SHAHJALAL UNIVERSITY OF SCIENCE & TECHNOLOGY, SYLHET

Final Professional MBBS Exnmination, November 2019

Subject: Medicine, Paper• I, Type: SAQ
Total marks: Seventy (70)
Time: Two hours and thirty minutes
(All questions carry equal marl<S. Answer any seven questions from cnch group. Use separate answer script for
each group)
,-. '
Group A

/ A 30-year-old woman presents with palpitation and exertlonal brea~hlessness for six months. Examination of
precordium reveals loud first hieard sound and a mid diastolic murm ur at t.he apex. "'<::.
a) What is the most likely diagnosis? 1
b) Mention investigations to arrive at a diagnosis along with expected findings. 2
/ , , c) Write down complications that may develop If she is left untreated. 2
/ · •. ~SO-year-old man who has been suffering from clironiic obstructive pulmonary disease, pre~ents in the
emergency department with severe respiratory distress, fever and expectoration of productive sputum for three
days. Examination reveals his blood pressure is 130/80 mmHg, pulse rat e is 110/min having cyanosis ahd
bilateral rhonchi. £.-. , -:::s~' _.
a) Mention appropriate investigations t61at will hielp you to manage him properly. 2
b) How would you treat him? 3
3./4 45-year-~ld man presents with gradually developed ascites for two months.
/ a) Write down some important differential dia.gnoses. 1
b) Mention check list in the history and physical findings that you would look for during his clinical
evaluation. 2
c) How would you investigate him? 2
4_,/A 25-year-old lady presents with 6ever and gum bleeding for two weeks. On examination, she is severely
L anaemic. ~ ~
a) Mention two omportant differential diagnoses. 1
b) Mention other findings that you wo~ld expect during physical examination. 1.5
./.4. c) Write down investigations along with expected findings in this case. 2.5
)K. A 35-year-old man is brought to the emergenc'f_de_partment in an unconscious st~_te. l::le Jtas_b.e.en.suff.ering from
;f type 1 diabetes mellitus for the Oast 18 years.
a) How would you differentiate hypoglycaemia from diabetic ketoacidosls at bed side? 2.5
b) How would you treat him if blood glucose is 1 mmol/1? 2.5

ft A 35-year-old diabetic @dy presents in the outpatient department for routine follow up. Her blood pressure is
160/100 mm Hg and BMI is 4~kg/m •
2

a) Classify obesity according to BMI. 1

b) Mention some potentially reversibl@causes of obesity. 2
/ c) Mention other compMcations of obesity. 2
/j_ A 40-year-old man presents with frequent passage of loose stool with signifl.cant weight loss for 3 months. On
examination, she has anaemia, angular stomatitis and glossitis. ~ ~
a) What are differential diagnosis of such presentation? k---' 1
b) What are the other points that you would search during history taking and physlca.1 examlnatlon?2
c) How would you investigate him? 2
~ A 30-year-old man suddenly develops collapse and respiratory distress just after giving intravenous ceftriaxone.
f- Physical examination reveals blood pressure is unrecordable and there Is bilateral wheeze on chest auscultation.
a) What is the most likely ctiagnosis7 1
b) MenHon other features that may have in such case. 1.5
c) How would you manage such case? 2.5

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0 ..... Group B
I

9. A 7O-year-old man presents with s-evere body ache, generalized weakness and easy fatigability for 2 month( Full
blood count reveals Hb - 6.7 gm/di, total white cell count- 3,1OO/cmm, neutrophil- 65%, lymphocyte - 33%,
eosinophil - 2%, platelet - 8O,OOO/cmm and ESR ls 150 mm In the first hour.
a) What is the most likely diagnosis? 1
b) How would you further investigate him? 2.5
A)c) Mention possible complications that may develop if he Is left untreated. 1.5
(}!!/A 4O-year-old woman presents with arthritis involvlng smalAJoints of hands and both knee for 2 months. 'l ~
· - a) Write down important differential diagnoses In such case. 1
b) How would you differentiate Anflammatory arthritis from degenerative arthritis at bed side?2
c) Mention investigations for her along with reasons for selection. 2
~A 48-year-old male who is alcoholic for the last 15 years presents with altered behavior and sleep pattern for 1
month. Physical examination reveals ascites and splenomegaly. ~E
a) What is the most likely diagnosis? 1
b) What are other signs ~hat you would look for during his clinical evaluation? 2
c) How would you select investigations for him along with reasons for selection? 2
:µ(A SO-year-old man presents in the emergency depa~ment with severe breathlessness. His blood pressure is
/ 220/120 mmHg, pulse rate Is 12O/min with regularrhythm, apex beat is heaving and there is bilateral basal
crepitations. L v~
a) What is the most likely diagnosis? 1
b) Write down investigations for him along with expected findings. ~
c} How would you treat him? 2.5
13. A 55-year-old man who s~okes heavily presents with right upper chest pain and cough for 1 month. Recently he
/ develops streaky haemoptysis on several o~casion,s. He has no history of fever. Chest examination reveals dull
percussion note and reduced breath sound at the right upper chest anteriorly. c::.~ .
a} What is the most like0y diagnosis? · 1
b) Write down non p~,-~on~-ry manifestations of the disease. 2
. _ c) Write down investigations to establish diagnosis. 2
• ,4,.((_newly ma~ried !ady presents with.fever wi~h chills and burning micturition for 3 days. c..-, - 6 ·
7 · : -,
....... •
a) How would you investigate and treat ~er? _. .
• ~ . . ii'- .. ... -
_
- .: • - -
_ __
- -
,3 .
- - -

- · ·b) Discuss non pharmacological management of such patient to prevent recurrence. 2

~ 17-year-old boy presents with anasarca for I month. His blood pressure is 110/70 mmHg_and urine
examination reveals proteinuria ++++but no RBC or RBC cast. N <.
a) What is the most likely diagnosis? 1
_./
b) Write down possible m~chanisms for developing anasarca in this case 1.5
c} How would you investigate him to establish diagnosis? 2.5
J-6· A 4O-year-old lady presents with lethargy, gradual weight gain, constipation and somnolenc~ for 3 years. H:r
puAse rate is SO/min with regular rhythm and blood pressure is 150/95 mm Hg with coarse skin. She has a history
of radloiodine ablation of thyroid gland for Graves' disease four years back. »':)~c.,½ · ~
a) What is the most likely diagnosis? 1
b) How wou~d yo l!l investigate her? 2
c) How would you treat her? 2

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 SHAHJALAL UNIVERSITY OF SCIENCE & TECHNOLOGY, SYLHET.
Final Professional MBBS Examination, November-2019
Subject: Medicine, Paper-II (Two) Type: SAO

Full Marks: 70 Time: 2:30Minutes

Use separate answer 5Crrtpt for each group.

Group: A

Answer any 7(Seven) questions from 8{Elght)

Q.1. A 25 years old Garments worker of G3Zipur has admitted in the medicine ward with the
complaints of high grade double peak fever, weight loss for .20 days with good appearance. He
also complaints of dysentery for the last 5 days. 1+2+1+1
a) What is the most probable clinical diagnosis?
b) I-Yow will evaluate the patient clinically?
c) Write down the name of investigations for this case.
d) ntion the c.omplications of this condition.

20 years young lady presented with H/0 low grade fever, headache, vomiting for three weeks. Examination
e aled the patient is confused, disoriented, neck rigidity with 3rd cranial nerve palsy. 1+1.5+2.5
a) What is your probable diagnosis? 1

b) How will investigate the patient?

c) How will you manage the patient?

~ O years old man presents with the history of recun·ent fall. 2.5+2.5
a) How will evaluate the man?
b) Write down the measures to prevent such type of fall.

la:'~A 50 years male patient admitted in male ~edicine wara brought f~om Dhaka Sylhet high
~ - · On examination his pupil was constricted. . . 1+4
a) What is your probable diagnosis?
b) How will evaluate and manage the patient?

th~
.-: - · ~--•-. 0 :}?'A-nurse working In TB-clinic pr;;;~ts with an a~ esthetic patch on the left forearm with
dlickened left ulnar nerve. . 1+1.5+2.S
a) What is your provisional diagnosis?
b) How will you confirm your diagnosis?
c) Write down the treatment schedule of this•patient.

n/
/v. a) Write down the DSM-V criteria of schizophrenia
2+1.5+1.5

b) What are the differential diagnoses of schizophrenia?

· c) Name three typical and two atyplcaA anllpsychotic drugs with their side effects.

i
Q { young adolascent boy presents to you with papulo-pustular, nodular lesions on Iha back
A and white head on the face.
a) What is your probable diagnosis?
1+1+1.5+1.5

b) How will you confirm your diagnosis clinically?

c) Write down the aetiopathogenesis of such lesion.
d) How will you treat such case?

3+2
a) Write down the chromosomal abnormality and clinical features of Turner's syndrome.
b) What are the methods used in prenatal testing of genetic diseases?

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 Group: B-1
Answer any 5 (Five) questions from 6(Six)

An 1 ~ years old female child presented with fever and arthritis for 2 months. On examination , she has
0.1 rash rn the body and oral ulceration. ,.

a) What is your most probable diagnosis? 1+1+1.5

b) Mention 2 important treatment options for this girt.
.
c) How will you give serological follow up of this case?
2
A days old_baby presented with deep jaundice extending up to palm and sole. On query, mother's

~ blood group Is 0-negative.

a) What is your probable diagnosis? 1+1.5+1
b) How will you investigate the baby?
c) How will you treat thf s case?
A .
2 years old boy presented with fever and maculopap ular rash all over the body.
l,,ef.3 a) What are the possibilities ? 1+1+1.5
'-,.. b) Write down the common complicatio ns of measles.
c) Name the vaccine currently given in EPI schedule of Bangladesh.

A 7 years old boy presented with fever for 4 days, convulsion for several episodes followed by
(?:'4 drowsiness for last 1 day. On examination , neck rigidity present. 1+1+1.5
,v
a) \-\'hat is the most likely diagnosis?
b) How will you investigate in this case?
c) How will you treat this boy?
A 1 month old infant presented with prolonged jaundice, poor feeding, hoarse cry and umbilical hernia.
a) What is your provisional diagnosis?

¥ b) What are the investigatio ns will you suggest to reach the diagnosis?
c) Outline the plan of manageme nt of this case.
1+1+1 .5

r Regarding IYCF-

a) Define IYCF.
b) What are the component s of ❖YCF .
1 +1+1 .5

c) Write down the advantages of breast feeding in children.

. GroupE11-i --- _ _ _
Answer any 5 (Five) questions from 6(Six)

~ 7 year-old boy presented with difficulty of walking for 7 days. His weakness was initially in both
lower

, Vi limbs, later involved both upper limbs. He had h/o gastroenter itis 1 week back. On examinatio n, his all
deep tendon reflexes are absent.
1+1+1.5

a) What is your most likely qiagnosis?

b) Write 2 important investigatio ns for this boy to reach your diagnosis.
'
c) Write down the plan of treatment.
A 2 years old female baby admitted with severe acute respiratory distress.
1+1+1 .5
a) What are the possible causes?
to reach the diagnoses?
Q.2 b) What histories and physical examination s do you expect
c) Outline the investigatio ns plan with interpretatio n.
A 2 years old child presented with repeated chest infection, bowing of both legs. On examination,
beading of costochond ral junction and Harrison sulcus present.
1+1 .5+1
a) What is your provisional diagnosis?
? b} What investigatio ns will you suggest to reach the diagnosis?
c) How will you treat this case?
A 6 years old boy presented with scanty micturition and high colored urine. He had h/o sore throat 2
weeks back. On examination , he had puffy race and BP is 140/100 mm of Hg.
1+1+1.5
a) What is your most likely diagnosis?
...~ b) Write down the investigatio ns plan with expected findings.
c) Outline the treatment plan for this boy.
A 3 years old boy presented with severe gum bleeding followed tooth extraction. H~ had h/o prolonged
, bleeding and easy bruising following minor trauma since his early infancy.
ai 1

l a) What is your provisional diagnosis?

b) What are the Investigatio ns you can do in this case?
1+1+1 .5

C) How will you counsel the parents of this boy?

A 2 years old female baby presented with bipedal oedema and h/o gross feeding mismanage ment. She
is weighing 6.5 kg.
1+1+1 .5

a/ a) What is your possible diagnosis?

b) \Nhat are the immediate complicatio ns may arise in this case?

\..
c) Outline the principles of manageme nt of this baby?
L
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 FinaJ Professional MBBS Examination. November, 2019 CurricuJurn-2012
Sub·ect: Sur e Pa er- One SA
Full Marks: 70 Time: 02 hours & 40 minutes
Marks are mentioned against each question.
Answer 5(Five) questions from each group.
Use separate answer scripts for each group.
Question No. 4,5,6 of Group-A 10,11,12 o/Gro11p-R 16,17,18 o/Group-C & 22,23,24 o/Group-D are compulsory.

Group-A (Marks: 17.5)

Q.] (a) What is wound? Write down the factors that influence wound healing. 1
(b) Define abscess. Write down the principles of abscess drainage by Hilton's method. 1
(~) Define Cyst. How do you differentiate 'Sebacious cyst' from a su,bcutaneous 'Lipoma'? 1.5
Q.l-/ (a) Write down the causes of metabolic acidosis and metabolic alkalosis. 1
(b) Wri~e down the differences between benign & malignant tumour. l
(c) Describe different stages of a non-specific ulcer. 1.5
~ (a) What is steriliz.ation? Write down the principles of autoclave. 1
(b) Define "Flap,, & ..Graff'. 1
,,, (c) Outline the prevention tetanus in a contaminated wound when ~e ommunization status is not known. 1.5
QA A 35 year old man of70 Kg body weight got admitted with 45% bum in his body & s h o c k ~
(a) How you will resuscitate this patient? , 1
(b) How do you ca1culate fluid for this patient & infuse it?
(c) How you will prevent compbcations in this patient?
ulf>
1
;t,- ~ 1
1.5
~5 A 40 year old man got two units blood transfusion. On the following day, he developed oliguria, '\
anaemia & jaundice.
(a) Write in short the underlying pathophysoology of his condition.
{b) How this complication could have been prevented?
(c) How will you treat this patient?
,~
~ ~
1
l,{_5
Q. 6 A 70 year old man has undergone partial gastrectomy for carcinoma stomach. On the 12th POD he n:::
/'
developed swelling of his right leg & mild pyrexia.
(a) What is your diagnosis? List its predisposing factors. 1
(b) How this complication could have been prevented? l
(c) Write in short the treatment of this condition. 1.5

Group-B (Marks: 17.5)

/
~ (a) How do you classify fractures dinically & radiologicaAly? 1
(b) Write down the causes ofnonunjon of fracture? 1
(c) Outline management of compound comminuted fracture of shaft of tibia & febula 1.5
~8 --- (a) Write down the clinical & radiological features of Giant Ce1l Tumour of bone. 1
(b) Write down the radiologicaJ features of "Osteosarcoma" & "Ewing's Sarcoma". 1
(c) What are the treatment options for i) fracture neck femur in adult ii) fracture neck femur in 1.5
elderly & iii) intertrochanteric fracture in all ages.
Q. 9 (a) Enumerate different types of regional anaesthesia. List the complications of spinal anaesthesia. 1
(b} Name the contrast X-Ray done for GIT. How will you prepare a patient for IVU? 1
/ (c) Write down the complications of Radiotherapy. Name four radio resistant tumours. 1.5
17 10 A 45 year old man presented with pain in his both calf muscles while walking for 5 years, followed
by rest pain and a non-healing ulcer in his left great toe.
(a) Write down the important fondings you expect on clinical examination of this patient? 1
(b) Name the investogations you would suggest for this patient.
l
,I\ (c) Write down the medical & surgical treatment of this patient.
1.5
Q( 1 I A 20 year old boy became unconscious after being injured in the head while playing football. He
regained his consciousness & completed his match. After returning home, again he lost his
consciousness.
(a) Write in short the underlying pathophysiology of his condition.
1
(b) What are the ca1Ydinal features of hjs condition? ,'!'_ l
(c) How you will assess the level of consciousness of this patient? 1.5
Q. 12 A 15 year old boy presented with a discharging sinus in hjs right leg. He has past history of high
y fever, severe pain & swelling of upper part of his right leg.
-
(a) Write in short t&ie pathophysiology of his most probable diagnosis. 1
(b) What are the complications this boy may develop? ~
(c) WRte down the investigations & treatment of this patient. 1.5

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Group-C (Mark.1: 17.5)
(a) Classify hernia clinicnlly. Write dovm the cardinal feature of strangulated inguinal hernia. 1
o/ (b) How do you assess the viability of gut during operation for obstructed ingwnal hernia?
(c) Classify hydrocele. Write down the name of operations for Primary Vaginal Hydrocele.
1
1.5
congenital hydroccle & encysted hydrocelc of cord.

y (a) Classi(y intestinal obstruction. Enumemte the cuuses of 'paralytic itcus'.

(b) How will you diagnose n cusc of intussusccpt-ion in children?
1
]
(c) Write down the underlying cnus~s & treatment of sigmoid colon volvulus. 1.5

Q. 15 (n) How you will prevent post splenectomy sepsis? l

(b) Enumerate the causes of acute pancroetlits. 1
(o) List the complications of acute pancreal'tits. How you will manage pseudopancreatic cyst? 1.5

) r
,,,
/
A 70 year old 0ady presented with yellow coloration of eyes & high color urine.
(a) Write down the important history & physical findings of trus patient.
(b) What complications the patient may develop during & after operation?
1
1

~17
/
,~5 (c) What measures you will take for this patient to prevent complications?

year old man presented wit.lb early morning diarrhoea, sense of incomplete defaecation and
~ u c o u s ~ o d with stool.
(a)~ . wn-t~_.im rtant examination findings you expect in this patient
1.5

l
(b) How,VIU you inv~igate this man to reach your diagnosis? I
( c) Write down the treatment plan for your most probable diagnosis. 1.5
/\
j)..18 A 3J year old man presented with upper a,bdominal discomfort, vomiting after meal with noraml
_a p~lile & past history of abdominal pain for log diuration.
. · ~ ~ t e in short the positive examination findings you expect in this patient 1
'
~ at findings do you expect in upper GI endoscopy & serum electrolytes of this p~tient? 1
c) How will you prepare this patient for opera~ion? 1.5

/ . .
Group-D (Mar~· 17 5)

OJ: (b) (a) Write down the pathophysiology of tension pneumothorax.

Define 'Flail chest'. What is the mechanism of its deve0opment?
1
I
( c) What is safe triangle? Write down its boundaries. 1.5
Q. 20 (a) How will you prepare a thyrotoxic patient for surgery? 1
(b) What is the surgical treatment for ihenign 9)3.fOtid tumour? Name the nerve and it's branches 1
you will have to safeguard..
(c) How will you manage a patient presenting with haematuria on the 1Olh day following TURP? 1.5

Q. 21 Ja) What compli~tio~s may develop_fro_m ~descen?ed tes~~? 1

(b) List the compl1cabons and contramdicabons of cucumc1s1on?
/ (c) What are the predisposing fac~ors for testicular torsion? How do you clinically differentiate
testicular torsion from acute epididymo-orcrutis?
I
1.5

I
7-22 A 32 year old lady presented with a lump in her left breast along with recent onset of nipple
retraction.
(a) Write down the relevant important history you will take from this patient. 1
(b) What clinical examination is to be done for this patient? 1
(c) Write down the investigations yolll will need to reach your diagnosis & to plan your treatment. 1.5
/ I
Q)Q3 A 45 year old Indy presented with a big swelling in front of her neck that moves with swallowing.
(a) What are the questions you will ask lhe patient about different systems of this patient? 1
(b) How will you clinically examine this patient? l
( c) Enumerate the post operative complications the patient may develop.
1.5
~

4 A 55 year old man presented with a bimanually paJpable mass in his right loin.
(a) What are the relevant questions you will ask the patient?
1
(b) What investigations the patient needs to be done?
l
(c) Write down the treatment options for different probable diagnoses oflhis patient.
..__ 1.5

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 SHAHJALAL UNIVERSITY OF SCIENCE & TECHNO~OGY.SYLHET
Fin 111Professional MBBS Examination, November 2019
Subject: Surgery, Paper-II (Ophthalmology)

Full Marks: 35 Time: 1 (Hour) 20 Minutes

(All qucsllons carry equal marks. Use seporute onswcr scnpl

• r
,or cue I1 group. Answc r any. 5(Five) from each group. Use diagram as
per ns practlcuble. Mnrks Allocation: a= I, b"" l, c= 1.5)

61 a) Draw and label layers of cornea .

Group-A (Marks-17.5}

b) How does cornea ·mainta in its transpa rency?

c) Differen ce betwee n neurotr ophlc and neurop aralytic corneaJ ulcer.
Write down four causes of loss of
corneal sensati on.
Q.2 a) Enlist five congen itaOanoma lies of eyelid . .
I b) Define trichias is and mentlcin-Us treatme nt options.
c) Enume rate the predispos!.ng factors of blephar ltls and write down . ..
treatme nt of seborrh eIc blepha ntis .

r a) Define toxic catarac t and list causes of it.

b) A 70 years olQ mal~ person came to Eye OPD with loss of vision, ..
severe eyeach e, rednes s, ~Mish col_our
of lens and pupil dilated, assoele ted ~vith heedeehe and 1.iomitiAg. What
is your diagno sis and wnte down its
plan of treatme nt ?
c) What precau tions should be taken to preven t post operati ve endoph
thalmit is regardi ng catarac t surgery ?
a) Define follicle and papillae w ith -two exampl es of each.
b) Define Dry Eye and mention ifs causes .
c) Compli cations and treatme nt options of dry eye.
A male person of 20 years old, wear-1 4.00 D spectac les in each eye.
Sudden ly patient develo ped painles s
loss of vision in right eye.
a) What are the other treatme nt options of the patient?
b) What are the possibl e causes of loss of vision in right eye?
c) Write down the patholo gical change s in left retina.
Q.6 a) Mention the cranial nerves related to eye.
b) Write down signs of 3ro nerve palsy and mention two causes of 3 rd
nerve palsy.
c) Effect of ih nerve palsy on eye and ifs manag ement.

Group-B (Ma.rks-17.5}

Q.7 a) Define staphyl oma. Classif y it.

b) Write down causes and complic ations of hyphae ma.
c) Write down manag ement and complic ations of alkali burn in eyes.
Q.8 A 45 years old lady comes to you with the compla ints of headac he,
severe eye ache, rednes s, waterin g,
photoph obia in right eye.
a) Write down three (3) differen tial diagnos is.
·
~ ) Mention the after effects of acute narrow angle glaucom a.
// c) Write down treatme nt of acute narrow angle glaucom a of affected
eye and her fellow eye.
L.,rf9 a) Write down the pathog enesis and treatme nt options of congen ital
DC.
b) Enlist the complic ations of acute dacryoc ystitis?
c) Write down steps of externa l OCR.
0 10 a) list causes of acute anterlo r uveitls.

7 b) Write down signs and what are the drugs used in the treatme nt of
acute anterio r uveitis.
c) Enume rate complic ations of chronic anterio r uveitis. Write down differen
slderosis bulbl. ce betwee n phthisis bulbi and

O / a) Define leucoco ria. List four (4) causes of leucocoria.

7 · b) Mention the cllnlcal feature s of retinobl astoma .
c) Write down treatme nt plan of 2° 11 stage of retinob lastoma .
0 .12 a) Write down function s and sources of vitamin-A.
b) Me_ntlon the prevent able ocular disease s under the banner of "Vision
c) Wnte down ocular manifes tations of OM.
2020°.

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 SHAH JALA L UNIVE RSITY OF SCIEN CE & TECH NOLO GY,SY LHET
Final Professional MBBS Examination, Novem ber-20 19
Subject: Surgery, Paper-II (ENT & Head Neck Surgery)
Ful❖ Marks: 35
(a & b carry 1 mark each. c-carrie 1.5 mar1<s.) .
All questio ns carry equal marks. Use separat e answer script for each h
group. Answer any 5 questio ns from eac group.

Group-C
Q .1. a) Define Pericho ndritls of Pinna, and How to treat It?
b) Define furuncu losis of Nose. Why it is danger ous ?
c) Write short notes on .
i) Septop lasty ii) Rhlnop lasty iii) Myringo tomy.
a) What are the causes of throat pain in adult.
b) Write down three importa nt indicati ons of tracheo stomy in adull
c) Write short notes on
i) OME ii) Anosm ia iii) Hoarse ness of Voice.
a) Write down the pathog enesis of ASOM.
b) Define epistax is. Name the vessels involve d in il
c) What are the types of thyroid surgery & complications of thyroid surgery
?
a) Define cholest eatoma . What are the ln~racranial complications of it?
b) Define atrophi c rhinitis. What are the drugs contraindicated in it?
c) What is dyspha gia & odynop hagia? Write down the oesoph ageal
causes of dyspha gia.
a) Write three causes of conduc tive hearing loss in children .
b) Name the ototoxi c drugs .
c) Write short notes on
i) Thyrog lossal Fistula ii) Rhinos poridiosis iii) Acoust ic Neurom a.
06. a) Define ear wax. Yiow will you treat a children with hard impacte d wax
?
/ b) What are the w-eatments of nasal ethmoid al polyp?
c) Define strider. Write down the causes of Strider in adult and in children
.

Group -0
a.V ~) Classify neck swellings.
L:.. b) Mentio n the indicati ons of modifie d radical mastoid ectomy (MRM)
c) Write short notes on
i) Cochle ar implant ii) LASER iii) FOL.
a) What is achalas ia cardia?
b). Draw and label the levels of neck nodes.
c) . Name the proced ure to remove the followin g foreign bodies.
i) Coin in upper end of oesoph agus ii) Round metallic baJI in the externa l ear canal iii) Metallic pin in
bronch us.
a) What are the f.unctions of larynx?
b) Write down four i.ndications of tonsille ctomy.
c) Classif y chronic suppur ative otitis media. Draw and label a central
perfora tion of left tympan ic membr ane.
a) Mentio n three commo n causes or parotid swelling in adult .
b) A boy of 15 years suffering from profuse recurre nt epistax is with
anemia . What is the most probab le diagno sis.
c) Write short notes on
i) Advice for the patient s sufferin g from CSOM ii) Otomyc osis iii) Second ary haemo rrhage followin g
tonsille ctomy.
y a) Mentio n three causes of sensori neural deafnes s In adult.
~ In which surgeri es a n:ticrosco~eJ_s -~sed _iry_ENT...:_
c) Mentio n five commo n maligna nt disease of Head & Neck region.
0 .6 a) Name the major salivary glands with their location s.
b) Draw and label the triangle s of neck.
c) Short Notes on
i) Allergic disease in ENT 11) ENT causes of vertigo iii) ENT causes .for Headac he

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 SHAHJALAL UNIVERSITY OF SCIENCE & TECHNOLOGY, SYLHE T
Final Professi onal MBDS Examin ation, Novemb er-2019
Subject : Obs & Gynae, Pnper-1 (Obs.)
Type of question SAQ+S EQ
Answer any seven question s from each group. Use separate answer script for each group.
All question s carries equal marks.
Full Marks: 70 Time: 2 Hours 30 Minutes
Group-A
Q.l A lady came al her 37 weeks of pregnan cy with repeated convuls ions at home O/E 5
Bp 160/ 100 mmHg ocdema ++ I- with, Wha~ is your diagnos is and how will you
manage her?

<µ a) What is labour? How wi ll you diagnos ed that a patient is in labour? 2+3
b) \Vhat is AMTSL ? What arc the advanta ge of AMTSL ?

r a) What are the indicati on of emerge ncy LSCS?

b) Write down the post operativ e order followin g LSCS due to obstruc ted Jabour.
c) Compli cations of obstruc ted labour.
1.5+ 1.5+2

/
L9fa A primigr avid patient admitte d in this hospital at 40+ weeks of pregnan cy with H/O
labour pain fo r 20 hours O/E She is dehydra ted bOadder full FHR 1208/M in.OS full
5

dilated, caput++ \Vhat is your diagnos is & How will you mange her?
l}q.5 a) What is involuti on? What are the factors hamper involuti on? 1.5+1.5 +2
' b) Write down the breast complic ations in pueQ'J)erium.
c) Write down the advanta ges of breast feeding .

JE A multi gravid lady present at her 38 weeks of pregnan cy with sudden gush of
watery discharg e PN for last 4 hour, How will you m anage this patient?
5

ft.7 a) WhaQis GDM?. l+l.5+2 .5

b) What are the investigation done for doagnos is of GDM/D M?
c) Complic ations ofDM.

¥ A women came at her 42 weeks of pregnan cy with no foetal movem ent for 3 days.
O/E FHS not audible. How will you manage this patient?
s

Group-B
Q.l a) How placenta develop ?
1.5+2+1 .S
b) How Amniot ic fluid is formed? Mention the function s of Amniot ic fluid.
c) Give the clinical importa nce of Amniot ic fluid.
/
912 A women delivere d a baby at home lwo hours back. She admitte d to the hospital with
sever PN bleedin g O/E Anaemi a+++ Pulse 1208/m in. BP 80/60 mmHg How will
5
you
mange this patient?
y
,

a) Define ANC. W hat are the aims and objectiv e ANC?

2.5+1+ 1.5
b) WHO schedul e of ANC. 7~~'c 't>
c) What are the investig ations done during first visit?
Q.4 A grand multi patient came at her 38 weeks of pregnan cy with H/O inductio n at home
5
and sever abdomi nal pain for 12 hours. O/E Anaemi a+++ BP 80/50 mmHg, FHS
absent and foetal parts easi ly palpable . How will you manage lhis patient?
Q.5 a) What is lie, presenta tion, position ?
b) What are the fate of occiput o posterio r position ? 2+1.5+1 .5
c) What are the comp I icalions of Transve rse lie?

0/' A 30 years lady came at her 36 weeks of pregnan cy sever abdomi nal pain and slight
PN bleeding O/E Anaemi a+++ BP 140/ 100 mmHg, FHS absent uterus tonicall y 5
contacte d, How w i~I you manage her?

a) Define Materna l death?

1.5+ 1.5+2
b) What are the direct importa nt causes of materna l death in Banglad esh.
c) How materna l death can be reduced ? .
A

Q:8 How will you manage a case of puerper al sepsis?

/
5

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 SHAHJALAL UNIVERSITY OF SCIENCE & TECHNOLOGY, SYLHET
Final Professional MBBS Examination, November-2019
Subject: Obs & Gynac, Paper-II (Gynae)
Type of question SAQ+SEQ
Answer any seven questions from each group. Use separate answer script for each group.
All questions carries equal marks.
Full Marks: 70 Ti.me: 2 Hours 30 Minutes

Group-A
Q.1 a) \Vrite down the boundary of Anatomical perineum. Mention its parts. 2+1+2
b) Name the deep endopelvic connective tissue ligamen~s of female pelvis.
c) Draw and mention the boundary of Pouch of Douglas
g;--
,,,.
How will you manage & follow up a patient of molar pregnancy of 20 weeks of
gestation?
5

1+2+2
07 a) Define menstruation.
b) Write dovm the different phase of mensttuation with duration & correlate them
with ovarian cycle.
c) Define ovulation. Name the ovarian honnones with their function.
~ Write down a short essay on AUB. 5
l"'Q;)' A lady presents with 20 weeks of pregnancy, on examination her height of uterus is 1+2.5+1.5
I 16 weeks size, no PN bleeding, internal os is close, cardiac pulsation absent on
USG---
a) What is your diagnosis?
b) How will you manage such a case?
c) What complications may arise from this case?

~ How can you suspect that an ovarian tumour to be malignant? 5

O? A 30 years old lady presents with curd like PN whitish discharge with itching, she
has family history of diabetes rnellitus ---
1+1.5+2.5
a) What is the probable diagnosis?
b) How will you confirm the diagnosis and mange the case?
c) Write down the defense mechanism of female genital tract.
0% Write down a sb01t essay on permanent methods of contraception. 5
*
Group-B
,,/I
l)Y-1 A married couple with 1 living issue presented with inability to conceive for 3yers -- 1+2+2
j ..
a) What is the diagnosis?
b) Write down the probable causes of this condition.
c) How will you investigate the couple for conception?
Q .2 Write clown the role of imaging in Gynaecology. 5

•
?5 a) Define ectopic pregnancy with it's types and sites.
b} Write down the clinical features of acute ruptured ectopic pregnancy.
1.5+1.5+2
.ot.. " ' - ~ 1..,,.
c) How will you manage a case of chronic niptµred ectopic pregnancy?
24" Write a short essay on treatmei:1t modaltties of carcinoma cervix. 5
Q.5 A 18 years old girl came with H/O primary amenorrhea, cyclical lower abdominal
pain for four years and retention of uriQle.O/E secondary sex characters are well 1+2+2
developed.
a) What is your diagnosis?
b) What investigations you would like to do?
c) Write down the management of this case
9-9~ Write down briefly about genitourinary fistula.
5
a) Define menopause. 1+2+2
b) What are the sign, symptoms & compiications of menopause?
-·; c) How will yotR prevent post menopausal symptoms & complications?
~-8 Outline the management plan of symptomatic endometriosis in a patient having no 5
. child. ~

·-
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