagnosis. (ii) Mention the investigations required for diagnosis of Idiopathic Nephrotic Syndrome. (iii) Outline the treatment of Steroid-Resistant Nephrotic Syndrome.

15 marks

A 5-year-old male child presents with generalized itchy excoriated papules over trunk, limbs and genitals of two weeks duration. There were few papulovesicles on palms and soles. His other sibling had similar skin problem. (i) What is the likely diagnosis? (ii) What is the cause for his condition? (iii) Enumerate the various topical preparations available to treat this condition. Describe the method of application of one preparation.

5 marks

A 40-year-old female fair in colour presented in casualty department with ' history of severe upper abdominal pain and vomiting after heavy fatty meal. On examination, tenderness is present in right hypochondrium. (i) What is the diagnosis of the above-mentioned clinical condition, its etiopathogenesis and differential diagnosis? (i) Outline the management of chronic cholecystitis with cholelithiasis.

A 75-year-old male presented with acute retention of urine with haematuria. On per rectal examination, hard nodular prostatic enlargement is present. (i) Discuss the diagnosis and its investigation. (ii) Outline the management of the above-mentioned condition.

Enumerate commonly used methods of female sterilization. What are the advantages and disadvantages of each method?

Define Assisted Reproductive Technology. Mention briefly the commonly used reproductive technologies. What are the indications and contraindications of each method?

What are trans-fatty acids?

Which foods are major source of trans-fatty acids?

What is the significance of trans-fatty acids from public health viewpoint?

Define Postpartum Haemorrhage (PPH). What are the causes of PPH? How would you manage the case of PPH just after delivery? Discuss the preventive measures for control of PPH. 2+4+7+7=20 ST ih-B-JNOBCS/37

Discuss the causes of Benign Breast Disease, its investigation and management of bilateral fibroadenosis with mastalgia.

5 marks

What are the primary objectives of Janani Suraksha Yojana'?

What are the salient features of this scheme?

What is the 'Vande Mataram Scheme'? How is it related to the Janani Suraksha Yojana?

5 marks

A 25-year-old male presented with history of off and on central abdominal distension with evening rising temperature and weight loss. On abdominal examination, firm, non-tender lump is present in right iliac fossa. () Discuss the differential diagnosis of the above-mentioned case. (ut) Mention the investigations and its findings. (tii) Outline the management of ileocaecal tuberculosis.

20 marks

Under the National Rural Health Mission (NRHM), what are the changes being carried out in the rural healthcare infrastructure in order to strengthen it?

Which of the existing programmes of Health and Family Welfare have been integrated into the National Rural Health Mission?

5 marks

Enumerate the common causes of menorrhagia in a 40-year-old woman. What are the different types of fibroid uterus? How would you manage the case of a 40-year-old woman suffering from menorrhagia due to fibroid uterus? 5+3+7=5 ST ih-B-SNBCH/37 7 [?2/70,0.

The End TB Strategy' is a logical evolution and a paradigm shift from the past global TB strategies. (i) What are its vision, goal, milestones and target indicators that are set to be achieved in specific future years? (ii) What are the major hurdles which stand in its success? (iii) What steps are required to overcome these hurdles?

20 marks

Define prolapse of uterus. Enumerate different degrees of prolapse of uterus. Enumerate the factors leading to prolapse of uterus. How would you manage the case of 3rd degree uterovaginal prolapse in a 38-year-old woman who has completed her family?

15 marks

A 35-year-old male 'sustains road traffic accident. On general examination, he is oriented and pale, pulse rate 120/minute, BP 90/60 mm of Hg, respiratory rate 32/minute. Chest contusion is present and right chest wall with decreased movement. On auscultation decreased breathing sound (Rt) with stony dullness (Rt) on percussion. (i) Discuss the differential diagnosis. (ti) How would you investigate? (iti) Give the treatment of the above-mentioned clinical scenario.

Describe dermatomes of lower limb.

Describe the development of interatrial septum.

Draw a diagram to depict blood flow in left versus right coronary artery.

Discuss the neurophysiological basis of sleep.

Give the role of vitamin C in scurvy and cholesterol metabolism.

Enumerate the thyroid function tests. Give the biochemical findings in hyper

Describe the process of thrombolysis. Write briefly about anti-coagulants.

Give a brief account of ulnar nerve.

Describe the role of cerebellum in regulation of posture and movement. What is

Describe the cutaneous nerve supply of dorsum of foot.

Outline the biochemical functions and the deficiency symptoms of sulphur- - containing vitamins.

15 marks

Describe the hip joint under the following headings

20 marks

Classification )

Name the hormones secreted by pituitary gland. Describe the role of growth hormone in the body.

15 marks

What is the basic principle behind the RFLP technique? Outline the clinical applications of RFLP.

What are sequential myocardial changes in myocardial infarction?

Describe pathogenesis and laboratory diagnosis of extra-intestinal amoeblasis.

Discuss the mechanism of COX-2 inhibitor induced cardiovascular toxicity.

Discuss the laboratory investigations in a case of myocardial infarction.

Discuss the physiological action, clinical features and post-mortem findings in a case of death due to alprazolam poisoning.

What is 'dysplasia? How will you differentiate it from metaplasia?

20 marks

Discuss the pathogenecity and laboratory diagnosis of meningococcal meningitis.

15 marks

Describe various possible injuries and cause of death in case of successful hanging.

20 marks

Define rape and write about various tests to detect semen. liposomal amphotericin-B is preferred over conventional formulation of the drug in the treatment of systemic mycosis low-dose aspirin is used for the prevention of re-infarction.

Describe laboratory diagnosis of AIDS.

Describe laboratory diagnosis of cryptococcosis.

20 marks

Classify acute myeloid leukemia by FAB classification. What is the blood picture in a'case of acute promyelocytic leukemia?

Discuss briefly the mechanism of action, uses and side effects of the following

Discuss the principles of magnetic resonance imaging (MRI). In which conditions, has it a better diagnostic value than computerized

An 18-year-old young girl has attacks of restlessness, insomnia, cold sweating and fear. Discuss the differential diagnosis. Outline the principles of management of "generalized anxiety disorder".

10 marks

Describe the clinical features of bilirubin encephalopathy in early neonatal period. (ii) Enumerate the predisposing factors contributing to bilirubin encephalopathy in newborn infants. (iii) Name the long-term pathological and clinical sequelae of bilirubin

Define "Severe stunting" and "Severe wasting" in under-five children. (ii) Outline the diagnostic criteria for "Severe Acute Malnutrition" (1) in children between 6 months — 5 years of age; and (2) in infants below 6 months of age.

A housewife develops itching and irritation in the webs of the hands, following peeling/cutting of vegetables such as jackfruit and lady's finger. It is relieved slightly on washing with cold water.; (i) What is the likely diagnosis? (ii) Discuss the etiopathogenesis, management and prevention of this condition.

10 marks

An 80-year-old male, bed-ridden for three weeks, develops sudden onset breathlessness, becomes unconscious and was brought to the casualty. (i) Discuss the probable etiologies of this episode. (ii) Outline the investigations required for diagnosis and management. (iii) Describe the management of acute anterlor wall iyucardial infarction.

25 marks

Define "persistent diarrhoea" in under-five children. How is it different from "chronic diarrhoea"? (ii) Discuss the dietary management of persistent diarrhoea. (iii) Enumerate a few common causes of chronic diarrhoea.

15 marks

A young adult presents with erythematous, raised, scaly plaques of various sizes, all over the body, specially the extensor aspects. (i) What other areas will you examine and what clinical tests will you perform to clinch the diagnosis? (ii) Enumerate the involvement of other systems and their presenting features. (iii) List the drugs that can be used in cases not responding to the standard management.

10 marks

A 17-year-old girl, with a history of seasonal wheezing, off and on, presents to the casualty with sudden onset breathlessness. (i) Describe the etiopathogenesis of this condition. (ii) Discuss the short-term and long-term management of this disorder.

25 marks

Discuss the classification and identification of treatment of a young infant (age 6 weeks) with feeding problem and malnutrition, according to IMNCI case-management guidelines.

15 marks

Describe the clinical features of one non-infective and one parasitic,

Describe the histopathological features of the above conditions in a healthy adult and in immuno-compromised individuals.

10 marks

A 70-year-old patient with uncontrolled type-2 diabetes mellitus (of 20 years duration) presents with tingling and pain in the legs, blurring of the vision, weakness, easy fatiguability and bony pains. Investigations

What is the likely diagnosis? (ii) How will you classify the chronic kidney disease? (iii) Discuss the management of advanced renal failure.

25 marks

A one-year-old, previously healthy child presents with fever, cold and cough for three days. Mother complains of whistling sound during breathing. There is no history of similar episodes in the past. Examination reveals tachypnea, audible wheeze and hyperinflated chest. His oxygen saturation is 94%. (i) What is the most likely diagnosis and what are the probable micro-organisms causing this condition? (ii) Classify the severity of disease in this patient. (iii) Outline the principles of management of this child.

15 marks

A young adult male presented to the medical intensive care unit with extensive blistering lesions of skin and mucosal surfaces. This was preceded by a history of high-grade fever and malaise for seven days. (i) What is your diagnosis and suspected etiopathogenesis? (ii) Outline the steps of management and briefly state the prognosis.

Discuss the etiology, types, clinical features, investigation and treatment modalities of renal stone.

10 marks

A 30-year-old female presented with thyroid swelling. Her S. T3, T4 and TSH are within normal limits. Gi) Discuss the differential diagnosis of the thyroid swelling. Gi) Throw light on the investigation of the above mentioned condition. Gii) Discuss the management of papillary carcinoma of thyroid.

10 marks

Enumerate few commonly used methods for IS* Trimester abortion. Briefly mention the immediate and remote complications uf surgical method of abortion.

10 marks

What are the different types of oral contraceptive pills? What is the mode of action of oral pills? Write briefly the indications and contra-indications of taking the pill. Enumerate the side-effects of taking the pill.

10 marks

Enumerate various goals and targets set for Child Health in India.

10 marks

Enumerate the causes of unengaged head in a primi at 38 weeks of pregnancy. Describe different stages of labour. How will you diagnose each stage of labour? How will you manage a case of prolonged I** stage

A 50-year-old male presented with a history of haematuria and dragging discomfort in the left loin. On abdominal examination, it was found that he has Lt sided renal lump with Lt varicocele. (i) Discuss the differential diagnosis and investigation of the above mentioned condition. (ii) Mention the treatment of left-sided renal ccll carcinoma.

Discuss the differential diagnosis and investigation of the above mentioned condition. (ii) Mention the treatment of left-sided renal ccll carcinoma.

15 marks

Write briefly on 'Stop TB Strategy'.

15 marks

A 50-year-old male who is a chronic smoker presents with dry gangrene of Rt great toe and rest pain in Rt lower limb. On examination, it was found that his Rt dorsalis pedis artery pulse is absent. (i) Define chronic limb ischaemia and discuss the causes of lower limb gangrene. (ii) Discuss the management of the above mentioned condition.

20 marks

What is meant by Network Analysis? Write in brief about Programme Evaluation and Review Technique (PERT). What are the uses of PERT?

15 marks

Define DUB (Dysfunctional Uterine Bleeding). How would you manage a patient of DUB with 35 years of age who has completed her family?

15 marks

What are the components and uses of Health Information System? Enumerate briefly the different sources of health information.

20 marks

A primigravida patient reports in casualty at 34 weeks of pregnancy

How would you manage the patient? What foetal and maternal complications are associated with this condition?

15 marks

Discuss the clinical features, investigation and management of varicose vein in Rt lower limb.

15 marks