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2nd MB Final Sem Paper-1

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NILRATAN SIRCAR MEDICAL COLLEGE


STUDENTS’ UNION

presents

Sorted out Semester Papers


of
3RD, 4TH & 5TH Semester 2016
from
All colleges of W.B.U.H.S

All the best for


nd
2 Professional MBBS!

1   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 

PHARMACOLOGY SORTED SEMESTER QUESTION


GENERAL  PHARMACOLOGY  
LONG  ANSWER  QUESTIONS(  10  marks)  
• What  is  biotransformation?  Enumerate  different  types  of  biotransformation.  What  are  the  
objectives  of  biotransformation?  What  are  the  genetic  variations  affecting  biotransformation.  
(2+3+2+3=10)        (CNMC)  
• Classify  different  types  of  receptors  with  example.  Define  agonist  and  antagonist.  What  are  different  
types  of  drug  antagonism,  explain  with  example.  (4+2+4=10)      (SDMC)  
• Enumerate  the  factors  that  modify  drug  actions  with  suitable  examples.  Mention  the  advantages  of  
Log  Dose  Response  curve  over  dose  response  curve.  Define  efficacy  and  potency  and  show  how  we  
can  compare  efficacy  and  potency  of  two  drugs  from  their  Log  Dose  Response  curve.  (5+2+2+1=10)    
(ESIJ)  
• What  are  the  different  routes  of  drug  administration?  Give  examples.  What  are    the  advantages  and  
disadvantages  of  intravenous  and  inhalation  routes.(4+2+4)    (IQ  CITY)  
• What  do  you  mean  by  bioavailability  of  drugs?  Mention  the  factors  that  influence  bioavailability.  
Write  down  the  significance  of  bioavailability.  How  is  the  bioavailability  of  an  orally  administered  
drug  measured?  (2+4+2+2)    (MALDA  MC)  (RGKAR  MC)  
• Write  in  brief  on  the  factors  modifying  absorption  of  a  drug.  Define  Pharmacovigilance.  (4+4=8)      
(MCK)  
• Define  apparent  volume  of  distribution.  Name  two  drugs  with  high  volume  of  distribution  and  two  
drugs  with  low  volume  of  distribution.  What  is  the  therapeutic  importance  of  apparent  volume  of  
distribution?  (3+2+5=10)      (MURSHIDABAD  MC)  
• Enumerate  parenteral  routes  of  drug  administration.  Mention  the  advantages  and  disadvantages  of  
oral  and  intravenous  routes.  Write  how  the  high  and  low  rectal  route  affects  the  bioavailability  of  
drug.  (2+3+3+2=10)      (NBMC)  
• What  is  biotransformation  and  what  is  its  purpose?  State  the  chemical  reactions  involved  in  
biotransformation.  What  is  meant  by  microsomal  enzyme  induction  and  what  is  its  clinical  
implication?  (1+5+4=10)    (IPGMER)  
• Define  drug  antagonism.  Describe  the  different  types  of  drug  antagonism  with  example.  Describe  
the  difference  between  competitive  and  non-­‐competitive  receptor  antagonism.    (2+4+4=10)      
(MALDA  MC)  
 
EXPLAIN  WHY(  3  marks)  
• Intravenous  route  is  the  route  of  emergency.    (  BURDWAN  MC)  (ESI  JOKA)  
• GTN  is  given  in  sublingual  route  to  manage  acute  attack  of  angina  pectoris.  (ESI  JOKA)  
• Acidic  drugs  are  absorbed  better  in  acidic  medium  and  basic  drugs  in  alkaline    
• Volume  of  distribution  of  drug  is  always  apparent.    (MIDNAPORE  MC)  
• Competitive  antagonists  are  safer  drugs  than  non-­‐competitive  antagonists.  (MURSHIDABAD  MC)  
• Age  should  be  considered  while  calculating  the  dose.    (NBMC)  
• Tolerance  and  resistance  are  not  the  same.    (NBMC)  
• Some  drugs  are  administered  as  loading  dose  and  some  are  administered  in  twice  or  three  times.    
(NRSMC)  
• Drugs  need  to  be  prescribed  with  extra  caution  during  pregnancy.    (IPGMER)  
• Alkalinisation  of  urine  is  done  in  management  of  acidic  drug  poisoning.  (ICARE)  
• Eliciting  medical  history  is  important  for  rational  therapeutics.  (BURDWAN  MC)  
 
MECHANISM  OF  ACTION  (3  marks)  
• Genetic  variation  in  Phase  II  metabolism  of  drugs.    (IPGMER)  
• Mechanism  of  toxicity  of    drugs  that  follow  zero  order  kinetics.  (ESI  JOKA)  
 

2   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
 
SHORT  NOTES  (3marks)  
• Essential  drugs.  (CNMC)  (NRSMC)  (RGKAR)  (MIDNAPORE  MC)  
• Plasma  half-­‐life.  (  BURDWAN  MC)  (KPC)  
• Loading  dose.    (  BURDWAN  MC)  (KPC)  (NBMC)  (RG  KAR)  
• 1st  pass  effect.    (BSMC)  
• Essential  drug  concept.  (BSMC)  
• Competitive  antagonism.  (BSMC)  
• Enzyme  induction.  (BSMC)  
• 1st  order  kinetics  of  drug  elimination.  (SDMC)  
• Volume  of  distribution.    (ESI  JOKA)  (CNMC)  
• Teratogenicity.    (ESI  JOKA)  (IQ  CITY)  (KPC)  
• Drug  antagonism.  (ICARE)  (MIDNAPORE  MC)  (NRSMC)  (NBMC)  
• Sublingual  route  of  drug  administration.  (ICARE)  (MIDNAPORE  MC)  (RGKAR)  
• Bioavailability.  (ICARE)  (KPC)  
• Phase  1  clinical  trial.  (KPC)  
• Plasma  protein  binding  of  drugs.  (KPC)  
• Therapeutic  index.  (  MALDA  MC)  (KPC)  (MIDNAPORE  MC)  
• Transdermal  therapeutic  system  (TTS).    (MALDA  MC)  
• Advantages  and  disadvantages  of  I.V.  route.  (MALDA  MC)  
• Zero  order  kinetics.  (MALDA  MC)  (RGKAR)  
• Idiosyncrasy.  (MALDA  MC)  
• Enzyme  linked  receptor.  (MCK)  
• Clinical  trial.  (MIDNAPORE  MC)  
• G  protein  coupled  receptor.  (MIDNAPORE  MC)  (NBMC)  
• Ion  channel  receptors-­‐  structure  and  function.  (MURSHIDABAD  MC)  
• Biotransformation  and  its  clinical  importance.  (MURSHIDABAD  MC)  
• New  drug  development.  (MURSHIDABAD  MC)  
• Redistribution  of  drug.  (  NBMC)  
• Super  infection.  (NBMC)  
• Differences  between  competitive  and  non-­‐competitive  antagonism.  (IPGMER)  
• Renal  elimination  of  drugs.  (IPGMER)  
• Intravenous  route  of  drug  administration.  (IPGMER)  
• Therapeutic  adherence.  (  IPGMER)  
• Pharmacovigilance.  (RGKAR)  (BSMC)  
• Apparent  volume  of  distribution.  (RGKAR)  
• Pharmacogenetics.  (CNMC)  
• Prodrug.  (CNMC)  
• Therapeutic  drug  monitoring.  (  KPC)  (NRSMC)  
• Rational  prescription.  (BSMC)  
• Importance  of  volume  of  distribution  in  clinical  practice.  (  BSMC)  
• Your  role  as  a  medical  student  in  promoting  Institutional  Pharmacovigilance  Programme.  (ESI  JOKA)  
• Half-­‐life  of  a  drug.  (MURSHIDABAD  MC)  (MALDA  MC)  
• Clearance.  (MCK)  (RG  KAR)  
• Essential  medicine.  (KALYANI  JNM)  
• Spurious  drugs.  (KALYANI  JNM)  
• Hit  and  run  drug.  (KALYANI  JNM)  

 
 

3   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 

ANS  
LONG  ANSWER  QUESTIONS  (10  marks)  
• Enumerate  cholinergic  drugs.  Narrate  their  indications.  Why  Acetylcholine  is  not  used  as  a  drugin  
clinical  practice?  (4+5+1)      (CNMC)  
• Classify  beta-­‐adrenergic  receptor  blockers.  Mention  their  therapeutic  uses.    What  maybe  the  
adverse  effects?  (4+3+3)  (BURDWAN  MC)  (ICARE)  
• ++  name  the  shortest  acting  beta  blocker.  (1)  (ESI  JOKA)  
• Enumerate  beta  blockers.  Give  two  cardiovascular  and  two  non-­‐  cardiovascular  indications  of  beta  
blockers  giving  rationale  of  their  use.  (2+8)      (BSMC)  
• Enumerate  peripheral  muscle  relaxants.  Mention  4  differences  between  depolarizing  and  non-­‐
depolarizing  skeletal  muscle  relaxants.  Mention  their  uses  and  how  can  you  reverse  the  effect  of  
non-­‐depolarizing  muscle  relaxants.  (4+2+2+2)      (SDMC)  
• Enumerate  cholinergic  drugs  and  discuss  their  therapeutic  effects  and  uses.  (4+6)    (ICARE)  
• How  will  you  treat  a  case  of  organophosphorus  poisoning?  What  is  the  duration  of  the  therapy?  
(8+2)    (KPC)  
• Enumerate  alpha-­‐blockers.  Mention  the  indications  and  adverse  effects  of  alpha  blockers.  Mention  
the  role  of  Phentolamine  on  Pheochromocytoma.  (3+3+4)    (MIDNAPORE  MC)  (CNMC)  
• Outline  the  pharmacological  management  of  Myasthenia  gravis  along  with  reasons  of  using  these  
drugs.  Mention  why  Edrophonium  is  used  in  the  diagnosis  of  Myasthenia  gravis?  (2+6+2)    (NBMC)  
• Enumerate  cholinomimetic  agents.  Mention  the  rationality  of  using  cholinergic  drugs  in  Myasthenia  
gravis.  How  can  we  differentiate  between  Cholinergic  crisis  and  Myasthenic  crisis?  (4+4+2)    (NRSMC)  
• Mention  the  cholinergic  receptors  with  their  important  locations.  Name  the  clinical  uses  of  atropine  
sulphate  and  uses  of  individual  atropine  substitutes.  (4+6)    (RGKAR)  
• Enumerate  atropine  substitutes.  Justify  the  use  of  atropine  substitutes  in  two  different  clinical  
conditions.  How  will  you  treat  a  patient  of  atropine  overdose?  (3+5+2)    (MURSHIDABAD    MC)  
• Enumeratethe  drugs  used  in  the  treatment  of  chronic  open  angle  glaucoma.  Write  down  the  
mechanism  of  action  of  beta  blockers  and  sympathomimetics  as  anti-­‐glaucoma  agent.  (4+2+2)  
(MCK)  
• Discuss  briefly  the  uses  of  atropine  or  its  substitutes  involving  the  ocular,  respiratory,  urinary  and  
cardiovascular  systems.  In  aclinical  setting,  why  is  neostigmine  therapeutically  more  useful  than  
acetylcholine?  Enumerate  (and  justify)  clinical  conditions  where  propanolol  is  over  carvedilol  and  
vice  versa.  1.5*4  +1+3  (ESI  JOKA)  
 

EXPLAIN  WHY  (3  marks)  


• Adrenaline  is  used  in  anaphylactic  shock.  (CNMC)  (SDMC)  (MALDA  MC)  (NRSMC)  (KPC)  
• Propanolol  should  be  avoided  in  bronchial  asthma.  (CNMC)  
• Glycopyrrolate  is  preferred  over  atropine  in  pre-­‐anaesthetic  medication.    (BURDWAN  MC)  (ESI  JOKA)  
• Timolol  is  preferred  agent  in  chronic  simple  glaucoma.  (BSMC)  
• Ephedrine  use  shows  the  phenomenon  of  tachyphylaxis.  (BSMC)  
• Tamsulosine  is  commonly  used  in  benign  hypertrophy  of  prostate.  (BSMC)  (RGKAR)  (IQ  CITY)  
• Hyoscine  is  the  most  effective  drug  in  motion  sickness.  (SDMC)  
• Oximes  are  used  within  24  hrs  of  OP  poisoning.  (IQCITY)  
• Adrenaline  is  mixed  with  local  anaesthetics.  (IQ  CITY)  
• Atropine  is  used  in  pre-­‐anaesthetic  medication.  (KPC)  
• Acetylcholine  is  not  used  clinically  as  a  drug.  (MALDA  MC)  
• Beta  blockers  are  not  given  alone  in  treatment  of  Pheochromocytoma.  (MCK)  
• Pralidoximeos  used  in  organophosphorus  poisoning.  (MIDNAPORE  MC)  (RGKAR)  
• Propanololshouldne  used  after  Phenoxybenzamine  during  preoperative  management  of  
Pheochromocytoma  and  not  vice  versa.    (MURSHIDABAD  MC)  
• Prazosin  should  be  used  at  bed  time  initially.  (NBMC)  
• Tiotropium  bromide  is  preferable  as  bronchodialator  in  COPD.  (NBMC)  
• Atracurium  is  preferred  in  renal  and  hepatic  failure.(NRSMC)  
4   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  
 
• Atropine  like  drugs  are  contraindicated  in  old  age.(IPGMER)  
• Pliocarpine  is  used  in  acute  angle  closure  glaucoma.    (IPGMER)  
• High  doses  of  atropine  in  OP  poisoning.  (CNMC)  
• Neostigmine  and  not  physostigmine  is  used  in  myasthenia  gravis.  (CNMC)  
• Dantrolene  is  used  in  malignant  hyperthermia.  (KPC)  
• Propranolol  has  reduced  oral  bioavailability.  (SDMC)  
• Atenolol  as  anti-­‐hypertensive  drug.  (MURSHIDABAD    MC)  
• Non  selective  beta  blockers  are  given  in  diabetic  patients.  (MCK)  
• Non  selective  beta  blockers  are  contraindicated  in  variant  angina.  (MALDA  MC)  
• Beta  blockers  are  used  in  congestive  heart  failure.  (NBMC)  
• Pralidoxime  is  not  used  in  carbamate  poisoning.  (RG  KAR)  
• Atracurium  is  preferred  muscle  relaxant  in  patients  with  hepatic  insufficiency.  (RG  KAR)  
• Succinylcholines  sometimes  produce  prolonged  apnoea.  (BURDWAN  MC)  
• Sudden  withdrawal  of  beta  blocker  use  is  discouraged.  (ICARE)  
• Between  adrenaline  and  nor  adrenaline,  one  demonstrates  the  phenomenon  of  vasomotor  reversal  
of  Dale,  whereas  the  other  does  not.  (ESI  JOKA)  
 
MECHANISM  OF  ACTION(3marks)  
• Atracurium  is  a  muscle  relaxant.  (CNMC)  
• Tamsulosin  in  benign  prostatic  hypertrophy.  (CNMC)  
• Adrenaline  as  haemostatic  agent.  (BURDWAN  MC)  
• Pliocarpine  in  glaucoma.  (BURDWAN  MC)  
• Tiotropium  bromide  in  COPD.  (SDMC)  (MALDA  MC)  
• Pliocarpine  in  angle  closure  glaucoma.  (ESI  JOKA)  (MALDA  MC)  (MIDNAPORE  MC)  
• Treatment  of  OP    poisoning.  (ICARE)  
• Treatment  of  Myasthenia  gravis.  (ICARE)  
• Treatment  of  motion  sickness.  (ICARE)  
• Miotics  in  glaucoma.  (IQ  CITY)  
• Succinylcholine  as  a  skeletal  muscle  relaxant.  (MCK)  (MURSHIDABAD  MC)  
• Atropine  as  pre  anaesthetic  medication.  (MIDNAPORE  MC)  
• Beta  blockers  as  anti-­‐hypertensive  drugs.  (MIDNAPORE  MC)  (ESI  JOKA)  
• Timolol  in  chronic  glaucoma.  (MURSHIDABAD  MC)  
• Oximes  in  OP  poisoning.  (IPGMER)  
• Anticholinesterase  agents  in  myasthenia  gravis.  (IPGMER)  
• Pralidoxime  in  OP  compound  poisoning.  (RGKAR)  (MIDNAPORE  MC)  
• Succinylcholine.  (MALDA  MC)  
• Tizanidine  as  a  muscle  relaxant.  (ESI  JOKA)  
• Adrenaline  in  anaphylactic  shock  (ESI  JOKA)  
• Darifenacin  in  increased  frequency  of  micturition.  (  Nbmc)  
 
SHORT  NOTES  (3marks)  
• Neostigmine.  (BURDWAN  MC)  
• Pralidoxime.  (BSMC)  
• Pre-­‐anaesthetic  medication.  (SDMC)  
• Selective  beta  2  agonists.  (ICARE)  
• Phenoxybenzamine.  (IQ  CITY)  
• Use  of  anticholinesterases  in  myasthenia  gravis.(ICARE)  
• Somatic  vs  ANS.  (KALYANI  JNM)  
• Anti-­‐adrenergic  vs  adrenergic  neuron  blocking  drugs.  (KALYANI  JNM)  
• Anticholinesterases  in  Alzheimer’s  disease.  (MCK)  
• Drug  therapy  of  anaphylactic  shock.  (MURSHIDABAD  MC)  

5   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Glycopyrrolate.  (MURSHIDABAD  MC)  
• Dopamine.  (NBMC)  
• Carvedilol.  (RG  KAR)  (SDMC)  
• Succinylcholine  apnoea.  (KPC)  (NBMC)  
• Nicotine  receptor.  (MURSHIDABAD  MC)  
• Atropine  substitutes.  (NRSMC)  
• Cardio  selective  beta  blockers.  (IQ  CITY)  
 
CNS  
LONG  ANSWER  QUESTIONS  (10  marks)  
• Enumerate  opoids.  Mention  pharmacological  actions  of  opoids.  Describe  the  management  of  
morphine  withdrawal.(4+4+2)    (NRSMC)  
• A  23  yr  old  woman  presents  to  the  emergency  with  tonic-­‐clonic  seizure  activity  continuing  for  over  
30  min.  Her  father  informs  that  she  is  a  known  epileptic  for  last  3  years  but  has  discontinued  her  
medication  about  6  months  back.  What  is  the  likely  diagnosis?  How  will  you  treat  this  case?  State  
the  adverse  effects  of  Phenytoin  therapy.    (1+5+4)    (IPGMER)  
• Enumerate  anti-­‐epileptic  agent.  Which  one  of  them  can  be  used  in  epilepsy  and  cardiac  arrhythmia?  
Mention  MOA  and  side  effects  of  valproic  acid.  (3+1+3+3)    (SDMC)  
• Enumerate  the  drugsused  in  Parkinson’s  disease.    Mentionthe  pharmacological  basis  of  each  drug.    
Explain  the  on  off  phenomenon.  Why  pyridoxine  is  contraindicated  along  with  L-­‐Dopa  but  indicated  
with  anti-­‐tubercular  drug?  (2+2+2+2+2)  (IQ  CITY)  
• Enumerate  antiepileptic  drugs.  How  sodium  valproate  is  useful  in  treatment  of  epilepsy?  What  is  the  
current  status  of  Benzodiazepines  in  seizure  disorders?  Mention  two  drugs  which  may  induce  
convulsion  in  susceptible  individuals.    (3+3+3+1)    (MURSHIDABAD  MC)  
• Enumerate  opoids.  Write  the  MOA  and  therapeutic  uses  of  morphine.  How  will  you  treat  a  
morphine  addicted  subject?  (3+3+3+1)    (NBMC)  
• Enumerate  the  drug  acting  via  GABA-­‐A  receptor  channel  complex.  Mention  therapeutic  uses  of  
individual  benzodiazepines.  Why  benzodiazepines  are  considered  safer  hypnotic  agents  as  
compared  to  barbiturates?  (5+2+3)  (RGKAR)  
• Enumerate  the  anti-­‐epileptic  drugs.  Explain  the  MOA  of  Phenytoin.  Enumerate  the  adverse  effects  
of  Phenytoin.  Describe  the  treatment  of  status  epilepticus.  (3+23+2)    (BSMC)  
• What  are  pre  anaesthetic  medications  and  why  are  they  used?  Enumerate  the  pre  anaesthetic  
agents.  Write  down  the  adverse  effects  and  contraindications  of  ketamine.  (3+2+3+2)    (BURDWAN  
MC)  
• Mention  antiparkinsonian  drugs.  Why  levodopa  is  prescribed  with  Carbidopa.  (4)    (KALYANI  JNM)    
• Discuss  the  mechanism  and  side  effects  of  Phenytoin  sodium.  (4)  (KALYANI  JNM)    
• Mention  the  therapeutic  uses  and  contraindications  of  morphine.  (4)  (KALYANI  JNM)  
• Anaesthetic  agents  for  ‘day  care  surgery’.  (4)    (KALYANI  JNM)  
• Explain  briefly  (with  appropriate  diagrams)  four  parameters  used  to  assess  the  pharmacokinetic  
aspects  of  an  orally  administered  drug.  Discuss  two  pharmacodynamic  parameters  you  will  use  to  
compare  between  two  opoid  analgesic  drugs.  Pictorially  explain  the  different  types  of  drug-­‐receptor  
antagonism.  ((1.5*4)+2+2)    (ESI  JOKA)  
• Classify  antiepileptic  drugs.  Describe  the  MOA  as  an  anticonvulsant.  Briefly  explain  the  role  of  
levitaceram  in  epileptic  patients.  Why  diazepam  is  not  preferred  for  routine  treatment  of  epilepsy.  
(3+3+2+2)    (ESI  JOKA)  
• Enumerate  the  drugs  used  in  Parkinson’s  disease.  Mention  the  pharmaco-­‐therapeutic  approach  of  
Parkinson’s  disease.  What  is  on-­‐off  phenomenon?  Write  the  drug  used  in  induced  Parkinsonism  with  
explanation.  (3+3+2+2)  (NBMC)  
 

EXPLAIN  WHY  (3marks)  


• Morphine  is  used  in  acute  left  ventricular  failure.    (CNMC)  (BSMC)  
• Bromocryptine  is  the  first  line  drug  for  hyperprolactinemia.  (BURDWAN  MC)  

6   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Morphine  is  contraindicated  in  head  injury.  (SDMC)    (RGKAR)  (MCK)  
• Levodopa  and  Carbidopa  are  combined  to  treat  Parkinson’s  disease.  (ESI  JOKA)  (MURSHIDABAD  MC)  
(NBMC)  
• Adrenaline  is  mixed  with  local  anaesthetics.  (IQ  CITY)  
• Valproate  is  effective  both  in  grand  mal  and  petit  mal  seizures.  (KPC)  
• Mannitol  is  used  in  cerebral  edema.  (KPC)  
• Levodopa  is  generally  not  used  alone  in  Parkinsonism.  (IPGMER)  
• Morphine  and  not  Pentazocine  is  preferred  in  the  treatment  of  myocardial  infarction.  
(MURSHIDABAD  MC)  
• Thiopentone  sodium  is  used  as  an  inducing  agent  in  general  anaesthesia.    (NBMC)  (ESI  JOKA)  
• Propofol  is  used  for  both  induction  and  maintenance  of  general  anaesthesia.  (NRSMC)  
• I.V.  injection  Naloxone  is  used  for  Morphine  poisoning.  (BSMC)    
• Benzodiazepines  are  preferred  over  barbiturates  as  hypnotics.  (BSMC)  
• Adrenaline  is  often  added  to  lignocaine.  (BURDWAN  MC)  (ICARE)  
• Methadone  is  used  in  morphine  withdrawal.(BSMC)  (CNMC)  
• Methadone  is  used  in  maintenance  of  opoid  dependence.  (MALDA  MC)  
• Thiopentone  sodium  is  not  used  in  maintenance  of  general  anaesthesia.  (MALDA  MC)  (NBMC)  
• Lignocaine  is  a  local  anaesthetic.  (CNMC)  
• Tricyclic  antidepressants  are  not  preferred  in  elderly  male  subjects.  (BURDWAN  MC)  
• L-­‐Dopa  is  not  used  in  treatment  of  drug  induced  Parkinsonism.  (MIDNAPORE  MC)  
• Methadone  in  morphine  addicts.  (ESI  JOKA)  
 
MECHANISM  OF  ACTION(3marks)  
• Sodium  valproate  as  antiepileptic  drug.  (Cnmc)  (Nrsmc)  (Midnapore  MC)  (Kpc)  (ICARE)  
• Atropine  substitute  in  drug  induced  Parkinsonism.  (Cnmc)  
• Lignocaine  as  local  anaesthesia.  (Sdmc)  (Murshidabad  MC)  (RG  Kar)  (Nrsmc)  (Cnmc)  (Bsmc)  
• Midazolam  as  sedative  and  hypnotic.  (Sdmc)  
• Lamotrigine  as  antiepileptic  agent.  (Sdmc)  
• Flouroxetine  as  antidepressant.  (EsiJoka)  
• Morphine  as  analgesic.  (EsiJoka)  (Midnapore  MC)  
• Benzodiazepine  as  hypnotic.  (Kpc)  (Mck)  
• Phenobarbitone  as  enzyme  inducer.  (Kpc)  
• Levodopa  in  Parkinsonism.  (Kpc)  
• Barbiturates  as  sedative-­‐hypnotic.  (Mck)  
• Rivastigmine  in  Alzheimer’s  disease.  (Murshidabad  MC)  
• Lithium  carbonate  as  a  mood  stabiliser.  (Nrsmc)  
• Enzyme  inhibiting  anti  parkinsonian  drugs.  (Nrsmc)  
• Morphine  overdose.  (IPGMER)  
• Alprazolam  in  anxiety  disorder.  (Murshidabad  MC)  (Burdwan  MC)    
• Lithium  in  bipolar  disorders.  (Murshidabad  MC)  (RG  Kar)  
• Valproic  acid  in  general  tonic  clonic  seizure.  (Nbmc)  (Murshidabad  MC)  (ICARE)  
• Carbidopa.  (Burdwan  MC)    
• Galantamine  in  Alzheimer’s  disease.  (Kpc)  
• Ethosuximide  as  an  antiepileptic  drug.  (Cnmc)  
• Methadone  used  in  morphine  de-­‐addiction.  (Cnmc)  
• Tricyclic  antidepressant.  (Mck)  
 
SHORT  NOTES  (3  marks)  
• Benzodiazepines.  (Cnmc)  
• Lithium  carbonate.  (Cnmc)  
• Propofol.  (Cnmc)  (Mck)  (Nrsmc)  

7   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Bupropion.  (Sdmc)  
• Pre-­‐anaesthetic  Medication.  (Sdmc)  
• Halothane.  (EsiJoka)  
• Diazepam.  (EsiJoka)  
• Ropinirole.  (Mck)  
• Use  of  anti-­‐depressants.  (IPGMER)  
• Olanzapine.  (Murshidabad  MC)  
• Levetiracetam.  (Murshidabad  MC,  MCK)  
• Non-­‐benzodiazepine  sedatives.  (Nbmc)  
• SSRI.  (RG  Kar)  (Bsmc)  (Malda  MC)  (Cnmc)  
• Roles  of  benzodiazepines  and  barbiturates  in  epilepsy  management.  (EsiJoka)  
• Therapeutic  indications  of  drugs  acting  on  dopamine  receptors.  (EsiJoka)  
• Opoid  antagonists.  (Burdwan  MC)  (ICARE)  
• Lithium.  (Burdwan  MC)  
• Lignocaine.(Bsmc)  
• Amantadine.  (Cnmc)  
• Fentanyl.  (Cnmc)  
• Spinal  anaesthesia.  (Kpc)  
• Pharmacotherapy  of  Schizophrenia.  (Bsmc)  
• Contraindications  of  morphine.  (Malda  MC)  
 
AUTACOIDS  
LONG  ANSWER  QUESTIONS  (10  marks)  
• Classify  NSAIDs  and  discuss  therapeutic  effects,  uses  and  adverse  effects  of  Aspirin.  (4+6)  (ICARE)  
• Classify  NSAIDs.  What  is  the  basis  of  their  anti-­‐inflammatory  actions?  What  are  the  therapeutic  uses  
of  NSAIDs?  (3+3+4)  
 
EXPLAIN  WHY  (3  marks)  
• Caffeine  is  combined  with  Ergotamine  in  the  treatment  of  acute  migraine.  (Sdmc)  
• Allopurinol  is  not  used  to  manage  pure  gout.  (EsiJoka)  (Mck)  
• 2nd  generation  antihistaminic  are  preferred  over  1st  generation  allergic  conditions.  (EsiJoka)  
• Low  dose  of  aspirin  is  usedin  post  myocardial  infarction  patients.  (ICARE)  
• Sumatriptan  and  Cyproheptadine  used  for  migraine.  (Kalyani  JNM)  
• Aspirin  may  precipitate  bronchial  asthma.  (Kalyani  JNM)  
• Prostaglandin  analogues  are  preferred  in  treatment  of  NSAID  induced  peptic  ulcer.  (Mck)  
• Colchicine  is  used  in  initial  phase  of  allopurinol  therapy.  (Cnmc)  
• Spironolactone  and  aspirin  are  not  co-­‐administered.  (Bsmc)  
• Ergometrine  should  not  be  used  for  induction  of  labour.  (Burdwan  MC)  
• Leucovorinresue  is  mandatory  in  methotrexate  therapy.  (Burdwan  MC)  
• DMARDs  are  beneficial  in  the  treatment  of  rheumatoid  arthritis.  (Murshidabad  MC)  
• Triptans  are  avoided  in  elderly  patients.  (Mck)  
• Promethazine  but  not  ondansterone  is  effective  to  control  nausea  and  vomiting  in  motion  sickness.  
(Murshidabad  MC)  
• Paracetamol  is  a  good  antipyretic  but  not  a  very  useful  anti-­‐inflammatory  agent.  (RG  Kar)  
• Aspirin  is  not  used  in  children  with  viral  infection.  (Nrsmc)  
 
MECHANISM  OF  ACTION(3  marks)  
• Promethazine  in  motion  sickness.  (Burdwan  MC)  
• Sumatriptan  in  acute  migraine.  (Bsmc)  (Nbmc)  (Nrsmc)  (Malda  MC)  
• Methotrexate  as  DMARD.  (EsiJoka)  

8   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Treatment  of  acute  attack  of  gout.  (ICARE)  
• Treatment  of  acute  attack  of  migraine.  (ICARE)  (Murshidabad  MC)  
• Aspirin  as  antiplatelet  action.  (IQ  City)  
• Allopurinol  in  gout.  (Nbmc)  (RG  Kar)  
• Methotrexate  in  rheumatoid  arthritis.    (RG  Kar)  
• Latanoprost  in  glaucoma.  (Cnmc)  (Kpc)  
• Methotrexate  as  an  anti-­‐cancer  agent.  (Cnmc)  
• Prostaglandin  analogue  in  glaucoma.  (Burdwan  MC)  
• NSAIDs  as  anti-­‐inflammatory  agent.  (ICARE)  
• Febuxostat  in  hyperuricemia.  (Mck)  
 

SHORT  NOTES  (3marks)  


• Cetirizine.  (Cnmc)  
• DMARDs  (ICARE)  (Nrsmc)  
• 5HT3  antagonists.  (ICARE)  
• Drugs  used  in  migraine.(IQ  City)  
• Conventional  vs  2nd  generation  antihistaminic.  (Kalyani  JNM)  
• Drugs  used  in  gout.  (Kalyani  JNM)  
• Methotrexate.  (Bsmc)  (Murshidabad  MC)  
• Leukotriene  receptor  antagonists.  (IPGMER)  
• Paracetamol  as  antipyretic.  (IPGMER)  
• Methotrexate  in  rheumatoid  arthritis.  (IPGMER)  
• Newer  antihistaminics.    (Burdwan  MC)  
• Non-­‐analgesic  uses  of  aspirin.  (Murshidabad  MC)  
• Ondansetron  (Nbmc)  
• Therapeutic  usesof  aspirin.  (Nbmc)  
 

CVS  
LONG  ANSWER  QUESTIONS(10  marks)  
• Enumerate  antianginal  drugs.  Write  down  the  pharmacological  management  of  Acute  Myocardial  
Infarction.  Give  justification  of  use  of  each  of  the  drugs.  (2+4+4)  (Cnmc)  
• Enumerate  anti-­‐hypertensive  drugs.  Mention  the  side  effects  of  sulfonylureas.  Dicuss  the  
management  of  hypertensive  emergency.  (5+2+3)    (Midnapore  MC)  
• Enumerate  the  antianginal  drugs.  Write  down  the  MOA  of  nitrates  in  Ischaemic  Heart  disease.  What  
do  you  understand  by  nitrate  tolerance  and  how  do  you  avoid  and  overcome  it?  (4+3+2+1)    (Cnmc)  
• A  54yr  old  male  presented  with  a  history  of  exertional  dyspnoea  and  fatigue  over  last  3  months.  The  
patient  was  diagnosed  as  a  case  of  Congestive  heart  failure.    
• Enumerate  the  drugs  that  can  be  used  for  the  treatment  of  the  patient.  
• Mention  the  group  of  drugs  can  cause  dry  cough  as  a  side  effect  with  reason.  
• How  will  they  be  helpful  in  the  above  mentioned  patient?  
• Mention  the  other  therapeutic  uses  and  two  absolute  contraindications  of  them.  (3+2+3+1+1)    (RG  
Kar)  
• Enumerate  diuretics.  Describe  the  role  of  thiazide  as  an  antihypertensive  agent.      Mention  the  
contraindication  of  thiazide.  Name  the  diuretics  used  in  secondary  hyperaldosteronism.  (3+3+3+1)    
(Nrsmc)  
• 52  years  old  male  patient  brought  to  the  emergency  department  with  the  complain  of  precordial  
chest  pain  for  last  3  hours.  ECG  shoes  it  to  be  a  case  of  anterior  wall  myocardial  infarction.  Write  
down  the  pharmacological  management  of  the  case.  Classify  different  thrombolytic  agents.  Write  
down  the  different  indications  and  contraindications  of  thrombolytic  therapy.  (4+2+2+2)    (Sdmc)  
• Enumerate  anti-­‐hypertensives.  Write  down  the  MOA  of  ACE  inhibitors  as  anti-­‐hypertensive.  What  
are  the  adverse  effects  of  ACE  inhibitors?  Name  two  drugs  used  in  hypertensive  emergency  in  
parenteral  route.  (3+3+3+1)    (Burdwan  MC)  

9   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Name  6  commonly  used  drugs  for  the  management  of  acute  myocardial  infarction.  Justify  the  uses  
of  these  drugs  in  this  situation.  (3+7)    (Cnmc)  
• Name  the  drugs  used  in  acute  myocardial  infarction.  Describe  the  MOA  and  adverse  effects  of  any  
one  of  them.  (4+3+3)    (Kpc)  
• Enumerate  the  drugs  used  in  myocardial  infarction  with  acute  left  ventricular  failure.  Discuss  any  
two  drugs  with  their  rationality  of  use  in  this  clinical  condition.  Justify  whether  Nifedipine  should  be  
used  or  not  in  this  patient.  (3+5+2)  (Murshidabad  MC)  
• Enumerate  the  drugs  used  in  the  treatment  of  angina  pectoris.  Briefly  outline  the  management  of  
unstable  angina.  (4+4=8)    (Mck)  
• Enumerate  the  drugs  used  in  the  management  of  congestive  heart  failure.  Briefly  describe  the  role  
of  ACE  inhibitors  in  Congestive  Cardiac  Failure.  Mention  the  adverse  effects  and  contraindications  of  
ACE  inhibitors.  (4+3+3)    (ICARE)  
 
EXPLAIN  WHY  (3  marks)  
• GTN  is  given  in  sublingual  route  to  manage  acute  attack  of  stable  angina  pectoris.  (EsiJoka)  (ICARE)  
• Hydrochlorothiazide  is  used  in  hypertension.  (Kpc)  
• Beta  blockers  are  anti-­‐hypertensive  drugs.  (Midnapore  MC)  
• Dopamine  is  useful  in  cardiogenic  shock  but  not  hypovolemic  shock.  (Murshidabad  MC)  (Nrsmc)  
(Midnapore  MC)  (EsiJoka)  
• Calcium  channel  blockers  are  not  used  in  treatment  of  heart  failure.  (Midnapore  MC)  
• Thiazide  diuretics  are  useful  in  treatment  of  hypertension.  (Midnapore  MC)  
• Angiotensin  Converting  Enzyme  inhibitors  is  contraindicated  in  bilateral  renal  artery  stenosis.  
(Nbmc)  
• Enalapril  and  spironolactone  should  not  be  co-­‐administered.  (Cnmc)  
• ACE  inhibitors  are  used  in  heart  failure.  (IPGMER)  
• Both  alpha  adrenergic  receptor  agonists  and  receptor  antagonists  maybe  used  in  treatment  of  
hypertension.  (EsiJoka)  
• Between  oral  and  sublingual  routes  of  administration  of  low  dose  aspirin,  one  is  preferred  over  the  
other  when  managing  a  case  of  AMI.  (EsiJoka)  
• Beta  blockers  are  contraindicated  in  variant  angina.  (Nrsmc)  
• Nitrates  are  used  in  angina  pectoris.  (Burdwan  MC)  
• Ramipril  is  preferred  as  an  antihypertensive  to  diabetes  mellitus.  (Cnmc)  
• Sodium  nitroprusside  is  the  preferred  drug  in  hypertensive  emergencies.  (Kpc)  
• ACE  inhibitors  are  better  to  be  avoided  in  patients  of  bronchial  asthma.  (Sdmc)  
• ACE  inhibitors  are  routinely  prescribed  in  patients  of  diabetes  mellitus.  (Murshidabad  MC)  
• ACE  inhibitors  reverse  remodelling  of  heart.  (Mck)  
• Eplerenone  is  used  in  congestive  heart  failure.  (Nbmc)  
• Indomethacin  for  the  treatment  of  patent  ductusarteriosus.  (ICARE)    
 
MECHANISM  OF  ACTION  (3  marks)  
• GTN  in  angina  pectoris.  (Bsmc)  (RG  Kar)  (Nbmc)  
• Methyldopa  is  antihypertensive  drug.  (Bsmc)  
• Dopamine  in  cardiogenic  shock.  (Malda  MC)  (Nrsmc)  
• Beta  blockers  as  antihypertensive  drugs.  (Midnapore  MC)  
• Atorvastatin  as  hypolipidemic  agent.  (Mck)  
• Amiodarone  as  cardiac  anti-­‐arrhythmic  agent.(Nbmc)  (Sdmc)  
• Hydrochlorothiazide  as  anti-­‐hypertensive  agent.  (Cnmc)  
• Statins  in  hyperlipidemias.  (Cnmc)  
• Nitrates  in  Ischaemic  heart  disease.  (IPGMER)  
• Statins  in  dyslipidemia.  (IPGMER)  
• Mechanism  of  synergism  between  rosuvastatin  and  exetimibe.  (EsiJoka)  

10   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Statins  as  hypolipidemic  agents.  (Nrsmc)  (Mck)  
• Digoxin  as  cardiac  inotropic  agent.  (Sdmc)  
• Digitalis  in  heart  failure.  (Burdwan  MC)  
• Amlodipine  as  anti-­‐hypertensive.  (Malda  MC)  
• Clonidine  as  anti-­‐hypertensive  agent.  (Kpc)  
• Metoprolol  in  prophylaxis  of  stable  angina  pectoris.  (Sdmc)  
• Atenolol  as  anti-­‐hypertensive  drug.  (Murshidabad  MC)  
• Fenofibrate  in  hypertrigliceridemia.  (Nbmc)  (EsiJoka)  
• Clonidine  in  primary  hypertension  treatment.  (Nbmc)  
 
SHORT  NOTES  (3  MARKS)  
• Dopamine.  (Nbmc)  
• Clonidine.  (Nbmc)  
• PPAR  as  drug  targets  in  metabolic  diseases.  (EsiJoka)  
• Drugs  acting  on  RAS.  (IQ  City)  
• Plasma  expanders.  (ICARE)  
• Atorvastatin.  (RG  Kar)  
• Phosphodiesterase  inhibitors.  (Cnmc)  
• Therapeutic  uses  of  calcium  channel  blockers.  (EsiJoka)  
 
RESPIRATORY  
LONG  ANSWER  QUESTION  (10  marks)  
• Describe  the  pharmacological  basis  of  treatment  of  bronchial  asthma.  Explain  the  MOA  of  any  of  the  
drugs  used  for  bronchial  asthma.  (5+5)  (Kalyani  JNM)  
• Enumerate  the  drugs  used  for  treatment  of  bronchial  asthma.  What  are  the  advantages  of  drug  
administration  by  inhalational  route?  Give  an  outline  for  the  treatment  of  status  asthmaticus.  
(4+2+4)    (Malda  MC)  
• Enumerate  the  drugs  used  in  treatment  of  asthma.  Outline  the  management  of  acute  severe  
asthma.  (4+4=8)  (Mck)  
• Enumerate  the  drugs  used  in  the  treatment  of  bronchial  asthma.  Mention  the  role  of  corticosteroids  
in  bronchial  asthma.  Write  down  the  management  of  acute  severe  bronchial  asthma.  (3+3+4)    
(Midnapore  MC)  
• ++  Mention  one  specialised  drug  delivery  system  in  the  treatment  of  bronchial  asthma  with  its  
advantages  and  disadvantages  in  comparision  to  the  current  dosage  forms.  (3)  (Murshidabad  MC)  
 
EXPLAIN  WHY  (3  marks)  
• Propranolol  should  be  avoided  in  bronchial  asthma.  (Cnmc)  
• Corticosteroids  are  combined  with  selective  beta  2  agonist  in  the  treatment  of  bronchial  asthma.  
(ICARE)    
• Sodium  chromoglycate  is  used  for  prophylactic  in  bronchial  asthma.  (Kalyani  JNM)  
• Nasal  decongestants  should  not  be  used  for  a  prolonged  period.  (Malda  MC)  
• Beta  blockers  should  be  avoided  in  bronchial  asthma.  (Midnapore  MC)  
• Tiotropium  bromide  is  preferred  as  bronchodilator  in  COPD.  (Nbmc)  
• Inhalational  glucocorticoids  are  used  in  bronchial  asthma.  (RG    Kar)  
• Short  acting  beta  2  adrenergic  agonists  used  in  acute  asthma.  (IPGMER)  
• Inhalational  route  is  preferred  for  pharmacotherapy  of  bronchial  asthma.(RG  Kar)  
• Combination  of  Salmeterol  and  Bedomethasone  is  used  in  meter  dose  inhaler  in  bronchial  asthma.  
(Kpc)  
• ACE  inhibitors  are  better  to  be  avoided  in  patients  of  bronchial  asthma.  (Sdmc)  
 
11   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  
 
MECHANISM  OFACTION  (3  marks)  
• Tiotropium  bromide  in  COPD.  (Sdmc)  (Malda  MC)  
• Role  of  glucocorticoid  in  bronchial  asthma.  (Malda  MC)  (Midnapore  MC)  
• Salbutamol  in  acute  severe  bronchial  asthma.  (Nbmc)  
• Monteleukast  in  the  treatment  of  bronchial  asthma.  ((Cnmc)  
 
SHORT  NOTES  (3  marks)  
• Tiotropium  bromide.  (IQ  City)  
• Mucolytics.  (Malda  MC)  
• Inhalational  glucocorticoids.  (Nbmc)  
• Management  of  acute  exacerbation  of  bronchial  asthma  in  primary  health  setting.  (EsiJoka)  
 
BLOOD  
LONG  ANSWER  QUESTIONS  (10  marks)  
• Define  and  enumerate  haematinics.  Write  down  the  pharmacotherapy  of  pernicious  anaemia.  What  
are  the  adverse  effects  of  erythropoietin?  (4+4+2)  (Burdwan  MC)  
• What  are  haematinics?  How  will  you  treat  a  case  of  iron  deficiency  anaemia?  (2+8)    (Kpc)  
• Enumerate  the  various  drugs  used  in  altering  blood  coagulation  and  mention  one  clinical  use  of  each  
drug.  What  is  drug-­‐displacement  reaction  and  explain  its  importance  in  oral  anticoagulation  therapy.  
Mention  the  clinical  condition  where  dual  antiplatelet  therapy  is  used  and  justify  this  use.  (5+3+2)    
(Murshidabad  MC)  
• Enumerate  anticoagulants  used  for  treatment  or  prophylaxis  of  deep  vein  thrombosis.  Why  are  low  
molecular  weight  heparins  being  preferred  over  unfractionated  heparin  nowadays?  What  is  the  
MOA  of  heparin  as  anticoagulant.  (3+4+3)  (  IPGMER)  
• How  will  you  treat  iron  deficiency  anaemia  in  pregnancy?  What  are  the  common  adverse  effects  of  
oral  iron  therapy?  (6+4)  (Kpc)  
 
EXPLAIN  WHY  (3  marks)  
• Vitamin  K  is  used  in  treatment  of  Warfarin  overdose.  (Burdwan  MC)  
• Low  dose  aspirin  is  used  in  post  myocardial  infarction  patients.  (ICARE)  
• Erythropoietin  is  used  in  the  treatment  of  chronic  kidney  disease.  (Mck)  
• Clopidogrel  should  carefully  be  co-­‐administered  with  Pantoprazol.  (Murshidabad  MC)  
• Oral  iron  preparation  should  not  be  used  with  antacid  preparation.  (Nbmc)  
• Vitamin  B6  is  used  in  INH  therapy.  (Cnmc)  
• Warfarin  should  be  stopped  few  days  before  an  elective  surgery  in  a  patient  who  is  on  warfarin  
therapy  for  the  past  six  months.  (EsiJoka)  
• Low  molecular  weight  heparins  are  preferred  over  unfractionated  heparins  in  Myocardial  Infarction.  
(IQ  City)  (Malda  MC)  
• Vitamin  B12  and  folic  acid  are  used  together  for  the  treatment  of  megaloblastic  anaemia.  (Bsmc)  
(Midnapore  MC)  
• Desfferrioxamine  is  used  in  thalassemia.    
• Folinic  acid  and  not  folic  acid  is  used  in  treatment  of  methotrexate  poisoning.  (IQ  City)  
• Omeprazole  maybe  added  in  patient  receiving  chronic  aspirin  therapy  whereas  should  not  be  added  
in  patient  on  clopidogrel  therapy.  (EsiJoka)  
• Warfarin  as  an  anticoagulant.  (Kpc)  (RG  Kar)  (Cnmc)  (ICARE)  
• Vitamin  K  may  be  used  to  overcome  type  A  adverse  reactions  of  certain  anticoagulant  drugs.  
(EsiJoka)  
 
MECHANISM  OF  ACTION  (3  marks)  
• Clopidogrel  as  anti-­‐platelet  agent.  (Burdwan  MC)  (Mck)  (Cnmc)  

12   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Aspirin  as  anti-­‐platelet  action.  (IQ  City)  (Sdmc)  
• Streptokinase  as  thrombolytic  agent.  (Malda  MC)  
• Low  molecular  weight  heparin  as  an  anticoagulant.  (Midnapore  MC)  
• Warfarin  in  deep  vein  thrombosis.  (Bsmc)  
• Erythropoietin  in  anaemia  of  chronic  renal  failure.  (Sdmc)  
• Warfarin  as  an  oral  anticoagulant.  (ICARE)  
 
SHORT  NOTES  (3  marks)  
• Therapeutic  uses  of  aspirin.  (EsiJoka)  
• Parenteral  iron  therapy.  (Mck)  
• Ticagrelor.  (Murshidabad  MC)  
• Desfferrioxamine.  (Midnapore  MC)  
• Low  molecular  weight  heparin.  (Nbmc)  (Midnapore  MC)  
• Erythropoietin.  (Cnmc)  
• Streptokinase.  (Cnmc)  
• Therapeutic  and  prophylactic  indications  of  Haematinics.  (EsiJoka)  
• Oral  iron  therapy.  (Sdmc)  
• Iron  preparations.  (ICARE)  
• Warfarin  sodium.  (Malda  MC)  
• Alteplase.  (RG  Kar)  (Bsmc)  
• Drugs  used  in  disorders  of  iron  homeostasis.  (EsiJoka)  
 
GIT  
LONG  ANSWER  QUESTIONS  (10  marks)  
• Classify  the  drugs  used  in  peptic  ulcer.  Describe  the  MOA  of  omeprazole.  Briefly  discuss  anti  H.  
pylori  Regimen.  (4+3+3)    (IQ  City)  
• Explain  the  MOA  of  any  anti  peptic  ulcer  drugs.  (5)  (Kalyani  JNM)  
• Why  aluminium  hydroxide  and  magnesium  hydroxide  are  used  in  combination.  (3)  (Cnmc)  
• A  35  year  old  female  patient  attended  the  outpatient  department  with  the  complaint  of  early  
satiety,  abdominal  fullness,  bloating,  indigestion  and  upper  gastro-­‐intestinal  endoscopy  shows  
antral  gastritis  with  rapid  urease  test+ve.  What  are  the  different  regimens  used  for  the  treatment  of  
the  patient.  Enumerate  different  drugs  used  for  the  reduction  of  gastric  acid  secretion.  Write  down  
the  MOA  for  pantoprazole.  (3+4+3)    (Sdmc)  
 
EXPLAIN  WHY  (3  marks)  
• Metoclopramide  is  avoided  in  patients  with  levodopa  induced  vomiting.  (ICARE)  
• Sucralfate  is  avoided  with  concurrent  administration  of  antacids.  (ICARE)  (RG  Kar)  (Malda  MC)  
• Lactulose  used  in  hepatic  coma.  (IQ  City)  
• Lactulose  used  in  hepatic  encephalopathy.  (Midnapore  MC)  (IPGMER)  (Malda  MC)  (EsiJoka)  
• Anti  H.pylori  drugs  used  in  management  of  peptic  ulcer.  (Nrsmc)  
• Promethazine  and  ondansetron  is  effective  to  control  nausea  and  vomiting  in  motion  sickness.  
(Murshidabad  MC)  
• Antacids  are  not  used  for  treating  peptic  ulcers.  (Bsmc)  
• Atropine  is  added  with  diphenoxylate  for  diarrhea  management.  (ICARE)  
 
MECHANISM  OF  ACTION  (3  marks)  
• Treatment  of  H.pylori  infection.  (ICARE)  
• Ondensetron  in  chemotherapy  induced  vomiting.  (IQ  City)  (Nbmc)  
• Proton  pump  inhibitors  as  anti-­‐ulcer  agent.  (Mck)  

13   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Omeprazole  in  peptic  ulcer.  (Midnapore  MC)  (RG  Kar)  
• Sucralfate  as  peptic  ulcer  healing  agent.  (Nbmc)  
• Rabeprazole  in  duodenal  ulcer.  (Murshidabad  MC)  
• Lactulose  in  hepatic  encephalopathy.  (RG  Kar)  (Kpc)  
• Ondansetron  as  anti-­‐emetic.  (Bsmc)  (Burdwan  MC)  
• Domperidone  as  antiemetic  and  prokinetic  agent.  (Murshidabad  MC)  
• PPI  in  treatment  of  peptic  ulcer.  (Midnapore  MC)  
 
SHORT  NOTES  (3  marks)  
• Anti  H.pylori  therapy.  (Sdmc)  (Burdwan  MC)  
• N-­‐acetyl  cysteine.  (Nbmc)  
• Lactulose.  (Murshidabad  MC)  
• Ondansetron.  (Nbmc)  
• Proton  pump  inhibitors  in  peptic  ulcer  disease.(IPGMER)  
• Metoclopramide.  (Nrsmc)  (Malda  MC)  
• Omeprazole.  (Bsmc)  
• Sucralfate.  (RG  Kar)  (Mck)  
 
RENAL  
LONG  ANSWER  QUESTIONS  (10  marks)  
• Mention  the  preferable  diuretics  used  in  management  of  hypertension,  acute  pulmonary  oedema  
and  ascites  due  to  cirrhosis  of  liver  along  with  reason.  Write  the  electrolyte  imbalance  occurred  due  
to  prolonged  use  of  diuretics.  (3+3+3+1)  (Nbmc)  
• Enumerate  diuretics.  Describe  the  role  of  thiazide  as  an  antihypertensive  agent.  Mention  the  
contraindications  of  thiazide.  Name  the  diuretic  used  in  secondary  hyperaldosteronism.  (3+3+3+1)  
(Nrsmc)  
 
EXPLAIN  WHY  (3  marks)  
• Furosemide  is  regarded  as  a  high  ceiling  diuretic.  (Bsmc)  
• Mannitol  in  cerebral  edema.  (Kpc)  (Cnmc)  
• Spironolactone  is  the  diuretic  of  choice  in  cirrhosis  of  liver.  (RG  Kar)  (Midnapore  MC)  
• Thiazide  diuretics  and  corticosteroids  both  are  unsafe  in  patients  of  diabetes  mellitus  on  long-­‐term  
use.  (Murshidabad  MC)  
• Mannitol  although  a  diuretic,  is  contraindicated  in  pulmonary  edema.  (Sdmc)  
• Furosemide  is  the  drugof  choice  in  the  treatment  of  acute  myocardial  infarction.  (Malda  MC)  
• Spironolactone  and  aspirin  are  not  co-­‐administered.  (Bsmc)  
 
 
MECHANISM  OF  ACTION  (3  marks)  
• Thiazides  in  diabetes  insipidus.  (Bsmc)  
• Furosemide  in  acute  pulmonary  edema.  (MidnaporeMC)  (EsiJoka)  
• Spironolactone.  (Malda  MC)  
 
SHORT  NOTES  (3  marks)    
• Effects  of  diuretics  on  serum  electrolyte  levels.  (EsiJoka)  
• K+  sparing  diuretics.  (Burdwan  MC)  
• Thiazide  on  electrolyte  balance.  (Burdwan  MC)  
• Osmotic  diuretics.  (ICARE)  
• Drugs  altering  Renin-­‐Angiotensin-­‐Aldosterone  axis.  (EsiJoka)  
 

14   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 

ENDOCRINE  
LONG  QUESTIONS  (10  marks)  
• Enumerate  hypoglycemic  drugs.  Mention  side  effects  of  sulfonylureas.  Discuss  management  of  
diabetic  ketoacidosis.  (5+2+3)  (Midnapore  MC)  
• Enumerate  oral  hypoglycemic  agents.  Write  down  the  mechanism  of  action  of  sulfonylurea.  What  
are  the  indications  of  insulin?  (3+2+3)  (MCK)  
• Name  some  synthetic  oestrogens  and  progestins  therapeutically.    Mention  the  uses  and  adverse  
reactions  of  progestins.  State  any  two  regimens  for  emergency  oral  contraception  along  with  
mechanism  of  action.  (3+3+4)  (IPGMER)  
• a)  A  routine  investigation  in  a  53  years  old  obese  male  smoker,  Mr.  Gupta  who  was  not  on  any  prior  
medication  ,  revealed  the  following:  BP:  176/96  mmHg  and  180/94  mmHg  on  two  successive  
recordings  7  days  apart,  Serum  total  cholesterol:  296  mg/dl,  Blood  glucose:  275  mg/dl  postprandial;  
165  mg/do  after  overnight  fast,  Fasting  triglycerides  250  mg/dl.  Urine  examination  revealed  
microalbuminuria.  ECG  and  echocardiogram  were  normal.  Briefly  outline  a  management  protocol  
for  this  patient.  b)  Enumerate  parenteral  drugs  used  in  the  management  of  Diabetes  mellitus  and  
diabetes  related  medical  emergency.  c)  What  could  be  the  problems  of  administering  s.c.  insulin  at  
the  same  site,  daily?  (4+(3+2)+1)  (ESI  JOKA)  
• Enumerate  systemic  corticosteroids.  Describe  the  pharmacological  actions  and  indications  of  
corticosteroids.  Name  one  glucocorticoid  antagonist.  (3+3+3+1)  (NRSMC)  
• Enumerate  the  insulin  analogues.  Why  human  insulin  is  preferred  over  pork  insulin.  Why  beta  
blockers  are  contraindicated  in  patients  receiving  insulin.  Mention  the  uses  of  insulin  in  different  
types  of  diabetes.  Explain  the  management  of  diabetic  ketoacidosis.  (2+1+2+2+3)  (IQ  CITY)  
• 45  yrs  old  executive  was  newly  diagnosed  to  be  suffering  from  type  2  diabetes.  Mention  the  various  
classes  of  hypoglycemics  that  could  be  suitable  for  him  and  their  adverse  effecrs.  Mention  the  
mechanism  of  DPP4  inhibitors.  (3+3+2+2)  (BSMC)  
• Mention  the  insulin  analogues.  Discuss  the  management  of  DKA.  (4)  
• Mention  the  different  types  of  OCP,  briefly  write  the  basic  mechanism  of  OCP.  (4)  (Kalyani)  
• Enumerate  the  drugs  used  in  the  treatment  of  diabetes  mellitus.  Mention  the  indications  of  insulin  
in  type  2  diabetes  mellitus.  Why  is  insulin  resistance?  (5+3+2)  (RGKMC)  
• Enumerate  the  oral  hypoglycaemic  drugs.  What  is  the  mechanism  of  action  of  gliptines?  Mention  
the  indications  of  insulin  in  type  II  diabetes  mellitus.  Write  down  the  name  of  one  rapid  acting  and  
one  long  acting  insulin  analogue.  (4+3+2+1)  (CNMC)  
• Give  an  outline  of  treatment  of  type  2  diabetes  mellitus.  What  are  the  indications  of  insulin  in  type  2  
diabetes?  (5+5)  (KPC)  
• Enumerate  four  corticosteroid  preparations  as  per  different  routes  of  administration  with  one  
appropriate  indication  of  each.  Describe  the  indications  and  role  of  corticosteroids  in  infective  
diseases.  ((4x1.5)+4)  (BMC)  
• Enumerate  commonly  used  glucocorticoids.  Briefly  describe  the  pharmacological  actions  of  
corticosteroids  utilised  for  therapy.  Mention  and  explain  any  two  contraindications  of  
corticosteroids.  What  are  the  measures  taken  to  minimize  HPA  axis  suppression.  (3+3+2+2)    
(EsiJoka)  
 
EXPLAIN  WHY(3  marks)  
• OCP  should  not  be  used  in  Rifampicin.  (IQ  CITY)  
• Both  carbimazole  and  iodine  preparation  are  required  to  prepare  the  patients  of  thyrotoxicosis  prior  
to  thyroid  surgery.  (Murshidabad  MC)  
• Levothyroxine  is  preferred  over  liothyronine  in  hypothyroidism.  (MCK)  
• Both  oestrogen  and  progesterone  is  combined  in  OCP.  (MCK)  (Bsmc)  
• Non  selective  beta  blockers  are  used  in  thyroid  storm.  (IPGMER)  
• Between  oxytocin  and  ergometrine,  one  is  preferred  in  induction  of  labour  whereas  the  other  is  
preferred  during  managing  post-­‐partum  haemorrhage.  (EsiJoka)  (Cnmc)  (Kpc)  

15   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Corticosteroid  therapy  should  not  be  abruptly  withdrawn.  (Sdmc)  (Cnmc)  
• Propranolol  is  used  in  thyroid  storm.  (Bsmc)  
• Lugol’s  iodine  is  used  in  preoperative  preparation  of  goitre.  (RG  Kar)  
• Sulfonylurea  is  contraindicated  in  pregnant  diabetic.  (Murshidabad  MC)  
• Non  selective  beta  blockers  are  avoided  in  diabetic  patients.  (Mck)  
• Sudden  withdrawal  of  systemic  glucocorticoids  is  dangerous  after  long  term  use.  (IQ  City)  
• Role  of  glucocorticoid  in  bronchial  asthma.  (Malda  MC)  
• Methyl  ergometrine  is  preferred  drug  over  oxytocin  in  post  partum  haemorrhage.  (Nbmc)  
• Propanolol  in  thyrotoxic  crisis.  (ICARE)  
• K+  channel  openers  are  avoided  with  sulfonylureas  inpatient  with  type  2  diabetes.  (ICARE)  
 
MECHANISM  OF  ACTION  (3  marks)  
• Metformin  in  diabetes  mellitus.  (Murshidabad  MC)  (EsiJoka)  (IQ  City)  (Burdwan  MC)  
• DPP-­‐IV  inhibitors  in  type  2  diabetes.  (IPGMER)  
• Bisphosphonates  in  osteoporosis.  (EsiJoka)(RG  Kar)  
• Lugol’s  iodine  in  hyperthyroid  patient  scheduledfor  thyroid  surgery.  (EsiJoka)  
• Sulfonylurea  as  an  anti-­‐diabetic  drug.  (Nrsmc)  
• Corticosteroids  in  asthma.  (Burdwan  MC)  
• Corticosteroids  as  an  anti-­‐inflammatory  agent.  (Bsmc)  
• Carbimazole  as  an  anti-­‐thyroid  drug.  (Kpc)  
• Combined  OCP.  (Bsmc)  (ICARE)  
• Radioactive  iodine  in  thyrotoxicosis.  (Murshidabad  MC)  
• Bisphosphonates.  (Malda  MC)  
• Glimeperide  as  a  hypoglycemic  drug.  (EsiJoka)  
• Exenatide  in  type-­‐2  diabetes  mellitus.  (Nbmc)  
 
SHORT  NOTES  (3  marks)  
• Sulfonylurea  and  ethyl  alcohol  interaction.  (Murshidabad  MC)  
• Emergency  contraceptive.  (“)  (Midnapore  MC)  (Sdmc)  
• Clomifene  citrate.  (“)  
• Sitagliptin.  (Midnapore  MC)  
• Glucocorticoid  antagonists.  (“)  
• Radioactive  iodine.  (RG  Kar)  (Malda  MC)  
• Metformin.  (“)  (Malda  MC)  
• Propylthiouracil  as  antithyroid  drug.  (IPGMER)  (IQ  City)  
• Corticosteroids  in  medical  emergencies.  (EsiJoka)  
• Bisphosphonates.  (Nrsmc)  (Bsmc)  (ICARE)  
• Ultra  short  acting  insulin.  (Sdmc)  
• Lugol’s  iodine.  (Sdmc)    
• Glargine.  (Murshidabad  MC)  
• Iodine  and  iodide  in  thyroid  dysfunction.  (Cnmc)  
• Treatment  of  myxoedema  coma.  (Kpc)  
• Health  benefit  of  OCP.  (Burdwan  MC)  
• Insulin  Lispro.  (Burdwan  MC)  
• Voglibose.  (Mck)  
• DPP-­‐IV  inhibitors.  (IQ  City)  (Midnapore  MC)  
• Inhalational  glucocorticoids.  (Nbmc)  
 
CHEMOTHERAPY  
LONG  ANSWER  QUESTIONS  (10  marks)  

16   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Enumerate  anti-­‐malarial  drugs.  Discuss  the  advantages  of  ACT.  Discuss  about  chemoprophylaxis  of  
malaria.  (3+2+3=8)    (Mck)  (Murshidabad  MC)  
• Enumerate  extended  spectrum  penicillin.  What  is  the  MOA  of  beta  lactam  antibiotics?    Write  down  
the  therapeutic  uses  and  adverse  effects  of  amoxicillin.(3+4+2+1)  (Cnmc)  
• A  35  year  old  female  patient  attend  the  medicine  out-­‐patient  department  with  the  complain  of  
fever  with  chill  and  rigor.  Peripheral  blood  picture  demonstrated  trophozoite  of  Plasmodium  vivax  .  
How  will  you  treat  the  patient?  Mention  different  uses  and  adverse  reactions  of  chloroquine.  Write  
down  different  artemisinin  based  combination  therapy.  (3+2+2+3)    (Sdmc)  
• Enumerate  anti-­‐malarial  drugs  and  discuss  MOA  and  adverse  effects  of  chloroquine.  (4+6)    (ICARE)  
(Nbmc)  
• Enumerate  the  drugs  used  to  treat  malaria.  Describe  briefly  the  drug  treatment  of  acute  attack  of  
falciparum  malaria.  (4+6)  (RG  Kar)  
• Name  the  anti-­‐amoebic  drugs.  What  are  the  therapeutic  uses  and  adverse  effects  of  Metronidazole?  
(4+6)    (Kpc)  
• Enumerate  the  drugs  used  in  Leprosy.  Outline  the  treatment  of  various  types  of  leprosy.  What  are  
lepra  reactions  and  how  are  they  treated.  (2+5+3)    (Bsmc)  
• Enumerate  the  drugs  used  in  UTI.  Write  down  the  therapy  of  acute  UTI.  (6+4)  (Burdwan  MC)  
• Describe  the  pharmacotherapy  of  uncomplicated  Falciparum  mlaria.  Mention  the  pharmacological  
basis  for  each  drug.  Explain  why  loading  dose  is  given  in  vivax  malaria.  Enumerate  non  malarial  uses  
of  chloroquine  and  its  adverse  effects.  (2+2+2+2+2)  (IQ  City)  
• Enumerate  anti-­‐malarial  drugs.  Mention  the  management  of  complicated  and  uncomplicated  
falciparum  malaria.  (4+3+3)  (Midnapore  MC)  
• Mention  the  common  adverse  effects  of  anti  neoplastic  drugs.  (5)  (Kalyani  JNM)  
• Mention  the  common  properties  of  aminoglycosides.(5)    (“)  
• What  are  the  principles  of  selection  of  antibiotics  for  an  infective  condition.  (5)  (Kalyani  JNM)  
• Enumerate  Aminoglycosides.  Mention  the  MOA,common  properties  and  adverse  effects  of  
aminoglycosides.  (Malda  MC)  
 
EXPLAIN  WHY  (3  marks)  
• Multiple  drug  therapy  is  recommended  in  tuberculosis.  (Cnmc)  (Murshidabad  MC)  (IQ  City)  
• Antibiotics  when  used  for  prolonged  period  can  be  harmful  for  the  body.  (Kpc)  
• Imipenem  is  given  in  combination  with  Cilastatin.  (Kpc)  (Sdmc)  
• Liposomal  Amphotericin  B  is  preferred  than  conventional  preparations  to  treat  sensitive  infectins.  
(Murshidabad  MC)  
• Cilastatin  is  combined  with  Imipenem,  but  not  meropenem  to  treat  sensitive  infections.  
(Murshidabad  MC)  
• Primaquine  is  contraindicated  in  patients  with  G-­‐6  PD  deficiency.  (Malda  MC)  
• Piperacilin  is  combined  with  tazobactum.  (Mck)  
• Mesna  is  used  along  with  cyclophosphamide.  (Mck)  
• Primaquine  is  used  both  invivax  and  falciparum  malaria.  (Cnmc)  
• Clavulanic  acid  is  used  along  with  amoxicillin.  (IQ  City)  (ICARE)  
• Difference  between  treatment  regimen  of  Rifampicin  in  tuberculosis  and  leprosy.  (Sdmc)  
• Indiscriminate  use  of  aminoglycoside  should  be  avoided  in  patient  with  competitive  neuromuscular  
blocker  during  surgical  operation.  (ICARE)  
• Trimethoprim  and  sulfamethoxazole  is  used  in  a  fixed  dose  combination.  (ICARE)  
• Probenacid  is  given  with  penicillin  in  the  treatment  of  gonorrhoea.  (ICARE)  
• Artemisinin  based  combination  therapy  is  preferred  in  acute  uncomplicated  P.falciparum  malaria.  
(Bsmc)  
• Paramomycin  use  in  luminal  amoebiasis.  (Nbmc)  
• Amoxicillin  is  positive  against  newer  gram  +ve  bacteria.  (Nbmc)  
• Combination  therapy  is  usually  beneficial  over  single  drug  therapy  in  malaria.  (EsiJoka)  
MECHANISM  OF  ACTION  (3  marks)  
17   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  
 
• Zidovudine  as  anti-­‐retroviral.  (RG  Kar)  
• Penicillin  as  antibiotic  agent.  (Kpc)  
• Penicillin  against  Gm  +ve  bacteria.  (Burdwan  MC)  
• Ciprofloxacin  in  Gm  +ve  and  Gm  0ve  conditions.  (Murshidabad  MC)  
• Cyclosporine  in  organ  transplantation.  (Mck)  
• Cisplatin.  (IQ  City)  
• Amphotericin-­‐B.  (IQ  City)  (Sdmc)  (EsiJoka)  
• Cotrimoxazole  as  anti-­‐microbial  agent.  (Midnapore  MC)  (Malda  MC)  (ICARE)  
• Aminoglycoside  antibiotics.  (Mck)  (ICARE)  
• Fluconazole  as  an  antifungal  agent.  (Cnmc)  
• Flouroquinolones  as  antimicrobial  agent.  (IQ  City)  
• Anti-­‐influenza  agents.  (ICARE)  
• Albendazole.  (ICARE)  
• Antimetabolite.  (ICARE)  
• Treatment  of  chloroquine  resistant  malaria.  (ICARE)  
• Treatment  of  category  I  pulmonary  tuberculosis.  (ICARE)  
• Gentamicin  as  bactericidal  agent.  (Nbmc)  
• Tobramycin  as  anti-­‐bacterial.  (EsiJoka)  
 
SHORT  NOTES  (3  marks)  
• Amantadine.  (Cnmc)         Rifampicin.  (Mck)  (Cnmc)  (Malda  MC)  
• Lamivudine.  (Mck)         Levofloxacin.  (Cnmc)  
• HAART.  (Cnmc)  (Kpc)  (Burdwan  MC)  (IQ  City)  (Kalyani  JNM)  
• Post  exposure  prophylaxis  of  AIDS.  (Sdmc)  (Murshidabad  MC)  
• Metronidazole.  (ICARE)       Nucleoside  reverse  transcriptase  inhibitors.  (ICARE)  
rd
• 3  generation  cephalosporin.  (ICARE)   Topical  antifungal  agents.  (ICARE)  
• Interferon  alpha.  (ICARE)  (Sdmc)     Amantadine.  (Cnmc)  
• Treatment  of  cerebral  malaria.  (Kpc)     HIV  infection.  (Sdmc)  (EsiJoka)  
• Liposomal  amphotericin-­‐B.  (Burdwan  MC)   Antimicrobial  resistance.  (Murshidabad  MC)  
• DOTS.  (Midnapore  MC)       CAT-­‐1  anti  TB.  (Kalyani  JNM)  (name  drug)  
• ACT.  (“)  (name  drug)         Multibacillary  leprosy.  (“)  (name  drug)  
• Amoebic  liver  abcess.  (“)  (name  drug)   Scabies.  (“)  (name  drug)  
• Syphilis.  (“)  (name  drug)       Lepra  reaction.  (“)  (name  drug)  
• Difference  between  antibiotics  and  chemotherapeutic  agents.  (Kalyani  JNM)  
• Bacteriostatic  vs  bactericidal  microbial  agents.  (Kalyani  JNM)  
• Metronidazole.  (Malda  MC)    (EsiJoka)   Anti-­‐  pseudomonal  beta  lactams.  (EsiJoka)  
• Targeted  drug  therapy  in  cancer  patients.  (EsiJoka)  
• Multi  drug  resistant  tuberculosis.  (EsiJoka)   Lomustine.  (Nbmc)  
MISCELLANEOUS  DRUGS  &  VITAMINS  
LONG  ANSWER  QUESTIONS  (5  marks)  
• Name  the  different  water  soluble  vitamins.  Mention  the  therapeutic  uses  of  vitamin  C  and  thiamine.  (5)  
(Kalyani  JNM)  
• What  are  the  properties  of  an  ideal  chelating  agent?  Mention  the  therapeutic  uses  of  penicillamine  and  
desferoxamine.  (5)  (Kalyani  JNM)  
 
EXPLAIN  WHY  (3  marks)  
• Ethyl  alcohol  is  used  in  methyl  alcohol  poisoning.  (Cnmc)  
 
MECHANISM  OF  ACTION  (3marks)  
• D-­‐  penicillamine  as  a  copper  chelating  agent.  (Kpc)  
• Tacrolimus.  (IQ  City)  
SHORT  NOTES  (3  marks)  
• Desferrioxamine.  (Murshidabad  MC)  
• Vitamin  D.  (Mck)  (Nbmc)  
• Monoclonal  antibody.  (IQ  City)  

18   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 

PATHOLOGY SORTED SEMESTER QUESTIONS


GENERAL
LONG QUESTIONS MARKS = 10
1) A 23 year old female attended the emergency with high rise in temperature, feeble pulse, oliguria and
respiratory distress. She gives a recent history of abortion. (1+3+4+2)
a) Name the condition the patient is suffering from.
b)Describe in brief the pathogenesis of such condition.
c)Mention the morphological changes in variousorgans.
d)Enlist the laboratory investigations yousuggest.
2) A patient is suffering from a boil in his thigh. (2+5+2+1) (ICARE)
a) Name the morphologic pattern of inflammation.
b) Discuss briefly its cellular events.
c) Define chemotaxis. Enumerate chemotaxis.
3) A person came to emergency dept with cold and clammy skin, rapid pulse rate, low BP and cold
sweating. He had been suffering from burn with severe infection. (2+5+3) (ICARE)
a) What is your diagnosis?
b) Briefly discuss the mechanism of it.
c) What are clinical stages?
4) 40 year old male presented with h/o fever, vomiting and diarrhea. Patient had temperature of 108 F, weak
rapid pulse, hypertension,tachypnoea and cold clammy cyanotic skin .Blood culture shows gram negative
bacterial infection.
a) What is your diagnosis?
b) Explain the pathogenesis and describe its various stages.
5) A 14 year old boy has undergone emergency appendisectomy for acute appendicitis. (4+4+2) (NRS)
a) Describe the process of healing of wound in such a case.
b) What are the factors that may affect the healing process?
c) What may be complications?
6) A 27 year old lady presented in the medicine OPD with the complaints of fever, arthralgia and rash over
both cheeks.(2+5+3)
a) What is your provisionaldiagnosis?(IPGMER)
b) Criteria to establish diagnosis?
c) Enumerate the glomerular changes occur in this condition.
7) A 10 year old boy while playing in the ground got an injury in the hand resulting in pain, swelling and
redness. (1+4+5)
a) What type of inflammatory reaction is it?
b) What are the vascular phenomenons?
c) What are the different chemical mediators of this phenomenon? 8) Answer (1+2+4+3) (NBMC)
a) Define diabetes mellitus.
b) What are the diagnostic criteria?
c) Outline briefly the pathogenesis of type II Diabetes Mellitus.
d) Enumerate the complications of DM.
9) A man suffered street accident leading to fracture one bone of forearm. (6+4) (MCK)
a) Describe the process of healing of bone with diagram.
b) What are the complications?
10) A 46 year old known diabetic patient suffering from pyelonephritis suddenly presented with tachypnea,
tachycardia and systolic blood pressure 76 mm Hg.(1+3+6) (IQ CITY)
a) What is your provisional diagnosis?
b) Name the common causative agents for this condition.
c) Describe the pathogenesis of the condition.
COMMENT ON MARKS =5
1)Differences between hypertrophy and hyperplasia. (CNMC)
2)Healing of fracture of bone. (CNMC)

19   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
3) Necrosis vs apoptosis. (BSMCH+MIDNAPORE+MURSHIDABAD+IPGMER)
4) Metastatic calcification vs dystrophic calcification. (MIDNAPORE+IPGMER)
5) Pathogenesis of exudate formation.
6) Dystrophic calcification. (BSMCH)
7) Retinoblastoma gene. (BSMCH)
8)Inflammation is beneficial. (SAGAR DUTTA)
9) Role of apoptosis is important in some physiological situations. (ESI)
10)Transudate differs from exudate. (ESI+KPC+BSMCH+CNMC)
11)Major histocompatibility complex. (ICARE)
12) Reactive oxygen species. (ICARE)
13)Metaplasia. (ICARE+MCK+NRS)
14)Inflammation is a double-edged sword. (IQCITY+KALYANI)
15)Granuloma in tuberculosis infection. (MCK)
16)Pathogenesis of edema in congestive cardiac failure is different from renal edema. (MCK)
17)Role of complements in acute inflammation. (MCK)
18)Dry and wet gangrene. (MIDNAPORE+ICARE)
19)Leukocyte recruitment to the sites of acute inflammation is a multistep process. (MURSHIDABAD)
20)The consequences of cell injury depend on the proportion,type, adaptability and genetic makeup of
the injured cell. (NBMC)
21)Complement, coagulation factors and kinin system play hand in hand manner in inflammation -
explain withflow chart. (NBMC)
22)Apoptosis serves many useful purposes. (NRS+ICARE)
23) Coagulative necrosis vs liquefactive necrosis. (NRS)
24) Type I hypersensitivity reaction. (IPGMER+ICARE)
25) Chemical mediators in the inflammation. (IPGMER)
26)Pathogenesis of edema in cardiac failure. (IPGMER)
27)Pathogenesis of primary and secondary healing is same.
28) Type II hyper sensitivity reaction. (ESI+SAGAR DUTTA)
29)Write briefly the pathogenesis of granulomatous inflammation with one example. (NBMC)
30)Write briefly the factors those affect the wound healing and enumerate the complications. (Malda)
31)Metaplasia is a double-edged sword. (CNMC)
32)P53 is called guardian of genome. (JNM)
33)Type IV hypersensitivity reaction plays important role in pathogenesis of tuberculosis. (JNM)
34)Necrosis differs from apoptosis. (JOKA)
35)Paraneoplastic syndrome may be helpful in the diagnosis of tumor. (NRS)
36)Carcinogenesis is a multistep process. (KPC)
37)All giant cell containing lesions are not neoplastic. (MCK)
38)Immobilization is the key for successful bone fracture healing. (BSMCH)
39)Hyperemia is an active process while congestion is a passive process. (NBMC)
40)An embolus is not always solid. (NRS)
41)Thrombus and intravascular clot are same phenomenon.
42)Thrombosis differs from clot. (SAGAR DUTTA+MIDNAPORE)
43)Granuloma vs granulation tissue. (SAGAR DUTTA)
44)Conjugated hyperbilirubinemia. (ICARE)
45) Development of neoplasia has a molecular basis. (IQ CITY)
46) Pathogenesis of edema due to cardiac disease. (SAGAR DUTTA)
47)Intact endothelium plays crucial role in homeostasis. (KALYANI)
48)Endothelial injury is the most important cause of thrombosis. (KPC)
49)Type I and II Diabetes mellitus difference (BSMC)

ANSWER THE FOLLOWING MARKS=5


1)Vascular events of acute inflammation. (CNMC)

20   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
2)Granulation tissue is not a feature of regeneration.
3)Hydrothorax is exudative in nature.
4)Chemical mediators and their role in acute inflammation. (SAGAR DUTTA)
5)Morphological pattern with examples of acute inflammation. (ESI+MURSHIDABAD)
6)Endothelium has both anticoagulant and procoagulantactivities. (ICARE)
7)Granuloma is not atumor of granulation tissue. (ICARE)
8)Macrophage lymphocyte interactions in inflammation. (IQ CITY)
9)Pathways of apoptosis with its definition. (IQ CITY+MCK+NBMC)
10)Mechanism of increased vascular permeability in acute inflammation.(KPC)
11)Pathogenesis of tubercular granuloma. (MIDNAPORE)
12)Pathophysiological classification of edema. (MURSHIDABAD)
13)Ischemic reperfusion injury. (NBMC)
14)Metaplasia. (NBMC)
15)Fat necrosis. (NBMC)
16)Autosomal recessive disorders. (IPGMER)
17)Pathogenesis of renal edema.
18)Multistep process of carcinogenesis.
19)Pathogenesis of septic shock. (MALDA, NBMC)
20)Lab diagnosis of amyloidosis. (MCK)
21)Pathogenesis of amyloidosis. (NRS)
22)Routes of metastasis with examples. (CNMC)
23)Pathology of septic shock. (CNMC, JOKA)
24)Differentiate Necrosis and Apoptosis. (CNMC, JNM)
25)Mechanism of migration of leucocyte in acute inflammation. (KPC)
26)Causes and types of gangrene. (KPC)
27)Healing of bony tissue. (MIDNAPUR)
28)Pathogenesis of thrombosis. (MIDNAPUR)
29)All granulomas are tubercular granulomas.
30)Granulation tissue is not a feature of regeneration.
31)Microscopic features along with labelled diagram of lepromatous leprosy. (ESI)
32)Examination of urine can help in differential diagnosis of jaundice. (BSMCH)
33)Fatty change is irreversible injury. (BSMCH)
34)Role of thrombin in hemostasis. (IQ CITY)
35)Thrombus. (MALDA+MCK)
36)Role of endothelial cells in thrombosis. (NRS)
37) Kidney changes in SLE. (BSMC)
38)Pathogenesis of diabetes mellitus (IQ CITY)
39)Pathogenesis of chronic complications of diabetes mellitus (JNM)
40)Significance of glycosylated hemoglobin (JOKA)

SHORT NOTES MARKS =5


1)Giant cell. (CNMC+ESI+ICARE+IQ CITY+MIDNAPORE)
2)Morphological types of necrosis. (CNMC)
3)Gaucher's cell.
4)Staining characteristics of amyloid. (KALYANI)
5)Innate immunity and acquired immunity. (BSMCH)
6)Reversible cell injury. (SAGAR DUTTA)
7)Phagocytosis. (ESI+NRS)
8)Turner's syndrome. (ESI+IPGMER+CNMC)
9)Klinefelter syndrome. (ICARE)
10)Spread of malignant tumor. (ICARE)
11) Acute phase reactants. (IQ CITY)

21   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
12)Trisomy 21 or Down's syndrome. (IQ CITY+MALDA)
13) Karyotyping. (KALYAN)I
14)Granulation tissue. (KALYANI+KPC)
15)Ketonuria. (KALYANI)
16)Hypovolemic shock. KPC
17)Gaucher’s disease. (KPC+MCK+MURSHIDABAD+NRS)
18)Endotoxic shock-pathogenesis. (MCK)
19)Role of macrophage in acute inflammation. (MCK)
20)Opsonins. (MIDNAPORE)
21)Exudate. (MIDNAPORE)
22) Carcinoma in situ. (KPC)
23)Type II hypersensitivity (CNMC, JOKA)
24)FNAC (JNM)
25)Factors influencing wound healing. (JNM)
26)Healing of wound by first intention. (KPC)
27)Pulmonary thromboembolism (KPC)
28)Tumor suppressor gene (MIDNAPORE+IPGMER)
29)Hypertrophy. (MIDNAPORE)
30)Air embolism. (MURSHIDABAD)
31) Granuloma. (MURSHIDABAD+NRS)
32)Healing by second intention. (IPGMER)
33)Etiology of amyloidosis.
34)WHO criteria for diagnosis of Diabetes Mellitus.
35)Decompression sickness.
36) Hypovolemic shock. (SAGAR DUTTA)
37) Amniotic fluid embolism. (SAGAR DUTTA)
38) Infarct (ESI)
39)Microvascular complications of diabetes (CNMC)
HAEMATOLOGY
LONG QUESTIONS MARKS = 10
1) 40 year old farmer presented with severe anemia, weakness and dyspnea on exertion .His blood
examination revealed Hemoglobin 6.5 mg/dl and low MCV. (2+2+6=10) (CNMC)
a)What is your provisional diagnosis?
b)What may be etiological causes in the case?
c)What laboratory investigations will you perform to confirm the diagnosis?
2) A 5 year old boy wasadmitted into hospital with epistaxis and petechial bleeding spots all over the
body. The boy was apparently healthy 2 days back .But there was post H/O fever with cold and cough 2
weeks before. O/E no hepatosplenomegaly,no lymphadenopathy,no sternal tenderness. (2+5+3/2+6+2)
(BSMCH/KPC)
a) What is your provisional diagnosis?
b) How can you confirm your diagnosis?
c) State the importance of three negative findings as seen during examination? OR, What are the
outcomes of this condition?
3) 45 year old male has a history of partial gastrectomy. Presently he has anemia and neurological
symptoms.
a) What is your provisional diagnosis? (2+5+3) (SAGAR DUTTA)
b) How you investigate the case to establish your diagnosis?
c) Discuss the pathogenesis of this anemia.
4) A 32 year old male having history of peptic ulceration presented with pallor, weakness and dyspnea.
Blood examination showed Hb 6 mg/dl and low MCH. (2+5+3) (IPGMER)
a) What is the possible diagnosis?
b) How will you proceed to establish the diagnosis in the laboratory?
22   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  
 
c) Discuss the pathogenesis of this condition.
5) A 7year old boy presented with petechial rash all over the body. He had a history of sore throat 2
weeks back.(2+5+3) (KALYANI)
a) What is your provisional diagnosis?
b) What lab investigations you will do to reach the diagnosis?
c) Discuss the underlying pathogenesis of this condition.
6) A 60 year old patient post gastrectomy patient presents with pallor and fatigue since a year following
gastrectomy. (1+9)(MALDA)
a) What is your provisionaldiagnosis?
b) How will you confirm the diagnosis by lab investigations?
7) 30 year old female presented with menorrhagia, weakness and dyspnea. Blood examinationrevealed
Hb =6g/dl;MCV=68fl; MCH=22pg. (1+6+3) (MURSHIDABAD)
a) What is your provisional diagnosis?
b) How will you proceed to investigate this patient to come to a diagnosis?
c)Discuss the causes and pathogenesis of this condition.
8) 65 year old male patient presented with low back pain,anemia and markedly raised ESR.X-ray of
lumbosacral region reveal multiple lytic lesions.(2+8)(CNMC)
a)What is your provisionaldiagnosis?
b) How will you proceed to confirm the diagnosis?
9) A 5 year old child presented with severe pallor and hepatosplenomegaly. He had history of repeated
blood transfusion. What is your provisional diagnosis?How will you diagnose the case in the
laboratory? (2+4+4)(JNM)
10) Discuss the underlying pathogenesis of the disease. An 18 year old boy has history of prolonged
bleeding, after trauma, hemarthroses and musclehematoma.His sister is free from these complaints.
(2+4+4) (KPC)
a) What is your provisionaldiagnosis?
b) How the conditions can be diagnosedin the laboratory?
c) Describe the mode of inheritance.

COMMENT ON MARKS =5
1)Blood transfusion is not always beneficial but may have adverse effects as well. (CNMC)
2) Sickle hemoglobin. (BSMCH)
3) Reticulocyte count is used to evaluate response to iron therapy. (IQ CITY)
4) Blast crisis is defined as transformation of chronic myeloid leukemia to acute leukemia like state.
(KPC)
5) Pathogenesis of anemia in Thalassemia. (MURSHIDABAD)
6) Component transfusion is better option than whole blood transfusion (CNMC)
7) Philadelphia chromosome may be found in Leukemia (MMC)
8) In Thalassemia, the globin chains are structurally normal. (KPC)
9) Absolute values of blood are important in assessment of anemia (JOKA)
10) Diagnosis of chronic myeloid leukemia (MALDA)
ANSWER THE FOLLOWING MARKS=5
1) Crises in sickle cell anemia. (CNMC)
2) Pathogenesis of anemia in beta thalassemia major. (NBMC+KALYANI+SAGAR DUTTA)
3)Special stains are very much useful for differential diagnosis of acute leukemias. (BSMCH)
4) Pathogenesis of DIC. (KALYANI)
5)Differences between Thalassemia major and iron deficiency anemia. (KPC)
6) Acute transfusion reaction. (MALDA)
7) Blood picture of thalassemia. (MALDA)
8) Importance of red cell indices in classification of anemia. (MIDNAPORE)
9) Blood and bone marrow picture in vitamin B12 deficiency. (MIDNAPORE)
10) Peripheral blood picture of hemolytic anemia. (MURSHIDABAD)

23   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
11) Pathogenesis of ITP. (JNM)
12) Prognostic factors for AML(JNM)
13) Diagnostic criteria of multiple myeloma. (KPC)
14) Peripheral blood smear in case of CML (JOKA)

SHORT NOTES MARKS =5


1) Disseminated intravascular coagulation (DIC)(CNMC)
2) Packed cell volume (PCV) (CNMC)
3) Vitamin B12 deficiency and folic acid deficiency anemia (BSMCH)
4) Thalassemia major and thalassemia intermedia (BSMCH)
5) Laboratory diagnosis of megaloblastic anemia(IQ CITY)
6) Diagnostic criteria of multiple myeloma(KPC)
7) Aplastic anemia (MURSHIDABAD)
8) Hazards of blood transfusion (JNM)
9) Hodgkin Lymphoma (BURDWAN)
10) Reed-Sternberg cell (MMC)
11) Differential diagnosis microcytic hypochromic anemia (KPC)
12) Leukemoidreaction (KPC)
CVS
Long Question10 Marks
1) A 45 year old man suffering from mitral stenosis, has history of tooth extraction. After that he
complains of low grade fever, haemorrhagic spots on skin and tender nodules on finger. On
examination he shows changing cardiac murmur.(1+4+5) (KPC)
a) Identify the condition.
b) What is the pathogenesis?
c) How the condition can be diagnosed?

Comment on (5 Marks)
1) Rheumatic fever is the only cause of vascular vegetations of the heart. (KALYANI+NBMC))
2) Vegetation in Rheumatic heart disease and bacterial endocarditis are not similar. (CNMC)
3) Rheumatic fever licks the heart but bites the joint (BURDWAN)
4) Utility of cardiac enzyme assay in the management of acute myocardial infarction. (MCK)
5) Role of laboratory parameters in the diagnosis of myocardial infarction. (NRS)
Answer the following. (5 Marks)
1) Pathogenesis of myocardial infarction (JNM)
2) Diagnosis of rheumatic fever (BSMC)
3) Complication of atherosclerosis (KPC)
4) Consequences and complications of myocardial infarction. (NBMC)
5) Pathogenesis of atherosclerosis. (KALYANI)

Short notes (5 marks)


1) Infective endocarditis. (MURSHIDABAD)
Liver
Long Question (10 Marks)
1) A 45 yearold chronic alcoholic male patient presented in the emergency with hematemesis. On
examination icterus was present ascites.(2+5+3) (CNMC)
a) What is your provisional diagnosis?
b) How will you approach to investigate the patient for confirmation of diagnosis?

24   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
c) Outline the pathogenesis of ascites in this case.
2) A 55 year old male with history of alcohol intake admitted in the Medicine department with clinical
features of ascites,edema,mild jaundice and upper gastrointestinal hemorrhage.(1+3+6) (R.G.KAR)
a)What is your provisional diagnosis?
b)What morphological changes are found in the organ involved?
c)Describe the laboratory tests usually done in this case for diagnosis.
3) A 50 year old male patient attended OPD and presented with long history of alcohol
intake,abdominal discomforts and occasional hematemesis.USG shows splenomegaly with fluid in
abdomen.(BURDWAN)
a)What is your provisionaldiagnosis? Suggest lab investigations to support? (2+2)
b)Describe the changes in liver in such condition;both morphological and histological. (2+2)
c)What complications do you expect in such critical condition? (2+2)

Comment on (5 marks)
1) Chronic hepatitis leads to hepatocellular carcinoma (IQ CITY)
2) Portal hypertension leads to ascites (IQ CITY)
3) Multiple etiological factors may lead to a single outcome of end stage liver disease (SAGAR
DUTTA)
4) Hepatitis B virus does not destroy hepatocytes directly (KPC)
5) Cirrhosis is not the only cause of portal hypertension (MCK)
6) Cirrhosis of liver has diverse etiology (MIDNAPORE)

Answer the following (5 marks)


1) Serological diagnosis/study of hepatitis B infection (BSMC & MMC)
2) Pathogenesis and complications of alcoholic cirrhosis (NRS)
3) Define cirrhosis. Write down the morphological classification of portal cirrhosis with examples of
each type. (2+3) (MALDA)
KIDNEY
Long Question (10marks)
1) A male patient 8 years old presented with passage of smoky urine oliguria & hypertension with
history of sore throat 2 weeks ago. (1+6+3) (IQ CITY)
a) What is your provisional diagnosis?
b) Discuss the pathogenesisof the condition.
c) Mention the urine examination findings of the above case.
Comment on (5 marks)
1) Difference between nephrotic & nephritic syndrome. (CNMC+MCK)
2) Rapidly progressive glomerulonephritis(RPGN) is not a specific etiologic form of
glomerulonephritis,rather it is a syndrome. (R G KAR, JNM)
3) Typical findings in various investigation will detect the cause of painless hematuria. (KPC)

Answer the following(5 marks)


1) Immune mechanism of glomerular injury causing glomerulonephritis. (R.G.KAR)
2) Classification of glomerulonephritis. (MURSHIDABAD)
3) Pathogenesis of post infectious glomerulonephritis. (MIDNAPORE)

Short Note (5 marks)


1) KW Lesion (IQ CITY)
2) Ketonuria (ESI)
3) Post streptococcal glomerulonephritis(NBMC)

25   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
4) Renal cell carcinoma.(NRS)

Female Genitalia
Long Question (10 marks)
1) 53 year old female presents with leucorrhoea & post menopausal bleeding for last 3
months.Colposcopic examination reveals a friable polypoid growth in the cervix.(BSMC) (2+6+2)
a) What is your provisional diagnosis?
b) How will you proceed for confirmation of your diagnosis?
c) How can you screen this ailment?
2) 40 year old female presents with post coital bleeding & foul smelling discharge par vagina.She loses
10% weight in every 2 months with loss of appetite.(2+5+3) (MIDNAPORE)
a) What is your provisional diagnosis?
b) Discuss etiopathogenesis of the condition.
c) What are the morphological features of the common type?

Comment on (5 marks)
1)Papanicolaou smear screening is effective in preventing in cervical cancer. (NBMC)
2)Cancer cervix is preventable in most cases. (MALDA)

Answer the following (5 Marks)


1) In situ carcinoma of cervix. (CNMC)
2) Lab diagnosis of cervical carcinoma (JNM)

Short note (5 Marks)


1) Benign cystic teratoma of ovary (CNMC+IQ CITY)
2) Cervical intraepithelial neoplasia (RG KAR)
3) Leiomyoma of uterus (KPC)
4) Classification of ovarian neoplasm (NBMC)
Lung
Long question (10 Marks)
1) A 55 year old male, non-smoker, presented with cough,dyspnea, hemoptysis.Radiological
investigation reveals a SOL in the hilar region. a) What is the provisional diagnosis? b) How will you
proceed to investigate for the diagnosis in the pathology laboratory? c) Write down the molecular
pathogenesis of the disease? (2+6+2)

Comment on (5 Marks)
1) Sarcoidosis & tuberculosis of lung. (BSMC)
2) Pathogenesis of emphysema. (BMC)

Answer the following (5 marks)


1) Pathogenesis & types of emphysema. (CNMC)
2) Emphysema vs chronic bronchitis. (MCK)
3) Primary vs secondary pulmonary tuberculosis.(NBMC)
Endocrine
Short notes (5 Marks)
1) Hashimoto Thyroiditis (IQ CITY)
2) Graves’ Disease of Thyroid(KPC)

26   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
3) Colloid Goiter(MIDNAPORE)
Breast
Long Question (10 Marks)
1) A 55 year old lady presented with a hard fixed lump in her left breast for the last 2 months. She also
complains of a bloody nipple discharge & dimpling of the skin over the lump.
a) What is your provisional diagnosis?
b) What is the role of cytology in the diagnosis of his case?
c) Mention various prognostic factors of this case.
d) Enumerate the various routes of metastasis. (JNM)
2) A 42 year old woman c/o right breast lump with retraction of nipple. How will you proceed to
diagnose the case? What are the histological types of CA Breast? (6+4) (MCK)
3) A 52 years old lady presented with a hard non tender mass in right breast with retraction of nipple.
a) What is your provisional diagnosis?(2+6+2) (NRS)
b) Describe the plan of investigations to reach the final diagnosis?
c) Enumerate the important prognostic factors of the condition.

Comment on(5 Marks)


1) Prognostic markers of cancer of breast. (IQCITY+KPC)
2) Prognostic and predictive factors of breast cancer (MIDNAPORE)

Answer of following (5 Marks)


1) Classify the carcinoma of breast. Write down the diagnostic work up of carcinoma breast.
(MALDA) (2+3)

Short note (5 Marks)


1) Fibroadenoma of breast. (BURDWAN)
2) FNAC of breast cancer. (RG KAR)
Male Genitalia
Answer of following (5 Marks)
1) Microscopic features of Seminoma testis. (MIDNAPORE)

Short Note (5 Marks)


1) Classification of testicular neoplasms. (JNM)
2) PSA is a prognostic marker for prostatic carcinoma. (BSMC)
3) Seminoma of testis. (BURDWAN)
4) Benign Hyperplasia of prostate. (MURSHIDABAD, MIDNAPORE)
5) Testicularteratoma (KPC)
Bone
Long question (10 Marks)
1) 8 year old boy presented with sudden onset of low grade fever, pain and redness of right knee joint
first followed by similar involvement of left knee joint along with occasional bouts of palpitation of
three days duration. He had sore throat and fever three weeks back that subsided without medication.
What is your provisional diagnosis? Discuss the pathogenesis of the condition. Which organ is
principally affected in this condition and what morphological changes are found in that organ? What
laboratory work up is necessary after clinical diagnosis is made? (1+2+4+3) (MALDA)

Comment on (5 Marks)
27   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  
 
1) Pathogenesis of osteomyelitis. (BURDWAN)
2) Histopathological examination can only confirm diagnosis of GCT of bone. (BSMC)

Answer of following (5 Marks)


1) Acute osteomyelitis. (IQCITY)
2) Morphology of osteogenic sarcoma. (NRS)

Short note (5 Marks)


1) Ewing’s sarcoma. (IQCITY, MALDA)
2) Osteosarcoma (CNMC, MURSHIDABAD)
3) Giant cell tumor of bone. (BURDWAN)
4) Sequestrum (KPC)
Skin
Short note (5 Marks)
1) Malignant melanoma (NBMC)
GIT
Long Question (10 Marks)
1) A 54 year old male presents with history of recurrent episodes of burning and aching pain in the
epigastric region. The pain is worse at night and occurs usually 1-3 hours after meals during the day.
Classically the pain is relieved by taking food. What is the provisional diagnosis? Describe the
etiopathogenesis of the disease. Describe the morphology and complications associated with the
disease. (2+3+5)
(NBMC)
Comment on (5 Marks)
1) Morphology of Crohn’s disease differs from that of ulcerative colitis (CNMC, BSMC,
MIDNAPORE, KPC)
2) All causes of colorectal carcinoma have the same pathogenic pathway. (JNM)
3) Carcinoma colon is a genetic disorder. (MURSHIDABAD, NRS)
4) Long standing H. pylori infection is a leading case gastric adenocarcinoma. (RG KAR)

Answer of following (5 Marks)


1) Difference between typhoid and tubercular ulcer. (RG KAR)
2) Intestinal tuberculous ulcer resembles typhoid ulcer. (BURDWAN)
3) Ulcerative colitis and Crohn’s disease are spectrum of same disease. (BURDWAN, MCK)
4) H. pylori and gastric disease. (MURSHIDABAD)
5) Pathogenesis of peptic ulcer (KPC)
CNS
Comment on (5 Marks)
1) Examination of CSF is helpful in differentiating between different types of meningitis. (NBMC)
2) Difference between cerebrospinal fluid findings in pyogenic and tubercular meningitis.
(MIDNAPORE, IQCITY)
3) Effect of reperfusion in ischemic tissue may be detrimental. (MALDA)

Short note (5 Marks)


1) Meningioma (JNM)

28   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
FSM SORTED SEMESTER PAPERS
MEDICAL LAWS AND ETHICS
Long Question 5 marks
1. Define consent? What are the different types of consents in medical practices? Describe briefly the procedure
of taking informed consent in a surgical operation case? Write the reasons for obtaining consent? (1+2+2+2)
(RG Kar+ Murshidabad)
2. Write down the formation of state medical council? Enumerate its function? (1+4)(KPC)
3. Define medical negligence? Discuss the conditions that must be satisfied to sue a doctor for medical
negligence? What are the differences and precautions to avoid charge of medical negligence? (1+1.5+2.5)(JNM)
4. What are the criminal courts in India? What are the powers and functions? (2.5+2.5)(PG)
5. Write in short the constitution and function of State and Indian medical council? (5)(PG+ICare)
6. What is professional medical negligence? Enumerate the types with suitable examples? Discuss the liabilities
for each type of negligence? What are the criteria to be fulfilled to prove a case of
negligence?(2+3+5+2)(ICare+ESI)
7. Write in brief about the duties of a registered medical practitioner? What are the advantages and privileges
enjoyed by a registered practitioner? (6+4)(SDMC)
8. How do you define medical ethics? Describe the function Indian Med Council? (2+8)(Medinipur)
9. Define infamous conduct? Discuss various examples of it? What are the consequences of infamous conduct?
(1+2.5+1.5)(JNM)
10. What is medical evidence? What are the different types of medical evidences? Which type of evidence
(according to presentation in court) is superior among them and why so? Describe different types of exception to
oral evidence? (1+2+2+5)(CNMC)

Short Notes 2.5 marks


1. Precaution against medical negligence (KPC) 2. Euthansia(KPC+ESI)
3. Privileged communication (NRS+Medinipur+NBMC)
4. Infamous conduct (BMC+MCK+Medinipur+KPC) 5. Informed consent (Medinipur)
6. Functions of medical council of India (Malda) 7. Consent (ESI)
8. Exhumation (ESI) 9. Vicarious liability (NRS)
10. Professional death sentence (NBMC) 11. Contributory negligence (RGK)
12. Doctrine of Res Ipsa Loquitor (SDMC)

Explain Why 2.5 marks


1. SEC 304A IPC is applicable for doctors (Malda)
2. Informed written consent is required before any medico legal examination (MALDA)
3. Therapeutic misadvantages and medical maloccurence could act as defences against alleged charge of
negligence against a doctor (NRS)
4. The unit in charge will be held responsible for mismatched blood transfusion by his or her internee PG)

Difference 2.5 marks


1. Civil and criminal negligence.(NBMC+SDMC)
2. Professional negligence and infamous conduct. (SDMC+PG+CNMC)
3. Medical ethics and medical etiquette. (JNM)

Medico-Legal Importance 2.5 marks


1. Euthansia(BMC)

LEGAL PROCEDURE
Long Questions 5 marks
1. Define inquest? What are the different types of inquest? In which section of Cr.PC the Magistrate Inquest is
done and what are the indications of magistrate inquest? (1+2+2)(IPGMER)

29   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
2. Define medical evidence? Enumerate different types of documentary evidence? What are the conditions where
leading questions are applicable in examination in chief? What are exceptions to oral evidence?
(1+2+1+1)(NRS+RGK+ICare)
3. Define summon? Being a practitioner you have received two different summons from different courts at same
day at same time. Which court will you attend and why? Give a brief description regarding the procedure to give
witness in court of law after receiving summon? (2+3+5)(NBMC)
6. Define court? Write in short the Procedure of recording of evidence in court of law? What do you mean by
hearsay evidence? What is cross examination? Classify different criminal courts in India? (1+3+1+4+4)
(JNM+Malda)
7. Enumerate the different types of medical evidence? Define subpoena? Mention the different steps of record of
evidence in the LD Court? (2.5+1+1.5)(BSMC)
8. Describe the procedure of giving evidence in a court of law? (5)(BMC)
 
Short Notes 2.5 marks
1. Witness (PG) 2. Inquest (Murshidabad+KPC+SDMC+Malda)
3. Summon (BMC+Murshidabad) 4. Magistrate Inquest (MCK)
5. Conduct money (ICare) 6. Common witness and expert witness (IQCity)
7. Subponea(ICare)
 
Explain Why 2.5 marks
1. Dying deposition is superior to dying declaration.
(JOKA+PG+SDMC+JNM+Murshidabad+Medinipur+ICare+MCK)
2. Oral evidence is superior to documentary evidence (PG)
3. Medical examiner system is superior form of inquest (ESI)
4. Doctors are considered as both common and expert witness (Malda)
5. Magistrate inquest is superior to police inquest (ICare)
 
Difference 2.5 marks
1. Examination inchief and cross examination (SSKM+MURSHIDABAD MC)
2. Police inquest and Magistrate inquest (BMC+KPC+NRS)
3. Perjury and Hostile witness (BMC+RGKMC)
4. Hostile witness and perjury. (Medinipur MC)
5. Dying declaration and dying deposition. (NBMC+Medinipur)
6. Common witness and expert witness (NBMC)
 
IDENTIFICATION
Long Questions 5 marks
1) Enumerate different types of fingerprints. State advantages and disadvantages of Dactylography? (RGK)
2) A bundle of bones is found in a dust-bin. How will you ascertain that the bones were of human origin? What
other information can you gather by examining the bones? SDMC
3) What is the medico legal importance of human hair? What is the difference between human and animal hair?
What is the rate of growth of human hair? KPC
4) How will you ascertain the age of a female with 17yrs of age? MMC
5) Among six criteria of Gustafson’s formulae which criteria can be detected in a living person? How can you
estimate the age of an unknown dead body whose total score of Gustafson’s criteria is 14? Describe the dental
charting according to F.D.I Notation. What is pink tooth? CNMC
6) A human skull is recovered from a paddy field beside a highway. A thirty year old male is reported missing
from a nearby village. How will you help the police in establishing the identification of skull to that person?
MCK
7) What are data for identification? From a crime scene investigation some black fibers have been discovered
from the body of the victim. How to establish the identity of the person after examining that fiber? NBMC
2+8
8) Sima a 16 yr old girl came to the gynae OPD with history of amenorrhea. While taking history the doctor
found that she did not attain menarche yet. On examination it was found that she had normal labia, clitoris and
vaginal introitus with normal size breast but scanty axillary hair and fallopian tube and ovaries but had testicles

30   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
in inguinal canal. Testosterone and DHT levels were within normal limits. Doctor stamped it was a case of
disorder of sexual development. What is your provisional diagnosis? Write down the basic pathology involved in
this case. How will you establish sex of Sima? NRSMC
9) Rattaan 16 yrs male had been presented at psychiatry OPD by his parents with chief complaints of
depression over the past 6 months. Taking him under confidence Psychiatrist found that his friends used to taunt
him because of his enlarged breasts like females after attainment of puberty. He was 5’11’’tall. On examination
it was found his arm span was 5’6’’.Though he was 16 yrs he had sparse axillary and pubic hair. His testicles
were small, firm, non-tender on palpation. 5th finger of his hand were bent towards the 4th finger. What is your
provisional diagnosis? What is the classical karyotype and nuclear sex? What is the characteristic finding in the
testicular tissue? NRSMC

Short Notes 2.5 marks


Latent Finger print. (SSKM) Cephalic index (SSKM)
Grenz ray study on fingerprint. (NRSMC) Rule of Hasse. (BSMC)
Turner’s syndrome. (ICARE) Intersex.(MCK)
Corpus delicti(MALDA) Sex chromatin.(MURSHIDABAD MC)
Age of mixed dentition.(ICARE) Data of identification in living person.(BSMC)
True Hermaphrodite.(SSKM) Desert syndrome.(SSKM)
Gustafson’s method.(RGKMC)
Zone of positive and negative Vital reaction.(JNM KALYANI)

Medico legal Importance 2.5 marks


Scar mark. (RGKMC) Angle of mandible. (SSKM)
Hair. (MMC) Latent fingerprint. (NRSMC)
Teeth. (MMC) Bertillon system of identification. (ESIJ)
Deciduous teeth. (MURSHIDABAD MC) Tattoo mark. (KPC)
21 yrs of age. (KALYANI MC) Bite mark. (KALYANIMC)
Fingerprint. (BSMC) 7 years of age. (CNMC)

Explain Why 2.5marks


Age estimated radiologically can be different from age estimated osteometrically. (MCK)
Fingerprint is superior to DNA fingerprint. (RGKMC)
Dactylography is considered superior to DNA fingerprinting. (ESIJ)
What is Portrait Parlae? (CNMC)
How will you determine sex and age from a tooth?(KPC)
What are the different methods of calculating stature from a beheaded body? (SSKM)
No teeth, No Burtonian line. (SSKM)

Differentiate between (2.5 marks)


Human hair and animal hair. (MCK)(SSKM)
Permanent and temporary teeth. (RGKMC)
True and psuedo-hermaphrodite. (NBMC)
Male mandible and female mandible. (NBMC)
RFLP and PCR technique of DNA fingerprinting. (ICARE)

DEATH AND ITS CAUSE


Long Questions 5 marks
1. What do you mean by sudden death? Enumerate the different causes of sudden death? What are the different
findings you will search for during postmortem examination of a sudden death and determine whether death is of
cardiovascular or respiratory origin? (1+2+2)(MCK)
2. Define death? Mention the different types of brain death? Describe in brief the changes in cadaver following
death? (1+4)(PG)
3. Define death? What is Brain death and how to establish brain death in a patient admitted in ICU while the
patient is unconscious and is on artificial ventilation? (2+8)(NBMC)

31   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
4. What is brain death? Classify death as per Gordon’s classification? One dead body was found at hotel
BLUEMOON. How will you establish that the person died within 24hrs of autopsy? (2+2+6)(PG)

Short Notes 2.5 marks


1. Suspended animation (SDMC+PG) 2. Brain Death (ESI) 3.
Sudden death (IQCity) 4. Brain stem death (Kalyani) 5. Brain stem
reflexes(RGK)

Explain Why 2.5 marks


1. Brain death is so important (KPC)
2. Classification of death has got a strong correlation with human organ transplantation in 1994(BSMC)

Differentiate between (2.5 marks)


Somatic death and molecular death. (ICARE) Pathological and medico legal autopsy. (ESIJ+JNM)

Medico-Legal Importance 2.5 marks


1. Brain stem death (JNM)
2. Sudden death (ICare)
3. Suspended animation (BSMC)

SIGNS OF DEATH
Long Question 5 marks
1) What is Rigor Mortis? Discuss the mechanism of development of Rigor Mortis. Enumerate the various
factors that affect the onset, persistence & disappearance of Rigor Mortis. (ICARE)
2) Define Rigor Mortis. Describe in brief its mechanism of formation .Discuss the condition simulating Rigor
Mortis. ( Kalyani, RG KAR)
3) What is putrefaction? Write the mechanism of putrefaction. What are the factors that influence putrefaction?
(KPC)
4) An unknown male dead body was found in a jungle on a hot, humid day in a state of decomposition with loss
of soft tissues & exposure of bones in places with offensive smell & maggots all over. Mention how you can
access the TSD of that person? (Malda)

Short Notes 2.5 marks


1) Changes in muscles after death (ESI) 2) Adipocere & mummification ( BSMC, NBMC, MSD)
3) Rigor Mortis (MSD, NRS) 4) Post mortem staining (IQ CITY)
5) Early signs of death (Malda) 6) Instantaneous rigor (PG)
7) Forensic entomology (RG KAR) 8) P.M Hypostasis (MSD)

Explain Why 2.5 marks


1) The cooling curve of human body is not a straight line. (PG,KPC)
2) First sign of decomposition is seen in right iliac fossa. (ESI,KALYANI,NBMC)
3) Entomological study in dead body helps in investigation. (MSD)
4) Greenish discoloration of right iliac fossa is the earliest sign of decomposition. (SDMC,MCK,MSD)
5) Post mortem cooling of the body is not a very reliable criterion for estimating the time since death. (ICARE)
6) P.M stain will not appear in a dead body floating in running water. (PG)
7) Heat stiffening is not followed by rigor mortis. (CNMC)
8) Stiffening of dead bodies occur in certain condition (MSD)
9) Post mortem caloricity. (KPC)
10) IN determining time of death, the doctor should consider multiple parameters.(BSMC)

Difference 2.5 marks


1) Rigor mortis & cadaveric spasm (KPC,SDMC,IQ CITY,ESI)

32   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
2) Stage of pr. Relaxation & sec. relaxation (kalyani)

Medico-Legal Importance 2.5 marks


1) Adipocere (ICARE,KPC,NBMC,SDMC) 2) Rigor mortis (MCK)
3) Entomology (BSMC) 4) Mummification (KPC)
5) Cadaveric spasm (MCK) 6) Post mortem staining (ICARE)
7) Examination of eye (kalyani)
 
INJURY
Long Questions 5 marks
1) What is the legal definition of Injury? Enumerate the different causes of Grievous hurt. How the age of a
bruise can be ascertained? (2+4+4) (Sagar Dutta)
2) Define Hurt. Classify wound medico legally? Enumerate the different causes of Grievous Hurt. (1+3+6)
(ICARE)
3) Define INJURY. What are the types of mechanical injury? Write medico legal importance of any one type of
mechanical injury. (1+2+2) (IQ CITY)
4) Define Laceration. Define different types. How can you differentiate incised wound & incised-looking
wound? (1+2.5+1.5) (Kalyani)
5) Define Bruise. Enumerate its type. What is its medico legal importance? Between abrasion and Bruise which
is more important medico-legally & why? (1+1+1+1+1) (KPC)
6) What is Duret’s Haemorrhage? Justify whether traumatic complete corneal scar is grievous hurt or not,
keeping in mind the option of treatment named “Corneal transplantation”. (5+5) (MCK)
7) What is Abrasion? Briefly describe the different types of Abrasion? (2+8) (Midnapore, ESI)
8) Define Sec 44 IPC. Name the commonest type of mechanical injury and write its medico-legal importance.
(2+1+5) (Murshidabad)
9) Define Bruise. State the color changes in bruise and its pigment. State the bruise whether there will be no
color changes will be there with its explanation. (1+2+2) (NRS)
10) Ms. Swapna Roy 12 yrs female was admitted at Casualty ward of NRSMCH with history of sudden onset of
severe unusual headache which was according to her the worst headache of her life. She had altered level of
consciousness, but no fever and no history of trauma. She had 3 episodes of vomiting before admission. Physical
examination revealed that she had neck rigidity and photophobia. What is your provisional diagnosis? Describe a
simple bed side test to confirm your diagnosis. Describe with diagram the possible commonest pathology in this
case. (NRS)
11) Define and classify stab injuries. How from the various features of a stab injury the offending weapon can be
identified? (2+3)
State Wilson’s classification of burn injuries .Describe in brief the features of ante-mortem superficial burn
injuries? (2+3) (RG KAR)
12) What is Bruise? How can you determine the age of bruise? What is mechanism of formation of parallel
bruise? (kalyani)
13) Enumerate the different types of Skull fractures. What is mechanism of producing fissure fracture? (2+2+6)
(IPGMER)
14) Define injury? Enumerate the different types of injuries produced by blunt objects. Describe briefly the
different types of Abrasion. (2+2+6) (IPGMER)
15) What is medico legal information can be obtained from a firearm wound of entry and exit and discuss the
points in detail? (10) (PG)
16) What is hurt? What is grievous hurt? Enumerate the IPC (s) in this connection. (1+3+1) (KPC)
17) Define Ballistics. Enumerate the different types of Ballistics. Describe the characteristics of riffled firearm
entry wound based on the different ranges of fire? (1+3+6) (ICARE)
18) Describe the mechanism of contre-coup injury of brain. Mention its medico legal importance? (3+2) (RG
KAR)
19) Classify burns according to the depth of tissue rupture. Describe post mortem findings of the respiratory
system in case of a fatal.
20) A recently married woman sustained burn injuries inside the kitchen with evidence of burning of her wearing
apparatus. She was shifted immediately to the nearest hospital where she was received dead by post mortem
examination. How will you ascertain a) cause of death b) nature of death? (3+2)

33   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
20) Classify mechanical injuries. a) How will you estimate time since injury from abrasion and mention medico
legal importance? (5) (ESI)
21) Describe the different types of intracranial Hemorrhages? (5) (Sagar Dutta)
22) What are the different types of intracranial hemorrhages? (5)
23) What are the different types of Skull fractures? (5) (IQ CITY)
24) Classify thermal injuries. What are the different causes of death due to burn injuries? (murshidabad)

Short Notes 2.5 marks


1) Tram track Bruise (IPGMER) 2) Ectopic Bruise (IPGMER)
3) Section 320 IPC (Murshidabad) 4) Extra dural HAEMORRHAGE (ESI)
5) Sunstroke (ESI) 6) Whiplash (ESI)
7) Contact shot rifled firearms (ESI) 8) Joule burn (BMC,MCK)
9) Thermic fever (BSMC) 10) Harakiri (BSMC)
11) Lacerated wound (murshidabad) 12) Circle of Willis (RG KAR)
13) Frost bite 14) Arborescent mark (MCK)
15) Fissure fracture (MCK) 16) Cartridge of a shot gun (NRSMCH)
17) Rule of nine 18) Homicide (NBMC)
19) Filigree burn (NBMC) 20) Undertaker fracture (NBMC)
21) Scald (CNMC) 22) Abrasion collar (ESI)
23) Tailing of wound (midnapore,CNMC) 24) Endogenous burn of electrocution (CNMC)
25) Hilt mark (Sagardutta) 26) Bevelled cut (IQ CITY)
27) Contrecoup injury (KPC) 28) Griveous hurt (Malda)
29) Rule of Wallace (murshidabad) 30) Pugilistic attitude (murshidabad)
31) Lucid interval in head injury (NBMC) 32) Chop wound (RG KAR)

Explain Why 2.5 marks


1) Tissue away from the wound tract is dangerous in gunshot injury, even not being struck at aim by the bullets
any other projectile.(CNMC)
2) Cutting an extra finger in a case of polydactyly is an eg of grievous hurt.(CNMC)
3) Color changes are noted in Bruise. (BMC)
4) The term injury & wound are different. (BMC)
5) Bruises can be found at sites different from the point of impact. (BMC)
6) Abrasion is medico legally more important than bruise. (BSMC, Sagardutta, malda, PG, ICARE, Midnapore,
CNMC)
7) Typical colour changes is not seen in sub conjunctival hemorrhage.(SDMC)
8) In case of fully penetrated stab injury, depth of wound is not always correspond with length of weapon.
(Kalyani)
9) Tattooing occurs in wound of entry in firearm injury. (KPC)
10) Incised wound bleeds more profusely than lacerated wound. (MCK, Murshidabad, ESI)
11) Absence of soot beyond bifurcation of trachea does not rule out ante mortem burn. (NRSMCH,MSD,MCK)
12) Stab injury to right ventricle is more fatal than left. (NRS,PG,BMC)
13) Arborescent markings seen in lightning (KPC)
14) Impotency in male can be caused by spinal injury. (KPC)
15) Superficial burns are more painful than deep. (ESI)
16) Degree of burn has no value in case of infected burn. (BSMC)
17) Pulling of trigger in automatic gun discharges projectile repeatedly.(BSMC)
18) Usual colour changes of bruise are not seen in sub conjunctival haemorrhage and sub dural heamorrhage.
(ICARE)
19) Primary marking and secondary markings of a recovered bullet is important for identification of firearm
injuries. (CNMC)
20) Primary impact secondary impact &secondary injury –all can occur together in RTA (JNM)
21) Wound of entry of bullet is not always smaller than wound of exit (JNM)
22) Sometimes burning and charring is present around the wound of entry in cases of electrocution. (NBMC)
23) In some cases of gunshot injury there may be an entry wound without any exit wound yet bullets can’t be
recovered .(SDMC)
24) Blood extravascated from vessels due to bruise can be collected in place other than the site of impact.
(MCK)

34   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 

Difference 2.5 marks


1) Hypostasis & bruise. (PG)
2) Burns & scalds. (KPC,ICARE,murshidabad.malda)
3) Secondary impact & secondary injury in road traffic injury (KPC)
4) Extradural & sub dural hemorrhage (KPC)
5) Auto mortem & post mortem wound. (NBMC,MSD)
6) Hanging & strangulation by ligature (ESI,MRS,ICARE)
7) Entry& exit firearm injury. (RGKAR,BMC)
8) Post mortem lividity & bruise. (KPC,CNMC)
9) Heat stroke & heat syncope.(CNMC)
10) Shot gun cartridge & rifle cartridge. (BSMC,RG KAR)
11) Incised & lacerated wound. (ICARE,MSD,IQ CITY)
12) Heat rupture & lacerated wound (ICARE, NRS)
13) Bruise& post mortem staining. (BMC)
14) Heat hematoma & extra dural hemorrhage. (MCK)
15) Traumatic SDH & traumatic EDH. (MCK)
16) Culpable homicide & murder. (kalyani)
17) Coup injury & contre coup injury.
18) Stab wound & firearm injury. (NBMC)
19) True bruise & false bruise. (BSMC, NBMC)
20) Stab & gunshot injury.(KPC)
21) Hypostasis & bruise. (midnapore)

Medico-Legal Importance 2.5 marks


1) Puppe’s rule 2) Entry wound (MSD)
3) Abrasion collar (BMC) 4) Hesitation cuts (BMC)
5) Ring fracture (SDMC) 6) Lacerated looking incised wound (CNMC)
7) Refilling of gun (KPC) 8) Gun powder residue (MCK)
9) Bevelled cut (midnapore) 10) Pugilistic attitude (MSD)
11) Fabricated injury (KPC) 12) Hilt mark (Malda,SDMC)
13) Lucid interval (NRS) 14) Ritochet bullet (CNMC, MCK)
15) Wallace rule of nine (MCK) 16) Death due to toligut ring (ICARE)
17) Defense wound (KPC)

Fill in the blanks with one word:

The commonest type of injury is ........ and its commonest type is ..........
The commonest pattern of fingerprint is ...... and its rarest pattern is .......
The commonest fracture of skull bone is ...... and fracture found in neonate is .....
Dowry death falls under .........IPC and injury falls under ..........IPC
First clause of grievious hurt is ............ and Hurt falls under .......IPC

ASPHYXIA
Long Questions 5 marks
1. Classify mechanical asphyxial death. Describe in brief the autopsy findings in a case of strangulation by
ligature. How will you differentiate it from case of hanging? (1.5+2+1.5) ESI
2. Matigara Police got information that a female was found hanging from the ceiling of room at ShivMandir
area. During investigation of the crime scenes as a Medical expert you found that a female was lying on the foor
with ligature mark over her neck? How will you come to conclusion regarding the mode manner and cause of
death of the deceased?(10)(NBMC)
3. Dead body of an unmarried girl recovered from the room of her residence in hanging condition from ceiling
fan. The arrangement of hanging process was shown disturbed.The door was not bolted from inside. By
postmortem examination how will you ascertain a) cause b) nature of death? (5+5) (Medinipur)

35   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
4. A dead body was found of a middle aged person in a jungle with multiple nail scratches abarations around the
mouth and nostrils. His lips and finger were found cyanated? What is the most probable cause and manner of
death? What postmortem findings do you expect in this case? (1+4)(CNMC+SDMC)
5. Define drowning as per WHO? How the 'Charming effect' is associated with fingerprint? Describe the
expected postmortem features of lung in a case of freshwater Drowning? (1+2+2)(CNMC+ESI)
6. Define drowning? What immersion syndrome? Discuss the patho-physiology of sea and pondwater drowning?
(2+2+6)(PG)
7. A 30yrs old female was found dead in her room with a ligature around her neck. The room was locked from
outside. A nylon rope was discovered from 1 corner of the room. How will you ascertain the cause and nature of
death? Name the main facts that should be preserved for further investigations? (2+2+1)(BMC)
8. Define drowning and classify it? Write the PM findings of freshwater drowning within 6 hours of death.
(1+2+4) (murshidabad)
9) Define hanging .what are the types of hanging? What is partial hanging? Describe PM findings of neck in
hanging? (1+1+1+2) (KPC)
10. Define Asphyxia? Define patho-physiology of asphyxia? Write down the cardinal science of asphyxia stating
the reason for production of such science? (1+4+5)(ICare+RGK)
 
Short Notes 2.5 marks
1. Sexual asphyxia (SDMC)
2. Wet Drowning (RGK)
3. Auto erotic asphyxia (ICare)
4. Hyoid bone fracture in respect to asphyxial death (NRS)
5. Traumatic Asphyxia (ESI+BSMC)
6. Classical signs of asphyxia (CNMC)
7. Judicial hangings (MCK)
8. Types of incision given during autopsy (ESI)
9. Caffey coronary (CNMC)
 
Explain Why 2.5 marks
1. Diatom test may not be conclusive in a case of drowning (SDMC+JNM+ICare)
2. Modified Y-shaped incision is used in a case of hanging (ESI)
3. Death due to drowning occurs earlier in freshwater than in saltwater (BMC+ESI)
4. Organ preserved in suspected poisoning are kept in different jars (ESI)
5. Hemodilution is more dangerous than hemoconcentration in case of drowning (Medinipur)
6. Asphyxial signs are more prominent in strangulation than hanging (MCK)
7. Sometimes typical findings are absent during autopsy in an alleged case of ante mortem drowning (NBMC)
8. Diagnosis of death due to starvation is always difficult in autopsy(BSMC)
9. The person is unable to release the knot in partial hanging though getting support from the part of the
body(Medinipur)
10. Water is not found in lung in dry drowning(KPC)
 
Difference 2.5 marks
1. Hanging and strangulation (SDMC+RGK+KPC)
2. Lung findings in freshwater and seawater drowning (ICare+BSMC+Malda
3. Fresh water and salt water drowning. (NBMC+MCK)

Medico-Legal Importance 2.5 marks


1. Partial hanging (Medinipur+Malda) 2. PostMortem examination of trachea (MCK)
3. Burking (BSMC) 4. Hyoid fracture (CNMC)
5. Hyoid bone (BMC) 6. Ligature mark around neck (Murshidabad)
7. Gettler test (NRS) 8. Tardieu spots (SDMC)
                                                                                                         
IMPOTENCY & STERILITY/PREGNANCY & ABORTION
Long Questions 5 marks

36   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
1) What is artificial insemination? What precaution should be taken prior to it? What are the probable legal
problems may arise out of artificial insemination? (1+2+2) (Murshidabad)
2) How would you define impotence? Describe the common causes of importance in a male? (1+4) (Midnapore)
3) Enumerate the grounds for termination of pregnancy as per MTP act 1971. Write down the detailed procedure
of termination of pregnancy. (1+4) (KPC)
4) Enumerate the presumptive signs of pregnancy.
5) What is assisted reproductive technique? Enlist the various methods of assisted reproductive technique. Write
in details about the artificial insemination. (1+3+6) (ICARE)
6) What do you mean by false virgin? Write down the positive signs of pregnancy. Write recent signs of
delivery. (1+4+3) (MSD)

Short Notes 2.5 marks


1) Lochia (malda,midnapore) 2) MTP act 1971 (RG KAR, MURSHIDABAD, malda)
3) Sterilisation (RG KAR) 4) Nullity of marriage (ICARE)
5) Superfecundation & superfoetation(CNMC,IQ CITY, NBMC)
6) Surrogate motherhood (kalyani) 7) Vaginismus (NBMC)
8) Artificial insemination (BMC, SDMC, ESI)
9) Pseudocyesis (KPC)
10) Quickening.(KPC)

Explain Why 2.5 marks


1) Immunological test is not a surest proof of pregnancy. (RG KAR)
2) Positive gravidex test or other immunological tests do not confirm pregnancy. (SDMC)
3) Amenorrhea is not considered to be a sure sign of pregnancy (Malda)
4) Hymen remains intact in spite of sexual intercourse (KPC, ICARE)
5) Impotence is a ground for divorce (ESI)
6) Sterility is not a ground for divorce.(BMC)
7) Ruptured hymen is not an absolute sign of defloration.(NBMC)
8) Presence of B-HCG in urine does not confirm pregnancy.(CNMC,MALDA)
9) A sperm donor cannot be charged with adultery.(BSMC)
10) Signs of resistance is not always found on physical examination of a victim of a rape .(ICARE)
11) Superfoetation may occur. (KPC)
12) Florence test has more negative value.(MALDA MC)
13) Impotency is a ground for grant of divorce.(ESIJ)

Difference 2.5 marks


1) Natural & criminal abortion. (PG,MCK,midnapore)
2) True vs false virgin. (malda,ESI,IQ CITY)
3) Torn hymen & fimbriated hymen (kalyani,ICARE)
4) Parous uterus and nulliparous uterus (CNMC)
5) Virginity and defloration (MCK, RG KAR)
6) Ruptured and fimbriated hymen. (JNM)

Medico-Legal Importance 2.5 marks


1) Hymen (midnapore,BMC) 2) Pregnancy (CNMC,BMC,KPC)
3) Quickening (ICARE,malda) 4) MTP act (kalyani)
5) Impotence (MCK) 6) Artificial insemination (BSMC,KPC)
7) Fimbriated hymen (malda,kpc) 8) Impotence quadhanc. (KPC)

INFANT DEATH
Long Questions 5 marks
1) Dead body of a new born baby is found in a dust bin. How will you ascertain that the baby was born alive or
not? (SDMC) 5
2) What is infanticide? Describe the autopsy findings in a case of live born infant. Outline the principle and
procedure of Hydrostatic test. (ESI JOKA) 1+2+2

37   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
3) What are the different acts of commission and omission related to neonatocide? (IQ) 5
4) Define stillbirth. Describe the salient autopsy findings in a case of stillbirth. (BMC) 2+3
5) Mrs. Savita Choudhury a booked case of NRSMCH 29 yrs. primigravida was admitted in labour ward in
active stage of labour. Her antenatal history was insignificant but due to delay in second stage of labour on duty
house surgeon tried forceps delivery. But the baby was born with significant respiratory distress and was
diagnosed a case of Meconium Aspiration Syndrome. On duty Paediatrician tried to resuscitate the baby but the
baby died with 10 mins following birth, in the meantime the mother suddenly developed severe respiratory
distress, became cyanotic and died with 1 hr. of delivery. Relatives of Savita Choudhury claimed that the baby
was stillborn and both baby and mother died due to medical negligence and demanded P.M. examination. Both
the dead bodies were sent to morgue.
a) How could you establish that the baby was not a case of stillborn but live born died sometimes after birth by
holding P.M. examination? 5
b) What could be the possible pathophysiology regarding the death of the mother? How will you confirm the
diagnosis? 2.5+2.5 (NRSMC)
6) One male neonate with attached umbilical cord and placenta was found lying in a roadside bush. The baby
was taken to the nearest hospital. The onduty RMO declared him brought dead and sent for post mortem
examination. Being an autopsy surgeon
a) How will you opine the baby was dead born or born alive?
b) What are the parameters you will examine to determine the age of the baby? 6+4 (MCK)
7) Enumerate the signs of recent delivery in a dead body. 5 (BMC)

Short Notes 2.5 marks


Precipitate labour(BMC) Caffey syndrome (NBMC, Malda) Radiological
findings in battered baby syndrome(NRS,KPC)

Explain Why 2.5 marks


1. A new born baby thought to be dead by his guardians suddenly started crying before cremation. (IPGMER).
2. Positive hydrostatic test is not the confirmatory test for the live birth. (MSD,kalyani,malda, KPC)
3. At times hydrostatic test may be negative even after the establishment of respiration. (Haldia)
4. Caput succedaneum and molding of the head of the newborn are generally absent in precipitate labour.
(midnapore)

Medico-Legal Importance 2.5 marks


1.Hydrostatic test(MCK,NRS) 2.Umbilical cord(JNM)

Difference 2.5 marks


1. Caput succedaneum and cephalhaematoma(MSD)
2. Respired and unrespired lung (NRS,BMC,IQ CITY, malda)
3. Dead born and live born (ESI JOKA,mursidabad,RGK)
Sexual Offences
Long Questions 5 marks
1) A minor girl with history of alleged assault has been brought to you. How would you examine your hymen?
What are the materials will you preserve in such a case? MMC
2) A teenage girl is brought by the police with history of alleged sexual assault. Describe the procedure of
examination of Victim. What will you preserve for further examination? BMC
3) One 19yrs girl is brought to the FMT dept of NRSMCH for medical examination with history of alleged rape
1 day back. What are the prerequisite needed before start of proper examination? What are the findings around
genitalia you will look for? What are the articles you will preserve for further investigation of case? MMC
4) A 16yr old unmarried girl comes to the Emergency room of the hospital you are working in and alleged that
she has been sexually assaulted by a man 4hrs back. How would you prove or disprove her? SDMC

Short Notes 2.5 marks


Sexual perversion. (MURSHIDABADMC) Sadism.(ESIJ)
Amendment of section 375 IPC .(SSKM) Vulvo-vaginal swab.(RGKMC)
IPC Section 377.(RGKMC) Drug facilitated sexual assault.(MCK)

38   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 

Medicolegal Importance 2.5 marks


Vaginal swab & smear in sexual offence cases.(RGKMC)

Explain Why 2.5marks


• Medical proof of intercourse is not legal proof of rape. (MURSHIDABAD MC)
• “Consent” plays an important role in case of sexual offence and rape. (MMC)
• Double negative opinion is given regarding the potency of subject in medico legal examinations. (NBMC)

FORENSIC PSYCHIATRY
Long Questions 5 marks
1) Define mentally ill person as per Mental Health Act. Discuss the different procedures of restraining of an
insane person. (Malda)
2) Define mentally ill person. Write various ways of restraining of a mentally ill person as per Mental Health
Act, 1987. (JNM)
3) Define illusion, delusion and hallucination. Write different types of delusion. (CNMC)

Short Notes 2.5 marks


1) Lucid interval (SDMC) 2) Delusion (RG KAR)
3) Obsession (ICARE) 4) Illusion is not diagnostic of insanity (BMC)
5) Mental Health Act (MMC) 6) Impulse (SDMC)
7) Hallucination (malda) 8) Testamentary capacity.(JNM)

Difference 2.5 marks


● Mc Naughten Rule and Sec 84 IPC (ESI, NRS)
● True insanity and feigned insanity (ESI)
● Indian and English law regarding Criminal responsibility of the insane (BMC)
● Psychosis and Neurosis. (midnapore)
Explain Why 2.5 marks
■ ‘Belief in God’ is not example of delusion (BMC)
■ Illusion is not diagnostic of insanity (BMC)
■ Delusion is the surest evidence of insanity.(MMC)

TOXICOLOGY
Long Questions 5 marks
1) Enumerate the factors which modifying the actions of poison.How will you suspect that a case of vomiting
with diarrhoea brought to the emergency is a case of poisoning? Briefly outline the management including legal
duty of such a case. (1+2+2=5) (KPC)
2) What is antidote? Enumerate different classes of antidote with examples. What is the antidote of Organo
phosphorus poisoning? 5 (malda)
3) A middle aged painter present with Paraesthesia and Atrophy of extensor muscles of hand and feet.
Examination reveals finely mottled brown pigmentations over skin flexures of eyelids, temples, neck region and
painless nasal septum perforation.
a) What is the most probable diagnosis?
b) What are the other signs and symptoms expected to be found in the case?(BMC)
c) What is the medico legal importance of the causative agent?
4) How will you manage a poisoning case (after securing airway, breathing and circulation) of Organ corrosive
causing constriction of pupil? 5(BMC)
5) A person is brought to emergency in delirious state with mydriasis and body temp. upto105F. History reveals
of taking some chapattis and curry being offered by fellow passenger in train.
a) What is the most probable diagnosis?
b) What are the other signs and symptoms expected to be found in the case? (BMC)
6) Define antidote. Discuss the different types of Antidotes with examples. 5(SDMC)

39   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
7) What are the contraindications of Gastric Lavage? What are the different types of fluids used in Gastric
Lavage? What are the complications of Gastric Lavage? 5 (MCK)
8) Write in short the signs, symptoms and treatment of chronic lead poisoning. 5(IQ CITY)
9) Mention the active principles of the following (KPC)
●Abrus precatorius ●Cannabis sativa
●Strychnosnux-vomica ●Aconitum napellus
●Yellow oleander
10) How will you manage a case of suspected poisoning with unconsciousness and constricted pupils? 5(BMC)
11) State the mechanism (toxicity) of (BMC)
■ Salts of arsenic
■ Datura seeds
■ Snake venom
12) Name the specific Antidote of (BMC)
● Copper sulphate ● Morphine
13) What is an Antidote? Enumerate different types with examples. Discuss the role of Activated charcoal in
treatment of poisoning. (ICARE)
14) Ravi a 40 yr. Old male subject came to Dental OPD with history of toothache. History revealed he was
working in paint manufacturing industry for last 10 years. Examination revealed he had carious tooth and a blue
coloured line on gingival surface. He was anaemic and his face was pale especially around mouth.
a) What is the provisional diagnosis?
b) Write down the detailed blood picture and mechanism of Anaemia in such a case.
c) How will you treat the case? (NRS)
15) Write the specific Antidotes:(NRS)
● Datura ●Paracetamol ●Cyanide ●Copper sulphate
16) A farmer alleged to have bitten by snake in the field. The farmer felt weakness of the limbs. He was brought
at casuality dept. (NRS)
a) What is the role of the doctor in the case?
b) How the bite mark help to differentiate poisonous or non-poisonous snake bite?
17) What are the different alkaloids present in datura? Describe briefly clinical features and management of a
case of Acute Datura poisoning. (1+2+2) (RG KAR)
18) What are the features of Organophosphorus? Mention the treatment. (3+2) (MMC)
19) In which poisoning such findings can be seen:
● Ochronosis ● Danbury tremors ●Basophilic stippling ●Hippus ●Opisthotonus(1*5) (MMC)
20) Describe briefly the stages of Acute Alcohol Intoxication.
State the criminal use of: ●Cannabis ●Datura seeds ●Marking nut(1*2=2+3) (midnapore)
21) A patient is brought to emergency with constricted pupil excessive salvation and vomiting which smells like
kerosene. How will you manage the case? 5 (SDMC)
22) a) McEwan’s sign is observed in which stage of which poisoning?
b) What’s the colour of urine in phenol poisoning and why?
c) Tactile Hallucination in cocaine poisoning is termed as _____________ symptom.
d) Chronic phosphorus poisoning causes ________ jaw.
e) Which portion of the spinal cord is affected in strychnine poisoning?
f) Name the action principle of Castor seeds which is a toxalbumen.
g) Corrosive sublimate is the other name of which poison?
h) ‘Run amok’ and ‘Trip’ are associated with chronic and acute __________ poisoning. (SDMC)
23) Mention the duties of doctor while attending a suspected case of poisoning in a Govt. Hospital. (Malda)(5)
24) Answer brief: (1*5=5)
● MOA of heavy metals
●Two poison causing dilation of pupil
●Constituent of universal antidote
●Two agents causing Food Poisoning
●Two contraindication of Gastric Lavage (Malda)
25) What are the dermatological signs of chronic arsenic poisoning. How can you differentiate between arsenic
poisoning and cholera?Burtonian line is seen in which poisoning? 5 (MCK)
26) Define drunken. What’s Koraskoff Psychosis? Management of a case of methanol poisoning? 5 (CNMC)
27) What are the viscera preserved for chemical analysis of a suspected case of poisoning? Name the
preservative used. Mention the indicators and contra-indicators. 5 (CNMC)

40   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
28) Write clinical features and specific treatment on case of accidental ingestion of parathion. What precautions
should be taken to minimize occupational exposure? 5 (JNM)
29) Answer briefly (JNM)
a) Write specific antidotes of methanol and Hydrocyanic acid?
b) Mention the mechanism of toxicity of Lead and Methanol.
30) Write in brief :(ESI)
a) Name the poison causes constriction of pupil.
b) Features of Methanol poisoning.
c) Features of chronic arsenic poisoning.
31) Classify poison. Describe general principles of treatment in case of poisoning. 5(ESI)
32) a) Name the acids causing liquefactive necrosis.
b) Name any three cardiac poisons.
c) Enumerate signs and symptoms of Monks Hood Poisoning.
d) What is sutari?
e) Classify corrosive poisons. (BSMC)

Short Notes 2.5 marks


● Lead palsy (midnapore) ● polyvalent snake venom (midnapore)
● vitriolage (midnapore) ●Antidote of a poison(IQ CITY)
● Chelating agents(RG KAR,BMC) ●Gastric lavage(BMC)
● Metal fume fever(NRS) ●medico logical importance of vitriolage.(SDMC)
● preservation of viscera for toxicological examination(BMC)
● viscera preservation for suspected case of poisoning (ESI)

Difference 2.5 marks


■ Tetanus and strychnine poisoning (SDMC)
■Morphological features of Cobra and Viper (IQ CITY)
■Drug addiction and Drug habituation (SDMC)
■ Tetanus and Nux vomica poisoning (RG KAR)
■Cobra and Viper bite. (RG KAR)

Explain Why 2.5 marks


○ Activated charcoal is not used in inorganic mercury salt poisoning but used in methyl mercury poisoning.
(bmc)
○Volatile poisoning in children is an absolute contraindication of stomach wash.(NRS)
○ BAL is not given by IV route.(SDMC)
○ Weak non-carbonate alkalis used in case of poisoning with corrosive acids.(IQ CITY)
○Identical longitudinal half of each kidney is preserved for chemical analysis.(IQ CITY)
○ Oximes are effective in organophosphorus poisoning not in organochlorines.(NRS)
○Stomach wash is contraindicated in kerosene oil poisoning.(ICARE)
○ Unconsciousness is not an absolute contraindication for gastric lavage.(PG)
○ Aconite can be used as ideal homicidal poison.(RG KAR)
○Viscera in a case of corrosive acid poisoning should NOT be preserved in NaCL solution.(malda)
○ Urine in phenol poisoning turns green exposure to environment.(ESI)
○ Of equal strength and volume alkalis produce more damage than acids.(BMC)
Fill in the blanks with one word:
1. Xanthoproteic Reaction is seen in .............. poisoning.
2. Absolute contraindication of stomach wash bya stomach tube is ........... poisoning.
3. Hippus is classicaly seen in ........... poisoning.
4. ........... is a chelating agent which can be given by oral route.
Miscellaneous
Long Questions 5 marks
1) A Burmese girl of about 16 yrs was found in unconscious state on Sealdah flyover in disturbed clothing &
presence of reddish stain over the undergarments. She was brought to the NRSMCH by an LSI of Entally P.S. a)
what are the pre-requisites of examination of victim girl? B) How will you proceed for examination? c) What is
Barbario’s test? ( NRS )

41   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
2) One dead body was found locked in a room inside, with one incised wound in front of the neck. One sharp
edged knife was found by the side of the body. Answer the following –a) what may be the possible cause of
death in this case? b) How can you opine that it is a suicidal injury by examining the body? c) What type of
evidence the knife is when produced in court?
3) Body of a 23 yrs old woman, married for 2 yrs, was discovered in sitting position in her locked washroom
with a dupatta around her neck, bearing a knot near the left angle of mandible. Multiple incise cuts were
observed on the anterior aspect of her left wrist. A) Determine the cause of her death. B) Mention the mode and
manner of her death. C) Enumerate the type of inquest and bare criminal act. D) Write down the findings around
neck during autopsy.

Short Notes 2.5 marks


• Post mortem findings of Chronic starvation.(ICARE)
• Philadelphia protocol (1969) of brain death.(KPC)
• Child abuse. (NBMC)

Medico legal Importance 2.5 marks


• Blood stain.(RGKMC)
• Blood group.(MCK)
• Saliva stain.(KPC)

Explain Why 2.5marks


• Why is it important to keep a patient under observation in case of head injury?(ESIJ)
• Positive benzidine test does not always indicate presence of blood. (RGKMC)

Difference between 2.5 marks


• Kidnapping and abduction. (JNM KALYANI)

Answer in short (MCK)


1. What is the maximum year of imprisonment one 1st Class judicial Magistrate can award?
2. Which reagent is used to stain Y chromosome?
3. What are the colors of post mortem stain in CO and Cyanide poisoning?
4. What are the causes of death in fresh water and salt water drowning?
5. Define Claustrophobia?
6. What is covering in relation to unethical medical practice?
7. Till what age can an offender be tried under juvenile act?
8. In which city was the first print bureau established?
9. By which stain can Y-chromosome be determined for sex chromosome study?
10. Dolicocephalic head is seen among which race?
11. Which criteria are excluded from Daliz method of Gustafson’s criteria?
12. How does superimposition help in identification?
13. What is the surest sign of starvation in post mortem table?
14. What are the asphyxial types in burking?
15. What is the commonest types of hallucination in organic disease?
16. What is Osiander’s sign of pregnancy?
17. Who is a calamite?
18. What is professional death sentence for one medical practitioner?

.........is a form of mechanical asphyxia which is almost accidental in nature.

TICK the correct answer


‘HESSEAE’S FORMULAE’ for estimation of a 4 months foetus is done by a)Square root of length in cm b) length in cm/5
c)Square root of lenth in inches. d) lenth in inches /5.
Type of hanging when knot is present at the region of occiput is a) Typical b) Atypical c)Incomplete. d) Complete.
Cause of death in ‘cafe’ category is a)Asphyxia b)Laryngeal oedema c)Cardiac arrest d) Hypertension.
A person of a minimum of ...... age can give valid consent of medical examination a) 7 years b) 10 yrs c) 12 years d) 18
years.
Which one is the positive findings of pregnancy a)Quickining b)Hegar’s Sign c)Braxton Hicks contraction d)Palpation of
fetal movement.

42   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 

MICROBIOLOGY SORTED SEMESTER QUESTIONS


GENERAL AND SYSTEMIC BACTERIOLOGY
Long Question10 marks
• A male patient aged 40 years has attended the OPD with complaints of low grade fever, night sweats and
haemoptysis since last one week and complaint of progressive weight loss. What is the clinical diagnosis?
Enumerate the causative agents. Outline the lab diagnosis. What are the methods for antibiotic sensitivity
testing for the same? (1+2+5+2)(MURSHIDABAD)
• A female patient aged 25 years has come to OPD with burning sensation during micturition for last one
week. She also complains of high fever and chills. What is the clinical condition? Enumerate the causative
agents. Write down the lab diagnosis of the commonest organism causing the disease. What is significant
bacteria? (1+2+5+2) (MURSHIDABAD, SAGAR DUTTA)
• A 10 years old child was bought to the emergency with severe diarrhea and dehydration. The stool was
liquid not mixed with blood. He gave a history of having taken food from roadside stall after school the day
before.
What is the causative agent?
How will you proceed for laboratory diagnose of such a case? (3+7) (MCK)
• A 40 year old male has come to OPD with a hard, indurate, painless ulcer in his penis.
What is your diagnosis?
What is the causative bacteria?
How will you proceed for laboratory diagnose of such a case? (1+1+8) (MCK)(RG KAR MC)
• A 40 year old male has come to OPD with a hard, indurate, painless ulcer in his penis. The inguinal
lymph nodes are swollen, discrete, rubbery and non tender. He had unprotected sexual exposure three weeks
back. What complications could occur if the patient left untreated? (2) (RG KAR MC)
• A 17 year old girl came to the Medicine OPD with history of cough and haemoptysis for last 2 weeks,
low grade fever and loss of weight over last six weeks. What is your provisional diagnosis? Write in brief the
lab diagnosis of this case.(2+8) (BURDWAN MC, NBMC,NRS)
• A 17 year old girl came to the Medicine OPD with history of cough and haemoptysis for last 2 weeks,
low grade fever and loss of weight over last six weeks.Name the bacteria responsible for the condition. What
do you mean by MDR-TB? (1+2)
• A 17 year old girl came to the Medicine OPD with history of cough and haemoptysis for last 2 weeks,
low grade fever and loss of weight over last six weeks.Acid fast bacilli is found on sputum examination. What
are the newer methods for diagnosing such cases? (7) (NBMC)
• A 17 year old girl came to the Medicine OPD with history of cough and haemoptysis for last 2 weeks,
low grade fever and loss of weight over last six weeks. How is the immune status of such a patient assessed?
Name the etiological agents.(2+2) (NRS)
• A number of people in a remote village suddenly had profuse loose watery stool accompanied with
vomiting following visiting in a fair. Some needed hospitalization and fluid therapy. What is your provisional
diagnosis? What specimen will you collect and how will you proceed to establish the diagnosis? Mention in
short the epidemiology of this disease in India. (1+1+5+3) (BURDWAN MC)
• A 10 yr old boy presented in the 2nd week of illness with history of step-ladder pattern fever. He was
found to have splenomegaly and leucopenia. What is your diagnosis? What are the bacteria responsible? How
do you go for laboratory diagnosis? What are the vaccines available?
(1+2+5+2) (CNMC, SAGAR DUTTA)
• A 25 yrs old man had a lacerated road injury. After 3 days the patient developed edema, increased
localized pain, watery serious discharge and crepitation on palpation of the injury site. The patient became
severely toxemic and skin color of the injury site changed to brown and black.What is your probable clinical
diagnosis? Name the bacterial agents responsible for such condition. How will you proceed for laboratory
diagnosis for such case? (1+3+6)
• A toxic child aged 4 yrs has been brought to emergency with fever, frequent passage of blood and mucus
per anus. What is provisional diagnosis? What are the causative bacteria? How will you proceed to diagnose
the case in the laboratory? What is the importance of microscopic examination of stool in such a case?
(1+2+5+2) (RG KAR MC)
• A 40 year old sexually active male patient attends the STI clinic of your hospital with a single relatively
avascular, painless, circumscribed superficial ulcer with surface covered with a rich glaryexudates on the
external genitalia with indurated margins of the last four weeks. On clinical examination painless, enlarged

43   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
lymph nodes with a rubbery texture are detected in the inguinal region. What is the clinical condition? Mention
the etiological agent? Describe the approach to laboratory diagnosis in this patient. (1+2+7)
(IPGMER, BSMCH)
• A 25 years old man is admitted into male medical ward with gradual rise of temperature along with
headache, malaise, anorexia & abdominal discomfort for last 7 days. On examination he looks toxemic& had
soft palpable spleen with hepatomegaly. What is your provisional diagnosis? Name the causative agents
responsible for this condition. Describe the laboratory diagnosis. What steps will you adopt to detect the
carriers & to prevent its spread?
(1+2+4+3)(MIDNAPORE MC)
• A young man has come to the OPD with a lacerated injury in the leg, with swelling and fetid odor and
crepitations.There has been a history of street injury 2 days back which was not properly attended.
What is your provisional diagnosis?
Describe the etiopathogenesis of this disease.
Give an outline of the laboratory diagnosis of this case. (1+5+4) (ICARE MC, MALDA MC)
Mention prophylaxis and treatment of such a case? (3)
• A nine year old girl attends to Medicine OPD with severe sore throat and fever for last three days. On
examination she was found enlarged tonsillar lymph nodes and exudates. What is your provisional diagnosis?
Name the causative agents. How will you proceed for laboratory diagnosis? Mention long term sequels of such
a case. (1+1+6+2) (MALDA MC)
• A 5 years old child comes to you with history of fever with stiffness of neck. His mother states that for
the last one month he has fever and sometime bouts of vomiting. His mother recently treated for tuberculosis.
What may be the causative organism of this clinical syndrome? Describe its pathogenicity in brief. How do you
go for confirmation of this case in microbiology laboratory?
(1+4+5) (BSMCH)
• Define sterilization & disinfection. Describe two methods of sterilization above 100 degrees C by moist
heat & dry heat with biological controls respectively. (2+4+4) (SAGAR DUTTA)
• Define sterilization & disinfection. Describe the principles- working and monitoring of a hot air oven.
How will you sterilize the following articles- a) glass water, b)Nutrient agar, c)platinum loop, d)blood agar,
e)gauge pieces, f)endoscopes. (5+3)(BURDWAN)
• Classify Streptococci. What are the different lesions produced by the organisms? Discuss the tests in the
laboratory to confirm the diagnosis. (3+3+4) (BURDWAN)
• An 8 year old girl was admitted through emergency because of high fever and migratory polyarthritis.
Her mother states that she developed these symptoms after a bout of sore throat accompanied by high fever
three weeks back. What may be the probable diagnosis? How do you proceed in the microbiology laboratory
for findings its etiological agents? What serological tests do you suggest in this case?
(1+6+3) (BANKURA)
• A 6 year old boy with sore throat developed a thick adherent membrane over pharynx which showed
bleeding spots on removal. What is your diagnosis? What is the etiological agent? How do you proceed for
diagnosis in the laboratory? Discuss the prophylactic measures available against this disease.
(1+1+6+2) ( CNMC)
• A 8 year old boy from rural Chhattisgarhwithout proper history of immunization presents with marked
swelling of the neck, fever and palpitation. On examination, he was found to have a dirty whitish patch on both
the tonsils and pharyngeal wall which bleeds on teasing.
What is your most probable clinical diagnosis and which is the responsible organism?
What are the complications other than sore throat caused by this bacterium? Mention the pathogenesis of the
disease.
Mention how would you diagnose the disease in the laboratory? (2+3+5) (NBMC)
• Describe different methods of genetic alternation in bacteria. How does a bacterium prevent action of
antimicrobial agents through these genetic alternations? How would you utilize the genetic makeup of a
bacterium for use in a clinical microbiology laboratory for confirmation of diagnosis? (4+3+3)
(IPGMER, ICARE)
• Describe different methods of genetic alternation in bacteria. Methods of gene transfer in bacteria?
Differentiate between mutational and transferable drug resistance.
(7+3) (IPGMER)
• A 4 yrs old child was admitted in Emergency Department with complaint of acute sore throat, dysphagia
and fever. On examination the child was found to have cervical lymphadenopathy and yellowish white
membranes over tonsils and tonsillar pillars. Name the etiological agents. How will you proceed to diagnose

44   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
the case? Write the prophylactic measures for such condition.
(1+6+3) ( IQ CITY)
• A 10 yrs old girl was brought to the hospital emergency with high fever, asphyxia and toxemia. On
examination a blackish white patch, which bleeds on removal was found over the facial area. What is your
provisional diagnosis? Name the causative organism. How will you proceed to do laboratory diagnosis? What
prophylactic measures can be taken for prevention of the disease?
(1+1+5+3)
• Define Pathogenicity. Discuss briefly the factors responsible for microbial pathogenicity.
(2+8) (MALDA MC)
• A 46 yrs old male has come to the OPD with a history of discharge of pus per urethra. He gives a history
of multiple sex partners.
What is the provisional diagnosis?
What is the causative agent?
How will you proceed to diagnose the case in the laboratory?
What is Waterhouse Friedrichsen syndrome? (1+1+5+3) (MCK)
• A 8 month old male child is brought to the emergency with history of few days pneumonia followed by
unconsciousness from today’s morning. He had an increased complete blood count. CSF was drawn and Gram
stain shows lanceolate shaped Gram positive cocci in pairs.
What is clinical diagnosis?
Outline in brief the laboratory diagnosis of the causative organism.
Write down the preventive measures. (1+6+3) (NBMC)
• A 25 years old female patient presented to Gynecology OPD with history of muco-purulent genital
discharge. On examination, there was purulent exudate coming out from the endocervix. Gram staining
revealed presence of intracellular Gram negative diplococcic with plenty of pus cells. What is probable
diagnosis? Name the causative agent. How will you proceed to diagnose the case in the laboratory?
(1+1+8) (NRS)
• A 24 yrs old patient has been brought to emergency with history of high fever, convulsion, vomiting
with neck rigidity, positive Kernig’s sign and petechial rash. What is the provisional clinical diagnosis?
Enumerate the causative agent. Describe the pathogenesis of the disease. How will you diagnose the case in the
laboratory? (1+1+2+6) (RG KAR)
• A six yrs old child developed fever with acute sore throat. On examination, there was purulent exudate
over the posterior pharynx and whitish pus points over the tonsillar crypts. Gram staining of the exudates
revealed Gram Positive cocci arranged in chains. What is the most common bacterium responsible for this
condition? Enumerate the enzymes and toxins produced by that bacterium. Discuss the laboratory diagnosis of
this condition. Name two important non-suppurative complications caused by this bacterium. (1+4+4+1)
( NRS )
Short Note 4 Marks
• Bacterial Flagella (SAGAR DUTTA, MMC)
• Bacterial conjugation (SAGAR DUTTA)
• DiarrhoeagenicE. coli (BURDWAN, KPC, IPGMER)
• Widal test (BURDWAN, IPGMER)
• Gram negative diplococci (BURDWAN)
• Lac operon hypothesis (BURDWAN)
• Fimbria and its clinical importance (NRS,BSMCH, IQCITY)
• Plasmids (BSMCH)
• Bacterial growth curve and its significance in medicine (BSMCH, ICARE, MALDA, IPGMER)
• Hot air oven (CNMC, IPGMER)
• Coagulase test ( NRS, BSMCH, CNMC, MMC, RG KAR)
• Bacterial appendages.
• Sterilization by moist heat
• Toxic shock syndrome (IQCITY, NBMC)
• Various kinds of genetic material in bacteria
• Fractional sterilization (ICARE)
• Toxins and enzymes of Streptococcus pyogenes and their roles in disease. (ICARE, KPC)
• Koch’s phenomenon (IQCITY, MIDNAPORE)
• Gaseous disinfectants (IQCITY)

45   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Transport media
• Non agglutinable Vibrio
• Types of Mutation (KPC)
• Atypical Mycobacteria (KPC)
• Bacterial Spore (MALDA, RG KAR)
• Generation time ( MCK)
• Mutation (MCK)
• Elek’s gel precipitation test (MCK, CNMC)
• Autoclave (MCK)
• Intermittent of fractional sterilization (NBMC)
• Transposons (NBMC)
• Virulence factors of Neisseria gonorrhoeae (RG KAR)
• Standard tests for Syphilis (MMC)
• Helicobacter pylori (MMC)
• Growth factor for Haemophilusinfluenzae(MMC)
• Non-gonococcal urethritis (NRS, MMC, BURDWAN)
• Environmental Mycobacteria (BURDWAN)
• Non suppurative complications of Str. pyogenes (BSMCH)
• EHEC (NBMC)
• Satellitism (NBMC)
• Mycoplasma (ESI)
• RCM (ESI)
• FTA-ABS Test (IPGMER)
• Lab diagnosis of Leptospirosis (MIDNAPUR)
• Halophilicvibrios (NRS, MIDNAPUR)
• Significant bacteriuria ( ICARE)
• X and V factors. (ICARE)
• Primary meningoencephalitis (PAM) (NRS)
• Non tuberculosis Mycobacteria (MALDA)
• VerocytotoxigenicE.coli (MALDA)
• MRSA (MALDA)
• Chlamydia trachomatis (MALDA)
• TSST ( SAGAR DUTTA)
• VDRL test (SAGAR DUTTA)
• Anamnestic response in Widal Test. (BSMCH)
• Disease caused by Helicobacter and Campylobacter. (BSMCH)
• Weil’s disease (ESIC)
• Clostridium difficile (ESIC)
• Actinomycosis (NBMC)
• H. pylori infection(NBMC)
• Enrichment media (JNM)
• Septicemic disease with outline of diagnostic (ICARE)
• Tuberculin test (KPC)
• 0-139 V. cholerae (KPC)
Difference Between 2 Marks
• Transferable& mutational drug resistance (SAGAR DUTTA, MALDA)
• Anthrax &anthracoid bacillus. (BURDWAN, NRS)
• Conjugation & Transformation (BURDWAN)
• Lag phase and log phase in bacterial growth curve. (BURDWAN)
• Gram positive and Gram negative bacteria (BSMCH, CNMC, MALDA)
• Enterococcus&Group D Streptococcus (CNMC)
• Cell wall of gram positive &gram negative bacteria (RG KAR, IQCITY)
• S. pneumoniae&Viridans Streptococci (IQCITY, MMC, SAGAR DUTTA)
• Elementary body &reticulate body of Chlamydia (SAGAR DUTTA)

46   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Flagella &fimbriae (KPC, IPGMER, RG KAR)
• Sterilization & Disinfection (KPC)
• S. aureus&S. epidermidis ( MCK)
• ETEC & EPEC (SAGAR DUTTA, MIDNAPUR)
• Classical& El Tor Vibrio (MIDNAPUR, CNMC)
• Free coagulase and bound coagulase (NBMC)
• Enriched and selective media (NBMC)
• Coagulase positive & negative Staphylococcus (MCK)
• Mycobacterium tuberculosis& NTM (MCK)
• M. tuberculosis&M. leprae (NBMC)
• M. tuberculosis&M. bovis (RG KAR, MIDNAPUR)
• Lepromatous&tuberculoid leprosy (ESIC, MIDNAPORE, MALDA)
• V. cholerae&V. parahemolyticus (IPGMER)
• VDRL & RPR (MIDNAPUR)
• Widal test & VDRL test ( ICARE)
• Lactose and non lactose fermenting bacteria (ICARE)
• Mycoplasma & cell wall deficient bacteria (BSMCH)
• Hard chancre & soft chancre (NBMC,ESIC, NRS)
• C.diphtheriae&diphtheroids (NBMC)
• Antiseptic & disinfectant (KPC)
Comment on 4 Marks
• All diphtheria bacilli isolated from throat are not pathogenic. (KPC)
• Some tests for syphilis may give biologically false positive results. (BURDWAN)
• H. influenzae does not cause influenza. (BURDWAN)
• Some special tests are needed for diagnosis of congenital syphilis. (BURDWAN)
• Widal test shows anamnestic reaction. (MMC)
• Mere isolation of gram positive bacilli with round terminal spores may not be indicative of Tetanus.
(RG KAR, MMC)
• Vibrio cholerae is not an invasive organism. (MMC)
• Only the presence of Corynebacteriumdiphtheriae in the throat does not suggest that the person is
suffering from diphtheria. (MMC)
• For a few pathogenic bacteria, Koch’s Postulates could not be established. (NRS, KPC)
• Moist heat is a better sterilizing agent than dry heat. (NRS)
• Transposons play an important role in transfer of antimicrobial drug resistance. (NRS)
• Pathogenesis of EIEC differ from that of ETEC (RG KAR)
• Some bacteria acquire gene for rug resistance by the process of transduction. (RG KAR)
• Sterilization by autoclaving needs monitoring. (KPC)
• Streptococcus pyogenes may cause both localized and systemic infections. (KPC)
• Bacterial appendages are of two types. (MCK)
• Gram negative cell wall has many layers. (MCK)
• There are various methods of bacterial gene transfer. (MMC)
• Robert Koch used certain criteria for proving the casual relationship between a microorganism and
specific disease known as Koch’s postulate. (MMC)
• Acute rheumatic fever can be sequelae of post streptococcal sore throat. (IQCITY)
• Bacteria can acquire drug resistance. (IQCITY)
• Single drug therapy is not recommended for treatment of leprosy. (IQCITY)
• Anaerobic culture can be achieved in RCM medium. (SDMC)
• Louis Pasteur is known as Father of Microbiology. (SDMC)
• Fastidious bacteria need enriched media for their growth. (SDMC)
• Spores are more resistant than vegetative organism. (BURDWAN)
• Isolation of Clostridium tetani from wounds is not diagnostic of tetanus. (BURDWAN)
• We can treat tetanus infection but not its toxin. (BSMCH)
• Antibiogram is must for Staphylococcus because of MRSA. (BSMCH)
• The presence of morphologically similar organisms does not prove the case to be diphtheria. (BSMCH)

47   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Gas gangrene is polymicrobial in nature. (BSMCH, KPC, SDMC)
• Enrichment and selective media are essentially different. (CNMC)
• Transferable drug resistance is a greater threat than mutational drug resistance. (CNMC)
• Gonococci differ from Meningococci in many ways. (CNMC)
• One bacterium cannot be firmly said to be associated with a disease, until and unless it fulfills the four
criteria of a certain postulate.
• Bacterial flagella. (I CARE)
• Koch’s Postulate. (I CARE, MURSHIDABAD, NBMC)
• Acute rheumatic fever can be sequelae of post streptococcal sore throat. (IQ CITY, MMCH, NBMC)
• Mantoux test positively may not be diagnostic of tuberculosis in India. (IQ CITY, IPGMER)
• Bacteria can acquire drug resistance. (IQ CITY)
• Single drug therapy is not recommended for treatment of leprosy. (IQ CITY)
• E. coli can cause diarrhea and dysentery. (CMC)
• Tetanus is a toxin mediated disease.
• VDRL is a non-specific test for Syphilis.
• Sterilization by autoclaving needs monitoring. (KPC, MALDA)
• All bacteria do not abide by Koch’s postulate. (KPC)
• Capsule/slime is an important weapon of the bacteria. (MMCH)
• Chocolate agar is more preferable than blood agar. (MALDA)
• The human host may acquire microbial agents by various modes of transmission. (MURSHIDABAD)
• Role of MRSA and VRE in hospital acquired infections. (NBMC)
• Conjugation is most important factor for drug resistance in bacteria. (NBMC)
• VDRL test is important even today. (MURSHIDABAD)
• VDRL test may be positive in non-treponemal disease. (JNM)
• Tuberculin test is not used for diagnosis of tuberculosis. (JNM, IQ CITY)
• Plasmids can play an important role in transmission of drug resistance. (JNM)
• Enterococcus is known for its multidrug resistance. (NBMC, ESIC)
• Mycoplasma infection cannot be treated by penicillin and cephalosporin group of drug. (NBMC)
• Selective media is mainly used for sample culture. (ESIC)
• Cl. welchii has both toxigenic invasive properties. (CMC)
• Sterilization by moist heat can take place at different temperatures. (CMC)
• Streptococcal pus is watery and often blood stained but staphylococcal pus is thick and creamy.
(BSMCH)
• Manifestation of Diphtheria is due to its toxicity. (BSMCH)
• Malignant pustule is not malignant in true sense. (BSMCH)
• Mantoux test may be used for detection of cell mediated immunity. (BSMCH)
• Rickettsiae have both viral and bacterial characteristics. (SDMC)
• After 10 days of Leptospiral infection blood culture is replaced by serology for diagnosis. (SDMC)
• Lepromin test has prognostic value. (SDMC)
• Mere presence of bacilli morphologically stimulating Corynebacteriumdiphtheriae in the throat swab
signifies little. (MALDA)
• Nocardia is detected by modified acid fast staining, (MALDA)
• In any tetanus prone injury, immediate passive immunization is needed in non-immune person.
(MALDA)
• In Primary Syphilis direct demonstration of causative agent is more rewarding than serodiagnosis.
(MALDA)
• Result of a single Widal test should be interpreted with caution. (NRS)
• VDRL positivity does not necessary mean infection by Treponema pallidum. (NRS, IPGMER)
• Patient with UTI may have a colony count of <100000 organisms per ml of urine. (NRS)
• Multibacillary leprosy is more dangerous than Paucibacillary leprosy. (I CARE)
• Enterotoxigenic bacteria are too many and their action may be different. (I CARE)
• Vibrios are not included in the family Enterobacteriaceae. (I CARE)
• Staphylococcal cross infection in hospital can be prevented by taking simple measures. (MMCH)
• A number of bacteria are responsible for causing inflammatory diarrhea. (MMCH)

48   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• At present there are many options for the detection of MTB and their drug resistance in extrapulmonary
tuberculosis. (MMCH)
• Identification of Enterobacteriacea requires a battery of tests. ( IPGMER)
• Structure of gram positive cell wall is different from gram negative cell wall. (IPGMER)
• Lepromin test is not a diagnostic test for leprosy.
• Loeffler’s serum slope is an enriched medium but is used as selective media for C. diphtheriae.
• A negative Widal test does not exclude typhoid fever.
• Acute rheumatic fever is immunologically mediated. (R G KAR)
• Mere rise of H antibody titre in Widal test is not diagnostic of Enteric fever.(R G KAR, IQ CITY)
• Some microorganism does not Koch’s postulate. (R G KAR)
• Watery diarrhea does not mean that the person suffering from cholera. (IQ CITY)
• There are many types of diarrheogenicE coli. (CNMC)
• Streptococcus pyogenes infection may lead to non-pyogenic sequelae. (CNMC)

Immunology
Long Question 10 Marks
• Define hypersensitivity. What are the types of hypersensitivity reaction? Describe one type of
hypersensitivity reaction with examples. (2+2+6) (SDMC, CNMC)
• A 4 year old girl who has been plagued with infections since infancy, an evaluation of her
immunological status is performed and observation suggests a defect in the complement system. What are the
different pathways of Complement activation? Describe in brief. (10) (NBMC)
Short Note 4 Marks
• Monoclonal Antibody (SDMC)
• Classical pathway of complement system. (SDMC, KPC)
• Atopy and anaphylaxis. (BSMCH)
• MAC (CNMC)
• MHC (CNMC, MIDNAPUR)
• IgE (ICARE, MCK)
• Secretory IgA (MALDA)
• Counterimmunoelectrophoresis (MALDA)
• IgM (MCK,MMC,RG KAR, BURDWAN)
• Superantigen (MCK, NRS, CNMC)
• Cellular factors of innate immune response (MIDNAPUR,MMC)
• Precipitation reaction (NBMC)
• Heterophile antigen (NBMC)
• Type IV Hypersensitivity (NRS,IPGMER, RG KAR)
• Null Lymphocytes (IPGMER)
• Type I Hypersensitivity reactions. (KPC)
• Type II Hypersensitivity (BURDWAN)
• Type III Hypersensitivity (MMC)
• NK Cell (RG KAR, JNM)
• Radioimmunoassay (MIDNAPUR)
• Antibody independent complement pathway (MIDNAPUR)
• Immunological tolerance (MCK)
Comment on 4 Marks
• Antigenic sharing between different species is helpful in serodiagnosis. (SDMC)
• All antibodies are immunoglobulin but all immunoglobulin are not antibodies. (CNMC)
• The basic pathogenesis of asthma and anaphylaxis are similar
• C3 protein plays a pivotal role in both innate and adaptive immunity.
• CD4+ T-helper cell plays a pivotal role in immune response(AMI &CMI) (JNM)
• Eradication of communicable disease depends on Herd immunity. (MALDA)
• Enrichment media is used in stool specimen. (MALDA)
• Immunity is of different types. (MCK)

49   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Atopy is a type of hypersensitivity. (MCK)
• Herd immunity is relevant in the control of epidemic disease. (MIDNAPUR)
• Complements can be activated by different pathways. (MMC)
• IgE mediates type I hypersensitivity reaction. (NBMC)
• Negative serological test should be interpreted with caution. (NRS)
• Complement is involved in tissue damaging reactions. (IPGMER)
• Concentration of antibody and antigen should be optimum in an antigen antibody reaction. (RG KAR)
• Haptens are incomplete antigen. (KPC)
• Penicillin can cause various types of hypersensitivity reaction. (BURDWAN)
• Alternative complement pathway is a part of innate immunity. (CNMC)
• Various mechanisms of autoimmunity.
• MHC plays an important role in immune system. (RG KAR)
• In immunization process adsorbed toxoid is a better option than fluid toxoid. (MIDNAPUR)
• Vaccines are enriched when used with adjuvants. (MIDNAPUR)
• Complements get activated in many ways. (ESIC)
• Heterophile antigens have diagnostic importance in some disease. ( RG KAR)
• Weil Felix is a heterophile agglutination test. (KPC)
Difference between 2 Marks
• Agglutination & Precipitation reaction (SDMC,CNMC, NRS)
• Innate immunity & Acquired immunity (SDMC, RG KAR)
• Active & Passive Immunity (BSMCH, MALDA, MMC)
• IgM&IgG (BSMCH, ICARE)
• Live vaccine & Killed Vaccine (ICARE)
• Exotoxin & Endotoxin (ICARE, IQC, KPC, MCK, MMC, RG KAR)
• Primary & Secondary immune response (MCK, NBMC, KPC, BURDWAN)
• CD4+ & CD8+ T-lymphocyte (NRS)
• Toxoid & Anti-toxin (IPGMER)
• T cell & B cell mediated Immune response (IPGMER, BURDWAN)
• Classical & alternate pathway of complement activation. (BURDWAN, RG KAR)
• ELISA Test
• Precipitation in liquid & precipitation in gel. (MIDNAPUR)
• ADCC (ESIC)
• Immediate & Delayed type of hypersensitivity. (KPC)

Parasitology
Long Question 10 marks
• A 40 year old lady was complaining of alternate day fever with chill and rigor for five days. On
examination he revealed a mild hepatosplenomegaly. What is your clinical diagnosis? What are the possible
etiological agents? Give an outline about the laboratory diagnosis of this condition. What are the complications
of this disease? 1+1+6+2
(MMCH,NRS,NBMC,BSMCH,BURDWAN,MURSHIDABAD,I CARE,SDMC)
• A 40 year old lady was complaining of alternate day fever with chill and rigor for five days. On
examination he revealed a mild hepatosplenomegaly. Write the life cycle of the agent in definitive host along
with diagram. 6 (IQ CITY)
• A 12 year old boy, belonging to low income group family, residing in a village, attended the OPD of our
hospital with complaints of dyspepsia, pallor, puffy face, edema of feet and ankle. On examination his Hb level
was found to be markedly low. His stool examination revealed presence of occult blood. What is the
commonest etiological helminth (genus and species) responsible for this condition? What may be the possible
route of infection in this case? Explain the cause and pattern of anemia in this helminthic infection. How the
laboratory diagnosis of this condition to be established. 1+1+4+4
(NRSMCH)
• A young man has a cystic mass in the liver with a history of close contact with the dog. What is your
provisional diagnosis? Name two etiological agents responsible for this. Write down the role of dog in such
case and laboratory diagnosis of such a case. 1+2+2+5 (ESIC)

50   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• A 40 yrs. old patient came to OPD with history of fever, anorexia, weight loss, severe pancytopenia,
hepatomegaly and huge splenomegaly for last six months. Which parasite may be causative agent? What is
your provisional diagnosis? What is the immunopathogenesis of this disease? How will you proceed for
laboratory diagnosis of this case? 1+1+3+5 (R.G.KAR)
• A child of 3 years hasbeen brought to the hospital emergency with high fever for 5 days and rashes over
the trunk which is not blanching on pressure. What is the most likely provisional diagnosis? How will you
confirm the diagnosis in laboratory? What are the complications of this clinical condition? Write briefly the
pathogenesis? 1+4+2+3 (JNM)
• A 12 years old boy residing in a rural area attended OPD with complication of indigestion, weakness,
and occasional pain in the epigastrium. On examination he is found to be anemic with hemoglobin
level8.7gm/dl. Name the probable helminths causing such clinical condition? Discuss the pathogenesis of such
disease. How do you proceed to establish diagnosis? 2+4+4 (MALDA)
Short Note 4 Marks
• Cutaneous larva migrants. (KPC)
• Pathogenesis of Extra intestinal amoebiasis. (KPC,IQ CITY)
• Hydatid cyst. (SDMC, CMC)
• Free living amoeba. (SDMC)
• Cerebral malaria. (MALDA)
• Cysticercosis. (MALDA)
• Ova of Hookworm. (I CARE)
• Occult filariasis. (BARDWAN,NBMC, MMCH)
• Visceral larva migrants. (BANKURA,IQ CITY)
• PKDL (BANKURA, NRS)
• Trichomonas vaginalis. (JNM,)
• NIH swab. (R G KAR)
• Hookworm anemia. (R G KAR)
• Differentiate between Ancylostomaduodenale&Necatoramericanus. (ESIC, CMC, SDMC)
• Toxoplasma. (CMC)
• Cysticercus. (CMC, NRS)
• Pathogenesis of filariasis. (NRS)
• Microfilaria. (CMC)
• Trophozoite of Entamoeba histolytica.(CMC)
• Ova of Enterobius. (CMC)
Comment On 4 marks
• Hookworm infection can cause severe anemia. (IQ CITY)
• Complications in patients suffering from falciparum malaria are multifactorial in organ. (MMCH)
• Iodine preparation of stool helps in differentiating amoebae. (NRS)
• Autoinfection can occur in certain helminthic infection. (NRS)
• Development of microcytic hypochromic type of anemia in Malaria is multifactorial in origin. (MMCH)
• Hypnozoites are responsible for relapse of malaria. (ESIC)
• Taeniasolium infection is more dangerous than Taeniasaginata infection. (IQ CITY)
• All forms of erythrocyte schizogony of Plasmodium falciparum are usually not found in peripheral
blood. (R G KAR, SDMC)
• Peripheral blood examination at mid night is important for diagnosis of classical filariasis. (BSMCH)
• Entamoeba histolytica may cause extra intestinal lesions. (BURDWAN)
• Parasitological demonstration is important for visceral leishmaniasis. (MURSHIDABAD)
• DEC provocative test is very helpful for detection of microfilariae. (MALDA)
• Microfilaria may not be present in peripheral blood in a case of filariasis. (KPC)
Difference Between 2 Marks
• Relapse and Recrudescence. (CMC)
• Classical filariasis and Occult filariasis. (ESIC)
• Wuchereriabancrofti&Brugiamalayi. (MMCH)
• Amoebic and bacillary dysentery. (NRS)
• Proglottides of T. solium and T. saginata. (MMCH, KPC)

51   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Fasciola hepatica vs Fasciolopsisbuski. (ESIC)
• Amastigote and Promastigote form of Leishmaniadonovani. (MALDA)
• Platyhelminthes and Nemathelminthes. (I CARE)
• Entamoeba histolytica and Entamoeba coli. (I CARE, NBMC)
• Trophozoite and cyst of Entamoeba histolytica. (BARDWAN)
• Amastigote and Promastigote. (BANKURA, IQ CITY)
• Microfilaria of W. bancrofti and microfilaria of Brugiamalayi.(R G KAR)
Virology
Long Question 10 marks
o A middle aged truck driver having a history of exposure with multiple sexual partner presented in OPD
with history of fever,weakness,wasting and chronic diarrhea for last 3 months.
§ What is the probable clinical diagnosis?
§ What are the different etiological agents?
§ Discuss in brief the different serological tests available for diagnosis of such a case. [1+2+7=10]
o A 15 year old slum dweller was admitted in the LD Hospital with muscle spasms,hyperactivity,seizures,
hyper salivation and pupillary dilation.His parents gave a history of dog bite 2 months back. [KPC]
§ What is the clinical condition and the causative agent?
§ How will you establish the laboratory diagnosis of such a case?
§ What measures taken after the animal bite could have prevented such a condition? [2+4+4=10]
o A girl while playing sustained a cut injury for which attended the ER of rural health center,where she
received one dose of tetanus toxoid.After a few weeks,she developed jaundice,loss of appetite and fever.
[IPGMER]
§ What is your clinical diagnosis? [1+1+5+3=10]
§ Name the two most likely etiological agents.
§ Describe the laboratory diagnosis of any one.
§ What are the prophylactic measures to be taken in the prevention of transmission of these infections?
o A child had an attack of fever followed by flaccid paralysis of left lower limb. [ESI-PGIMSR]
§ What will be the probable etiological agent? [1+5+4=10]
§ How will you proceed to diagnosis the case?
§ What preventive measures will you take to prevent the disease?
o A 25 year old male with a history of multiple sex partners is admitted with complaints of unexplained
fever,progressive loss of weight,persistentdiarrhea&generalized lymphadenopathy for past 6 months.
§ What is the probable diagnosis? [ESI-PGIMSR,SDMC]
§ Draw a labelled diagram of the morphology of the causative agent? [2+3+5=10]
§ Discuss the pathogenesis and laboratory diagnosis.
o Define arbovirus.Name the arbovirus prevalent in India. Name the causative agents of viral hemorrhagic
fever. Discuss the approach to laboratory diagnosis and monitoring test in patient of dengue fever.[NRS]
[1+2+2+3+2=10]
o A 30 year old male patient was brought to the emergency with complains of hallucination, fluctuating
level of consciousness and difficulty in drinking of water despite of intense thirst. He had a past history of
animal bite 5 days back. [NBMC]
§ What is your probable clinical diagnosis? [1+5+4=10]
§ How will you confirm the diagnosis in the laboratory?
§ What are the measures available to prevent such a condition?
o A truck driver with history of exposure, has been admitted in hospital with fever,weakness,severe loss of
weight, anorexia,chronic diarrhea and generalized lymphadenopathy for last 6 months [R.G.KAR]
§ Enumerate the viruses which may cause such disease. [1+5+4=10]
§ How will you proceed to diagnosis the case in the laboratory?
§ While drawing blood from the patient you got a needle prick injury,what post exposure prophylaxis will
you take?
o A 62 year old male with history of COPD presented severe URTI in month of January.He had had
history of exposure to a patient having similar condition.Throat swab collected & sent to reference lab for real
time PCR which revealed causative agent could be segmented RNA virus. [ESIC]
§ What is the etiological agent and mechanism of emergence of this particular strain of virus?[1+2]
§ Describe the mode of transmission & laboratory diagnosis of causative agent.[1+4]
§ What are the preventive measures available for this condition?[2]

52   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
o A 40 year old man attended the medicine OPD of MMCH with insidious onset of anorexia,nausea and
vomiting along with arthralgia and urticaria.On examination he was found having deep jaundice.On repeated
query he reveals his homosexual activity four months back. [MMCH]
§ What is your provisional diagnosis?
§ What is the causative agents?
§ Describe the laboratory diagnosis In brief.
§ Write down the modes of prevention. [1+1+5+3=10]
o A 15 years boy presented with mild fever,malaise,loss of appetite and yellow discoloration of eyes.He
has a recent history of injury 2 months back treated by injections and the wound repaired in a clinic. [IQ CITY]
§ What is the possible clinical diagnosis?
§ What is /are the etiological agents? How will you establish the laboratory diagnosis of the most common
etiological agents?
§ What prophylactic vaccine could have been offered to prevent the condition? [1+1+6+2=10]
o A boy having a history of dog bite 2 weeks ago with no history of vaccination has been admitted in the
hospital with fever,headache,muscle spasm particularlywhile trying to drink water. [JNM,BSMCH]
§ What is the clinical diagnosis?
§ What is the etiological agent?
§ Discuss the protocol for laboratory diagnosis of the disease. [1+1+4+4=10]
§ What is the post exposure prophylaxis in case of dog bite?
o A patient has come with anorexia,abdominal discomfort and jaundice for a week.He gives a history of
blood transfusion 6 months back. [CMC]
§ What is your diagnosis?
§ What are the causative viruses? [1+1+5+3=10]
§ How will you proceed for laboratory diagnosis?
§ How can you prevent such a condition?
o A 21 year old boy presented at the OPD of hospital with the complaint of loss of appetite and low grade
fever and high colored urine for last one week.There was history of taking some injection from local
practitioner about five months ago.On examination, he had yellow discoloration of skin and conjunctiva and
tender hepatomegaly. [BURDWAN]
§ What is probable diagnosis?
§ Name the etiological agents causing such infection.
§ Discuss the laboratory diagnosis of such case. [1+2+5+2=10]
§ How such type of infection can be prevented?
o A child aged 10 years has been admitted to the hospital with irritability,photophobia & convulsion.He
refuses to take food and water. There is a history of dog bite 10days back. [ICARE]
§ What may be the clinical diagnosis & what is the causative agents?
§ What are the steps for confirmation of diagnosis in the laboratory? [2+4+4=10]
§ Mention the different steps for prevention of such illness.
o A 40 yrs old man presented to the medical OPD with high fever,severe headache and pain around the
eyes for the last 5 days .Petechial lesions were noted on the forearm. [KPC]
§ What is your provisional diagnosis?
§ What is your probable etiological agents? [1+4+4+1=10]
§ How will you confirm your diagnosis in the laboratory?
§ Is there any measure by which you can prevent such disease?
o A 20 years old girl attended Medicine OPD with complaint of persistent fatigue,loss of appetite,nausea,
vomiting,abdominal pain and passing high colored urine for 2 weeks.Biochemical examination showed
elevated serum bilirubin and liver enzyme. [MALDA]
§ What is your provisional diagnosis?
§ What are the probable etiological agents?
§ How do you proceed to establish diagnosis? [1+2+5+2=10]
§ What may be the immunoprophylaxis of such disease?
Short Note 4 Marks
• Laboratory diagnosis of Japanese Encephalitis
• Prophylaxis of rabies [SDMC]
• Mechanism of Dengue Hemorrhagic fever & DSS [KPC, BSMCH]
• Inclusion bodies [CNMC,ESIC]
• Evidences of viral growth in tissue culture systems [IPGMER]

53   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• Opportunistic infection in AIDS patients [IPGMER]
• Serological markers of Hepatitis B virus infection [NRS, BSMCH]
• Dengue shock syndrome [NRS]
• Cultivation of viruses [ICARE]
• Swine flu [ESIC]
• Lab diagnosis of HIV infection[MMCH]
• Interferons[MMCH,KPC]
• Antigenic variations of influenza virus [IQ CITY]
• Prion disease[JNM]
• CPE [MURSHIDABAD MC, JNM]
• Post exposure prophylaxis against HIV infection [BURDWAN]
• Viral gastroenteritis [ICARE]
• Oncogenic viruses [MALDA]
Comment On 4 marks
o Serological test HBV infection is helpful in differentiating between chronic active and chronic persistent
hepatitis.
o Inclusion bodies are important in diagnosis of certain viral infection. [KPC]
o Viruses have different capsid symmetry [CMC]
o Herpes virus is of many type. [CMC]
o Viral hepatitis can be caused by different ways.[CMC,KPC]
o Rabies vaccines are of various kinds.[CMC]
o Diagnosis of viral infection [CNMC]
o HIV infection destroys both arms of immune system [IPGMER]
o Herpes Zoster infection prevents chicken pox [IPGMER]
o Varicella Zoster differs from primary infection. [ESI-PGIMER]
o A single rapid serological test may not be sufficient to declare a case to be HIV sero-positive [NRS]
o Cytopathic effect produced by different viruses sometimes helps in the identification of virus. [NRS,
BURDWAN]
o Inclusion bodies often help in diagnosis of disease. [ICARE]
o Viruses can be transplanted along with organ transplantation. [NBMC]
o Recurrence is common in Herpes Simplex infection. [NBMC]
o Detection of serological markers of Hep B is useful for diagnosis of acute HBV infection. [RGK]
o Role of interferon in viral disease[ESIC]
o Viral encephalitis prevalent in West Bengal[ESIC]
o Complication of dengue virus infection are having different reasons[MMCH]
o Dengue hemorrhagic fever commonly occurs in endemic areas.[IQ CITY, BSMCH]
o Virus can cause diarrhea. [JNM,BSMCH,KPC]
o Opportunistic infections occurs in AIDS.[JNM]
o HIV/AIDS is associated with immunosuppression.[MURSHIDABAD MC]
o Viral infection may result in malignancy.[BSMCH]
o Duration of fever is important in dengue serodiagnosis. [SDMC]
o Following emergence of avian influenza in a poultry farm culling of birds is mandatory to prevent
pandemic influenza. [SDMC]
o Stages of HBV infection may be determined by different serological markers. [ICARE]
o Antigenic shift has a role to play in causing pandemic of influenza.[ICARE]
o In window period of HIV infection,antibody detection is not useful. [MALDA]
o Immunoprophylaxis of influenza may show failure.[MALDA]
o Influenza vaccine developed for one season/year may not be effective in an epidemic of next
season/year [ESI-PGIMER]
Difference between 2 Marks
• Antigenic shift and antigenic drift [JNM,MURSHIDABAD MC,R.G.KAR,NRS]
• Salk & Sabine vaccine [KPC, SDMC, ESI]
• Hepatitis A & Hepatitis B [CNMC,ESI-PGIMSR]
• Herpes Simplex 1 & Herpes Simplex 2 [IPGMER,MMCH]
• Bacteria & Virus [ICARE,KPC]
• Mycoplasma & Viruses [NRS]

54   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  


 
• HIV-1 & HIV-2 [ESIC]
• Street virus & fixed virus[IQ CITY,BURDWAN]
• Orthomyxoviridae vs paramyxoviridae [IQ CITY,CMC,BSMCH]
• Virion vs viroid [ICARE]
• Dengue vs Japanese B encephalitis virus.[MALDA]
• Neural and non-neural vaccine against rabies. [NRS]

Mycology
Long Question 10 marks
• A 45 years old farmer presented to the surgical OPD with a h/o multiple swellings in the right foot with
discharge of pus from the sinuses. What is your provisional diagnosis? What is the probable etiological agent?
How will you confirm your diagnosis in laboratory? (1+4+5) (KPC)
• A patient has come to the dermatology OPD with a circular lesion on his back with itching and redness.
The lesion has central clearing and peripheral extension. What are the causative fungi? How will you proceed
for laboratory diagnosis? What is Id reaction? (3+6+1) (CMC)
• A 42 years old pigeon lover presented to the emergency ward with fever for 2 weeks accompanied by
convulsion and neck rigidity of recent onset. Lumbar puncture is done and increased pressure of CSF is noted.
CSF analysis shows: protein -500 mg/dl, sugar -30 mg/dl, TLC -100/C.mm with predominance of
lymphocytes. Which fungal agent is responsible for this? How will you establish the laboratory diagnosis?
Mention the rapid tests you should perform to help the clinician? (2+6+2) (KPC)
Short Note 4 Marks
• Germ tube test.
• Laboratory diagnosis of Dermatophytes.
• Opportunistic mycosis. (KPC)
• Cryptococcus. (SDMC, IQ CITY, NBMC)
• Opportunistic fungi. (MALDA, I CARE)
• Dermatophytes. (BURDWAN)
• Dimorphic fungi. (BSMCH, NRS)
• Aspergillus. (JNM)
• SDA media. (R G KAR)
• Classification of fungi. (MMCH)
Comment On 4 marks
• Species level diagnosis of superficial fungal infection can’t be confirmed by KOH amount only. (KPC)
• Fungal culture is required to identify of Dermatophytes. (SDMC, NRS)
• Negative staining is very helpful for Cryptococcus detection. (MALDA)
• There are different methods for diagnosis of fungal disease. (IU CARE)
• Cryptococcus can be diagnosed rapidly. (MURSHIDABAD)
• Some fungi are dimorphic. (BURDWAN, R G KAR)
• Germ tube test is used for detection of Candida species. (BSMCH)
• Mycetoma can be caused by fungi as well as bacteria. (JNM)
• Thermal dimorphism is demonstrated by fungi. (JNM)
• Coccidian parasitic infection is common in HIV patients. (NBMC)
• Subcutaneous fungal infection may be yeast or mould. (ESIC)
• In diagnostic mycology clinical samples should be collected and cultured in pairs.
• Many fungal pathogens cause opportunistic infection. (KPC)
Difference between 2 Marks
• Cryptococcus and Candida albicans. (KPC)
• Infection type of food poisoning. (KPC)
• Eumycetoma & Actinomycetoma. (SDMC, MALDA, BURDWAN, BSMCH, RGKAR, KPC)
• Candida albicans and Non-albicansCandida. (JNM)
• Pseudohyphae and Hyphae. (JNM, MMCH)
• Yeast and yeast like fungi. (CMC)
 

55   A  NRS  Medical  College  Students’  Union  Initiative   2nd  Prof  MBBS  

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