TEERTHANKER MAHAVEER MEDICAL COLLEGE

& RESEARCH CENTRE

Department of Pathology
MBBS 2021-22 Batch
Pre-University examination
Paper I Part B
Time: 10:20AM -1:00 PM Max. Marks:
80 Date: 03.01.24

1. 50/M veg male presented with progressive weakness and tiredness

for 1month. She also C/of tinging and numbness in her legs. o/E she
had pallor and a red beefy tongue. 1+1+3+3+2=10
What is your diagnosls?
b What is the deficiency in this condition?
C Describe the pathogenesis of this condition.
What are the findings in peripheral blood and bone marrow
aspiration?
e What are the other investigations to be done in this condition?

2. Define Gangrene. Mention the various types. Tabulate the differences

between each
type.
(2+3+5-0)

3. Define Neoplasia. What are the hallmarks of neoplasia? What are the
suitable
routes of metastasis? Discuss in brief viral carcinogenesis with
example. (1+4+3+2-40)

4. Short Notes (5X4)

I) Discuss Shock and itstypes.
I) Disseminated Intravascular Coagulation (DIC)
I) Sickle Cell Disease
M) Type 1 hypersensitivity reaction
5Differentiate between(5X4)
) Necrosls and Apoptosis
I) Leukaemoid reaction and CML
DPrimary and secondary immunodeficlency disorder
L
M Kwashiorkor and Marasmus

6. Reasoning question/ Short answers (5X2)

) Why cell swellng occurs in cell injury
I) Why do diabetic patlents present with chronic non
healing foot ulcer?
I) P53 is called as Guardian of the Gename, why?
I) gve reason far anaemia in chronic inflammation
) Give reason for false high hemoglobin in jaundiced patients. What are
other causes of falsely elevated hemoglobin value.
 TEERTHANKER MAHAVEER MEDICALCOLLEGE&
RESEARCH CENTRE
Department of Pathology
MBBS 2021-22 Batch
Pre-University examination
Paper I Part A(MCQ)
Time: 10:00AM -10:20 PM Max. Marks:
20 Date: 03.01.24
Student's Name:.
Dept.
Roll No.....

1. Which of the following ls the hallmark of acute

A. NeutrophilsB. Connective tissue inflammation:
macrophages
C. Granulation tissueD. Granuloma formation
2. Heart falure cells seen in
A.Renal failure B. Liver failure
C. CVC lung D. Carcinoma stomach

3. Incorrect match with respect to Principal Actions of Arachidonic Acld

Metabolites is ?
A Prostaglandins PGI2 (prostacyclin): Vasodilation
B. Thromboxane A2:Vasoconstriction
C. leukotrienes C4, D4, E4: Vasodilation
 D. Leukotrienes B4,: Chemotaxis,and leukocyte adhesion

4. Lines of Zahn are found In:

B. thrombus
A. Head injury
C. Drowning D. gangrene

5. All are free radical except:

A. Superoxide B. Hydrogen peroxide
CHydroxide D. Selenium

6 HLA B27 0s assoclated with Increased risk of development of:

A. OsteoarthritisB. Rheumatoid arthritis
C. Ankylosing spondylitisD. Reiter's syndrome

7Virchaws' triad composed of all except:

A.Hypercoagulability B. Thrombosis
C. Endothelial injury D. Embolism

8. Molecular pathogenesis of a-thalassemia irvoves:

A. Mutation in transcription promoter sequence
B. Gene deletion
C. Codon termination mutation
D. mRNA splicing defect

9. During autopsy, a light brown pigment is seen In the cardiac muscle

fibres of an 80-year old
man. The plgment is likely to be:
A. LipochromeB. Hemosiderin
C. Anthracotic pigmentD. Hematoidin
 allEXCEPT:
10.Giant platelets are seen in B. Sickle cell Anemia
A. May-hegglin Syndrome D. Grey Platelet
C. Wiskott aldrich Syndrome
syndromne
a major role in intiation of thrombus
11. Whlch of the following factor plays
farmation?
cascade activation
A. Vasoconstriction B. Coagulation
C. Platelets activationD. Endothelial injury
immune mediated
12. Which of the following falls under the category of
hemolytic anernia?
anemia
A. Paroxysmal nocturnal haemoglobinuria BAplastic
C. hereditary elliptocytosis D. Hemolytic disease of the
newborn

13. Leucocyte alka line phosphatase (LAP) scores are elevated in:
A. AML B. CML
C. Myeloid metaplasia D. Myeloid leukemoid reaction

14. Type I hypersensitivity reaction is mediated by:

A. lgG antibody B. lgM antibody
C. igE antibodyD. lgA Antibody

15. The classic Karotype of Klinefelter's syndrome is:

A. 47XXY B. 48XXXX
C. 45XO D. 46XYJ47XXY

16. The following gene has a probable role in obesity:

A. Fibrillin B Merlin
C. Leptin D. Neurofibramin

17. Which of the following is not a correct match for anyoidosis associated
disease and precursor protein:
A. Systemic senile amyloidosis : Transthyretin
B. Hemodialysis-associated amyloidosis : B2-microglobulin
C. Medullary carcinoma of thyroid : thyroglobulin
D. All are correct

18.Commonest fixative used for electron microscopy studies is:

A. Formalin
C. Alcohol B.Glutraldehyde
D. Bouin's fluid
 L
19. DNA extraction is a pre-requisite for the follawing
molecular
techniques except:
A. PCR technique B. In situ hybridisation
C. Western blot technique D. Southern blot technique

20. Deposition of calcium in dying tissues is called as:

A Metastatic calcification B. Dystrophic calcification
C. Heterotopic calcificationD. Normal calcification
 RESEARCH CENTRE
TEERTHANKER MAHAVEER MEDICAL COLLEGE &
MBBS 2021-22 Batch
Department of Pathology
Time: 10:20 -13.00 Pre-University examination Paper II Part B Date: 04.01.24
1. A Max. Marks: 80

for 250-year-old male presents with cough, dyspnoea and intermittent haemoptysis
months along with loss of weight and appetite. He is a chronic smoker for the
Past 3decades. CT chest
A) What is your revealed mass lesionin right lobe of lung (2T
probable
B) What are the Lab diagnosis?
diagnosis? investigations you would like to do in order to reach the definitive
C) Discuss the role of biopsy,
management of this patient. immunohistochemistry and molecular pathology in tne
D) Define paraneoplastic
disease. syndrome and discuss paraneoplastic findings associated with the
2. Define Ischemic heart
disease. Describe pathogenesis and
Myocardial infarction. Discuss complications
(2+4+4) and laboratorymorphological features o
work up of the disease.
3. A 45-year-old male was
found to have increased blood sugar 166
blood investigation. g/dl on routine
A) Discuss the screening and
B) Enumerate its diagnostic tests for diagnosis of(2+2+2+2+2)
diabetes mellitus.
C) Describe the
types.
D) What are longpathophysiology
of diabetes mellitus
term complications of this disease
E) Discuss how you will monitor such
4. Write shori notes on patients.
I) Atherosclerosis (5X4)
II) Alcoholic liver disease
II) Benign hyperplasia of Prostate
IV) Phyllodes tumor
4. Differentiate between
(5X3)
) Complete and Partial mole.
II) Nephrotic syndrome and nephritic syndrome.
III) Gastric and Duodenal ulcer.
5. Describe how AETCOM skills contribute to effective doctor-patient
communication and enhance the patient-doctor relationship. (5 marks)
6. Reasoning question
I)Give reason for ocular changes in Grave's disease. (5X2)
II) Give reason for Peau d orange appearance of overlying skin in
III) Why do we seek history of sore throat in the past in breast cancer.
rheumatic heart disease?
suspected patients of
IV) Why there is involvement of both lung and kidney in Good
Syndrome?
V) Give reason for cobblestone appearance of mucosa in Crohn's
Pasture
disease.
 kEy
Name.. .... Dept. Roll No....

TEERTHANKER MAHAVEER MEDICAL COLLEGE & RESEARCH CENTRE

MBBS 2021-22 Batch
Department of Pathology
Pre-University examination
Paper II Part A
Time: 10:00 -10.20 Max. Marks: 20 Date: 04.01.24

1. Libman - sacks endocarditis is scen in which of the following:

a) Rheumatoid arthritis t Systemic lupus erythematósus
c)Rheumatic fever d) Poly arteritis nodosa
2. Xantho-granulomatous pyelonephritis is often associated with infection by which óf the following
organism:
LaProteus 6)E.coli
c)Klcbsiella d) Staphylococcus ayreus.
3. Myocarditis can be caused by which of the following?
La) Schistosoma b) Ancylostoma duodçDale
c)Trichuris trichiura
TrichinelJáspiralis
4 Histological features of coeliac disease include All EXCEPT
a) Crypt hyperplasia )Ingfease in thickness of the mucosa
c)lncrease in intraepithelial lymphocytes d) Shortening of villi
5. Glomerulonephritis associated with sensory neural dçáfness are seen in
a) Turner's syndrome b) Fabry's syndrome
JAlport's syndrome d) Nail patella syndrome
6. Giant hypertrophy of gastric mucosa similarfo brain surface is seen
a) Peptic ulcer discase b) Carcinoma stomach
o Menetrier's disease d) Leiomyosarcoma
7. Which of the following is the most specific histological finding in
diabetic nephropathy?
a) Splitting of glomerular basement membrane b) Nodular sclerosis
c) Hyaline sclerosis of the glomeruli
d) Hyperplastic arteriosclerosis
8. Which ofthe following is NOT true about ulcerative colitis
La) Transmural inflammation b) Cryptitis
c) Crypt abscess d) Distal intestinal involvement
9. Which of the following type of renal cell
carcinoma is associated with sickle cell anemia:
LaMedullafy carcinoma b)Chromophobe carcinoma
c)Papillary carcinoma d)Clear cell carcinoma
10. Diabetic patient with liver cirrhosis and
a) Wilson's disease hyper-pigmentation of skin, what is your diagnosis?
c) Primary sclerosing cholangitis b) Hepatitis B
Ldh Hemochromatosis
11. Lung disease not caused by Air Pollutants
a) Anthracosis b) Silicosis
c) Asbestosis
d) Pheumonia
 12. Most Common Benign Tumors of the Salivary Glands
La Pleonmorphic adenoma b) Mucoepidermoid carcinoma
c) Warthin tumor d) Adenocarcinoma
13. Which of the following is most important risk factor for
Peptic Ulcer Disease
La Cigarette use b) Tobacco use
c) Protein diet
d) Ketogenic diet
14. Cause of granuloma is
Va)Crohn Disease
c) Silicosis b) Enteric fever
d) Brucellosis
15. Active yiral replication is signified by
La) HBeAg b) HBsAg
c) HBV-DNA
d) IgM-anti-HBc
16. Rokitansky Aschoff sinus is seen in
a) Chronic cholecystitis b) Acute appendicitis
c) Rheumatic heart disease
d) Rheumatoid arthritis
17. Principal Systemic Manifestations of Chronic Kidney
a) Dehydration Disease and Uremia
c) Anemia b) Edema
All of the above
18. Gestatjonal Trophoblastic Disease is
vá) Hydatidiform Mole
c) Adenocarcinoma b) Hydatid cyst
d) Leiomyosarcomas
19. Risk Factors for breast
factors
a) Germline mutations
)Both Iand 2 b) First-degree relatives with
d) None breast cancer
20. Causes of Hypercalcemia
ayHyperparathyroidism
c) Breast carcinoma b) Hyperthyroidism
d) Hypopituitarism
 Department of Pharmacology
M: 80 Time: 2 Hours, 40 Minutes
ate: 05th January, 2024
erratic behavior and strange
by his mother who has been concened about her son's
A 19-vear-old male student is brought into the clinic harassing messages to him. In addition, he reports hearing voices at a
telling
beliefs. He destroyed a TV because he felt the TV was sending result, he is not eating. After a diagnosis is made,. Drug X is prescribed
him that family members are trying to poison his food. As a
gradually increasing dose on an outpatient basis. The drug improves the patient's positive symptoms but ultimately causes intolerable
which, over the course of several weeks of treatment, improves
adverse effects develop, although more costly, Drug Y is then prescribed, (2,4,4)
patient.
his symptoms and is tolerated by the
a What are the medications that are given to this patient for his complaint?
b
Describe the mechanism of action, adverse effects, drug interactions and uses of Chlorpromazine?
C.
What is the role of atypical class of drugs being used in schizophrenia, cite with appropriate examples?
as key players in the health care system.
The impact of socio-economic situations in determining health care access and the role of doctors
2. What are the implications of health care as a right?
b. What are the social and economic implications of health care as a right?
C. What are the implications for doctors? (2,4,4)

Nuclear Receptor. Differentiate between

Describe signal transduction through receptors. Describe in detail the process of action througn (3,4,3)
desensitization and supersensitization with examples.
(3X6 = 18)
Write Short Notes on:
a Hypersensitivity Rcaction
H. pylori therapy
C. Valproic Acid
Management of COPD (Chronic Obstructive Pulmonary Discase)
Management of suspected case of Organophosphorus toxicity
f Succinylcholine

5. Explain why: (2X5 =10)

Adrenaline is combined with lignocaine.
b S; mpathomimetics are used in patient suffering from Asthma.
Probenecid is combined with penicilin.
Thiopentone is used for induction of anesthesia.
e. SSR0s are preferred over TCAfor paticnts suffering from depression.

Enumerate: (3X4 =12)

Factors modifying drug action.
b Uses ofNSAIDs
C Drugs used in glaucoma with brief rational.
d Drugs used in parkinsonism.

Ahealthy 45-year-old physician attending a reunion in a vacation hotel developed dizziness, redness of the skin over the head and
chest. and tachycardia while eating. Ashort time later, another physician at the table developed similar signs and symptoms with
marked orthostatic hypotension.The menu included a green salad, sautéed fish with rice, and apple pie. (1,2,4,3)
a. What could have happened in this patient that led to these symptoms?
b What are the drugs that can be used in this patient.
What are the uses of antihistaminic drugs and give the rational of use of antihistaminic in parkinsonism?
d Mention the adverse effects and contraindication of antihistaminic drugs.
 Department of Pharmacology
M: 80 Time: 2 Hours, 40 Minutes
Date: 06h January, 2021
He has been generally healthy, is sedentary, drinks several
1. A 35-year-old man presents with a blood pressure of 150/95 mm Hg.
cocktails per day, and does not smoke cigarettes. He has a family history of hypertension, and his father died of a myocardial
infarction at age 55. Physical examination is remarkable only for moderate obesity. Total cholesterol is 220, and high-density
x-ray is normal. Electrocardiogram shows left
lipoprotein (HDL) cholesterol level is 40 mg/dL. Fasting glucose is 105 mg/dL. Chest
ventricular enlargement
basis
(a) Write list of medications effective that are to be used in this patient with their pharmacological
(b) Write the MOA, therapeutic uses, adverse effects and interaction of captopril
(c) How are beta blockers effective in hypertension (3+4+3=10)

2. A 38-year-old female is diagnosed with Diabetes Mellitus and Hypertension comes the OPD.
(a) What are the responsibilities of patient and doctor in decision making?
(b) What should the patient be told about their diagnosis, prognosis and further treatment
(c) What aspect of autonomy will be important for this patient? (3+4+3 =10)

3. Explain Why (2x 5=10)

(a) Digoxin is used for atrial flutter
(b) Low molecular weight heparin is preferred over unfractionated heparin
(c) Propylthiouracil is preferred over carbimazole in pregnancy
(d) Sulfamethoxazole is combined with trimethoprim
(e) Corticosteroids should be withdrawn gradually after prolonged use
4. Write Short note on (3x6=18)
(a) Toxicity amelioration of anticancer drugs
(b) Clomiphene
(c) Management of iron poisoning
(d) Ciprofloxacin
(e) Sulfonylureas
() Highly active anti-retroviral therapy (HAART)

5. Write Management of (2x 5=10)

(a) Newly Diagnosed case of tuberculosis
(b) Myocardial infarction

6. Enumerate/differentiate (3x4=12)
(a) Contraindications of Hormonal Contraceptives
(b) Adverse Effects of Corticosteroids
(c) Uses of Chloroquine
(d) Differentiate between Aminoglycosides and Macrolides
7. A55-year-old man is brought to the local hospital emergency department by ambulance. His wife reports
that he had been in his normal state of health until 3 days ago when he developed a fever and a productive
cough. During the last 24 hours he has complained of a headache and is increasingly confused. His wife
reports that his medical history is significant only for hypertension, for which he takes hydrochlorothiazide
and lisinopril, and that he is allergic to amoxicillin. She says that he developed a rash many years ago when
preseribed amoxicillin for bronchitis. In the emergency department, the man is febrile (38.70C (101.7°F|D,
hypotensive (90/54 mm Hg), tachypneie (36/min), and tachycardic (110/min). He has no signs of
meningismus but is oriented only to person. A stat chest x-ray shows a left lower lung consolidation
consistent with pneumonia. The plan is to start empiric antibiotics and perform a lumbar puncture to rule
out bacterial meningitis. (2+4+4)
a. Name the ANTIMICROBIAL AGENTS to be used for empiric therapy
b. Describe the mechanism of action, uses and adverse effects of Penicillin
c. Explain the rational of combination of amoxicillin with clavulanic acid
 DEPARTMENT OF MICROBIOLOGY
BATCH
PRE- UNIVERSITY EXAMINATION 2" M.B.B.S. 2021-22 Date :08/0I/2024
Subject:- Microbialagy I Max. Marks- 100
Time:- ID:00 AM to O1:00PM (3 hours)
Attempt all questions.
Draw proper diagran to support your answer.
(1x20 Mark)
(A) Multiple Choice Questions

(1 x 15 marks)
(B.) Problem based /Long answer/Structured question:
A 12 year old boy was admitted with high grade
fever, abdomen pain, nausea, vomiting and anorexia for
8days on examination, tongue was coated, step ladder pyrexia, spleen was palpable, blood was sent for
llie past (1+5+4+1+4-15)
investigation for culture and serology test.

a) ldentify the etiological agent.

b) Discuss the pathogenesis.
c) Oher tests used for diagnosis in different weeks.
d) Drug of choice for treatment.
e) Adda note on its vaccines

like rice water stool. On examination, her pulse

2. A 22-Year old woman developed severe watery diarrhea (12-15 times)membranes were dry. Stool sample was processed
ws I5 per minute and blood pressure was 80/50 mm Hg. Her
mucous
(1+2+4+3=10)
iurther in microbiology laboratory.
a What is the probable clinical diagnosis?
b. Enumerate the different etiological agents for diarrhea.
C Discuss the pathogenesis of the disease. condition.
d. Discuss the laboratory diagnosis for above
(6x5=30)
(C)Short structured answer type questions:
a) Delayed type Hypersensitivity Reaction.
b) Laboratory Diagnosis of HIV.
c) (omplications of falciparum malaria
d) Five moments of hand hyegine
e Ventilator associated pneumonia
f) MRSA
(10x2=20 marks)
/Reasoning question
B. Short answer type
a) Org.unism causing NGU
b) Eurichment media
c) Pathogens causing anaemia
more virulent?
d) Capsulated organisms are
e) SssS
) Flesh eating bacteria
g) Secretory antibody
h) Yeast like fungi.
i) BCG
4Major health care associated
infection .
)
(1x5=5 marks)
E.AETCOM: of unexplained fever,
25-year-old male with history of having multiple sex partners is admitted with complaints6 months. His serum
A for the past
and generalized lymphadenopathyidentity
progressive loss of weight, persistent diarrhea
Explain confidentiality pertaining to in laboratory results to the
sample was reactive for HIV antibodies
patient and their relatives.
 DEPARTMENT OF MICROBIOLOGY
PRE- UNIVERSITY EXAMINATION 2D M.B.B.S. 2021-22 BATCH

Subject:- Micrabialogy |l Date :09/0I/2024

Time:- 0:00 AM to 01:00PM (3 hours) Max. Marks- 100
ATTEMPT ALL QUESTIONS.
DRAW PROPER DIAGRAM TO SUPPORT YOUR ANSWER.
(A) Multiple Choice Questions (1x20=20Marsks)

(B) 1. Problen based Long answer question:

a. A 65 Year patient brought to the emergency with H/O high grade fever, loss of consciousness & seizures
for past lday. On clinical examination the patient was found unconscious, febrile (1020F), Nuchal rigidity
(++), Deep tendon reflexes are exaggerated & presence of intermittent generalized tonic clonic seizures.
(1+3+7+4-15)
a) What is the most probable clinical diagnosis?
b) Enumerate Bacterial pathogens causing similar clinical condition?
c) Cytological , Microbiological and biochemical parameters of CSF in normal individual ?
d) Discuss the laboratory diagnosis of this condition.
b. A 32 Year old male truck driver comes to the STD clinic with history of an ulcer over his
genital organ
having history of regular visitor to commercial sex workers . On clinical examination, a 3x4 cm painless,
indurated, non-bleeding ulcer is present over the glans penis. (1+2+4+3=10)
a. What is your most probable clinical diagnosis?
b. List the various pathogens causing STD's.
C. Discuss clinical type and features of this condition.
d. Discuss common investigation for laboratory diagnosis .
C. Write Briefly: (6x5=30 Marks)
a. Gas gangrene
b. Mycetoma
c. Recent diagnosis of Tuberculosis
d. Clinical spectrum of Staphylococcus aureus infection.
e. Prophylaxis of Polio.
f. Clinical manifestation & prophylaxis of diphtheria.

D. Short answer type /Reasoning question : (10x2=20 Marks)

a. Streptococcus causes spreading infection.
b. M.leprae is not cultivable on artificial media.
C. C.S.F. sugar level in acute meningitis may be low upto Omg/dl.
d. Post kala zar dermal leishmaniasis.
e. Mycobacterium tuberculosis is acid fast bacilli.
f. Negri bodies
g. ESBL producer are more resistant pathogens
h. Agent causing Painful Genital Ulcer
i. 5 Biological agents for Bioweapons.
j. Congenital rubella syndrome
E. AETCOM: (1X5=5 Marks)
A patient was waiting for appendectomy surgery.The surgeon wanted to rule out HIV status
preoperaratively. The serological test for HIV was found to be Reactive..Explain confidentiality
pertaining to identity in laboratory results to the patient and their relatives.