Department of Pathology Vardhman Mahavir Medical College & Safdarjung Hospital a! nt al examination MBBS Batch 202 Paper -1 Date: 08.07.2025 Time: 10.00 a.m. to 1.00 p.m. (3 hour) Maximum marks: 100 Note: Attempt Part A, Part B and Part C in separate answer sheets. Draw diagrams & flowcharts wherever necessary. Part-B ____________Total Marks 40 QI: A445 years old man was admitted to hospital after a massive road traffic accident. He had a pelvic bone fracture and was immobile for 7-8 days. On 9* day of hospital admission, he developed sudden chest pain and breathlessness. a, What is probable diagnosis? b. Describe the etiopathogenesis of the disease. c. What are the complications of the disease? wae Q2: Answer the following questions: (5x6 =30) a. _Define shock and classify its types. b. Explain the mechanisms of ischemic cell injury. c. Enumerate the types of necrosis with examples, 4. Discuss the role of complement system in inflammation. ¢. Differentiate between transudate and exudate f. Differentiate between red infarct and white infarct, Part C Total marks 40 Q3: A 22-year-old woman presents with a 2-week history of fatigue, bleeding from her ‘gums, and very heavy menstrual bleeding, Physical examination reveals a pale woman with an enlarged spleen and petechiae on her legs. A complete blood cell count shows a markedly elevated white cell count. a. What is the most likely diagnosis? b. Describe the peripheral smear findings with a well labelled diagram. ©. Describe the bone marrow findings with a well labelled diagram. aad Q4: Answer the following questions: (5 x 6=30) a, Discuss and classify blood group systems. b. Enumerate and discuss various laboratory tests done to confirm diagnosis of iron deficiency anemia ¢. Differentiate between leukemoid reaction and CML 4. Describe the pathophysiology of iron deficiency anemia ¢. Drawa well labelled diagram of PS finding in Acute myeloid leukemia, f, Discuss the advantages of working in a team in healthcare settings in a large tertiary care hospital. peeverrrrreee saeeeDepart thology Verdhman Mahavir Medical College & Safdarjung Hospital Date: 09-07-2025 ‘Eadhology ssnt up annual examination MBBS Batch 2023 Eaper ll Time: 10.00 a.m. t0 1.00 p.m. (3 hour) Marimum marks: 100 Note: Attempt Part A, Part B and Part Cin separate answer sheets. Draw diagrams & flowcharts wherever necessary, PartA ‘Separate queition and anawer shee! (o be returned back after 20 minutes.) CO Total questions 10. ‘Total marks 20 Part B___Totel marka-49_ Q.1: A 39-yearold woman comes tothe physician because she has noticed a lump inher breast. Over the past 2 months, the {eft breast has become slightly enlarged compared with the right breast. On physical examination, the skin overlying the le breast is thickened, reddish orange, and pitted, Mammography shows a 3-em underlying density with BIRADS --V Gt3+4=10) ‘A. What are the rik factors for the development of this disease? 'B. Write the etiopathogenesis ofthe disease ©. Deseribe the morphology of the disease, Q2: Write short notes on the following (Sx6=30) ‘8, Write etiopathogenesis, morphology and clinical course of chronic viral hepatitis b. Discuss in deal about cardlomyopathies €. Discuss pathogenesis, morphology and complications of Inflammatory Bowel Disease 4, Discuss in brief about occupational lung diseases © Classify cystic diseases of kidney. Discuss pathogenesis and pathology of polycystic kidney £ Enumerate the various types of vasculitis and discuss about polyarterts nodosa Part C Total marks 40 Q3:A_ 7-year child presented with generalised swelling and periorbital edema since one month, Urine examinetion showed 4+ protein and no RBC. Pulse rate is 80 /min and BP is 130/80 mm of Hg. QH4t4=10 2. Give your provisional diagnosis. b. Deseri ¢ the light microscopy, immunofluorescence and electron microscopic changes of this condition differences between nephritic and nephrotic syndrome Q4: Answer the following questions: (Sx 6=30) Classify adenomas of intestines. Discuss in detail etiopathogenesis of colon carcinoma Describe the etiopathogenesis of formation of atheromatous plaque ‘Tabulate the differences between complete and partial mole Differentiate berween obstructive and nonobstruct i Differentiate berween pyogenic, Tubercular and viral meningitis, Describe and differentiate common granulomatous lesions of lung pease/ ‘Rareea wd gare eae FATT 3 Minis ot Heath & Family Wettare = SEE ethane gre Atwater we mera rere, wt Rrra 10029- ‘Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi-110029 aerate Rrra Pear Department of Microbiology Max Marks :80 Time Limit: 02.30 hours Instructions: ‘Attempt all questions from Section A, B & C as directed. Answer Section A (MCQ) on question paper itself and use separate answer sheets for sections B & C (descriptive questions). Draw neat & suitable labelled diagrams wherever necessary. (Section B) Long Question: (a) Enumerate the different methods of horizontal gene transfer in bacteria. (b) Briefly describe the following: i Plasmids and its functions ii, Conjugation. iii. Significance of conjugation in antimicrobial resistance. (2434342 = 10 marks) Short Notes: 1. Write a short note on Autoclave under the following headings: (@) Principle of autoclaving. (b) Sterilization conditions. (c) Sterilization control. (14242 =5 marks) 2 Describe the principle and working of a compound light microscope. Define the terms magnification and resolving power. (G42 =5 marks)3: Discuss ELISA (Enzyme-Linked Immunosorbent Assay) under the following subheadings: (a) Explain the principle of ELISA, (6) Deseribe the steps involved in Direct and Indirect ELISA, with the help of a neat, labelled diagram. (©) Mention ANY TWO clinical applications of ELISA in microbiology. (1+3#1 = § marks) 4. Define “Vaccine’. Write THREE differences between live attenuated and killed vaccines with ONE example of each. (1+3+1 = 5 marks) 5. Define autoimmunity. Describe the mechanisms of central and peripheral immune tolerance and their role in preventing autoimmunity. Mention any two examples of autoimmune diseases. (143+ 5 marks) 6. (a) Define the complement system and mention its main components, (b) Enumerate the three pathways of complement activation (c) State ANY THREE biological functions of the complement system (d) Mention ONE clinical condition associated with complement deficiency. (H1.5+1.5+1 =5 marks) PAPER-I (SECTION C) Long Question: A G-yearold girl presents with migratory arthritis involving knees, ankles, hips, and elbows, along with an abnormal gait. She has painless, mobile subcutancous nodules over bony Prominences and a murmur in the mitral area, ECG shows prolonged PR interval. She had a sore throat 3 weeks ago, (a) What is the most likely clinical diagnosis? Name the etiological agent. (b) Discuss the pathogenesis of this clinical condition. (c) Name the diagnostic criteria used to confirm this condition. (4) What measures can be taken to prevent recurrence of such episodes? (2+4+1+3 = 10 marks) Short Notes: 1, (@) Name FOUR viruses causing gastroenteritis. (b) Draw a neat, labelled diagram of Rotavirus, (©) Name two rotavirus vaccines, (24241 =5 marks) 2. A31-year-old male from Bihar presented with fever, pallor, and marked splenomegaly. ‘A bone marrow aspirate was obtained and stained with Giemsa stain, which revealed intracellular amastigote forms of a parasite within macrophages.(a) Based on the clinical history and findings, what is the likely etiological agent? (b) Briefly describe the life cycle (Diagrammatic representation only) of this organism. (©) Enumerate the laboratory techniques employed for the diagnosis of this condition, (14242 = 5 marks) (a) Draw a neat labelled schematic diagram of Hepatitis B virus. (b) Briefly describe the laboratory diagnosis of Hepatitis B virus infection. Qt marks) . 35-year-old male from a slum with poor sanitation presents with right upper quadrant pain, fever with chills, and weight loss. Liver is tender and enlarged. Ultrasound shows a hypoechoic lesion in the right lobe; CT-guided aspiration yields ‘anchovy sauce’ pus. He had an episode of dysentery 2 weeks ago. (a) Identify the disease and the causative agent. (b) Draw a neat labelled diagram of the life cycle of the etiological agent. (©) Briefly describe the laboratory diagnosis of this clinical condition. (14242 =5 marks) . A 27-year-old woman presented with high-grade fever, severe joint and muscle pain, and petechial rash. Examination revealed jaundice, hepatomegaly, and thrombocytopenia (30,000/[Link]). Tourniquet test was positive with 25 petechiae/in?. She reported recent mosquito bites. (a) Based on the clinical history and findings, what is the likely etiological agent? (b) Briefly describe the laboratory diagnosis of this condition, (©) Name ONE licensed vaccine available for human use against this disease. (14341 = 5 marks) ‘A 52-year-old man with newly diagnosed lung cancer visits the outpatient department with his son, After reviewing the reports, the doctor informs only the son about the diagnosis and asks him not to disclose it to the patient, fearing that the news will emotionally disturb him. The patient, sensing something serious, asks the doctor directly about his condition, Based on the above scenario, answer the following: (a) Identify and briefly describe the ethical issue involved. (b) What principles of communication and professionalism should be applied in this case? (©) How would you address the patient's right to know while being sensitive to the family’s concems? (@) Mention any one AETCOM competency that this case highlights. (1424141 = 5 marks)AT ATER Governmentotindia warea ve Stare wear aise Ministry of Health & Family Wettare worse Uae prey afta sietor wed awecaia arevarar, af forest 10029- \Vardhman Mahavir Medical College & Safdarjung Hospital, New Deni-110029 Agere Fra Peart Deparment ot Mceboogy MBBS Batch-2023 Sent up Ex: yn Paper-II Max Marks :80 Time Limit: 02.30 hours Instructions: Attempt all questions from Section A, B & C as directed. Answer Section A (MCQ) on question Paper itself and use separate answer sheets for sections B & C (descriptive question). Draw neat & suitable labelled diagrams wherever necessary. SECTION B Long Question: A 26-year-old sexually active woman presented with 4 days of painful genital ulcers, dysuria, 7 and low-grade fever. Examination revealed multiple vesicles and ulcers on the external genitalia. She had a history of multiple unprotected sexual exposures; her partner had similar symptoms. Tzanck smear from the lesion showed multinucleated giant cells. (a) What is the most likely causative agent(s) of this condition? (b) Describe the morphology of the causative agent with the help of a neat, labelled diagram. (©) Briefly discuss the pathogenesis of this clinical condition. (@) Briefly describe the laboratory diagnosis of this clinical condition. (e) How will you treat and prevent the above condition? (142424342 = 10 marks) Short Notes: 1. Describe the diagnosis of pulmonary tuberculosis in accordance with the guidelines of the National Tuberculosis Elimination Programme (NTEP). (S marks) 2. Write a short note on Cutaneous Larva Migrans. (S marks)3. A4-year-old girl presented with acute onset of fever, productive cough, and respiratory distress for 2 days. Chest examination revealed. dullness on percussion. Direct mierscopy of sputum showed numerous pus cells and Gram-positive, lanceolate diplococci with a clear halo, (@) Name the probable etiological agent, (b) Describe the laboratory methods used to confirm the diagnosis. (144 =5 marks) (2) Enumerate the genera of dermatophytes, (b) Outline the laboratory approach to diagnosing dermatophytosis. (+4 =5 marks) 5. (@) Briefly outline the pathogenesis of urinary tract infections (UTI), (b) Describe the laboratory diagnosis of UTI (243 = 5 marks) & A 45-year-old male agricultural worker from rural Rajasthan presents with a I-year history of painless, non-tender swelling over his left foot. He Teports. gradually increasing nodularty and multiple discharging sinuses exuding seropurulent material With black granules. Plain X-ray of the foot shows soft tissue swelling and underlying bone involvement. (a) What is the most likely diagnosis? (b) What are the agents that can cause the above condition? (©) Describe the laboratory diagnosis of this condition, (14242 =5 marks) SECTION C Long Question: A 53-year-old girl presents with 2-day history of high-grade fever, neck stiffness, and altered sensorium. Brudzinski's sign is positive. CSF microscopy shows Gram-negative diplococei with flattened adjacent sides and a clear halo. (@) What is the most probable clinical diagnosis? Identify the most likely etiological agent. (b) Mention two important virulence factors of the causative organism. (©) Describe the laboratory methods used to confirm the etiological diagnosis, (@) Outline the steps for prevention and prophylaxis in close contacts, (2424343 = 10 marks)pe Short Notes: 1, Enumerate the different types of tran: i in infection \smission-based precautions used in infectior control, Name ANY THREE organisms that are primarily transmitted via respiratory droplets. (243 = 5 marks) 2. Define zoonotic infections. Briefly describe the laboratory diagnosis of Rabi (1+4=5marks) 3. A 24-year-old male from a rural area presents to the emergency department with his first episode of generalized tonic-clonic seizure. He reports intermittent headaches for the past month but denies fever or trauma. CT scan of the brain reveals a single ring- enhancing lesion in the right parietal lobe with eccentric scolex. ical agent. (a) What is the most likely clinical diagnosis? Identify the etiologi (243 = 5 marks) (b) Briefly describe the life cycle of the causative organism. 4. A.62-year-old diabetic male in ICU for septic shock developed high-grade fever, chills, and hypotension on day 6 of central venous catheter use. Blood cultures from both central line and peripheral vein grew the same Gram-positive cocci in clusters within 2 hours. (a) What is the most likely clinical diagnosis? (b) Briefly outline the laboratory diagnosis of this clinical condition. (0) State ONE preventive measure to reduce the risk of this condition. (14341 = 5 marks) 5. Expand the acronym “TORCH”. Briefly outline the clinical features of ‘Congenital Rubella syndrome’. (243 =5 marks) 6. Write a short note on the fundamental principles of Bioethics in Clinical Medicine. (marks)MBBS Sent up examination 2025 (Batch 2023) Pharmacology PAPER I ‘Time:20 Minutes Section-A, 1, Which statement about thiazde diuretics is CORRECT? 4) Reduce urinary calcium excretion 'b) Effective in acute pulmonary edema ©) Cause metabolic acidosis 8) Wotk in thick ascending limb 2. Which ofthe following erosses BBB? 2) Dopamine b) Propranolol ©) GABA 8) Suxamethonium 3. Half fe (¢%) doesnt depend on: 3) Biotransformation b) Time of drug absorption ©) Concentration ofa dng in plasma 4) Rateof drug elimination 4. The primary mechanism of action of local anesthetics is 3) Activation of ligand-gated potassium channels 'b) Blockade of voltage gated sodium channels ©) Stimulation of voltage gated N-type calcium chennels 4) Blockade the GABA-gated chloride channels 5. Which ofthe following statements correctly describes the pharmacological use of methachy 8) Itis a2 agonist used to treat acute bronchospasm ') itis an antimuscarinic agent used to prevent asthma attacks ©) Iisa muscarinic agonist used to diagnose sway hyperreactivity 4) Itact by blocking B receptors to provoke bronchoconstrstion 6. _Allof the following drugs reduce preload EXCEPT: a) Nitrates b) Furosemide ACE inhibitors Dobutamine 7. Which statement about Phas I clinical tials is CORRECT? 8) Determine the optimal dose for treatment 1) Determine efficacy in patient populations ©) Assess safety and pharmacokinetics in healthy volunteers 4) _Arepost-marketng studies 8. Which one ofthe following is TRUE about the volume of distribution (V4)? 4) High V4 indicates drug remains mostly in plasma b) Low Vd suggests extensive tisue binding. ©) High Va suggests extensive tissue binding @)Vdhas wits of mass 9. A drug follows first-order kinetics. Which statement is CORRECT? 4) Elimination rates independent of drug concentration ') A constant amounts eliminated per unit time ©) Clearance varies with concentration 8) A constant fraction is eliminated per unit time 10. What isthe mechanism of leirudin used in heparin induced thrombocytopenia? 8) _Indiect inhibition of thrombin via antithrombin I ) _Imeversibe inhitition of Factor Xa ©) Direct irreversible inhibition of thrombin 44) Direct reversible inhibition of thrombin Max. Marks:201. 4 1”. 20, |. Drug usod in irritable bowel syndrome with constipation 1) Lubiprostone ) Alosetron| ©) Loperamide Clonidine >. Newer Anti-platelet drug which act by inhibiting Protease activator receptor-1(PAR-1) 2) Cangrelor ) Ticagrelor ©) Vorapaxar 4) Prasugrel ‘A S4-year-old woman had an attack of myocardial infarction. Which of the following would be appropriate prophylactic amiarshythmic pharmacotherapy? 2) Quinidine >) Verapamil ©) Phenytoin 8) Metoprotol TG is a43 year old woman who presents with a 2 week history of epigastric pain and «postive serum antibody for H. pylori. Which of the following would be considered the preferred inital therapy for H. pylori? a) PPI+metronidazoletlevofloxacin b)_PPl+amoxicillinHevofloxacin ©) PPl+amoxicilin¢clarithromycin 4) _PPl+metronidazolerbismuthtetracycline A patient admitted to the gastroenterology sevice and is being treated with sulfasalazine. Which ofthe following isthe most likely indication for this drug to be given 8) Antibiotic associated pseudomembranous colitis ') Echerichiacoli-induced diathea ©) Gastric [Link] infections 8) Uleerative colitis Which drug would be mos suitable fr the relief of some of the sigs and symptoms of encephalopathy in alcoholic patients? a) Esmoprazole b) Lactulose ©) Propranolol 4) Oweotide ‘Which of the following is proper nutrition counseling for patients who are being treated with warfarin? ') Avoid all foods containing vitamin K ) Avoid excessive alcohol intake a it decreases the effectiveness of warfarin ©) Maintain a consistent dietary vitamin K intake Nalmepene ©) bean 0) Oltine ind overeating are unugfl side effets associa with which of tae rugs? 1. Octreotide is used in all except: 8) Esophageal varices ) Carcinoid tumor ©) Acromeraly 6) Zollinge-Elison syndrome ‘Rufinamide i antiepileptic, specifically approved to treat: 2) tuberous sclerosis j b) Childhood absence epilepsy ©) Lennox-Gastaut syndrome )_Dravet syndrome Absorption of which ofthe loving din incre afer ty mes a) Amphotericin B b) Griseofalvin ©) Ampicilin 8) Aspirin Which ofthe folowing statements is correct regarding the facilitation of labour? 4) Intravenous Dinoprostone is the most commonly used drug for labour induction b) PGF2a analogues are ten times more potent than PGE? analogues on lcal application ©) Oral PGF2a isn’t used due to severe gastoinestinal toxicity 4) Oral oxytocin derivatives are superior to oral PGE2 analogues, ‘Best characterized mechanism of action of acamprosate is: 8) weak NMDA receptor antagonist and GABA A receptor activator increase beta endorphins ©) Serotonergic reuptake 8) peopioid recepor activity ‘Which ofthe following is FALSE about bisphosphonates? 8) Inhibit ostencast activity b) Used in osteoporosis ©) Cause esophagitis 4) Increase PTH secretion ‘Which of the following drugs has been FDA approved for Eyelash Hypotrichosis? a) Bimatoprost by Travoprost ©) Latanoprost 0) TafluprostMBBS Sent up examination 2025 (Batch 2023) Pharmacology Paper 2 ‘Tim[Link] hours she Max. Marks:80 Answer all questions. Answer section B & C in separate booklets. Section B 1, 52-year-old male presents with increased thirst, frequent urination, and weight loss forthe past 2 months. His random blood glucose is 286 mg/dL, and HbA Ic is 8.2%. He is overweight (BMI: 28.5 kg/m?) and no signs of organ damage. G+3+4) 8) What class of drug is preferred as first-line therapy in this patient and also explain the mechanism of action and adverse effects of the same. ') Classify insulin preparations based on duration of action with suitable examples, ©) Discuss the pharmacological management of Diabetic Ketoacidosis ‘DL Explain why @Bx5=10) 8) Explain why several of the highly selective COX-2 inhibitors have been withdrawn from the market. 'b) Oxytocin is preferred over ergometrine in induction of labour © Morphine is contraindicated in patients with head injury. @ Combining SSRIs with MAO inhibitors is contraindicated @ Tetracyclines should not be given to children under 8 years of age or pregnant women, J Write MOA, therapeutic uses, adverse effects Gx5- 10) 8) Alendronate b) Amphotericin B ©) Selegiline 4) Cyclosporine ©) Carbimazole Section C % A30-year-old woman presents with intermittent wheezing, chest tightness, and dry cough, especially early 4__in the moming and after exposure to dust. She has had similar symptoms on and off forthe past 2 years but ‘was never formally diagnosed. Spirometry shows reversible airflow limitation. (242424242) 8) Classify the drugs used in the treatment of bronchial asthma. Give two examples of each class. 'b) What role do inhaled corticosteroids (ICS) play in asthma management? List two common side effects. ©) What is the rationale for using ICS + LABA combination in this patient? 4) Therapeutic status of theophylline in bronchial asthma. ©) Management of status asthmatics Write stor notes 2) Difference beeen ypcal and sypical antipsychotics 'b) Post exposure prophylaxis of HIV infection. ©) Anabolic steroids d) Preanesthetic medications 6) Tero of empathy inte care of patients > Discuss in brief the pharmacological management of the following Gx5=10) 8) Chloroquine resistant falciparum malaria b) Multibacllary leprosy ©) Severe Migraine 4) Status epilepticus ©) Amoebic liver abscess