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

পরীক্ষা৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]তারিখতারিখ অনির্ধারিতসময়16 minutes
মোট প্রশ্ন৪০
সিলেবাস
Exam - 1 Medicine-01 1. Diseases due to infections: Approach to infectious diseases — diagnostic and therapeutic principles General principles and rational use of antibiotics Dengue Enteric fever Amoebiasis, Giardiasis Kala-azar Malaria Filariasis Rabies Tuberculosis HIV/AIDS Leprosy Cholera, Diarrheal disease 2. Sexually Transmitted Diseases (STD) Gonorrhoea Syphilis Nongonococcal urethritis 3. Approach to common symptoms of disease: Fever, Pain, Palpitation, Jaundice, Anaemia, Bleeding, Haemoptysis, Dyspnoea, Paralysis, Syncope, Ascitis, Oedema, Cough, Vomiting, Dysuria 4. Neurological System Cerebrovascular diseases Meningitis: viral, bacterial and tuberculosis Encephalitis, viral Peripheral neuropathy 5. Diseases of the cardiovascular system: Ischaemic heart disease Rheumatic fever and rheumatic heart disease Valvular diseases of heart Infective endocarditis Hypertension and hypertensive heart diseases Cardiac arrhythmias (common) Heart failure — acute and chronic Acute and chronic pericarditis, pericardial effusion & cardiac tamponade
প্রশ্ন দেখুনঅনুশীলন
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উত্তরিতবর্তমানপুনরায় দেখুনঅসম্পূর্ণ

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

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

১.
What is the characteristic stool appearance in cholera?
  1. ক
    Bloody diarrhea
  2. খ
    Rice-water stool
  3. গ
    Mucus-filled stool
  4. ঘ
    Greasy stool
ব্যাখ্যা
Cholera is characterized by voluminous, watery diarrhea with a “rice-water” appearance (pale, milky fluid with flecks of mucus) due to massive fluid secretion in the gut caused by the cholera toxin.
২.
What is the most appropriate initial imaging modality for a patient presenting with acute stroke symptoms?
  1. ক
    Non-contrast CT brain
  2. খ
    MRI brain with diffusion-weighted imaging
  3. গ
    CT angiography
  4. ঘ
    PET scan
ব্যাখ্যা
In acute stroke, the priority is to differentiate ischemic stroke from hemorrhagic stroke is the main concern & it is done by Non-contrast CT brain.
৩.
Which drug is contraindicated in pregnancy-related hypertension?
  1. ক
    Methyldopa
  2. খ
    Labetalol
  3. গ
    ACE inhibitors
  4. ঘ
    Nifedipine
ব্যাখ্যা
ACEi/ARB are teratogenic and avoided in pregnancy
৪.
What is the hallmark feature of primary syphilis?
  1. ক
    Rash
  2. খ
    Gummas
  3. গ
    Tabes dorsalis
  4. ঘ
    Chancre
ব্যাখ্যা
Primary syphilis, caused by Treponema pallidum, presents with a painless chancre (ulcer) at the site of infection, typically on the genitals, which is highly infectious. Rash is seen in secondary syphilis, and gummas and tabes dorsalis are features of tertiary syphilis
৫.
What is the most specific initial symptom of subarachnoid hemorrhage?
  1. ক
    Focal neurological deficit
  2. খ
    Seizure
  3. গ
    Fever
  4. ঘ
    Sudden severe headache
ব্যাখ্যা
A sudden, severe “thunderclap” headache is the hallmark symptom of subarachnoid hemorrhage.
৬.
Which biomarker rises earliest after myocardial injury?
  1. ক
    Troponin
  2. খ
    CK-MB
  3. গ
    Myoglobin
  4. ঘ
    BNP
ব্যাখ্যা
Myoglobin rises within 1–3 hours but is less specific. Troponin is gold standard but peaks later
৭.
Which diagnostic test is most commonly used to confirm enteric fever?
  1. ক
    Widal test
  2. খ
    Blood culture
  3. গ
    Stool culture
  4. ঘ
    Bone marrow culture
ব্যাখ্যা
Blood culture is the gold standard for diagnosing enteric fever caused by Salmonella Typhi or Paratyphi. It is most sensitive during the first week of illness, with a positivity rate of 60–80%. The Widal test is less specific due to cross-reactivity and is not preferred in modern practice. Bone marrow culture is highly sensitive but invasive, and stool culture is less reliable early in the disease
৮.
Which clinical test is most specific for diagnosing carpal tunnel syndrome?
  1. ক
    Tinel’s sign
  2. খ
    Phalen’s test
  3. গ
    Froment’s sign
  4. ঘ
    Finkelstein’s test
ব্যাখ্যা
Phalen’s test (wrist flexion for 60 seconds to reproduce paresthesia in the median nerve distribution) as highly specific for carpal tunnel syndrome. Tinel’s sign (a) (tapping over the median nerve causing tingling) is less specific, Froment’s sign (c) is used for ulnar nerve dysfunction, and Finkelstein’s test (d) is specific for de Quervain’s tenosynovitis.
৯.
A patient with IV drug use presents with fever and a murmur. Blood cultures grow Staphylococcus aureus. Which valve is most commonly affected?
  1. ক
    Aortic
  2. খ
    Mitral
  3. গ
    Tricuspid
  4. ঘ
    Pulmonary
ব্যাখ্যা
IV drug use-associated endocarditis often involves the tricuspid valve
১০.
Sudden-onset, severe epigastric pain radiating to the back is most suggestive of:
  1. ক
    Acute cholecystitis
  2. খ
    Perforated peptic ulcer
  3. গ
    Appendicitis
  4. ঘ
    Acute pancreatitis
ব্যাখ্যা
Severe epigastric pain radiating to the back is classic for pancreatitis, often accompanied by vomiting and elevated serum amylase/lipase
১১.
What is the most critical clinical feature indicating progression to severe dengue?
  1. ক
    Fever
  2. খ
    Thrombocytopenia
  3. গ
    Plasma leakage
  4. ঘ
    Myalgia
ব্যাখ্যা
Severe dengue is characterized by plasma leakage, leading to hemoconcentration, pleural effusions, or ascites. This is the hallmark of dengue hemorrhagic fever and dengue shock syndrome. Warning signs include persistent vomiting, abdominal pain, mucosal bleeding, and evidence of plasma leakage (e.g., rising hematocrit). Early recognition is critical for fluid management to prevent shock.
১২.
What is the most critical initial investigation for a patient presenting with chest pain suggestive of ACS?
  1. ক
    ECG
  2. খ
    Troponin levels
  3. গ
    Chest X-ray
  4. ঘ
    Echocardiography
ব্যাখ্যা
An ECG is the most critical initial investigation in suspected ACS to identify ST-elevation myocardial infarction (STEMI) or ischemic changes (e.g., ST depression, T-wave inversion) that guide urgent management (e.g., percutaneous coronary intervention).
১৩.
The drug of choice for all stages of syphilis is:
  1. ক
    Doxycycline
  2. খ
    Ceftriaxone
  3. গ
    Penicillin
  4. ঘ
    Azithromycin
ব্যাখ্যা
Penicillin remains first-line for all stages; alternatives (e.g., doxycycline) are used only if penicillin-allergic
১৪.
Hemoptysis with sudden severe pleuritic chest pain and dyspnea suggests:
  1. ক
    Lung cancer
  2. খ
    Pulmonary embolism
  3. গ
    Bronchitis
  4. ঘ
    Pneumonia
ব্যাখ্যা
PE can cause hemoptysis due to pulmonary infarction, often with sudden dyspnea and pleuritic pain
১৫.
What is the most common extraintestinal manifestation of amoebiasis?
  1. ক
    Brain abscess
  2. খ
    Liver abscess
  3. গ
    Lung abscess
  4. ঘ
    Splenic abscess
ব্যাখ্যা
Amoebiasis, caused by Entamoeba histolytica, most commonly leads to amoebic liver abscess as an extraintestinal complication. This occurs when trophozoites invade the portal vein, causing abscesses in the liver, typically presenting with fever, right upper quadrant pain, and hepatomegaly. Other extraintestinal sites like the brain or lung are rare
১৬.
Which finding on ECG suggests ventricular tachycardia (VT)?
  1. ক
    P waves before every QRS
  2. খ
    wide QRS
  3. গ
    PR interval prolongation
  4. ঘ
    Delta waves
ব্যাখ্যা
VT shows broad QRS (>140 ms) and AV dissociation
১৭.
What is the most common cause of mitral stenosis in adults?
  1. ক
    Degenerative calcification
  2. খ
    Infective endocarditis
  3. গ
    Congenital malformation
  4. ঘ
    Rheumatic heart disease
ব্যাখ্যা
Rheumatic heart disease as the most common cause of mitral stenosis, particularly in developing countries, due to post-streptococcal inflammation leading to valve scarring. Congenital malformation (b) is rare, infective endocarditis (c) may cause regurgitation rather than stenosis, and degenerative calcification (d) is more associated with aortic stenosis in the elderly.
১৮.
What is the first-line treatment for uncomplicated P. falciparum malaria in a non-immune patient?
  1. ক
    Chloroquine
  2. খ
    Artemether-lumefantrine
  3. গ
    Quinine
  4. ঘ
    Mefloquine
ব্যাখ্যা
Artemether-lumefantrine, an artemisinin-based combination therapy (ACT), is the first-line treatment for uncomplicated P. falciparum malaria due to its rapid action and high efficacy. Chloroquine is ineffective against resistant strains, and quinine is reserved for severe cases
১৯.
Which congenital heart defect is most likely to present with cyanosis at birth?
  1. ক
    Atrial septal defect
  2. খ
    Coarctation of the aorta
  3. গ
    Transposition of the great arteries
  4. ঘ
    Bicuspid aortic valve
ব্যাখ্যা
Transposition of the great arteries (TGA) causes severe cyanosis at birth due to parallel pulmonary and systemic circulations. Mixing of blood (e.g., via a patent ductus arteriosus) is required for survival until corrective surgery.
২০.
Foot drop is most commonly caused by injury to which nerve?
  1. ক
    Sciatic
  2. খ
    Femoral
  3. গ
    Common peroneal
  4. ঘ
    Tibial
ব্যাখ্যা
The common peroneal nerve is vulnerable at the fibular head; injury causes foot drop
২১.
Projectile vomiting without nausea is a red flag for:
  1. ক
    Gastroenteritis
  2. খ
    Peptic ulcer
  3. গ
    Increased ICP
  4. ঘ
    Cholecystitis
ব্যাখ্যা
Projectile vomiting suggests brainstem compression (e.g., tumor, hydrocephalus)
২২.
What is the most likely cause of a pansystolic murmur heard at the apex in a young adult?
  1. ক
    Mitral regurgitation
  2. খ
    Aortic stenosis
  3. গ
    Hypertrophic cardiomyopathy
  4. ঘ
    Pulmonary stenosis
ব্যাখ্যা
A pansystolic murmur at the apex, radiating to the axilla, is characteristic of mitral regurgitation. This occurs due to retrograde flow from the left ventricle to the left atrium during systole.
২৩.
What is the most common site of extrapulmonary TB?
  1. ক
    Lymph nodes
  2. খ
    Bones
  3. গ
    Meninges
  4. ঘ
    Kidneys
ব্যাখ্যা
Lymph node TB (e.g., cervical lymphadenitis or scrofula) is the most common form of extrapulmonary TB, especially in high-prevalence areas. It presents as painless, enlarged lymph nodes. Other sites like bones, meninges, and kidneys are less common
২৪.
Pel-Ebstein fever is characteristic of which condition?
  1. ক
    Tuberculosis
  2. খ
    Hodgkin’s lymphoma
  3. গ
    Typhoid fever
  4. ঘ
    Malaria
ব্যাখ্যা
Pel-Ebstein fever describes cyclical fever (1–2 weeks of fever alternating with afebrile periods), classic for Hodgkin’s
২৫.
Which investigation is most diagnostic for acute abdominal pain due to a perforated peptic ulcer?
  1. ক
    Ultrasound
  2. খ
    CT scan
  3. গ
    Endoscopy
  4. ঘ
    Erect chest X-ray
ব্যাখ্যা
An erect chest X-ray is highly diagnostic for a perforated peptic ulcer, showing free air under the diaphragm in ~70–90% of cases. CT is sensitive, ultrasound may detect fluid, and endoscopy confirms ulcers, but X-ray is the initial, rapid test for perforation.
২৬.
What is the characteristic skin lesion in tuberculoid leprosy?
  1. ক
    Ulcerative lesions
  2. খ
    Nodular lesions
  3. গ
    Diffuse erythematous rash
  4. ঘ
    Hypopigmented anesthetic patches
ব্যাখ্যা
Tuberculoid leprosy, caused by Mycobacterium leprae, presents with few hypopigmented, anesthetic skin patches with well-defined borders due to a strong cell-mediated immune response. Nodular lesions are seen in lepromatous leprosy, not tuberculoid
২৭.
Which of the following is a major Jones criterion for diagnosing acute rheumatic fever?
  1. ক
    Erythema nodusum
  2. খ
    Erythema migrans
  3. গ
    Erythema marginatum
  4. ঘ
    Arthralgia
ব্যাখ্যা

Major criterias are:

Arthritis
Carditis 
Chorea
Erythema marginatum
Subcutaneous nodule

২৮.
What is the most likely cause of acute right lower quadrant abdominal pain in a young adult?
  1. ক
    Appendicitis
  2. খ
    Diverticulitis
  3. গ
    Cholecystitis
  4. ঘ
    Pancreatitis
ব্যাখ্যা
Appendicitis as the most common cause of acute right lower quadrant pain in young adults, often with tenderness at McBurney’s point, fever, and nausea. Diverticulitis typically affects the left side in older patients, cholecystitis causes right upper pain, and pancreatitis is epigastric, making appendicitis the best fit.
২৯.
Which finding is pathognomonic for typhoid fever?
  1. ক
    Koplik’s spots
  2. খ
    Rose spots
  3. গ
    Osler’s nodes
  4. ঘ
    Janeway lesions
ব্যাখ্যা

Rose spots (blanching pink macules on the trunk) are classic but rare.

Koplik’s spots - Measles

Osler’s nodes & Janeway lesions - Infective endocarditis

৩০.
A 70-year-old patient with isolated systolic hypertension (SBP 170 mmHg, DBP 80 mmHg) and no comorbidities is started on antihypertensive therapy. Which drug class is first-line?
  1. ক
    ACEi
  2. খ
    ARB
  3. গ
    CCB
  4. ঘ
    Beta blocker
ব্যাখ্যা
CCBs (e.g., amlodipine) or thiazide diuretics as first-line for isolated systolic hypertension, particularly in the elderly, due to their efficacy in reducing systolic BP and improving arterial compliance.
৩১.
Which initial test is most useful for evaluating palpitations?
  1. ক
    Echocardiogram
  2. খ
    Holter monitor
  3. গ
    Chest X-ray
  4. ঘ
    Thyroid function test
ব্যাখ্যা
Holter monitor (24–48-hour ECG) is the most useful initial test to capture intermittent arrhythmias causing palpitations. Echocardiogram assesses structural heart disease, thyroid function tests screen for hyperthyroidism, and chest X-ray is less relevant, but Holter monitoring directly correlates symptoms with rhythm changes.
৩২.
Which of the following is a characteristic finding in enteric fever?
  1. ক
    Bloody diarrhea
  2. খ
    Rose spots
  3. গ
    Painless lymphadenopathy
  4. ঘ
    Jaundice
ব্যাখ্যা
Rose spots are faint salmon-colored macules on the trunk and abdomen seen in about 30% of cases
৩৩.
A 50-year-old woman presents with a thunderclap headache and photophobia. CT head is normal. What is the next step?
  1. ক
    Lumbar puncture
  2. খ
    MRI brain
  3. গ
    Cerebral angiography
  4. ঘ
    Discharge with analgesia
ব্যাখ্যা
If CT is negative but clinical suspicion remains, lumbar puncture to detect xanthochromia is essential for diagnosing SAH
৩৪.
Which lab finding is diagnostic of dengue infection?
  1. ক
    Leukocytosis
  2. খ
    Thrombocytosis
  3. গ
    NS1 antigen positivity
  4. ঘ
    Elevated creatinine
ব্যাখ্যা
NS1 antigen is detectable in the first 5 days of infection, confirming acute dengue
৩৫.
Which of the following is the drug of choice for amoebic liver abscess?
  1. ক
    Metronidazole
  2. খ
    Ciprofloxacin
  3. গ
    Isoniazid
  4. ঘ
    Amphotericin B
ব্যাখ্যা
Metronidazole is the drug of choice for invasive amoebiasis including liver abscess
৩৬.
Which CSF finding suggests bacterial meningitis?
  1. ক
    Lymphocytosis, normal glucose
  2. খ
    Neutrophilia, low glucose
  3. গ
    Protein <0.4 g/L
  4. ঘ
    Elevated opening pressure alone
ব্যাখ্যা
Bacterial meningitis typically shows-
neutrophilic pleocytosis, elevated protein, and low glucose
৩৭.
Which of the following is the earliest marker to detect HIV infection?
  1. ক
    HIV antibodies
  2. খ
    CD4 count
  3. গ
    Viral culture
  4. ঘ
    p24 antigen
ব্যাখ্যা
p24 antigen appears earlier than antibodies and is used in fourth-generation HIV tests
৩৮.
What is the most common complication of untreated gonorrhoea in men?
  1. ক
    Prostatitis
  2. খ
    Urethral stricture
  3. গ
    Orchitis
  4. ঘ
    Epididymitis
ব্যাখ্যা
Untreated gonorrhoea in men can lead to epididymitis, presenting as painful swelling of the epididymis. Urethral stricture is a late complication, and prostatitis or orchitis is less common
৩৯.
A 45-year-old office worker reports numbness in the thumb, index, and middle fingers. Electromyography confirms median nerve compression at the wrist. What is the diagnosis?
  1. ক
    Ulnar neuropathy
  2. খ
    Carpal tunnel syndrome
  3. গ
    Radial neuropathy
  4. ঘ
    Peroneal neuropathy
ব্যাখ্যা
Median nerve compression at the wrist causes carpal tunnel syndrome, often due to repetitive strain
৪০.
Which of the following clinical findings is a guide to the cause of secondary hypertension specifically indicating coarctation of the aorta?
  1. ক
    Abdominal bruits
  2. খ
    Enlarged kidney
  3. গ
    Radio-femoral delay
  4. ঘ
    Peripheral edema
ব্যাখ্যা

Coarctation of aorta: radio-femoral delay

Abdominal bruits are associated with renal artery stenosis, enlarged kidneys with polycystic kidney disease, and characteristic facies & habitus with Cushing's syndrome.