Code/M/241 M.B.B.S. Second Year Prof. Examination-2023(1) Subject- Pathology Paper-1 {Time-03 Hrs] [Max Marks: 100] Section-A (50 Marks) Be Define apoptosis, disuess mechanism and any two diseases associated with misfolding of proteins. Enumerate differences between apoptosis and necrosis. (+5+443=15) * 2. Short answer questions :- (Sx5=25) (a) Define thrombosis. Enumerate virchow's triad. Discuss fate of thrombosis. (b) Define neoplacia. Write events in chemical carcinogenesis. (©) What is pigment. Give a classification with apropriate example of each. (d) Define hypersensitivity reaction. Write mechanism of immunologically m hypersensit reaction with example. (©) Write the role of effects of tobacco on human body innumerate organs specific carcinogenes in tobacco smoke. 3. Objective type question: - Answer it in answer copy. (1) True False = (a) CD95 is a marker of extrinsic pathway of apoptosis. (b) C3 factor present in final common terminal complement pathway. (11) Fill up the blank : @) (@) Duchenne muscular distrophy is inherited as (b) BRCA 1 gene is located on ... - (II) MCQ :- (6) (2) Coagulative necrosis is found in which ty (i) Tuberculosis (ji) Sarcoidosis Necrosis (iv) Fungal infection (b) Which of the following helps in generating reactive oxygen intermediates in neutrophils :~ oxidase () NADPH oxydase (ii) Superh dismutase (iii) Catalase (iv) Glutathione peroxidase (©) The correct sequence of the cell cycle is: (i) G0-GI-S-G2-M (ii G0-G1-G2-S-M (@) MYC gene is :- (@ Protein kinase inhibitor (ji) Growth factor inhibitor ii) GTP ase (iv) Transcription activator (©) Which is not use of tumor marker :- (i Screening of cancér _(ii) Followup of cancer patient to know reccurance (ii) Confirmation of diagnosed cancer (iv) For monitoring of treatment of cancer (© Diagnosis of X-linked agammaglobulinemia should be suspected if = (j) Absent tonsil and no palpable lymph node (iii) High isohemagglutinins titers (iv) Low CD3 @) f infection :- i) GO-M-G2-S-G1 (iv) G0-G1-S-M-G2 © scanned with OKEN Scanner1 Code/M/241 M.B.B.S. Second Year Prof. Examination-2023(I) Subject- Pathology Paper-i [Time-03 Hrs} [Max Marks: 100] Section-B (50 Marks) 2 year old boy has significant weakness and joint pain of an on, abdominal distension and frequent history fever. On physical examination, pallort+++, moderate splenomegaly wRere present . Bood = investigation with 2% sodium metabisulphite is positive. Write provisional diagnosis, etiopathogenesis, clintcal feature and lab diagnosis ofthis disease. (245434: Short answer questions := (5x: (8) What are the characteristics of an effective health care team? (b) Define transfusion reaction. Enumerate different types. Enlist adverse effect of transfusion reaction. (©) What is the leukemoid reaction? Enumerate any four causes, compare and contrast leukemoid reaction and chronic myeloid leukemia on basis of peripheral smear. (4) What are different typeps Hodgkin's lymphoma, Write morphology and immunophenotype. (©) What is hemolytic disease of new bom. Discuss pathophysiology of Rh type hemolytic disease Objective type question: - Answer it in answer copy. @Mco: (10) (2) Hematocrit is the rato of :- (i) WBC to whole blood (ii) Platelet to whole blood. Gi) RBC to whole blood (iv) Total blood cells to plasma (b) Maturation failure in poor absorption of ‘Vit. Br, is associated with = () Microeytic hypochromic anemia (i) Sickle cell anemi (iii) Anemia after 3 monts of poor absorption (iv) Causes of polycythemia (©) Beell marker are all except (I) CD19. (i) CD20. Git) CDIO_ (ivy CDI35 (2) Which ofthe following is false - (i) BeL-6 is associated with Burkitt's lymphoma ssociated with follicular lymphoma ii) CD-10 associated with mantle cell lymphoma (iv) CD-34 is associated with diffuse large B cell lymphoma (© Mycosis fungoides is (i) Cutaneous lymphoma (i) Fungal infection of skin (iv) Exflitive erythroderma (®) Thrombospondin is (Git) Coagulation promoting protein (iv) Contractile protein (@) Allare true about thrombotic thrombocytopenic purpura except :- () Grossly abnormal coagulation test (i) Microangiopathic hemolytic anemi ‘Thrombocytopenia (iv) Normal complement level absolute venous hematocrit of more than : (55% (iii) 65% (iv) 75% (i) Allof the infection are transmitted by blood transfustion except :- (i Parvo 19 virus (ii) Dengue virus (ili) Cytomegalo virus (jv) Hepatitis virus ) One unit of fresh blood arises the Hb% concentration by :- (HO1gm% Gi) Lgm% —(ii)10gm% (iv) 2em% © scanned with OKEN ScannerCode/M/242 M.B.B.S. Second Year Prof. Examination-2023(1) : Subject Pathology Paper-ll [Time-03 Hrs] {Max Marks: 100} Section-A (50 Marks) 1. A.76 year old female having H pylori infection two year back, with macro ovalocytic anemia, Presents with complain of 10 kg unintentional weight loss with in 6 months in previous 2 weeks she had 4-5 episodes of hemetemesis. On examination her BP 160/90mm Hg, pulse 90/min, temp. 97.2°F, (2) Write two most possible differential diagnosis with justification. @ (©) Investigation advice to confirm diagnosis. 7 (© IFitis an malignancy, what can be pathogenesis. 6 (@ What morphological changes you expect in gross and microscopy. o (©) Discuss the couse of disease. 0G) (x5=25) 2. Short answer questio (a) Define hemochromatosis. Classify according to etiology and discuss pathogenesis. (b) Discuss morphology and staging of stomach adenocarcinoma (c) Define Bronchiectasis. Describe its pathogenesi (@) Define rheumatic heart disease, enumerate diagnostic criteria and morphological features. (©) What is acute hung injury diseuss etiopathogenesis of acute respiratory distress syndrome. 3. Objective type question: - Answer it in answer copy. @McQ (a) Achalasia cardia :-() Absence of nerve _(i) Absence of muscle (ii) Hypertrophy of nerve (iv) None (b) Hour glass deformity is seen in the :- (]) Carcinoma stomach (ii) Peptic ulcer (ii) Duodenal atresia (iv) Pylorie stenosis (©) Kruken Berg tumour of overy is - (i) Metastatic tumor (ii) Diagnosed by CA-125 level (ili) Caused by spread of stomach cancer (iv) All are true (4) False about obstructive jaundice := (i) Ieterus (ji) Positive indirect Van Den Berg (iii) Pruritis (iv) Pale stool (©) Carcinoma of gall bladder have following features except () One has similar presentation with benign biliary disease (ii) Squamous cell carcinoma is 40% ofall cases. (Gil) Most prominant present with advanced disease (iv) Prognosis is poor. (®) Kiatskin tumor is (io) ) Nodular type of cholangio carcinoma i) Fibrolamellar hepatocellular carcinoma (iil) Gall bladder carcinoma (iv) hepatocellular carcinoma (8) Atherosclerosis initiation by fibroblast plaque is mediated by injury so == (i) Smooth muscle (i) Media Gili) Adventitia (iv) Endothelium (h) Aschoff bodies are seen in :-() Rheumatic myocarditis (ji) Rheumatic arthritis (iii) Bacterial endocarditis (jv) Ankylosing spondylitis ‘A hyperplastic mass containing neuroendocrine cells in area of chronic inflammation and scarred tissue of lung is called = (9) Carcinoid i) Tumorlet (ii) Hamartoma (iv) Teratoma G Incorrect statement about small cell carcinoma of lun (i) Surgical resection is treatment of choice (li) Associated with paraneoplastic syndrome (iii) Most patients have distant metastasis on diagnosis (iv) Contain neuro secretory granules. © scanned with OKEN ScannerCode/M/242 M.B.B.S. First Year Prof. Examination-2023(1) Subject- Pathology Paper-Il 03 Hrs} [Max Marks: 100] Section-B (50 Marks) ‘AS year boy reached clinic with rapidly growing mass in left side of abdomen. He passes pif urine and cries during micturation. Physical examination revealed regular, smooth ‘edged mass on left side which did not cross mid line. (a) What is the differential diagnosis for this abdominal mass. @ (b) What more investigations required to confirm the diagnosis. 2 (¢) If it is malignancy, what can be pathogenesis. @) (@) What morphological changes you find in gross and microscopy. @) (€) Discuss the course of disease @) (5x5=25) Short answer questions :- (a) Discuss pathogenesis and laboratory diagnosis of Hashimoto's thyroiditis. (b) Describe pathogenesis and morphology of osteosarcoma, (©) Describe pathogenesis and morphology of benign prostatic hypertrophy. (@) Define acute renal failure. Draw a flow chart explaing sequence of event in acute tubular necrosis leading to acute renal failure and inumerate any four complication, (©) What is working in a health care team. Objective type question: - Answer it in answer copy. @Mcq:- (10 marks) (a) Following strain of HPV is low risk for carcinoma cervix := @u G16 Gig ivy 31 (b) Which of the following ovarian tumor is sex chord tumor = (i) Teratoma (ii) Choriocarcinoma_ (iii) Fibroma (jv) Yolk sac (©) Following pathogene is frequent cause of osteomyelitis in individual with sickle cell disease : (i) E.coli (ii) Kleibsiella, (ji) H influenza (iv) Salmonella (@) Carcinoma prostate commonly metastases to = (i) Lung (ji) Bone ii) Brain (iv) Livey, (©) CSF in tubercular meningitis have :- (i) Lymphocytic Predominant Pleiocytosis (ii) Color less appearance i) High protein low sugar ) All are truss (f) Which are the following is true for basal cell carcinoma :- ‘Tumor usually metastases (ji) Lesions are flat i) Lesion is alway singlg- _(iv) Tumor is related to Immunosuppression (g) Low radio active iodine uptake with high T3 and TA is a feature of - (j) Pain less thyroiditis(ii) Thyrotoxicosis (ji) Hashitoxicosis (jv) De Quervains disease (h) Fouchet's test in urin is positive for (i Billirubin, (ji) Billiverdin, Urobilinogen, (iv) All of above (i) Epithelial crescent formation can be seen in all except :- i) Acute diffuse proliferative glomerulonephritis (ji) Membranous GNy ii) Henoch Schonlein purpura (iv) Rapidly progressive GN ) Patient with hereditary retinoblastoma are at greater risk to develop :- () Chondrosarcoma (ji) Osteogenic sarcoma (ii) Osteoclastoma (jv) All of above — © scanned with OKEN Scanner‘ Code/M/245 M.B.B.S, Second Year Prof. Examination-2023(I) Subject- Pharmacology ) Paper-| [Time-03 Hrs} (Max Marks: 100] Section-A (50 Marks) 1. What is meant by bioavailability of drug. What are the measures/indices of (15) bioavailbiiy. We Tactors affecting orl bioavailability of drug and how itis assesed. 2. Short answer questions :- (5x5=25) (a) Treatment of organophosphorus poisoning. (b) Classify general anaesthetics. Write advantages and disadvantages of ketamine. (©) Uses of beta adrenergic blockers. (@) Frumerate anti epileptic drugs. Write mechanism and adverse effect of phenytoin. (©) Enumerate drugs acting vi benzodiazepine-GABA-A receptor complex channel. Write therapeutic uses of benzodiazepie and the treatment of its overdose. 3. Objective type question: - Answer it in answer copy. (© True/ False = Q (2) Intravenous inj: (6) Hypnotic benzodiazepines are more powerful enzyme inducer than barbiturates. (1) Fill up the blank := @ (8) nnn Stage of sleep is responsible for incidence of dreams. (b) The mechanism of carbidopa action is... (IID Assersion and reason :- Q) (a) The main reason for giving levodopa, the precursor of dopamine, instead of dopamine is ? (b) Neostigmine is preffered over physyostigmine for treatment of myasthenia gravis? (IV) One word answer :- Q) (a) The diagnostic triad of opioid overdose is . (b) Extra pyramidal reactions can be treated by . (V) MCQ:- (2) (@) Lithium carbonate is useful in the treatment of :- (i Petitmal seizures (ji) Bipolar disorder (iii) Neurosis (iv) Trigeminal neuralgia (b) Write the competitive antagonise of benzodiazepine receptor (i Flumazenil (ii) Buspirone (ii) Picrotoxin__—_(jv) Diazepam © scanned with OKEN ScannerCode/M/245 M.B.B.S. Second Year Prof. Examination-2023(1) Subject- Pharmacology Paper-I (Time-03 Hrs] [Max Marks: 100] Section-B (50 Marks) Enumerate glucocorticoids. Write ‘therapeutic uses and adverse effects of (15) slucocorticoids. 1. Short answer questions :- (5x5=25) (a) Drugs used in treatment of rheumatoid arthritis, (b) An 8 year old boy arrives at emergency ward with severe respiratory distress and wheezing. What will be drug management to provide relief and what will you prescribe to prevent future similar attack. (c) Emergency contraceptive. (@) Leukotriene antagonist. (©) Therapeutic uses of antihistamines. 3. Objective type questior (D) True! False (a) Chymotrypsin is an agent containing free sulfhydryl group. (b) Cimetidine has no effect on hgpatic drug metabolism. (1) Fill up the blank :~ (a) The mechanism of stimulant purgatives is (b) The most important receptor involved in cytotoxic drug induced vomitting is . (IM) Assersion and reason : (a) N-acetyl cysteine is beneficial in acute paracetomol poisoning. (b) Inhaled salbutamol is useful in bronchial asthama, (IV) One word answer :- (a) Budesonide is @ cum (b) The physical half life of radioactive '"'Tis, (yyMc- (@) Insuline resistance can be minimised by the use of :- (i) Corticosteroids i) Tolbutamide ity Protamine (iv Mono componen/human insuline. (b) Circulating testoterone level in men are elevated during treatment with :- ()Danazol (ij/Finasteride (iii) Flutamide (iv) Ketoconazole : - Answer it in answer copy. 2) (2) Q) Q) 2) © scanned with OKEN ScannerCode/M/246 f M.B.B.S. Second Year Prof. Examination-2023(1) Subject- Pharmacology Paper-II [Time-03 Hrs} [Max Marks: 100) Section-A (50 Marks) | 1. Write the outline of ideal therapeutic regimen for congestive cardiac failure. What are (15) the cardiac toxic effect of digitalis and what are the early indication of toxicity and how will you manage the toxi 2. Short answer questions : (5x5=25) (@) Therapeutic uses and adverse effects of nitrates. (b) Pottasium sparing diuretics. (©) Prokinetic agents. @ Parenteral iron therapy. - (©) Osmatic diuretics. 3. Objective type question: - Answer it in answer copy. () True/ False :- @), (@) Common unwanted effect of dihydropyridines are due to vasodilation. (b) Verapamil has a significant effect on automaticity in the SA node. (1D Fill up the blank :~ @) (@) Digoxin is the derivative of the plant... (b) Losartan isa selective .. (IID) Assersion and reason :- @ | (@) Positive inotropic action of digoxin takes place several hours to develop because. (b) Persistant dry cough may occur as a side effect of enalapril. (IV) One word answer :~ @ (a) Rapid intravenous injection of clonidine causes rise in BP due to ? (b) Primary site of action of thiazide diuretics is? (vy) MCQ ) (a) The following tissue is most sensitive to vasopres: (@ Renal collecting duct (ii) Intestinal smooth muscle i) Vascular smooth muscle (jv) Uterus, (b) The following anti hypertensive is used topically to treat alopacia areata :~ (i Hydralazine (ii) Prazosin (iii) Minoxidil (iv) Indapamide © scanned with OKEN ScannerCode/M/246 M.B.B.S. Second Year Prof. Examination-2023(1) 1 2. Subject- Pharmacology Paper-II [Time-03 Hrs} [Max Marks: 100] Section-B (50 Marks) combination. Write common adverse effect, how will you treat a case of multidrug resistant tuberculosis. Short answer questions :- (a) Post exposure prophylaxis of HIV. (b) Chelating agent. () Thrombolytic drugs, (@) Toxicity of anticancer drugs. Classify drugs used in treatment of pulmonary tuberculosis. Why they are used in (15) (5x5=25) (©) What drugs are prescribe to prevent the recurrence of acute rheumatic fever in adult and children. How long the prophylactic treatment should be continued. Objective type question: - Answer it in answer copy. (© True! False :- (2) Bovine insuline is less antigenic than porsine (b) Estorgen possess immunomodulators properties but immunodepresent ones. (1D) Fill up the blank :- (a) HI histamine receptor sub type is distrubuted in . (b) Mechanism of action of levomisole is... progestins do (111) Assersion and reason := (@) Antacid combination of magnesium and aluminium salt are superior to single component preparations. (b) Anti motion sickness drugs are best administered at one hour before commencing of hilly journey. (IV) One word answer :- porgative are used for. (b) Super infection are more common with. (wy McQ :- (@) Select the fourth generation cephalosporin among the following :- ()Cefpirome (ii) Ceftizoxime Ceftazidime (iv) Cefuroxime (b) Which of the following anti tubercular drug is not hepatotoxic :- (Ison (ii) Rifampicin (iii) Pyrazinamide (jv) Ethambutol Q) @) @) Q) © scanned with OKEN ScannerCode/M/243 I M.B.B.S. Second Year Prof. Examination-2023(0) Subject- Microbiology Paper-I (Time-03 Hrs} [Max Marks: 100] Section-A (50 Marks) 1. Define disinfection, classify disinfectant with their mode of action. Write test used for determination of eficacy of disinfectant. (2+5+8=15 marks) | 2. Short answer questions :- (5x5=25) (@) Briefly write about bacterial flagella and its demostration, () Universal safety precaution. (©) Draw and explain bacterial growth curve and its significance. (4) Inumerate the factors which interfere the microbial pathogenecity (©) Define biomedical waste, Give four color coded bin recomended for disposal of waste. 3. Objective type question: - Answer it in answer copy. (True! False = @) (2) Moist heat sterlization protocol requites the use of higher temprature for longer duration, - (b) Senitization leaves an object free of microbes. (Q) Fill up the blank :. Q) (a) In an autoclave, the application of presure to is increased to allow the steam to achieve temprature above the boiling point of water. (b) Ifused for extended period of time,.. ‘germicides may lead to sterility. (IID) Assersion and reason :- Q) (@) Why is the use of skin disinfecting eompounds requires for surgical scrubing and not for every day hand washing (b) When plotting microbial death curve, how might they look defferent for bactericidal versus bacteriostatic treatments, (IV) One word answer :- 2 (2) Respiratory mask can be cleaned by? 7 (b) Which germicide can kill the vegetative cell? (yy McQ + @) (2) The construction and use of compound mictoscope is attributed to := @ Antony Van Leeuwenhoek (i) Robert Koch (ii) Louis Pasture (iv) Ferdinand Cohn (b) L-forms of bacteria are without :~ (Nucleus (i) Cell Wall Gii)DNA (iv) Cell Membrane © scanned with OKEN ScannerLL Code/M/243 M.B.B.S, Second Year Prof. Examination-2023(1) Subject- Microbiology Paper-1 {Time-03 Hrs} [Max Marks: 100] Section-B (50 Marks) 1, Define and classify hypersensitivity, Describe Type-1 hypersensitivity reaction. (2+5+8-15) 2. Short answer questions := (5x5=25) (a) Briefly describe the biological ac ties of IgG. (b) Describe briefly the diagnosis of hydatid disease. (©) Define precipitation reaction, give diagnostic application of immuno diffusion. (d) Enumerate Concentration techniques for demostration of OVA and Cyst in stool. Describe flotation technique. (e) Name four common pathogenic intestinal parasite? Discuss life eycle and laboratory diagnosis of Ascaris lumbricoides. 3. Objective type question: - Answer it in answer copy. (© True/ False :~ @ (@) Round worm is a nematode which is oviparous. (b) Vaccines can be prepared from cytotoxin. (UD Fill up the blank := Q) (2) In transplantation acuhe graft rejection occurs with in (b) Number of amino acid in variable region of antibody is, (11D) Assersion and reason :- Q (@) Alveolar hydatid disease is caused by ehinococcus granulosus. (b) IgM is the first antibody formed after infection. (IV) One word answer :- Q) (a) American trypanosomiasis is eaused by? (b) First line of body defense is? (vy McQ: Q) (a) Guineaworm disease is caused by :- (i) Schistosoma haematobium Gi) Dracunculus medinensis (iii) Ancylostoma duodenal (iv) Trichinella spiralis, (b) Mature helper T cell is := ()CD4-CD8+ (ii) CD4+CD8+ (ili) CD4-CD8- (iv) CD4+cD8- © scanned with OKEN ScannerLL Code/M/244 M.B.B.S, Second Year Prof. Examination-2023(1) Subject- Microbiology Paper-II [Time-03 Hrs} ae [Max Marks: 100) Seetion-A (50 Marks) in detail the moist method (i) + Define sterlization. Classify methods of sterlization and describe i below 100°C and above 100°C. ) Short answer questions :~ (a) Describe various virulence factors in bacteria with example. (6) Principle of presumptive coliform testing and its interpretation. (©) Anaerobic culture method. (@) Laboratory diagnosis of enterie fever. (e) A 50 year old women, agriculture worker came with complaint of fever, malaise, headache, with yellow discoloration of sclera for past 5 days. On examination having microalbuminuria . What is your diagnosis, give lab diagnosis. 3. Objective type question answer copy- (@ True! Fals Q) (2) Monotrichous flagella is present in Ecol (b) Swarming growth is common in protease, (1) Fill up the blank :- (2) (a) Campylobacter jejuni is one of the most common food poison, it is also associated with post diarrheal syndrome that is knoWMn aS wn... (b) Except .... Mycoplasma pneumonia, H. influenza, chlamydia trachomatis can spread the disease by droplet particle. (111) Aesersion and reason :- C(niut Mare) Q) (a) Lowenstein Jensen medium is incubbated for 8 weeks. () In case of Neisseria gonorthocae infection the most recommended samples is ‘morning urine. Q) (IV) One word answer :- (a) Most significant and specific test for diagnosis of PUO. (b) Most appropriate speciment for diagnosis of bordetella. (McQ =: @) (a) In Vitek-2 automated system, antimicrobial suscepibilty test can be performed for i) Yeast (DA&B cD (iv) Parasite (b) The main features of prokaryotic organisms : (i) Absence of locomotion GeFAbsence of nuclear envelope (ii) Absence of nuclear material (iv) Absence of protein aga neeeeasaut © scanned with OKEN ScannerEE Code/M/244 M.B.BS, Second Year Prof, Examination-2023(1) Subject- Microbiology Paper-Il [Time-03 Hrs} [Max Marks: 100] Section-B (50 Marks) Enumerate Hepatitis viruses, Describe the morphology. : Hepatitis virus, ue (5x5=25) i pathogenesis and loboratory diagnosis of 2. Short answer questions (@) Write antigenic shift and antigenic drift in influenza virus. (®) Write a note on cryptococcosis. (©) Laboratory diagnosis of oral candidiasis. (@) Write on immunoprophylaxis of Polio. (©) Write on mechanism of viral oncogenesis. 3. Objective type question: - Answer it in answer copy. () True/ False :- 2 (a) Sabouraud dextrose agar can be incubated in the incubator. (b) Cytoplasmic inclusion bodies can be seen in RNA virus. | | (11) Fill up the blank :- @ I (@ wus ig the most common fungal pathogen recovered from respiratory tract | ine (b) One of the routine microscopic loboratory identification methods of fungal specimen is done by usin (ID) Assersion and reason =~ @ (2) Cytopathie effect of viral growth can be detected in cell line (b) Plasmids are ideal vector for gene cloning ' (IV) One word answer :- @) (a) Confirmatory test for cryptococcus. | | | a (b) HIV testing can be confirmed by? (yy McQ :- Q) (a) Example for DNA virus : (i Polio virus GB Adeno virus (iii) Echo virus (iv) HIV virus (b) The naked viruses with icosahedral symmetry having double standard super coiled DNA are known as :- i (i) Papavo virus (iiyPox virus 58) Parvo virus (iv) Adeno virus © scanned with OKEN Scanner