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৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]

পরীক্ষা৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]তারিখতারিখ অনির্ধারিতসময়20 minutes৩৯ বৈধ · অসম্পূর্ণ
মোট প্রশ্ন৪০
সিলেবাস
Exam - 3 Medicine-03 1. Diseases of the gastrointestinal tract: · Peptic ulcer disease and non-ulcer dyspepsia · Malabsorption syndrome · Irritable bowel syndrome and inflammatory bowel disease · Acute viral hepatitis and chronic hepatitis · Abdominal tuberculosis 2. Pancreatic Disease Acute pancreatitis Chronic pancreatitis 3. Liver and Biliary Tract Disease Viral hepatitis Chronic liver disease Cirrhosis of liver Carcinoma liver Liver abscess 4. Diseases of the Blood Anaemia: iron deficiency Common haemolytic anaemia (Thalassemia and acquired haemolytic anaemia) Common bleeding disorders (Thrombocytopenia and haemophilia) Agranulocytosis and aplastic anaemia Leukaemias: Acute and chronic Lymphomas Multiple myelomas Blood transfusion
ঘনত্ব
উত্তর
উত্তরিতবর্তমানপুনরায় দেখুনঅসম্পূর্ণ

৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]

৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived] · তারিখ অনির্ধারিত · ৪০ প্রশ্ন

.
Which of the following is most typical of irritable bowel syndrome?
  1. Blood in stools
  2. Night-time symptoms
  3. Relief of symptoms after defecation
  4. Raised inflammatory markers
সঠিক উত্তর:
Relief of symptoms after defecation
উত্তর
সঠিক উত্তর:
Relief of symptoms after defecation
ব্যাখ্যা
IBS is a functional disorder with abdominal discomfort that improves post-defecation. No alarm features like bleeding or weight loss.
.
Which of the following is most specific to ulcerative colitis?
  1. Cobblestone appearance
  2. Transmural inflammation
  3. Continuous colonic involvement from rectum
  4. Skip lesions
সঠিক উত্তর:
Continuous colonic involvement from rectum
উত্তর
সঠিক উত্তর:
Continuous colonic involvement from rectum
ব্যাখ্যা
UC typically involves continuous inflammation starting from the rectum, unlike Crohn’s disease which has skip lesions and can affect any GI segment.
.
Best indicator of acute Hepatitis B infection?
  1. HBsAg
  2. Anti-HBc IgG
  3. Anti-HBc IgM
  4. HBeAg
সঠিক উত্তর:
Anti-HBc IgM
উত্তর
সঠিক উত্তর:
Anti-HBc IgM
ব্যাখ্যা
IgM anti-HBc indicates acute or recent infection. HBsAg shows current infection but doesn’t differentiate acute from chronic.
.
Most common cause of acute pancreatitis-
  1. Alcohol
  2. Viral infection
  3. Gallstones
  4. Hyperlipidemia
সঠিক উত্তর:
Gallstones
উত্তর
সঠিক উত্তর:
Gallstones
ব্যাখ্যা
Gallstones and alcohol account for the majority of acute pancreatitis cases. Gallstones are more common in females.
.
A key feature of chronic pancreatitis is:
  1. Hyperinsulinemia
  2. Pancreatic calcification
  3. Gallstones
  4. Rapid onset pain
সঠিক উত্তর:
Pancreatic calcification
উত্তর
সঠিক উত্তর:
Pancreatic calcification
ব্যাখ্যা
Chronic inflammation leads to fibrosis and calcification. Pain is chronic and may lead to exocrine and endocrine insufficiency
.
Most accurate test for exocrine pancreatic insufficiency:
  1. Serum amylase
  2. CT scan
  3. Faecal elastase
  4. Lipase
সঠিক উত্তর:
Faecal elastase
উত্তর
সঠিক উত্তর:
Faecal elastase
ব্যাখ্যা
Faecal elastase is a sensitive non-invasive test for pancreatic enzyme output. Low values indicate exocrine insufficiency.
.
Which of the following is a hallmark sign of obstructive jaundice?
  1. Elevated unconjugated bilirubin
  2. Pale stools and dark urine
  3. Hemolytic anemia
  4. Splenomegaly
সঠিক উত্তর:
Pale stools and dark urine
উত্তর
সঠিক উত্তর:
Pale stools and dark urine
ব্যাখ্যা
In obstructive (post-hepatic) jaundice, conjugated bilirubin cannot reach the intestine, leading to pale stools and is excreted in urine, causing dark discoloration.
.
Which type of hepatitis virus is most commonly transmitted through contaminated food or water?
  1. HBV
  2. HAV
  3. HCV
  4. HDV
সঠিক উত্তর:
HAV
উত্তর
সঠিক উত্তর:
HAV
ব্যাখ্যা
HAV and HEV are transmitted via the faeco-oral route, especially in areas with poor sanitation.
.
Which marker indicates immunity due to past HBV infection?
  1. HBsAg
  2. Anti-HBc IgM
  3. Anti-HBs
  4. HBeAg
সঠিক উত্তর:
Anti-HBs
উত্তর
সঠিক উত্তর:
Anti-HBs
ব্যাখ্যা
Anti-HBs indicates recovery and immunity. HBsAg indicates current infection, and anti-HBc IgM suggests acute infection.
১০.
Which vitamin deficiency is commonly seen in chronic liver disease due to fat malabsorption?
  1. Vitamin C
  2. Vitamin K
  3. Vitamin B1
  4. Vitamin B12
সঠিক উত্তর:
Vitamin K
উত্তর
সঠিক উত্তর:
Vitamin K
ব্যাখ্যা
Chronic liver disease can lead to impaired bile production and fat-soluble vitamin (A, D, E, K) malabsorption. Vitamin K deficiency can cause coagulopathy.
১১.
Spider naevi in chronic liver disease are due to:
  1. Portal hypertension
  2. Hypoalbuminemia
  3. Vitamin deficiency
  4. Hyperestrogenism
সঠিক উত্তর:
Hyperestrogenism
উত্তর
সঠিক উত্তর:
Hyperestrogenism
ব্যাখ্যা
Chronic liver disease reduces hepatic clearance of estrogen, leading to features like spider naevi, gynecomastia, and palmar erythema.
১২.
Which is a major complication of portal hypertension in cirrhosis?
  1. Cholelithiasis
  2. Esophageal varices
  3. Steatosis
  4. Hepatitis
সঠিক উত্তর:
Esophageal varices
উত্তর
সঠিক উত্তর:
Esophageal varices
ব্যাখ্যা
Portal hypertension leads to collateral formation, especially esophageal varices, which can bleed massively
১৩.
Most important risk factor for hepatocellular carcinoma (HCC) worldwide
  1. Alcohol use
  2. Fatty liver
  3. Chronic hepatitis B infection
  4. Smoking
সঠিক উত্তর:
Chronic hepatitis B infection
উত্তর
সঠিক উত্তর:
Chronic hepatitis B infection
ব্যাখ্যা
HBV is a major cause of HCC, especially in endemic regions. Cirrhosis of any cause increases HCC risk.
১৪.
Tumor marker most commonly associated with hepatocellular carcinoma:
  1. CEA
  2. CA 19-9
  3. Alpha-fetoprotein (AFP)
  4. PSA
সঠিক উত্তর:
Alpha-fetoprotein (AFP)
উত্তর
সঠিক উত্তর:
Alpha-fetoprotein (AFP)
ব্যাখ্যা
AFP is elevated in up to 70% of patients with HCC and used as a screening and diagnostic tool.
১৫.
Most common organism in pyogenic liver abscess:
  1. E. coli
  2. Entamoeba histolytica
  3. Klebsiella
  4. Staphylococcus
সঠিক উত্তর:
E. coli
উত্তর
সঠিক উত্তর:
E. coli
ব্যাখ্যা
Pyogenic liver abscesses are often polymicrobial, with E. coli and Klebsiella among the most common.
১৬.
Which lab finding best confirms iron deficiency?
  1. High serum ferritin
  2. High transferrin saturation
  3. Low serum ferritin
  4. High serum iron
সঠিক উত্তর:
Low serum ferritin
উত্তর
সঠিক উত্তর:
Low serum ferritin
ব্যাখ্যা
Ferritin reflects iron stores; low levels confirm iron deficiency. Note: ferritin is also an acute phase reactant and may be falsely elevated in inflammation.
১৭.
Which test confirms autoimmune haemolytic anaemia?
  1. Reticulocyte count
  2. Direct Coombs test (DAT)
  3. Bone marrow biopsy
  4. Serum haptoglobin
সঠিক উত্তর:
Direct Coombs test (DAT)
উত্তর
সঠিক উত্তর:
Direct Coombs test (DAT)
ব্যাখ্যা
The direct antiglobulin (Coombs) test detects antibodies attached to RBCs, confirming autoimmune hemolysis.
১৮.
A child presents with hemarthrosis. What is the most likely diagnosis?
  1. Platelet deficiency
  2. von Willebrand disease
  3. Haemophilia A
  4. Scurvy
সঠিক উত্তর:
Haemophilia A
উত্তর
সঠিক উত্তর:
Haemophilia A
ব্যাখ্যা
Haemophilia A (factor VIII deficiency) typically causes deep bleeds into joints and muscles.
১৯.
Most serious complication of agranulocytosis:
  1. Anaemia
  2. Bleeding
  3. Life-threatening infection
  4. Autoimmune reaction
সঠিক উত্তর:
Life-threatening infection
উত্তর
সঠিক উত্তর:
Life-threatening infection
ব্যাখ্যা
Neutropenia leaves patients vulnerable to severe bacterial and fungal infections.
২০.
Pancytopenia with hypocellular bone marrow suggests:
  1. Leukaemia
  2. Aplastic anaemia
  3. Megaloblastic anaemia
  4. Myelofibrosis
সঠিক উত্তর:
Aplastic anaemia
উত্তর
সঠিক উত্তর:
Aplastic anaemia
ব্যাখ্যা
Aplastic anaemia is characterized by pancytopenia and a hypocellular marrow. Often idiopathic or drug-induced.
২১.
The most common childhood leukemia is:
  1. CML
  2. ALL
  3. AML
  4. Hairy cell leukemia
সঠিক উত্তর:
ALL
উত্তর
সঠিক উত্তর:
ALL
ব্যাখ্যা
ALL peaks between ages 2–5 and presents with anemia, thrombocytopenia, and lymphadenopathy.
২২.
Which marker is typically positive in chronic myeloid leukemia (CML)?
  1. CD19
  2. Philadelphia chromosome
  3. Bence Jones protein
  4. HLA-B27
সঠিক উত্তর:
Philadelphia chromosome
উত্তর
সঠিক উত্তর:
Philadelphia chromosome
ব্যাখ্যা
The BCR-ABL fusion gene (t(9;22)) is diagnostic of CML and is the target of tyrosine kinase inhibitors like imatinib.
২৩.
Reed–Sternberg cells are characteristic of:
  1. Non-Hodgkin lymphoma
  2. Hodgkin lymphoma
  3. ALL
  4. CLL
সঠিক উত্তর:
Hodgkin lymphoma
উত্তর
সঠিক উত্তর:
Hodgkin lymphoma
ব্যাখ্যা
Reed–Sternberg cells (giant binucleate cells) are pathognomonic for Hodgkin lymphoma.
২৪.
Which is a common complication of multiple myeloma?
  1. Aplastic anaemia
  2. Renal failure
  3. Splenomegaly
  4. Hypernatremia
সঠিক উত্তর:
Renal failure
উত্তর
সঠিক উত্তর:
Renal failure
ব্যাখ্যা
Myeloma kidney results from light chain deposition, hypercalcemia, and hyperuricemia.
২৫.
A pathognomonic feature of Crohn’s disease is:
  1. Pseudopolyps
  2. Transmural granulomas
  3. Crypt abscesses
  4. Continuous mucosal inflammation
সঠিক উত্তর:
Transmural granulomas
উত্তর
সঠিক উত্তর:
Transmural granulomas
ব্যাখ্যা
Crohn’s shows skip lesions, cobblestoning, and non-caseating granulomas.
২৬.
The most common cause of IDA in adults is:
  1. Dietary deficiency
  2. Chronic blood loss
  3. Hemolysis
  4. Malabsorption
সঠিক উত্তর:
Chronic blood loss
উত্তর
সঠিক উত্তর:
Chronic blood loss
ব্যাখ্যা
GI bleeding (e.g., ulcers, colon cancer) or menstrual loss are primary causes.
২৭.
First-line treatment for hepatic encephalopathy includes:
  1. Antibiotics
  2. Lactulose
  3. Proton pump inhibitors
  4. Corticosteroids
সঠিক উত্তর:
Lactulose
উত্তর
সঠিক উত্তর:
Lactulose
ব্যাখ্যা
Lactulose reduces ammonia absorption via colonic acidification.
২৮.
Which lab finding best supports a diagnosis of Idiopathic Thrombocytopenic Purpura (ITP) in a patient presenting with petechiae and bruising?
  1. Elevated PT and PTT
  2. Markedly decreased platelet count with normal red and white blood cell lines
  3. Presence of schistocytes on peripheral blood smear
  4. Positive direct Coombs test
সঠিক উত্তর:
Markedly decreased platelet count with normal red and white blood cell lines
উত্তর
সঠিক উত্তর:
Markedly decreased platelet count with normal red and white blood cell lines
ব্যাখ্যা
: ITP is an autoimmune disorder characterized by isolated thrombocytopenia due to increased platelet destruction and/or impaired platelet production. The hallmark lab finding is a significantly low platelet count (often below 100,000/µL, and sometimes below 20,000/µL), while other cell lines (red blood cells and white blood cells) remain normal. Options a, c, and d are more indicative of other conditions: elevated PT/PTT suggests coagulation factor deficiencies, schistocytes suggest microangiopathic hemolytic anemia, and a positive direct Coombs test indicates autoimmune hemolytic anemia.
২৯.
Which lab finding would provide the strongest evidence for a hemolytic anemia?
  1. Low haptoglobin
  2. Elevated serum iron
  3. Normal mean corpuscular volume (MCV)
  4. Positive antinuclear antibody (ANA)
সঠিক উত্তর:
Low haptoglobin
উত্তর
সঠিক উত্তর:
Low haptoglobin
ব্যাখ্যা
Hemolytic anemia is characterized by premature destruction of red blood cells. Haptoglobin is a protein that binds to free hemoglobin released during red blood cell destruction.
৩০.
Which laboratory finding is most indicative of hemolytic anemia?
  1. Low hemoglobin with high reticulocyte count
  2. Low serum ferritin
  3. High mean corpuscular hemoglobin (MCH)
  4. Elevated white blood cell count
সঠিক উত্তর:
Low hemoglobin with high reticulocyte count
উত্তর
সঠিক উত্তর:
Low hemoglobin with high reticulocyte count
ব্যাখ্যা
Hemolytic anemia is characterized by increased red blood cell destruction, leading to low hemoglobin (anemia) and a compensatory increase in reticulocytes (immature red blood cells) due to bone marrow response.
৩১.
A hallmark characteristic of megaloblastic anemia is:
  1. Microcytic, hypochromic red blood cells
  2. Increased reticulocyte count
  3. Hypersegmented neutrophils
  4. Normal vitamin B12 and folate levels
সঠিক উত্তর:
Hypersegmented neutrophils
উত্তর
সঠিক উত্তর:
Hypersegmented neutrophils
ব্যাখ্যা
Megaloblastic anemia is primarily caused by impaired DNA synthesis, most commonly due to vitamin B12 or folate deficiency. This leads to ineffective erythropoiesis and the presence of abnormally large red blood cell precursors (megaloblasts) in the bone marrow. A key peripheral blood smear finding is hypersegmented neutrophils (five or more lobes), which are characteristic of defective nuclear maturation in granulocytes.
৩২.
Which of the following is a common neurological manifestation of vitamin B12 deficiency in megaloblastic anemia?
  1. Tetany
  2. Peripheral neuropathy
  3. Seizures
  4. Tremors
সঠিক উত্তর:
Peripheral neuropathy
উত্তর
সঠিক উত্তর:
Peripheral neuropathy
ব্যাখ্যা
While both vitamin B12 and folate deficiencies cause megaloblastic anemia, only vitamin B12 deficiency typically leads to neurological symptoms. These can include peripheral neuropathy, subacute combined degeneration of the spinal cord (affecting posterior and lateral columns), paresthesias, gait disturbances, and even cognitive impairment. Folate deficiency does not cause these specific neurological issues.
৩৩.
Which of the following is a common clinical presentation in a patient with severe aplastic anemia?
  1. Lymphadenopathy
  2. Frequent infections
  3. Jaundice
  4. Bone pain
সঠিক উত্তর:
Frequent infections
উত্তর
সঠিক উত্তর:
Frequent infections
ব্যাখ্যা
Due to severe neutropenia (a component of pancytopenia), patients with aplastic anemia are highly susceptible to infections, which can be life-threatening. Anemia leads to fatigue and pallor, while thrombocytopenia causes bleeding tendencies (e.g., petechiae, ecchymoses, mucosal bleeding).
৩৪.
A key feature often observed in abdominal tuberculosis is:
  1. Generalized abdominal tenderness without specific localization
  2. A doughy abdomen
  3. Acute onset, severe colicky pain
  4. Absent bowel sounds
সঠিক উত্তর:
A doughy abdomen
উত্তর
সঠিক উত্তর:
A doughy abdomen
ব্যাখ্যা
Abdominal tuberculosis (TB) can affect any part of the gastrointestinal tract, peritoneum, mesentery, or abdominal lymph nodes. A "doughy" abdomen on palpation, often with tenderness, is a classical but not always present sign, particularly in peritoneal TB due to thickened omentum and adhesions. Other common features include chronic abdominal pain, weight loss, fever, and ascites.
৩৫.
A common manifestation indicating the progression of chronic liver disease to decompensation is:
  1. Increased appetite
  2. Spontaneous bacterial peritonitis
  3. Elevated albumin levels
  4. Absence of fatigue
সঠিক উত্তর:
Spontaneous bacterial peritonitis
উত্তর
সঠিক উত্তর:
Spontaneous bacterial peritonitis
ব্যাখ্যা
Chronic liver disease (CLD) is a broad term encompassing various conditions leading to progressive liver damage. Decompensation signifies the failure of the liver to perform its essential functions, often leading to complications like ascites, hepatic encephalopathy, variceal bleeding, and spontaneous bacterial peritonitis (SBP). SBP is an infection of the ascitic fluid and is a serious complication of advanced CLD with ascites.
৩৬.
Which of the following laboratory findings is most indicative of synthetic dysfunction in chronic liver disease?
  1. Elevated alkaline phosphatase
  2. Decreased prothrombin time
  3. Elevated gamma-glutamyl transferase
  4. Normal serum bilirubin
অনির্ধারিত
ব্যাখ্যা
সঠিক উত্তর: Increased prothrombin time
অপশন খ) - এর Decreased-এর পরিবর্তে Increased হলে এটা সঠিক উত্তর হতো।
লাইভ পরীক্ষায় সঠিক উত্তর না থাকায় উত্তর বাতিল করা হয়েছে।
⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯
The liver synthesizes various proteins, including clotting factors (prothrombin). In CLD, impaired synthesis of clotting factors leads to a prolonged prothrombin time (PT) or elevated international normalized ratio (INR), indicating synthetic dysfunction and an increased risk of bleeding.
Albumin synthesis is also impaired, leading to hypoalbuminemia, but PT/INR is a more sensitive and earlier indicator of acute synthetic impairment.
৩৭.
The primary characteristic of leukemia is:
  1. Solid tumor formation in lymphoid organs
  2. Proliferation of abnormal white blood cells
  3. Decreased production of all blood cell lines
  4. Presence of Reed-Sternberg cells
সঠিক উত্তর:
Proliferation of abnormal white blood cells
উত্তর
সঠিক উত্তর:
Proliferation of abnormal white blood cells
ব্যাখ্যা
Leukemia is a group of cancers affecting the blood-forming tissues, primarily the bone marrow. It is characterized by the uncontrolled proliferation of abnormal, immature white blood cells (blasts) that accumulate in the bone marrow, peripheral blood, and sometimes other organs, impairing the production of normal blood cells.
৩৮.
Which of the following is a frequent cause of pyogenic liver abscesses?
  1. Amoebic infection
  2. Biliary tract infection
  3. Systemic fungal infection
  4. Hydatid cyst rupture
সঠিক উত্তর:
Biliary tract infection
উত্তর
সঠিক উত্তর:
Biliary tract infection
ব্যাখ্যা
Pyogenic liver abscesses are most commonly caused by ascending infection from the biliary tract (e.g., cholangitis, gallstones obstructing bile ducts), portal vein pylephlebitis from intra-abdominal infections (e.g., appendicitis, diverticulitis), or hematogenous spread from systemic infections. Amoebic liver abscesses are caused by Entamoeba histolytica but are less common than pyogenic abscesses in many parts of the world.
৩৯.
Which of the following clinical pentad components is characteristic of TTP, although not always fully present?
  1. Fever, rash, arthralgia, lymphadenopathy, splenomegaly
  2. Renal failure, neurological symptoms, fever, thrombocytopenia, microangiopathic hemolytic anemia
  3. Elevated white blood cell count, disseminated infections, severe bleeding, bone pain, hypercalcemia
  4. Severe anemia, prolonged PT/INR, normal platelet count, deep vein thrombosis, pulmonary embolism
সঠিক উত্তর:
Renal failure, neurological symptoms, fever, thrombocytopenia, microangiopathic hemolytic anemia
উত্তর
সঠিক উত্তর:
Renal failure, neurological symptoms, fever, thrombocytopenia, microangiopathic hemolytic anemia
ব্যাখ্যা
The classic pentad of TTP includes: 1) microangiopathic hemolytic anemia (MAHA), 2) thrombocytopenia, 3) neurological abnormalities (e.g., headache, confusion, seizures, stroke), 4) renal impairment, and 5) fever. While the full pentad is not always observed, MAHA and thrombocytopenia are almost universally present.
৪০.
A central pathophysiological event in Disseminated Intravascular Coagulation is:
  1. Localized thrombosis in a single vessel
  2. Widespread activation of coagulation and fibrinolysis
  3. Primary impairment of platelet production
  4. Isolated deficiency of a single clotting factor
সঠিক উত্তর:
Widespread activation of coagulation and fibrinolysis
উত্তর
সঠিক উত্তর:
Widespread activation of coagulation and fibrinolysis
ব্যাখ্যা
DIC is a complex, acquired disorder characterized by systemic activation of blood coagulation, leading to widespread fibrin formation in the microvasculature. This results in both consumptive coagulopathy (depletion of clotting factors and platelets) and secondary fibrinolysis, manifesting clinically as both thrombosis and bleeding.