Medical Science

UPSC Medical Science 2022 — Paper I

All 8 questions from UPSC Civil Services Mains Medical Science 2022 Paper I (400 marks total). Every stem reproduced in full, with directive-word analysis, marks, word limits, and answer-approach pointers.

8Questions
400Total marks
2022Year
Paper IPaper

Topics covered

Anatomy and Physiology of Stomach, Growth Hormone, Jaundice, Kidney Anomalies, Placental Hormones (1)Uterus Anatomy, Blood Pressure Regulation, Protein Synthesis, Radioimmunoassay (1)Basal Ganglia, Excitation-Contraction Coupling, Vitamin A, Facial Nerve, Rotator Cuff (1)Iron Absorption, Thyroid Function Test, Stretch Reflex, Mammary Gland Lymphatics, Interventricular Septum (1)Breast Carcinoma, IgA, Opportunistic Infections, ARB, Granulomatous Inflammation, Firearm Wounds (1)Rheumatic Heart Disease, Cirrhosis, Celecoxib, Chloroquine, Giardia, Dengue (1)Organophosphate Poisoning, Benign vs Malignant Tumours, Cancer Cervix, Type I Diabetes, TB Second Line Drugs, Aldosterone Antagonists (1)Aspergillus, Dysentery, Drowning, Hyoid Bone, Metformin, Thiazides (1)

A

Q1
50M Compulsory discuss Anatomy and Physiology of Stomach, Growth Hormone, Jaundice, Kidney Anomalies, Placental Hormones

(a) Discuss the stomach under the following headings: (i) Peritoneal relations (ii) Blood supply (iii) Lymphatic drainage (15 marks) (b) Discuss the regulation of secretion and physiological functions of growth hormone. (10 marks) (c) Define physiological jaundice of the newborn. What are the predisposing causes and effects of this condition? (10 marks) (d) Discuss in brief the developmental anomalies of the kidney and the ureters. (5 marks) (e) Discuss the physiological functions of placental hormones in pregnancy. (10 marks)

हिंदी में पढ़ें

(a) निम्नलिखित शीर्षकों के अंतर्गत आमाशय का वर्णन कीजिए : (i) पर्दुयाँ संबंध (ii) रक्त आपूर्ति (iii) लसीका जल-निकासी (15) (b) वृद्धि हार्मोन के स्राव-नियमन तथा शारीरक्रियात्मक कार्यों की व्याख्या कीजिए। (10) (c) नवजात में होने वाले शारीरक्रियात्मक कामला को परिभाषित कीजिए। इस अवस्था के प्रवर्तनपूर्व कारकों और उसके प्रभावों के बारे में लिखिए। (10) (d) वृक्क तथा गवीनी की विकासीय असंगतियों की संक्षेप में व्याख्या कीजिए। (5) (e) गर्भावस्था में अपरा से स्रावित होने वाले हार्मोनों के शारीरक्रियात्मक कार्यों की व्याख्या कीजिए। (10)

Answer approach & key points

Framework: Medical Science, Paper 1. (a) discuss: intro > 3-4 dimensions > example > balanced close | (b) discuss: intro > 3-4 dimensions > example > balanced close | (c) define: precise definition > the distinguishing feature > one example | (d) discuss: intro > 3-4 dimensions > example > balanced close | (e) discuss: intro > 3-4 dimensions > example > balanced close Full marks: Comprehensive, accurate, and well-structured answers with clear mechanisms and clinical relevance.

  • Peritoneal relations: lesser omentum, greater omentum, bare area
  • Blood supply: celiac trunk branches (left/right gastric, splenic, hepatic)
  • Lymphatic drainage in four zones (left gastric, pancreaticosplenic, right gastroepiploic, pyloric) to coeliac nodes
  • Venous drainage: portal system (left/right gastric veins)
  • Regulation: GHRH (stimulation) and Somatostatin (inhibition)
  • Hypothalamic-pituitary axis control
  • Physiological functions: growth, protein synthesis, lipolysis
  • Role of IGF-1 (Somatomedin) in mediating effects
  • Definition: transient hyperbilirubinemia in healthy newborns
  • Causes: increased RBC mass, immature hepatic conjugation
  • Effects: risk of kernicterus if severe, usually self-limiting
  • Distinction from pathological jaundice
  • Kidney anomalies: horseshoe kidney, ectopic kidney
  • Ureter anomalies: ureteropelvic junction obstruction, vesicoureteral reflux
  • Mention of specific embryological origins (metanephros, ureteric bud)
  • Brief description of clinical significance
  • hCG: maintenance of corpus luteum, early pregnancy
  • hPL: insulin resistance, lipolysis, nutrient supply
  • Estrogen/Progesterone: uterine maintenance, breast development
  • Other placental hormones such as CRH, with relaxin (largely corpus luteum) for cervical softening
Q2
50M describe Uterus Anatomy, Blood Pressure Regulation, Protein Synthesis, Radioimmunoassay

(a) Describe the anatomy of uterus under the following headings: (i) Gross features (ii) Relations of uterus (iii) Ligaments and supports (iv) Blood supply (v) Lymphatic drainage (vi) Applied aspects (15 marks) (b) Discuss the physiological mechanism of short-term and long-term regulation of arterial blood pressure. (15 marks) (c) (i) Explain the process of initiation of protein synthesis in eukaryotes. Enumerate any four inhibitors of protein synthesis with their mechanism of action. (6+4=10 marks) (ii) Explain the principle and applications of radioimmunoassay. (10 marks)

हिंदी में पढ़ें

(a) निम्नलिखित शीर्षकों के अंतर्गत गर्भाशय के शरीररचनाविज्ञान का वर्णन कीजिए : (i) सकल विशेषताएँ (ii) गर्भाशय के संबंध (iii) स्नायु तथा अवलंब (iv) रक्त आपूर्ति (v) लसीका जल-निकासी (vi) अनुप्रयुक्त पहलू (15) (b) धमनिय रक्तदाब के लघु-अवधि तथा दीर्घ-अवधि नियमन की शारीरिकीयत्मक क्रियाविधि की व्याख्या कीजिए। (15) (c) (i) सुकेंद्रकी जीवों में प्रोटीन संश्लेषण प्रारंभ की प्रक्रिया की व्याख्या कीजिए। किन्हीं चार प्रोटीन संश्लेषण सदमकों के नाम गिनाइए और उनके कार्य करने की क्रियाविधि उल्लिखित कीजिए। (6+4=10) (ii) रेडियोइम्यूनोएसे के सिद्धांत तथा अनुप्रयोगों की व्याख्या कीजिए। (10)

Answer approach & key points

(a) describe: define > structure or process in order > labelled diagram > significance | (b) discuss: intro > 3-4 dimensions > example > balanced close | (c(i)) explain: definition/context > points in order > small example > short close | (c(ii)) explain: definition/context > points in order > small example > short close Full marks: Comprehensive, accurate, and well-structured answers with diagrams and specific examples.

  • Gross features: pear-shaped, fundus, body, isthmus, cervix
  • Relations: anterior (urinary bladder), posterior (rectum), superior (peritoneum)
  • Ligaments: broad, round, uterosacral, cardinal (transverse cervical)
  • Blood supply: uterine artery (branch of internal iliac), ovarian artery
  • Short-term: Baroreceptor reflex (carotid sinus/aortic arch)
  • Short-term: Chemoreceptor reflex (carotid/aortic bodies)
  • Long-term: Renin-Angiotensin-Aldosterone System (RAAS)
  • Long-term: renal pressure natriuresis (renal–body fluid mechanism) as the dominant controller
  • Initiation: Binding of 43S pre-initiation complex to mRNA
  • Initiation: Scanning to start codon (AUG) and 60S subunit joining
  • Inhibitor 1: Chloramphenicol (inhibits peptidyl transferase)
  • Inhibitor 2: Tetracycline (blocks tRNA binding to A site)
  • Principle: Competitive binding between labelled and unlabelled antigen
  • Principle: Inverse relationship between antigen concentration and radioactivity
  • Application: Measurement of hormones (e.g., TSH, insulin)
  • Application: Measurement of drugs or tumour markers
Q3
50M discuss Basal Ganglia, Excitation-Contraction Coupling, Vitamin A, Facial Nerve, Rotator Cuff

(a) (i) Discuss the functions of basal ganglia. Add a note on Parkinson's disease. (5+5=10 marks) (ii) Discuss the mechanism of excitation-contraction coupling in the skeletal muscle. (10 marks) (b) Explain the biochemical role of the different derivatives of vitamin A. Add a note on the causes, clinical manifestations and management of vitamin A deficiency. (15 marks) (c) (i) Describe the functional components, course, branches and applied aspects of the facial nerve. (10 marks) (ii) Discuss the attachments and applied aspects of rotator cuff muscles of the shoulder joint. (5 marks)

हिंदी में पढ़ें

(a) (i) आधारी गांडिका के कार्यों की व्याख्या कीजिए। साथ ही पार्किनसन रोग पर एक टिप्पणी लिखिए। (5+5=10) (ii) कंकाल पेशी में उत्तेजन-संकुचन युग्मन की क्रियाविधि की व्याख्या कीजिए। (10) (b) विटामिन A के विभिन्न व्युत्पन्नों की जैव रासायनिक भूमिका की व्याख्या कीजिए। साथ ही विटामिन A अल्पता के कारणों, रोगलक्षण अभिव्यक्तियों तथा प्रबंधन पर एक टिप्पणी लिखिए। (15) (c) (i) आनन तंत्रिका के क्रियात्मक घटकों, मार्ग, शाखाओं तथा अनुप्रयुक्त पहलुओं का वर्णन कीजिए। (10) (ii) स्कंध संधि की रोटर कफ पेशियों के संलग्नकों तथा अनुप्रयुक्त पहलुओं की व्याख्या कीजिए। (5)

Answer approach & key points

Framework: Medical Science, Paper 1. (a(i)) discuss: intro > 3-4 dimensions > example > balanced close | (a(ii)) discuss: intro > 3-4 dimensions > example > balanced close | (b) explain: definition/context > points in order > small example > short close | (c(i)) describe: define > structure or process in order > labelled diagram > significance | (c(ii)) discuss: intro > 3-4 dimensions > example > balanced close Full marks: Comprehensive coverage of all sub-parts with correct mechanisms, diagrams, and clinical correlations.

  • Motor control functions (initiation, modulation)
  • Non-motor functions (cognitive, emotional)
  • Dopaminergic pathway degeneration mechanism
  • Clinical features and treatment of Parkinson disease (levodopa-carbidopa, agonists, DBS)
  • Action potential propagation to T-tubules
  • DHP receptor to RyR interaction
  • Calcium release from sarcoplasmic reticulum
  • Cross-bridge cycling and relaxation
  • Role of Retinal in vision (rhodopsin)
  • Role of Retinoic acid in differentiation
  • Causes of deficiency (dietary, malabsorption)
  • Clinical manifestations (night blindness, xerophthalmia)
  • Functional components (SVE branchial motor, GVE secretomotor, SVA taste, GSA)
  • Course through temporal bone (facial canal)
  • Major branches (temporal, zygomatic, etc.)
  • Applied aspects (Bell's palsy, parotid surgery)
  • Names of the four muscles (SITS)
  • Specific bony attachments (tuberosities)
  • Applied aspect: Rotator cuff tear
  • Applied aspect: Shoulder instability
Q4
50M explain Iron Absorption, Thyroid Function Test, Stretch Reflex, Mammary Gland Lymphatics, Interventricular Septum

(a) (i) Explain the mechanism of iron absorption in the intestine. What are the factors regulating the process? (15 marks) (ii) Explain the diagnostic role of thyroid function test (TFT) in the diagnosis of thyroid disorders. (5 marks) (b) (i) Draw a well-labelled diagram of stretch reflex. (5 marks) (ii) What are the functions and clinical applications of stretch reflex? (10 marks) (c) (i) Discuss the lymphatic drainage of the mammary gland and its clinical significance. (5 marks) (ii) Describe the development of the interventricular septum and write briefly about the congenital anomaly of the heart related to this structure. (10 marks)

हिंदी में पढ़ें

(a) (i) आंत में लोह अवशोषण की क्रियाविधि की व्याख्या कीजिए। ऐसे कौन-से घटक हैं, जो इस प्रक्रम का नियमन करते हैं? (15) (ii) अवटु विकारों के निदान में अवटु क्रिया परीक्षण (टी० एफ० टी०) की नैदानिक भूमिका की व्याख्या कीजिए। (5) (b) (i) तनाव प्रतिवर्त का सुचिहित आरेख खींचिए। (5) (ii) तनाव प्रतिवर्त के कार्यों तथा लाक्षणिक अनुप्रयोग क्या-क्या हैं? (10) (c) (i) स्तन ग्रंथि की लसीका जल-निकासी तथा उसके लाक्षणिक महत्व की व्याख्या कीजिए। (5) (ii) अन्तरालिलय पट के विकास का वर्णन कीजिए तथा इस रचना से संबंधित हृदय की जन्मजात असंगति के विषय में संक्षेप में लिखिए। (10)

Answer approach & key points

Framework: Clinical Sequence (Definition > Aetiology/Pathophysiology > Features > Investigation/Management). (a(i)) explain: definition/context > points in order > small example > short close | (a(ii)) explain: definition/context > points in order > small example > short close | (b(i)) describe: define > structure or process in order > labelled diagram > significance | (b(ii)) explain: definition/context > points in order > small example > short close | (c(i)) discuss: intro > 3-4 dimensions > example > balanced close | (c(ii)) describe: define > structure or process in order > labelled diagram > significance Full marks: Comprehensive, clinically relevant, and mechanistically accurate with clear diagrams.

  • Distinguish between heme and non-heme iron absorption
  • Detail duodenal uptake via DMT1 and ferroportin
  • Explain the role of hepcidin in regulating ferroportin
  • Identify factors like iron stores, erythropoiesis, and pH
  • Interpretation of TSH levels (primary screening)
  • Interpretation of Free T3 and Free T4 levels
  • Differentiation between primary and secondary hypothyroidism
  • Identification of hyperthyroidism vs. hypothyroidism
  • Labeling of muscle spindle (receptor)
  • Labeling of Ia afferent nerve fiber
  • Labeling of alpha motor neuron (efferent)
  • Labeling of the effector muscle
  • Role in maintaining muscle tone and posture
  • Role in protective reflexes (e.g., knee jerk)
  • Clinical use in neurological examination (DTRs)
  • Differentiation of UMN vs LMN lesions based on reflexes
  • Identification of axillary lymph nodes as primary drainage
  • Mention of parasternal (internal thoracic) nodes
  • Clinical significance in breast cancer metastasis
  • Role in sentinel lymph node biopsy
  • Formation of the muscular septum (from ventricular walls)
  • Formation of the membranous septum (from endocardial cushions)
  • Description of Ventricular Septal Defect (VSD)
  • Interventricular foramen closed by the membranous septum, and VSD as the commonest congenital heart defect with its effects (left-to-right shunt, Eisenmenger)

B

Q5
50M Compulsory describe Breast Carcinoma, IgA, Opportunistic Infections, ARB, Granulomatous Inflammation, Firearm Wounds

(a) Describe the molecular mechanisms of carcinogenesis of breast carcinoma. Describe the salient histopathological features of invasive carcinoma of no special type. (10 marks) (b) (i) Draw a diagram of IgA. What is its role in a disease? (5 marks) (ii) What are opportunistic infections? Enumerate the various bacterial, parasitic, viral and fungal opportunistic infections seen in a case of AIDS. (5 marks) (c) Discuss about angiotensin II receptor blocker (ARB). How are they different from angiotensin converting enzyme (ACE) inhibitors? Write the pharmacotherapy of hypertensive emergency. (10 marks) (d) Define granulomatous inflammation. Describe in brief different types of granuloma. (10 marks) (e) What is a firearm? What are the features of a firearm ammunition entry wound that will help in determining the range and direction of fire? (10 marks)

हिंदी में पढ़ें

(a) स्तन कार्सिनोमा में कैंसरजनन के आण्विक यांत्रिकताओं का वर्णन कीजिए। किसी ऐसे आक्रामक कार्सिनोमा, जो विशिष्ट प्रकार का नहीं है, के मुख्य उतकविकृति लक्षणों का वर्णन कीजिए। (10) (b) (i) IgA का एक आरेख बनाइए। किसी रोग में उसकी क्या भूमिका होती है? (5) (ii) अवसरवादी संक्रमण क्या हैं? एड्स के मामले में देखे जाने वाले विभिन्न प्रकार के अवसरवादी जीवाणुज, परजीवी, विषाणुज तथा कवकीय संक्रमणों के नाम गिनाइए। (5) (c) ऐंजियोटेंसिन II रिसेप्टर ब्लॉकर (ए० आर० बी०) की व्याख्या कीजिए। ये ऐंजियोटेंसिन कनवर्टिंग एंजाइम (ए० सी० ई०) इन्हीबिटरों से कैसे भिन्न होते हैं? उच्च रक्तदाबजन्य (हाइपरटेंसिव) इमरजेंसी की भेषजचिकित्सा लिखिए। (10) (d) कणिकागुल्मीय शोथ को परिभाषित कीजिए। विभिन्न प्रकार के कणिकागुल्मों का संक्षेप में वर्णन कीजिए। (10) (e) आर्म्स क्या है? आर्म्स गोली के प्रवेश घात की वे क्या विशेषताएं हैं, जिनके आधार पर यह निश्चित करने में मदद मिलती है कि गोली कितनी दूरी और किस दिशा से चलाई गई? (10)

Answer approach & key points

Framework: Medical Science, Paper 1. (a) describe: define > structure or process in order > labelled diagram > significance | (b(i)) describe: define > structure or process in order > labelled diagram > significance | (b(ii)) enumerate: list the items in order > one line each > no commentary | (c) discuss: intro > 3-4 dimensions > example > balanced close | (d) describe: define > structure or process in order > labelled diagram > significance | (e) explain: definition/context > points in order > small example > short close Full marks: Comprehensive, accurate, and well-structured answers with specific examples and mechanisms.

  • Molecular mechanisms of breast carcinogenesis
  • Salient histopathological features of invasive carcinoma of no special type
  • Diagram of IgA
  • Role of IgA in a disease
  • Definition of opportunistic infections
  • List of bacterial opportunistic infections in AIDS
  • List of parasitic opportunistic infections in AIDS
  • List of viral and fungal opportunistic infections in AIDS
  • Discussion of angiotensin II receptor blockers (ARBs)
  • Difference between ARBs and ACE inhibitors
  • Pharmacotherapy of hypertensive emergency
  • Definition of granulomatous inflammation
  • Description of different types of granuloma
  • Definition of a firearm
  • Features of firearm ammunition entry wound for determining range
  • Features of firearm ammunition entry wound for determining direction of fire
Q6
50M describe Rheumatic Heart Disease, Cirrhosis, Celecoxib, Chloroquine, Giardia, Dengue

(a) (i) Describe in brief the pathogenesis and histopathological features of rheumatic heart disease. (10 marks) (ii) Enumerate two important causes of cirrhosis. Describe the key histopathological features of cirrhosis. (10 marks) (b) State the therapeutic indications, drug interactions and side effects of the following drugs: (i) Celecoxib (ii) Chloroquine (5+5=10 marks) (c) (i) What is Giardia lamblia? Write the manifestations of the disease produced by infection with Giardia and give its laboratory diagnosis. (10 marks) (ii) What are the different dengue viruses? Give the pathogenesis of the infections by them. How is the laboratory diagnosis done in a case of dengue haemorrhagic fever? (10 marks)

हिंदी में पढ़ें

(a) (i) रूमेटी हृदय रोग के विकृतिजनन तथा उतकविकृति विशेषताओं का संक्षेप में वर्णन कीजिए। (10) (ii) सिरोसिस के दो महत्वपूर्ण कारण गिनाइए। सिरोसिस की मुख्य उतकविकृति विशेषताओं का वर्णन कीजिए। (10) (b) निम्नलिखित दवाओं के चिकित्सार्थ संकेतों, औषधि अन्योन्यक्रियाओं तथा प्रतिकूल प्रभावों को उल्लिखित कीजिए : (i) सेलेकोक्सिब (ii) क्लोरोक्वीन (5+5=10) (c) (i) जियार्डिया लैम्बलिया क्या है? जियार्डिया के संक्रमण से उत्पन्न होने वाले रोग की अभिव्यक्तियों के बारे में लिखिए और उसका प्रयोगशाला में निदान कैसे किया जाता है, उल्लिखित कीजिए। (10) (ii) डेंगू के विभिन्न विषाणुज कौन-कौन से हैं? उनके संक्रमण से रोगजनन की व्याख्या कीजिए। डेंगू रक्तस्रावी ज्वर का प्रयोगशाला में निदान कैसे किया जाता है? (10)

Answer approach & key points

Framework: Medical Science, Paper 1. (a(i)) describe: define > structure or process in order > labelled diagram > significance | (a(ii)) enumerate: list the items in order > one line each > no commentary | (b(i)) enumerate: list the items in order > one line each > no commentary | (b(ii)) enumerate: list the items in order > one line each > no commentary | (c(i)) explain: definition/context > points in order > small example > short close | (c(ii)) explain: definition/context > points in order > small example > short close Full marks: Comprehensive, accurate, and well-structured with all key points and mechanisms.

  • Molecular mimicry mechanism
  • Aschoff bodies and Anitschkow cells
  • Valvular fibrosis and thickening
  • Chronic valvular deformity
  • Alcoholic liver disease
  • Viral hepatitis (B or C)
  • Regenerative nodules
  • Fibrous septa formation
  • COX-2 selective inhibitor
  • Osteoarthritis or rheumatoid arthritis
  • Cardiovascular risk (thrombosis)
  • GI side effects (ulcers)
  • Malaria prophylaxis or treatment
  • Retinal toxicity (maculopathy)
  • QT prolongation
  • Interactions such as antacids reducing absorption and additive QT prolongation
  • Protozoan parasite (flagellated)
  • Giardiasis (diarrhea, malabsorption)
  • Stool microscopy (cysts/trophozoites)
  • Antigen detection (ELISA)
  • Four serotypes (DENV 1-4)
  • Viremia and immune response
  • Plasma leakage mechanism
  • NS1 antigen or IgM/IgG serology
Q7
50M discuss Organophosphate Poisoning, Benign vs Malignant Tumours, Cancer Cervix, Type I Diabetes, TB Second Line Drugs, Aldosterone Antagonists

(a) What are organophosphate compounds? Discuss briefly the clinical features, treatment and postmortem findings of a case of organophosphate poisoning. (15 marks) (b) (i) Enumerate four differentiating features between benign and malignant tumours. Describe in brief the pathogenesis of cancer cervix. (10 marks) (ii) Describe in brief the pathogenesis of type I diabetes mellitus. Enumerate two important glomerular lesions of diabetic nephropathy. (10 marks) (c) (i) Discuss the second line drugs used for the treatment of tuberculosis. (10 marks) (ii) Discuss the role of aldosterone antagonists as vasodilators. (5 marks)

हिंदी में पढ़ें

(a) ऑर्गेनोफॉस्फेट यौगिक क्या हैं? ऑर्गेनोफॉस्फेट विषाक्तता के रोगलक्षणों, उपचार तथा मरणोत्तर जाँच-परिणामों की संक्षेप में व्याख्या कीजिए। (15) (b) (i) सुदम तथा दुर्दम अर्बुद के बीच विभेद करने वाली चार विशेषताओं को गिनाइए। गर्भाशयग्रीवा कैंसर के रोगजनन का संक्षेप में वर्णन कीजिए। (10) (ii) डायाबिटीज मेलिटस टाइप I के रोगजनन का संक्षेप में वर्णन कीजिए। मधुमेहज वृक्कविकृति की दो महत्वपूर्ण केशिकास्तवकीय विक्षतियों को गिनाइए। (10) (c) (i) ट्यूबरकुलोसिस के उपचार में प्रयुक्त द्वितीय पंक्ति की दवाओं की व्याख्या कीजिए। (10) (ii) वाहिका-विस्फारक के रूप में एल्डोस्टेरोन एंटागोनिस्ट की भूमिका की व्याख्या कीजिए। (5)

Answer approach & key points

Framework: Medical Science, Paper 1. (a) discuss: intro > 3-4 dimensions > example > balanced close | (b(i)) enumerate: list the items in order > one line each > no commentary | (b(ii)) describe: define > structure or process in order > labelled diagram > significance | (c(i)) discuss: intro > 3-4 dimensions > example > balanced close | (c(ii)) discuss: intro > 3-4 dimensions > example > balanced close Full marks: Comprehensive, accurate, and well-structured answers with all required points and mechanisms.

  • Definition: Inhibitors of acetylcholinesterase
  • Clinical: Cholinergic crisis (SLUDGE/DUMBELS)
  • Treatment: Atropine and Pralidoxime (2-PAM)
  • Postmortem: Organophosphate levels in viscera
  • Four distinct differences (e.g., metastasis, capsule)
  • Pathogenesis: HPV 16/18 infection
  • Pathogenesis: CIN progression to invasive cancer
  • Pathogenesis: Autoimmune destruction of beta cells
  • Lesion 1: Kimmelstiel-Wilson nodules
  • Lesion 2: Diffuse glomerulosclerosis
  • Fluoroquinolones (e.g., Levofloxacin)
  • Injectable amikacin, noting kanamycin and capreomycin are phased out
  • Rifabutin or Ethionamide
  • Newer agents bedaquiline, linezolid, delamanid or pretomanid
  • Mechanism: Blocking aldosterone receptors
  • Effect: Reducing vascular tone and fibrosis
Q8
50M enumerate Aspergillus, Dysentery, Drowning, Hyoid Bone, Metformin, Thiazides

(a) (i) Enumerate different species of Aspergillus and the infections caused by them. Give the laboratory diagnosis of a case of pulmonary aspergillosis. (10 marks) (ii) What is dysentery? Give the differences between bacterial and amoebic dysentery. Describe the laboratory diagnosis of a case of amoebic dysentery. (10 marks) (b) (i) What is drowning? Explain briefly the different types of drowning. (10 marks) (ii) Draw a labelled diagram of the hyoid bone. Discuss briefly the various fractures of the hyoid bone. (10 marks) (c) (i) Elaborate the mechanism of action of Metformin. (5 marks) (ii) Briefly describe the therapeutic indications and adverse effects of Thiazides. (5 marks)

हिंदी में पढ़ें

(a) (i) ऐस्पर्जिलस की विभिन्न जातियों और उनसे होने वाले संक्रमणों के नाम गिनाइए। फुप्फुस ऐस्पर्जिलसता के मामले में प्रयोगशाला में निदान कैसे किया जाता है? (10) (ii) पेचिश क्या है? जीवाणुज तथा अमीबी पेचिश के बीच के अंतर बताइए। अमीबी पेचिश के मामले में प्रयोगशाला में निदान कैसे किया जाता है, वर्णन कीजिए। (10) (b) (i) ड्राउनिंग क्या है? ड्राउनिंग के विभिन्न प्रकारों के बारे में संक्षेप में समझाइए। (10) (ii) हायॉइड अस्थि का चिह्नित आरेख बनाइए। हायॉइड अस्थि में होने वाले विभिन्न अस्थिभंगों की संक्षेप में व्याख्या कीजिए। (10) (c) (i) मेटफॉर्मिन के कार्य करने की क्रियाविधि की व्याख्या कीजिए। (5) (ii) थायजाइड के चिकित्सार्थ संकेतों तथा प्रतिकूल प्रभावों का संक्षेप में वर्णन कीजिए। (5)

Answer approach & key points

Framework: Medical Science, Paper 1. (a(i)) enumerate: list the items in order > one line each > no commentary | (a(ii)) compare: paired headings or table > key differences > significance > conclusion | (b(i)) explain: definition/context > points in order > small example > short close | (b(ii)) describe: define > structure or process in order > labelled diagram > significance | (c(i)) explain: definition/context > points in order > small example > short close | (c(ii)) describe: define > structure or process in order > labelled diagram > significance Full marks: Comprehensive, accurate, and well-structured answers with all key points and clinical relevance.

  • List A. fumigatus, A. flavus, A. niger, A. terreus
  • Link species to specific clinical syndromes
  • Mention KOH mount and culture on Sabouraud's agar
  • Include serology (galactomannan) or histopathology
  • Define dysentery (bloody/mucoid diarrhea)
  • Point-wise comparison of bacterial and amoebic dysentery (onset, stool, microscopy, ulcers)
  • Stool microscopy for trophozoites/cysts
  • Mention antigen detection or culture
  • Define drowning as respiratory impairment from submersion
  • Explain wet drowning (aspiration)
  • Explain dry drowning (laryngospasm)
  • Immersion syndrome, secondary drowning and shallow-water drowning
  • Label body, greater horns, lesser horns
  • Mention fracture of greater horns (strangulation)
  • Types: inward compression (throttling), antero-posterior compression, avulsion (hanging)
  • Discuss forensic significance of fractures
  • Inhibition of hepatic gluconeogenesis
  • Increase in peripheral insulin sensitivity
  • Activation of AMP-activated protein kinase (AMPK)
  • Mention no hypoglycemia risk
  • Indications: Hypertension, edema
  • Adverse: Hypokalemia, hyperuricemia
  • Adverse: Hyperglycemia, hyperlipidemia
  • Mention mechanism (Na/Cl reabsorption inhibition)

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