FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2017

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
GENERAL MEDICINE
PAPER II
MED/J/17/11/II
Time 3 hours
Max. Marks 100
IMPORTANT INSTRUCTIONS
• This question paper consists of 10 questions divided into Part and Part each part
containing 5 questions.
• Answers to questions of Part and Part are to be strictly attempted in separate answer
sheet(s) and the main supplementary answer sheet(s) used for each part must be tagged
separately.
• Answers to questions of Part attempted in answer sheet(s) of Part or vice versa shall
not be evaluated.
• Answer sheet(s) of Part and Part are not to be tagged together.
• Part and Part should be mentioned only on the covering page of the respective answer
sheet(s).
• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.
• Indicate the question number correctly for the answer in the margin space.
• Answer all the parts of a single question together.
• Start the answer to a question on a fresh page or leave adequate space between two answers.
• Draw table/diagrams/flowcharts wherever appropriate.
Write short notes on:
PART A
1. What is hypoxic-ischemic encephalopathy
Clinical features of HIE.
Outline the approach to diagnosis of HIE.

2. Pathogenesis of Clostridium difficile infection.
Diagnosis and treatment of Clostridium difficile infection.

3. What is microbial bioterrorism?
Enumerate the agents used in this.
Outline the measures of containment/prevention of
microbial bioterrorism.

4. A 42 year old male presents with fever, headache and
vomiting of four week duration and has neck rigidity on
examination:
What is the clinical diagnosis?
What are the causes of this condition?
Outline the approach to his management.

5. Clinical features of acute cocaine intoxication.
How will you manage it?
5+5
Please read carefully the important instructions mentioned on Page
• Answers to questions of Part and Part are to be strictly attempted in separate answer
sheet(s) and the main supplementary answer sheet(s) used for each part must be tagged
separately.
• Answers to questions of Part attempted in answer sheet(s) of Part or vice versa shall
not be evaluated.
PART B
6. Commonly used severity of illness scoring systems.
Role of these scoring systems in the intensive care unit.
5+5
7. Enumerate causes of pancytopenia.
Clinical features and treatment of aplastic anemia.

8. A 35 year old woman presents with massive splenomegaly.
What is the differential diagnosis?
Outline the approach to its management.
4+6
9. Enumerate the Rickettsial infections of clinical importance.
Outline the approach to diagnosis of these infections.
4+6
10. A 25 year old woman presents with fever and jaundice of four
days duration.
Outline the approach to diagnosis in the patient.
How will you manage her at primary care level?
5+5