Medicine Sessional Question papers

Batch 16

Sem 6

1.A 43 year-old lady, a known patient of bronchial asthma complains of excessive weight gain for 6 months and amenorrhoea for the last 3 months. Her bronchial asthma, however, is well controlled. On examination she is obese, her skin is thin and multiple bruises are seen over her upper limbs. Her blood pressure is 170/106 mmHg.

a.What is the complete diagnosis? Justify.
b.Briefly explain the pathophysiological basis for at least 4 symptoms and/ or signs seen in her.
c.What are the other clinical features expected in this condition? [3+4+3]

2.Write short notes on: [3x5]

a.Clinical findings on examination of a patient with consolidation due to community acquired pneumonia.
b.Rheumatic fever
c.Causes and clinical features of left ventricular failure.
page tags: batch16 medicine mmmc questions

Batch 14

Sem 8

SECTION A
1. 35 years old male patient complains of Jaundice, gradual distension of abdomen, and pedal edema for 3 months. He is working in Bangkok and has history of intravenous drug abuse. He complains of vomiting blood of recent onset and from 4 days he has altered sensorium.
- What is the diagnosis?
- Name three most important investigations and explain the relevance of each, to this case.
- How do you treat this case?
10 marks (2+3+5)

2. 60 year old male complains of sudden onset of weakness of Right half of the body; power 3/5 in Upper limb and 4/5 lower limb. He has facial deviation to right side. He is right handed and also complains of inability to speak. He is old hypertensive and diabetic on Ramipril 5 mg with BP maintained at 140/90 and on Diamicron 80 mg bd and Mtformin 1 gm bd. On investigations, he has Sr. Creatinine level 250 umol/L and Fasting sugars 9 mmol/L, postprandial sugars 10 mmol/L with HBA1c 8 gm%. His pulse is irregular and has Mid diastolic murmur in the mitral area
- What is the diagnosis?
- Name three most important investigations and explain the relevance of each, to this case.
- How do you manage this case and what medications need to be modified?
10 marks (2+3+5)

3. Write short notes on: 5 marks each x 6 = 30
a. Rheumatoid arthritis
b. Diagnosis and management of Acute severe asthma
c. Complications of Chronic Renal Failure
d. Opportunistic infections in HIV patient
e. Management of Peptic ulcer
f. Paracetamol poisoning

SECTION B
1. 50 year old male, smoker complains of sudden onset of chest pain radiating to left arm with profuse sweating and not relieved by Sublingual Glyceryl trinitrate and chest pain is retrosternal, constricting and squeezing type.
- What is the diagnosis?
- Name three most important investigations and explain the relevance of each, to this case.
- How do you treat this case?
10 marks (2+3+5)

2. 48 years old female, known Ischemic Heart Disease patient on medications complains of breathless, pedal edema.
Her renal parameters are normal.
- What is the diagnosis?
- Name three most important investigations and explain the relevance of each, to this case.
- How do you treat this case?
10 marks (2+3+5)

3. Write short notes on: 5 marks x 6 = 30
a. Nephrotic syndrome
b. Anaemia
c. Chronic Myeloid Leukemia
d. SLE nephritis
e. Infective Endocarditis
f. Myasthenia Gravis

Sem 9

Section A

1. 65 year old diabetic, hypertensive lady presented with weakness left of the body, while walking, preceded by severe headache and blood pressure is 210/200 mmHg. On examination, power in the upper limbs is 2/5 and lower limb is 2/5.
a. What is your complete diagnosis (2)
b. Enumerate five important investigations that need to be done in her case ad why? (5)
c. Describe the treatment for her condition. (3)

2. Short notes: (5x3 = 15)
a. Describe the stepwise approach in treating Asthma.
b Describe Light's criteria. name four causes for exudative and two causes for transudative pleural effusion.
c. Compare and contrast treatment of unstable angina and MI.

Section B

1. 56 year old male chronic smoker presented with shortness of breath followed by cough productive of pink frothy sputum, abdominal distension and leg swelling, preceded by history of repeated chest pain episodes on walking, for which he has not taken medical consultation.
a. What is the complete diagnosis? (2)
b. Enumerate five important investigations that need to be done and why they should be done? (5)
c. How do you treat this case? (3)

2. Write short notes on: (5x3=15)
a Describe the treatment of Acne vulgaris.
b. Enumerate the causes of hyperkalemia and describe the treatment of it.
c. Describe the investigations to be done in a case of malabsorption syndrome.

Section C

1. 43 year old male chronic alcoholic presented with fever, cough productive of sputum for which he has been given Augmentin 1g BD for 5 days. He continues to have fever, shortness of breath. On examination, there is stony dull note on percussion over right lower lobe region, skin is red and there is local rise of temperature and increased tactile fremitus noted.
a. What is your complete diagnosis? (2)
b. Describe five important investigations that need to be done and why? (5)
c. How do you treat this case? (3)

2. Write short notes on: (5x3=15)
a. Describe the medical management of inflammatory bowel disease.
b. Treatment of Rheumatoid arthritis
c. Compare and contrast the different modes of treatment modalities for MI with respect to indications, golden period, contraindications and success rates.

Section D

1. 55 year old chronic alcoholic presented with massive hematemesis, malena, abdominal distension and jaundice. On examination BP is 90/60 mmHg, pulse is 140/min, deeply jaundiced, parotids enlarged, left lobe of liver more enlarged, hard in consistency. His GCS is 7/15.
a. What is your complete diagnosis? (2)
b. Describe five important investigations that need to be done and why? (5)
c. Describe the medical management of this case. (3)

2. Write short notes on: (5x3=15)
a. Acute pancreatitis - Enumerate the causes and investigations.
b. Describe the treatment for AML.
c. Describe the treatment for DKA.

Batch 12

Sem 9

SECTION A
100 Marks Question
A 22-year old female, with history of multiple episodes of polyarthritis involving the large joints during her childhood treated by an unqualified medical practitioner, attends the outpatient clinic with history of fever of 10 day duration. Physical examination reveals pallor, splenomegaly and a grade III murmur at the cardiac apex, (a) Write the most likely diagnosis with the justification, (b) Enumerate four appropriate investigations with the anticipated abnormalities helpful for the diagnosis, (c) Briefly describe the treatment plan of this patient, (d) List two life-threatening complications of the disease.
(1+4+4+2)

2 Write short notes on:
A Osteoporosis in the elderly.
B Multi-drug resistant tuberculosis.
C Gene therapy.

(5+ 5 + 5 )

SECTION B.

Question
1 A 26-years old female is admitted for the evaluation of gradually-progressive effort intolerance of 6 months duration. Initial evaluation revealed: pallor, tachypnoea, scratch-marks on the skin, blood pressure 170/102 mm of Hg, muscle wasting, normochromic normocytic anemia in the blood smear and a serum creatinine value of 946 micromols/L. (a) Mention the most appropriate diagnosis with the justification, (b) Write three appropriate investigations with the expected_abnormalities to confirm the-diagnosis. (c) Outline the treatment plan for this patient, (d) Enumerate two acute complications for which this patient can be brought to the emergency department if not under proper treatment. (2+3+4+1)

2.Write short notes on:
A Management of diabetic ketoacidosis.
B Hyponatremia.
C Metabolic alkalosis.
(5 +5 + 5)

SECTION C
Question

1 A 54-year old male with history of heavy amounts of alcohol consumption for
the past 26 years is admitted for the evaluation of passage of dark tarry stools
for the past two weeks. Physical examination reveals_anaemia, oedema of legs
and moderate ascites. (a) List two important differential diagnoses you should
consider while evaluating this patient with valid reasons, (b) Enumerate four
investigations with anticipated abnormalities to arrive at a proper diagnosis, (c)
Outline the treatment plan for this patient
(1+4+5)

2 Write short notes on:
A Ulcerative colitis.
B Gout.
C Vitamin A and health.
( 5+5+5)

SECTION D
Question
1 A 60-year old female is admitted with history of sudden onset of weakness
of the left upper and lower limbs and deviation of the angle of mouth to the
right side. Physical examination reveals hemiparesis and upper motor
neuron-type facial weakness of the left side, (a) What is the diagnosis? (b)
Enumerate four essential investigations and the anticipated abnormalities for
the proper evaluation of this patient, (c) Outline the treatment plan while the
patient is in the hospital and after discharge. (1+4+5)

2 Write short notes on:
A Dementia.
B Scabies.
C Paracetamol poisoning.
(5+5+5)

Batch 13

SECTION A

1. A 42 year old male visits the outpatient clinic in Feb 2008 for evaluation of cough with minimal expectoration of sputum, mild fever during evening hours and marked loss of weight over the past two months. He had been advised continuous treatment for six months for similar illness in early september 2007 (after sputum examination and chest radiograph) but stopped treatment during the latter half of november 2007 following a symptom free interval of one month.

a. Mention your clinical diagnosis. (1)
b. Enumerate three diagnostic investigations with the anticipated abnormalities. (3)
c. Briefly describe the treatment plan for this patient. (4)
d. Enumerate four complications specific to the drug-treatment of this disease. (2)

2. Write short notes on: (5 mark each)
a. Causes of falls in the elderly.
b. Management of Heart failure.
c. Stem cells.

SECTION B

1. A 26 year old female is admintted for the evaluation of generalised anasarca. Physical examination revealed: gross oedema of the legs, blood pressure 106/72 mmHg, normal jugular venous pressure, ascites and bilateral pleural effusions. Her serum creatinine was 106 mmols/L, blood urea 6.8 mmol/L and cholesterol 9.6 mmol/L. Urine examination revealed ++++ proteinuria and no other abnormalities.
a. Mention the most appropriate diagnosis with the justificaiton. (2)
b. Write THREE appropriate investigations with the expected abnormalities to confirm diagnosis. (3)
c. Outline the treatment plan for this patient. (4)
d. Enumerate two complications of this disease. (1)

2. Write short notes on: (5 marks each)
a. Diabetic neuropathy.
b. Hyperkalemia.
c. Metabolic Acidosis.

SECTION C

1. A 54 year old male with history of heavy amounts of alcohol consumption for the past 26 years is admitted for the evaluation of passage of dark tarry stools for the past two weeks. Physical examination reveals anemia, edema of legs and moderate ascites.
a. List TWO important differential diagnosis you shuld consider while evaluating this patient with valid reasons. (2)
b. Enumerate FOUR investigations with anticipated abnormalities to arrive at a proper diagnosis. (4)
c. Outline the treatment plan for this patient. (4)

2. Write short notes on: (5 marks each)
a. Malabsorption syndrome
b. Reactive arthritis.
c. Vitamin C and health.

SECTION D

1. A 62 year old male was brought to the accident and emergency unit with sudden onset of weakness of the right upper and lower limbs and deviation of the angle of the mouth to the left side. Physical examination revealed dense hemiplegia and upper motor neuron-type facial weakness on the right side and global aphasia and drowsiness.
a. Write the complete diagnosis with justification. (2)
b. Enumerate four risk factors for the Illness. (2)
c. List THREE investigations useful for the diagnosis with expected abnormalities. (3)
d. Outline the treatment plan for this patient. (3)

2. Write short notes on: (5 marks each)
a. Wernicke's encephalopathy.
b. Atopic dermatitis.
c. Organophosphate compound poisoning.

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