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Question Paper Specific Instructions

Please read each of the following instructions carefully before attempting questions:
There are EIGHT questions divided in TWO SECTIONS and printed both in HINDI and in
ENGLISH.
Candidate has to attempt FIVE questions in all.
Questions no. 1 and 5 are compulsory and out o f the remaining, any THREE are to be attempted
choosing at least ONE from each section.
The number o f marks carried by a question /part is indicated against it.
Answers must be written in the medium authorized in the Admission Certificate which must be
stated clearly on the cover o f this Question-cum-Answer (QCA) Booklet in the space provided. No
marks will be given for answers written in a medium other than the authorized one.
Word limit in questions, wherever specified, should be adhered to.
Illustrate your answers with suitable sketches and diagrams, wherever considered necessary.
Coloured pencils may be used for the purpose.
Attempts of questions shall be counted in sequential order. Unless struck off, attempt o f a question
shall be counted even if attempted partly. Any page or portion o f the page left blank in the
Question-cum-Answer Booklet must be clearly struck off.

C-AVZ-O-NFEB

#
A

SECTION A

Q l.

(a)

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(i)

^?R

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(ii)
A 40-year-old Non-Resident Indian visiting India develops acute, sudden
breathlessness one week after landing in India. A resident of USA, he
has no such previous history of breathlessness.

(b)

(i)

List the differential diagnosis.

(ii)

How would you investigate this patient ?

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(ii)

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A newborn baby weighing 1*5 kg develops respiratory distress on the

first day of life.
(i)

List the differential diagnosis.

(ii)

How would you assess this baby ?

30-=i#
(i)
(ii)

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A 30-year-old business executive, who is asymptomatic, has been tested

positive for Hepatitis-B surface antigen.
(i)

How ^ould you further investigate this individual ?

(ii)

What steps would you take for the management ?

C-AVZ-O-NPEB

fi
I

(iii) How would you manage the most common condition manifesting
with respiratory distress in the newborn ?
2+4+4=10

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(c)

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5+5-10

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(i)

Define "Infant Mortality Rate (IMR).

(ii)

List the major causes of IMR in India.

(iii)

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What are the key steps that can bring down the
India ?

(e)

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

List the differential diagnosis.

(ii)

How would you investigate this patient ?

(iii) How would you treat the most common condition manifesting with
the given symptomatology ?
2+4+4=10

Q2.

(a)

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(iii)

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A 60-year-old gentleman presents with anaemia, Hb 6*8 gm/dl. Apart

from weakness, there are no localizing symptoms or signs. He was
diagnosed with myocardial infarction 8 years earlier and remains
asymptomatic on atorvastatin and low dose aspirin since the M.I.
(i)

What is the likely cause for anaemia in this patient ?

(ii) Which laboratory investigations are helpful in his management ?

(iii) What is the appropriate treatment for this condition ?

C-AVZ-O-NFEB

3+7+7=17

I
.

(b)

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A iO-year-old boy presented with history of recurrent joint swelling of

knees, elbows and ankles, following trivial injuries. His maternal uncle
had similar illness.
(i)

What is the nature of disease and the likely diagnosis ?

(ii) Which investigations can confirm this disease ?

.

(iii) What is the medical management in this young patient ?

(iv) What is the advice for his mother ?

(e)

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A 45-year-old lady develops itchy, hyperpigmented, scaly lesions on face.

These lesions become worse after the use of hair dye which she started
using five months earlier.
(i)

What is the most likely diagnosis ?

(ii) How can this diagnosis be confirmed ?

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

Q3.

(a)

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3+5+7=15

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(ii)
(iii)

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C-AVZ-O-NFEB

f ?
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A 45-year-old gentleman presented in emergency With haematemesis.

Examination revealed massive splenomegaly.
(i)

List five differential diagnosis o fmassive splenomegaly.

(ii) What is the most likely diagnosis in this patient ?

(iii) Which investigations are warranted in the patient described
above ?
(iv) Enumerate the steps in the initial management of this patient in
emergency.
5+2+5+6=18
(b)

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I
An 11-month-old infant is brought to hospital with delayed weaning and
history of recurrent diarrhoeal episodes. The child is apathic, weighs
5*5 kg, has depigmented hair and oedema over the limbs.
(i)

What is the most likely diagnosis ?

(ii) Enumerate the clinical assessment and investigations that would

be helpful in this infant.
(iii) Enumerate the ten essential steps and two phases of treatment for .
this child.
2+7+8=17
(c)

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An 18-year-old unmarried young lady, highly conscious of her body

image, develops severe weight loss. She has amenorrhoea for 7 months
and her food intake is minimal.
(i)

What is the most likely diagnosis ?

(ii)

What is the management in such a case ?

C-AVZ-O-NFEB

3+12=15

Q4.

(a)

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w z it# 11

.-, ; A 23-year-old young man presents to medical emergency with recurrent

seizures for 2 days.
:

(i)

Enumerate the points in clinical history and examination that are

relevant to the diagnosis.

(ii)

Wliich investigations are warranted to arrive at the diagnosis ?

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

(iv) Name three common diseases that can manifest with recurrent
seizures.
4+4+6+3=17
(b)

t o r

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3T^

f ?

Globally, about a quarter of all neonatal deaths are caused by birth

asphyxia. What are the guidelines and interventions in
resource-limited settings for effective resuscitation to reduce neonatal
mortality ?
(c)

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(ii)

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(iv)
'

15

RT^ I

A term neonate bom to Kh negative mother is brought at 22 hours of life

with jaundice, fever and one episode of convulsion.
(i)

What is the most likely diagnosis and its basis ?

(ii)

Enumerate the key investigations and principles of management.

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

(iv) Mention the preventive measures.

C-AVZ-O-NFEB

3+7+4+4=18

B
SECTION B
Q5.

(a)

(i)

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(ii)

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(iii) f% r % -w RWi hi 3
(i)

srt^it

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i t <hmi ^

< r f a f a w t ?

List the causes of tongue ulcer.

(ii) . State the predisposing factors which may lead to the development
of tongue carcinoma.
(iii) What is the preferred modality of treatment in carcinoma of the
tongue ?
2+4+4=10
(b)

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(i)

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| I

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(ii)

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(iii)

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% fat* 3TN

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

(i)

List the differential diagnosis.

(ii) What steps would you take to relieve him of his condition ?
(iii) How would you investigate this patient to reach at the
diagnosis ?
2+4+4=10
(c)

(i)

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<wr

| ?

(ii) 3^ W lf
wra
(iii) ^

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to t

f i

srf^ P T

^TT |3TT

irar ^irar t , <ft aiftfore %

w | ?
(i)

What is the objective of Pre Conception Pre Natal Diagnostic

Techniques (PCPNDT) Act ?

-*

(ii) Enumerate the forms that must be filled by the attending doctors
while carrying out a pre-natal ultrasound.
(iii) If a medical doctor is found to be violating the PCPNDT Act, what >
is the legal provision for punishment prescribed under the
Act ?
3+4+3=10

C-AVZ-O-NFEB

(d)

(i)
.( i i ) 1

+i4(cifa

(iii) srri 'tftem

sreta ^
^r f t n

i
tor

(i)

What is PAP smear ?

(ii)

Briefly state its procedure.

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(iii) How do you interpret the test results ?

(e)

(i)

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(ii)

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a#c

Q6.

(a)

3+3+4=10
mR*JTCI

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^

t ^ rf ^tf^nr

(i)

Define the sensitivity and specificity of a diagnostic test.

(ii)

Briefly discuss the role of Rapid Diagnostic Test (RDT) in malaria

comparing it with the slide test.
4+6=10

(i)

SWIiTRI

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yc(i5

Hi?n I

(ii)

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;^
(i)
(ii)

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I

Draw a flow chart on how youvwould evaluate a 50-year-old lady

1presenting with abnormal uterine bleeding.
How does menopause influence the bone mineral density ?

(iii) What measures can be taken by a peri-menopausal woman to

safeguard against osteoporosis ? List them.
10+5+5=20
(b)

( i ) Tf f i i t? ( s N ^ i l l ) % ^RWf ^ Tjjft
(ii)

%W R ^

I
if ^

(i) ' List the causes of haematuria.

(ii)
(c)

Briefly discuss the management of carcinoma of the prostate.

3

tj#

cT^fr , Rig, ^rsrra,

3frr ^T^ft ^rc 5T%TT ^raf

affc %?rR

5+10=15

% 3Tftr w r l^ f

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

C-AVZ-O-NFEB

15

^Q 7.

(a)

(i)

(% fe ?) s i f e w

(ii) 3TTO 3H tW *ft

wjjtr | ?

f e t 3RJR =F^ feren

(iii) ^k-^SfiTT % fMt % JWtR 3

l1 ^ I
(i)

I ?
% M

cR

fa fe y i eft S jfe l RC *t$fa 3 *T*tf

What are the key clinical features of abdominal tuberculosis ?

(ii) How would you investigate a patient suspected to be a case of

abdominal tuberculosis ?
(iii) Briefly discuss the role of surgery in the management of a patient
with abdominal tuberculosis.
5+7+8=20
(b)

(i)

ftn

|?

(ii) fe ^ t nra 3cf^-cnfe M ^ft

3
fe n w
i
(iii)

f e t f 5tr^R 3

fctfeqR rff
e)<t<-c||f$d CTTf % 5TCTR

fe ft ^

<lb^ % (cm, o^R t I'M I

sftftrc; f e f e
^ I

(i)

What are vector-borne diseases ?

(ii)

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

(iii) Specify the International Travel Health Regulations that have

been derived to check the spread of vector-borne diseases.
5+5+5=15
(c)

(i)

sract eft

(ii) f e i M
wsr
(i)

stto

|?

% n fer 3 ^
fe f

fe n w
^

3 srrq

What is trial of labour ?

(ii) How would you manage a trial of labour in a patient who has had a
Caesarean Section previously ?
5+10=15

Q8.

(a)

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-gra nc tstcHI

(i)

C-/AVZ-0-NFEB

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(iii)

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fe ? ^

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% f e f e $ itnfesft

I I

A 7-year-old girl is brought with a history of dog-bite five minutes ago.

She has abrasions on her hand, but no bleeding.
(i) What category of bite would this injury fall under ?
(ii) What are the first-aid measures which need to be given to this child ?
(iii) What prophylactic steps would you take to prevent rabies in this
child ?
3+7+10=20
(b)

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ark
% *nsr
t i
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(i)

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(ii)

arm

(iii) 3TTC

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te r

cST f^H

^fN

jwk

JRER ^

?
%3Tt ^

A 25-year-old married lady presents with history of 10 weeks

amenorrhoea, acute lower abdominal pain and fainting. On clinical
examination, she has tachycardia, hypotension and pelvic tenderness.
(i) What is the most likely diagnosis ?
(ii) How would you investigate such a patient ?
(iii) How would you manage such a patient ? List the key points.
(c)

(i)

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(ii) m w ?ft %

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cfteft m %

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(iii) ott y\w{?ft %

(i)

5+5+5=15

i
set

wm

List the five most commonly found cancers in India.

(ii)

Enumerate the clinical features of carcinoma of upper third of

oesophagus.
(iii) How would you manage a case of carcinoma of upper third of
oesophagus ?
5+5+5=15

C-AVZ-O-NFEB

10