DECEMBER 2018 PAPER 1

DECEMBER 2018 PAPER 2

DECEMBER 2018 PAPER 3
DECEMBER 2018 PAPER 4
JUNE 2018 PAPER 1
JUNE 2018 PAPER 2
JUNE 2018 PAPER 3
DECEMBER 2017 PAPER 1

1. a) Define Sick Euthyroid Syndrome. Write down its diagnosis & management.
b) Amiodarone induced thyroiditis (1+2+2)+5

2. a) Clinical features and Treatment of OCDs.

b) Causes of Delirium and its treatment (3+2)+(3+2)

3. What is Gestational Diabetes? Write down its pathophysiology, Diagnostic criteria and management.
2+(3+2+3)

4. a) Balanced Diet
b) Indications and disadvantages of Enteral nutrition therapy 5+5

5. a) What is Fecal Microbiota? Enumerate the indications for Fecal Microbiota transplantation.
b) Maturity Onset Diabetes of young (2+3)+5

6. What is Cushing’s Syndrome? Write down its causes, clinical features, diagnosis and treatment.
2+(2+2+2+2)

7. a) Enumerate the varioius clinical problems of Aging. Write down the clinical tests to prevent them.
b) Vaccines recommended for Elderly people. (3+2)+5

8. a) Clinical features and treatment of Atopic Dermatitis.

b) Enumerate the causes and treatment of Hirsuitism. 5+5

9. a) Stem Cell therapy in treatment of anemia.

b) Complications of Blood Transfusion. 5+5

10. a) Write down the types, Differential diagnosis and treatment of Vertigo.
b) Difference between Case Control and Cohort Studies. (1+2+2)+5
DECEMBER 2017 PAPER 2

1. a) Clinical features and treatment of Wernicke’s Disease.

b) Central pontine Myelinolysis (3+3)+4

2. What is Tumor Lysis Syndrome? Discuss its complications and treatment. 2+(4+4)

3. a) Clinical features and treatment of Organophosphorous Poisoning

b) Clinical features and treatment of High Altitude Sickness (2+3)+(2+3)

---------------------------
4. a) What is Heparin Induced Thrombocytopenia? How will you manage it?
b) Causes of Anemia in Chronic Disease and its differentiation from microcytic anemia.
(2+3)+(2+3)

5. a) Define Orthostatic Hypotension and Enumerate its causes.

b) Tests for detecting Autonomic dysfunction (2+3)+5

6. a) Enumerate various Oncologic emergencies.

b) Causes, Clinical features and treatment of Superior Venacava Syndrome. 3+(2+2+3)

7. a) Clinical features and Treament of Bell’s Palsy.

b) Viral hemorrhagic fever (2+3)+5

8. What is Multiple Sclerosis? Discuss it’s types, clinical features and management. 1+(2+3+4)

9. a) What is IRIS? Enumerate the various opportunistic infections in HIV.

b) Diagnosis and Treatment of Fungal Pneumonia. (2+3)+(3+2)

10. Define Adult Respiratory Distress Syndrome. Write down it’s diagnostic criteria, causes, pathophysiology
and treatment. 2+(2+2+2+2)
DECEMBER 2017 PAPER 3

1. 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. 3+3+4

2. a) Classify Interstitial Lung Disease.

b) Diagnostic Utility of BAL in ILD
c) Treatment of Non Specific Interstitial Pneumonia 3+4+3

3. a) Define Acute Kidney Injury and enumerate it’s causes.

b) Role of urinary sediments in AKI
2+(3+5)

4. a) Indications and treatment of Chronic Hepatitis C

b) Enumerate various factors associated with reduced response to treatment (2+5)+3

5. Pathology, clinical features and treatment of Takayasu arteritis (3+3+4)

6. a) Enumerate the causes of Dilated Cardiomyopathy.

b) Newer Inotropic agents in the treatment of Acute decompensated heart failure.
c) Cardiac Resynchronisation Therapy 3+3+4

7. a) Solitary Pulmonary Nodule.

b) Types of Mechanical Ventilation 5+5

8. a) Classification of Lupus nephritis.

b) Pathophysiology and Treatment of Diabetic Nephropathy 5+5

9. Describe the etiology, clinical features and management of Hepatic venous outflow tract obstruction.
3+3+4

10. a) CASPAR criteria for Psoriatic Arthritis

b) Classify Vasculitic Syndromes and enumerate the conditions which mimic Vasculitis. 5+(3+2)
JUNE 2017 PAPER 1

1. a) Outline heme biosynthesis with its regulation.

b) Clinical features and diagnosis of acute intermittent porphyria (2+2)+(3+3)

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

3. a) Physiology and stages of sleep.

b) Enumerate the causes of primary insomnia. 6+4

4. A 33 year old primigravida at 30-weeks of pregnancy 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+5

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. 2+3+5

6. a) Define syncope.
b) Broad classification of syncope.
c) Diagnosis of neurally mediated syncope 2+4+4

7. A 32 year old HIV infected male presents with oral lesions.

a) Discuss the differential diagnosis.
b) Outline the management of oral candidiasis. 6+4

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

9. a) Causes of hypomagnesemia.
b) Outline its management. 4+6

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

a) What is the differential diagnosis?
b) Outline the approach to this patient. 5+5
JUNE 2017 paper 2

1. a) What is hypoxic-ischemic encephalopathy (HIE)?

b) Clinical features of HIE.
c) Outline the approach to diagnosis of HIE. 2+4+4

2. a) Pathogenesis of Clostridium difficile infection.

b) Diagnosis and treatment of Clostridium difficile infection. 4+(3+3)

3. a) What is microbial bioterrorism?

b) Enumerate the agents used in this.
c) Outline the measures of containment/prevention of microbial bioterrorism. 2+3+5

4. A 42 year old male presents with fever, headache and 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. 1+4+5

5. a) Clinical features of acute cocaine intoxication.

b) How will you manage it 5+5

6. a) Commonly used severity of illness scoring systems.

b) Role of these scoring systems in the intensive care unit. 5+5

7. a) Enumerate causes of pancytopenia.

b) Clinical features and treatment of aplastic anemia. 3+(4+3)

8. A 35 year old woman presents with massive splenomegaly.

a) What is the differential diagnosis?
b) Outline the approach to its management. 4+6

9. a) Enumerate the Rickettsial infections of clinical importance.

b) Outline the approach to diagnosis of these infections. 4+6

10. A 25 year old woman presents with fever and jaundice of four days duration.
a) Outline the approach to diagnosis in the patient.
b) How will you manage her at primary care level? 5+5
JUNE 2017 paper 3

1. a) Physiology of the Sino-Atrial (SA) node.

b) Enumerate the causes of SA node dysfunction.
c) Outline the approach to the diagnosis of SA node dysfunction. 3+4+3

2. a) What are the organisms causing cavitary lung lesions?

b) Diagnosis and management of lung abscess 3+(3+4)

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

b) Outline the management of anemia in CKD. 5+5

4. a) Enumerate the causes of pulmonary renal syndromes.

b) Diagnosis and treatment of these disorders. 2+(4+4)

5. a) What is non alcoholic fatty liver disease? Comment on its epidemiology.

b) Outline the clinical features and treatment of this condition. (1+3)+(3+3

6. a) Enumerate the etiologies of heart failure with preserved ejection fraction (EF).
b) Outline the treatment of such heart failure. 4+6

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

b) Outline pathogenesis and management of IBS 3+(4+3)

8. a) Pathogenesis of atherosclerosis.
b) Elaborate on the concept of atherosclerosis risk factors. 5+5

9. a) Enumerate the spondyloarthropathies.

b) Clinical features and diagnosis of ankylosing spondylitis. 2+(4+4)

10. a) Define Raynaud’s phenomenon.

b) Causes of Raynaud’s phenomenon with points of main difference between primary and secondary types.
c) Outline its management. 1+6+3
DECEMBER 2016 PAPER 1

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

2. a) Anatomy of the coronary circulation.

b) Diagnosis of acute myocardial infarction. 5+5

3. A 24 year old male presents with 4 days fever and a rash.

a) List differential diagnosis.
b) Outline the approach to the management. 3+7

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

b) Diagnosis and complications of GDM. 2+(4+4)

5. a) What is a case control study?

b) What are the advantages and disadvantages of a case control study? 2+(4+4)

6. a) What is neuroleptic malignant syndrome?

b) What are its predisposing risk factors?
c) How will you manage such a patient? 2+3+5

7. a) Outline the iron metabolism in the body.

b) Diagnosis of Iron deficiency.
c) Complications of Iron therapy? 4+3+3

8. a) Define obesity.
b) Etiology/risk factors for morbid obesity.
c) Medical management of morbid obesity 1+3+6

9. a) Define hyponatremia.
b) Enumerate the causes of hyponatremia.
c) Clinical features of hyponatremia. 1+4+5

10. a) Enumerate the causes of hypercalcemia.

b) Management of hypercalcemia. 4+6
DECEMBER 2016 PAPER 2

1. a) Classify the aspergillus infections of humans.

b) Risk factors for invasive aspergillosis.
c) Diagnosis of invasive aspergillosis. 2+4+4

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

b) Management of such patient with a cobra bite 5+5

3. a) Define Adverse Drug Reactions (ADRs).

b) ADRs of anti-tuberculosis drugs.
c) Outline the management of anti-tubercular treatment (ATT) induced hepatitis. 1+5+4

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

b) Clinical features and management of cryptococcal meningitis. 3+(3+4)

5. a) Define dementia.
b) Enumerate the reversible causes of dementia.
c) Management of a patient with Alzheimer’s disease. 1+3+6

6. a) Differential diagnosis of fever with joint pains.

b) Outline the diagnosis and management of Chikungunya. 5+(3+2)

7. a) Define and classify respiratory failure.

b) Indications of Non-Invasive Ventilation. (1+4)+5

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

b) Diagnosis and management of CML 3+(3+4)

9. a) Enumerate the causes of Disseminated Intravascular Coagulation (DIC).

b) Diagnosis of DIC.
c) Outline the management of DIC. 3+3+4

10. a) Mechanisms of antimicrobial resistance.

b) Consequences of antimicrobial resistance.
c) Concept of antibiotic stewardship. 4+3+3
DECEMBER 2016 PAPER 3

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

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

b) What are the risk factors for development of HAP?
c) Management of ventilator associated pneumonia. 3+4+3

3. a) Diagnosis of a case of malabsorption syndrome.

b) Clinical features and management of celiac disease in an adult. 5+(3+2)

4. a) Classify chronic kidney disease.

b) How will you estimate glomerular function of a patient?
c) Metabolic bone disease in a patient of chronic kidney disease. 3+2+5

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? 2+4+4

6. a) What are the extra-articular manifestations of rheumatoid arthritis?

b) Management of rheumatoid arthritis. 4+6

7. a) Enumerate the causes of aortic regurgitation.

b) Management of patients with aortic regurgitation. 4+6

8. a) Pathophysiology of myasthenia gravis.

b) Clinical features of myasthenia gravis and outline laboratory diagnosis of myasthenia gravis. 4+6

9. a) Enumerate the causes of ANCA-associated vasculitis.

b) Clinical features and management of microscopic polyangitis. 3+(4+3)

10. a) Risk factors for venous thromboembolism.

b) Diagnosis of acute pulmonary embolism.
c) Outline the management of acute pulmonary embolism. 3+4+3
JUNE 2016 PAPER 1
1. a) Define fever and hyperthermia. What are the differences between the two?
b) Enumerate causes of hyperthermia syndrome.
c) Treatment of hyperthermia. 4+2+4

2. A 26 year old day 3 post partum lady presents with acute onset
headache, seizures, altered sensorium and focal neurological deficit.
a) Outline the differential diagnosis.
b) Clinical features of cortical venous thrombosis.
c) Management of cortical venous thrombosis. 3+3+4

3. a) Define delirium.
b) Enumerate the causes of delirium.
c) Outline the approach to evaluation of a patient with delirium. 1+3+6

4. a) Define hyponatremia.
b) Outline the diagnostic approach to hyponatremia.
c) Causes of the Syndrome of inappropriate antidiuretic hormone secretion (SIADH). 1+4+5

5. a) Outline the components of nutritional assessment in an adult.

b) Normal and abnormal anthropometric measurements.
c) What are the physiological characteristics of hypermetabolic states? 2+6+2

6. a) What are Randomized Control Trials?

b) Various methods of randomization.
c) Outline the advantages and disadvantages of Randomized Control Trials. 2+4+4

7. a) Trace the pathway of cough reflex.

b) What are the causes of hemoptysis?
c) Outline evaluation of a patient with hemoptysis. 2+3+5

8. Pathogenesis and clinical presentations of cutaneous drug reactions. 5+5

9. a) Pathogenesis of Type 2 diabetes mellitus.

b) Treatment goals in adults with diabetes mellitus.
c) Incretins: mechanism of action, indications and adverse effects. 3+3+4

10. a) Outline the physiology of prolactin secretion.

b) Enumerate the causes of hyperprolactinemia.
c) Outline the management of prolactinoma. 2+4+4
JUNE 2016 PAPER 2

1. a) Differential diagnosis of pancytopenia.

b) Outline the clinical features and treatment of aplastic anemia. 4+(3+3)

2. a) Classify and enumerate the oncologic emergencies.

b) Clinical manifestations and management of tumour lysis syndrome. 4+(3+3)

3. Risk factors, clinical features and management of methicillin resistant staphylococcus aureus infections.
4+3+3

4. Clinical manifestations and management of opioid overdose. 4+6

5. a) Outline the assessment of severity of critically ill patients.

b) What are the complications seen in patients with critical illness? 5+5

6. a) Pulmonary manifestations of HIV infection.

b) Clinical features, diagnosis and management of pneumocystis pneumonia. 3+(2+2+3)

7. a) Define multidrug resistant (MDR) and extensively drug resistant (XDR) tuberculosis.
b) Role of nucleic acid amplification tests in the diagnosis of tuberculosis.
c) Outline the management of MDR-TB under the Revised National Tuberculosis Control Programme (RNTCP).
2+4+4

8. Etiology, clinical presentation and management of chronic meningitis. 3+3+4

9. A 32 year old male presents with fever and jaundice.

a) Discuss briefly the differential diagnosis.
b) Outline the approach to evaluation of this patient.
c) Management of leptospirosis. 3+4+3

10. Clinical features, diagnosis and treatment of multiple sclerosis. 4+3+3

JUNE 2016 PAPER 3

1. Clinical manifestations, diagnosis and treatment of peripheral arterial disease. 3+3+4

2. A 20 year old male has a blood pressure of 180/110mmHg.

a) Enumerate the possible causes of hypertension in this patient.
b) Outline the diagnosis and treatment of renal artery stenosis. 3+7

3. a) Etiology of infective endocarditis.

b) Outline the diagnosis (clinical and laboratory) of infective endocarditis. 4+6

4. a) Enumerate the causes of pulmonary infiltrates with eosinophilia.

b) Clinical manifestations and management of eosinophilic granulomatosis with polyangiitis (EGPA).
4+(3+3)

5. a) Define obstructive sleep apnea-hypopnea syndrome (OSAHS).

b) Pathophysiology, diagnosis and health complications of obstructive sleep apnea. 2+(2+3+3)

6. a) Classify the major causes of acute kidney injury (AKI).

b) Role of urinary sediment findings in AKI.
c) List the indications for dialysis of AKI. 4+4+2

7. Diagnosis and treatment of ulcerative colitis. 5+5

8. a) Management of chronic hepatitis C infection.

b) Outline the complications of chronic hepatitis C infection 7+3

9. a) Classify anti-phospholipid antibody syndromes.

b) Clinical features and treatment of anti-phospholipid antibody syndromes. 3+(4+3)

10. Diagnosis and treatment of ankylosing spondylitis. 5+5

APRIL 2016 PAPER 1

1. a) Define atopy.
b) Outline the pathophysiology of bronchial asthma.
c) Pulmonary function abnormalities in bronchial asthma. 2+5+3

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. (2+2)+3+3

3. a) Case control study.

b) Its advantages and disadvantages. 2+(4+4)

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.
3+2+5

5. a) What is autologous bone marrow transplantation?

b) What are its indications?
c) Complications of bone marrow transplantation. 3+2+5

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

b) What investigations will you perform in a patient with suspectedsecondary diabetes? (2+3)+5

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

b) What clinical features give a clue to your diagnosis?
c) What investigations are needed to confirm your diagnosis? 3+4+3

8. a) Peripartum cardiomyopathy.
b) Puerperal psychosis. 5+5

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

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? 4+3+3

10. a) Principles of adult immunization.

b) Immunization of a healthy 70 year old female.
c) Immunization of a 40 years old male with splenectomy. 4+3+3
APRIL 2016 PAPER 2--------APRIL 2016 PAPER 3
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+(4+4)

2. a) What is obstructive sleep apnoea syndrome?

b) Risk factors for obstructive sleep apnoea syndrome and principles of its management. 3+(3+4)

3. a) Drugs used for the treatment of hepatitis C virus (HCV) infection.

b) Management protocol of a patient with HCV genotype 3 infection. 4+6

4. a) What is Gastro-esophageal Reflux Disorder (GERD)?

b) Risk factors and management strategies for GERD. 2+(3+5)

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

6. a) Describe a typical attack of angina pectoris.

b) Mention all possible clinical findings during an attack & briefly describe the causative mechanism.
c) What is angina equivalent? 3+5+2

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

b) How will you assess the severity of CAP?
c) Outline the management of CAP in a 50 year old male patient. 2+4+4

8. a) Pathophysiological basis of formation of various renal casts.

b) What is telescoped urinary sediment?
c) Clinical features of acute interstitial nephritis. 3+3+4

9. a) What is irritable bowel syndrome?

b) What are the “warning signs” in a patient with irritable bowel syndrome?
c) Management of irritable bowel syndrome. 2+4+4

10. a) What is reactive arthritis?

b) When will you suspect that a patient is suffering from reactive arthritis?
c) What investigations can be done in such a patient? 2+5+3
DECEMBER 2015 PAPER 1

1. a) High risk factors for syncope.

b) Pathophysiology of syncope.
c) Classify syncope. 3+4+3

2. a) Define obesity.
b) Pathophysiologic consequences of obesity. 1+3+6
c) Goals of therapy, lifestyle management, diet therapy, pharmacotherapy and surgery for obesity.

3. a) Mention causes of isolated splenomegaly.

b) How would you differentiate clinically between causes of isolated splenomegaly?
c) Indications of splenectomy. 3+4+3

4. A 21-year old woman, previously healthy, presents with 3- months history of headaches.
a) What are the likely etiologies?
b) How would you investigate her?
c) Pharmacotherapy for prevention of migraine. 3+4+3

5. a) Define Fever of Unknown Origin (FUO).

b) Causes of FUO.
c) Approach to a patient with classic FUO. 1+4+5

6. a) Basic principles of screening.

b) Uses and abuses of screening tests 5+5

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

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

a) What are the likely etiologies?
b) Laboratory tests to arrive at diagnosis. 5+5

9. Clinical features, diagnostic tests and treatment of diabetic ketoacidosis. 3+3+4

10. Clinical features, diagnostic evaluation and therapy of thyrotoxicosis. 4+3+3

DECEMBER 2015 PAPER 2

1. Risk factors, prevention, diagnosis and management of ventilator-associated pneumonia 2+3+3+2

2. Risk factors, D/Ds and severity assessment scales of acute ischaemic stroke. 4+4+2

3. Clinical manifestations, immuno-pathogenesis and treatment of Guillain Barré Syndrome. 4+3+3

4. Clinical features, complications and management of severe septic shock. 3+3+4

5. Differential diagnosis, investigations and treatment of acute complicated P.falciparum malaria. 3+3+4

6. a) Approach to prevent cancer. 5+5

b) Screening tests for early detection of breast, colorectal, lung, ovarian and prostate cancer.

7. A 15-year-old boy presents with severe anaemia, mild jaundice, splenomegaly, reticulocytosis and elevated
LDH.
a) How would you investigate this patient?
b) Clinical features of paroxysmal nocturnal haemoglobinuria (PNH). 5+5

8. Clinical features, laboratory tests, differential diagnosis and treatment of typhoid fever 3+2+2+3

9. a) Muscarinic, nicotinic and central nervous system features of acute intentional organophosphorous
pesticide poisoning.
b) Management of acute organophosphorous poisoning 5+5

10. a) Clinical features of neurotoxic snake bite.

b) Management of severe envenomation caused by cobra bites.
c) Complications of Viper bite. 3+4+3
DECEMBER 2015 PAPER 3

1. a) Role of fibrin-specific thrombolytic therapy in ST-elevated acute myocardial infarction,

b) Contraindications for thrombolysis and
c) Complications of thrombolytic therapy. 4+3+3

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

b) Cardiac biomarkers for diagnosing chronic heart failure.
c) Explain how angiotensin converting enzyme (ACE) inhibitors improve the quality of life of patients with
chronic heart failure. 2+4+4

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

b) Outline therapy for acute pulmonary embolism. 5+5

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

b) Mention the steps for slowing progression of diabetic nephropathy. 5+5

5. a) Pulmonary manifestations of Sarcoidosis.

b) Diagnostic tests to detect Sarcoidosis.
c) Outline the management of Sarcoidosis. 3+3+4

6. Causes, clinical features and pathophysiology of membranoproliferative glomerulonephritis. 3+3+4

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

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

9. Causes, diagnostic evaluation and complications of acute severe pancreatitis. 3+4+3

10. a) What are common causes for Acute Respiratory Distress Syndrome (ARDS)?
b) Pathophysiology and ventilator management in ARDS. 5+5
JUNE 2015 PAPER 1

1. a) Pathogenesis and clinical causes of edema.

b) Name drugs associated with edema formation. (5+3)+2

2. a) Approach to a patient with inherited disorders.

b) Use of Gene Therapy in Clinical Medicine. 6+4

3. a) Systemic effects of aging.

b) Tools used in functional assessment of older patients. 5+5

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

5. a) Anatomical basis of internuclear ophthalmoplegia.

b) Anion Gap. 5+5

6. a) Physiology of circulation in the third trimester of pregnancy.

b) Management of tuberculosis in pregnancy. 6+4

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

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

9. a) Classify hyperpigmentation disease.

b) Metabolic causes for hyperpigmentation. 4+6

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

JUNE 2015 PAPER 2

1. a) Principles involved in cancer chemotherapy.

b) List the advanced cancers that can be cured by chemotherapy
c) Acute complications of chemotherapy. 4+2+4

2. a) Causes for cobalamin deficiency.

b) Haematological and neurological manifestations of cobalamin deficiency. 2+(4+4)

3. a) Define multi-drug resistance TB (MDR-TB) and extensively drug resistant TBXDR

b) Management of MDR-TB under RNTCP programme. 2+8

4. Clinical manifestations and treatment of severe falciparum malaria. 6+4

5. a) Neurological complications of HIV.

b) ART program that is being implemented by NACO in our country. 6+4

6. Massive blood transfusion: Definition, indications, complications & their prevention, and management.
2+2+3+3

7. Clinical features and management of viper snake bite. 5+5

8. a) Types of respiratory failure.

b) Non invasive positive pressure ventilation.
c) Complications of mechanical ventilation. 4+3+3

9. Clinical features, pathogenesis and treatment of Wernicke’s encephalopathy. 6+2+2

10. Clinical features, diagnosis and management of myasthesia gravis. 3+3+4

JUNE 2015 PAPER 3

1. a) Etiologies of chronic heart failure.

b) Pathogenesis of heart failure with a depressed ejection fraction.
c) Drugs for treatment of chronic heart failure. 3+2+5

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

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

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

5. a) Staging;
b) Fluid, electrolyte & acid base disorders;
c) Calcium & phosphate metabolism disorders; and
d) Measures to slow progression in CHRONIC KIDNEY DISEASE. 2+3+2+3

6. Etiology, pathogenesis and treatment of acute uncomplicated urinary tract infection 2+4+4

7. a) Pathology of ulcerative colitis.

b) Enumerate its extra-intestinal manifestations.
c) Medical management of ulcerative colitis. 4+4+2

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

9. a) Pathogenesis and diagnosis of rheumatoid arthritis.

b) DMARDs (Disease Modifying Anti-Rheumatic Drugs) & Biological therapy in rheumatoid arthritis. (3+3)+4

10. Clinical manifestations, laboratory & radiographic testing andtreatment of fibromyalgia. 3+3+4
DECEMBER 2014 PAPER 1

1. Describe the physiological role of zinc in health. Name the zinc deficiency states. Describe signs of zinc
deficiency 4+2+4

2. Discuss the terms – true positive rates and true negative rates in relation to research 5+5

3. What is gestational diabetes ? What is the risk to foetus ? GDM management. 2+3+5

4. What is stem cell biology ? Classify cultured stem cells. What are the applications of stem cells in Clinical
Medicine? 3+4+3

5. Describe lung problems in environmental disorders 10

6. How is HPA axis regulated ? Discuss etiology and clinical features of adrenal insufficiency. Describe the
workup in suspected case of Addison’s disease 4+3+3

7. Define delirium, what are its etiological causes ? Describe the workup in case of delirium

8. a State the Cockcroft-gault formula and its use

b. Describe lab findings in pre renal azotemia 3+3+4
c. List the modifications of diet in renal disease with reasons

9. Describe causes, manifestations and management of genital ulcers. 3+4+3

10. Define PUO . List the infective causes. Evaluation in case of PUO 2+4+4
DECEMBER 2014 PAPER 2

1. Biomedical terrorism

2. SIRS

3. Cardio renal syndromes

4. Methyl alcohol poisoning

5. Clinical featiures, complications and chemotherapy regimes used in treatment of multiple myeloma 3+3+4

6. a. Discuss the infective agents in Community acquired and nosocomial pneumonia

b. Outline the management in both types 5+5

7. list the causes of lower limb pain due to organic pathology in the vertebrae and spinal cord. Outline the
management approach 4+6

8. Define and classify gastrointestinal neuroendocrinal tumours. How are they diagnosed and managed. 5+5

9. what is latent tuberculosis? Describe the investigations and management for latent tuberculosis 2+4+4

10. neuroleptic malignant syndrome 10

DECEMBER 2014 PAPER 3

1. WHO classification of Lupus Nephritis and its Management 4+6

2. Extra articular manifestation of Lupus Nephritis 10

3. Electrophysiology of atrial fibrillation and its medical and surgical management. 4+4+2

4. Pathophysiology, classification, diagnosis and management of pulmonary hypertension 2+2+2+4

5. Variants, clinical features and treatment of HUS 3+4+3

6. Causes ond pathogenesis of refractory hypokalemia 10

7. Systemic manifestations of COPD 10

8. Pathogenesis of HRS. Discuss in brief its management and prognosis 6+4

9. Causes and mechanism of Diarrhoea due to disorders of Gut Mucosal Function or Structure 10

10. Classification and management of chronic hepatitis. 5+5

JUNE 2014 PAPER 1

1. How do ketone bodies form in our body? How does their excess production overwhelm our system in
diabetes and starvation to produce ketosis? 5+3+2

2. Incretin physiology. How can we use it in clinical situations 10

3. Adipocytes as an endocrine organ 10

4. How does post transcriptional modification occur in health? give examples of diseases caused by
Post transcriptional changes in the genes. 6+4

5. what common pathogenetic factors link the components of metabolic syndrome? How does exercise
help in metabolic syndrome 6+4

6. how do genetic factors and the environmental insult of high salt intake interact to produce
hypertension? 10

7. what are the diseases associated with prolonged QT interval? How are genetic factors involved in
their pathogenesis? 4+6

8. discuss the genetic basis of HOCM. What clinical features distinguish it from valvular AS? 3+7

9. what is effective circulatory volume? What percentage of body water is in that compartment? How is
It affected in a) nephritic syndrome b) nephrotic syndrome 3+1+3+3

10. what is transcellular water? Describe briefly the pathogenesis of Anasarca, in various disease states. 2+8
JUNE 2014 PAPER 2

1.Describe the role of Hepcidin in normal iron metabolism. How does it get altered in primary hemochromatosis
and thalassemias? 4+3+3

2. When will you suspect that a patient is suffering from TTP? Explain pathogenesis 5+5

3. when will you suspect amyloidosis? Draw a diagnostic flowchart for investigation 4+6

4. what is tumour lysis syndrome? Prevention and management 2+4+4

5. infection and immunity- who controls whom 10

6. management of suspected Kala Azar? Recent treatment guidelines 6+4

7. causes of reversible dementia? How to diagnose dementia 4+6

8. what is albuminocytological dissociation? Describe the pathogenesis of this condition in 4

Diseases where its seen 2+8

9. what is OSA syndrome? Pathogenesis of cardiovascular complications 4+6

10. describe how posture and balance id affected by various diseases of the nervous system 10
JUNE 2014 PAPER 3

1. Brief account of formation of atrial septum. How does it explain the secundum type of ASD? 6+4

2. what clinical and radiological features are common in congenital heart diseases with R to L shunt 7+3

3. clinical features of peripartum cardiomyopathy. How does it differ from ischemic cardiomyopathy 6+4

4. define bronchiectasis and emphysema. How does clinical features differ in later stages of
Manifestation 2+2+6

5. environmental and genetic interaction in pathogenesis of COPD 10

6. Describe the neural regulation of GI tract. How is it affected in achalasia cardia and in diffuse esophageal
spasm. 6+2+2

7. Describe the pathogenesis of peptic ulcer disease. what systemic diseases increase the chance of PUD 5+5

8. How does arsenic affect our liver? Hallmarks of chronic arsenic toxicity 4+6

9. causes of compressive myelopathy? Differences between compressive and non compressive.

C/F of ALS 3+4+3

10. what is salt losing nephropathy? Enumerate the causes. What features are common to all of them? 3+3+4
DECEMBER 2013 PAPER 2

1. what are prothrombotic states? Management(D+T) of massive pulmonary embolism 3+3+4

2. etiology, c/f, serological diagnosis and treatment of chikungunya 3+2+3+2

3. classify chronic myeloproliferative disorders. Describe chromosomal findings and treatment of CML
3+3+4

4. causes of vertigo. Diagnosis and management of BPPV. 3+3+4

5. Etiopath, D/Ds & treatment of RPGN 3+3+4

6. significance of serum cardiac biomarkers in STEMI. Discuss pre-hospital management 5+5

7.what is pneumothorax, its types. C/F and Mx of tension pneumo 1+2+3+4

8. classification criteria for RA. Role of biological in Mx. 5+5

9. Define Epilepsy. Mechanism of eliptogenesis &principles of selection of AED 2+2+4

10. enumerate disease manifestations of cigarette smoking and strategies for cessation 5+5
DECEMBER 2013 PAPER 3

1. Define Heart Failure. Pathophysio, Dx and Tx 1+2+3+4

2. define aplastic anemia. Pathophysio and treatment. 2+4+4

3. what are X linked disorders? What are the types? Name 4 diseases( x linked) 3+3+4

4. etiopath of IBD. Dx and Tx of UC 4+3+3

5. c/f of MG. how will you investigate. 5+5

6. C/F of ADPKD, methods of diagnosis and risk factors that lead to progression 4+3+3

7. etio, C/F and Mx of hypersensitivity pneumonitis. 2+3+5

8. pituitary apoplexy. Clinical features and Mx. 2+5+3

9. Gouty arthritis- C/f, Dx and Mx 4+3+3

10. Define NIV. Indications and CI for its use. Adv and Disadv 2+4+4
DECEMBER 2013 PAPER 4

1.enumerate the host factors in infection and discuss the immune response in brief. 5+5

2. define NAFLD. Pathogenesis, Dx and Mx 2+4+2+2

3.pathophysio of migraine. Drugs used in Tx in relation to pathophysio 4+6

4.describe various ventilator functions? Discuss the flow volume curves in obst and restrictive lung disease
5+5

5. pathophysio, C/F, Dx & Tx - wilsons 3+2+2+3

6. define PUO. Classifications and investigations 2+3+5

7. classify chemicals in bioterrorism and discuss their Mx .4+6

8. describe a cohort study. Adv and disadv 4+3+3

9. pharmacokinetics of a drug and principles of anti bacterial chemotherapy .5+5

10. sources of stem cells used in tissue repair and strategies for stem cell replacement. 4+6