block 3 b23

8/12/2019 BLOCK 3 B23

1/23 Page 1 of 2

Melaka Manipal Medical College (Manipal Campus) Progress Examination

International Centre for Health Sciences Block: GIT, Hepatobiliary, CVS and RS

September 2008 (Batch 23) and Date: Thursday, June 3, 2010

Refreshers March 2008 Batch Time: 1.45 pm to 3.45 pm

PATHOLOGY : PAPER I

1. A 64 year old retired teacher with a long history of hypertension experiences pain in his chest whilewalking around in the market. The pain is central with radiation down his left arm. He sits down, the pain

decreases in intensity after 5 minutes but persists.

a. What is the most likely cause of chest pain in this case ? What tests would be relevant to diagnose thepatients condition?

After a year, the same patient experiences severe chest pain on waking up in the morning with nausea and

profuse sweating. He is rushed to the emergency and a diagnosis of acute myocardial infarction is made.

In spite of the best treatment the patient dies after 3 days.

b. On autopsy, what are the possible changes that can be seen in the cardiovascular system of thispatient?

(2+5=7 marks)

2. Rheumatic fever licks the joints and bites the heart. Explain this statement.(5 marks)

3. Define asthma. Describe the pathological features and pathogenesis of atopic asthma.(1+2+2=5 marks)

4. A 50 year old bus driver, a chronic smoker presented to the OPD with complaints of severe pain in theright hip after a trivial fall.He also had cough, haemoptysis and loss of weight of 6 kgs in 2 months. X-ray

of the lung showed a coin sized central radio-opaque shadow in the right lung and x-ray of the right hip

revealed an inter-trochanteric fracture of femur. His serum calcium level was 35 mg/dl (normal level is 9-

10.5 mg/dl).

a. What is your final diagnosis?b. Describe the morphology of the lesion in the lung.c. What are the other investigations you will do for this patient?d. Give reasons for the high serum calcium level and the fracture right femur.

(1+2+1+1=5 marks)

Please turn over..

INSTRUCTIONS

1. Answer all questions; answer them in the same order as in the question paper.2. Draw diagrams wherever appropriate.3. Write the question number clearly in the margin space.

The marks scored will count only if you have the mandatory course

requirement of at least 90% attendance in the subject in this block.

8/12/2019 BLOCK 3 B23

2/23 Page 2 of 2

5. A 45 year old diabetic is admitted to ICU with sudden onset of fever, dyspnoea, tachypnoea and bluishdiscolouration of lips and tongue. General physical examination showed an ulcer in the right foot with

ascending cellulitis. The patient does not respond to treatment and dies in progressive respiratory failure.

a. What is the condition the patient is suffering from?b. List four important causes for the condition.c. Explain the pathogenesis of the condition.

(+1+3=5 marks)

6. Briefly discuss the role of H. pylori in the pathogenesis of gastritis and gastric neoplasms.(2+4=6 marks)7. Compare the morphology of a benign and malignant gastric ulcer.

(5 marks)

8. In a tabular format, enumerate the endoscopic, macroscopic and microscopic differences between Crohnsdisease and Ulcerative colitis.

(2+2+2=6 marks)

9. With the help of a diagram, explain the adenoma carcinoma sequenceand its molecular biology.(5 marks)

10.Discuss the aetiopathogenesis and the morphology of pancreas in acute pancreatitis.(4+2=6 marks)

11.Describe the aetiopathogenesis and complications of acute appendicitis.(3+2=5 marks)

* * * * *

8/12/2019 BLOCK 3 B23

3/23 Page 3 of 2

Melaka Manipal Medical College (Manipal Campus)

International Centre for Health Sciences

September 2008 (Batch 23) and Refreshers March 2008 Batch

MANIPAL 576 104

Block: GIT, Hepatobiliary, CVS and RS

Roll No.

Date : Thursday, June 3, 2010

Time : 4.00 pm to 5.00 pm

Duration : 60 minutes

INSTRUCTIONS

Read carefully before you begin.

1. For each statement, select T (True) or F (False) in the answer sheet.2. Indicate your choice by darkening the appropriate circle in the answer sheet.3. Use only HB or 2B pencils to darken the circle.4. Leave blank for Don't Know response.5. Scoring system:

Correct +1

Wrong 0.5

Don't Know 0

6. Indicate your roll number clearly and correctly in the answer sheet.7. DO NOTwrite anything in the question paper.8. The True/False statements are numbered from 101 to 160 and 201 to 260 (Total 120 statements).

PROGRESS EXAMINATION

Pathology : Paper II



8/12/2019 BLOCK 3 B23

4/23 Page 4 of 2

Regarding atherosclerosis

101. Turbulent blood flow plays an important role in the pathogenesis of atherosclerosis102. There is decreased expression of ICAM-I and E-selectin103. Plaques vulnerable for rupture have a large fibrocalcific component with little inflammatory

component

Causes of secondary hypertension include

104. Chronic renal failure105. Phaeochromocytoma106. Steroid therapy107. Conns syndrome

Regarding malignant hypertension

108. It can occur in previously fit individuals109. The characteristic histological lesion seen is intimal proliferation and hyalinization of the muscular

media

110. It can cause sudden death from cerebral haemorrhageCapillary microangiopathy in diabetes

111. Is due to abnormal glycosylation of proteins within the vessel wall112. Shows fibrinoid necrosis of small vessels113. Leads to basement membrane thickening114. Causes increased vascular permeability

Thrombo-angiitis obliterans

115. Is also known as Takayasus disease116. Is associated with smoking117. Causes gangrene of toes and fingers which require amputation

Left ventricular failure

118. Results in congestion of the lungs119. Is caused by systemic hypertension120. Due to chronic obstructive lung disease is called cor pulmonale121. Leads to congestive organomegaly

Infective endocarditis

122. Results in immune mediated destruction of heart and valves123. Causes rupture of chordae tendinae124. Involves the aortic valve in drug addicts125. Can cause glomerulonephritis

Coarctation of aorta

126. Can cause intracerebral haemorrhage127. Presents with cyanosis at birth128. Causes notching of ribs129. Is more common in females

8/12/2019 BLOCK 3 B23

5/23 Page 5 of 2

Regarding cardiomyopathy

130. It can cause sudden cardiac death131. It is due to atherosclerosis of the coronary arteries132. There is marked hypertrophy of the left ventricle

Causes of pericarditis include

133. Uraemia134. Rheumatoid arthritis135. Myocardial infarction

Regarding pneumoconiosis

136. With the progression of the disease, pulmonary function tests will show an obstructive defect137. Inhalation of organic dusts results in hypersensitivity pneumonitis138. Bulla formation can occur in progressive massive fibrosis

Alpha-1 antitrypsin

139. Is an acute phase serum protein140. Inhibits the action of elastase and collagenase141. Enzyme deficiency is inherited as autosomal dominant trait

Morphological features of chronic bronchitis include

142. Neutrophilic infiltrate within the bronchial wall143. Mucous plugging of airways144. Hypoplasia of submucosal glands145. Squamous metaplasia

Regarding lobar pneumonia

146. It is a disease where proximal airways are filled with suppurative exudate147. It is a disease predominantly of distal airways including alveoli148. Characteristically there is an interstitial inflammatory infiltrate149. The commonest aetiological organism is streptococcus pneumoniae

Regarding pathological basis for clinical signs and symptoms of lobar pneumonia

150. Bronchial breathing is due to well aerated alveoli conducting bronchial sound151. Dullness to percussion is because of exudate replacing air in the distal airways152. Pleuritic pain which occurs during inspiration is due to muscular pain153. Patient presents with rusty sputum due to altered RBCs in it

Regarding bronchopneumonia and other pneumonias

154. Bronchopneumonic involvement results in exudation seen in large segments of lung parenchyma155. Bronchopneumonia is usually patchy in its involvement156. Viral and mycoplasmal pneumonia produce typical alveolar exudate of fibrin rich fluid157. Cryptococcal pneumonia is common in the immunocompromised hosts

Regarding neonatal respiratory distress syndrome

158. Hyaline membrane disease is commonly seen in full term babies born after caesarean section159. The basic defect is a deficiency of surfactant resulting in atelectasis160. The hyaline membrane seen in alveoli is associated with numerous neutrophils

8/12/2019 BLOCK 3 B23

6/23

8/12/2019 BLOCK 3 B23

7/23 Page 7 of 2

The following adenomas are correctly matched with the gross appearance

233. Tubular adenoma : Grossly resembles a raspberry234. Villous adenoma : Is usually pedunculated235. Villous adenoma : Grows like a thick carpet

Regarding amoebiasis,it

236. Is caused by Entamoeba coli237. Leads to flask shaped ulcers in the colon238. Can result in liver abscess

Typhoid ulcers

239. Are transverse ulcers240. Are associated with typhoid nodules in the intestine, liver and kidney

Regarding carcinoma pancreas

241. It is usually a squamous cell carcinoma242. Fibrolamellar variant is a common variant243. Acute pancreatitis can lead to carcinoma of the pancreas244. Flitting venous thrombosis is seen

Regarding chronic pancreatitis

245. Steatorrhoea is a complication246. It can occur because of repeated episodes of acute pancreatitis247. Autoimmunity can cause chronic pancreatitis248. Grey-Turners sign is positive in chronic pancreatitis249. Amylase levels help in the diagnosis

Cholelithiasis

250. Of the cholesterol type is associated with haemolytic anaemia251. Of the pigment type is yellow in colour252. Can lead to mucocoele and empyema253. Can result from deficit of bile salts

Acute cholecystitis

254. Is associated with abdominal pain in the right hypochondrium255. Has thickened gall bladder due to fibrosis256. Shows Aschoff-Rokitansky sinuses histologically

In chronic cholecystitis

257. The wall of the gall bladder appears thinned out258. Palpable gall bladder with obstructive jaundice is seen

Carcinoma of the gall bladder

259. Is usually an adenocarcinoma260. Has a good prognosis

8/12/2019 BLOCK 3 B23

8/23 Page 8 of 2


International Centre for Health Sciences Block: GIT, Hepatobiliary,

September 2008 (Batch 23) and CVS and RS

Refreshers March 2008 Batch Date: Saturday, June 5, 2010

Time: 1.45 pm to 3.45 pm

PHARMACOLOGY : PAPER I

1. Give pharmacological basis for:a. Combining ezetimibe with statins for the treatment of hyperlipidaemia

b. Using dopamine in cardiogenic shockc. Praziquantel is preferred over niclosamide for tape worm infestations.d. Mesalazine is better tolerated than sulfasalazinee. Lignocaine is used in ventricular arrhythmia

(2x5=10 marks)

2. Write short notes on:a. Short course chemotherapy for pulmonary tuberculosis.

b. Metoclopramidec. Inhaled glucocorticoids

(3x3=9 marks)

3. a. Mention the mechanism of action of ranitidine and explain its drug interaction with sucralfate.b. Name three drugs each useful in dry and productive cough.

(3+3=6 marks)

4. a. A 45 year old man with chronic duodenal ulcer due to H.pylori was treated with a combination ofdrugs. Mention a triple drug regimen for this patient and explain the role of each drug in this regimen

b. A patient is hospitalized with hydatid disease. He refused to undergo surgery for removal of cysts.

Which drug could be helpful in this patient and mention its three other therapeutic uses.

(3+2=5 marks)

5. A 60 year old female with history of diabetes was found to be hypertensive. An antihypertensive wasprescribed to control her BP.

a. Which class of antihypertensives is preferred in this case? Mention three drugs belonging to the sameclass.

b. Explain the antihypertensive action of the above drugs.(2+2=4 marks)

6. a. Explain the positive ionotropic action of digoxin with the help of a diagram.b. Outline the management of digitalis toxicity and explain its interaction with quinidine.

(2+3=5 marks)

Please turn over..

INSTRUCTIONS




8/12/2019 BLOCK 3 B23

9/23 Page 9 of 2

7. A 16-year old girl treated for asthma develops skeletal muscle tremors and palpitation after taking aninhaled antiasthmatic drug.

a. What was the drug taken by the patient? Mention another drug belonging to the same class.b. Explain how the above class of drugs help the asthmatic paient ?

(1+1=2 marks)

8. a. Mention two prostaglandin analogues with their therapeutic uses.b. Enumerate two second generation antihistaminics and mention their two advantages over the

first-generation antihistaminics.

c. Explain the mechanism of action of metronidazole and mention its four therapeutic uses.

(2+2+4=8 marks)

9. A 60-year-old hypertensive patient with BPH had been treated with hydrochlorothiazide to control hiselevated BP, and then he developed weakness.

a. What could be the reason for onset of weakness? Name two drugs which can be added to overcomeweakness?

b. Explain the basis for using hydrochlorothiazide in this patient.c. Which class of antihypertensive would be preferred in the above patient? Explain.

(1+2+2=5 marks)

10.70 year old Karthik experiences severe chest pain when he walks uphill in cold weather to his home. Thepain disappears when he rests. He was advised to take nitroglycerin whenever he gets chest pain.

a. How nitroglycerin relives acute anginal attack?b. Mention two other uses of nitroglycerin with its route of administration.c. Mention two groups of drugs with two examples each that can be given prophylactically in the above

patient.

(2+1+3=6 marks)

* * * * *

8/12/2019 BLOCK 3 B23

10/23 Page 10 of 2




MANIPAL 576 104


Roll No.

Date : Saturday, June 5, 2010



INSTRUCTIONS



Correct +1

Wrong 0.5

Don't Know 0



Pharmacology : Paper II



8/12/2019 BLOCK 3 B23

11/23 Page 11 of 2

Compared to metronidazole, tinidazole

101. Has higher cure rate in amoebiasis102. Has a shorter duration of action103. Is not well tolerated104. Has simpler dosage regimen

Diloxanide furoate

105. Kills tropozoites in the liver106. Is the drug of choice in chronic cyst passers107. Produces flatulence

Fenofibrate

108. Acts by activating lipoprotein lipase109. Is useful in patients with marked rise of triglycerides110. Reduces the incidence of gall stones111. Is contraindicated in pregnancy

Following are the desirable properties of plasma volume expanders. They should

112. Exert oncotic pressure higher than that of plasma113. Not remain in circulation for longer duration114. Not be pyrogenic115. Be pharmacodynamically inert

In multidrug resistant tuberculosis

116. Resistance is seen to both isoniazid and rifampin117. Second line antitubercular drugs are useful118. Choice of drugs is independent of drugs used in the previous regimen119. The duration of combination therapy is 12-24 months

Isoniazid

120. Acts by inhibiting mycolic acid synthesis121. Is contraindicated in children less than 6 years of age122. Causes reddish discolouration of urine123. Is administered along with pyridoxine

Regarding antitussives

124. They reduce tussal impulses from the respiratory tract125. They are useful in productive cough126. Dextromethorphan acts through opioid receptors127. Promethazine acts by inhibiting cough centre

Ivermectin

128. Inhibits GABA nergic transmission in worms129. Is the drug of choice in strongyloidosis130. Produces tonic paralysis in nematodes131. Is used orally for the treatment of scabies

8/12/2019 BLOCK 3 B23

12/23 Page 12 of 2

Regarding diethylcarbamazine (DEC)

132. It is used to reduce transmission of filariasis133. Its overdose can cause Mazzotti reaction.134. It rapidly kills the adult worms.135. It can be used for tropical eosinophilia.

Omeprazole

136. Is a prodrug.137. Inhibits Na+-K+-ATPase in the parietal cells.138. Can be given by both oral and intravenous route.139. Is effective for the treatment of Zollinger-Ellison syndrome.

Colloidal bismuth subcitrate

140. Inhibits mucosal PGE2production.141. DetachesH. Pylorifrom the mucosal surface.142. Should be taken along with antacids.143. Causes blackening of tongue and stools.

Regarding antacids

144. They can cause metabolic acidosis.145. Aluminium hydroxide delays gastric emptying.146. Calcium carbonate can cause acid rebound.147. They are used to protect the gastric mucosa.

Important effects of digitalis on the heart include

148. Increased atrioventricular conduction velocity149. Increased intracellular calcium150. Decreased ectopic automaticity

Drugs found to be useful in heart failure include

151. Alpha-adrenoceptor agonists152. Beta-adrenoceptor agonists153. Beta-adrenoceptor antagonists154. ACE inhibitors

ACE inhibitors

155. Competitively block angiotensin II at its receptor156. Decrease angiotensin II concentration in the blood157. Cause potassium retention158. Are safe in pregnancy

Positive inotropic drugs include

159. Dobutamine160. Amrinone

8/12/2019 BLOCK 3 B23

13/23 Page 13 of 2

Digoxin toxicity is precipitated by

201. Administration of captopril202. Administration of calcium203. Hyperkalemia204. Hypomagnesmia

Sumatriptan

205. Is a 5-HT2A receptor agonist206. Has a high oral bioavailability207. Is effective in the treatment of acute migraine208. Can be safely used in epileptic patients

Montelukast

209. Is a leukotriene synthesis inhibitor210. Can be administered orally211. Is used to terminate an attack of acute asthma

Drugs used to terminate an attack of acute asthma includes

212. Ipratropium bromide213. Sodium chromoglycate214. Budesonide215. Bambuterol

Cyproheptadine

216. Blocks 5-HT2Areceptors217. Has poor antipruritic action218. Can suppress appetite in children219. Is used in the treatment of carcinoid syndrome

Sodium chromoglycate

220. Inhibits degranulation of mast cells221. Can be used to terminate an attack of allergic rhinitis222. Is ineffective in preventing exercise-induced bronchospasm

Regarding central sympatholytics

223. Clonidine stimulates 2receptors224. Methyldopa acts as a false neurotransmitter at dopamine receptors225. Administration of clonidine can be stopped abruptly226. Methyldopa can be administered safely during pregnancy

Following antihypertensive drugs are correctly matched with their adverse effects

227. Sodium nitroprusside : Reflex tachycardia228. Minoxidil : Alopecia229. Furosemide : Hypoglycaemia230. Methyldopa : Haemolytic anaemia231. Diazoxide : Hyperglycemia

8/12/2019 BLOCK 3 B23

14/23 Page 14 of 2

Sodium nitroprusside

232. Decomposes on exposure to light233. Causes vasodilatation by releasing nitric oxide234. Is used for the treatment of mild to moderate hypertension235. Causes metabolic acidosis

Drugs effective in prinzmetals angina include

236. Verapamil237. Propranolol238. Pinacidil239. Isosorbide dinitrate

The following drugs correctly match with their uses

240. Felodipine : Raynauds phenomenon241. Nimodipine : Cerebral vasospasm242. Nifedipine : Premature labour243. Sodium nitrite : Myocardial infarction244. Verapamil : Migraine

Lactulose

245. Is used to empty the bowel before surgery246. Increases the production of NH3in the colon247. Breaks down into acidic products in the colon248. Is a stimulant purgative

Regarding antimotility drugs

249. Loperamide is combined with atropine to discourage its abuse250. They act by blocking receptors in the CNS251. They can cause toxic megacolon252. They are contraindicated in ulcerative colitis

Ondansetron

253. Blocks 5HT3receptors on vagal afferents in the GIT254. Can cause constipation255. Is used in motion sickness256. Is useful in cancer chemotherapy induced vomiting

Adenosine

257. Acts by activating K+ channels258. Is preferred over verapamil for PSVT259. Can cause long lasting adverse effects260. Is given orally

8/12/2019 BLOCK 3 B23

15/23 Page 15 of 2


International Centre for Health Sciences Block: GIT, Hepatobiliary,

September 2008 (Batch 23) and CVS and RS

Refreshers March 2008 Batch Date: Monday, June 7, 2010

Time: 1.45 pm to 3.45 pm

MICROBIOLOGY : PAPER I

1. A 25 year old American adventurist returned from Uganda with fever, chills and myalgia since 2 days.Blood smear for malaria was negative .Two days later he developed an urticarial rash and bloody diarrhea

with pain in right upper quadrant. His liver was enlarged and liver enzymes were elevated. He was foundto have eosinophilia. His stool sample sent for investigation revealed a parasitic egg with characteristic

lateral spine.

a. Identify the etiology in this caseb. Briefly discuss the life cycle of the agent.

(1+3=4 marks)

2. Discuss the pathogenesis of enteric fever.(5 marks)

3. Describe the morphology of influenza virus and discuss the role of antigenic variations in influenzainfections

(2+4=6 marks)

4. Discuss elaborately the pathogenesis of glandular fever with a special emphasis on their mechanismsinvolved. This disease is an exclusive human disease, substantiate?

(4+1=5 marks)

5. Discuss the laboratory diagnosis of diphtheria.(4 marks)

6. Differentiate the pathogenesis of cholera and rotaviral diarrhoea(6 marks)

7. Ralp a 20 year old, living in squalid circumstances was emaciated and undernourished. Radiologicalexamination revealed miliary lung mottling. His sputum specimen was given for laboratory diagnosis and

on specialized staining showed acid fast bacilli.

a. Based on the above findings, diagnose the disease.b. Describe the pathogenesis of afore said disease with reference to immune response of the host.c. Write a note on hypersensitivity elicited due to the organism and list the uses of this test

(1+3+3=7 marks)

Please turn over..

INSTRUCTIONS




8/12/2019 BLOCK 3 B23

16/23 Page 16 of 2

8. Give reasons for the following:a. Colonies ofH.influenzaethat grow in close proximity to S.aureus are larger

b. M.tuberculosisglows brighter in the luciferase assayc. An overnight broth culture of S.pneumoniaeclears after addition of 10% deoxycholated. Extra-intestinal amoebiasis manifests as hepatic amoebiasis with anchovy sauce pus

(4x2=8 marks)

9. A 5-year-old girl developed watery diarrhoea since two days after attending her uncle's wedding party.She did not have any fever. She had travelled from US to Kundapur along with her parents for her uncle's

wedding. Her stool sample in the laboratory grew lactose fermenting, indole producing motile gram

negative bacilli. It did not utilise citrate nor produced hydrogen sulphide.

a. What is the most probable pathogen in the above case?b. Explain the pathogenesis in the above case.

(1+4=5 marks)

10.Discuss the role of seromarkers in the diagnosis of Hepatitis B infection in self limited and carrier patients.(5 marks)

11. Write short notes on:

a. Pathogenesis of Clostridium botulinumb. Morphology of Helicobacter pylori

(2x2=5 marks)

* * * * *

8/12/2019 BLOCK 3 B23

17/23Page 1 of 5




MANIPAL 576 104


Roll No.

Date : Monday, June 7, 2010



INSTRUCTIONS



Correct +1

Wrong 0.5

Don't Know 0



Microbiology: Paper II



8/12/2019 BLOCK 3 B23

18/23Page 2 of 5

Vibrio parahemolyticus

101. Produces a heat labile cytotoxin102. Invades the intestinal epithelial cells103. Is diagnosed by Kanagawa phenomenon

Enterobius vermicularis

104. Infection in women manifests as vaginitis105. Produces a bile stained egg106. Infection is diagnosed by demonstration of eggs using NIH swab

Trichuriasis

107. Results due to the penetration of the rhabditiform larva108. Manifests as iron deficiency anemia if there is massive prolonged infection109. Is diagnosed by the demonstration of bile stained egg

Strongyloides stercoralis

110. Have a soil cycle leading to the development of an infective larva111. Is called old world hook worm112. Larval forms causes larva currens

Clonorchis sinensis

113. Have cercariae as infective forms for humans114. Infection leads to the inflammatory reactions in the biliary epithelium115. Infection is diagnosed by demonstration of an operculated egg from aspirated bile

Fasciola hepatica

116. Has humans as the intermediate host117. Is a hermaphrodite118. Infection manifests as abscesses in the liver parenchyma

Taeniasis

119. Manifesting as cysticercosis results due to the consumption of larva120. Is characterized by the production of a bile stained egg121. Is diagnosed by the demonstration of scolex in the stool.

Hymenolepis nana

122. Infection results due to the ingestion of bile stained eggs123. Infection in children manifests as epileptic convulsions124. Has an indirect cycle having insects as intermediate hosts

Diphyllobothrium latum

125. Has fresh water fish as the definitive host126. Manifests as pernicious anemia due to deficient vitamin B 12absorption127. Infection is diagnosed by the demonstration of operculated egg

8/12/2019 BLOCK 3 B23

19/23Page 3 of 5

Rhinovirus

128. Attaches using the capsid protein with ICAM 2129. Infection leads to life long immunity130. Infection is diagnosed by demonstration of antigen from exfoliated cells

Echinococcus granulosus

131. Causes unilocular hydatid disease132. Adult form resides in the duodenum of sheep133. In humans is transmitted by ingestion of measly meat134. Is diagnosed by a delayed hypersensitivity skin test135. Eggs are non-bile stained

Regarding Enteric fever

136. Blood culture is done in the 1stweek of infection137. Etiological agent produces non lactose fermenting colonies138. Typhoid fever is caused by anerogenic bacilli139. Is prevented using live vaccine containing Vi capsular polysaccharide140. The live attenuated vaccine is stable mutant of ty-2 strain

Cytomegalovirus

141. Is a flavivirus142. Causes heterophil negative mononucleosis143. Infection is characterised by presence of atypical lymphocytes144. Is transmitted by saliva145. Inhibits T cell response resulting in transient immunosuppresion

Regarding oral cavity infections

146. Broad spectrum antibiotics cause impaired immunity predisposing to oral thrush147. Vitamin D deficiency allows residents to cause gum infections148. Streptococcus mutans infection results in dental caries149. The bacteria in plaque use sugar to form lactic acid which decalcifies tooth150. Bacterioides fragilis are associated with gingivitis

Influenza

151. Infection is diagnosed by haemagglutination inhibition test152. Virus has fusion protein153. Infection results in interstitial pneumonia154. Is prevented by using live attenuated thermal mutants of the virus155. Causes syncytium formation in cell culture

The following etiology matches with the infection

156. Actinomyces viscosus : Periodontal disease157. Haemophilus influenzae : Ottitis media158. Bacteroides : Acute epiglottitis159. Streptococcus pneumoniae : Ottitis externa160. Streptococcus pyogenes : Pharyngitis

8/12/2019 BLOCK 3 B23

20/23Page 4 of 5

Verotoxigenic E.coli

201. Produces toxin that resembles shiga toxin202. Infection leads to haemolytic uremic syndrome203. Produces non sorbital fermenting colonies on modified Mac Conkey's medium204. Is transmitted by inhalation of the organism

Hepatitis E virus

205. Is a single stranded DNA virus206. Spreads through parental route207. Infection runs a severe course in pregnant woman208. Has a carrier phase

Helicobacterpylori

209. Is a gram positive curved bacilli210. Has a enterotoxin as its virulence factor211. Infection is diagnosed by urea breath test212. Does not produce oxidase213. Infection is associated with carcinoma of the stomach

Antibiotic associated diarrhoea is

214. Caused by Clostridium difficile215. Characterized by the formation of cytotoxin216. Treated with vancomycin

Micro-organisms associated with food poisoning include

217. Staphylococcus aureus218. Vibrio parahemolyticus219. Clostridium botulinum220. Diarrhoeal strain of Bacillus cercus

Respiratory syncytial virus

221. Has G protein for fusion of the virus to host cell surface222. Belongs to family orthomyxoviridae223. Infection has an immunopathologic basis224. Is a enveloped DNA virus225.

Infection is prevented by vaccination

Mumps

226. Is caused by paramyxovirus227. Virus has segmented ssRNA as its genome228. Is characterized by maculopapular rashes on the skin229. Virus has hemagglutinin and neuraminidase peplomers230. Infection causes aseptic meningitis

8/12/2019 BLOCK 3 B23

21/23

8/12/2019 BLOCK 3 B23

22/23Page 6 of 5


International Centre for Health Sciences Block: GIT, Hepatobiliary, CVS and RS

September 2008 (Batch 23) and Date: Wednesday, June 9, 2010

Refreshers March 2008 Batch Time: 2.00 to 3.15 pm

(Total time for Paper I and Paper II)

FORENSIC MEDICINE

PAPER I

Note: Essay and MTF answer scripts will be collected together at the end of 1 hour 15 minutes.

1. Explain Delusionand Illusionwith examples.(2+2=4 marks)

2. Briefly explain the mechanism of action and clinical features of strychnine poisoning.(1+2=3 marks)

3. Briefly explain the clinical features and management of Methanol poisoning.(1+1=3 marks)

4. Describe the clinical features of organophosphorous poisoning.(3 marks)

5. Mention the active principles of Cannabis indica. Briefly describe the various cannabis preparations.(1+5=6 marks)

6. Describe the clinical features and treatment of chronic mercury poisoning. Add a note on saturnism.(3+3=6 marks)

PAPER II

INSTRUCTIONS



Correct +1

Wrong 0.5

Don't Know 0

6. Indicate your roll number clearly and correctly in the answer sheet.7. DO NOTwrite anything in the question paper.8. The True/False statements are numbered from 101 to 130 (Total 30 statements).

MTFs

Please turn over.

INSTRUCTIONS




8/12/2019 BLOCK 3 B23

23/23

MTFs:

Regarding cardiac poisons

101. Nicotiana tobaccum resembles horse radish102. Cerberin is an alkaloid103. Folinerin and rosagenin are active principles of pink oleander

About asphyxiants

104. Carbon monoxide poisoning results in cherry red colored lividity105. 40-50% concenteration of CoHb in blood resembles drunkenness106. Cyanide poisoning results in histotoxic anoxia

A mentally ill person

107. If marries, the marriage is valid108. Can make a valid will109. Cannot withstand lack of sleep110. Can be acquitted in the court of law for any crime committed as per Mc Naughtens rule

Chronic ethanol consumption

111. Leads to Wernickes encephalopathy112. Is treated with methanol113. causes optic neuritis114. Can be treated with disulfiram

The following are the examples of inorganic acids

115. Sulphuric acid116. Nitric acid117. Carbolic acid

Sulphuric acid

118. Is also known as aqua fortis119. Acts by extracting water from the tissues120. Produces yellowish discoloration of the tissues

The characteristic features of chronic lead poisoning are

121. Bluish discoloration at the junction of the teeth and gums122. Chronic diarrhea123. Basophilic stippling of red blood cells124. Signs and symptoms resembling tetanus

Regarding first aid in a case of snake bite

125. Reassurance plays a major role in preventing death126. Immobilization of the limb should be done127. Tourniquet is tied in case of bites on the limbs

Datura seeds

128. Resemble chilly seeds129. Contain abrin as active principle130 C t ti f il

block 3 b23

Documents