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MEDICINE VIVA 2018
1ST HALF
#medicine jototuk mne ase...
Long case:copd.nazmul sir..salient feature..kno bolso
copd kno bronchial asthma na..xamination finding..kno
barrel shape.liver border koi...cardiac area bolsilam
oblitered..sir aita check korse..ekta invstgn
bolo..spiromtry te ki pabo
Short case...nazmul sir..neck node chlo dd ki..ki inv
Enayet sir...sir etto cute chilen ajk..pulse dekhau..sinus
tachy cz..carotid a ki dekhi
Mrinal sir...paraplegia cz..UMN LMN a ki paba..ekta
examination bolo..cz ki ki..gbs type inv n treatmnt
Paedi...provat sir-NS chilo..abdomen examination..
Rashed sir..general xaminatn..jaundice chlo..cz ask
korsen.hate ki dekhi
Viva:nazmul sir xray MR.. data CMlL
Mrinal sir .rheumatoid arthritis.. drugs methotrexate
kivave dey... upper abdominal pain..r mne nai
Enayet sir:ecg mi Af dutai..data: agn scenario food
poisoing ..kon type poisoning..cz of toxic food
posoing..autosomal dominant disease nam bolo
koyekta
Rashed sir..leukaemia...poisoinig..rheumaic fever..Epi
schedule...
Provat sir...xray rickets...bone marrow aspiration
needle..qstn.. poisoningr mne nai
Skin mamun sir...urethritis conversion disorder r
hallucinations..r mne nai�
Shobai paedi te chocolate niye jais
r nam n code likhe base lagiye jais
Alhamdulillah.Exam shesh.�
#Medicine .
Exam start hoiche exact 8.15 theke.lotary kore khata
tulchi,khatay bed number deya chilo.8.55 er sir ra ber
kore dichen room theke(academic corner er pashe
choto ekta room e 10 minutes rakhchen)
er por lotary onujai nazmul sir 5 jon, mrinal sir 5 jon er
enayet sir 4 jon er exam nichen.so,je first person hobe
se khub kom shokoy pay,tai taratari kora lagbe
sobaikei cz lotary onujai rool 5 o emon hoile pare je
kunu sir er kache prothome viva deya lagte pare.eita
sesh hoar por 5 jon kore short case er jonno
dakchen.11.30 er dike short case sesh hoiche. 30
minutes oi chutu room e porar shomoy dichen, er por
viva shuru hoiche tana 6 ta board.
LONG CASE:shomoy khub e olpo paoa jay.10
minutes er moddhe dx ar exam kora na gele salient
feature porjonto likha possible na.
amar case chilo AML.
name:jitu mia,36.
symptomps:1.breathlessness for 1 months.
2.bleeding per nose and gum bleeding for 10 days.
g/e te bony tenderness,multiple petechia,anaemia
chilo.
systemic exam:spleen 4 cm chilo.liver palpable chilo
jodio ami pai nai.boli o nai.
d/d te aplastic anaemia bolchi sudhi.
Q chilo:present ur case?why acute
leukaemia?clinically kivabe bujhcho eita acute
leukaemia-anaemia causing exertional breathlessness,
superficial bleeding due to thrombocytopaenia,deep
seated bleeding hole abar coagulation abnormalityr
dike jay...tai hemathrosis,haemoptysis eigula je nai ta
bola lagbe)
d/d ki? aplastic na keno?(previous viral infection like
HBV,HCV) eigular history chilo na,bony
tenderness,organomegaly,L.N pulpable.
then bolchen( registrar Mursalin sir er dike takaye) eita
CLD na keno,amar kache to CLD mone hoy?(eita
bolche most probably confuse korar jonno(than amar
positive findings gula abar bollam).
CLD ar AML/leukaemia alada korba kivabe?(CBC
diye-anaemia,thrombocytopaenia,leukocytosis ar
atypical cell(sir er kache keu blast cell boilo na).
ar ki korba-PBF.
confirm kivabe korba-bone marrow study.
ki ashe koro-blast cell more than 20%.cellularity ki
paba-hypercellular.Aplastic anaemia te ki paba-
hypocellular,more than 50% space is occupied by fat
cell.
than liver palpate korte bolchen.
ei patient er fever er history nicho?-nichi sir,nai.
thakte pare naki pare na?-pare.(due to abnormal
leukocyte)
case clear cut chilo.pt o school tecaher.so,ei case niye
keu tension koiro na.amio prothom bar dichi AML.but
Enayet sir onek benign chilen.ar mursalin sir boila
dichilen je organimegaly ache,bony tenderness
ache.so,methodical hoilei hoilo.COPD ke jodi asthma
o banao,kintu defend korte paro taile sir problem
korben na.onnoder case chilo-Only pneumonia,pleural
effusion,stroke,nephrotic,copd...baki gula jani na.oder
post tkeke dekhe neio.
Short case:eksathe 5 jon er nichen.
ami second person.
tai first Enayet sir er board e first chilo.
Q-inspect the chest of this patient.
er por auscultate.
amar patiend er mone hoy upore pneumonia ar nicher
dike pleural effusion chilo.exam er shomoy PE er
findings khub valo pai nai...tar por o sir khub beshi
jhamela koren nai.percussion koraye ar pleural
effusion er cause dhoraye chere dichen.
er por pacdi.
provat sir.NS er case chilo.
Q-examine the abdomen and do relevant.
ki paicho-NS er feature gula.
amader patient er fluid thrill ar shifting dullness duitai
positive chilo.
ar ki dekhte chao-bed side urine for protein.BP,onno
kuno jaygay oedema ache kina,JVP,cvs examination ar
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stigmata of CLD bolchi.
then d/d ask korchen.
er por paedi arekta board.external sir mone hoy jahid
sir ba oirokom namer keu hobe.
Q-do the G/E of this patient.
jaundice chilo.
boshaye L.N pulpate kora pordonto korchi than hct,bp
ar anthropomometry korte chai bolchi.
Q-positive findings ki?-jaundice
ki hote pare-heriditary haemolytic most probably
thalasaemia,acute viral hepatitis,liver abscess,cld
eigula bolchi.
left shoulder e ki jekhla-BCG mard.
kivabe dey-intra dermal.
er por nazmul sir.
Q-pulpate the abdomen.spleenomegaly chilo.-13 cm
from costal margin.
d/d ki-ami cml,thalasaemia,malaria,kala-
azar,myelofibrosis,cld with portal hypertention eigula
bolchi.
than Cervical lymph node dekhte bolchen.
pulpabe chilo ar exta theke biopsy o neya hoiche.
then ami bolchi I want to add on my d/d as lymphoma
and disseminated TB.
pore bollo kunta bolba-ami lymphoma bolchi.(most
probably matted chilo,TB hote pare)
er por mrinal sir...female chilo flacid paraparesis er
.(chelera female attendent ar kotha bolte vule jaio na).
bollo inspection e jodi akta jinish dekhte chao taile ki
dekhba?
-ami fassiculation bolchi to differentiate between GBS
ar MND.but sir sunte chan power.inspection ei naki
power dekha jay.
jai hok er por power dekhte bolche.power chilo 2.than
bollo ki hote pare-bolla Multiple sclerosis,GBS,spinal
cors trauma ,TB eigula.
Multiple sclerosis ar GBS er moddhe kivabe parthokko
korba-flacid ar spastic paraperesis hobe.jark
exagerated ar absent paro.planter extensor pabo.
jerk dekhao-absent chilo.keu jendrassik maneuvre
korte vhuilo na.
then ask korche ekhon ki hote pare-GBS,diabetic
amayotropi,peripheral neuropathy due to any pause.
GBS kibabe dx korba?-nerve conduction study .
ki paba-conduction block paro.
ki type er lession hoy-axonal,demyelinating.
eikhane sensory loss hoy?-na sir except AMSAN
veraity.
treatment ki diba-IVIg,plasmapherssis.
viva: eksathe 7 jon er nichen.1 first e nazmul sir.,ami
mrinal sir,3 enayet sir,4 mamun sir,5 paedi external,6
srovat sir.ar 7 rsst e chilo.5 minutes pore 6 rest e geche
eirokom hoiche.nazmul sir er board e view box chilo-x
ray ar data .mrinal sir ECG ar data.enayet sir ecg ar
data.mamun sir mone hoy 10 trs ager toiri kora skin er
3 ta ar psychi er 2 ta question niye boschen.paedi
external data ar provat sir instrument ar view box niye
boschen.
Amar first viva:board A2-
respiratory,GIT,haematology,hepatoly chilo.
Q-45 or eirokom yr er smoker low grade
fever,cough,respiratory distress niye asche.cxr e rt
lower lobe e opacity ache-how will you approach to
dx?
ami TB ar carcinoma dhore history,exam,investigation
eigula bolchi.
most probably atypical pneumonia o d/d te ashbe.(sir
derke ask kore sure hoye neio)
Q-26 years male with recurrent upper abdominal
pain...how will you approach?
ami PUD,chronic cholecystitis ar chronic pancretitis
bolchi.er history,exam bolchi.
confirm korba kivabe-endoscopy,usg ar pancreas er
jonno contrast enhanched ct bochi sir manen nai then
s.lipase bochi.sir bollen koto din pore lipase barbe(pari
nai)
Q-cld patient with oesophageal varies niye asche..what
is ur approach?
ami history te stigmata,exam e signs of portal
hypertension eigula bolchi.
ar ekta AGN er urine R/M/E report chilo most
probably.ar ekta ECG chilo mone hoy extensive
anterior MI.
er por viva enayet sir .
first e ECG chilo.
Infero-lateral MI.(ST elevation in 2,3 aVF,V4,V6)
ekta urine R/M/E. oita mone hoy AGN chilo.
Q-paraperesis niye ashle lession koi hobe eirokom type
q.ki ki paba-niche UMNL er signs pabo ar upore ekta
sensory level pabo.jodi hand involve na kore ar higher
psychic function alter na hoy taile koi lession -thorasic
segment e.
Q-16 years boy comes with high grade intermittent
fever for 10 days with constipation ? dx ki-Enteric
fever.
Mamun sir: kichu bolen nai sudhu question diye
takaye thaken bujha o jai na right hocche naki wrong
hocche.
skin theke 3 ta question
1.scabies er complication aro 2 ta q chilo oikhane.
2.gonococcal urethritis er scenario.
cause ki?
tx ki?
ar ki hote pare?
3.HAART ki?koi deya hoy?
psychi theke-1.MDD er scenario.
dx ki?ki tx?ki risk ache?(suicidal)
2.childhood psychiatric disorder koekta nam bolo.
autism er dxtic criteria.
schizophrenia er DMS-4 criteria .
paedi external sir-first urine R/M/E dichen ekta-NS
chilo.
acute leukaemia er cbc chilo.lymphoblast beshi chilo.
12 yrs girl with knee joint swelling fever and recently
developed Pansystolic marmur.
dx-acute rheumatic fever with carditis
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jones critesia major-
tx ki?
acute viral hepatitis er ekta scenario chilo
Provat sir-sir ekta kotha o bollen nai.registrar ma'am
pashe chilen.
first rickets er xray
severe penumonia er ekta scenario-15 months,R/R-
74,fever,feeding problem.
IMCI classification?
ar kun kun danger ign dekhba-baki 3 ta
tx ki?
ar mone nai.
ar mrinal sir er board e RA er dx,tx,dxtic criteria
dhoraiche.-criteria box er ta na.
6-7 ta je point ache oigula.
shob sheshe boss nazmul sir-
prothome ekta xray.
cardiomegaly ar increased vascular markings chilo.dx
is MR.
cz-cardiomegaly MS e hobe na.MR e hobe.
ami incresed broncho vascular markings bolate sir ask
korche bronchia markings kemn dekha jay(radiolucent
shadow pabo bronchial wall er karone ar er moddhe air
er karone radioopaque shadow pabo.ar vascular
markings hobe puratai white mane radioopaque)
so,keu broncho-vascular boilo na .shudhu increased
vascular markings boilo.
MS e kun chamber enlarge hoy-Lt atrium
MR e kun chamber enlarge hoy-Lt atrium and Lt
ventricle.
Er por CBC-
Hb-9.6
MCV,MCH,MCHC normal.
leukocyte cound 3,50,000/ml
platelet-1,70,000/ml
myelocyte-46%
blast cell-5%
Dx-CML
clinically koyta phase ache?-3
ta.chronic,accelerated,blast crisis.
ekhon kun phage e ache-accelerated phage e.
sir mainly blast crisis e je nai oita jante chan.
ami sir er board e jaoar age rest e chilam tokhon ekta
xray chilo.saiful sir ke ask korle sir bolchen eita naki
bronchiectasis.jai hok vaggo valo je oita pore
nai.onekei oitake penumonia or tb bolche.
ar amar MR diagnosis korteo onek kosto hoiche.
so,sir er board e kichu kharap hoite pare..but eitar
jonno onno board jate kharap na hoy oidike kheyal
raikho.Nazmur sir er question common phalano jabe
na.na parleo uni sunchi pass mark dey.
shobai valo moto exam edio.
300 taka niye jaoa lagbe,11 tar dike kichu khabar dey
,nijeo kichu nite paro.
sir ra bolche er poren shobai code number likhe Apron
e pin diye lagaye rakhte.
Duar dorkhastho thaklo shobar kache abaro.
MEDICINE;
long case:NS (mrinal sir)
salient feature bolo,dx,ki investigation, ki diye confirm
korba,aetiology bolo,ei pt er risk factor ki,herbal
medication r history obosshoi nbi,dm er oral drugs,ei
pt e konta dbo,konta valo,ckd pt k metformin dbo
kkina,konnta dile vlo,oitar class ki, ckd pt anemia niye
ashe kno?ki treatment dbo?NS e ki treatment
dbo?somogi effect ki?rkta ki jno dhorchilo vule gchi
short case:
Gbs(mrinal sir):power dkho,ki paicho,flaccid kina
bujhba kvbe,reflex dkho,finding, ki hote pare,dd ki,ki
investigations, treatment,kno continuous monitoring?
Back of chest(najmul sir);examination,ki paicho
radial pulse(enayet sir):ki paicho,ki ki dkhcho,sinus
bradycardia r 2ta cz
paedi:general examination, abdomen examination, dd,
viva:
najmul sir: xray(malignant lung abscess wd metastatic
lesion) lab report(aplastic anemia,ki niye asbe)
mrinal sir:ecg(AF),RA dx,treatment, investigation, ro
2/3ta chilo mne porteche na
enayet sir:ecg(ant.inf mi),lab report:AGN
spastic paraplegia r lesion koi,ki investigation diye
confirm korbo,1ta clinical sign jeta diye flaccid r
spastic alada korba,opc poisoning er antidote,kmne
dei,enteric fever er ekta scenario sir
bolchen,investigation,treatment, autosomal recessive
disorder er nam bolo
mamoon sir;MDD,treatment, ki complications hote
pare,schizophrenia dsm 4 criteria,anxiety disorder nam
HAART ki,indication, scabies er complication,std niye
onk kichu chilo, eta pore jas
external paedi:ARF,investigation, treatment, AML,
investigation, ki sign pabo,
provat sir: xray (TOF),acute viral hepatitis,very severe
pneumonia, treatment
এই ,, �
& All the best! �
amr mone thake na joto tuku mone ase dilam
long case :decompensate cld with PT
keno bollam,findings, ab pain thakle ki bole,spleen
palpate korte bolsen.keno Cld,investigation, SAAG
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mane ki,treatment. (2)enayet sir:ecg silo MI r data AGN.scenario sir

short case: mukhe bolsilo enteric fever er.rx ki diba.bed side a
1.examination of head nd neck,lymphnode spastic r flaccid kmne alada kore.autosomal dominant
chilo,fever,anemia chilo.diagnosis. disease er nam
2.pleural effusion.back examination nd findings (3) pedi:thalassaemia photograph r data NSr
3.paedi: ascitis chilo. ab examination, finding, card:AGN,rheumatic fever er scenario.childhood
diagnosis. psychiatric disorder ki ki,autism er criteria,rx,current
4.paedi:general examination EPI schedule
5.lowe limb er power dekhte bolsen,diagnosis if power (4)pedi:xray rickets r card:SAM,viral hepatitis er
2/5(paraplegia). causes of paraplegia, gbs er typ. scenario,IMCI,accidental cause in pedi.kerosene
viva: poisoning
nazmul sir: data of pancytopenia,types of (5)nazmul sir:xray ssilo d/d ki ki bolsi TB r pneumonia
pancytopenia, aikhane kunta. r data silo CML er
cardiomegaly r x-ray chilo.left broder dekhaite treatment,complication,presentation. sir ki 1ta scenario
bolsen.LVH er cause. disilo past MI ro ki ki bujhini.wht is angina equivalent
mrinal sir : Ecg Af,RA citeria, ar mone nai. (6)mrinal sir:ecg silo AF.card a silo RA er
enayet sir: rx,diagnostic criteria,DMARD.methotrexate er dose
ecg: MI, enteric fever er scenario, common
poison,sylhet e kun sanke common , lower limb e ro onk kisu dhorse vitore maximum e amr mone nai
spastic paralysis hole lession kuthay.
mamun sir: leprosy, HAART,genital ulcer,urethral Long case: Stroke with left sided hemiparesis (Mrinal
discharge er cause,hallucination, type sir)
paedi viva: . present ur case
rashed sir: RF,ALL,measels r features, complication. . positive findings
provat sir:X-ray TOF .dx ki
insturment ambu bag,kerosine poisioning, .knee jerk & planter reflex dekhaw
complication of kerosine poisioning, acute viral . sensory kmn chilo?
hepatitis. .Lesion koi
aro chilo bt mone nai shob... . ki dhoroner stroke
ar shobai obboshoi chocolate niya jabi. paedi r baccha . ki inv korba?
der dite hoy. . Hemisection of spinal cord at the level of L1 hole
sensory ki hobe? koi lost hobe?
#long case:
(najmul sir)CLD short case:
kno bolso d/d ki kinta kno.spleen dekhao a) paedi( Rashed sir)
#short case: . do general examination
mdcn .ki findings( jaundice)
:(1)enayet sir:rt sided PE:cause ki hote pare ai age .r ki ki korte chaw
a?investigations .dx ki (acute viral hepatitis)
(2)nazmul sir:rt sided consolidation:auscultate chest . ki ki virus er jnno hoy
from back nd findings bolo.cause ki hote pare
(3)mrinal sir:flaccid paraparesis:inspection koro.sir b) paedi( provat sir)
bolse inspection o naki power dekha jay.patient k hatu . palpate abdomen
na venge upre tulte bolbo.eta kora jay inspection a .ki findings
bollo.jerk dekhao.ki test korba.ekhane nerve .ki dx
conduction study sunte chay.2ta variety ase bolsilo
axonal r myelin(dekhe jeo aita).ki treatment diba. c) Flaccid paraparesis(Mrinal sir)
(4)pedi:ascitis dekhao . see power, knee jerk & planter reflex of the patient
(5)pedi:general examination:jaundice er . ki findings
cause.meningitis er type.bed side a LP puncture a .koi lesion
pyogenic meningitis er findings ki hobe.pressure besi . ki cause hote pare
bed side a kmne bujhba.(speed a asbe.jet flow na kijani .GBS er rx
bolsilo)
#viva:
d) plapate abdomen( nazmul sir)
(1)skin:card a silo scabies er
. findings ki
complications,diagnosis,urethritis er cause,gonococcal
.ki cause hote pare
urthritis er scenario silo.treatment,HAART r psychi
silo hallucination, schizophrenia,depressive er disorder
er scenario e) pleural effusion ( enayet sir)
2 . inspect from back, ki findings
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.auscultate from back, ki findings pulmonary opacity chillo), pancytopeniar data, cause!
. percuss koro, ki findings Baki sob viva board 95% same question sobar.tai r
.ki dx likhlam na.
All the best sobaike...
( ই ই,
) 1.Code ekta kagoje likhe apron er shathe lagaye ashbi
:p
viva: Paedi (Brd1+2) 2.Paedi baccha der jonno chocolate niye ashbi
.acute rheumatic fever er scenario (fever, joint
swelling, systolic murmur), dx criteria, tx Long case: Ns (najmul sir)
. kerosene poisoning, SAM, severe pneumonia, Positive findings (ascites,leukony)
instrument: bone marrow needle, use. Dd ami 4 tai bolchilam but sir got annoyed. He likes to
xray -rickets. data AGN hear cld :/
Why ns not cld
viva. nazmul sir. Confirm kivabe
. read the xray, Pulmonary tb chilo, Eta ki type disease
. 65 yrs male, h/o of old mi, now present with Cause ki
breathlessness, ki d/d. Kemne bujhla primary cause?
what is angina equivalent Amar case relapse er chilo, so explain korsi koybar
. data: cml holo and all

viva.: mrinal sir Short case

.Ecg, AF Head and neck ( lymph node chilo ter o pai nai -_- )
. cause of upper abdominal pain Lower limb (gbs)
.Diagnostic criteria of RA Abd (pai nai kichu)
Back of chest(pleural effusion)
viva: enayet sir Paedi gen ex
. ECG, inf, lateral mi Paedi ascites
. data. agn
. causes of flaccid paralysis Viva
. common poisoning
. opc poisoning er antidote, sign of atropinization. Mdd
Enteric fever Hallucination
Genital ulcer
viva: skin( Mamun sir) Upper abd pain evaluation
.scabies er 3 complications Spastic paraplegia cause, koi lesion
. type of leprosy Poisoning ki ki ache
.gonococcal urethritis er scenario, rx Opc antidote
. genital ulcer er cause Ecg Allah jane ki chilo acute ant MI ar AF bole ashchi
.HAART? indication Xray TOF
psychi: schizophrenia, anxiety disorder,, hallucination UMBO

long case- CLD
Case presentation, porer din severe pain hole ki
suspect korbe? Kivabe confirm korbe? Rx ki dibe?
Portal HTN kivabe bujhba? Endoscopy kore grape like
structure pele ki ki bujhba? Rx ki dibe? Patient er f/up
dite giye jodi dekho pt ultapalta kotha boltese dx ki?
Oi pt ke mutton, egg ki amount e khete bolbe? Kon
drugs dibena? Ascities examination dekhao
Short case-
1. Examine head nd neck (nazmul sir): lump node
chilo
2. Radial pulse (enayet sir)
3. Lower leg er power nd jerk ( mrinal Sir)
4. General examination: jaundice er cause, relevant, rx
3. Abdominal examination : ascities er cause
Viva:
nazmul sir: brochial carcinaoma xray (PE, peripheral
Amar memory khub weak mone porlei edit kore dibo
Edited: HAART ki, indication
Urethritis scenerio, ki ki cause
ALL data features
Scabies complications
RA criteria
Onk kicchu vule gesi..jototuku mone ase
Long case: pnumonic consolidation (nazmul sir nisen.
Unar question bujha jay na.)
Dx ki? Ki consolidation? ( pulmonary) kno bolso? Ki
coz? Thn sir pt examination kore bolsen amr mone
hocche mass lession with collapse with patent
bronchus. Amk wrong prove kore tumr ta establish
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koro �. Aita ki TB hote pre na? Kno na? Single treatment konta kokhon dei?Cat 1 er duration ar drug
investion that will exclude TB nd confirm pneumonia. name bolo.Gene expert..
R ki inves? X ray te konta te ki findings.
Short case----
Short case: paedi: 1.Examine the lower limb(Mrinal sir)
NS: common ques chilo. Examine the power of muscle.power koto?ei dui paye
General examination : jaundice chilo. Ki coz? Konta power 2/5 eke ki bolba?ar ki ki dekte chaw.Jerk ki
kmne confirm korba expected,jerk dekaw.eita kon typer lesion.ar ki dekte
Short case: Medicine chaw.ki expected? cause ki ki?
1.flaccid paraperesis.. Coz ask korsen. GBS kmne GBS er type,diagnosis inv,treatment.
confirm. Ki treatment
2. Do the general examination of head of neck region. 2.Palpate the abdomen(Nazmul sir)
( aita khub faltu disi.) nazmul sir nisen Ki findings.(18cm splenomegaly chilo),cause ki ki
3. Plural effusion hote pare.kon Leukemia?
Viva!
Board 1. Nazmul sir. 3.Examine the radial pulse(Enayet sir)
X ray : MR Ami pulse exam kore sob dekchi.Radio femoral delay
Data:CML porjonto dekbi.ami left hand e pulse pai nai tai na
Board 2: mrinal sir ( sir vlo onk) bolchi.pore sir absent pulse er cause jiggas
ECG : AF korche.Tracheal position dekhaite bolche.
Data: acute leukemia
Ques: mone korte prtesi na ( sorry) 4.Pedi--Provat sir.
Board 3: mamun sir.. Examine the abdomen.
Scabies, MDD, schizophrenia, r mone nai Findings ki? cause ki hote pare.pore basa koi jiggasa
Board 4: enayet sir kore amake dekiye marks diche(8.5/10)
ECG : acute ant inf MI Provat sir somvoboto 8 er niche kawkei dey nai.
Data: AGN
Scenario: enteric fever 5.Pedi(Rashed sir)Do the general Examination of the
Paraplagia baby.
Board 5: Jaundice,arr mild Anaemia chilo.Jaundice er provable
ARF cause.ki ki virus Jaundice kore?Anthropoimetry ki ki
R mone nai. dekhi?HCT te kon condition e proteinuria paba?
Board 6: x ray : rickets
Scenario : severe pnumonia, kerosine poisoning,
Board Viva
Sorry amr kno jni kichu e mone portese na..topics gula
o thikmoto mone nai. � pore mone korle post kore
dibo.. Sobai doa kris..R toder jonne o onk onk doa. Vlo 1.Nazmul sir
hobe in sha allah ☺ Xray (Cardiomegaly),Data (Pancytopenia),cause

Long case---(Mrinal sir,Alhamdulillah besh valo
hoiche)
Left sided Parapneumonic pleural effusion
Present your case.
Why pleural effusion?
Possible cause.Establish your diagnosis.
Tubercular hole ki paita?
Bronchigenic na keno?
Suppose eiI pt er hemoptysis ar clubbing
ache,diagnosis ki bolba?
Clubbing er ar ki ki cause ache?
Consolidation na keno tomar Case.
Pneumothorax e percussion note kemon hobe?
ei patient er lymph node thakle ki inv korta?
Investigation dara kivabe alada korba TB ar
pneumonia?Bronchogenic e ki expect koro?
pleural fluid study te kontar colour ki?Protein kemon
thakbe? ar ki inv korba(ADA),Chest x ray te ki
findings.ei sobgular por o na manle tumi ki
korba?Category 1 TB treatment ar category 2 TB
2.mrinal sir
ECG--AF,Data --Acute leukemia
Echara Sceenario--ARF,Recurrent upper abdominal
pain -- 3 cause,3 inv, aro 3 ta chilo common e
3.Mamun sir
Psychi--Scenario,Diagnosis,Schizophrenia DSM
Criteria,Anxiety disorder types,Risk of the
patient,Treatment,
Skin VD--Scabies,Gonococcal urethritis
Scenerio,other causes of Urethritis.Genital ulcer cause.
4.Anayet sir.
ECG--MI,Lab data---AGN
Nervous theke 1 ta ques korche,common
poisining,OPC poisoning er antidote,kivabe dey
kotokkon,autosomal recessive disease name
(5+6)--Rashed sir, provat sir.
Acute leukemia data,TOF xray,Umbo Bag.
Structured question sobar eki chilo.
 7
Prothom kotha- Kalke theke shobai bacchar jonno
choclate nia jaish. Provat sir naile mind korte pare.
Ditio kotha- Gynae te jerokom code likha kagoj er
badge porsish, shobaike erokom pore ashte bolsen.
Tobuo Redwan sirer shathe beparta confirm kore nish.
-Long case- Stroke with right sided hemiparesis
Salient features
Differentiate from ICSOL
Show me the planter response
Examine the peripheral pulses of lower limb
Stroke er ki ki risk patient er paiso?
-Short case 1- Flacid paraparesis
Causes
GBS er types & Tx
-Short case 2- Do the general examination of head
neck region (Lymphadenopathy, anemia chilo.)
DD (ALL,CLL,Lymphoma ar TB bolsi)
Tubercular lymphadenopathy kemon hobe palpation e?
-Short case 3- Pleural Effusion
Causes
Ki ki examination korte chao cause determine korte?
Ki investigation korba?
-Short case 4 (Paediatrics)- Ascitis
Causes
NS hole diagnosis er jonno ki investigation korba?
-Short case 5 (Paediatrics)- Do general examination
(Jaundice chilo)
Causes
Signs of meningial irritation ki ki ache?
Causes of bony tenderness
-Viva- (Card shobar same chilo. Je questiongula ektu
different ogula likhbo)
Angina equivalent ki?
X ray te fibrosis ar consolidation alada korba kivabe?
Food posioning keno hoy?
koyekta bacteriar nam jara food e toxin release kore
(Bacillus cereus, Clostridium botulinum bolsi.)
long case:Nazmul sir
pneumonia
case shob clear cut thake na,so history likhar age must
examination kore confirm kore nibi
sir eshe direct ask korsen diagnosis,then bolsen
history,examination theke points in favour bolte,then
sir ekta chart korsen amar findings gular,& nije
examination kore milaisen
sir confuse korsen onek diagnosis ar findings niye,but
finally establish korte parsilam pneumonia �
erpor investigation,Rx ektu ask kore chere dise
so,beware abour ur findings,banai na dewai valo
short case: pedi Rashed Sir thalassemia(liver,spleen
palpable chilo,kivabe bujchi spleen,keno kidney
na,hepatospelomegaly cz ki,fever sathe thakle ki hoito)
ns(examination related common qst,heat coagulation
test niye ektu details ask korsen provat sir)
examination of face: Mrinal Sir (bell's palsy
chilo,rx,umn hole ki hoto,facial nerve er
course,nucleus koi thake)
examination of face: nazmul sir( plethoric or redness
in eye,cz? sathe cyanosis o chilo eta miss korsi)
examination of radial pulse: enayet sir, bradycardia
cz,ekta scenario bolsilo pulse related,diagnosis chilo a-
v block)
viva: Pedi: � Both board was easy qst,& Provat
sir,Rashed sir both are joss
skin,psyche: Mamun sir ghumai thaken,keu unake
jaganor try koro na �
ja paro icchamoto boila jaba
mrinal sir: Af er ecg,af er cause,lymphadenopathy
cz,chest pain cz aro ki ki chilo mone nai but
scenario/qst ez chilo
Enayet sir: MI er ecg,microcytic hypochromic anemia
er data,er cz,middle age female hole ekhetre kisher
history nibo,
sir mukhe mukhe kisu scenario banaise,just jhotpot
diagnosis bolte bolse
ekta chilo RA,Tb tb er diag kemne korbo,inv,rx arekta
scenario mone nai
demyelinating koekta disease er nam
Nazmul sir: Xray: interpret
ami bolsi rt sided pneumothorax,increased
bronchovascular margin
sir ar kisu bole nai
scenario chilo chikungunya,snake venom related kisu
qst chilo
venom gular nam ask korse,pari nai
ar mone nai
Best of luck to all
long case:cld (nazmul sir)
dx ki? kno blsi? d/d ki? testis palpate kora lgbe.ami
kore kichu bujhi nai..tai sir rag krsen.nd sir nij pt k
examine koren.cld te fever kokhn hoi? complication of
cld.
short case:
1/radial pulse (enayet sir)
bradycardia r cz
2/facial palsy: mrinal sir
funding ki,rx ki?
3/
face inspection (nazmul sir)
 8

findings ki? pursed lip breathing) Then just inspect the hand.
4/ general examination(pedi) (clubbing and flapping tremor) what's your dx. Ami
findings. COPD with type 2 respiratory failure bolchi. Hoi nai.
5/thalassemia( spleenomegaly, hepatomegay r cz) DPLD hbe.

viva:1/ nazmul sir Mrinal sir:Bell 's palsy Tx, dx(side bolte vule gechi Sir
hydropneumothorax onk mind korchen.. Left side LMN type facial nerve
chikungunia r senerio. palsy bolbi) facial nerve pons theke ber hoye koi jai?
common poison r nam. Facial canal a.
venomus snake name
Viva:Nazmul sir: Allah r nam nea chara kichu kore lav
2/ mrinal sir. nai!!Tora parbi inshaallah, Ami mukh tao khulte Pari
Af r ecg.cz of AF. nai. Sir onk onk birokto chilen amr upr ��� Doa
hypertension r cz,nonpharmacological Rx, r bki gula korish.
mne portese na. Hydropnemothorax chilo.
Scenario:70 year old lady with 3 days fever, first ankle
3/ mamun sir pain then shoulder pain then erythema nodusum. Dx
ki. Chikungunya hbe. Ami Dengue, SLE, Septic
urethritis,rx ki? arthritis bolchilm.
genital ulcer r cz,scabies r complication.
schezophrenia r criteria, rx. Mrinal sir:Hypothyroidism
Lymadenoathy
Paedi
4/ pedi... ( topics)
TOF
diarrhoea
Diarrhoea
dehydation,rx
AGN r report
instrument chinte dei
perinatal asphyxia
Mamun sir: Genital ulcer r cause
tof r xray
Urethritis r cause.
nephritic syndrome.
Ami psychiatry ques dekhi nai ��kichu boli nai.. Sir
picture of SAM,down syndrome
ghumai chilen. Uni o kichu bolen nai
Allah vorosha. Just Allah r nam niye pore Ja.. Amra
r kichu mnene nai apatoto shobai pass korbo inshaallah!
dua korish sobai.
Sorry for being late. Long case COPD with cor
long case - NS (enayet sir )
pulmunale.
case present koro ,,,
Mrinal sir chilen.
CLD keno bolla na ??
Ami first person chilm.kicchu likhte Pari nai..Sir kichu
kototuk protein gele NS bolba? albumin koto??
bolen nai. Just history nichi ar examination korchi 2
r ki karone ascietes hote pare ??
system.Notun patient dey. Even in short case patient
CLD, NS ki aksathe hote pare ?? ( ha,,hep B,C)
repeat kore nai��
NS er pt er hematuria hobe kokhon ?? ( complication
Question :salient feature. Kno bolcho?? Chronic
hoye renal artery thrombosis hole)
bronchitis kake bole? Kivabe asthma theke exclude
korcho? Tx( both COPD and heart failure).
Amk yamin sir dx bole dichiln. Confusion thakle sir sir family history details shunte chay - koy jon family
der k must jiggas koris. member ,,,ki disease ache

Short case: Paedi.
Ascites dekhbao. Clinically kom ascites thakle kn
method a dekhi(Pari nai)
Palpate the abdomen.
DD of hepato splenomegaly. Treatment of thalassemia.
Medicine:Enayet sir
Radial pulse dekhao. Collapsing pulse dekhle sir
khushi hon. Bradycardia r cause. (old age a heart
block)
Nazmul sir. Inspect the face(ami bolchi eye congested,
no jaundice, plethoric face and central cyanosis with
urine RME te kon cast pele NS bolba ?? (pari nai )
fluid thrill dekhao,, investigations, SAAG ki ,treatment
aro 2/3 tata ques korsilo, ,,mone korte partrsina
short case,,table viva : sobai k same dhorse
First e long case (case number lekha copy tulte hoy
like suegery)
My case: asthma
Niyechen enayet sir..
Ami first e chilam tonnir moto, kono time i
paini....shobai examination ta khub fast koro n
complete koro jate amar moto na hoy karo :( :(
 9

Questions asked :History presentation, why asthma, severe dehydration

inspect then examine the precordium Q: how will you catagorize this according to IMCI
(this means just classifcation of diarrhoea)
Then short case Management of this patient

Paedi short case: Complication of thalassemia

1) do the general examination (patient er ascites chilo)
Ques : diagnosis.. Xray of tof, components
Nephrotic 4 components
Instrument indentification ( bm needle, lp needle,
2) palpate the abdomen tongue depressor)
Ques: findings
No 6. Paedi scenario: pt with smoky urine pressure
Medicine short cases deya chilo dx : agn
Investigation of agn
1) nazmul sir : do the general examination of the Complications of agn
"face" of the patient
Then findings bolo: eyes congested (sir plethoric What is growth, development, domains of
shunte chan,patient cyanosed. pursed lip breathing ta development
ami bujhi ni )
Then sir tells than look at the hands of this patient Scenario: pt with cyanosis, fatigue with ejection
Tell me the findings: clubbing chilo systolic murmur in the left lower sternal area, dx?
What is your most likely dx? Then shobar mon ja chay Cyanotic congetinal heart disease (tof)
boleche n tokhon i sir er exam neya shesh hoye jay Principal duita components
:p dx was dpld
No. 1 e giyechilam
2) enayet sir Nazmul sir
Xray of, hydropneumothorax
Inspect the chest of this patient Scenario : woman with jonit pain with fever and rash
Asymmetry chilo both sides e ...ekside depressed chest jeta koik din por onno joint affect kore ..sir gave us
arek pash ta bulged chilo clues, jodi dhaka theke patient hoy (dengue,
Ques: tomar mone hoy kon side e pathology chikungunya,)
Examine the position of the trachea
No 2
3) mrinal sir Mrinal sir
Ecg of af
Ques: examine the face of this patient Causes of af

(Female bosha, tar right side e facial paralysis chilo, No 3

face was deviated to the left) Mamoon sir
Psychi
Findings bolo, diagnosis: right sided lower motor type Scenario: female with loss of enjoyment, apetite,
of facial nerve palsy faillure to perform daily activities erokom
Other name of this : bell's palsy Dx: mdd
Treatment of bell's palsy Dd of this diagnosis
Is this reversible Treatment

Then viva Dsm criteria of schizo

7 jon kore dhukay last er jon pasher bed e wait kore
then turn change hote thake (osper moto kore) Hallucination def type
(viva te time thake, keu purotuk jete pereche keu
pareni.. ami amr face kora ques gulo bolchi, ar amar Skin :
board e boshar serial wise bolchi) Complication of scabies
Gonorrhea, scenario : pt with urethral discharge,
No 7. Paedi scenario : meingitis, csf findings treatment
Causes of genital ulcers
Scenario (15 months baby e diarrhea for 3 days er What is HAART? Indication of HAART
moto patient lethargic dx: acute watery diarrhoea with
 10
No.4
Enayet sir
Data of thyroid profile
Dx : primary hypothyroidism
Treatment
Ecg: infero lateral mi
Scenario: young boy with dysentry, how will you
prove this is bacillary dysentry
Young boy with high fever chest pain cough
Dx, investigation, sputum e ki examination korbe
(gram stain and c/s)
Sorry eto late holo, shobar jonno onek onek dua
thaklo. May Allah have mercy on all of us
Assalamualaikum !
Long case (Mrinal sir): Hereditary haemolytic
anaemia-case present, dx, points in favour, why
hepatosplenomegaly in thalassemia, types of
thalassemia, thalassemia te main defect ta kothay hoy,
Hb F ki, kokhon bare, treatment of thalassemia,
complication
Short case: Paedi (Rashed sir)-Palpate the
abdomen,findings ki (hepatosplenomegaly),
describe..sir bolsen hepatic bruit r splenic rub dekhte
hobe na short case a..then ask korsen clinically spleen r
kidney kivabe differentiate korbo
Provat sir: Ascitis-Sir amake kono examination korte
den nai..shudhu ques korsen..ei patient er ascitis er
cause ki hote pare, ki investigation kore bujhba eta
nephrotic syndrome, ki findings pawa jabe, heat
coagulation test kivabe korte hoy, kototuku urine nite
hoy, heat kothay dite hoy, heat dile ki pawa jay, kon
reagent add kore amra protein theke others kono
ingredient k alada korte pari, protein chara r ki ekhane
thakte pare, acetic acid dile konta disappear hobe, cld
er investigation, serum ALP barbe naki kombe, r kon
disease a bare
Medicine (Enayet sir): Ki examination korte
chaw..pulse naki chest..ami bolsi pulse..then radial
pulse dekhaite bolsen, findings ki, bradycardiar cz ki,
kokhon amra kono pulse pabo na, ventricular rate koto
Nazmul sir: General examination of face, findings ki,
plethoric face with purse lip chilo..eta bujhi nai
Mrinal sir: Bell's palsy-Inspect the face, findings ki,
facial nerve examination, lesion kothay, dx ki
Viva (Mamun sir): Psychiatry-MDD, treatment, most
risky complication ki hote pare, hallucination ki,
schizophreniar criteria, treatment, anxiety disorder er
types, Skin-Scabies er complication, gonorrhoear
treatment, HAART ki, kothay dewa hoy, urethritis er
cz, genital ulcer er cz
Enayet sir: Data-Dx ki (Hypothyroidism), kivabe
bujhla, primary naki secondary, ecg-dx ki
(Inferiolateral MI), amoebic & bacillary dysentry k
clinically kivabe differentiate korbo, scenerio-dx ki
(pulmonary tb), investigation, treatment, kon regimen
dibo, ki ki drugs dibo
Rashed sir: X ray- Findings ki, dx ki (TOF),
complication ki, scenerio-dx ki (acute watery diarrhoea
with severe dehydration), r ki ki type diarrhoea ase,
persistent koto din thake, dehydration er types, severe
dehydration k ki treatment dibo, 15 month er baccha k
koto khon dhore rehydration korbo, scenerio- dx ki
(Meningitis), investigation, pyogenic er khetre CSF
study te ki pawa jabe, Instrument-Bone marrow
aspiration neddle, lumber puncture neddle, er
therapeutic use ki
Provat Sir: Picture-dx ki (SAM with dermatosis, down
syndrome, diptheria), scenerio-dx ki (AGN),
investigation, complication, ns theke alada korbo
kivabe, scenerio-dx ki (TOF), components,
complcation, scenerio-dx ki (ALL), kivabe bujhla,
leukemia te ki ki feature pawa jay
Nazmul sir: X ray-Findings ki, dx ki
(Hydropneumothorax), hyper translucent area dekhao,
hyper translucent kon kon khetre pawa jay, scenerio-
dx ki (Chikunguniya), ami dengue bolsi..sir kisu bolen
nai, bd er koyekta venomous snake er nam & tader
dara produced venom er nam
Mrinal sir: ECG-dx ki (AF), cz ki, hypothyroidism a ki
ki clinical feature pawa jay, treatment ki dibo,
hypertension er secondary cz, non pharmacological ki
ki treatment dibo...that's all
Sobai dua korish amar jonno...toder sobar jonneo onek
onek dua roilo...best of luck �
Case :stroke(enayat )
Present, dx, where is d lesion,risk factor,inv, rx ai pt
jnno... Xm jerk,arterial dorsalis pedis ai pt
only lower limb e weakness clo lesion medial surface
of cerebral hemisphere r sir inquary krclo j BP both
hand e measure krc kina,r family history in details
likhis sir details sunte chai members koi jn, ami
actually 1st e xm diace so history fully complete krte
Pari ni salient feature o likhi ni.. Jst
systemic(Nervous+Cvs) prjnto thn salient feature
jnno gap dx r d/d diaclm.
Short case:
1.lower limb(faccid)
1ta sign differ krte kn type(planter reflex)
Thn cause of faccid
Differ GBS & peripheral neuropathy(position sense)
1 history
 11

2.Inspect&Palpate abdomen(hepatospleenomegaly) 2.AFP def, cause, rx of GBS

Dd 3.OPC poisoning:rx
4.ALL data
3.palpate abdomen(spleen) Instruments:AMBU, bone marrow needle
See lymphnode
Dd Rashad sir:
Differ leukemia & lymphoma 1.TB lymphadenopathy, history te r ki niba
2.VSD, complication
Pedi 3.neonatal jaundice deu to RH, inv, rx
4. abdomen(ascitis) 4.JIA,inv,rx
Dd, clinically differ agn&ns Xray:Ricket, rx
Cause of swelling in agn Picture:Oral candidiasis, organism, rx
Cause of swelling in ns
SIR onk helpful sobai..
5.General xm(edema) dua koris ই amr jnno �
Dd
Clinically differ agn&ns
Ai pt ar urin side e clo oita high colour so aiber dx ki LONG CASE- ( Mrinal sir)
CLD with portal HTN
present ur case, positive findings ki ki ache, cld
Viva:
stigmata ki ki, portal HTN keno bolso, cld er
Nazmul sir:
complications exclude korar jonno tmi history te ki ki
Xray:Cardiomegaly
niso, complications dekhar jonno ekta difinitive
Cause
examinations ki korso, kore dekhao, Abdomen e ki ki
Scenario:1.haemostasis+cause
positive findings paiso, patient er liver kmn paba,
2 Dd, 2 clinical findings to differ it
spleen palpate koro, keno eta spleen prove koro, testis
2.epIgastric pain
palpate korso, ki paiso, testis ta kmn thakbe, umbilicus
Dd, differ it from history
er charpasher vessels gula ki bole, portal HTN er
3.45 yrs dm+joint swelling
features ki, patient severe abdominal pain niye ashlo
2 dd, inv
dx ki hbe, ki tx diba, SBP er clinical findings ki paba,
rupture esophageal varices er positive findings ki, pt er
Enayat : immunization er history ki niso, D/d ki, inv ki ki, pt
Ecg:AF ascitic fluid er colour kemon chilo ki bolse, r ki ki
Data: microcytic anemia colour hote parto, ascitic fluid study te r ki ki dekhi,
Ai data nia middle ekjn famale এ protine kmn paba ekhane, keno kom paba, kothay
data:Hypothyroidism kothay protine beshi thakbe, ascitic fluid e r ki dekhi,
Type(primary) rx cld er cause ki, ki ki virus diye hoy, hepatitis ki ki
Scenario:1.MI aslo Intern krba tumi, rx, virus ache(hepatitis G porjonto sir shunte chay) konta
ai pt 3din pr chest pain nia aslo precordium e ki dangerous, keno dangerous, mutant virus ki.
hbe(pericarditis)
2.RBS 200mg/dl SHORT CASE
Dm blba( aro xm krbo) Enayet sir
1) GBS
ankel jark, planter dehkhao, findings ki, dx ki, ekta
sir: history niye dx confirm koro
Ecg:ant mi
Scenario:1.limb weakness +fever 1wk back Nazmul sir
Dd(GBS), dx kivbe krba 2)palpate the abdomen
findings- acitis, keno bolla, cause ki ki hote pare, NS
2.OCP keno hobe, CCF keno hobe na ekhane, bed side e ki
Rx korba, ki paba, ascitic fluid er colour ki ki paba, konta
kisher jonno paba.
3.AIDS natural history
Mrinal sir
4 geriatric disease name, support 3) palpate the abdomen
findings - spleenomegaly
Pedi cause ki ki
Provat sir: examine the nack - findings - rt sided
1.IMCI def, component, bd te childhood survival lymphodenopathy, tahole akhon cause ki ki hote pare,
barate program ekta inv bolo confirm korar jonno, CBC te lymphoma
 12

te ki paba, leukemia te ki paba, leukemia te cell Instruments - AMBU bag, tounge depressor, bone
increased eta ke ki bole, leukaemoid reaction ki. marrow aspiration niddle(just identification)

Pedi- Nazmul sir-

Rashed sir
4)G/E (sir G/E e neck rigidity dekha pochondo koren,
neck rigidity dekhte vule geleo r ki ki korte chaw ask
korle oi shomoy bolleo hoy)
r ki ki korte chaw, positive findings ki(jaundice) cause
ki ki, jaundice present tahole relevant r ki dekhte chaw,
1ta tender 1ta non tender hepatomegaly er cause bolo,
viral hepatitis ki ki ache, kon kon virus er vaccine
ache, hepatitis b er vaccination schedule ta bolo,
patient k ki advice korba.
Provat sir
5) palpate the abdomen and confirm the ascitis
cause ki ki, ns keno bolso, agn na keno, agn hole ki ki
thakto, examination e ki ki peta, ns er cardinal
features, inv. fluid trill e majkhane hat keno rakhso.
Viva
Skin psychi- previous card
Enayet sir-
ECG- Inferior MI
intern doctor hishebe pt ke tmi kivabe mx korba
Data- NS
keno bolso, r ki positive findings ache, AGN na keno.
shudhu data dekhe confirm NS boa jabe kina.(Yes)
sir arekta data mukhe mukhe boltesilo DM niye je
RBS 200, pt diabetic r non diabetic duita kivabe
confirm korba(ami question ta valo kore bujhar agei
bell pore gese, Allah bachaise :P )
Pedi-
Rashed sir
1) scenario - dx- Tubercular Lymphodenopathy
history te r ki ki positive findings paba, inv
2) scenario - Dx -VSD
inv
complications
3) scenario -dx- neonatal jaundice
inv, tx
4) Scenario - dx- JIA, inv, tx
Xray- rickets (just dx)
picture - white patches in tongue, causes
X-ray- cardiomegaly, causes.
card-
1)scenario - fever, clubbing, cough with haemoptysis.
2ta d/d, other positive c/f ki ki pabo duitar khetre.
2)severe acute upper abdominal pain
3d/d, alada vabe shbgular presentation bolo, pt ki ki
complaint niye ashbe
(aro ekta chilo mone porche na)
Mrinal Sir
ECG- Anterior MI
Card-
1)opc poisoning, mx
2)AIDS er definitive condition (ki j chilo eta bujhi ny,
ami prodromal phase, acute infection r asymptometic
bole diye ashchi :/ ) AIDS er drugs gular nam
3) down syndrome er genetic defect ki, C/F
4) geriatric disease ki ki ache, patient care kivabe niba
Sesh..... �
[ chocolate, 300tk, code number gynea er moto likhehe
niye jete hobe, r pedi te growth chart shate rakhle sir ra
khushi hon, r parle shhobai shokal 8tar moddhe chole
jais, polash sir ajke boltesio shobai taratari chole ashle
sir ra naki 8.10 e xm shuro kore dey....5min xtra tiime
pawa jay.. time khub e kom pawa jay. khatai likha
complete na thakleo sir ra temon mind kore na but
history examination niya must complete kore rakhte
hbe, r jader swelling er case porbe tara history
examination korar shate shate pt ke urine er jonno test
tube niye pathai dibi, strip diye dey, 2min por e colour
change dekhe nibi, nahoy pore mone thake na dekhte,
oi room theke shobaike ber kore deya hoy, r kichu na
parle pichone sir der dike takabi,sir ra pichone darai
thake, sir ra khub helpful, onk kichu ishara kore korei
bole dey � )
shobar jonno onk onk doa roilo... �

Provat sir
1)scenario - d/d - ITP, Leukemia
inv for both D/d, inv findings in ITP
2)Define IMCI
components
erokom govt er r ki ki program ache?
3)Define AFP
Examples
4) scenario - OPC poisoning
dx, tx
Data- ALL