Kazi Raad - IM12 Asif Hossain - IM9-08

General:
Diseases responsible for smoking, One and only one disease which must be due to
smoking, Fever for 3 days, no focal signs symptoms, what's is your d/d, ? weight
loss er cause, Smoking er long term effect ki ki ? 3 din er fever neye ashlo kono
focal sign symptom nai,, ki ki hoite pare ? fever without focal sign …
CVS:
***Ek jon pt sudden severe central chest pain niye ashlo management bolo,
central chest paind/d,clinically exclude** *23 yrs female with repeated
palpitation... How to evaluate?
Causes of arrhythmia? A 45 years old diabetic, hypertensive male has been
presented to you with dyspnoea but not chest pain.
What are the D/Ds ? Accha ei patient er jodi chest pain thake shekhan theke MI
develope korar mechanism ki ?What will be the treatments ?
* **chest pain d/dd....MI management...
Acute severe chest pain neye ashlo tmi ki chinta korba ar ki Mx plan korba ? ,,
keno MI te breathlessness hoy ? angina r MI er pain er difference, MI er 3 din por j

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pain hoy oita ki….sudden sever chest pain ,MI management,acute complication

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which coz breathllessness in MI Ho
***Acute Severe Chest pain, cause? ki korba? Management kivabe diba? what r the
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end organ damage in htn***How will u differentiate lvf from acute severe asthma
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by chest examination....*** sudden severe chest pain in 60 year old man. dd? Dd
M.

gular on kon investigation must korba diagnosis er jonno?

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Hypentensive pt er ki ki investigation korba? ( age urine RME ) cause of

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hypertension? htn er def, essential hypertension, exaggerating hypertension ki?

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secondary causes of hypertension.*** 20 yrs old akta pt bp-160/110 niye asle...dx

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ki? 20 yrs er pt er khetre htn er cz ki? clinically kivabe dx korba? ****25 years
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female presented with HTN - cuase? Kon glomerulonephritis e persistent HTN

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thakbe? Ei female pregnant hole ki anti-hypertensive diba? ki diba na? ARB dewa
jabe?
***A pt with fever, hematuria murmur ...dx ki.. organism of infective endocarditis,
symptoms and rx. **pt come wiith DM with HTN with severe breathlessness..mx
of this pt.
Respiratory:
A patient came to u with ascites and breathlessness, what are the examinations u
want to do immediately? What is ur diagnosis? What are the findings u expect on
clinical examination in this case? pt admitted in orthopedic department
developed sudden severe respiratory distress, wht the possibilities. how will u
differentiate pulmonary embolism from LVF.blood nd imaging investigation of
pulmonary embolism. treatmnt of pulmonary embolism.** *50 yrs male with
hemoptysis... D/D? How to differentiate clinically? Investigations?
D/D of breathlessness, s/s of every d/d, how will you confirm by clinical
examination, Auscultaion findings in LVF, Acute severe breathlessness er ekta
patient ashlo ,ki ki hoite pare ? lung er allergy er nam, dysopnea ki,….
pneumothorax er managent***dibatic and htn pt developed suddn severe
breathlessness at midn8.clinically ki dekhba tmi,rx of tension pneumothorax and
acute severe asthma
ccu te jaoar pothe severe breathlessness hoilo kn?(pulmonary edema hobe) ekta
finding bolo.(basal crepitation) smoking er complications. …1 diff btm copd &
athma in history,breathless er coz….Cyanosis with Breathlessness, cause?
Asthmar pt & copd er pt, kar cyanosis pawar chance beshi?
Renal:
end stage renal disease. kano bolla? renal replacement therapy er option ki ki?
konta valo? complications of ckd, Causes of generalized oedema. a female comes

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to u leg swelling for 2 wks duration without any other complaints. histry te ki ask
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korba.ki possibilities. nephrotic syndrome ki. Ho
****AKI vs CKD,nephrotic confrm krba kivbe? anuria oliguria,fever with
if
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hepatomegaly,d/d ki,cnfrm krba kivbe?**** Causes of ckd.nephrotic syndrome ki,

feature ki, leg edema d/d, ****CKD er pt er anemia kn hy,mx?** polyuria r pt er ki
M.
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histry niba,ki clnically dekhba,polyuria r d/d,DM r DI kivabe dffrntiate krba,

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kontar specific gravity beshi, 1ta pt ashlo creatinine level 2.5 er beshi.kivabe
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bujhba eta ARF nki CKD, ***50 yrs pt hematuria nea ashle ki ki history r examine
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krba,ki investigation korte chao,Xray krle ki paba,USG te ki paba...*** Pt come to u

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s. Creatinine level 5.. Repeated inv shows same result .. What is your dx,s/s of this
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pt.. If pt develops hyperkalemia how will u mx.. After doing all 3 measures for
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hyperkalemia still K+ increasing how will u mx r8 now.

Abdomen:
*epigastric pain er d/d, abdominal distension ki ki cinta korba?
ascites ar ki ki investigation korba?? Pud er c/f...kon ulcer e weight bare kontate
kome?*** 40 year old lady - Upper abdominal pain dd ki? Kn ta te ki feature ? Pain
er nature?Kon kon investigation must korte hobe differentiate korar
jonno? ****ekta pt ashlo abdominal distention niye but oedema nai,d/d****causes
of chronic diarrhoea,inflamatory bowel dis ki ki,birdem e commonest ki cause e
2mnth chronic diarrhoe pt ashe/bd commonest ki,… a 40 yr patient with ascites..
how will you proceed to diagnosis! How will u confirm ascites with 1 test. Name 3
condition where ascites will be prominent ( Cld, abdominal tb & abd malignancy
).*** 6 months er diarrohea ki hote pare, ibd er type, duitar dif, konta
kharap, ****A man with dysphagia .d/d. confirm korba kivabe?

Neuro:
comar cause, epilepsy ki
***what r the causes of sudden severe headache....how to dx meningitis? sir:what
is meningitis and what is enchaepalopathy..give some eg of encephalopathy.
mononeuropathy, polyneuropathy, peripheral neuroparhyr def, cause,
hemiplegia, paraplegia, quadriplegiar def, urticaria….**sudden severe headache
er d/d, migraine er c/f,drug of acute migraine,*** a pt suddenly dvlpd wknesss in
both lower limb,wht r the d/d,*** a pt ē severe headache..D/D ki? subarachnoid
hmrrg er 1 ta invstgatn ar 1 ta drug.
Electrolytes:
hyperkalemiar treatment, hyperkalaemia er ecg change ki ki hoi? treatment of
hyperkalaemia., akta patient er BP 70/50mmHg but periphery warm. duita

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diagnosis (septic shock, anaphylactic shock), anaphylactic shock er treatment e ki

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ki drug diba, adrenaline kon route e diba, koto dilution e diba.. serum electrolytes
Ho
e ki ki dekhi? normal soduim level? hco3 barle ki bole take? metabolic acidosis er
if

ekta condition er nam ***ekta pt severe diarrhoea niye ashse tar electrolyte e ki
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change hbe? Hypokalemiar cz,mx. Hyperkalemiar cz ***wht r d/d and

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invstigation,rx of hyperkalemia, aisob mx eo thik hoche na..lst step ki***What is

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hyperkalemia, causes nd Ecg findings.. rx.. if after all the rx it is corrected.. ki

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krba? dialysis ki birdem e kora hoy?

Endocrine:
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hypoglycemic r dka er moddhe clinically differentiate koro, DM er

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Cx,hypoglycemic coma er cause nd Rx….thyroid a ki ki disease hote pare?

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Hyperthyroidism er cause? Investigation ki ki korba? Kon tar Finding ki? Radio

iodin uptake a kon tar ki paba? Kon disease a uptake kom ? Kon disease a beshi?

Rheumatology:
akta patient migratory poly arthritis niye ashche. ar ki ki clinical ar lab feature
khujba. acute rheumatic fever e ki Sydenham chorea hoi? (answer is no)., what
are the criterias of rheumatic fever? What is migratory polyarthritis? Which joints
are mostly involved?
30 bochorer ekjon Female tomar kache Knee joint er swelling niye ashche ? Dx Ki?
Ar kothao hote pare ??? fever nia aslo 4 dib ar d/d ki? investigation? RF er dx
criteria,DMARD ki,nam bolo ,MTX er adv effect,gout ki,c/f ki,great toe te hole eta
ke ki bole, ekta mohila multiple joint pain niye ashche. Ki hote pare?
*Migratory arthritis er cause, gout kno hoy....kono drugs er jonno ki gout hote
pare?gout er treatment.r anti uric acid drug kokhn dibo?
25 year old female finger joints e redness n swelling niye ashche, Dx? ki ki type
arthritis ase, sero negative gula ki ki? reactive e ki hoy?*** akta 50yrs er mohila
rheumatoid arthitis niye aslo....diagnostic criteria ki ki ? inv ki korba?
****5 year old patient with migratory polyarthritis...cause? rheumatic fever er
criteria,investigation,treatment,*** Seronegative spondarthritis er criteria, most
common cause, kivabe confirm korba, ***A 40 yr man with first
metacarpopharyngeal joint pain.. dx, cause of gout & rx, side effects of cholchicine,
early and late s/e.
Skin:
Ekta patient 2 din er jor niye ashche ...kono rash nai...ki hote pare ?? ekta bolba..
Bullae r Cyst er difference ki ??? Diabetic patient bullae niye ashche..Ki hote pare
fate ??? purpuric rash d/d? d/d gular features?? purpuea nie ashle d/d ki? confrm
krba kivbe? psoriasis kisher disease,kmn lesion hoy,

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***cause of pruritus? generalized cause of pruritis...presentation of a pt with
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urticaria ***prutitic skin lesion er name, atopic eczema kader usually hoy,
treatment, scabies er complication, AGN keno hoy , kivabe hoy,scabies er drug er
if
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nam,
M.

Scabies ki, kothay hoy, ki diye hoy, fungal infection of skin ki ki ache, nails e hole
S.

ki bole?.**** scaly lesion niye akta pt ashlo,wht may b the cause,complication of

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psoriasis,psoriatic arthropathy ki seropositive nki seronegative,

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Poisoning:
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opc er management, Common poisoning ki ??? OPC common kano ???

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*Near drowning & drowning ki? Near drowning er management? snakebite er

treatment**Arsenicosis s/s and treatment.
Infectious disease:
mymensing theke ashlo 2months er jor d/d, kalaazar er investigation, sir:what is
leishmaniasis, organism,types,what are the investigations done to detect kala
azar. Which organs are involved? What are the treatment options? Which one is
the drug of choice now a days? What is significant wt loss? What are the types of
fever? ..Characteristics of fever in case of tb patient. confirmatory test for enteric
fever, Can viral fever cause enteric fever?? how?? 2 dn er fever and
unconsciousness nie ashse? ki mathay ashbe? mymensingh thk 3 dn er fever nie
ashse,ki hbe, malaria pt unconscious hoa gele ki Rx diba,quinine dile ki Cx hote
pare, Enteric fever er 1ta Inv. jdi bolte boli konta bolba ? …
***how will u dx a scabies pt.Fever 4 diner with gaaye betha, cause?
Dengue vs enteric fever?
Dengue suspect korteso, ki investigation diba?
Platelet <90,000, ki bujhba?*** pabna theke ashche with fever, ki hote pare, ki ki
physical sign paba, ****t with prolonged fever came to u.d/d. investigation ki
korba?
Nutritional disease:
BMI ki, BMI er classification. Obesityr mechanical complications, What's is your
BMI??, BMI more than 30 what is called this condition, obesity er cause, effect of
obesty, Mx, Wt loss er cause ki ? wt gain er cause ki ? BMI ki ? range ,,, Obesity er
cause ? .. Ekta patient 6months ageo valo chilo.. 6month dhore Weight loss
hocche, ki karon?
Hepatology:
Hepatitis er marker, 20yrs female hypertension.,ki ki investigate krba?

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complications of jaundice, s/s of obstractive jaundice, viral jaundice vs obstractive

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jaundice, Mx of obstractive jaundice, hepatic encephalopathy ki,c/f ki , hb bare
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kokhon, komle ki hoy, normal value,… jaundice kokhon bolbo, types,
hepatocellular jaundice kise hoy, ekta pt ascites ache sathe splenomegaly cause
if
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ki….fever bruish hepatosplenomegaly bone pain dx ki

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***Pt with nausea, vomiting, yellowish discolouration of sclera, ki bujhba?

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abdomen e clinical ki finding paba? Ar kon kon condition e tender hepatomegaly

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pawa jay?
Liver abscess er dx er jonno ekta investigation? serum bilirubin er normal value,
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koto hole clinical bolba, types of jaundice, obstructive jaundice er ekta pt er ki

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history thakbe….. young male pt jaundice for 6 days and fever, dx? S/S ki ki? pain
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kno hobe? same pt 2 month jaundice niye ashlo with altered sleep pattern, dx?
clinically ki ki paba? ***,jaundice er pt er kivabe histry niba,truck driver er khtre
kon hstry imp,akta***fever with itching er cause....obstructive jaundice e ki bare?
ALP r kon bone disease e bare? Osteomalacia er. cause ki? ***Hepatotrophic and
non hepatotrophic virus ki.. 7 day er viral hepatitis er pt ki symptoms niye ashbe..
***a pt 20 years old,icteric ē anorexia ,nausea ..D/D ki? abdmn a ki fndng khujba??
**kta pt anorexia, nausea,vomiting r yellow discoloration nea ashlo ki ki jigsh
krba,abdomen exm e ki ki expect koro,ki investigation krba,LFT te ki ki kore
Hematology:
*20 yrs male with purpura n bruise... D/D? How to differentiate clinically?
Investigations? PBF findings? How to confirm? severe anaemia, splenomegal.....?
wht is your d/d. ekta baccha aslo gum bleeding r rash niya what's ur d/d..how will
differentiate leukomia? …anemia r purpuric rash er d/d, ***Anaemia with
hepatospleenomegaly without fever, kon leukomia,kon lymphoma,CML er
investigations nd finding. staging (scenerio diye ask korce kon stage) CML er drug
er nam bolo****A 20 yrs old pt came to u with purpuric spot.d/d ?? kivbe evaluate
korba? ITP te treatment ki dey? Steroid dewar poreo thik hocche na.ki korba?
(splenectomy). splenectomy korar age ki korba? ***A man with dysphagia .d/d.
confirm korba kivabe?
Psychiatry:
Distress komanor jonno ki diba ?? High flow oxygen ki ?? delirium ki,hallucination
ki,auditory hallucinations kon disease e hoy,visual ta kon disease e hy,dementia
ki,…. anxiety & thyrotoxicosis difference. schizophraniar criteria
Paediatrics:
-neonatal convultion er cause.perinata asphyxia er managemntg and complication

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..Imci thke danger sign. -child comes with jayndice. Cause ki hote pare? Ki ki
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investigation korba? Complication ki hote pare? Hepatic encephalopathy er ekta
Ho
clinical finding bolo bed side a? Ekta child Anaemic , agey blood transfusion korse,
if

ki hote pare ? Ki ki investigation korba? Ki paba cbc pbf a kon cell paba ? Ei
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anemia te cell er ki hoy? ( microcytic hypochromic ) Aro koyekta anaemia bolo

M.

emon type
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- young male pt jaundice for 6 days and fever, dx? S/S ki ki? pain kno hobe? same
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pt 2 month jaundice niye ashlo with altered sleep pattern, dx? clinically ki ki
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paba?
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- 11 month er baccha resp distress ar cough niye ashse , d/d ki ?pneumonia ar

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acute bronchiolitis er difference ki, x ray te ki paba, treatment ki , hemophilia er

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scenario , kibahbe diagnosis korba -preterm low birth et er immediate cx, scanty
urine r puffy face er d/d, convulsion niye ashlo ki kore manage korba -lathergic
baby...fast breathing ase imci onujae kon pneumonia? treatment ki?
akta bacca aslo urinary frequency nia ki ki history niba??? jodi bole scanty urine
tahole dx kiI? -akta bachcha polyuria niye ashche. differentials bolo. bahchader
DM diagnosis korar criteria bolo. bachcha ashche with generalized swelling and
scanty micturition differentials bolo. nephrotic syndrome er specific treatment
bolo. ki ki jinish dekhba followup e. akta bachcha er sudden severe attack of
asthma hoilo. ki ki management diba. salbutamol koebar diba, kivabe diba?
-ek rate bleeding spot hoise.dx ki.rx ki? Imci er full form ki?imci e diarrhea r
classification koro. diarrhea 9kg 13 month age. Rx dao. Rehydration chara r ki
korba? Gbs er ekta scenario
****severe dehydration neonate,Rx of plan c,cholera saline e ki ki ache ja ns e
nei.scenario:agn,nephrotic syndrome,nephrotic er main feature ki ki.purpura
neonate dd,itp confirm kivabe?marriw findings ki,itp r rx,anti d ma k kokhn
dei,bacchak ki dei itp te anti d?hemophilia feature.*** Anaemia with
hepatospleenomegaly without fever, kon leukomia,kon lymphoma,CML er
investigations nd finding. staging (scenerio diye ask korce kon stage) CML er drug
er nam bolo
-nutritional disease ki ki ase? ida te ki ki features paba? kivaba dx korba?
fever with convulsion niye asle dd ki? kivabe differentiate korba? kivabe mx
korba?
akta baccha severe breathlessness niye asle dx ki? ki rx diba?
puffyness of face niye asle r ki ki features dekhba? dx ki hobe? dd ki hobe? Rx
-Paedi ward koi ? Geso ? Ki dkhso giye ? Ki case commonly thake ?ki ki Resp
problem niye ashe bachhara ? Pneumonia related kichu ask krsilo.. ekta bachcha 3
maash er severe resp distress, chest indrawing and cough niye ashche..r ekta

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bachha same age playful with chest indrawing and crepts..
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konta dx ki and management ki dba? Dehydration assess korar criteria gula bolo ?
Ho
Management..- fever with itching er cause....obstructive jaundice e ki bare? ALP r
if

kon bone disease e bare? Osteomalacia er. cause ki?

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-baccha diarrhoea niye asche.maa ke dui ta q koro imci onujayi.

M.
S.

Baccha severe asthma nie aschi.treatment dao. Ki ki form e steroid dba.koto bar
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salbutamol diba.
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10 din er baccha jor convulsion nie asche. D/d dao alada koro ki ki korba bolo.
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