January 2024 (2021 Regular)

Dr. NTR UNIVERSITY OF HEALTH SCIENCES

M.B.B.S. DEGREE EXAMINATION – JANUARY, 2024

SECOND M.B.B.S. EXAMINATION

PHARMACOLOGY - PAPER-I (Theory Questions)

Time: 2 Hours 40 Minutes   |   Max Marks: 80

NOTE: Answer all questions. Draw a neat diagram wherever necessary.

SECTION-II (THEORY QUESTIONS – 80 MARKS)

WRITE AN ESSAY ON THE FOLLOWING: (2×15 = 30 Marks)

1) Classify adrenergic drugs. Explain the mechanism of action, uses and adverse effects of adrenaline. Discuss the management of anaphylactic shock.

2) Classify drugs used in management of angina. Write the mechanism of action and adverse effects of nitrates. What is nitrate tolerance and how it can be overcome? Discuss the management of myocardial infarction.

WRITE A SHORT NOTE ON THE FOLLOWING: (10×5 = 50 Marks)

3) Enumerate the factors affecting absorption of drugs.

4) List the different types of drug antagonism with suitable examples.

5) What are the advantages of benzodiazepines over barbiturates?

6) A patient is admitted with history of restlessness, violent behaviour and incoherent speech. He was earlier diagnosed with bipolar disorder and is on medications. What is the management of bipolar disorder? What pharmacotherapy needs to be administered for the present acute episode?

7) List the uses and adverse effects of loop diuretics.

8) A 20-year-old woman complains of 1-2 episodes of one-sided headache every month affecting her routine work. Describe the management of migraine for this woman.

9) Give the rationale for combining levodopa with carbidopa. What advice needs to be given to the patient when prescribing this combination?

10) What are the ways to prevent adverse reactions to drugs?

11) Mention three therapeutic uses of prostaglandins with examples.

12) Write the mechanism of action, uses and adverse effects of sodium valproate.

---

Dr. NTR UNIVERSITY OF HEALTH SCIENCES

M.B.B.S. DEGREE EXAMINATION – JANUARY, 2024

SECOND M.B.B.S. EXAMINATION

PHARMACOLOGY - PAPER-II (Theory Questions)

Time: 2 Hours 40 Minutes   |   Max Marks: 80

NOTE: Answer all questions. Draw a neat diagram wherever necessary.

SECTION-II (THEORY QUESTIONS – 80 MARKS)

WRITE AN ESSAY ON THE FOLLOWING: (2×15 = 30 Marks)

1) Classify anti-malarial drugs. Write the mechanism of action, uses and adverse effects of chloroquine. What is the role of primaquine in malaria?

2) Classify oral hypoglycemic agents. Write the mechanism of action, uses and adverse effects of Glimepiride. Discuss the management of diabetic ketoacidosis.

WRITE A SHORT NOTE ON THE FOLLOWING: (10×5 = 50 Marks)

3) Write the rationale for combined use of antimicrobials with suitable examples.

4) Explain the mechanism of action, uses and adverse effects of methotrexate.

5) What is the rationale for the use of drugs in diarrhea?

6) Write the mechanism of action and uses of albendazole.

7) Write the advantages of azithromycin over erythromycin.

8) Compare and contrast Low Molecular Weight (LMW) heparin and unfractionated heparin.

9) A 30-year-old diabetic patient has been prescribed injection insulin for daily use. How will you communicate with her regarding the use of insulin?

10) Enumerate and discuss the role of inhaled steroids in bronchial asthma.

11) A 45-year-old businessman who travels a lot for his work complains of lower abdominal pain with intermittent episodes of diarrhea and constipation. He has been diagnosed to have Inflammatory Bowel Disease (IBD). Write the drugs used in management of IBD and give the rationale for their use.

12) Define chelating agent. Discuss management of copper poisoning.

---

Dr. NTR UNIVERSITY OF HEALTH SCIENCES

M.B.B.S. DEGREE EXAMINATION – JANUARY, 2024

SECOND M.B.B.S. EXAMINATION

PATHOLOGY - PAPER-I (Theory Questions)

Time: 2 Hours 40 Minutes   |   Max Marks: 80

NOTE: Answer all questions. Draw a neat diagram wherever necessary.

SECTION-II (THEORY QUESTIONS – 80 MARKS)

WRITE AN ESSAY ON THE FOLLOWING: (2×15 = 30 Marks)

1) A 25-year-old male was brought to the emergency room, 10 minutes post-vaccination. On examination, he was dyspneic. Pulse and blood pressure were low.
a. What is the provisional diagnosis and why?
b. Discuss the sequential events in this condition.

2) A 5-year-old child was admitted with splenomegaly and lymphadenopathy. Laboratory findings are as follows: Hb 6.8 gm/dL, WBC count 100x10⁹/L, Thrombocytopenia. Bone marrow shows an increase in blast cells, which is positive for PAS stain. LDH and serum uric acid levels are increased.
a. What is the provisional diagnosis and why?
b. Describe the blood and bone marrow picture in this condition.
c. Mention the types as per FAB classification with labels.
d. Describe the immunophenotypes of this disease.

WRITE A SHORT NOTE ON THE FOLLOWING: (10×5 = 50 Marks)

3) Define Necrosis and discuss its types with examples.

4) Pathogenesis of septic shock.

5) Hypersensitivity reaction type II.

6) Physical examination of urine.

7) Chemical carcinogenesis.

8) Enumerate the differences between hyperplasia and hypertrophy.

9) Classification of leprosy.

10) Role of arachidonic acid metabolites in inflammation.

11) Blood transfusion reaction.

12) Enumerate the differences between benign and malignant neoplasms.

---

Dr. NTR UNIVERSITY OF HEALTH SCIENCES

M.B.B.S. DEGREE EXAMINATION – JANUARY, 2024

SECOND M.B.B.S. EXAMINATION

PATHOLOGY - PAPER-II (Theory Questions)

Time: 2 Hours 40 Minutes   |   Max Marks: 80

NOTE: Answer all questions. Draw a neat diagram wherever necessary.

SECTION-II (THEORY QUESTIONS – 80 MARKS)

WRITE AN ESSAY ON THE FOLLOWING: (2×15 = 30 Marks)

1) A 55-year-old male was brought to the emergency room unconscious with a history of chest pain. On examination, he was dyspneic, and his pulse and blood pressure were low. ECG showed ST segment elevation.
a. What is the provisional diagnosis and why?
b. Discuss the sequential events in this condition.
c. Describe the microscopic picture of the myocardium in the above condition.
d. List the immediate and late complications.

2) A 15-year-old male child was admitted with a painful, progressively enlarging mass around the left knee joint. X-ray of the knee joint shows a mixed lytic mass with Codman triangle and sunburst appearance of the proximal tibial mass, which is extending into the soft tissue. Laboratory findings are as follows: serum alkaline phosphatase levels are increased.
a. What is the provisional diagnosis and why?
b. Describe the pathogenesis of this condition.
c. Write the gross and histological subtypes in this condition.
d. Provide a labeled microscopic diagram of the lesion.

WRITE A SHORT NOTE ON THE FOLLOWING: (10×5 = 50 Marks)

3) Teratoma ovary.

4) Hashimoto's thyroiditis.

5) Write about the pathogenesis and complications of type II diabetes mellitus.

6) Pleomorphic adenoma.

7) Pathophysiology of fatty liver. Add a note on special stains to demonstrate fat.

8) Enumerate the differences between nephrotic and nephritic syndrome.

9) Bronchiectasis.

10) Classification of cardiomyopathy. Discuss any one type in detail.

11) Astrocytoma.

12) Enumerate the differences between ulcerative colitis and Crohn's disease.

---

Dr. NTR UNIVERSITY OF HEALTH SCIENCES

M.B.B.S. DEGREE EXAMINATION – JANUARY, 2024

SECOND M.B.B.S. EXAMINATION

MICROBIOLOGY - PAPER-I (Theory Questions)

Time: 2 Hours 40 Minutes   |   Max Marks: 80

NOTE: Answer all questions. Draw a neat diagram wherever necessary.

SECTION-II (THEORY QUESTIONS – 80 MARKS)

WRITE AN ESSAY ON THE FOLLOWING: (2×15 = 30 Marks)

1) Define hypersensitivity reaction. Classify hypersensitivity reactions. Describe in detail about immune complex diseases (Type-III), delayed hypersensitivity (Type-IV) and add a note on Schwartzman reaction.

2) A young female from a slum area presents with complaints of abrupt onset of high fever, headache, muscle pains, joint pains, and epistaxis. Lymphadenopathy and rash on chest were found on physical examination. Blood cell count revealed thrombocytopenia.
a. What is your diagnosis?
b. What is the etiological agent?
c. Describe the pathogenesis and clinical manifestations of the disease.
d. Write about laboratory diagnosis.

WRITE A SHORT NOTE ON THE FOLLOWING: (10×5 = 50 Marks)

3) Antimicrobial resistance.

4) Chemical disinfectants.

5) Diarrheagenic Escherichia coli.

6) Helicobacter pylori infections.

7) Amoebic liver abscess.

8) A patient attended the OPD clinic complaining of 3 episodes of vomiting after taking a meal. Vomiting contained food particles without the presence of blood. On history, she had abdominal pain in the last one week and also episodes of vomiting. No history of fever. In blood investigations, HBsAg is positive. How do you proceed with the laboratory investigations for hepatitis B viral infection?

9) Gas gangrene.

10) Laboratory diagnosis of leprosy.

11) Actinomycosis.

12) Empathy towards patients.

---

Dr. NTR UNIVERSITY OF HEALTH SCIENCES

M.B.B.S. DEGREE EXAMINATION – JANUARY, 2024

SECOND M.B.B.S. EXAMINATION

MICROBIOLOGY - PAPER-II (Theory Questions)

Time: 2 Hours 40 Minutes   |   Max Marks: 80

NOTE: Answer all questions. Draw a neat diagram wherever necessary.

SECTION-II (THEORY QUESTIONS – 80 MARKS)

WRITE AN ESSAY ON THE FOLLOWING: (2×15 = 30 Marks)

1) A 6-year-old boy was brought to the ENT OPD with a history of fever and sore throat for the past 2 days. His throat examination revealed pus on inflamed tonsils. Throat swab showed Gram-positive cocci in chains along with pus cells. Culture on blood agar showed beta-hemolytic pinpoint colonies.
a. What is your provisional diagnosis?
b. What is the pathogenesis of the above disease?
c. Discuss laboratory investigations.
d. Write a note on treatment.

2) A young sexually active male of 25 years presented with a single, painless, and indurated ulcer on the shaft of the penis with a duration of 2 weeks. He gives a history of promiscuous behavior. His serum was positive for reagin antibody.
a. What is the provisional diagnosis?
b. What is the pathogen responsible?
c. Discuss laboratory investigations to confirm the diagnosis.
d. Discuss pathogenesis and differential diagnosis.
e. Write a note on treatment and prevention.

WRITE A SHORT NOTE ON THE FOLLOWING: (10×5 = 50 Marks)

3) Cryptococcal meningitis.

4) Toxoplasma encephalitis.

5) Tetanus prevention.

6) A 7-year-old was brought to the OPD with bilateral swelling of the face, local pain, and tenderness, and severe pain on salivation.
a. What could be the clinical condition?
b. What is the probable causative agent?
c. What is the mode of infection?
d. Complications of the condition?
e. Mention the vaccine available for this virus.

7) Pneumocystis pneumonia.

8) Laboratory diagnosis of urinary tract infection.

9) Oncogenic viruses.

10) Zygomycosis.

11) Tularemia.

12) In the midnight, the microbiology laboratory receives sputum and CSF specimens from a patient for culture. The technician is already processing a huge load of investigations; therefore, he informed the clinical team that these specimens can only be processed the next day. Discuss briefly the importance of respect for patient samples.