FINAL PROF PAPERS (KEMU)

Annual 2007

Medicine Paper A

1. Write short essay on inflammatory bowel disease. Discuss common extra GIT manifestations of ulcerative colitis. (20)

2. Write short essay on bronchial asthma. Evaluation and management of patient with acute attack of asthma. (20)

3. 12yr girl, presents with breathlessness, palpitations, fever. Has dyspnea at rest, 101 F fever, soft 1st heart sound, pansystolic murmur at mitral area. What is diagnosis? Discuss D/D. Investigations. Management. (27)

4. 50yr businessman, acute chest pain, dyspnea, sweating. BP 90/60, heart rate 120, orthopnea. Diagnosis? Discuss D/D. Management of cardiogenic shock? (27)

5. Write essay on various types of leukemias. What are acute leukemias. Discuss their classification and management. (27)

6. Write essay on motor neuron disease. Investigate these patients. Management. (20)

Medicine Paper B

1. Discuss types of Diabetes Mellitus. Management of DKA. (20)

2. Discuss causes, investigations and management of ARF. (21)

3. 45yr lady, polyarthritis involving joints of both hands, morning stiffness. Diagnosis, D/D, investigate and manage her. (27)

4. Young lady, 2 months pregnant, H/O cough, fever, left sided chest pain for 1 month. Dull percussion note with reduced breath sounds on left side. Diagnosis, investigate her. Management with special precautions to pregnancy. (27)

5. Discuss predisposition presentation and management of schizophrenia. (20)

6. Discuss acne, classification. Management of acne vulgaris. (20)

Surgery paper A

All questions carry 22.5 marks.

1. Diff types of anesthesias. Complcatons from most common type of anesth. used. What form of anesth. is used for:
-small lipoma
-ing. hernia
-ingrowing toenail
-subtotal thyroidectomy
-circumcision
-pneumonectomy

2. 18yr boy, fell from rooftop. Responds to pain, pulse 150, resp rate 30. Discuss priorities in mngment.

3. 23yr girl, vomiting blood for 12 hours, pale& tachycardiac. D/D, emergency management in first 24hrs.

4. Describe main steps in mngment of cancers in general.

5. D/D of cervical lymph node enlargement. What is meant by "block dissection of neck"? Diff types of block dissections?

6. Surg. important diff anaerobic infections? Principles in their mngment? Which antibiotics are useful?

Surgery paper B

All questions carry 22.5 marks.

1. Surg anatomy of breast under these headings:
anat. relations
b. supply
lymph. drainage

2. 12yr boy, swollen right scrotum, severe pain for 4 hours, vomited once. Discuss D/D & management.

3. Diff in presentation of CA of right and left colon? Reasons for these differences? Pathological staging of colon CA.

4. 35yr man, paan eater, 2cm ulcer on lateral margin of tongue. D/D, how would you make diagnosis, management.

5. Presentation of abdominal TB? How do you make diagnosis? Management?

6. 40yr man, increasing dysphagia. Diagnose & manage him.

Paeds (Send up) paper 2007

1. Clinical features, management, complications, prevention of measles. (15)

2. Short notes on:
-developmental milestones of 1 yr child
-epi vaccine schedule
-role of zinc in chronic diarrhea
-management of hyperkalemia (4,4,3,4)

3. 6yr child, known diabetic, presents with drowsiness, high fever, vomiting, irritability. H/O irregular insulin dosage. Laboured breathing 40/min, 99.6F, Po2 is 90mmHg, pH 7.2, HCO3 16 mmol. Clinically assess and manage. (10,10)

4. 6yr boy in emergency, came from hostel, alright one day back, high fever, headache, vomiting, altered behaviour. Temp 103F, resp 25/min, pulse 110/min. He is combative, has purpuric spots on legs.
Diagnosis, confirm your diagnosis, steps of management, protect contacts. (5,5,5,5)

5. What is ITP. Diagnosis and management. (15)

6. Short notes on:
-Surgical prep of child with cleft lip and palate
-Causes of intussusception
-Screening and treatment of congenital hypothyroidism
-Infant of diabetic mother (4,3,4,4)

 ANNUAL  2006

    Medicine A
ATTEMPT ANY 6. (None is compulsory)


Q1

A. common organisms for community acquired pneumonia...2
B. how will u investigate these patients (of comm aq pneumonia)...4
C. Discuss management of comm aq pneumonia...7


Q2. A young lady presents with headache, high grade fever and vomiting. She has photophobia and neck stiffness.

A. Discuss dd... 3
B. discuss differences in CSF exam between acute pyogenic meningitis and tuberculous meningitis...3
C. What are complications of acute pyogenic meningitis...3
D. Discuss management of Acute pyogenic meningitis...4

Q3. A thiry year old lady was told to have a heart murmur five years back and has been on treatment. She started fever and generalized weakness with Shortness of breath and palpitations 10 days after c-section.

A. most likely diagnosis...1
B. What physical signs would you look for esp in this patient...4
C. how will u investigate this patient...4
D. Discuss management of this patient... 5


Q4
A. what is viral hepatitis. Discuss various types...4
B. How will u investigate a case of viral hepatitis...4
C. Discuss management of Hep C positive case...5


Q5
Short notes:
A. Aplastic anemia...7
B. Sideroblastic anemia...7


Q6
A fifty years business man heavy smoker with hypertension and diabetes mellitus presents with acute shortness of breath and BP 90/70 mmHg,

A. discuss dd...3
B. how will u investigate this patient...4
C. discuss management of cardiogenic shock...6


Q7
Short notes:
A. Hemiballismus...3
B. trigeminal neuralgua...5
C. Uses of MRI...5

Medicine B
ATTEMPT 6 Qs, part C is compuslory.

PART A

Q1
A. What is metabolic syndrome...6
B. How will u manage a pt of type 2 DM...7

Q2 A young motorcyclist brought to emergency dept after road accident. he has been bleeding profusely, but recovers after surgery and massive blood transfusion. However, his urine output is less than 400ml/24hrs. He is restless with nausea and vomiting.

A. most likely diagnosis...2
B. Investigate this pt...4
C. manage this pt...4
D. most likely prognosis...3

Q3 Short notes:
A. Metabolic acidosis...7
B. Resp alkalosis...6

Part B

Q4
A. Describe common features of depressive illness...6
B. Management of depression...7

Q5 A 55 yr old male presents with pain and redness in right eye for last 3 days. It was followed by blisters on forehead, upper eye lid and nose on the right side.

A. most likely diagnosis...3
B. complications...5
C. management of this pt...5


Part C

Q6 A 1 yr child presents to emergency dept with 3 days history of vomiting, diarrhea and fever. Eyes sunken and not passed urine for last 10 hours.
A. Immediate management....7
B. What steps will u take to prevent diarrheal disease in community?...7

Q7 Short notes:

A. Cretinism...7
B. Congenital Jaundice...7

Eye
Attempt any 4


Q1. Describe etiology, clinical features and management of myopia...15

Q2. Enumerate causes of watering of eye in an adult. How will u manage a case of chronic dacryocystitis?...15

Q3. Describe symptoms, signs and management of vernal catarrh (allergic conjunctivitis)...15

Q4. Describe symptoms, signs and management of primary open angle glaucoma...15

Q5.Short Notes:
A. Hypopyon corneal ulcer... 7.5
B. Keratoconus...7.5

ENT
Attmept any 4.


Q1
A. Name extrancranial complications of chronic suppurative otitis media. What is its pathogenesis?...7.5
B. how will u manage a case of otogenic facial nerve palsy... 7.5

Q2.
A. what is nasal polyp? what are its various types? ...7.5
B. how will u manage chronic ethmoiditis with nasal polyps...7.5


Q3.
A. describe the surgical anatomy of middle ear...7
B. enlist causes of sensorineural hearing loss & conductive hearing loss... 4,4



Q4.
A. describe the clinical features of chronic adenoiditis...7.5
B. what post op care is needed after tracheostomy operation... 7.5


Q5. short notes:
A. persitonsillar abscess...5
B. benign stricture esophagus...5
C. cricothyroidotomy...5

Obstetrics
Attempt any 5

Q1. Primigravida at 19 weeks of pregnancy is booked for antenatal case. Describe her ante natal care....13

Q2. Briefly explain various anatomical variations of placenta and their significance...13

Q3. Primigravida presents with vaginal bleeding at 28 weeks of pregnancy. What is dd and how will u manage her?...13

Q4. Define polyhydramnios. Enumerate its etiological factors and describe the management of pregnancy with polyhydramnios...13

Q5. Short Notes:
A. Management of 3rd stage of labor...7
B. External cephalic version...6

Q6. Define intrauterine growth restriction. How will u manage a pt with diagnosis of IUGR...13

Gynecology
Attempt any 5


Q1. define primary amenorrhea. what are its causes? discuss management of 17 years old girl with primary amenorrhea...13

Q2. define dysfunctional uterine bleeding. how will u manage a 30 years old lady with DUB...13

Q3. how will u manage a 30 years lady with diagnosis of endomeriosis...13

Q4. how will u diagnose and treat a patient with pelvic TB? 13

Q5. Short notes:
A. Imperforate hymen...6
B. Hirsutism...7

Q6. enumerate various methods of contraception. Describe oral contraceptive pills in detail...13

Surgery A
Attempt 6 qs. Q No 1 is compulsory.

Q1. Describe the surgical anatomy of extra hepatic biliary apparatus with special reference to cholecystectomy and CBD exploration...15

Q2. Classify post operative hemorrhage. How can u prevent and treat secondary hemorrhage...13

Q3. enumerate different types of shock. how would u manage septicemic shock after a repair of typhoid perforation....13

Q4. what are the common methods of spread of a malignant abdomina tumor... 13

Q5. enumerate common skin infections. how iwll u manage carbuncle of nape of neck...13

Q6. what are common causes of lymphedema. how would u manage carbuncle of nape of neck...13

Q7. Short notes:

A. partial thickness skin grafting... 6.5
B. treatment of basal cell carcinoma... 6.5

Surgery B
Attempt 6 qs. Q # 1 is compulsory.

Q1. discuss management of fracture of pelvis. especially inrelation to associated injuries...20

Q2. a young boy was hit with a pistol butt on the left side of his head. one hour later he fell unconscious in the emergency. what is the possible diagnosis. how would u manage him...20

Q3. a 65 years old man has presented with gradually increasing dysphagia and weight loss. how would u investigate his condition and what treatment would u suggest...20

Q4. a 25 yrs old man has presented with a neck swelling, palpitation and heat intolerance. what other clinical features would u look for and how would u manage him...20


Q5. what are signs and symptoms of hemorrhoids? what complications can occur? how would u treat strangulation? ...20

Q6. describe the operative details for complete rectal prolapse in an old man...20

Q7. short notes:(ANY TWO)
A. complications and management of varicocele...10
B. clinical features and treatment of hypertrophic pyloric stenosis...10

C. ingrowing toe nail...10

                         ENDS HERE