DNB General Medicine Paper1- June 2021

Question Number : 1 Question Id : 3271871741 Question Type : SUBJECTIVE

Correct Marks : 10
a) Discuss about the calcium homeostasis. [5]
b) Write down the management of hypercalcemia. [5]

Question Number : 2 Question Id : 3271871742 Question Type : SUBJECTIVE

Correct Marks : 10
"Cytokine Storm" in COVID-19 infection:
a) Pathophysiology and clinical manifestation. [5] Management. [5]

Question Number : 3 Question Id : 3271871743 Question Type : SUBJECTIVE

Correct Marks : 10
Describe the mechanism of action and uses of Incretin based therapy. [5+5]

Question Number : 4 Question Id : 3271871744 Question Type : SUBJECTIVE

Correct Marks : 10 Discuss about the sensory pathways of the pain transmission and management
of neuropathic pain. [5+5]

Question Number : 5 Question Id : 3271871745 Question Type : SUBJECTIVE

Correct Marks : 10
Discuss about the four domains of quality palliative care and write down the elements of
communicating bad news. [5+5]

Question Number : 6 Question Id : 3271871746 Question Type : SUBJECTIVE

Correct Marks : 10
Role of urine analysis and peripheral smear with examples (abnormal findings) in systemic
diseases. [5+5]

Question Number : 7 Question Id : 3271871747 Question Type : SUBJECTIVE

Correct Marks : 10
Write down metabolic oncologic emergencies and management of tumor lysis Syndrome. [5+5]

1
Question Number : 8 Question Id : 3271871748 Question Type : SUBJECTIVE
Correct Marks : 10
Write down the causes, differential diagnosis and pathophysiology of syncope. [2+3+5]

Question Number : 9 Question Id : 3271871749 Question Type : SUBJECTIVE

Correct Marks : 10
a) Draw the coagulation cascade. [3]
b) Write down the classification and diagnosis of bleeding disorders. [3+4]

Question Number : 10 Question Id : 3271871750 Question Type : SUBJECTIVE

Correct Marks : 10
a) Define and discuss the various mechanisms of ageing. [2+4] Write down the various
pharmacological interventions to delay ageing. [4

DNB General Medicine Paper2

Question Number : 1 Question Id : 3271871751 Question Type : SUBJECTIVE Correct

Marks : 10
Describe the pathogenesis, risk factors, clinical manifestations and management of pulmonary
embolism. [3+2+2+3]

Question Number : 2 Question Id : 3271871752 Question Type : SUBJECTIVE Correct

Marks : 10
Discuss the clinical features, diagnosis and management of multiple myeloma. [3+3+4]

Question Number : 3 Question Id : 3271871753 Question Type : SUBJECTIVE Correct

Marks : 10
Write down the pathogenesis, risk factors, clinical features and management of mucormycosis.
[3+2+2+3]

2
Question Number : 4 Question Id : 3271871754 Question Type : SUBJECTIVE Correct
Marks : 10
Classify and enumerate the causes of cardiomyopathy. Write short note on Takotsubo
cardiomyopathy. [1+4+5]

Question Number : 5 Question Id : 3271871755 Question Type : SUBJECTIVE

Correct Marks : 10
Differentiate between obstructive and restrictive lung disease. Write down the classification of
interstitial lung disease. [5+5]

Question Number : 6 Question Id : 3271871756 Question Type : SUBJECTIVE Correct

Marks : 10
Define, classify and write down the clinical features and principles of management of lupus
nephritis. [2+3+2+3]

Question Number : 7 Question Id : 3271871757 Question Type : SUBJECTIVE Correct

Marks : 10
Classify critical illness neuromuscular weakness. Describe its pathophysiology, clinical features
and management in short. [2+3+3+2]

Question Number : 8 Question Id : 3271871758 Question Type : SUBJECTIVE Correct

Marks : 10
Write down the clinical features, pathogenesis, diagnosis and management of celiac disease.
[2+2+3+3]

Question Number : 9 Question Id : 3271871759 Question Type : SUBJECTIVE Correct

Marks : 10
Classify diabetes based on the etiology. Write down dermatological complications of diabetes.
[5+5]

3
Question Number : 10 Question Id : 3271871760 Question Type : SUBJECTIVE Correct
Marks : 10
Describe the clinical features, differential diagnosis and management of Parkinson's disease.
[3+3+4]

DNB General Medicine Paper3 june 2021

Question Number : 1 Question Id : 3271871761 Question Type : SUBJECTIVE

Correct Marks : 10
Classify acute pancreatitis. Write down its causes, severity markers and complications. [3+2+2+3]

Question Number : 2 Question Id : 3271871762 Question Type : SUBJECTIVE

Correct Marks : 10
Classify vasculitis syndrome. Discuss the pathogenesis, clinical features, diagnosis and treatment
of granulomatosis with polyangiitis. [2+2+2+2+2]

Question Number : 3 Question Id : 3271871763 Question Type : SUBJECTIVE

Correct Marks : 10
What are the monoclonal antibodies, it's classification and describe the role of biologicals in the
management of various connective tissue disorders. [2+3+5]

Question Number : 4 Question Id : 3271871764 Question Type : SUBJECTIVE

Correct Marks : 10
Enumerate the causes, pathophysiology and management of endocrine hypertension. [3+3+4]

Question Number : 5 Question Id : 3271871765 Question Type : SUBJECTIVE

Correct Marks : 10
a) Define and classify obesity. [1+2]
b) Describe mechanism, enumerate its complications and principle of management. [2+2+3]

Question Number : 6 Question Id : 3271871766 Question Type : SUBJECTIVE

4
 Correct Marks : 10
Briefly discuss about the types, dose and side effects of various COVID vaccines. [4+2+4]

Question Number : 7 Question Id : 3271871767 Question Type : SUBJECTIVE

Correct Marks : 10
Write down the causes, differential diagnosis, diagnosis and management of chronic inflammatory
demyelinating polyradiculoneuropathy. [3+2+2+3]

Question Number : 8 Question Id : 3271871768 Question Type : SUBJECTIVE

Correct Marks : 10
Enumerate the causes and discuss diagnosis and treatment of superior vena cava syndrome.
[3+3+4]

Question Number : 9 Question Id : 3271871769 Question Type : SUBJECTIVE

Correct Marks : 10
Classify hemolytic anemias. Write clinical features, diagnosis and management of paroxysmal
nocturnal hemoglobinuria. [2+2+3+3]

Question Number : 10 Question Id : 3271871770 Question Type : SUBJECTIVE

Correct Marks : 10 Differentiate between nonalcoholic fatty liver disease and nonalcoholic
steatohepatitis. How will you diagnose and treat nonalcoholic fatty liver disease? [2+4+4]
DNB General Medicine Paper4 june 2021

Question Number : 1 Question Id : 3271871771 Question Type : SUBJECTIVE

Correct Marks : 10
a) Newer antiepileptic drug. [5]
b) Discuss andropause and its management. [5]

Question Number : 2 Question Id : 3271871772 Question Type : SUBJECTIVE

Correct Marks : 10
a) Describe the mechanism of action, dose and side effects of newer SGLT 2 inhibitors. [5] b)
Briefly discuss reversal of diabetes. [5]

Question Number : 3 Question Id : 3271871773 Question Type : SUBJECTIVE

5
Correct Marks : 10
a) Importance of statistical analysis in research. [5]
b) Gene therapy in Hemophilia. [5]

Question Number : 4 Question Id : 3271871774 Question Type : SUBJECTIVE

Correct Marks : 10
What is deep brain stimulation therapy? What are its various indications for use? [5+5]

Question Number : 5 Question Id : 3271871775 Question Type : SUBJECTIVE

Correct Marks : 10
Write down various sources of stem cells and uses of stem cell therapy. [5+5]

Question Number : 6 Question Id : 3271871776 Question Type : SUBJECTIVE

Correct Marks : 10
a) Newer Oral anticoagulants. [5]
b) Epigenetics. [5]

Question Number : 7 Question Id : 3271871777 Question Type : SUBJECTIVE

Correct Marks : 10
a) IgG4 related disease. [5]
b) Significance of DAS in rheumatoid arthritis. [5]

Question Number : 8 Question Id : 3271871778 Question Type : SUBJECTIVE

Correct Marks : 10
a) Newer antitubercular drugs. [5]
b) Angiotensin receptor neprilysin inhibitor. [5]

Question Number : 9 Question Id : 3271871779 Question Type : SUBJECTIVE

Correct Marks : 10
a) Biomarkers of acute kidney injury. [5]
b) Biomarkers of osteoporosis. [5]
Question Number : 10 Question Id : 3271871780 Question Type : SUBJECTIVE
Correct Marks : 10 Oral JAK inhibitors. [5] PCSK9 inhibitors. [5]

6
DEC 2020
Paper 1
1. Discuss the mechanism of action and clinical uses of metformin. 5+5
2. Classify neuromuscular weakness related to critical illness. Describe 2+(4+4) patho-
physiology and clinical features of neuromuscular weakness related to critical illness.
3. Describe pulsus paradoxus using a labelled diagram. Discuss the 4+(3+3) clinical
examination findings and list the conditions causing it.
4. Describe the types of hyponatremia and discuss its evaluation and 3+4+3 treatment.
5. Describe the principles of antimicrobial stewardship and discuss the 5+5 mechanisms of
antibiotic resistance.

6. Describe the pathogenesis of Hepatitis B infection. List the various 5+5 serological markers
and their significance in clinical practice

7. Classify hemolytic anaemia and discuss its laboratory diagnosis. 5+5

8. Describe the physiology of sleep regulation. List the causes and 4+(2+4) describe the
treatment of hypersomnolence.

9. Describe the functional anatomy of lungs, the physiology of breathing and respiratory
function abnormalities in Obstructive versus Restrictive Lung diseases.

10. Describe the anatomy and physiology of different segments of the Nephron and outline the
renal function tests used for diagnosis of Tubulo-interstitial renal diseases.

Paper II

1. a) Name the various immune-mediated and non-immune mediated (3+3)+(1+3) adverse

reactions following blood transfusion. Write a note on Transfusion Related Acute Lung Injury
(TRALI).
b) How is Acute Myeloid Leukemia (AML) diagnosed? What are the genetic
abnormalities in AML that are associated with favorable outcomes, if
appropriately treated?

2. a) What are the ROME-IV diagnostic criteria for diagnosing Irritable Bowel 2+3+5 Syndrome
(IBS)? Discuss the newer agents introduced for treating IBS.
b) Enumerate the differences between type-1 and type-2 Crigler Najjar syndromes.

1. a) How do you diagnose Spontaneous Bacterial Peritonitis (SBP)? How do (2+4)+4 you treat
SBP?
b) What are the diagnostic criteria for diagnosing Hepato-Renal Syndrome (HRS)?
7
2. a) Definition and causes of Acute Respiratory Distress Syndrome (2+2)+6 (ARDS).
b) What are the various strategies employed in mechanical ventilation in
ARDS?
1. What is the operational definition of Osteoporosis? What are the risk (1+3)+6 factors
for Osteoporotic fracture?
b) Dual-energy X-ray absorptiometry (DXA) scan.

2. a) Biological functions of Thiamine in the human body. 2+4+4 b) Beriberi.

b) Pellagra.

7. a) Draw a labeled diagram of the spinal cord at the C4 level. 7+3

b) List the findings of CSF examination in a case of acute bacterial meningitis.

8. Risk factors, clinical features, diagnosis, and re-warming strategies in a 2+3+2+3 case of
hypothermia.
1. a) Hyporeninemic hypoaldosteronism and hyperkalemia. 6+4
b) ECG changes in hyperkalemia.

2. a) Classify diabetes mellitus. 4+6

b) Physiological response to an episode of hypoglycemia.

Paper III

1. a) What are the various auto-antibodies that can be detected in 3+3+4 systemic lupus
erythematosus (SLE)? Enumerate their target antigens and clinical relevance.
b) SLICC criteria for classification of SLE.

2. a) Myeloma kidney. 5+5

b) Treatment of hypercalcemia.

3. a) Classify the α-Thalassemia syndromes. 5+5

b) Draw a labeled diagram of Circle of Willis.

4. a) Complement system. 6+4 b) Diagnosis of Wilson’s disease.

5. a) What are the various patterns of arthropathy seen in psoriatic 5+5

arthritis?
b) Raynaud’s phenomenon.

6. a) Enumerate the various non-immune cutaneous drug reactions. 5+5

8
 b) Enumerate the Ann-Arbor staging for lymphoma.

7. a) Empirical antibiotic treatment of Community Acquired Pneumonia. 6+2+2

b) List the sub-types and variants seen in Guillain-Barré syndrome, with their
associated antibodies.

8. a) Sick Euthyroid Syndrome. 6+4 b) Ivabradine

9. a) Friedrich’s ataxia. 5+5

b) How will you differentiate articular pain from non-articular pain?

10. a) Treatment of Cryptococcus meningitis in HIV-positive patient. 6+4

b) FGF-23 (Fibroblast Growth Factor).

Paper Iv
1. a) Revised Duckett-Jones criteria for acute rheumatic fever. 5+5
b) Infections in post-splenectomy patients.

2. a) Gompertzian growth in tumours. 4+6 b) Lactic acidosis

3. a) Draw a labeled structure of the severe acute respiratory syndrome 6+4 coronavirus-
2.
b) ECG changes in acute pericarditis.

4. a) Cardio-renal syndrome. 5+5 b) Secretory diarrhea. 5+5

5. a) Haemoglobin with altered oxygen affinity. b) Bedaquiline.

6. a) What are the principles of radiation therapy in malignancy? 5+5

b) Genotype-based treatment of HCV infection.

7. a) HIV drug resistance. 6+4

b) West Haven classification of Hepatic Encephalopathy.
8. a) List the potential complications of gene therapy. 5+5 b) Falls in the elderly.
9. a) Treatment of pre-eclampsia. 5+5 b) Tocilizumab.
10 a) List the various presentations of Telomere disease. b) Classify pulmonary hypertension.

June 2020 paper I

9
1. Define Basic Reproduction number (R0 ) and describe its importance 3+7 in epidemiology
of disease.
2. Describe the patho-physiology and diagnosis of SARS-CoV-2 5+5 infection.
3. Outline the mechanism of action, clinical uses and adverse effects of 3+4+3 metformin.
4. Describe anti-neutrophilic cytoplasmic antibodies. Discuss their uses 3+(3+4) in Medicine
and their interpretation.
5. Define Antimicrobial Stewardship. Discuss the components of an 3+7 Antimicrobial
Stewardship programme.
6. Describe the physiology and regulation of sleep. Discuss the (3+2)+(3+2) causes and
treatment of Hypersomnolence.
7. Describe the regulation of bone remodeling. Outline the role of 4+(3+3) magnetic resonance
imaging and radionuclide bone scan in musculoskeletal disease.
8. Describe the iron absorption in the body. Discuss the tests for 5+5 the diagnosis of iron
deficiency.
9. Describe the conducting system of the heart. Discuss the 3+(4+3) mechanism of re-entrant
tachycardia and the essentials of radio frequency ablation.
10. Describe pulsus paradoxus and explain with a labelled diagram. (3+2)+(3+2) Discuss clinical
conditions associated with pulsus paradoxus and outline its significance

Paper ii
1. Describe the pathogenesis, risk factors, clinical 3+2+3+2 manifestations and management of
cerebral venous thrombosis.
2. Outline the neurological manifestations of HIV infection. 3+(3+2+2) Discuss the clinical
features, diagnosis and management of cerebral toxoplasmosis.
3. Differential diagnosis and approach to diagnosis of a patient 4+6 presenting with high grade
fever and jaundice.
4. Clinical features, complications, diagnosis and treatment of 2+3+2+3 ulcerative colitis.
5. Clinical features and management of a Russel Viper bite. 5+5
6. Define resistant hypertension. Discuss the causes and 2+(4+4) approach to management of a
patient with resistant Hypertension.
7. Clinical features and management of idiopathic 4+6 thrombocytopenic purpura.
8. Risk factors, diagnosis and management of hospital 3+3+4 acquired pneumonia.
9. Clinical features, diagnosis and management of 3+3+4 hyperosmolar non ketotic coma.
10
10. a) Causes of upper gastrointestinal bleeding. 4+6
b) Management of variceal upper gastrointestinal bleeding.

PAPER III
1. Define Acute Kidney Injury (AKI). Discuss diagnosis and 3+(4+3)
management of renal tubular acidosis.
2. Outline the infections in the post kidney transplant patients. 4+(3+3) Discuss the clinical
features and management of cytomegalovirus infections.
3. Clinical features, diagnosis and management of multiple myeloma.
4. Define Multi Drug Resistant Tuberculosis (MDR TB). Discuss the current strategies of
management of MDR TB under the National Programme.
5. Outline the transfusion related reactions. Discuss the clinical features and management of
TRALI (Transfusion Associated Acute Lung Injury).
6. What is the concept of plasma therapy? Discuss the indications and complications of plasma
therapy.
7. Define delirium. Discuss causes and approach to the management of a patient with delirium.
8. Clinical features, diagnosis and management of 3+4+3 autoimmune hepatitis.
9. Outline the clinical features, diagnosis and management of 3+4+3 ankylosing spondylitis.
10. Clinical features and management of acute gouty arthritis.

Paper IV
1. Structure, functions of telomeres and relation of telomere length to disease risks.
2. Pathogenesis and management of sarcoidosis.
3. Enumerate oral JAK inhibitors and their role in treatment of diseases.
4. Recent advances in diagnosis and management of Irritable bowel syndrome.
5. a) Lung as an endocrine organ. b) Outline the recent advances in management of interstitial
lung disease.
6. What is the human microbiome? Outline the relationship between microbiota with specific
disease states. Describe fecal microbiota transplantation.
7. Diagnosis and management of Legionella infections. 5+5
8. a) Impact of Hepatitis C- HIV co-infection. b)Management of HCV infection in HIV patient
9. a) Concept of emerging infectious diseases. b)Effect of climate change on disease.
10. Indications and strategies of domiciliary oxygen therapy.
DEC 2019- Paper 1’

11
1. a) Etiology, history and physical examination findings in a patient with generalized edema.
b) Diagnosis and management in a case of ascites.
2. a) Pathophysiology of pain. 3+2+(2+3)
b) Management of Trigeminal Neuralgia.
c) Diagnosis and management of myasthenia gravis.
3. a) Mechanisms of antibiotic resistance. 5+5
b) Drugs dose modification in kidney failure.
4. a) Differential diagnosis of fever of unknown origin. 4+6
b) Diagnostic approach to patient having fever with altered sensorium.
5. a) Etiology of gait disorders. 4+(3+3)
b) Diagnosis and treatment of Obstructive Sleep apnea syndrome
6. a) Food poisoning causes and management.
b) Etiology, workup and treatment of malabsorption syndrome.
7. Causes, evaluation and management of hyponatremia. 3+3+4
8. a) Describe the coagulation pathway. 4+(3+3)
b) Approach and treatment of idiopathic thrombocytopenic purpura.
9. a) Pharmacovigilance — definition and clinical implications. 5+5
b) Clinical features of severe drug reactions.
1 0. a) Bilirubin synthesis and metabolism. (3+3)+4
b) Diagnosis and treatment of Wilson's disease.

Paper II
1. a) Classify Hemoglobinopathies. b) Diagnosis and treatment of Sickle Cell Syndromes.
2. a) Enumerate complications and management of alcoholic cirrhosis.
b) Aetiology and management of massive hematemesis.
3. a) Treatment of Hepatitis C infection .b)Extræintestinal complications of ulcerative colitis.
4. Pathophysiology and treatment of cardiogenic shock. 5+5
5. a) Newer anti-diabetic drugs. 4+(1+1 +2+2)
b)Precipitating factors, clinical features, laboratory findings and treatment of Hyperglycemic
hyperosmolar state
6. a)Classify seizures b)Enumerate epilepsy syndromes c)Treatment of refractory seizures.
7. Clinical features, approach and treatment of neurotoxic snake bite.
8. Clinical features, prevention and treatment of high altitude illness.
9. Causes, clinical features, investigations and treatment of hypercalcemia.
12
10. a) Causes and complications of acute pancreatitis.
b) Differential diagnosis of patient with fever and thrombocytopenia.

Paper III
1. Evaluation and management of obesity.
2. Clinical features, diagnosis and treatment of rheumatoid arthritis.
3. A) Clinical staging and diagnosis of HIV infection /AIDS.
b) Neurological and respiratory manifestations of AIDS.
4. Clinical features, diagnosis and treatment of chronic myeloid leukemia.
5. Aetiology, clinical features, investigations and treatment of atypical pneumonias.
6. Clinical types, differential diagnosis and treatment of multiple sclerosis.
7. Clinical features, diagnosis and treatment of pulmonary embolism.
8. Differential diagnosis of pulmonary renal syndrome.
9. A)Differential diagnosis of acute flaccid paralysis.
B)Diagnosis and treatment of Guillain-Barré syndrome.
10. Clinical features, diagnosis and treatment of Parkinsonism.

Paper IV
1. A) Differential diagnosis of bullous lesions. b)Substance abuse — management.
2. A) Newer diagnostic tests for diagnosis of tuberculosis. b)Revised guidelines for treatment of
tuberculosis.
3. Diagnosis, hematological, cutaneous and renal manifestations of systemic lupus erythematosus.
4. Indications, contraindications and postoperative management of Liver transplant.
5. Mechanism and treatment of paroxysmal SVT b) Management of infective endocarditis.
6. Classification of chronic kidney disease (CKD). b)Bone manifestations of CKD.
c)Causes of anemia in CKD and its management.
7. a) Hematopoietic stem cell transplantation: Mechanism, indications and complications.
b)Jaundice in pregnancy.
8. a) Deep Brain Stimulation - indications and clinical implications.
b)Autoimmune hepatitis: diagnosis and management.
9) Pathogenesis and treatment of atherosclerosis. 5+5
10. a) Newer anticoagulants. b) Role of vitamin D in various diseases.

JUN 2019 PAPER I

13
1. a) Neural pathways for pain sensation. 3+(3+4)
b) Causes and evaluation of chronic headache.
2. a) Describe pulsus alternans 2+(4+4)
b) Clinical features and management of acute left ventricular failure.
3. a) Physiology of thermoregulation. 3+(3+4)
b) Causes and management of hypothermia.
4. a) Definition, causes and clinical features of syncope. (1+2+3)+4
b) Diagnostic evaluation for syncope in adult.
5. a) Regulation of respiration. 4+(3+3) b) Etiology and management of sleep apnoea.
6. a) Physiology of sleep and wakefulness.
b) Clinical features and management of narcolepsy.
7. a) Physiology of deglutition.
b) Etiology and diagnosis of dysphagia.
8. a) Enumerate cutaneous manifestations of mycosis fungoides.
b) Definition and etiology of papulo-squamous skin lesions.
9. a) Physiology of red cell production.
b) Diagnosis and management of autoimmune hemolytic anemia.
10. a) Autoregulation of cerebral blood flow.
b) Assessment of glomerular filtration rate.
Paper ii
1. a) Definition of acute respiratory distress syndrome. 3+(3+4)
b) Etiology and treatment of acute respiratory distress syndrome.
2. a) Clinical features and complications of falciparum malaria. (3+3)+4
b) Management of complicated malaria.
3. a) Indications of genetic counseling. 4+6
b) Enumerate autosomal recessive disorders and mode of their inheritance.
4. a) Etiology of chronic hepatitis. 5+5
b) Management of Chronic Hepatitis B.
5. Clinical features, diagnosis & treatment of acute intermittent 3+3+4 porphyria.
6. a) Etiology and clinical features of infective endocarditis. (2+3)+5
b) Treatment of subacute bacterial endocarditis.
7. a) Clinical manifestations of mercury poisoning. 4+(3+3)
b) Diagnosis and treatment of delirium tremens.
8. a) Etiology of chronic meningitis. 2+(4+4)
14
 b) Diagnosis and management of Cryptococcal meningitis.
9. a) Hypothalamic pituitary axis. 3+(3+4)
b) Clinical features and management of myxedema coma.
10. a) Etiology and pathogenesis of obesity. (3+2)+(2+3)
b) Definition and management of metabolic syndrome.

Paper III
1. a) Etiology and pathogenesis of heart failure. (2+3)+5
b) Treatment of heart failure with reduced ejection fraction.

2. a) Etiology and clinical features of cavitary pneumonias. (2+3)+(2+3)

b) Diagnosis and management of lung abscess.

3. a) Mechanisms of acid base regulation. 5+(2+3)

b) Etiology and management of high anion gap acidosis.

4. a) Clinical features and staging of chronic kidney disease. (4+2)+(2+2)

b) Indications and complications of dialysis.

5. a) Pathogenesis of acute pancreatitis. 4+(2+4) b) Causes and management of lower

gastrointestinal bleed.

6. a) Indications and contraindications of liver (3+3)+4 transplantation.

b) Complications of liver transplantation.

7. a) Clinical features and complications of cutaneous (3+3)+4 sclerosis.

b) Management of scleroderma renal crisis.

8. a) Definition and etiology of hypercalcemia. (2+2)+(3+3)

b) Clinical features and management of hypercalcemia.

9. a) Clinical features and laboratory diagnosis of chronic (3+3)+4 myeloid leukemia.

b) Management of blast crisis

15
10. a) Clinical features and diagnosis of multiple sclerosis. (3+3)+4
b) Treatment of multiple sclerosis.

Paper IV
1. a) Clinical features of atypical pneumonia. 3+3+(2+2)
b) Pneumonia severity index.
c) Indications and complications of extra-corporeal membrane oxygenation.

2. a) Echocardiographic findings of pulmonary embolism. 2+3+5

b) Diagnosis of heparin induced thrombocytopenia.
c) Newer oral anticoagulants.

3. a) Indications of plasmapheresis and its complications. (3+2)+(2+3)

b) Indications and adverse effects of blood transfusion.

4. a) Transmission and diagnosis of HIV infection. (3+2)+5

b) National guidelines for anti-retroviral therapy.

5. a) Newer diagnostic techniques in tuberculosis. 3+(2+5) b) Diagnosis and treatment of drug

resistant tuberculosis.
6. a) Biology of aging. 5+5
b) Common neurological problems in the elderly.

7. a) Clinical features and diagnosis of rheumatoid arthritis. (3+3)+4

b) Use of biologicals in treatment of rheumatoid arthritis.

8. a) Enumerate causes of secondary hypertension. 3+(3+4)

b) Diagnosis and management of renal artery stenosis.

9. a) Etiology and clinical features of tachyarrhythmias. (3+2)+5

b) Device therapy for treatment of cardiac arrhythmias.

10. a) Health aspects of International travel. b) Immunization in adults

DEC 2018 Paper I

16
1. a) Anatomy of conduction system of heart. 3+3+4
b) Enumerate causes of bradycardia.
c) Discuss indications of permanent pacemaker implantation.

2. a) Clinical assessment of visual function. 5+3+2

b) Enumerate causes of sudden loss of vision.
c) Clinical presentation of amaurosis fugax.

3. a) Functions of mitochondria. 4+3+3

b) Enumerate mitochondrial disorders.
c) Clinical features of Turner’s syndrome.

4. a) Enumerate fat soluble vitamins & describe their 4+(3+3) functions.

b) Clinical features & management of hypervitaminosis A.

5. a) Define erythema nodosum. Discuss its differential diagnosis. (2+2)+(3+3) b) Clinical

features & management of erythema nodosum leprosum.
6. a) Enumerate neurological disorders in pregnancy. 2+(4+4)
b) Clinical features and management of HELLP syndrome.

7. a) Enumerate causes of repeated falls in elderly. (2+2)+(2+2+2) Enumerate strategies

for their prevention.

b) Define and classify mood disorders. Discuss treatment of depression .

8. a) Enumerate hormones secreted by adrenal cortex. 2+(2+3+3)
b) Etiology, clinical features & management of Addisonian
crisis.
9. a) Enumerate causes of hyperuricemia. 3+(3+4)
b) Clinical features & management of acute gouty arthritis.

10. a) Steps involved in scientific research. 4+3+3 b) Various formulae for calculating sample
size.
c) Differences between primary data & secondary data

Paper II
1. a) Enumerate various endocrinal emergencies. 2+3+(3+2)
b) Enumerate paraneoplastic manifestations of carcinoma lung.
c) Laboratory diagnosis & treatment of SIADH.
2. a) Define pyrexia of unknown origin. 2+(3+2+3)
b) Clinical features, diagnosis & treatment of H1N1 infection.
3. a) Define & classify hemoglobinopathy. (2+3)+(2+3) b) Clinical features &
management of sickle cell anaemia (including crisis).

17
4. a) Enumerate poisoning from plants. 4+(3+3)
b) Clinical features & management of Dhatura poisoning.

5. a) Acute radiation sickness. 4+(3+3) b) Clinical features & management of

vasculotoxic snake bite.
1. a) Classification of epilepsy. 3+(3+4)
b) Enumerate causes & management of status epilepticus.

2. a) Define sudden cardiac death. 2+(4+4)

b) Causes & management of cardiogenic shock.

3. a) Enumerate causes of biomedical terrorism. 4+(3+3)

b) Clinical features & management of botulism.

4. a) Differential diagnosis of haemorrhagic fever. 3+(4+3)

b) Clinical features & management of scrub typhus.

5. a) Clinical features & management of trigeminal (2+2)+(3+3) neuralgia.

b) Indications & contraindications of thrombolytic therapy for acute ischemic stroke.

Paper III
1. a) Enumerate risk factors for ischemic heart disease. 2+(4+4)
b) Clinical features & management of acute coronary syndrome.
2. a) Enumerate causes of recurrent pleural effusion. 2+(4+4)
b) Etiopathogenesis and management of Hepatitis B.

3. a) Define NASH. Describe its clinical features & management. (1+2+3)+(2+2)

b) Advantages & disadvantages of Fibro-scan in hepatic pathology evaluation.
4. a) Enumerate indications & contraindications of renal (3+3)+(4)
transplantation.
b) Immunosuppressive therapy in recipient of renal transplant.
5. a) Define & enumerate causes of migratory arthritis.
b) Clinical features & management of acute rheumatic fever
6. a) Define & describe causes of pericardial effusion. (2+3)+(3+2)
b) Clinical features & echocardiographic diagnosis of cardiac tamponade.

7. a) Enumerate causes of recurrent urinary tract 4+(3+3) infection.

b) Clinical features & management of emphysematous
pyelonephritis.

18
8. a) Define pneumothorax. Enumerate types of pneumothorax. (2+2)+(3+3) b)
Clinical features & management of tension pneumothorax.

9. a) Enumerate acute & chronic complications of liver cirrhosis. (2+2)+(3+3) b)

Clinical features & management of spontaneous bacterial peritonitis.

10. a) SLICC classification of systemic lupus 4+(3+3) erythematosus.

b) Clinical features & radiographic findings in a case of ankylosing spondylitis.

Paper IV
1. Define systemic inflammatory response syndrome. Describe its presentation, diagnostic
evaluation and management.
2. Describe hyperbaric oxygen therapy, its mechanism of action, mode of delivery and indications.
3. Enumerate and discuss role of biological agents in the treatment of rheumatoid arthritis.
Enumerate their contraindications.
4. Risk factors for osteoarthritis and its pharmacological treatment.
5. Principles and the utility of stem cell therapy in medicine.
6. Clinical features, diagnostic approach and management of fibromyalgia.
7. Classify oral anticoagulants. Describe their indications and contraindications.
8. Describe various modalities of artificial liver support system 5+2+3 and enumerate their
advantages and disadvantages.
9. Describe total parenteral nutrition. Enumerate its indications 6+(2+2) and complications.
10. Pathophysiology, diagnostic evaluation and management of 4+3+3 cardio-renal syndrome.

JUNE 2018 PAPER I

1. a) Pharmacogenomics – Definition and clinical relevance. 4+3+3 b) Cardiac Cycle.
c) Circle of Willis- Basic and applied anatomy.

19
2. a) Glycaemic variability and its clinical relevance 4+(2+2+2)
b) Diagnosis & treatment of diabetic ketoacidosis and monitoring while treating.

3. What is pregnancy induced hypertension? Write about its 1+(2+2+3+2) pathophysiology,

diagnosis, treatment and complications.

4. Define obesity and write about its complications and 2+4+4 management.

5. a) Pathophysiology of vertigo and its causes. (2+2)+(2+4)

b) Recurrent jaundice - Causes and clinical evaluation.

6. a) Clinical evaluation of a 70-year old female patient with 4+(2+2+2) acute new onset
headache.
b) Clinical features, diagnosis and treatment of pheochromocytoma.

7. a) Define and give the significance of Sensitivity and (2+2+2+2)+2

Specificity, Absolute and Relative Risk Reduction.
b) Interpretation of P value.

8. a) Clinical features, types and treatment of urticaria. (2+2+2)+(2+2)

b) Transfusion transmitted infections - agents and prevention.

9. a) Clinical features, pathogenesis and treatment of heat 2+2+2+(2+2)

stroke.
b) Green House effect and its impact on human health.

10. a) Health advice for International travel. 4+(3+3)

b) Clinical features and treatment of Schizophrenia.

PAPER II

20
1. a) What are Paraneoplastic Syndromes? List the paraneoplastic (1+2+3)+4 syndromes of the
nervous system and discuss LambertEaton Myasthenic syndrome?
b) Tumour markers and their role in diagnosis and treatment of malignancies.

2. a) Peripheral Blood Smear- Its diagnostic utility in medicine. 4+( 2+2+2) b)

Clinical features, diagnosis and treatment of acute ITP.
3. Principles and procedure of Plasma Exchange and write about 2+2+3+3 its indications and
complications.

4. a) Clinical features and management of Vitamin D overuse. 2+2+(2+2+2)

b) Clinical features, complications and treatment scorpion bite.

5. a) Non Invasive Ventilation. 4+(2+2+2)

b) Diagnosis, treatment and prevention of Ventilator Associated Pneumonia.
6. Pathophysiology, clinical features, diagnosis, treatment and 2+2+2+2+2 complications of
Dengue fever.

7. a) Clinical features and treatment of Parkinson’s disease. 3+3+(1+1+2)

b) Causes, clinical features and treatment of Cortical Venous Sinus Thrombosis.

8. a) Treatment of status epilepticus. 4+(3+3) b) Clinical features and treatment of Guillain

Barre Syndrome.

9. a) Nerve gases exposure - clinical features and management 2+2+(2+2+2)

b) Clinical features, diagnosis and treatment of Organophosphorus poisoning.

10 Etiology, clinical manifestation, diagnosis and treatment of 2+2+3+3 infective endocarditis.

PAPEr III

21
1. 1. a) Treatment of cardiogenic pulmonary oedema. 3+(2+2)+3
b) Clinical features and treatment of Mitral Valve Prolapse.
c) Prinzmetal’s variant angina.

2. a) Define Pulsus Paradoxus and enumerate its causes. 2+2+(2+4)

b) Clinical features and treatment of atrial fibrillation.
3. a) Markers of kidney injury. 4+(2+2+2)
b) Causes, diagnosis and treatment of Renal Tubular Acidosis.

4. a) Causes, diagnosis and treatment of RPGN. (2+2+2)+(2+2)

b) Acute and chronic complications of Haemodialysis.

5. a) Recurrent urinary tract infection in a 25-year old female - (2+2+2)+(2+2)

Causes, diagnosis and treatment.
b) Clinical features and treatment of acute gouty arthritis
6. a) Clinical features and diagnosis of MCTD. (3+3) +4
b) Extra articular manifestations of rheumatoid arthritis.

7. a) Extra Pulmonary manifestations of COPD. 4+(3+3)

b) Etiopathogenesis and treatment of Bronchiectasis.

8. a) Etiology, diagnosis and treatment of hypersensitivity (2+2+2) +4 pneumonitis.

b) Treatment of ulcerative colitis.

9. a) Management of chronic Hepatitis B infection. 6+(2+2) b) Clinical features and diagnosis

of Hepato-Pulmonary syndrome.

10. a) Causes and management of massive hematemesis. (2+4)+(2+2) b) Diagnosis

and treatment of H.pylori induced gastritis

JUNE 2017 PAPER 1

22
1. a) Outline heme biosynthesis with its regulation. (2+2)+(3+3)
b) Clinical features and diagnosis of acute intermittent porphyria

2. A 55 year old male presents with hemoptysis for the first 5+5 time:
a) Enumerate the causes of hemoptysis.
b) Outline the approach to the management of this patient.

3. a) Physiology and stages of sleep. 6+4

b) Enumerate the causes of primary insomnia.

4. A 33 year old primigravida at 30-weeks of pregnancy 5+5 detected to be hypertensive with

a BP of 160/110mm Hg:
a) What are the possible complications? b) Outline the management of this patient.

5. a) What is evidence based medicine? b) Sources of evidence.

c) Outline the advantages and disadvantages of such an approach as decision support tools.
6. a) Define syncope. b) Broad classification of syncope.
c) Diagnosis of neurally mediated syncope
7. A 32 year old HIV infected male presents with oral lesions. 6+4
a) Discuss the differential diagnosis. b) Outline the management of oral candidiasis.

8. Clinical features and management of panic attack. 5+5

9. a) Causes of hypomagnesemia. b) Outline its management.

10. A 26 year old woman is detected to have hyperprolactinemia: 5+5

a) What is the differential diagnosis?
b) Outline the approach to this patient.

Paper II
1. ) What is hypoxic-ischemic encephalopathy (HIE)? 2+4+4 b) Clinical features of HIE.

23
c) Outline the approach to diagnosis of HIE.

2. a) Pathogenesis of Clostridium difficile infection. 4+(3+3)

b) Diagnosis and treatment of Clostridium difficile infection.

3. a) What is microbial bioterrorism? 2+3+5

b) Enumerate the agents used in this.
c) Outline the measures of containment/prevention of microbial bioterrorism.

4. A 42 year old male presents with fever, headache and 1+4+5 vomiting of four week duration
and has neck rigidity on examination:
a) What is the clinical diagnosis?
b) What are the causes of this condition?
c) Outline the approach to his management.

5. a) Clinical features of acute cocaine intoxication. b) How will you manage it?
6. a) Commonly used severity of illness scoring systems. 5+5
b) Role of these scoring systems in the intensive care unit.

7. a) Enumerate causes of pancytopenia. 3+(4+3)

b) Clinical features and treatment of aplastic anemia.

8. A 35 year old woman presents with massive splenomegaly. 4+6

a) What is the differential diagnosis?
b) Outline the approach to its management.

9. a) Enumerate the Rickettsial infections of clinical importance. 4+6

b) Outline the approach to diagnosis of these infections.

10. A 25 year old woman presents with fever and jaundice of four 5+5 days duration.
a) Outline the approach to diagnosis in the patient.
b) How will you manage her at primary care level?
Paper III
1. a) Physiology of the Sino-Atrial (SA) node. 3+4+3

24
b) Enumerate the causes of SA node dysfunction.
c) Outline the approach to the diagnosis of SA node dysfunction.

2. a) What are the organisms causing cavitary lung lesions? 3+(3+4)

b) Diagnosis and management of lung abscess

3. a) Pathophysiology of anemia in chronic kidney disease 5+5 (CKD).

b) Outline the management of anemia in CKD.

4. a) Enumerate the causes of pulmonary renal syndromes. 2+(4+4)

b) Diagnosis and treatment of these disorders.

5. a) What is non alcoholic fatty liver disease? Comment on (1+3)+(3+3) its epidemiology.
b) Outline the clinical features and treatment of this condition.
6. a) Enumerate the etiologies of heart failure with preserved 4+6 ejection fraction (EF).
b) Outline the treatment of such heart failure.

7. a) Clinical features of irritable bowel syndrome (IBS). 3+(4+3)

b) Outline pathogenesis and management of IBS.

8. a) Pathogenesis of atherosclerosis. 5+5

b) Elaborate on the concept of atherosclerosis risk factors.

9. a) Enumerate the spondyloarthropathies. 2+(4+4)

b) Clinical features and diagnosis of ankylosing spondylitis.

10. a) Define Raynaud’s phenomenon. 1+6+3

b) Causes of Raynaud’s phenomenon with points of main difference between primary and
secondary types.
c) Outline its management

DEC 2017 Paper I

) Define Sick euthyroid syndrome. Write down its (1+2+2)+5 diagnosis & treatment.

25
b) Amiodarone induced thyroiditis

2. a) Clinical features and treatment of Obsessive (3+2)+(3+2)

compulsive disorders.
b) Causes of delirium and its treatment.

3. What is gestational diabetes mellitus? Write down its 2+(3+2+3) pathophysiology,

diagnostic criteria and treatment.

4. a) Balanced diet 5+5

b) Indications and disadvantages of enteral nutrition therapy.

5. a) What is fecal microbiota? Enumerate the indications (2+3)+5 of fecal microbiota

transplantation.
b) Maturity onset diabetes of young
6. What is Cushing syndrome? Write down its causes, 2+(2+2+2+2) clinical features, diagnosis
& treatment.

7. a) Enumerate various clinical problems of aging. Write (3+2)+5 down various screening
tests to prevent them.
b) Vaccines recommended for elderly people.

8. a) Clinical features and treatment of atopic dermatitis. 5+5

b) Enumerate the causes and treatment of Hirsutism.

9. a) Stem cell therapy in treatment of anemia. 5+5

b) Complications of Blood Transfusion.
10 ) Write down the types, differential diagnosis & (1+2+2)+5 treatment of vertigo.
Difference between case control and cohort studies

Paper II
1. a) Clinical features and treatment of Wernicke’s disease (3+3)+4

26
b) Central Pontine myelinosis

2. What is tumour lysis syndrome? Discuss its complications 2+(4+4) and treatment.

3. a) Clinical features and treatment of organophosphorus (2+3)+(2+3) poisoning.

b) Clinical features and treatment of high altitude sickness.

4. a) What is heparin induced thrombocytopenia? How will (2+3)+(2+3) you manage it?
b) Causes of anemia in chronic disease and its differentiation from microcytic anemia.

5. a) Define orthostatic hypotension & enumerate its (2+3)+5 causes.

b) Tests for detecting autonomic dysfunction
) Enumerate various oncologic emergencies. 3+(2+2+3)
b) Causes, clinical features & treatment of superior vena Cava syndrome.

7. a) Clinical features and treatment of Bell’s palsy. (2+3)+5

b) Viral hemorrhagic fever.

8. What is multiple sclerosis? Discuss its types, clinical 1+(2+3+4) features and management.
9. a) What is IRIS? Enumerate various opportunistic (2+3)+(3+2) infections in HIV.
b) Diagnosis and treatment of fungal pneumonia.

10. Define adult respiratory distress syndrome. Write down 2+(2+2+2+2) its diagnostic criteria,
causes, pathophysiology & treatment

PAPER III
1. Enumerate the causes of ejection systolic murmur 3+3+4 heard at aortic area.

27
b) Causes of mitral stenosis
c) Differentiate between constrictive pericarditis and restrictive cardiomyopathy.
2. a) Classify interstitial lung disease 3+4+3
b) Diagnostic utility of BAL in interstitial lung disease
c) Treatment of non-specific interstitial pneumonia

3. a) Define acute kidney injury (AKI) & enumerate its (2+3)+5 causes.
b) Role of urinary sediments in AKI.
4. a) Indications and treatment of chronic hepatitis C. (2+5)+3
b) Enumerate various factors associated with reduce response to treatment.
5. Pathogenesis, clinical features and treatment of Takayasu (3+3+4) arteritis.
6. a) Enumerate the causes of ejection systolic murmur heard at aortic area.
b) Causes of mitral stenosis
c) Differentiate between constrictive pericarditis and restrictive cardiomyopathy.

7. a) Classify interstitial lung disease 3+4+3

b)Diagnostic utility of BAL in interstitial lung disease
c)Treatment of non-specific interstitial pneumonia

8 a) Define acute kidney injury (AKI) & enumerate its (2+3)+5 causes.
b)Role of urinary sediments in AKI.

9 a) Indications and treatment of chronic hepatitis C. (2+5)+3

b)Enumerate various factors associated with reduce response to treatment.

10 Pathogenesis, clinical features and treatment of Takayasu (3+3+4) arteritis.

DEC 2016 Paper I

28
1. a) Define hypoglycemia. 1+4+5
b) Enumerate the causes of hypoglycemia.
c) Outline the management of hypoglycemia.

2. a) Anatomy of the coronary circulation. 5+5

b) Diagnosis of acute myocardial infarction.

3. A 24 year old male presents with 4 days fever and a rash. 3+7 a) List differential diagnosis.
b) Outline the approach to the management.

4. a) Define gestational diabetes mellitus (GDM). 2+(4+4)

b) Diagnosis and complications of GDM.

5. a) What is a case control study? 2+(4+4)

b)What are the advantages and disadvantages of a case control study?
6. a) What is neuroleptic malignant syndrome? 2+3+5
b) What are its predisposing risk factors?
c) How will you manage such a patient?

7. a) Outline the iron metabolism in the body. 4+3+3

b) Diagnosis of Iron deficiency. c) Complications of Iron therapy?

8. a) Define obesity. 1+3+6

b) Etiology/risk factors for morbid obesity.
c) Medical management of morbid obesity.

9. a) Define hyponatremia. 1+4+5

b) Enumerate the causes of hyponatremia.
c) Clinical features of hyponatremia.

10. a) Enumerate the causes of hypercalcemia. 4+6

b) Management of hypercalcemia.

Paper II

29
1. a) Classify the aspergillus infections of humans. 2+4+4
b) Risk factors for invasive aspergillosis. c) Diagnosis of invasive aspergillosis.

2. a) Outline the various clinical manifestations of snake bites. 5+5

b) Management of such patient with a cobra bite.

3. a) Define Adverse Drug Reactions (ADRs). b) ADRs of anti-tuberculosis drugs.

c) Outline the management of anti-tubercular treatment (ATT) induced hepatitis.

4. a) Enumerate the neurological manifestations of HIV infection.

b) Clinical features and management of cryptococcal meningitis.

5. a) Define dementia. 1+3+6

b) Enumerate the reversible causes of dementia.
c) Management of a patient with Alzheimer’s disease.
6. a) Differential diagnosis of fever with joint pains. 5+(3+2)
b) Outline the diagnosis and management of Chikungunya.

7. a) Define and classify respiratory failure. (1+4)+5

b) Indications of Non-Invasive Ventilation.

8. a) Clinical features of chronic myeloid Leukemia (CML). 3+(3+4)

b) Diagnosis and management of CML

9. a) Enumerate the causes of Disseminated Intravascular 3+3+4

Coagulation (DIC).
b) Diagnosis of DIC.
c) Outline the management of DIC.

10. a) Mechanisms of antimicrobial resistance. 4+3+3

b) Consequences of antimicrobial resistance.
c) Concept of antibiotic stewardship.

Paper III

30
1. a) Phenomenon of ‘Re-Entry’. 4+3+3
b) Diagnosis of paroxysmal supraventricular tachycardia (PSVT).
c) Outline the management of PSVT in a 30 year old female with BP – 90/60mmHg.

2. a) Enumerate the etiology of hospital acquired pneumonia 3+4+3 (HAP).

b) What are the risk factors for development of HAP?
c) Management of ventilator associated pneumonia.

3. a) Diagnosis of a case of malabsorption syndrome. 5+(3+2)

b) Clinical features and management of celiac disease in an adult.

4. a) Classify chronic kidney disease. 3+2+5

b) How will you estimate glomerular function of a patient?
c) Metabolic bone disease in a patient of chronic kidney disease.

5. a) What is a complicated urinary tract infection (UTI)? b) Diagnosis of UTI.

c) How will you manage UTI in a 6 month pregnant lady?
6. a) What are the extra-articular manifestations of rheumatoid arthritis?
b) Management of rheumatoid arthritis.

7. a) Enumerate the causes of aortic regurgitation.

b) Management of patients with aortic regurgitation.

8. a) Pathophysiology of myasthenia gravis. 4+6

b) Clinical features of myasthenia gravis and outline laboratory diagnosis of myasthenia gravis.

9. a) Enumerate the causes of ANCA-associated vasculitis. 3+(4+3)

b) Clinical features and management of microscopic polyangitis.

10. a) Risk factors for venous thromboembolism. 3+4+3

b) Diagnosis of acute pulmonary embolism.
c) Outline the management of acute pulmonary embolism.
APRIL 2016 paper I
1. a) Define atopy.

31
b) Outline the pathophysiology of bronchial asthma.
c) Pulmonary function abnormalities in bronchial asthma.

2. a) What is exfoliative dermatitis? Enumerate its causes.

b) What haemodynamic alterations are expected in such a patient?
c) Medical complications of generalized exfoliation.

3. a) Case control study.

b) Its advantages and disadvantages.

4. a) Neural circuit responsible for the cough reflex.

b) Enumerate causes of cough.
c) Clinical histories and findings which would help to localize the cause of cough in a given
individual.

5. a) What is autologous bone marrow transplantation?

b) What are its indications?
c) Complications of bone marrow transplantation.

6. a) Define secondary diabetes and enumerate its causes.

b) What investigations will you perform in a patient with suspected secondary diabetes?

7. a) When will you suspect that a patient is suffering from panhypopituitarism?

b) What clinical features give a clue to your diagnosis?
c) What investigations are needed to confirm your diagnosis?

8. a) Peripartum cardiomyopathy. b) Puerperal psychosis.

9. a) How is temperature regulated in the body? 4+3+3

b) How is it altered in presence of an invading viral illness?
c) How does it differ from a patient having high fever after a prolonged sun exposure?

10. a) Principles of adult immunization. 4+3+3

b) Immunization of a healthy 70 year old female.
c) Immunization of a 40 years old male with splenectomy.

PAPER III

32
1. a) What is effective circulatory volume ? b) Enumerate conditions with increased and
decreased effective circulatory volume states and basic management strategies for each.

2. a) What is obstructive sleep apnoea syndrome? 3+(3+4)

b) Risk factors for obstructive sleep apnoea syndrome and principles of its management.

3. a) Drugs used for the treatment of hepatitis C virus (HCV) 4+6

infection.
b) Management protocol of a patient with HCV genotype 3 infection.

4. a) What is Gastro-esophageal Reflux Disorder (GERD)? 2+(3+5)

b) Risk factors and management strategies for GERD.

5. Clinical features, diagnosis and management of ankylosing 4+3+3 spondylitis.

6. a) Describe a typical attack of angina pectoris. 3+5+2

b) Mention all possible clinical findings during an attack & briefly describe the causative
mechanism.
c) What is angina equivalent?

7. a) Enumerate the etiologic agents of community acquired 2+4+4 pneumonia (CAP).

b) How will you assess the severity of CAP?
c) Outline the management of CAP in a 50 year old male patient.
8. a) Pathophysiological basis of formation of various renal 3+3+4
casts.
b) What is telescoped urinary sediment?
c) Clinical features of acute interstitial nephritis.

9. a) What is irritable bowel syndrome? 2+4+4

b) What are the “warning signs” in a patient with irritable bowel syndrome?
c) Management of irritable bowel syndrome.

10. a) What is reactive arthritis? 2+5+3

b) When will you suspect that a patient is suffering from reactive arthritis?
c) What investigations can be done in such a patient?

DEC 2015 paper I

1. a) High risk factors for syncope. 3 b) Pathophysiology of syncope. 4

33
c) Classify syncope. 3

2. a) Define obesity. 1 b) Pathophysiologic consequences of obesity.

c)Goals of therapy, lifestyle management, diet therapy, 6 pharmacotherapy and surgery for obesity.
3. a) Mention causes of isolated splenomegaly. 3 b) How would you differentiate clinically
between causes of 4 isolated splenomegaly? 3
c) Indications of splenectomy.
4. A 21-year old woman, previously healthy, presents with 3- months history of headaches.

a) What are the likely etiologies? 3 b) How would you investigate her? 4
c) Pharmacotherapy for prevention of migraine. 3
5. a) Define Fever of Unknown Origin (FUO). 1 b) Causes of FUO. 4
c) Approach to a patient with classic FUO. 5
6. a) Basic principles of screening. 5 b) Uses and abuses of screening tests? 5

7 A 28 year-old man presents with 10 kg unintentional weight loss, over three months.
a) What are the likely etiologies? 5 b) How would you investigate this patient? 5

8. A 35-year-old woman presents with acute fever and macular rash.

a) What are the likely etiologies? 5 b) Laboratory tests to arrive at diagnosis. 5
9. Clinical features, diagnostic tests and treatment of diabetic ketoacidosis.
10. Clinical features, diagnostic evaluation and therapy of thyrotoxicosis.

PAPER II
1. Risk factors, prevention, diagnosis and management of ventilator-associated pneumonia.
2. Risk factors, differential diagnosis and severity assessment scales of acute ischaemic
stroke.
3. Clinical manifestations, immuno-pathogenesis and treatment of Guillain Barré
Syndrome.
4. Clinical features, complications and management of severe septic shock.
5. Differential diagnosis, investigations and treatment of acute complicated
P.falciparum malaria.
6. a) Basic principles of screening. 5 b) Uses and abuses of screening tests? 5
7. A 28 year-old man presents with 10 kg unintentional weight loss, over three months.

34
 What are the likely etiologies? How would you investigate this patient?
8. A 35-year-old woman presents with acute fever and macular rash.
What are the likely etiologies? Laboratory tests to arrive at diagnosis.
9. Clinical features, diagnostic tests and treatment of diabetic ketoacidosis.
10. Clinical features, diagnostic evaluation and therapy of thyrotoxicosis.

Paper III
1. a) Role of fibrin-specific thrombolytic therapy in ST-elevated 4 acute myocardial infarction,
b) Contraindications for thrombolysis and 3
c) Complications of thrombolytic therapy. 3

2. a) Enumerate factors that can decompensate chronic heart 2 failure.

b) Cardiac biomarkers for diagnosing chronic heart failure. 4
c) Explain how angiotensin converting enzyme (ACE) 4 inhibitors improve the quality of life of
patients with chronic heart failure.

3. a) Diagnostic tests to rule in or rule out acute venous 5 thromboembolism.

b) Outline therapy for acute pulmonary embolism. 5

4. a) Etiopathogenesis of anemia in chronic kidney disease (CKD).

b) Mention the steps for slowing progression of diabetic nephropathy.
5. a) Pulmonary manifestations of Sarcoidosis. 3 b) Diagnostic tests to detect Sarcoidosis. 3
c) Outline the management of Sarcoidosis.
6. Causes, clinical features and pathophysiology of membrano- proliferative glomerulonephritis.

7 Diagnosis and management of tuberculosis of intestine. 5+5

8 Clinical features, investigations and treatment of enteropathic 3+4+3

arthritis.
9 Causes, diagnostic evaluation and complications of acute severe pancreatitis.

10 a) What are common causes for Acute Respiratory Distress Syndrome (ARDS)?
b) Pathophysiology and ventilator management in ARDS.

JUNE 2015 Paper I

35
1. a) Pathogenesis and clinical causes of edema. (5+3)+2
b) Name drugs associated with edema formation.

2. a) Approach to a patient with inherited disorders. 6+4

b) Use of Gene Therapy in Clinical Medicine.

3. a) Systemic effects of aging. 5+5

b) Tools used in functional assessment of older patients.

4. Indications, efficacy and risks & benefits of specialized 3+3+4 nutritional support.

5. a) Anatomical basis of internuclear ophthalmoplegia. 5+5 b) Anion Gap.

6. a) Physiology of circulation in the third trimester of 6+4 pregnancy.
b) Management of tuberculosis in pregnancy.

7. Pathogenesis, natural history and management of diabetic 3+3+4 nephropathy.

8. Post menopausal hormone therapy: Benefits, risks and 4+4+2 approach.

9. a) Classify hyperpigmentation disease. 4+6

b) Metabolic causes for hyperpigmentation.

10. Clinical features and management of major depression. 5+5

PAPER II
1.
a) Principles involved in cancer chemotherapy.
b) List the advanced cancers that can be cured by chemotherapy
c) Acute complications of chemotherapy.

2.
a) Causes for cobalamin deficiency.

36
b) Haematological and neurological manifestations of cobalamin deficiency.

3.
a) Define multi-drug resistance TB (MDR-TB) and extensively drug resistant TB (XDR-TB).
b) Management of MDR-TB under RNTCP programme.

4.
Clinical manifestations and treatment of severe falciparum malaria.

5.
a) Neurological complications of HIV.
b) ART program that is being implemented by NACO in our country.

6.
Massive blood transfusion: Definition, indications, complications & their prevention, and
management.

7.
Clinical features and management of viper snake bite.

8.
a) Types of respiratory failure.
b) Non invasive positive pressure ventilation.
c) Complications of mechanical ventilation.

9.
Clinical features, pathogenesis and treatment of Wernicke’s encephalopathy.

10.
Clinical features, diagnosis and management of myasthesia gravis.

PAPER III
1. a) Etiologies of chronic heart failure. 3+2+5

37
b) Pathogenesis of heart failure with a depressed ejection fraction.
c) Drugs for treatment of chronic heart failure.

2. Risk factors, etiology and management of metabolic 3+3+4 syndrome.

3. Classification, pulmonary function testing and treatment of 3+3+4 interstitial lung disease.

4. Classification, etiology, diagnosis and treatment of lung 2+2+3+3 abscess.

5. a) Staging; 2+3+2+3 b) Fluid, electrolyte & acid base disorders;

c) Calcium & phosphate metabolism disorders; and
d) Measures to slow progression in CHRONIC KIDNEY
DISEASE.
6. Etiology, pathogenesis and treatment of acute uncomplicated 2+4+4 urinary tract infection.

7. a) Pathology of ulcerative colitis. 4+4+2

b) Enumerate its extra-intestinal manifestations.
c) Medical management of ulcerative colitis.

8. Acute Hepatitis B infection: Virology and etiology, laboratory 3+3+4 features and
complications.

9. a) Pathogenesis and diagnosis of rheumatoid arthritis. (3+3)+4

b) DMARDs (Disease Modifying Anti-Rheumatic Drugs) &
Biological therapy in rheumatoid arthritis.

10. Clinical manifestations, laboratory & radiographic testing and 3+3+4 treatment of
fibromyalgia.

DEC 2014 PAPER I

38
Describe the physioiogical role of zinc in health. Name the zinc 4+2+4 deficiency states. Describe
signs of zinc defigiency.
2, Discuss the terms 'True Positive Rates' and 'True Negative 5+5 Rates' in relation to research.
3. What is gestational diabetes? What is its risk to foetus? How is 2+3+5 gestational
diabetes managed?
4. What is stem cell biology? Classify cultured stem cells. What 3+4+3 are the applications of
stem cells in clinical medicine?
5. Describe lung problems in environmental disorders.
PART B
6. How is hypothalamo-pituitary adrenal axis regulated? Discuss the etiology and clinical
features of adrenal insufficiency. Describe the work up in suspected case of Addison's disease.
7. Define delirium. What are its etiological causes? Describe the workup in case of delirium.
4+3+3
8. a) State the Cockcroft-Gault Formula and its use. 3
b) Describe lab finding in pre-renal azotemia. 3
c) List the modifications of diet in renal disease with reasons. 4
9. Describe causes, manifestation and management of genital 3+4+3
ulcers.
10. Define Pyrexia of Unknown Origin (PUO). List the infective causes of PUO. Describe the
evaluation in case of PUO

Paper ii
1 . Biomedical terrorism.
2. Systemic inflammatory response syndrome.
3. Cardiorenal syndrome.
4. Methyl alcohol poisoning.
5. Clinical features, complications and chemotherapy regimens used in treatment of multiple
myeloma.
6A) Discuss the infective agents in community-acquired and nosocomial pneumonias.
c) Outline the management in both types.
7 List the causes of tower fimb pain due to organic pathology in the vertebrae and spinal
cord. Outline the management approach.
8 Define and classify gastrointestinal neuroendocrinal tumours. How are they diagnosed
and managed?
39
 9 What is latent tuberculosis? Describe the investigations and management for latent
tuberculosis.
10 Neuroleptic malignant syndrome.

Paper iii
1. WHO classification of Lupus Nephritis and its management.
2. Extra-articular manifestations of rheumatoid arthritis.
3. Electrophysiology of atrial fibrillation & its medical and surgical management.
4. Pathophysiology, classification, diagnosis and management of pulmonary hypertension.
5. Variants, clinical features and treatment of hemolytic uremic syndrome.
6. Causes and pathogenesis of refractory hypokalemia.
7. Systemic manifestations of COPD.
8. Pathogenesis of hepato-renal syndrome. Discuss in brief its management and prognosis.
9. Causes and mechanisms of diarrhea due to disorders of gut mucosal function or structure.
10. Classification and management of chronic hepatitis.

JUNE 2014 PAPER I

1. How do ketone bodies form in our body? How does fteir excess production
overwhelm our system in diabetes and starvation to produce ketosis?
2. Write short note on: "Incretin physiology: How can we use it in clinical situations"
3. Write short note on: Adipocytes as an endocrine organ"
4. How does post-transcriptional modification occurs in health? Give examples of
diseases caused by post-transcriptional changes in the genes.
5. What common pathogenetic factors link the components of metabolic syndrome?
How does exercise help in metabolic syndrome?
6. How do genetic factors and the environmental insult of high 10 salt intake interact to
produce hypertension?
7. What are the diseases associated with prolonged QT 4+6 intervals? How are genetic
factors involved in their pathogenesis?
8. Discuss the genetic basis of hypertrophic obstructive 3+7 cardiomyopathy.
What clinical features distinguish it from valvular aortic stenosis?
9. What is effective circulatory volume? What percentage of 3+1+(3+3) body water is in
that compartment? How is it affected in: a) Nephritic syndrome b)Nephrotic syndrome

40
 10. What is trans-cellular water? Describe , briefly the2+8 pathogenesis of anasarca, in
various disease states

PAPER II
1. Describe the role of hepcidin in normal iron metabolism. How does it get altered in primary
haemochromatosis and thalassemias?
2. When will you suspect that a patient is suffering from T.T.P.? Outline the pathogenesis of a
full blown case of T.T.P.
3. When will you suspect that a patient is suffering from amyloidosis? Draw a diagnostic flow
chart of a patient whom you need to investigate.
4. What is tumor lysis syndrome? How would you prevent it? How do you manage such a
patient?
5. Write short note on: "Infection and immunity — who controls whom?"
6. How do you manage a patient suspected of having Kala-azar? Mention recent guidelines in
the treatment of Kala-azar?
7. . What are the causes of 'reversible dementia'? How do you go about to diagnose a demented
patient?
8. . What is albumino-cytological dissociation? Describe the pathogenesis of this condition in 4
diseases where it is seen.
9. . What is obstructive sleep apnoea syndrome (OSAS)? Briefly describe the pathogenesis of
the cardiovascular complications of OSAS.
10. . Describe how posture and balance is affected by various

Paper III
1. Give a brief account of the formation of the atrial septum. How does it explain the secundum
type of atrial septal defect?
2. What clinical and radiological features are common in congenital heart diseases with a right
to left shunt?
3. What are the clinical features of peripartum cardiomyopathy? How does it differ from
ischaemic cardiomyopathy?
4. Define bronchiectasis and emphysema. How do their clinical features differ in the later stages
of their manifestation?
5. How do environment and genetics interact in the pathogenesis of COPD?

41
 6. Describe the neural regulation of the gastro-intestinal tract. How is it affected in achalasia
cardia and diffuse oesophageal spasm?
7. Describe the pathogenesis of peptic ulcer disease. What systemic diseases increase the
chances of peptic ulcer disease?
8. How does arsenic affect our liver? What are the hallmarks of chronic arsenic toxicityQ
9. Enumerate causes of compressive myelopathy. What are the differences between
compressive and non-compressive myelopathy? Describe clinical features of Amyotrophic
lateral sclerosis.
10. What is salt losing nephropathy? Enumerate the causes. What features are common to all of
them?

JUNE 2013 PAPER I

1. Define hypercalcemia. Discuss the etiology, clinical manifestations and management of
hypercalcemia.
2. Discuss the clinical manifestations of Helicobacter pylori infestation, its diagnosis and
recommended treatment regimen.
3. Discuss the clinical features and management of viperine snake bite.
4. Describe the role of inflammatory mediators in bronchial asthma. Discuss the management of
acute severe asthma.
5. What is malabsorption syndrome? Discuss the clinical manifestation of Vitamin B12
deficiency and its treatment.
6. What is Systemic Inflammatory Response Syndrome (SIRS)? Discuss the complications and
management of severe sepsis.
7. Define dementia. Discuss the causes of reversible dementia. Describe the management of
Alzheimer's disease.
8. Define metabolic syndrome. Discuss the etiology and management of metabolic syndrome.
9. Define acute kidney injury. Discuss the etiology and management of acute tubular necrosis.
10. Discuss the pathophysiology of supra ventricular tachycardia. Describe the management of
Paroxysmal Supraventricular Tachycardia (PSVT).

PAPER II
42
 1. Discuss the etiology, management and complications of community acquired pneumonia.
2. Discuss the causes of Upper Gastrointestinal (UGI) bleeding. Describe the management of
variceal UGI bleed.
3. Discuss the risk factors, clinical features, diagnosis and management of cortical venous
thrombosis.
4. Enumerate the causes of fever with jaundice. Discuss the clinical features and management of
leptospirosis.
5. Discuss the causes of chronic meningitis. Describe the management and complications of
tubercular meningitis.
6. Discuss the risk factors, diagnosis and management of osteoporosis. 3+3+4
7. Discuss the etiopathogenesis, clinical features and management of ankylosing
spondylitis.
8. Discuss the etiopathogenesis of anemia of chronic kidney disease and outline its
management. 5+5
9. Discuss the etiology, clinical features and management of Immune Thrombocytopenic
Purpura (ITP) 3+3+4
10. Discuss the epidemiology of influenza virus infection, risk factors forcomplications and
treatment in adults.

Paper 3
1. Discuss the etiology, diagnosis and management of peripheral arterial disease.
2. Discuss the etiology and clinical manifestations of hyperprolactinemia. Describe the
management of prolactinoma of the pituitary. (3+3)+4
3. Discuss the clinical manifestations, diagnosis and management of multiple myeloma.
4. Discuss the etiology, clinical features, diagnosis and management of Immune Reactivation
Inflammatory Syndrome (IRIS) in HIV infection. 2+3+3+2
5. Discuss the clinical manifestations, diagnosis and management of sarcoidosis. 3+4+3
6 Discuss the etiology, clinical features and diagnostic evaluation of urinary tract infection.
7 Describe the clinical features, diagnosis and management of chronic hepatitis C infection.
8 Discuss the clinical features, diagnosis and management of multiple sclerosis.
9 Describe the clinical manifestations, diagnosis and complications of enteric fever.
10 Discuss the indications for Long Term Oxygen Therapy (LTOT). Describe the modalities of
delivery and monitoring of patients receiving LTOT.

43
PAPER 4
1. Classify antiretroviral drugs. Discuss the indications of antiretroviral treatment (ART)
and monitoring of patients on ART.
2. What are nucleic acid based tests? Discuss the advantages and disadvantages of
cartridge based nucleic acid tests in the diagnosis of tuberculosis.
3. Describe the metabolism of hemoglobin in the body. Discuss the clinical features of
hemolytic anemias.
4. Describe a case control study. What are the advantages and disadvantages of case
control studies?
5. Describe the role of resident bacterial flora in the human body. Discuss the indications
of use of probiotics.
6. Describe the mechanisms of anti-microbial drug resistance. Discuss the clinical
implications of anti-microbial drug resistance.
7. Define standard work precautions. Describe the role of personal protective equipment
and hand washing in daily practice.
8. What is post exposure prophylaxis? Discuss the role of post exposure prophylaxis in
relation to any two infections.
9. What is Anion Gap? Describe the causes of metabolic acidosis and role of anion gap in
metabolic acidosis.
10. What is Total Parenteral Nutrition. Discuss the indications and complications of Total
Parenteral Nutrition.

DEC 2013 PAPER ii

44
 1. What are Prothrombotic states? Discuss briefly diagnosis and treatment of massive
pulmonary embolism.
2. Write briefly about the etiology, clinical features, serologic diagnosis and treatment of
Chikungunya fever?
3. Classify chronic myelo-proliferative disorder. Describe chromosomal findings and treatment
of Chronic Myeloid Leukemia.
4. What are the causes of vertigo? How will you diagnose and treat B ppv?
5. Discuss the etiopathogenesis, differential diagnosis and treatment of rapidly progressive
glomerulonephritis.
6. Describe significance of serum cardiac biomarkers in STEMI. What is the strategy of pre-
hospital management of STEMI?
7. What is pneumothorax? What are its types? Describe clinical features and management of
Tension Pneumothorax.
8. What are classification criteria for rheumatoid arthritis? Discuss role of biologicals in
management of Rheumatoid arthritis.
9. Define epilepsy. Discuss briefly mechanism of epileptogenesis and principles of selection of
anti-epileptic drugs.
10. Enumerate disease manifestations of cigarette smoking and strategies for smoking cessation.

Paper III
1. Define heart failure. Describe its pathophysiology, diagnosis and treatment.
2. Define aplastic anemia. Discuss its pathophysiology and treatment.
3. What are X-Iinked disorders? What are the types of X-Iinked disorders? Name four diseases
that are transmitted as X-Iinked disorder.
4. Describe the etiopathogenesis of inflammatory bowel disease. Discuss the diagnosis and
treatment of ulcerative colitis.
5. Describe the clinical features of myasthenia gravis. How will you investigate a suspected case
of myasthenia gravis?
6. Enumerate clinical features of autosomal dominant polycystic kidney disease, methods of
diagnosis and the risk factors that lead to progression of the disease.
7. Describe etiology, clinical features and management of Hypersensitivity Pneumonitis.

45
 8. What do you understand by pituitary apoplexy? Discuss its clinical features and management.
9. Describe clinical features, diagnosis and management of gouty arthritis
10. Define noninvasive ventilation. Mention indications and contraindications for its use. What
are its advantages and disadvantages?

Paper IV

1. Enumerate the host factors in infection and discuss the immune response in brief.
2. Define non alcoholic fatty liver disease. Discuss its pathogenesis, diagnosis and management.
3. Describe the pathophysiology of migraine. Discuss the various drugs used in treatment of
migraine in relation to pathophysiology.
4. Describe various ventilatory functions. Discuss the flow volume curves in obstructive and
restrictive lung disease.
5. Describe pathophysiology, clinical features, diagnosis and treatment of Wilson's disease.
6. Define Pyrexia of unknown origin. How is it classified? Enumerate the investigations that are
necessary to arrive at a diagnosis of Pyrexia of unknown origin.
7. Classify chemicals used in bioterrorism and discuss their management.
8. Describe a cohort study. What are its advantages and disadvantages?
9. Discuss in brief the pharmacokinetics of a drug and principles of antibacterial chemotherapy.
10. Discuss the sources of stem cells used for tissue repair and discuss the strategies for stem cell
replacement.

DEC 2011- Paper 1

46
1 .Define hepato-renal syndrome. Describe its pathogenesis, diagnostic criteria and treatment
modalities. 1 +3+3+3
2.Describe clinical presentation, diagnosis and treatment of a patient with hypertensive
encephalopathy. 2+3+5
3.Enumerate thromobolytic agents. Describe their indications, contraindications and complications in
acute myocardial infarction. 2+2+2+4
4.Describe clinical features, diagnosis and treatment of herpes simplex viral encephalitis. 2+3+5
5.Describe causes, evaluation and treatment of a patient wit massive haemoptysis. 2+3+5
6.What is Immune Reconstitution Inflammatory Syndrome? Discuss its pathogenesis, diagnosis and
treatment. 1 +2+3+4
7.Classify tumour markers and describe their role in various medical conditions. 4+6
8.Enumerate causes of hypercalcemia. De#cribe the clinical presentation and management of a
patient with severe hypercalcemia. 2+2+6
9.Describe the clinical presentation, etiopathogenesis and management of hypokalemic periodic
paralysis. 3+3+4
10.Briefly discuss thyroid function tests. Discuss Sick Euthyroid Syndrome 5+5

PAPER II
1 .Describe the clinical features, diagnostic evaluation and 4+2+4 management of a patient with
organophosphorous poisoning.
2.Describe the etiology, diagnosis and management of a patient 2+2+6with atypical pneumonia.
3. What are Gliptins? Describe their mechanism of action and specific indications of usage.
4. How do you approach a patient with cardiac arrhythmia? Classify 5+5 anti-arrhythmic drugs.
5. Describe diagnostic evaluation of a patient presenting with 5+5 peripheral neuropathy.
Enumerate the neuropathic patterns associated with diabetic mellitus. management of a patient with
a malabsorption syndrome.
7.Describe etiology, clinical presentation and management of cerebral venous thrombosis.
6.Describe diagnostic evaluation, clinicalfeatures and 3+3+4
8.Describe clinical features, investigations and management of multiple myeloma. 2+3+5
9.Describe the clinical presentation, diagnostic evaluation and management of 'Dengue fever'.
10.Define 'brain death'. Outlines the means of ascertaining brain death. 3+7

PAPER Ill

47
1 .Enumerate causes of acute renal failure. Describe the management and preventive guidelines in
such a patient. 3+5+2
2.Describe the etiopathogenesis, clinical presentation and management of Hepatitis C infection,
3.Describe diagnostic evaluation of a patient with adrenal insufficiency. Discuss the management of
adrenal crisis. 5+5
4.Classify cyanotic congenital heart diseases. Describe the clinical features and management of
Fallot's tetralogy. 2+4+4
5.Define spontaneous bacterial peritonitis. Describe its etiopathogenesis, clinical features and
management 1+2+3+4
6.What are the diagnostic criteria for depression? Briefly describe the principles of management 3+7
7.Describe the principle and clinical uses of stress test. Differentiate between stress
echocardiography and stress thallium. 2+3+5
8.Describe the indications and complications of mechanical ventilation. 4+6
9.Describe the clinical presentation, diagnostic evaluation and management of right ventricular
myocardial infarction. 3+3+4
10.Describe the skin manifestation of internal malignancies. Discuss its prognostic value.

Paper IV
1. Describe the nerve supply of urinary bladder and discuss the physiologic basis of automatic
bladder. 5+5
2.Enumerate parasitic infestations of central nervous system. Describe the diagnosis and
management of neurocysticercosis.-.3+3+4
3.Describe various diagnostic tools for detection of pulmonary and extrapulmonary tuberculosis.5+5
4.Classify dyslipidaemias and describe various management strategies.4+6
5.Discuss vitamin B12 absorption and consequences of its deficiency.4+6
6.Discuss the role of Renin-Angiotensin-Aldosterone axis in the pathogenesis of essential
hypertension. Discuss direct renin inhibitors.3+7
7.Describe pathophysiology of Parkinson's disease. Describe clinical features and management of a
patient with Parkinsonism.4+2+4
8.Define febrile neutropenia. Describe its etiopathogenesis, diagnostic evaluation and management.
9.Describe pathophysiology, diagnostic evaluation and management of primary pulmonary
hypertension. 2+5+3
10 Define evidence based medicine. Describe the key processes and mention the currently available
tools. 3+3+4
48