QUESTION BANK WITH ANSWER

FOR 3rd & 4th YEAR MEDICINE WARD (CAUSEOLOGY)

HISTORY TAKING & GENERAL Examination

Question No.01: What do you mean by occupational disease & some important
example?
Answer: An occupational disease is any chronic disease that occurs as a result of
a particular work/occupation.
Example:
Work Disease
Shipyard worker Asbestosis
Dairy farmers Farmers lung
Deep sea driver Decompression, sickness
Healthcare worker HIV, Hepa-B,C
Industrial workers Dermatitis, Occupational Cancer

Question No.02: What is Clubbing? Some important causes of it.

Answer: Obliteration of angle between nail bed & is called Clubbing.
Causes:
1. Respiratory Causes- Br. Carcinoma, Interstitial lung disease
Supportive Lung disease(Lung abscess, Bronchiectasis)
2. CVS- Infective endocarditis, congenital cyanotic heart disease.
3. GIT- Liver cirrhosis, Inflammatory bowel disease.
4. Others- Sarcoidosis, Trauma, Familial.

Question No.03: What is cyanosis? Causes of cyanosis. Different between central

& peripheral cyanosis.

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Answer: It is the bluish discoloration of skin & mucous membrane due to mark
amount of deoxygenated hb in the blood.
It is two types i. Central & i. Peripheral cyanosis

Causes- Central Peripheral

 Severe COPD/Asthma * Exposure to cold
 Congenital cyanotic heart disease * Raynaud’s phenomenon
 Massive pulmonary embolism
 Heart failure
 Cardiogenic shock
 High altitude
 Polycythemia
Question No.4: Some important nail change with example of associated disease?
Answer:
Change Disease
Clubbing Previous
Leukonychia Hypoalbuminemia, CLD
Koilonychia Iron deficiency anaemia
Splinter hemorrhage Trauma, vascularitis
Half & half nail CKD
Onycholysis Psoriasis
Nail pitting Iron deficiency anemia

Question No.05: Causes of generalized lymphadenopathy?

Answer:
»» Infective- TB, Brucellosis, toxoplasmosis,
»»Viral- HIV,IMN
»»Hematological- Leukemia, Lymphoma
»»Connective Tissue- RA,SLE,
»»Drugs- Phenytoin
»»Others- Sarcoidosis

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Question No.06: What is jaundice? Classify
Answer: Yellow discoloration at skin, sclera& mucous membranes due to
accumulation of excess amount of bilirubin more than 3mg/dl.
Types-
1.Hemolytic- No bilirubin is pass in urine(unconjugated)
2.Hepatocellular- hepatitis is the cause( conjugated+ unconjugated)
3.Obstructive- itching, dark urine, pale stool(conjugated).

Question No.07: What is Edema? Classify with example ,Causes

Answer- Swelling of any part of the body due to accumulation of excess fluid in
interstial space is called edema.
Types-1.Pitting-NS,HF,CLD,Malnutrition.
2.Non-pitting- Hypothyroidism, Filariasis, Lymphedema
*Another- Generalized & Localized

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CARDIOVASCULAR SYSTEM

Question No.01-What is pulse? Name Some abnormal pulses with example.

Answer- Rhythmic elongation & expansion of lateral wall of artery is called
pulse.
Some Abnormal pulse
1.Collapsing pulse/Water hammer- AR,PDA, Hyper dynamic circulation, RSV
2. Pulsus Alternus -LVF
3.Pulsus paradoxus- Massive pericardial effusion, Constrictive
pericarditis,COPD,Pulmonary embolism.
4. Pulsus deficit- Atrial fibrillation
5.Pulsus Bisfirings- AS,AR, hypertrophic cardiomyopathy.
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Question No.02- Some important causes of tachycardia?
Answer- *Exercise ,Pain ,Emotion * Atrial Fibrillation
*Pregnancy * Atrial Flutter
* Thyrotoxicosis * VT,SUT
*Anemia *Drugs
* Sinus tachycardia

Question No.03- Some important causes of bradycardia?

Answer-
 Athletic training *Obstructive Jaundice
 Hypothyroidism * Hypothermia
 Heart block * Drugs-B-Blocker
 Deep sleep
Question No.04- Some causes of high volume & low volume pulse?
Answer-
High volume- Low volume-
*Anemia *AS,MS
*Pregnancy *Shock
*Thyrotoxicosis * Constrictive pericarditis
*AR *Pericardial effusion
*PDA,PVD,AS shunt
Question No.05- Causes of regularly irregular & irregularly irregular pulse?
Regularly irregular- regular rhythm followed by irregular rhythm.
»»Sinus arrhythmia
»»Ventricular ectopic
»»2nd degree heart block
»»Atrial ectopic
Irregularly irregular – irregular in rhythm and volume
»» Atrial fibrillation
»»Atrial flutter with variable block
»»Multiple ectopic
Question No.06- What is apex beat? Types of apex beat.
Answer- It is the lowermost and outermost definitely palpable cardiac impulse.

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Types
Tapping-MS
Heaving-LVH
Thrusting- MR,AR
Diffuse-Lean & thin person, AMI

Question No.07- Some causes of impalpable apex beat?

Answer:
- Thick chest wall - Pericardial effusion
- When behind the rib - Dextrocardia
- Emphysema

Question No.08- First heart sound

Answer- Loud- MS,TS,HDC Soft- MR, Cardiomyopathy

Question No.09- Some causes of absence of peripheral pulse?

Answer- PVD

Question No.10- Cardinal features of LVF & RVF/CCF

Answer- LVF RVF
Pulsus alternas Raised JVP
Bilateral basal crepitation Tender hepatomegaly
Gallop rhythm(tachycardia with 3rd/4th HS ) Dependent edema
Question No.11- Some causes of raised JVP
Answer-
-CCF -Pulmonary Embolism
-Pericardial effusion -Pulmonary HTN
-Constrictive Pericarditis - SVC obstruction(non pulsatile)
-TS, TR

Question No.12- Different between arterial & jugular venous Pressure

Answer-
Artery JVP
One peak per beat Two peak per beat
Don’t varies with posture Varies with posture
Independent of respiration Falling with inspiration
Palpable Not palpable
Hepatojugular reflex absent Hepatojugular reflex present
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Question No-13:What is murmur? Classify with example & Causes
Answer- Abnormal heart sound produced by normal blood flow through
abnormal valve or abnormal blood flow through normal valve is called murmur.
Types-
1. Systolic murmur:
i. Ejection systolic: AS,PS,HCM,ASD
ii. Pan systolic : MR,TR,VSD,AVS
2. Diastolic Murmur:
i. Early diastolic: AR,PR
ii. Late diastolic: MS,TS
3. Continues Murmur: PDA,A-V fistula

Question No-14: Some causes of chest pain?

Answer:
Central Peripheral
Cardiac: Angina -Pneumothorax
MI -Consolidation
Pericarditis -Pleurisy
Non-cardiac: - Herpes
Aortic dissection -Trauma
Esophageal spasm
PUD

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RESPIRATORY SYSTEM
Question No.01: Causes of Breathlessness?
Answer:
Respiratory – Asthma, COPD, Pneumonia, Pleural effusion, Pneumothorax.
CVS – LVF, Pericardial effusion, Cardiomyopathy.
Non Cardiorespiratory – Anemia, Metabolic acidosis, Obesity.

Question No.02: What is Cheyne stroke breathing? Some example. What is air
hunger?
Answer:

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 Cyclical variation in the depth of respiration characterized by gradual deepening
of respiration till a maximum followed by gradual diminished respiration till
apnea.
Ex- Acute LVF, Deep coma, Narcotic poisoning, Head injury
Air hunger: It is characterized by deep sighing repair respiration at regular rate
due to stimulation of respiratory center.
Metabolic acidosis, Diabetic ketoacidosis ,Renal failure.

Question No.03: Causes of tachypnea & Bradypnea?

Answer: Tachypnea Bradypnea
-Anxiety, Exercise - Deep sleep
-Asthma, COPD, Pneumonia - Narcotic drugs
-LVF, Metabolic Acidosis
(All causes of breathlessness)

Question No.04: Types of sputum according to color?

Answer:
Mucoid- COPD Serous- Acute pulmonary edema
Purulent- Lung abscess Rusty- Pneumococcal Pneumonia
Bronchiectasis

Question No.05: What is hemoptysis? Some important Causes of it?

Answer:
Coughing up blood from the respiratory tract is called hemoptysis.
Causes:
*TB *Carcinoma of lung
*Lung abscess *Bronchiectasis
*Pulmonary infarction *Trauma
*Acute LVF
Question No.06: Some causes of shifting of trachea?
Answer:
Same side(Lesion side) Opposite side
-Collapse -Massive pleural effusion
-Fibrosis -Pneumothorax
-Pneumonectomy
* Same causes of shifting apex beat.

Question No.07: Name some percussion note of the chest with causes?

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Answer:
1.Normal Resonant- Normal People
2.Hyper Resonant- Pneumothorax
Emphysema
3.Woody Dull- Consolidation
Collapse
Mass lesion
4.Stony Dull – Pleural effusion
Haemothorax
Question no.08 -Some causes of supportive lung disease
- Lung abscess
- Bronchiectasis
- Empyema

Question No.09-Some causes of cavitation lung disease.

Answer –lung abscess
- TB
- Pulmonary infarction
- Br. carcinoma
- Rheumatic nodule

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GIT & HEPATOBILLIARY SYSTEM

Question no 01: What is the normal shape of abdomen. Some causes of distended
abdomen.

Answer: Scaphoid shape

Causes –
- Fat (obesity)
- Fluid (ascites)
- Flatus
- Feces
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 - Fetus

1.Left lobe of liver – -Hepatoma

- Secondary metastasis
- Liver abscess
- Hydrated cyst
2. Pancreas – Pseudo cyst
- Ca.head of pancreas
3.Epigastric hernia
4.Ca. Stomach

Question no.03- Causes of Hypo gastric mass?

Answer-
-Bladder
-Ovarian trauma
-Pregnancy
-Pelvic tumor

Question no.04- Some causes of Rt & Lf hypochondrium mass?

Answer- Right Left
1.Hepatic Mass- Hepatoma - Splenomegaly
-Secondary Metastasis - Renal Mass
-Hydrated cyst - Mass in splenic flexure of colon
-Abscess - Ca. Tail of Pancreas

2.Gall Bladder- Carcinoma, Muccocele

Emphysema
Question no.05- Causes of visible epigastric pulsation?
Answer- -Normally thin body build
-Right ventricular Hypertrophy
-Abdominal Aorta aneurysm
-Pulsatile liner in TR
Question no.06.Some causes of everted umbilicus?
Answer- -Ascites
-Ovarian cyst
- Umbilical hernia

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Question no.07.Some causes of ascites?
Answer-
- Intra abdominal TB - CLD
- Hepatic cirrhosis with portal hypertension - CCF
- Intra abdominal malignancy - NS
- Pancreatitis - PEM
-SLE -Protein Loss -AGN
-Meig’s Syndrome(rt pleural effusion+Ascitis+Ovarian tumor)

Question no.08. Some causes of hepatosplenomegaly?

-Kala-azar
-Malaria
- CML/CGL
-Myelofibrosis
-Lymphoma
-Amyloidosis
-Sarcoidosis
-CLD with portal HTN
Question no.09. Some causes of Hepatomegaly?
Answer- Non tender- Tender
Malaria Viral hepatitis
Kala-azar Liver Abscess
Leukemia CCF
Lymphoma Hepatoma
Congenital hemolytic anemia Budd chiari Syndrome

Question no.10- Some causes of hepatomegaly with jaundice?

Answer- Viral hepatitis
Hemolytic anemia
Will’s Disease
Obstructive jaundice
Question no.11- Some cause of Hepatoslenomegaly with Ascites?
Answer-
- CLD
- Abdominal TB
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 - Lymphoma
- Leukemia
Causes of H-S megaly with Fever
- Leukemia
- Lymphoma
- Abdominal TB
Question no.12- Some causes of massive/huge splenomegaly?
Answer- When the size of spleen is more than 20cm.
-Chronic Malaria -Myelofibrosis
-Chronic Kala-azar -Congenital Hemolytic anemia
-CML/CGL
Question no.13- Some causes of just palpable splenomegaly?
Answer- *Enteric fever
*Sub acute bacterial endocarditis
*Viral infection
*SLE *Sarcoidosis

Question no.14- What are the hall marks of portal HTN?

Answer: Splenomegaly
Ascites
Question no.15: Some causes of Portal hypertension?
Answer: -Liver cirrhosis due to any cause -Amyloidosis
-Portal vein thrombosis -Budd chiari syndrome
-Sarcoidosis -Constrictive pericarditis
Question no.16: Causes of CLD?
Answer:
-Chronic Viral hepatitis -Autoimmune hepatitis
-Alcoholic liver disease - Hemochromatosis
-Non alcoholic fatty liver disease -Wilson’s disease

Question no.17:Some stigmata’s of CLD?

Answer:
- Hepatic face - Feature of portal HTN
- Jaundice - Pelman erythema
- Clubbing - Decreased body hair
- Gyaecomastia , Spider nevi
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 RENAL SYSTEM
Question no.01:Some causes of Hematuria?
Answer:
-AGN(P) -Loin pain hematuria syndrome(P)
-UTI (P) -Schintosomiasis
-Renal cell carcinoma -TB
-Carcinoma cell anywhere in urinary tract- Trauma
-Renal calculi(P) -Acute tubular necrosis
-Coagulation disorder
*P = Pain full hematuria.

Question no.02: Some causes of proteinuria?

Answer:
-NS due to any cause
-Diabetic Nephropathy
-Lupus Nephritis
*Massive proteinuria causes
-NS
-Toxemia of pregnancy
-Multiple myeloma
-Burn, Fever
-Orthostatic proteinuria
-Multiple Myeloma
-Amyloidosis

Question no.03: Some causes of Polyuria?

Answer:
-Excess fluid intake -Hypokalemia
-DM,DI -Diuretics
-Hypercalcemia

Question no.04:Some causes of Oliguria?

Answer:
1.Pre Renal Causes- Dehydration, Cardiogenic or hypovolemic shock
2.Renal Causes-Stone, Tumor
3.Post Renal – Any obstruction in the urine flow

Question no.05: Some causes of Anuria?

Answer: Failure of kidney to produce urine
(ARF any cause of Before ans.)

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Question no.06: What is Nephrotic syndrome?
Answer:
A syndrome include massive proteinuria with hypoalnuminemia with
hypercholeromia and generalized edema.

Question no.07: What is nephritic syndrome/AGN?

Answer:
Disorder of kidney consist of Hematuria ,Oliguria, blood pressure and
generalized edema.
Causes- Most common cause is post streptococcal glomerulonephritis.
-Lupus Nephritis -Good pasture’s syndrome
-IgA disease

Question no.08: Difference between Nepthrotic and Nephritic syndrome?

Answer-
Traits Nephortic Nephritic
Urine volume Usually not affected Oliguria
Urine appear Froth (due to protein) Red( due to RBC)
Proteinuria Massive Mild/Not
Hypoalbuminemia Present Not present
HTN Usually not present Present
Red cell Not present Present

Question no.09: Some causes of Palpable Kidney?

Answer-
-Hydronephrosis -PKD
-Pyenephrosis -Amyloidosis
-Renal cell carcinoma
Question no.10: Some causes of Atrophic/small Kidney?
Answer:
-Congenital Hypoplasia -Chronic Pyelonephritis
-CKD -Senile kidney
-Chronic glomerulonephritis
Question no.11:How will u differentiate kidney from spleen?

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Answer:
Kidney Spleen
Don’t move with respiration Moves with respiration
Possible to get above Not possible
Smooth shape Splenic notch
Tympanic on percussion Dull on percussion
Ballot able Not ballot able

Question no.12:Some causes of CKD?

Answer: -DM -PKD
-HTN -Obstructive disease
-Glomerulo disease
Question no.13: Classical feature of CKD?
Answer: Anemia, HTN, Edema
Yellow complexion
Pallor
Nail Change
Bruising easily
Peripheral Neuropathy

Question no.14. Some cause of hydronephrosis?

Answer: Bilateral Unilateral
-Congenital stricture of urethra -Uretic stone, tumor
-BPH -Retro peritoneal fibrosis
-Carcinoma of prostrate -Any growth that compress the urethra
-Bladder outlet obstruction

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 NERVOUS SYSTEM

Question no.01: Difference between UMNL and LMNL

Answer-

UMNL LMNL
Spastic paralysis Flaccid paralysis
Hypertonia Hypotonic
Tendon reflex Exaggerated Absent
Plantar response Extensor Normal
No muscle wasting Muscles wasting
No fasciculation present Fasciculation Present

Question no.02:Some causes of hypertonic?

Answer- -UMNL
-Extrapyramidal lesion
-Strychnine poisoning
-Conversion Disorder
Question no.03: Some causes of Hypotonia?
Answer- -LMNL -Polyneuropathy
-Cerebellar lesion -Hypo/Hypercalcemia
-Dorsal column lesion -Muscle relaxing drugs
Question no.04:Some causes of absent of ankle jerk but extensor plantar
response?
Answer-
1.Sub acute combined degeneration of spinal cord
2.Multiple sclerosis
3.Taboperesis
4.Fricdrich Ataxia
5.DM with cervical radiculopathy
Question no.05: Some causes of UMNL?
Answer-
1.Stroke 5.CNS tumor
2.Traumatic brain injury 6.Cerebral palsy
3.Multiole sclerosis 7.MND
4.Spinal cord compression
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Question no.06.Some causes of LMN?
Answer- 1.Peripheral neuropathy
i.GBS
ii. Diabetic amyotrophy
iii. Diphtheria
iv. Chronic lead poisoning
2.Polio
3.Cauda equine syndrome
Question no.07: Some causes of peripheral neuropathy?
Answer- -DM
-Nutritional deficiency -Infection
-Alcoholism -Others-CKD,SLE
-GBS -Paraneuropathic syndrome
-Drugs
Question no.08:Features of cerebellar lesion?
Answer-
-Scanning of speech
-Nystagmus
-Dysdikokinesis
-Pendular knee jerk
-Drunken gait
-Heel shin test impaired

Question no.09: Difference between Bulbar and Pseudo bulbar palsy?

Answer:
Bulbar Pseudo bulbar
LMN type lesion UMN type lesion
Tongue atrophy fasciculation present Tongue spastic
Emotional liability Present
Brain stem tumor Bilateral hemisphere

Question no.10: What is Bells palsy? And Phenomenon?

Answer- Bells Palsy: it is an LMN type if facial nerve paralysis

Phenomenon: On attempting to close eye the eye ball rolls upwards and
outwards an its call balls Phenomenon .

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Question no.11: Some causes of facial nerve paralysis?
Answer- UMN type LMN type
-CVA/ stroke -Fracture bone of skull
-Brain tumor -Parotid gland tumor/surgery
-Infection -Otitis media
-Balls palsy
-Herpes zoster
Question no.12:Why upper part of face is escape in case of UMNL type of facial
palsy?
Answer- Due to Bi-cortical innervation of upper part of the face.

Question no.13: Features of 3rd nerve palsy?

Answer-
a) Ptosis
b) Diplopia
c) Paralysis of accommodation.

Question no.14: What are the features of Horner’s syndrome?

Answer- Ipsilateral- Ptosis
-Miosis
-Anhydrasis
Question no.15: Some feature of raised ICP? Cushing triad.
Answer-
a)Headache
b)Nausea/Vomiting
c)Papilledema/Blurring of vision
d)Cushing triad
i.Bradycardia
ii.HTN
iii.Irregular respiration
Question no.16:Some causes of Headache?
Answer-
-Tension/Stress
-Migraine headache
-Raised ICP
-Cluster headache

Question no.17: Some cause of Ptosis?

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Answer-
a) 3rd nerve palsy
b) Horner’s syndrome
c) Senile ptosis
d) Mechanical ptosis
Question no.18: What is Plegia and Peresis?
Answer-
Plegia means complete paralysis
Peresis means Partial paralysis
Monoplegia means one limb paralysis
Paraplegia means both lower limb
Hemiplegia means same side both upper and lower limb
Qudriplegia means all four limbs paralysis

Question no.19: Some cause of muscle wasting?

Answer- a) any chronic disease
-Cancer
-CKD
-COPD
b) LMNL
c) Cushing syndrome
d) Starvation

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 ENDOCRINE SYSTEM
Question no.01:When we call diabetic and prediabetic?
Answer-
Diabetic: 1. When fasting blood glucose is more than 7.0mmol/L
2.When RBS/ 2 hours after 75gm glucose load level is more than
11.0mmol/L.
Prediabetic: 1.If more than 6.0mmol/L but less than 7.0 mmol/L
2.7.8-11.0mmol/L 2 hrs ABF.

**Venous blood is more reliable for level of blood glucose.

Question no.02: Some feature of Hyperthyroidism?
Answer-
- Weight loss
- Heat intolerance
- Palpitation, tremor
- Fatigue, Inability, Insomnia
- Amenorrhea,
- Anxiety
- Loss of libido
- HTN
Question no.03:Some features of Hypothyroidism?
Answer-
- Weight gain
- Cold intolerance
- Somnolence
- Dry skin and hair
- Depression
- Menorrhagia
- Husky voice
Question no.04: Some feaure of cushing syndrome?
Answer-
-Moon face
-Hairsutism
-Centrally Obesity -Osteoporosis
-Thinning of skin -Poor wound healing
-Bruising easily -HTN, Abdominal striae

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Question no.05:Some causes of weight gain?
Answer-
1.Excess food intake 5.Pcos
2.Pregnancy 6.Hypogonadism
3.Cushing syndrome 7.Some drugs
4.Hypothyroidism
Question no.06:Some cause of weight loss?
Answer-
1.Malnutrition 5.Any chronic disease
2.Hyperthyroidism 6.Addison’s disease
3.Uncontrolled DM
4.Any malignancy

Refference: Dr. Md Rafiul Hasan Sir

Completed by: Humayon Ahamed Bappy

SMMAMC 2nd Batch

2.

THANK YOU

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