C S MAIN 2015 M E D IC A L S C IE N C E II P aper II

Q l. A 40 year old Non Resident Indian visiting India develops acute, sudden breathlessness
one week after landing in India A resdent of USA he has no such previous history of breathlessness
List the differential diagnosis

How would you investigate this patient?

A newborn baby weighing 15 kg develops respiratory distress on the
first day of life.
List the differential diagnosis.

How would you assess this baby
(iii) How would you manage the most common condition manifesting
with respiratory distress in the newborn

A 30-year-old business executive, who is asymptomatic, has been tested
positive for Hepatitis-B surface antigen.

How would you further investigate this individual

What steps would you take for the management 5+5-10

Define "Infant Mortality Rate (IMR)”.

List the major causes of IMR in India.

(iii) What are the key steps that can bring down the IMR in
India

A 25-year-old unmarried female presents with asymptomatic
depigmented macules of varying sizes over the breast, back, arms and
legs for the last two years.

List the differential diagnosis.

How would you investigate this patient

(iii)’ How would you treat the most common condition manifesting with
the given symptomatology

Q2 A 60-year-old gentleman presents with anaemia, Hb 6.8 gm/dl. Apart
from weakness, there are no localizing symptoms or signs. He was
diagnosed with myocardial infarction 8 years earlier and remains
asymptomatic on atorvastatin and low dose aspirin since the M.I.

What is the likely cause for anaemia in this patient

Which laboratory investigations are helpful in his management

(iii) What is the appropriate treatment for this condition

A 10-year-old boy presented with history of recurrent joint swelling of
knees, elbows and ankles, following trivial injuries. His maternal uncle
had similar illness.

What is the nature of disease and the likely diagnosis

Which investigations can confirm this disease

What is the medical management in this young patient

What is the advice for his mother

A 45-year-old lady develops itchy, hyperpigmented, scaly lesions on face.
These lesions become worse after the use of hair dye which she started
using five months earlier.

What is the most likely diagnosis

How can this diagnosis be confirmed

(iii) What medical advice can be given to this lady

Q3. A 45-year-old gentleman presented in emergency With haematemesis.
Examination revealed massive splenomegaly.

List five differential diagnosis of‘massive splenomegaly’.

What is the most likely diagnosis in this patient

(iii) Which investigations are warranted in the patient described
above

Enumerate the steps in the initial management of this patient in
emergency.

An 11-month-old infant is brought to hospital with delayed weaning and
history of recurrent diarrhoeal episodes. The child is apathic, weighs
5.5 kg, has depigmented hair and oedema over the limbs.

What is the most likely diagnosis

Enumerate the clinical assessment and investigations that would
be helpful in this infant.

(iii) Enumerate the ten essential steps and two phases of treatment for .
this child.

An 18-year-old unmarried young lady, highly conscious of her body
image, develops severe weight loss. She has amenorrhoea for 7 months
and her food intake is minimal.

What is the most likely diagnosis

What is the management in such a case

Q4. A 23-year-old young man presents to medical emergency with recurrent
seizures for 2 days.

Enumerate the points in clinical history and examination that are
relevant to the diagnosis.

Wliich investigations are warranted to arrive at the diagnosis

(iii) List the steps in the management of this patient in emergency.

Name three common diseases that can manifest with recurrent
seizures.

“Globally, about a quarter of all neonatal deaths are caused by birth
asphyxia.” What are the guidelines and interventions in
resource-limited settings for effective resuscitation to reduce neonatal
mortality

A term neonate bom to Kh negative mother is brought at 22 hours of life
with jaundice, fever and one episode of convulsion.

What is the most likely diagnosis and its basis

Enumerate the key investigations and principles of management.

(iii) List four important long-term complications of this disease.

Mention the preventive measures.


Q5. List the causes of tongue ulcer.

. State the predisposing factors which may lead to the development
of tongue carcinoma.

(iii) What is the preferred modality of treatment in carcinoma of the
tongue

A 55-year-old male presents with acute urinary retention.

List the differential diagnosis.

What steps would you take to relieve him of his condition

(iii) How would you investigate this patient to reach at the
diagnosis

What is the objective of Pre Conception Pre Natal Diagnostic
Techniques (PCPNDT) Act

Enumerate the forms that must be filled by the attending doctors
while carrying out a pre-natal ultrasound.

(iii) If a medical doctor is found to be violating the PCPNDT Act, what
is the legal provision for punishment prescribed under the
Act

What is PAP smear

Briefly state its procedure.

(iii) How do you interpret the test results

Define the sensitivity and specificity of a diagnostic test.

Briefly discuss the role of Rapid Diagnostic Test in malaria
comparing it with the slide test.

Q 6. Draw a flow chart on how youvwould evaluate a 50-year-old lady
1 presenting with abnormal uterine bleeding.

How does menopause influence the bone mineral density

(iii) What measures can be taken by a peri-menopausal woman to
safeguard against osteoporosis List them.

List the causes of haematuria.

Briefly discuss the management of carcinoma of the prostate.

Briefly discuss the proposed goals and targets under the Integrated
Reproductive, Maternal, Newborn, Child and Adolescent Health in
India.

Q 7 . What are the key clinical features of abdominal tuberculosis

How would you investigate a patient suspected to be a case of
abdominal tuberculosis

(iii) Briefly discuss the role of surgery in the management of a patient
with abdominal tuberculosis.

What are “vector-borne diseases”

List any five vector-borne diseases specifying the vector in each.

(iii) Specify the “International Travel Health Regulations” that have
been derived to check the spread of vector-borne diseases.

What is trial of labour

How would you manage a trial of labour in a patient who has had a
Caesarean Section previously

Q8. A 7-year-old girl is brought with a history of dog-bite five minutes ago.
She has abrasions on her hand, but no bleeding.

What category of bite would this injury fall under

What are the first-aid measures which need to be given to this child

(iii) What prophylactic steps would you take to prevent rabies in this
child

A 25-year-old married lady presents with history of 10 weeks
amenorrhoea, acute lower abdominal pain and fainting. On clinical
examination, she has tachycardia, hypotension and pelvic tenderness.

What is the most likely diagnosis

How would you investigate such a patient

(iii) How would you manage such a patient List the key points.

List the five most commonly found cancers in India.

Enumerate the clinical features of carcinoma of upper third of
oesophagus.

(iii) How would you manage a case of carcinoma of upper third of
oesophagus