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

পরীক্ষা৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]তারিখতারিখ অনির্ধারিতসময়20 minutes
মোট প্রশ্ন৪০
সিলেবাস
Exam - 12 Pathology-02 k. Common protozoal diseases: • Malaria • Kala-azar • Giardiasis l. Sexually transmitted diseases: • Gonorrhea • Syphilis • Nongonococcal urethritis m. Routine laboratory procedures for: • Peripheral blood film • Urine • Stool • Malarial parasite • Sputum for Gram stain and AFB • Blood test for Hb%, ESR n. Special pathology for diseases like: • Tuberculosis, Pneumonia, Bronchial carcinoma, Chronic bronchitis, Bronchiectasis, Pleurisy, Pleural effusions • Liver diseases — Viral hepatitis, Hepatic amoebiasis, Liver abscess, Primary and secondary carcinoma of liver • Collagen diseases — SLE, Systemic sclerosis, Dermatomyositis, Rheumatoid arthritis • Joint diseases — Gout, Spondylitis, Psoriatic arthritis, Osteoarthritis, Seronegative arthritis • Endocrine diseases — Pituitary tumors, Acromegaly, Thyroid tumors, Hyperthyroidism, Hypothyroidism • GIT diseases — Peptic ulcer, Stomach & colon carcinoma • Renal diseases — Glomerulonephritis (acute & chronic), Pyelonephritis, Polycystic kidney disease, Renal artery stenosis, Renal failure
প্রশ্ন দেখুনঅনুশীলন
ঘনত্ব
উত্তর
উত্তরিতবর্তমানপুনরায় দেখুনঅসম্পূর্ণ

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

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

১.
Which of the following is the most common cause of a transudative pleural effusion?
  1. ক
    Congestive heart failure
  2. খ
    Pneumonia
  3. গ
    Tuberculosis
  4. ঘ
    Lung carcinoma
ব্যাখ্যা
Explanation :
Transudative pleural effusions are caused by systemic factors such as increased hydrostatic pressure or decreased oncotic pressure.
Congestive heart failure is the most common cause, leading to fluid leakage into the pleural space.
In contrast, pneumonia, TB, PE, and cancer usually cause exudative effusions due to local inflammation or capillary permeability.
২.
Organism responsible for non gonococcal urethritis -
  1. ক
    Chlamydia tracomatis ( L serotype)
  2. খ
    Tricomonas vaginalis
  3. গ
    Staphylococcus aureus
  4. ঘ
    Mycobacterium tuberculosis
ব্যাখ্যা
Explanation :
Causes of non-gonococcal urethritis :
C.trachomatis ( Serotype D-K)
Mycoplasma
Acinetobacter
CMV
Candida albicans
U.urealyticum
Gardnella vaginalis
HSV-2
Trichomonas vaginalis
৩.
Giardia intestinalis -
  1. ক
    Habitat in large gut
  2. খ
    Infective form - Trophozoite
  3. গ
    Causes watery, foul smelling diarrhoea
  4. ঘ
    Azithromycin is the preferable drug
ব্যাখ্যা
Explanation :
(a) Habitat in upper part of jejunum in male
(b) Infective form is cyst
(c) Causes non bloody watery diarrhea 
(d) Metronidazole is the preferable drug
৪.
In the pathophysiology of Rheumatoid Arthritis, which immune cell type is primarily responsible for initiating the autoimmune cascade?
  1. ক
    B lymohocyte
  2. খ
    CD8+ T cell
  3. গ
    CD4+ T cell
  4. ঘ
    Dendritic cell
ব্যাখ্যা
Explanation :
CD4+ T helper cells play a central role in the initiation of RA.
They become activated in response to autoantigens presented by dendritic cells, leading to the release of cytokines (like IL-17, IFN-γ, and TNF-alpha) that promote inflammation.
These T cells also help activate B cells, which produce autoantibodies such as rheumatoid factor (RF) and anti-CCP antibodies.
Although B cells and dendritic cells are involved, CD4+ T cells are the primary initiators.
৫.
Which of the following laboratory findings is most consistent with primary hyperthyroidism?
  1. ক
    High TSH, high free T4
  2. খ
    Low TSH, high free T4
  3. গ
    High TSH, low free T4
  4. ঘ
    Low TSH, low free T4
ব্যাখ্যা
Explanation :
In primary hyperthyroidism, the thyroid gland overproduces hormones, which suppresses TSH via negative feedback.
So  low TSH and high free T4 (and often high T3).
This confirms thyrotoxicosis of thyroid origin.
৬.
Which of the following is a common feature of secondary syphilis?
  1. ক
    Painful ulcer
  2. খ
    Lymphadenopathy
  3. গ
    Nerve palsy
  4. ঘ
    Genital warts
ব্যাখ্যা
Explanation :
Secondary syphilis presents with systemic symptoms, including a generalized rash that often affects the palms and soles, mucous patches, and lymphadenopathy.
৭.
Amoebic dysentery presents as -
  1. ক
    Odorless stool
  2. খ
    Bright red colour stool
  3. গ
    RBC in clumps
  4. ঘ
    Numerous macrophage
৮.
What is the most common mode of inheritance for adult-onset polycystic kidney disease?
  1. ক
    Autosomal recessive disorders
  2. খ
    X- linked recessive disorders
  3. গ
    Autosomal dominant disorder
  4. ঘ
    Sex linked disorders
ব্যাখ্যা
Explanation :
Adult onset polycystic kidney disease is the most common form of PKD in adults. It follows an autosomal dominant inheritance pattern and often presents in the third to fifth decade of life.
৯.
Which of the following best defines chronic bronchitis?
  1. ক
    Productive cough following a recent upper respiratory tract infection
  2. খ
    Recurrent episodes of wheezing and breathlessness
  3. গ
    Persistent dry cough for more than 2 weeks
  4. ঘ
    Productive cough lasting at least 3 months for 2 consecutive years
ব্যাখ্যা
Explanation :
Chronic bronchitis is clinically defined as a productive cough for at least 3 months in a year for 2 consecutive years, in the absence of other causes.
It is one of the major forms of COPD and is associated with airway inflammation and mucus hypersecretion.
১০.
What is the single best confirmatory test for Kal-azar diagnosis -
  1. ক
    CBC
  2. খ
    Aldehyde test
  3. গ
    ELISA
  4. ঘ
    rk39 test
ব্যাখ্যা
Explanation :
The rK39 test is a rapid immunochromatographic test used for diagnosing visceral leishmaniasis (VL), also known as Kala-azar. It detects antibodies against the recombinant K-39 antigen, which is produced by Leishmania parasites. The test is simple, rapid, relatively inexpensive, and can be performed in the field by paramedics.
Confirmatory to diagnosis of kalazar
১১.
Which of the following findings is most consistent with nephritic syndrome caused by glomerulonephritis?
  1. ক
    Heavy proteinuria (>3.5 g/day)
  2. খ
    Hematuria with red blood cell casts
  3. গ
    Severe hypoalbuminemia
  4. ঘ
    Frothy urine
ব্যাখ্যা
Explanation :
Nephritic syndrome is characterized by:

Hematuria (often microscopic or macroscopic)

Red blood cell casts in urine

Mild to moderate proteinuria

Hypertension These findings indicate glomerular inflammation, as seen in glomerulonephritis.
In contrast, heavy proteinuria and hypoalbuminemia are features of nephrotic syndrome.
১২.
A thyroid cancer that arises from parafollicular C cells and secretes calcitonin is:
  1. ক
    Papillary carcinoma
  2. খ
    Medullary carcinoma
  3. গ
    Anaplastic carcinoma
  4. ঘ
    Follicular carcinoma
ব্যাখ্যা
Explanation :
Medullary carcinoma is derived from C cells, which produce calcitonin.
It can cause diarrhea and is associated with MEN 2 syndromes.
Measuring serum calcitonin helps in diagnosis and monitoring.
১৩.
Which parasite entering through inoculation of skin -
  1. ক
    Trichomonas vaginalis
  2. খ
    Plasmodium vivex
  3. গ
    Enerovius vermicularis
  4. ঘ
    Toxoplasma gondii
ব্যাখ্যা
Explanation :
Parasites entering through inoculation of skin -
Plasmodium
L.donovani
T.brucei
১৪.
Which of the following is the most appropriate test to confirm H. pylori infection in a patient not recently treated with antibiotics or PPIs?
  1. ক
    Endoscopy with biopsy
  2. খ
    Urea breath test
  3. গ
    Serum gastrin level
  4. ঘ
    Stool antigen test
ব্যাখ্যা
Explanation :
The urea breath test is a non-invasive, highly sensitive and specific test for detecting active H. pylori infection.
It relies on the urease activity of the bacteria.

It is preferred in patients not recently on PPIs or antibiotics, as those can give false negatives.
Stool antigen is also useful but less preferred than breath testing in many settings.
১৫.
Mycobacterium -
  1. ক
    Produce toxins
  2. খ
    Doubling time 18 hours
  3. গ
    Obligate anaerobe
  4. ঘ
    Spleen is the primary site of infection
ব্যাখ্যা
Explanation :
Mycobacterium tuberculosis -
Aerobic,slowly growing,facultative intracellular, acid fast bacili
Obligate aerobe
Site of primary infection -
Lungs and lymph node
Intestine
Kidney
Skin
Tonsil
১৬.
What is the initial vascular manifestation commonly observed in patients with systemic sclerosis?
  1. ক
    Raynaud phenomenon
  2. খ
    Digital ulcer
  3. গ
    Pulmonary arterial hypertension
  4. ঘ
    Sclerodactyly
ব্যাখ্যা
Explanation :
Raynaud phenomenon is often the first clinical sign of systemic sclerosis and may precede other symptoms by months or years.

It is caused by vasospasm of digital arteries, leading to triphasic color changes (white → blue → red) in fingers/toes.
Though digital ulcers and sclerodactyly develop later, Raynaud's is usually the earliest sign and a key diagnostic clue.
১৭.
Which of the following investigations is most definitive for diagnosing bronchiectasis?
  1. ক
    Chest X-ray
  2. খ
    Spirometry
  3. গ
    Sputum culture
  4. ঘ
    High resolution CT scan
ব্যাখ্যা
Explanation :
HRCT scan is the gold standard for diagnosing bronchiectasis.
It clearly shows dilated, thick-walled bronchi and the "signet ring sign".
While chest X-ray can show suggestive changes, it is less sensitive.
Spirometry may show obstructive patterns, but it is not diagnostic.
১৮.
Which organism is most commonly responsible for genital ulcer -
  1. ক
    T.pallidum
  2. খ
    H.ducreyi
  3. গ
    C.trachomatis
  4. ঘ
    HSV-2
ব্যাখ্যা
Explanation :
Causes of genital ulcer :
HSV -2( most common)
HSV-1
T.pallidum
H.ducreyi
Calymmatobactrrium
C.trachomatis
১৯.
What is the primary cause of gout?
  1. ক
    High urea level
  2. খ
    Low calcium level
  3. গ
    High uric acid level
  4. ঘ
    Vitamin D deficiency
ব্যাখ্যা
Explanation :
Gout is primarily caused by hyperuricemia, which means elevated levels of uric acid in the blood.
When uric acid accumulates, it can form sharp crystals in joints, leading to inflammation and pain.
২০.
Which of the following findings on a peripheral blood film is most characteristic of iron deficiency anemia?
  1. ক
    Macrocytic, normochromic red blood cells
  2. খ
    Target cells and Howell-Jolly bodies
  3. গ
    Microcytic, hypochromic red blood cells with anisopoikilocytosis
  4. ঘ
    Hypersegmented neutrophils and oval macrocytes
ব্যাখ্যা
Explanation :
In iron deficiency anemia, the red blood cells are smaller than normal (microcytic) and have less hemoglobin (hypochromic), giving them a pale appearance.
There is also anisopoikilocytosis, which means variation in cell size (anisocytosis) and shape (poikilocytosis).
This is the classic appearance in iron deficiency and helps distinguish it from other causes of anemia.
Hypersegmented neutrophils and macrocytes point to megaloblastic anemia, not iron deficiency.
২১.
Neisseria gonorrhoeae -
  1. ক
    Gram +ve diplococci
  2. খ
    Required chocolate agar media to grow
  3. গ
    Ferments glucose and maltose
  4. ঘ
    Lipopolysaccharide is the infective form
ব্যাখ্যা
Explanation :
(a) Gram -ve diplococci, facultative intracellular, affects columnar cell
(b) Farments glucose but not maltose
(d) Infective form-
Pilli
Lipo-oligosaccharide
Outer membrane protein
IgA protease
২২.
Which of the following is the best initial screening test for acromegaly?
  1. ক
    Insulin-like growth factor-1
  2. খ
    Pituitary MRI
  3. গ
    Serum growth hormone level
  4. ঘ
    Oral glucose tolerance test
ব্যাখ্যা
Explanation :
IGF-1 is the preferred screening test for acromegaly because it reflects average GH levels over time (GH itself fluctuates).
If IGF-1 is elevated, the diagnosis is confirmed with a glucose suppression test (GH fails to suppress), followed by imaging (MRI) to locate the adenoma.
২৩.
In a patient with suspected pneumonia, the Gram stain of a good-quality sputum sample reveals Gram-positive diplococci. Which of the following pathogens is most likely?
  1. ক
    Haemophilus influenzae
  2. খ
    Klebsiella pneumonae
  3. গ
    Staphylococcus aureus
  4. ঘ
    Streptococcus pneumoniae
ব্যাখ্যা
Explanation :
Streptococcus pneumoniae appears on Gram stain as Gram-positive, lancet-shaped diplococci.
It is one of the most common causes of community-acquired pneumonia.

Staphylococcus aureus appears as Gram-positive cocci in clusters, Klebsiella is a Gram-negative bacillus, and Haemophilus influenzae is a Gram-negative coccobacillus.
২৪.
Which of the following is the most important precipitating factor for hepatic encephalopathy?
  1. ক
    Hypokalemia
  2. খ
    Dehydration
  3. গ
    Gastrointestinal bleeding
  4. ঘ
    Increase urea
ব্যাখ্যা
Explanation :
GI bleeding introduces a high nitrogen load into the gut, which is converted to ammonia and other neurotoxins. This is a common and serious precipitating factor for Hepatic encephalopathy.
২৫.
Which of the following is the most common cause of chronic renal failure worldwide?
  1. ক
    Hypertension
  2. খ
    Diabetes melitus
  3. গ
    Polycystic kidney disease
  4. ঘ
    Glomerulonephritis
ব্যাখ্যা
Explanation :
Diabetic nephropathy is the leading cause of chronic kidney disease globally.

Persistent hyperglycemia damages the glomeruli, leading to progressive loss of kidney function.
২৬.
Which gene is most commonly associated with ankylosing spondylitis?
  1. ক
    HLA-DR3
  2. খ
    HLA -B27
  3. গ
    HLA -A2
  4. ঘ
    HLA-DQ2
ব্যাখ্যা
Explanation :
HLA-B27 is strongly associated with seronegative spondyloarthropathies, especially ankylosing spondylitis.
Over 90% of AS patients are HLA-B27 positive.
২৭.
Which CBC parameter is typically reduced in iron deficiency anemia?
  1. ক
    RDW
  2. খ
    Total iron binding capacity
  3. গ
    MCV
  4. ঘ
    Haematocrit only
ব্যাখ্যা
Explanation :
Blood picture of iron deficiency anaemia -
২৮.
A patient with liver abscess presents with fever, right upper quadrant pain, and hepatomegaly. What is the best initial imaging investigation?
  1. ক
    USG of W/A
  2. খ
    Liver biopsy
  3. গ
    Endoscopy of upper GIT
  4. ঘ
    Abdominal X ray
ব্যাখ্যা
Explanation:
Ultrasound is the first-line imaging to evaluate liver abscess.
It is non-invasive, widely available, and effective in detecting the size, number, and location of the abscess.
২৯.
What does the presence of nitrites in urine suggest?
  1. ক
    Kidney stone
  2. খ
    Preeclampsia
  3. গ
    Proteinurea
  4. ঘ
    Bacterial infection
ব্যাখ্যা
Explanation :
Nitrites are produced when Gram-negative bacteria (like E. coli) convert nitrates in urine. Their presence suggests a bacterial UTI.
৩০.
Promastigote form of Leishmania donovani is found in -
  1. ক
    Sand fly
  2. খ
    Peripheral blood film
  3. গ
    Biopsy materials
  4. ঘ
    Buffy coat
ব্যাখ্যা
Explanation :
Promastigote form found in -
Sand fly
Culture media 
Amastigote form found in -
Staining/ Peripheral blood smear,Buffy coat
Biopsy,Dog
৩১.
A patient with gastric carcinoma develops a hard left supraclavicular lymph node. What is this finding called?
  1. ক
    Sister Mary Joseph nodule
  2. খ
    Virchow’s node
  3. গ
    Courvoisier’s sign
  4. ঘ
    Troisier’s sign
ব্যাখ্যা
Explanation :
Virchow’s node is a left supraclavicular lymph node enlargement due to metastatic spread from abdominal cancers, especially gastric carcinoma.
It reflects lymphatic drainage via the thoracic duct.
৩২.
Which pattern of joint involvement is most characteristic of psoriatic arthritis?
  1. ক
    Symmetrical small joint polyarthritis
  2. খ
    Assymetrical oligoarthritis
  3. গ
    Large joint monoarthritis
  4. ঘ
    Axial skeleton only
ব্যাখ্যা
Explanation :
Psoriatic arthritis often presents with asymmetrical oligoarthritis, meaning a few joints are affected and not in the same pattern on both sides of the body.
However, it can also involve the spine (axial) or present with a pattern similar to rheumatoid arthritis in some cases.
৩৩.
Which of the following conditions is commonly associated with a very high ESR (>100 mm/hr)?
  1. ক
    Iron deficiency anaemia
  2. খ
    Polycythemia
  3. গ
    Osteoarthritis
  4. ঘ
    Rheumatoid arthritis
ব্যাখ্যা
Explanation :
Causes of Sky-High ESR (>100 mm/hr) – In Short:

? Infections (Chronic or Severe):

Tuberculosis


? Autoimmune/Inflammatory Diseases:

Rheumatoid arthritis (RA)

Systemic lupus erythematosus (SLE)


? Malignancy:

Multiple myeloma

Lymphoma

Metastatic cancer
৩৪.
Which of the following is the most common type of primary hepatic carcinoma?
  1. ক
    Hepatocellular carcinoma
  2. খ
    Cholangiocarcinoma
  3. গ
    Hepatoblastoma
  4. ঘ
    Hepatic angiosarcoma
ব্যাখ্যা
Explanation :
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, typically arising in the setting of chronic liver disease such as hepatitis B or C infection, or cirrhosis. Cholangiocarcinoma (bile duct cancer) is less common, and metastatic tumors (like colorectal cancer) are secondary, not primary hepatic cancers
৩৫.
Which type of lung cancer is most commonly associated with paraneoplastic syndromes such as SIADH and ectopic ACTH production?
  1. ক
    Small cell carcinoma
  2. খ
    Large cell carcinoma
  3. গ
    Adenocarcinoma
  4. ঘ
    Carcinoid tumor
ব্যাখ্যা
Explanation :
Small cell lung carcinoma (SCLC) is a highly aggressive tumor that often produces paraneoplastic hormones, including:

ADH → SIADH (hyponatremia)

ACTH → Cushing’s syndrome
It is almost always found in smokers and has a central location in the lungs.
৩৬.
A 45-year-old woman presents with fatigue, cold intolerance, weight gain, and constipation. On examination, she has dry skin and a slow heart rate. What is the most likely diagnosis?
  1. ক
    Hypothyroidism
  2. খ
    Cushing syndrome
  3. গ
    Addison's disease
  4. ঘ
    Iron deficiency anaemia
ব্যাখ্যা
Explanation :
This patient has classic features of hypothyroidism, including:

Fatigue, weight gain, cold intolerance

Bradycardia (slow heart rate)

Dry skin and constipation
These symptoms reflect a slowed metabolic rate due to reduced thyroid hormone levels.
৩৭.
Which combination of markers indicates immunity due to past hepatitis B infection, not vaccination?
  1. ক
    HBsAg positive, Anti-HBc positive
  2. খ
    Anti-HBs positive, Anti-HBc negative
  3. গ
    HBsAg negative, Anti-HBs positive, Anti-HBc positive
  4. ঘ
    HBeAg positive, Anti-HBs positive
ব্যাখ্যা
Explanation :
HBsAg negative → no current infection

Anti-HBs positive → immune

Anti-HBc positive → had natural exposure (core antibody is not present in vaccine-only immunity)


In contrast, vaccine-induced immunity will show Anti-HBs positive only, with no Anti-HBc.
৩৮.
Which of the following antibodies is most specific for Systemic Lupus Erythematosus (SLE)?
  1. ক
    Anti-centromere antibody
  2. খ
    Anti-Ro (SSA) antibody
  3. গ
    Anti-dsDNA antibody
  4. ঘ
    Anti nuclear antibody
ব্যাখ্যা
Explanation :
Anti-double-stranded DNA (anti-dsDNA) is highly specific for SLE and is associated with disease activity, especially lupus nephritis.
It helps confirm the diagnosis and monitor disease progression.
৩৯.
Which investigation have prognostic value in treponemal disease -
  1. ক
    FTA-ABS
  2. খ
    TPHA
  3. গ
    VDRL
  4. ঘ
    RPR
ব্যাখ্যা
Explanation :
VDRL -
Have prognostic value
Become non reactive after effective treatment 
But specific tests - once positive,remains positive for lifelong
৪০.
P.falciparum associated malarial fever -
  1. ক
    Causes benign tertian malaria
  2. খ
    Relapse is common
  3. গ
    24 hours fever periodicity
  4. ঘ
    Hypnozoites is present
ব্যাখ্যা
Explanation :
P.falciparum associated malaria -
Persistant as pre-erythrocytic only
Causes Malignant tertian malaria
Recrudescence upto 1 year
Option (a),(b),(d) is the characteristics of P.vivex and P.ovale