IN} Exam + 2017 fafieer-faaa (3ea-aa-I1) are: aa ave, afta si : 250 Wawa were fase aya (pam wet % om Ha od Frafafts we ages eras va) eal one ver $1 a wel Hatt & cen feet Gi otitoh aT A wd A wari a ga vie oe % sae 2 a1 we ten 1 sit 5 afiard & aan arf wet 48 wee ave a an Ba ew we Ge Ha ae oe aI wate waar %& fee Fad sim sath UPA fee me eI reat 5 se eA pa rem H fer oA say, Fre Sera ons wwe Heat ea 8, sie ATO a EW Bja We-we-3M (Ho Slo Uo) yferat & Hage we Plge ea fren ser safe! Sigfead HIeTH % aAfale =r ref rem % fora me aoe aE sis wei fret vet A wee vin, af fate &, a1 ager fen oer area) vel adi of ora ard, ofa tenes a ata arm ara sei Al caren Are) ga Bq Sh BRR ar set fara waa z1 weal & aad A orn sengan AL sreH ae are ae A, a ver H see AM oT Al SH aR ge Se ier: eT ean Bt wees Gera FH Urehh StS RM YU A Sa si Sl BE | a areal se sea STH-D-MDCS MEDICAL SCIENCE (PAPER-II) Time Allowed : Three Hours. Maximum Marks : 250 QUESTION PAPER SPECIFIC INSTRUCTIONS (Please read each of the following instructions carefully before attempting questions) There are EIGHT questions divided in two Sections and printed both in HINDI and in ENGLISH Candidate has to attempt FIVE questions in all. Question Nos. 1 and 5 are compulsory and out of the remaining, THREE are to be attempted choosing at least ONE question from each Section. The number of marks carried by a question/part is indicated against it. ‘Answers must be written in the medium authorized in the Admission Certificate which must be stated clearly on the cover of this Question-cum-Answer (QCA) Booklet in the space provided. No marks will be given for answers written in a medium other than the authorized one, Word limit in questions, if specified, should be adhered to. Illustrate your answers with suitable sketches and diagrams, wherever considered necessary. Coloured pencils may be used for the purpose. Attempts of questions shall be counted in sequential order. Unless struck off, attempt of a question shall be counted even if attempted partly. Any page or portion of the page left blank in the Question-cum-Answer Booklet must be clearly struck off. ST h-D-HAWES/37 1 [P.-T.0,Ws—A / SECTION—A 1. (a) Road we at 4 wm 23 af A fee gat 4 de ae orem ar see FT| saat Fa SM TT aT k? am geal Rem sik wpe saad feeEr ar weer a at? A young 23-year-old lady had attempted suicide thrice in last one year. What is the cause of her condition? How do you diagnose and manage Major Depressive Disorder? 10 (b) 40 a an ges Roe a ast @ seit aah otk uRalta aia anradt @ Peet aaTH 2) ar-@ fates Feri ar aa fan ati? ong seals git Actes fies a ‘waif EA? A 40-year-old man gives history of gradual loss of weight and altered bowel habits for last two years. What differential diagnosis would you consider? How will you manage Idiopathic Tropical Malabsorption Syndrome? 5+5=10 (oc) siteaPeacear (gatanfttarfi) % fara Fr-ae 8 8? gear Acts met wa 8? What are the principles of Echocardiography? What is its diagnostic significance? 5+5=10 (@) wb Rig +1 34 eae A ania He wee BST; TH Ya ae Mt Sa ae Gee Sera Bl ra 21 @ 7 fag aoe dee S aeapl wel a aiae Ahi! (i) er Gare Peg & de HI apa Fifa) (i) oy 4 wae A eR a AAAI A baby is delivered at 34 weeks of gestation; develops respiratory distress soon after birth. (i) List the important causes of respiratory distress in this baby. (i) Mention the pathogenesis of Respiratory Distress Syndrome. (ii) Outline the management of the baby. 243+5=10 ©) @ TAA 5 ad A ong 8 yea Org % eel are aa Be Afar Mention the important causes of mortality in children under 5 years of age. () Tai 3 da see Her ote A a eR GA atch Aad wt aaiae Aire! Enlist the vaccines which can reduce the incidence of Acute Respiratory Infection in children. (ii) TIT A TA TH Wo ao Alo (TAG vie fay) GeO A A HAH sai a 3a Af Mention the measures to reduce mother to child transmission of HIV (Human Immunodeficiency Virus) infection. 2+2+6=10 STH-V-NWCS/37 2«2. (a) (b) (©) 70 aS ge yea A Teh A ase He dees (RIS) oT SE of aT atea safer ae om) SB Syed A aT AT sad Se A arrs asia cet an 8? erates freeesiisa ar ony Ha veins ata? A 70-year-old man was found comatose on the road by a passerby. There were no external injuries. He was brought to the casualty. What are the common medical conditions in his case? How will you manage Diabetic Ketoacidosis? 10+10=20 we 2 me & fig A Sate eae (aaa) 2) ae era FA AR A TH 41 (@) a Wea we yas} aa sed erate (aries) ea oi & fates fer a watag Fhe) (i) Jarre waite (aris) ea Hit A saat a aga Fife (ii) rates (aries) ek & wer A Setar weqa Fire) A 2-month-old infant presents with Central Cyanosis. He had two episodes of cyanotic spells. () Enlist the differential diagnosis of Congenital Cyanotic Heart Diseases with reduced pulmonary blood flow. (i) Mention the complications of Congenital Cyanotic Heart Diseases. (iii) Outline the management of a cyanotic spell. 44447215 45 af } asm yea St aaa @ Silas %, a fod uw ad Al Tale BAR sik st 4 gad gaet aret aida Rafal @) aden ae aw Ae, we, aad sik faa oth afeanttna gach arch faaftat ar vor semi get caer Gre, yeh, yeahhh aa, aTea-site cafe oats Oy se werent ar eer ware @ sive Safa far ear 8? (i) eR an % are A wails FAS fore ong a-S wham gH? das A avis ifs (ii) TY Fs ASH WES HT TER a SHA? A 45-year-old gentleman, agriculturist by occupation, presents with recurrent itchy scaly lesions over face and limbs of one year duration. Examination revealed hyperpigmented scaly lesions over face, neck and upper and lower limbs. There were involvement of skin creases, eyelids, retroauricular areas and nasolabial folds. He gave history of photosensitivity. () What is your likely diagnosis? (i) What tests will you perform to establish the cause of his condition? Describe in brief. (iii) How will you treat this gentleman? 5+5+5=15, STh-B-PIWCS/37 3 [P.7.0.3. (a) am Ria da ox A afte ww 30-aia HER a gE A ores fawn A oda sae A aT Ta) (ye ha rT aT A aaa B? (i) ara Sart afer ar to-Rer aie wee 8 se? (ii) Ge Fore PSIG GH BH-S #7 A 30-year-old labourer, with high fever of three days duration, was brought to emergency in hospital in semiconscious state. (i) What are the likely causes for it? (ii) How will you diagnose and manage Japanese Encephalitis? (iii) What are the bad prognostic indicators for it? 8+7+5=20 (bo) & 4-avia wen gfetem (see gia) ait were thas a afta 81 as a Pee sata eT) () Pee Fer a ea Af Gy Sifeore MH % fer % fea ores aie a aga Ae) (ii) FA A SAfsons Wit H water A wrtar vega Ai A 4-year-old child presents with stunted growth and moderate pallor. The child had history of intermittent diarrhoea. () Mention the differential diagnosis. (i) Mention the investigations required for diagnosis of celiac diseases. (iii) Outline the management of celiac diseases in children. 3+6+6=15 (o) 30 a A afer & srd sik fae sii A usp aA a Gael aref feaftal 8) wen ae ei, werd sit smaiel % sae ag esi see ve ate waar | 1 AM sik heh fafeasit Al safeeia arf wa 81 () fated Ren on agai % fem ft sa ait A ora wha Bt? (i) Fram a afifira aa fore sm aha-a adar HEA? (ii) A ea fee a1 TAK Ha FA? A 30-year-old female presents with itchy lesions over upper and lower limbs of one month duration. On examination, multiple discrete flat-topped skin- coloured and violaceous papules were present around ankles, wrist and forearms. () Which other areas will you examine to arrive at a clinical diagnosis? (ii) What are the tests will you perform to confirm the diagnosis? (iii) How will you treat this lady? 5+5+5=15, 4. (a) we 20-aia vagae wove feed & me Sqeed A ae va sam or 220/130 mm Hg %| frod & staat x of sear cra aga sift sfgfesd fan wT aT fates Ran a 2? amg aah ats sik wae FS ahh? STih-B-HIWCS/37 4A 20-year-old young man was brought to the casualty with severe headache. His blood pressure was 220/130 mm of Hg. On previous two occasions also his BP was recorded very high. What is the differential diagnosis? How will you investigate and manage him? 20 (ob) & 3-afa cen ara sis @ afea 81 @) Paes fer a ane ARC (i) ee en ee ee q (ii) Rige-sRO sada firge } oR A eran Ac) A 3-year-old child presents with generalized oedema. () Enlist the differential diagnosis. (i) Mention the investigations required for diagnosis of Idiopathic Nephrotic Syndrome. (ii) Outline the treatment of Steroid-Resistant Nephrotic Syndrome. 3+6+6=15 () & S-atia aan Rad 2 aa 8 ag, abit she Hab S see eer _ quell are Preiga yfarst ft safeafa fear 21 sat eater sik agel 4 ge seem year i 8) sa aa weet of eh aif rar wHET FI (@) sen ana Fer an 8? (i) Sa ee GM FFT SRM ze? (ii) aM > sean % fae sores ta wa Best GR S aA ae zai) a Fr feat we ca om A ae an a Are AS-year-old male child presents with generalized itchy excoriated papules over trunk, limbs and genitals of two weeks duration. There were few papulovesicles on palms and soles. His other sibling had similar skin problem. () What is the likely diagnosis? (ii) What is the cause for his condition? (iii) Enumerate the various topical preparations available to treat this condition. Describe the method of application of one preparation. 5+5+5=15 Ws—B / SECTION—B 5. (a) 40 a4 A Hd after wt dha Sod Salta Her otk afte se ate GT GH & ae sedi & are Sagar’ Paar Hiren aan) geen BAe are sreaas wee (eres eIN) Fare oe 7A @ we faerie an a an fem 2? aa @ gaan feei-teera sik fates fer ae (i) PfefaPentie & Pred frreesia % sees Ft etter ega Are STih-D-PAWES/37 S. [P.T.0.A 40-year-old female fair in colour presented in casualty department with history of severe upper abdominal pain and vomiting after heavy fatty meal. On examination, tenderness is present in right hypochondrium. () What is the diagnosis of the above-mentioned clinical condition, its etiopathogenesis and differential diagnosis? (i) Outline the management of chronic cholecystitis with cholelithiasis. 5+5=10 (o) & 75-a8a Fe wes 4 oats & wre a a a Seer (GR Pa) Ban eT) FeTA aha & ore wer vila yeas (Wee) feats sofa ven ATI @ fer ak aah sia A fee ee) (i) See ans ee A etter wee AE) A 75-year-old male presented with acute retention of urine with haematuria. On per rectal examination, hard nodular prostatic enlargement is present. () Discuss the diagnosis and its investigation. (i) Outline the management of the above-mentioned condition. 5+5=10 (o) Site defer & fare eran: Se A a ach fatal a PrreR) wee AAR ar sie ate wat Enumerate commonly used methods of female sterilization. What are the advantages and disadvantages af each method? 545-10 (@) afres fotefaes Seieisi a oferta fe) erarera: sede A SA atch sa Met ffeeet a aaa 4 aga Are) wee fale & que sik fiftsant gar 8? Define Assisted Reproductive Technology. Mention briefly the commonly used reproductive technologies. What are the indications and contraindication of each method? 2+4+4=10 fe) () gia-aiia sea (grata eft) en &? What are trans-fatty acids? (i Fr-ar a ara-rerd zeae oa} qe ala 8? Which foods are major source of trans-fatty acids? (iy) ager arco =A af zieeaeta orci a aa Tes 8? What is the significance of trans-fatty acids from public health viewpoint? 3+3+4=10 6. (a) waah Tra (Ho the wo) a uefa Af) flo Ho Uae & Ha-S wren 8? waa H Ta ‘are the fio tao % a ar sig a wees FA? the tho Wao % Haan Bg daa & aa A fear Sire) Define Postpartum Haemorrhage (PPH). What are the causes of PPH? How would you manage the case of PPH just after delivery? Discuss the preventive measures for control of PPH. 2+4+7+7=20 STih-D-PAWES/37 66) Weer % are, Be ots wa arden & aa feoeia wretches & wes A ee Aaa) Discuss the causes of Benign Breast Disease, its investigation and management of bilateral fibroadenosis with mastalgia. 5454515 (SrA Men ater aR aa aT 8? What are the primary objectives of Janani Suraksha Yojana’? (i) wa At A yea Parent en 8? What are the salient features of this scheme? (it) “Saree aise’ gear 2? ae Se Gear sen S HS gel 2? What is the ‘Vande Mataram Scheme’? How is it related to the Janani Suraksha Yojana? 5+5+5=15 7. (a) && 25-afa Tah A A a aa eadl seta stem a dea 2, fel ea a aA aga tok ma an aH Ft Sada aoe | arf sie Star 4 ge, Sefee oa eH eT @ sae a 4 Rites Fer Al fae Alfie) fi) sta ok ae frat a aga ARI (iy) Series sen & wer A eater wea Afra) A 25-year-old male presented with history of off and on central abdominal distension with evening rising temperature and weight loss. On abdominal examination, firm, non-tender lump is present in right iliac fossa. () Discuss the differential diagnosis of the above-mentioned case. (ii) Mention the investigations and its findings. (ii) Outline the management of ileocaecal tuberculosis. 8+6+6=20 (o) () Ter aro career fea (GHo sike Udo UHo) % sinia anf canea Baril AY der a eae FO % faq en chads fq oe A? Under the National Rural Health Mission (NRHM), what are the changes being carried out in the rural healthcare infrastructure in order to strengthen it? (i) ae ORR Fea 8 were fafa thee aries aA cts oof eareea fiers aT ‘sit at fea a 8? Which of the existing programmes of Health and Family Welfare have been integrated into the National Rural Health Mission? 10+5=15 (o) we 40-asia niger 9 oranda 3 ara areola flrteg! wrgatgs Tiere & fata wee eT 87 wergaigs mafera % apreor srearda B fea WH 40-aeia aiken & Se ar veer sry Bas? Enumerate the common causes of menorrhagia in a 40-year-old woman. What are the different types of fibroid uterus? How would you manage the case of a 40-year-old woman suffering from menorrhagia due to fibroid uterus? 5+3+7=15 STih-B-HNBCS/37 @ [P.T.0.8. (a) ‘Ris Ao ato Best’ wa wer wh Ales Go Hho Geil a alts Rare ca frases uftada @1 (9 we sigh, ce, Hla H yen cer Teas wa, fire veer 4 faire aa sige we ara 8? (i) eae Goa BA A Ger qed an-er 8? (ii) ee A | FA} foe ae-Aa aeH so IM saws 2? ‘The End TB Strategy’ is a logical evolution and a paradigm shift from the past global TB strategies. (i) What are its vision, goal, milestones and target indicators that are set to be achieved in specific future years? (ii) What are the major hurdles which stand in its success? (ii) What steps are required to overcome these hurdles? 6+6+8=20 () wie dz Ghee) A ver Are) THis sie Al falta eat a Page! sa ara = free St ater sit 3 rT wae Fl UH 38-asia afgen a HF, fare sa vRa yO a fen %, ora ala feet ara aaa vi a weiv BA HLA? Define prolapse of uterus. Enumerate different degrees of prolapse of uterus. Enumerate the factors leading to prolapse of uterus. How would you manage the case of 3rd degree uterovaginal prolapse in a 38-year-old woman who has completed her family? 3+3+4+5=15 (co) 35-a8a yea wee R arafers gdzameT gam AAT whan HF ae fegPentea afk ste ra 7a Set A = 120/fer, The 90/60 mm Hg sik aaA HX 32/Prre A) aa HK ta safe en atk arli aa Gar aE ae ae a oh aioe aA ea ta (RY) Ste aha (eRRA) Te WaT SATE (Re) STRAT aT (y Rae fer A Bea Afr (i) Sa Sa Ba BEA? (iti) soe PaRrcechia oitges ar ster aarge) A 35-year-old male sustains road traffic accident. On general examination, he is oriented and pale, pulse rate 120/minute, BP 90/60 mm of Hg, respiratory rate 32/minute. Chest contusion is present and right chest wall with decreased movement. On auscultation decreased breathing sound (Rt) with stony dullness (Rt) on percussion. () Discuss the differential diagnosis. (i) How would you investigate? (ii) Give the treatment of the above-mentioned clinical scenario. 5+5+5=15 kak STih-B-FNBCS/37 8 SB8—670