BMDC Exam 2017, April

1. common nutritional deficiencies in BD

-Iron deficiency Anemia/megaloblastic aneamia
-protein energy malnutrition
-vitamin A,C,D & K deficiency
-iron deficiency disorders

2. Gram positive Bacilli

-Aerobic- Bacillus, listeria, Corynebacterium,
-Anaerobic- Clostridium, actinomyces, Propionibacterium, lactobacillus.

3. Contagious disease
-Scabies
-Tb
-Herpes
-Trichononiasis
-Meseales

4. Acute inflammation pathophysiology

-increased blood flow
-increased vascular permeability
-Leukocytic infiltration

5. Down’s syndrome features.

-problem in 21st chromosome
-47,XY+21
-increased gap between 1st and 2nd toe
-flat facies
- Single Palmer crease
- sever pond of music
-mental retardation
-increase chance of leukemia
-heart defect

6. Perforation of hollow viscera

-initially localized then diffuse abdominal pain

- nausea,vommiting
- chills.
-anorexia

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-tachypnea
-change/alter bowel habit

7. Sources of vitamin
-Vitamin A- Green vegetables
-vitamin B6-Banana potato fish
-Vitamin- D- Sunlight
-iron- meat,fish,poultry,lentils

8. cell injury features

- Cell injury causes cell death
-Keryolysis is nuclear dissolution
-pyknosis is nuclear condensation
- karyorrhexis is fragmentation of the nucleus

9. organs having no lymphatic drainage

-Brain,spinal cord,inner ear, bone marrow, cartilage, eyeball

10. TCA antidepressant drugs name

- amitriptyline,imipramine,clomipramine,doxepin,trimipramine
Desipramine,nortryptaline

11. Name of ACE inhibitors

-Ramipril,Enalapril,fosinopril
-Captopril

12. Metabolic effect of insulin

-Increase glycogenolysis
-Increase gluconeogenesis
-Raise K+ uptake

13.Abnormal constituents of urine

-Proteinuria, cast&cells, hematuria, pyuria, crystalluria, hemoglobinuria,
myoglobinuria, creatinuria, ketoneuria

14. OPC poisoning features

-pin point pupil, increased all secretions,bradycardia and
hypotension
-Atropine, pralidixome is used as treatment

15. Name of first generation antihistamine

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 - chlorpheniramine, diphenhydramine
- fexofenadine
- cetirizine
- loratadine

16. Lifesaving hormone

-Insulin
-cortisol
-aldosterone
-parathyroid hormone

17. High ESR found in

-MRCP
-Malignacy
-Multiple Myeloma
-RA
-Collagen disease like SLE
-Pulmonary Tb
-Pregnancy

***LOW RSR in polycythemia

18. Gastric outlet obstruction features.

- Vomiting
-Weight loss
-Constipation
-pain(occasionally)

19. Beta blocker contraindications

-2nd 3rd Heart block, asthma, COPD

20. Angina pectoris treatment

-rest
-nitroglycerine

21. Sympathetic nervous system actions

- Broncho dilation
- Pupillary dilation

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22. Occupational lung disease
-pulmonary fibrosis
-Asthma,COPD
-Malignancy
- hypersensivity pneumonitis

23. Vitamin K dependent factors

-Factor II
-Factor VII
-Factor- IX
-Factor- X

24. Ventricular septal defect

- ventricular septal defect (VSD) is a defect in the ventricular septum, the

wall dividing the left and right ventricles of the heart

Clinical manifestation
Symptoms:
-maybe asymptomic
-fatigue
-reduced exercise tolerance
Signs
-prominent apex beat
-systolic thrill in lower left parasternal area
-pansystolic murmur in lower left parasternal area
-if reverse shunt develops: central cyanosis, clubbing, features of heart failure.
Invertigation
ECG, Chest x-ray, Echocardiography
Treatment
-Surgical closure before the development of severe pulmonary
hypertension
-fatigue and mild dyspnoea are treated with diuretics and afterload
reduction.
- Prophylaxis for infective endocarditis

Digoxin-increase the strength of hearts construction

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Fursomide- decrease amount of fluid in circulation in the lung
Bisoprolol- keep the heartbeat regular.

25. Clinical features of mitral stenosis

-Low volume pulse
-Mital Face/Malar Flash
-Apex is localized
-Apex Tapping in nature
-Murmur MDM
-1-St Hs is loud
-Di-astolic thrill
-Opening Sanp
-Low pitch

26. Juvenile idiopathic arthritis features

-Carditis
-swelling & deformity

27. Malaria features

-The onset is often insidious
-Malaise
-Headache
-Vomiting
-Anemia
-if cerebral malaria then ( Confuaion,Seizure,Coma)

28. Scabies clinical features

-intensive itching, especially at night
-eczema like signs
-typical distribution of severe itch and rash
-in immunosuppression patients the infestation is intensive
-patient with sensational defects

29. Total RBC increased / Erythrocytosis causes.

-Hypoxia
-High altitude

30. Organism causes liver cirrhosis

-Hepatitis A virus
-Hepatitis B virus
-Hepatitis E virus
-epstein barr virus

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31. oral contraceptive pill complications

Nausea, vomiting, intermenstrual spotting, scanty period, post pill

amenorrhea, increased weight gain, thromboembolic disorder, acne,
alopecia, anemia, thyroid dysfunction, cvd, pigmentation

32. Pregnancy of first trimester can diagnosed by

-USG
-period of amenorrhea
-morning sickness
-immunological test

33. Causes of early pregnancy bleeding

- abortion
- ectopic pregnancy
- molar pregnancy

34. Pneumonia C/F

Fever
Cough
Respiratory distress
chest pain which increase during inspiration and cough

35. white patches in tonsil

-Acute follicular tonsilitis
-Diptheria,agranulocytosis,oral thrush,vincent angina
-glandular fever,leukemia

36. Laryngeal carcinoma clinical features

-early features
-dysphagia,sore throat
-pain in the ear
Late symptoms
-hoarseness
-weight loss
-anorexia

37. Referred otalgia found in

-tooth pain: due to abscess, gingivitis
-tongue: glossitis

Tanvir Ahmed-SHZU’13
-temporomandibular joint: Arthritis
-Throat: pharyngitis, laryngitis, epiglottitis
Sinusitis

38.causes of tachycardia
-anxiety
-alcohol
-ischemic heart disease
-thyrotoxicosis
-digitalis toxicity
-WPW syndrome

39. High risks pregnancy

-elderly primi>= 30 years

- short strature <= 140 cm
-threatened abortion
-APH
-Malpresentation
-pre eclampsia
-eclampsia
-Anemia
-Elderly grand multipara
-twins
-H/O IUD, IURD
-H/O instrumental delivery

40.ectopic pregnancy

-Ectopic pregnancy, also known as tubal pregnancy, is a complication

of pregnancy in which the embryo attaches outside the uterus.

-Sudden colicky abdominal pain with fainting attack

-white discharge
-anemia

41. Complication of measles

-Bronchopneumonia
-Otitis media
-Diarrhoea

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 42. Sexually transmitted infections

-Gonorrhea
-Syphilis
-Genital Herpis
-AIDS
-Genital wart
-Chronic Hepatitis
-Monalial vaginitis

43.developmental milestone of baby

Age Gross motor Fine motor Speech, Social,

&vision language & emotional,behavior,
hearing self help/autonomy
6 weeks -when pulled from -follows -scared to loud -child smiles in the
supine to sitting there is moving objects noises response to mother’s
partial head lag. or face by smile
-primitive reflexes are turning the head
persist
3 -neck control is achieved -reaches out for -Vocalizes alone -recognize mother
months -primitive reflexes toys or when spoken -becomes excited by
persist to coos and toys
laughs
6-8 -sits without support -transfer object --turns to soft -tries to feed him or
months -at 6 months with round from one hand sounds out of herself
back to another sight
-at 8 months with -palmar grasp is
straight back attained
9-10 -crawls -pincer grip -says bi syllable -plays peek a boo waves
months -stands holding words, e.g. Baba bye bye
Furniture -says one word
with meaning
12 -walking unsteadily, -throws objects -says 2-3 words -drinks from cup
months broad gaits, hands apart -turns pages of with meaning
a book other than
dada/mama
--responds to own
name by turning
when called from
behind

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15-18 -walks alone steadily -scribbles with -says 12-15 -asks for things by
months pen words pointing
18-20 -walks backwards -builds a tower -points to body -holds spoon and gets
months of 3 cubes parts on request food to mouth.
-begins to join 2
words together

44. definitive host in human

-pinworms schistosomes and pinworms

45. Cause of thrombocytopenia

-ITP
-DIC
-HUS

46. Cause of ascities with splenomegaly

-Malaria
-Portal HTN

47. Pathophysiology of PUD

-H.Pylori is responsible for it.
-H.Pylori eradication is main target.
-Amoxicillin can be used for Rx
Vagotomy definative anti acid surgery

48.Avascular structure of body

-Cornea
-Lens
- vitreous hemorrhage

49. Retinal hemorrhage caused by

-HTN
-DM,vasculitis

50.infectious diarrhea caused by

-Salmonella
-E.Coli

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-Rota Virus
-Vibrio Cholerae
-Shigella
-Campylobacter jejuni

51. Uncontrolled hemorrhage found in

-shock
-metabolic acidosis

52. Complication of massive transfusion

-Coagulopathy
-Hypothermia
- hypokalemia

53. Fluid in post traumatic patient

-Hantman solution
-5% DNS

54. Severe dehydration fluid choice.

--Hantman solution
5% DNS
-normal saline

55.hematoma in brain
Fracture of squamous temporal bone
Biconvex hyperdense shadow with or without midline shift
Urgent evacuation by burr hole prior to formal craniotomy

56.X-ray finding in rickets

- X-ray knee and wrist shoes-
-Widening, Cupping and frying of metaphysis.
-wide gap between epiphysis and metaphysis.
-density of shaft of bone is reduced.
-Deformity of long bone may reduced.
-green stick fracture maybe present.
thickening and Widening of epiphyseal plate

Chest X-ray shows

-Chondral ends of ribs are expanded, cupped and indistinct.
-Rachitic rosary maybe identified radiologically.

57.causes of generalized edema

Tanvir Ahmed-SHZU’13
-fluid overload
-hypoproteinemia

58.factors released from kidney

- Renin
-Angiotensin II

59. Myocardial infection – features

-Site: center of the chest
- mode onset: take several minutes or even longer to develop
-character: dull, constricting, chocking or heavy, and usually described as
squeezing, crushing, burning or aching.
-Radiation: it may radiate to both arms, to the throat, jaw
-associated symptoms: feeling of breathlessness, sweating, nausea,
vomiting, anxiety.
Duration: persist for prolonged duration

60. Asthma steps of Mx

61. Fat soluble vitamins

- Vitamins A, D, E, and K

62. Viral meningitis features

-Fever
-Headache

Tanvir Ahmed-SHZU’13
-Neck stiffness
-Photosensitivity
-Decreased consciousness
-Nausea or vomiting

63. false cyst features

-walled off collection of fluid not lined by epithelium
Result of exudation or degeneration

64.staphylococcus aureus - positive tests

-Stephylococcus aureus coagulation of plasma*
‘Free’ Staphylocoagulase
|
Fibrinogen+CRF Fibrin

65. FCF features

66. Diazepam withdrawal features

-seizures
-headache
-increased sensitivity to noice
-sweating
-difficulty in falling asleep
-pain
-weight loss
-shaking
-blurred vision
-nervousness
-depression

67. Ankylosing spondylitis- C/F

-Age- between 20-50 years
- male:female= 3:1
-Spinal features
-low back pain
-early morning stiffness
-symptoms are exacerbated by inactivity and relieved by movement
-these disease tends to ascend slowly, ultimately involving the whole
spine
-Physical sings
-restriction of movements of the lumber spine in all directions
-pain on sacroiliac stressing
-a few patients develop marked kyphosis of dorsal & cervical spine

Tanvir Ahmed-SHZU’13
-failure to obliterate the lumber lordosis on forward flexion.

68. side effect of Timolol

- Burning sensations, hyperemia, superficial punctate keratopathy,
corneal anesthesia, bradycardia, arrhythmias, heart failure, syncope,
bronchospasm & airway obstruction.

69. Avascular necrosis

Sites

Head of Femur
Scaphoid
Talus
Humerus head

Causes:

Fractures
Dialocation
Septic Arthritis
Radiation
Sickle cell anemia

70. Dengue Fever

-dengue fever is an acute febrile illness of 2-7 days duration sometimes
with two peaks having the following manifestation.
-sudden onset continuous fever.
-severe headache
-reion orbital pain severe myalgia/aethralgia/back pain
-hemorrhagic manifestation
-nausea/vomiting/abdominal pain
-rash
-high index of suspicion based on period , population and place.
- absence of convincing evidence of any other febrile illness.

71. Mechanism of edema

-Capillary endothelial injury by toxins/histamine/anoxia/drugs
|
Endothelial gap
|
Increase capillary permeability to plasma proteins
|

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Decrease oncotic pressure
|
EDEMA

72. Gout clinical features

-acute gout
-middle aged males are commonly effected
-sudden onset of agonizing pain, swelling and redness of the first MTPJ
joint
-other common sites are ankle, mid-foot, knee, small joints of hand, wrist
and elbow.
-Untreated attacks last about 5-14 days.
-bursitis, tenosynovitis or cellulitis.

73. Wound healing factors

Factors affecting wound healing
-local factors
-Desiccation
-infection/bacterial load
-maceration
-necrosis
-pressure
-trauma
-edema
Systemic factors
-older age
-diabetes
-obesity
-hypothyroidism
-immunosuppression
-corticosteroid use
-radiation therapy or chemotherapy
-laboratory values
-Vascular insufficiency
-smocking

74. Features of marasmus

-growth failure
-wasting of all tissues including muscles and adipose tissue
-edema present
-no hepatic enlargement
-anemia is present
-well alert, wizened face.

Tanvir Ahmed-SHZU’13
-sometimes mental change
-appetite is good

75. OPC poisoning management

-further exposure should be prevented
-contaminated clothing and contact lenses should be removed
-the skin washed with soup and water and eyes irrigated
-the airway should be cleared of excessive secretions and high-flow
oxygen administrated
-intravenous access should be obtained
-gastric lavage or activated charcoal maybe considered within one hour of
investigation.
-Atrophine: muscarinic antagonist
-0.6-2 mg IV
-repeated every 10-25 minutes until sign of atropinization
-large doses maybe needed. But excessive doses may cause
anticholinergic effects
-atropinization should be maintained upto 48-72 hours
-the dose should be titrated based on clinical criteria
Pralidoxime:
- specific antidote, which activates acetylcholinesterase
- 2 gm IV over 4 Minutes
- Repeated 4-6 times daily

-Ventilatory support
-Treatment of convulsions and fasciculations- by benzodiazepines
( diazepam 10-20mg, lorazepam 2-4 mg.

Tanvir Ahmed-SHZU’13