Mastering the BDS III

Year
(Last 25 Years Solved Questi
 JAYPEE BROTHERS MEdicAl
Hemant Gupta mdS Mastering the BDS I
New delhi | London | Panama (Oral and maxillofacial Pathology, microbiology and
PuBliSHERS Indore,
Shivommadhya
multispeciality
Pradesh,dental
India Clinic
Thoroughly Revised and Updated According to the Latest Syllabus of D
7th Edition
Forensic Odontology)
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(Last 25 Years Solved Ques
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stering the BDS IIIrd Year (Last 25 Years Solved Questions)

enth Edition: 2019
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To my wife Smita Sharma Gupta
Almighty SAI BABA
for being so much understanding and
My grandparents Shri HD Gupta and Smt
Last
Late
butShri
not VK my lovely
leastGupta angel
and Late Smt
sonAnju Gupta
Dedicated to
Vijaylakshmi Gupta
Meetaan Gupta
In loving memory of my parents
for making life worthwhile
 Preface to the Seventh
edition
Any
It isofa the
maꢀer
suggestions
of great pride
and criticism
and pleasure
should
to introduce
be welcomed
the seventh
at macrocyte@gmail.com.
edition of Mastering the BDS IIIrd Year (Last 25
Years Solved Questions). The aim of this text is to enable the student of dentistry to learn fundamentals. All the se
tions are rewriꢀen and the answers of each and every section are revised as per the latest syllabus. This new edition
is updated and expanded, bringing forth new information gained since production of last edition. The text has
been made more clinically oriented so as to beꢀer correlate the text with clinical aspects. The text consists of a larg
number of illustrations, which enhances the understanding of wriꢀen description. I, as an author, wish to express
my hope that material presented is clear and understandable. The book is never meant to replace any of the text-
book. All the respective textbooks of all subjects should be read thoroughly to gain the deep knowledge of subject.
This book provides an idea of questions and answers in BDS examinations and multiple choice questions (MCQs)
in pre-PG examinations. I hope that the content will be enough to stimulate the insight and new trends of thoughts
in all the subjects of IIIrd year.

Hemant Gupta
 Preface to the firSt
edition

The subjects of IIIrd year still ring fear in the minds of students—baseless fear that rest on silent assumptions
and those that distort thinking. However, self-study, dedication, motivation and hard work are the virtues that
It is a maꢀer of great pride and pleasure to introduce the first edition of Mastering the BDS IIIrd Year.
And last but not
go aleast,
longI way
thank inour
the publisher,
making ofShri
a genius—a
Jitendar success.
P Vij (Group
Listen,Chairman)
think, read
of and
M/sanalyze
Jaypee Brothers
with an open mind and you
books have got continued support and good response, we have kept the same basic paꢀern, but the sequ
Medical Publishers
definitely
(P) Ltd,
cannotNewgo Delhi,
wrong.India,
I would
for like
his whole-hearted
to clarify that this
support
bookand
is not
helpmeant
to make
to replace
this book
your
a reality.
standard textbooks,
chapters has been arranged in a simpler way for a wider and systematic coverage of the topics.
but yet coupled with your effort and sincerity, it will definitely make you clinch and help you put your best foot
forward to reach great heights of success.

Hemant Gupta
 acknowledgment
S

I am very grateful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Ritu Sharma
(Director–Content Strategy), Ms Sunita Katla (PA to Group Chairman, and Publishing Manager), Ms Samina
Khan (Executive
Thanks
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Heartily
to Mr to
Anupam
Achievement
thanks
Director–Content
to
Prasad
Dr of
Deepak
from
thisStrategy),
book
M/s
Aggarwal
Jaypee
wasDr
possible
(MDS),
Pinki
Brothers
Chauhan,
byMrs
Medical
theSangeeta
help
DrPublishers
and
Nidhi
Surange,
support
Sinha,
(P)
ofand
Dr
Ltd,
Almighty
Ambika
Mrs
Indore,
Kriti
SAI
Kapoor,
Madhya
Gorkhe,
BABA,Pradesh,
for
myhelping
grandpa
i
Dr Neeti Swarup
India,
(Development
for
arranging
his whole-hearted
my the
wife,
Editors),
appropriate
teachers
Ms
support.
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and
question
friends.
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papers.
(Cover Visualizer), and the whole team of M/s Jaypee
Special thanks to those who remain behind the curtain and help in arrangement of study material for the
Brothers Medical Publishers (P) Ltd, New Delhi, India, for all their support to work in this project and make it a
success. Without their cooperation, I could not have completed this project.
 ꢀ •ꢀ
ꢀ •ꢀ
ꢀ •ꢀ
1. Wound, Sinus and Fistula ꢀ •ꢀ
2. Acute Infections
20. STOMACH 3. Specific Infections 4. Diseases of Cardiovascular System
21. Operative Surgery 16. Neck Swelling
4. Ulcer
5. Diseases of Respiratory System
contentS
22. Neurological Injuries 6. Diseases of Renal System
17. Salivary 5. Lymphatics and Lymph Node Enlargement
23. Fractures of BoneGland 7. Diseases of Blood1. Introduction
18. yroid and Parathyroid6. Skin Tumors
Gland
8. Diseases of Endocrine System
2. Diseases of Gastrointestinal Tract
19. Tonsils 7. Bleeding Disorders
9. Nutrition and Metabolic
3. Defects
Diseases of Liver
8. Shock
9. Burn
SECTION
Multiple 2:
Choice general
Questions 10. Diseases of Nervous SECTION
System 1: general
FillꢀinꢀtheꢀBlanksꢀ
Surgery 11. Tropical and Infectious Diseases
medicine
ds of Surgery and Radiology 460 ꢀ •ꢀ 10. Arterial Diseases 12. Miscellaneous
11. Venous Diseases Viva-VoceꢀQuestionsꢀforꢀPracticalꢀExaminationꢀ250
12. Cyst AdditionalꢀInformationꢀ
13. Oral Cavity, Lip and Palate
14. Cleft Lip and Palate
15. Oral Cancer 137
312 143
376 261
313 165
426 ꢀ •ꢀ 383 273
322 253 189 110 20 ꢀ •ꢀ 3
426 ꢀ •ꢀ 397 281 37 ꢀ •ꢀ
335 214 9
434 ꢀ •ꢀ 402 297 70 ꢀ •ꢀ
337 231
444 ꢀ •ꢀ 99 ꢀ •ꢀ
243

409 VI. Forensic Odontology 25. Sterilization

425 21. Forensic Odontology II. Disturbances of Microbial Origin 26. Upper Limb Ischemia
342 IV. Disturbance of the
12. Metabolism
Spread of Oral infection 5. Cysts
6. Bacterial Infections of Oral
of oral Cavity
Cavity 27. Rectum and Anal Canal
Metabolic
343 16. Oral Aspects of 13. Diseases
Physical and Chemical
7. Viralinjuries
Infections of Oral cavity
Diseases Pulp and Periapical Tissues 28. Miscellaneous
AdditionalꢀInformationꢀ
357 V. Diseases of Specific System
of the
11.oral cavity of the
8. Fungal Infections of I. Disturbances
Oral Cavity of Development and Growth
302 III. Injuries
14. Regressive and Repair
Alterations 1. Developmental Disturbances of
17. Diseases of Bone and Joints 9. Diseases
of theofteeth
periodontium
ꢀChoiceꢀQuestionsꢀ 15. Healing of Oral Wounds 2. Benign and malignant oral
Oral and tumors of Structures
ParaSECTION
Oral cavity3:512oral
18. Diseases of blood and blood forming organs 625 10. Dental Caries
eꢀBlanksꢀ 3. Tumors of Salivary Glands MultipleꢀChoiceꢀQuestionsꢀ
19. Diseases of Skin Pathology
ceꢀQuestionsꢀforꢀPracticalꢀExaminationꢀ640 4. Odontogenic tumors FillꢀinꢀtheꢀBlanksꢀ
20. Diseases of nerves and muscles
alꢀInformationꢀ Viva-VoceꢀQuestionsꢀforꢀPracticalꢀExaminationꢀ482
tꢀClassificationsꢀ 540
548
553
601
631 562 463
603
642 562 466
610
644 644 568 466
615 493 493 485
652 644 573 466
615
630 576 470
618
638 580 479
618
590
 1. Introduction

4. Diseases of Cardiovascular System

8. Diseases of Endocrine
5. Diseases Diseases
of2.Respiratory Gastrointestinal Tract
SystemofSystem
Diseases
6. Diseases of3.Renal of Liver
System 1
7. Diseases of Blood

10. Diseases of Nervous System

General Medicine
11. Tropical and Infectious
9. Nutrition and Metabolic
Diseases Defects
Viva-voce Questions for Practical Examination
Multiple Choice 12. Miscellaneous
Questions as per DCI and Examina-
Additional Information
tion Papers of Various Universities
 ♦

♦ ♦ ꢀ

– ♦ – –
– – – causes of clubbing
– – –
•ꢀ Cirrhosis of liver Cardiac disorders
•ꢀ Tumorsꢀofꢀlung
•ꢀ Malignancy of liver Pulmonary disorders
•ꢀ Suppurationꢀofꢀlung
Disorders of endocrine system Lung abscess
Regional ileitis Mesothelioma
Bronchiectasis
•ꢀ Myxedema •ꢀ CyanoticUlcerative colitis Q.1. Enumerate the causes of clubbing.
congenital heart diseases
Primary lung cancer
•ꢀ Thyroid acropachy Metastatic lung
bacterial endocarditis Suppurative
cancer pneumonia
Malabsorption
•ꢀ Subacutesyndrome
•ꢀ Acromegaly •ꢀ Atrial myxoma Ans. Clubbing bulbous enlargement of soft part of terminal
Write
is aimportant cause of digital clubbing.
ꢀ Enumerateꢀtheꢀcausesꢀofꢀclubbingꢀofꢀfingers.ꢀ
Disorders of gastrointestinal system and liver Fig. 1: Clubbing Or
phalanges with both transverse and longitudinal Or
curving
1. IntroductIon
•ꢀ Inflammatoryꢀbowelꢀdisease of nails.

(Mar 2001, 5 Marks) (Mar 1998, 5 Marks)

2 Marks)
(Mar 2011, (Feb 1999, 4 Marks)

♦
♦
♦ ♦ ♦ ♦ ♦ ♦
General ♦MedIcIne
♦
♦
central cyanosis type of cyanosis Grades of clubbing
Peripheral cyanosis
Miscellaneous
•ꢀ Hereditary

ii. Peripheral cyanosis Grade

Q. 2. Write Softening
shortI:note of nail bed because of hypertrophy of
on cyanosis.
tissue at that site.
Grade II: In addition to grade I changes, there is
It occur because of poor oxygenation of blood
iii. Cyanosis duein
tolungs
abnormal pigments
curs because of removal of oxygen from the blood Generally, there are four types of cyanosis: obliteration of angle between nail base and adjacent skin
due to interference of exchange iv.ofMixed i.e. oxygen
gases,cyanosis. Ans.and
Cyanosis is a bluish discoloration of the skin and mucus
n circulation is slow due to congestive cardiac failure ofꢀtheꢀfinger.
i. Central cyanosis
carbon dioxide in respiratory failure or pulmonarymembrane
edema. due to reduced hemoglobin Or (more than 5 •ꢀ Unidigital:
•ꢀ Idiopathic
Traumatic or tophi deposit in gout
e to shock causing
Centralvasoconstriction.
cyanosis is visible at under surface of tongue and Grade III: In addition to grade II changes, nail itself
Central cyanosis is also visible in some congenitalmg%) heart
Writein blood.
short answer on cyanosis. (Apr 2018, 3 Marks) •ꢀ Only in•ꢀupper
Unilateral:
limbs Pancoast
in heroin tumor,
addictssubclavian
due to chronic
and innominate
can also occurmucous
in healthymembrane
people when
of oral
extremities
cavity and palate. loses its longitudinal ridges, becomes convex from above
diseases where deoxygenated blood from right side mixes obstructive
artery
phlebitis.
aneurysm
ery cold. downwards and from side to side. The nails assume
to the oxygenated blood from left side. This brings down
visible in lip, nail, tip of nose, lobule of ear. (Mar 1996, 7.5 Marks) "parrot’s
shape of(Apr 2015,beak" or terminal segment may become
3 Marks)
oxygen saturation of blood.
bulbous like a "drum stick".
Grade IV: Finger changes are associated with hypertrophic
pulmonary osteoarthropathy.
(Feb 2013, 5 Marks)
 ♦

♦ – ♦ ♦ ♦ 4
–
–
–
– Mixed cyanosis
– causes of cyanosis
–
Mixed cyanosis – Central cyanosis
♦ –
– •ꢀ Pulmonaryꢀcauses Normal hemoglobin has iron in ferrous form. In
•ꢀ Cardiovascularꢀcauses–
ferric form
methemoglobinemia, iron is in the cyanosis duedesignated
to abnormal Pigments
•ꢀ Acute left ventricular failure•ꢀ Abnormalꢀhepatoꢀpulmonaryꢀsyndrome High altitudes
Pneumothorax
Lobar pneumonia as methemoglobin. Several substances like nitrite
•ꢀ Mitral stenosis Peripheral cyanosis Severe acute asthma
•ꢀ Due to arterial obstruction Arterioꢀvenousꢀfistula
pulmonary
AcuteCyanotic edema
heart disease ingestion, sulfonamide or aniline dyes oxidize hemoglobin
•ꢀ Congestive heart failure
Cor pulmonale to methemoglobin, but this is immediately reduced back to
obstruction
•ꢀ Due to venous Q.3. Enumerate causes
•ꢀ Exposure to cold Due to combination of both the factors, e.g. cor
hemoglobin bypulmonale
methemoglobin
due reductase I or diaphorase
Cyanosis due to abnormal
Or of centralpigments
cyanosis. to pulmonary emphysema. I.ꢀIfꢀthereꢀisꢀdeficiencyꢀofꢀdiaphoraseꢀI,ꢀmethemoglobinꢀ
•ꢀ Methemoglobin formation
(Sep 1999, 5due to ingestion
Marks) Multiple small pulmonary thromboembolism
sulphonamide and aniline dye circulates in blood, causing cyanosis.
Chronic obstructive pulmonary disease Mastering the BDS IIIrd Year (Last 25 Years Solved
•ꢀ Sulfhemoglobin formation due to sulphonamide, Respiratory failure Sulfhemoglobin is an abnormal sulphur containing
phenacetin substance, which is not normally present, but is formed by
ionꢀofꢀtheꢀheartꢀbyꢀanꢀaccumulationꢀofꢀfluidꢀinꢀtheꢀpericardialꢀsac.ꢀ toxic action of drugs and chemicals like sulphonamides,
phenacetinꢀandꢀacetanilide.ꢀSulꢁemoglobinꢀformsꢀanꢀ
irreversible change in the hemoglobin pigment that has
no capacity to carry oxygen and causes cyanosis.

♦
♦
causes
Mechanism

•ꢀ Asthma
♦ꢀ Cardiovascularꢀcauses
•ꢀ High altitudes
•ꢀ Pneumothorax
•ꢀ Emphysema •ꢀ Lobar pneumonia
•ꢀ Airway obstruction Acute
•ꢀ •ꢀ Severe
•ꢀ Arterioꢀvenousꢀfistula
pulmonary
Cyanotic acute
edema
heart asthma
disease
Superior vena cava obstruction Ans. Refer to Ans 2 of•ꢀsame chapter.
♦ꢀ Abnormalꢀhepato Cor pulmonaryꢀsyndrome
pulmonale
Lung conditions Q.4. Enumerate the •ꢀ causes
ꢀ Q.5.ꢀ Describeꢀbrieflyꢀpulsusꢀparadoxus.ꢀ of cyanosis.
Ans. Following are the causes of central cyanosis:
Decrease
Decreasein inreturn
Pooling ofpressure
bloodof blood toless
blood in leftthan
pulmonary Ans.
and left
atrium vasculature The term
as the pulsus paradoxus is used to describe
•ꢀ Multiple small Pulmonaryꢀcauses
♦ꢀpulmonary thromboembolism
ventricle of lung expansion
10 mm resultInspiration •ꢀ
increasesand dramatically fall in blood pressure
Whenꢀtheꢀsystolicꢀbloodꢀpressureꢀfallsꢀlessꢀthan
venous intrathoracic
more return to right side of heart during inspiration,
•ꢀ Chronic obstructive pulmonary disease
Write important causes
and
(Pulsus pressure
there paradoxus)
is during
fall in left 10
active phase
ventricular mm, the i.e.
pulsecharacteristic
of respiration
output is referred of
to *tamponade,
pulsus pericardial
paradoxus. constriction
•ꢀ Respiratory failure
and severe airway obstruction. of central cyanosis.
•ꢀ Pulsusꢀparadoxusꢀisꢀtheꢀ*exaggerationꢀofꢀtheꢀnormalꢀ
(Mar 2011, 2 Marks)
phenomenon.
ꢀ *Exaggeration=ꢀGreaterꢀthanꢀitꢀreallyꢀis

(Feb 1999,(Mar 1998, 5 Marks)

3 Marks)
 ꢀ ♦
ꢀ ♦ ♦ ♦ ♦ ♦ ♦ ♦
♦
causes

•ꢀ Fever
Cardiac lesions •ꢀ Beri beri Physiological
Q9. *Tarry= Smeared with tar •ꢀ Liver
•ꢀ Paget’s cirrhosis
disease
•ꢀ Cor pulmonale Cardiac condition
•ꢀ Arteriovenousꢀfistula •ꢀ Chronic alcoholism •ꢀ Pericardialꢀeffusion
•ꢀ Systolic hypertension •ꢀ Pregnancy Waterꢀ hammerꢀ pulseꢀ isꢀ aꢀ largeꢀ boundingꢀ pulseꢀ withꢀ
•ꢀ ThyrotoxicosisHigh output states or syndrome
•ꢀ Anemia increased stroke volume of left ventricle and•ꢀdecrease
Constrictive pericarditis
•ꢀ Aortic regurgitation in the peripheral resistance, leading to wide •ꢀ pulse
Severe congestive cardiac failure
•ꢀ Rupture of sinus of Valsalva into heart chamber pressure. ꢀ Q.6.ꢀ Describeꢀbrieflyꢀwaterꢀhammerꢀpulse.ꢀ
Fig. 2: Water hammer pulse •ꢀ Patent ductus arteriosus Theꢀpulseꢀstrikesꢀpalpatingꢀfingerꢀwithꢀrapid,ꢀforcefulꢀjerkꢀ
(Sep 2009, 4 Marks) (Sep 1999, 3 Marks)
•ꢀ Aortopulmonary window and quickly disappears. Ans. It is also called as Corrigan pulse.
•ꢀ Bradycardia It is best felt in radial artery with patient’s arm elevated.
It is described as having a water hammer quality because
of its sudden impact and collapsing quality because it falls
away so rapidly.
The collapsing pulse caused by artery suddenly emptying
asꢀsomeꢀofꢀtheꢀbloodꢀflowꢀfromꢀaortaꢀtoꢀventricle.
sciousness,ꢀaccompaniedꢀbyꢀinabilityꢀtoꢀmaintainꢀanꢀuprightꢀposture

♦ ♦
causes Ans.
♦
clinical Features
•ꢀ Gastric ulcer.
Less common •ꢀ Gastric Common causes
•ꢀ Telangiectasia erosion •ꢀ Itꢀhasꢀnoꢀeffectꢀofꢀposture
•ꢀ Acute pancreatitis
•ꢀ Carcinoma stomach •ꢀ Duodenal ulcer and changes mandible
on position
has no
*anacrotic wave on Arterial
arechange
upstroke,pulse
•ꢀ Varices which on is not felt. This is
•ꢀ COPD •ꢀ Angiomas •ꢀ Esophagitis absent the wave
•ꢀ Polycythemia vera •ꢀ Bleeding diathesis followed by percussion wave
•ꢀ Aortic aneurysm whichꢀisꢀfeltꢀbyꢀpalpatingꢀfinger
•ꢀ Hypoparathyroidism.
Rare cases
Q.8. Enumerate the causes of hematemesis.
(Sep 1999, 4 Marks) •ꢀ Arterialꢀpulseꢀisꢀbetterꢀfeltꢀthanꢀ •ꢀ Venousꢀpulseꢀisꢀbetterꢀseenꢀ
Q.9. Write short note on hematemesis.(Mar 2009, 5 Marks) •ꢀ Thereꢀisꢀnoꢀeffectꢀofꢀabdominalꢀ •ꢀ Pressureꢀoverꢀtheꢀ liverꢀdis-
Ans. Rapid loss of blood from •ꢀ
a Changesꢀ
lesion in withꢀ seen
esophagus, in appearance
respirationꢀ •ꢀ •ꢀ
stomach than felt
Changesꢀwithꢀtheꢀrespirationꢀ
Normalꢀ pulseꢀ hasꢀ aꢀ
ꢀ Q.7.ꢀ smallꢀ •ꢀ Normalꢀvenousꢀpulseꢀconsistsꢀ
Howꢀwillꢀyouꢀdifferentiateꢀarterialꢀandꢀvenousꢀpulse?
Patient presents vomiting of blood or complaint of compression tends the vein
Ans.ꢀ with
ForꢀdefinitionꢀandꢀcausesꢀreferꢀtoꢀAnsꢀ8ꢀofꢀsameꢀchapter. or duodenum above the level of ampulla of •ꢀ Pressureꢀbelowꢀtheꢀangleꢀofꢀ
Vater will •ꢀ Pressureꢀbelowꢀtheꢀangleꢀofꢀ
passing the *tarry stools.
result in vomiting of blood. Section 1: General Medicine
up on bed

and position are present

•ꢀ Itꢀdisappearsꢀwhenꢀpatientꢀsitsꢀ of three positiveVenous pulse
waves and
mandible obliterates the wave
two negative waves
(Mar 2008, 2 Marks)

5
 ♦
♦ ♦ 6
♦ ♦ ♦ ♦
– ♦ ♦
– causes Specific Management
♦
– –
– – –
– – – General
– – –
–•ꢀ Iatrogenicꢀ – – •ꢀ Cardiacꢀ
– – –
– •ꢀ Immunologicalꢀ – •ꢀ Respiratoryꢀ
•ꢀ–Bleedingꢀdisordersꢀ –
Purpura
Leukemia Put the patient to the bed.
Causes for true hemoptysis
Agranulocytosis
Following bronchoscopy Mitral stenosis Arrange
Maintain fresh blood
nutrition transfusion.
and hydration.
Thrombocytopenia
Polyarteritis nodosa. Aneurysm of which
aortaincludes stained sputum.
Lung biopsy
Goodpasture’s syndrome Treat underlying condition appropriately.
Hematemesis is mixed with food particles.
Endotracheal intubation Wegener’sꢀgranulomatosisꢀ
Trauma to the airways and lung Q.10. Enumerate the
Anti coagulant therapy Pneumonia Manyꢀpatientsꢀwithꢀcoffeeꢀgroundꢀvomitingꢀareꢀpresent.
AV malformations. Once the crisis is over and bleeding subsides, than treatment
causes
Ans.ꢀ Hemoptysisꢀisꢀdefinedꢀasꢀcoughingꢀoutꢀofꢀtheꢀbloodꢀ
Pass a Ryle’s tube andofdohemoptysis.
constant
In cases
suction.
of severe
In cases
hemorrhage
of sus­ there may be fresh rectal
Hemophilia and anticoagulant therapy. Tuberculosis basic
is to be planned according to the(Feb disease.
2006, Drug­
Marks)
Bronchogenic carcinoma and adenoma pected peptic ulcer an antacid
2.5 in bleeding
gel formoris *giddiness
given too early.
and *syncope due to sudden hypo­
Left ventricular failure and primaryinduced hematemesis shall require symptomatic relief.
pulmonary
Pulmonary embolism volemia. Mastering the BDS IIIrd Year (Last 25 Years Solved
hypertension.
Lung abscess
Bronchiectasis and other infections of lung and
bronchi

♦
♦
♦ ♦ ♦
♦ ♦
♦ ♦ ♦ Ans.
♦
♦ Management Investigation
tysis.•ꢀ Reactionꢀisꢀalkaline mesis?ꢀ
•ꢀ Bloodꢀisꢀcoughedꢀup

on chest radiograph. Hemoptysis

pulmonary and cardiac disease

Causes for pseudohemoptysis

f origin of blood is known and is limited to one lung,
leeding lung should be placed in the dependent position
Establishingꢀaꢀdiagnosisꢀisꢀaꢀfirstꢀpriority.
oꢀthatꢀbloodꢀisꢀnotꢀaspiratedꢀtoꢀtheꢀaffectedꢀlung. •ꢀ Bloodꢀ isꢀ relativelyꢀ
•ꢀ Stoolꢀbecomeꢀrustyꢀnextꢀday inꢀ smallꢀ •ꢀ Bloodꢀisꢀinꢀlargeꢀamount
•ꢀ Stoolꢀisꢀtarryꢀnextꢀday •ꢀ Malignancy of mouth, pharynx and larynx
Whenꢀhemoptysisꢀisꢀmaintained,ꢀadequateꢀgasꢀexchangeꢀ Ans.ꢀ Hemoptysisꢀisꢀdefinedꢀasꢀexpectorationꢀofꢀbloodꢀfromꢀ
amount
•ꢀ Bloodꢀisꢀbrightꢀred,ꢀfrothyꢀandꢀ •ꢀ Bloodꢀisꢀcoffeeꢀground,ꢀmixedꢀ
ndotracheal intubation and mechanical intubation are
♦ꢀ CTꢀscan: blood
FullFor Hemodynamic
count and
peripheral hematological
lesion resuscitation
investigation and bronchoscopy
which
Q.12.tests.
Outline are
theseen is done.
investigation and •ꢀ Symptomsꢀ andꢀ
of signꢀ areꢀ
ꢀQ.11.ꢀ
hemop- Bleeding
ofꢀ •ꢀ•ꢀSymptomsꢀ spongy
andꢀ
•ꢀ Trauma signsꢀ areꢀ ofꢀ
of gums
mouth, inpharynx
scurvy. and larynx
Howꢀwillꢀyouꢀdifferentiateꢀhemoptysisꢀfromꢀhemate-
preventingꢀbloodꢀfromꢀspleenꢀintoꢀunaffectedꢀareaꢀofꢀlungꢀ respiratory tract, spectrum varies
mixedfrom blood
withmanagement
the sputum of
streakwith food particles
ecessary to maintain the airways. Chest
Bronchoscopy radiograph
to exclude for TB,
central pneumonia,
bronchial tumor,
carcinoma pulmonary
and •ꢀ Tuberculosis, syphilis or pyogenic infection of mouth,
and avoiding asphyxiation are the highest priority. sputum to cough up or large amount of pure blood.
alloonꢀcathetersꢀandꢀinflatingꢀballoonꢀatꢀtheꢀbleedingꢀsiteꢀ
to provideinfarction.
tissue diagnosis for the suspected. pharynx and larynx.
Keeping the patient at rest and partially suppressing cough
re helpful in control of the bleeding.
are helpful to subside bleeding. •ꢀ Reactionꢀisꢀacidic •ꢀ Bloodꢀisꢀvomited
aser phototherapy, embolotherapy and surgical resection
f involved area of lung are the other methods. Surgical
esection is done in life­threatening hemoptysis. Hematemesis
gastric or abdominal disease

(Mar 2000, 5 Marks) (Apr 1999, 5 Marks)

 ♦
♦
♦
♦
♦
♦
♦ causes
ꢀ i.e.
♦
♦ ♦ꢀ Immunological:
Peptic ulcer
Typhoid fever
♦ꢀ Traumatic: Ulcerative
Malignant colitis
tract
•ꢀ Serum sickness Crush injury. PortalGI
hypertension
•ꢀ Tuberculosis
•ꢀ Malignancy Q.14. Enumerate common causes of fever.
Assessment of alkaline phosphatase levels:•ꢀ Connective
If alkalinetissue diseases.
♦ꢀ Endocrine: Thyrotoxicosis, Addison's 2008, 2.5 Marks) (Mar 1998, 5 Marks)
(Sepdisease.
phosphatase levels are higher following infections are
♦ꢀ Metabolic:
ꢀQ.15.ꢀ Gout, porphyria, acidosis,
Ans.dehydration
•ꢀ Collagen disease, SLE,Followingꢀareꢀtheꢀcausesꢀofꢀfever:
rheumatoid arthritis.
suspected, i.e. biliary tract infections, alcoholic hepatitis,
♦ꢀ Hematological:•ꢀAcute
Drug hemolytic
fever crisis
♦ꢀ Vascular:
importantꢀinvestigationꢀinꢀcaseꢀofꢀaꢀprolongꢀfever: ♦ꢀ Acute myocardial infarction, pulmonary Q.13. Enumerate the causes of malena. (Mar 1998, 5 Marks)
Infections:ꢀBacterial,ꢀviral,ꢀrickeꢂsial,ꢀfungal,ꢀparasitic,ꢀetc.
primary and secondaries of liver, hypernephroma, Howꢀwillꢀyouꢀinvestigateꢀaꢀcaseꢀofꢀprolongꢀfever?ꢀ
Ans. Followingꢀareꢀtheꢀinvestigationsꢀwhichꢀareꢀcarriedꢀoutꢀasꢀanꢀ Ans.ꢀ Malenaꢀisꢀdefinedꢀasꢀtheꢀpassageꢀofꢀdarkꢀcoloredꢀbloodꢀ
♦ꢀ Physicalꢀagents: Heat stroke, radiation
embolism, ♦ꢀ sickness.
pontine hemorrhage,
Neoplasms: Bleeding
Fever may
etc. bediathesis, i.e. purpura,
present with any hemophilia,
neoplasm but leukemia.
cytomegalovirus
tuberculosis,withꢀthrombocytosis,ꢀfollowingꢀdiseasesꢀcanꢀbeꢀthinkꢀoff,ꢀ
ESR platelet correlation:ꢀIfꢀESRꢀisꢀmoreꢀthanꢀ100ꢀmmꢃ/ꢃhrꢀ
(Sep
lymphoma, militaryIfꢀESRꢀisꢀlessꢀthanꢀ100ꢀmmꢃ/ꢃhrꢀwithꢀthrombocytosis,ꢀ in stool.
♦ꢀ Miscellaneous:
2009, 5 Marks)Factitious
(Feb/Mar fever,
2004, habitual
5 Marks)hyperpyrexia,
commonly with hypernephroma, lymphoproliferative
infection. viral infection can be suspected. cyclic neutropenia malignancies, carcinoma of pancreas, lung and bone and
Serological tests: They are helpful in assessing enteric fever,
hepatitis, CMV infection, tularemia, secondary syphilis, hepatoma.
brucellosis, Q fever, amoebiasis, HIV.

♦
– ♦ ♦
♦ ♦ ♦ ♦
causes ♦ ♦ causes
Trauma.
♦ treatment
Renal clinical Features
–
­ ­
­
­ ­ ­
­ Imaging techniques:
­ Others ­ •ꢀ Glomerulonephritis Leg elevation of patient.
Primary Sodium restriction is done.
Secondary
–
Swelling appears on the feet and ankle.
Enumerate the
Q.17.Piꢂingꢀtypeꢀofꢀedemaꢀisꢀpresent.
i.e. spironolactone. •ꢀ X-rayꢀchest: In cases with prolonged fever when initial
Mesangial proliferative Diuretics should be used,
Alport’s syndrome
Infective endocarditis Management of causes of hematuria.
Obstruction
underlying of
disorder. Q.16. Write
inferior short
vena note
cava. •ꢀ CTꢀscan:
on pedal Provide
edema. excellent
(Sep X­
2005, imaginga in
ray is3normal,
Marks) second
obeseX­patient.
ray must be taken after
Mesangiocapillary
Fabry's disease erythematosus
Systemic lupusBerger’s ACE inhibitors (Sep
are 2008, 2.5 Marks)
given. Ans.ꢀ SOL in liver is more than cm and
three1weeks
Pedalꢀedemaꢀisꢀdefinedꢀasꢀswellingꢀofꢀfeetꢀandꢀankleꢀ to CNS lesion
rule out is more
military tuberculosis.
disease
Benign familial hematuria
Polyarthritis nodosa Ans.ꢀ than 0.2 cm. •ꢀ Ultrasound:
causedꢀbyꢀcollectionꢀofꢀfluidꢀinꢀtheꢀtissuesꢀandꢀisꢀaꢀ Excellent imaging is done in thin
99m
Hematuriaꢀisꢀdefinedꢀasꢀpr •ꢀ Radionuclideꢀscans:
possible sign of congestive heart failure. Tc­sulphur
individuals andcolloid is used for
poor imaging in obese individuals,
esenceꢀofꢀbloodꢀinꢀurine. scanning liver and spleen.
SOL 111inIndium
hepatobiliary
labeledtree Section
leukocytes
of more than 1: General
1 cm and Medicine
are used for detectionendocarditis vegetation
of intra­abdominal mass.of more than 2 mm can be
detected.