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Key for Trophy Test --- 4th year
(Questions 1 - 25)

1- What are various alcohol related disorders. (12)
a- Alcoholic dementia.
b- Subdural haematoma.
c- Withdrawl convulsions.
d- Delerium tremens.
e- Cardiomyopathy.
f- Hypertension.
g- Alcoholic hepatic cirrhosis.
h- Portal hypertension.
i- Pancreatitis.
j- Dupuytren's contracture.
k- Proximal myopathy.
l- Peripheral neuropathy.

2- What are various tobacco related disorders. (9)
a- Cerebrovascular disease.
b- Tobacco amblyopia.
c- Carcinoma mouth.
d- Carcinoma lung.
e- Chronic obstructive pulmonary disease.
f- Ischemic heart disease.
g- Peptic ulcer.
h- Obstetric problems.
i- Peripheral vascular disease.

3- Give Abbreviated mental tests. (10+3)
a- Time.
b- Day of week.
c- Month.
d- Year.
e- Age.
f- Place.
g- Name of Objects e.g. apple, table coin.
h- Dates of Special Event.
i- Name of Prime Minister.
j- Count backward 20-1.

Each item scores 1 point.
Normal scores 8-10.
Mild-moderate dementia 4-7.
Moderate-severe dementia 0-3.

4- Give spot diagnosis in a patient, i/ Blue sclerae (1) ii/ Protruded low jaw (1) iii/ Beaked nose (1) iv/ Woody legs appearance 
(1) (4)
a- Osteogenesis Imperfecta.
b- Acromegaly.
c- Scleroderma.
d- Scurvy.

5- Information available from a Hand shake. (5).
a- Large hand with excess sweating --- Acromegaly.
b- Hot & sweaty hands --- Thyrotoxicosis.
c- Cold & sweaty hands --- Anxious.
d- Dry & Course Skin --- Hypothyroid.
e- Delayed relaxation of grip --- Dystrophia myotoxica.

6- Three abnormal facial expressions are seen in, i/ Apathy (1) ii/ Poverty of expression (1) iii/ Agitation (1) (3)
a- Apathy --- Depression.
b- Poverty of Expression --- Parkinsonism.
c- Agitation --- Hypomania.

7- Give conditions causing depigmentation of body. (3)
a- Vitiligo.
b- Albinism.
c- Hypopituitarism.

8- Give conditions in which patients have myoclonic jerks while sleeping. (2)
a- Chronic renal failure.
b- Respiratory failure with CO retention.

9- Give causes of Short Stature. (8)
a- Down's syndrome.
b- Turner's syndrome.
c- Achondroplasia.
d- Intra-uterine growth retardation.
e- Protein-energy depreviation.
f- Rickets.
g- Renal failure.
h- Biliary disease.
i- Cretinism.
j- Craniopharyngioma.
k- Hypopituitarism.
l- Malabsorption.
m- Congenital heart disease.
n- Suppurative lung disease.
o- Severe scoliosis.

10- Give causes of Oedema. (4)
a- Fundal haemorrhage.
b- Tonsils.
c- JVP.
d- Cardiac size.
e- Gynaecomastia.
f- Blood pressure.
g- Pleural effusion.
h- Spleen.
i- Liver.
j- Ascities.
k- Clubbing, leukonychia.
l- Abdominal veins.
m- Genital oedema.
n- Petechial haemorrhage.

11- Give features of panhypopituitarism in female patient. (9)
a- Visual field defect.
b- Pallor.
c- Skin texture.
d- Postural hypotension.
e- Breast atrophy.
f- Weight loss.
g- Low-volume pulse.
h- Pubic, axillary hair loss.
i- Genital atrophy.

12- Causes of Erythema Nodisum. (5)
a- Sarcoid.
b- Tuberculosis.
c- Post-streptoccocal infection.
d- Connective tissue disease.
e- Drugs.

13- Causes of Pyoderma Gangrenosum. (2)
a- Ulcerative colitis.
b- Rhumatoid arthritis.

14- Give disease in which following nail abnormalities are present,
i/ Splinter haemorrhage. ii/ Bean's line. iii/ Pitting with onycholysis. (3)
a- Systemic vasculitis or Trauma.
Infective endocarditis.
b- Temporary arrest of nail growth. (Acute severe illness).
c- Psoriasis.

15- A 78 year old lady presented with " buzzing noises in head ". She also has right sided periorbital edema and severe chemosis. Give its likely cause. (5)
a- Carotid-cavernous fistula.

16- Give various diseases associated with following occupational exposure, 
i/ Organic solvents. ii/ Vibrating tools e.g. electric saw. iii/ Deep sea diving. (4)
a- Arrythmias.
b- Cardiomyopathy.
c- Raynaud's phenomenon.
d- Embolism through Foramen ovale.

17- Give drugs causing dizziness. (3)
a- Vasodilators e.g. Nitrates.
b- Alpha-blockers.
c- ACE inhibitors.

18- Give causes of dizziness/syncope. (7)
a- Brady arrythmias.
b- Postural hypotension.
c- Aortic stenosis.
d- Hypertrophic obstructive cardiomyopathy.
e- Atrial myxoma.
f- Epilepsy.
g- Simple faints.

19- Tabulate the differences between pain in Angina & Myocardial Infarction. (7)

20- Give facial clues to Heart Disease. (6)
a- Corneal arcus.
b- Xanthelasma.
c- Cyanosis.
d- Malar flush.
e- Venous pulsation.
f- Carotid bruit.

21- Give signs of Infective Endocarditis. (15)
a- Subconjunctival haemorrhage.
b- Roth spots.
c- Dental caries/surgery.
d- Cafe au leit lesions.
e- I/V injections.
f- Splenomegaly.
g- Haematuria.
h- Osler's nodes/Janeway lesions.
i- Splinter haemorrhage.
j- Petechial haemorrhage.
k- Finger/Toe clubbing.
l- Absent pulses.
m- Basal crepitations.
n- Changing murmurs.
o- Raised JVP.

22- Tabulate the differences between Carotid pulsation & JV Pulsation. (6)

23- What are the prominent waves in JVP in following conditions. (3)
i/ Tricuspid regurgitation. (1)
ii/ Tricuspid stenosis. (1)
iii/ Complete heart block. (1)
a- Giant 'V' waves.
b- Giant 'A' waves.
c- 'Cannon' waves.

24- Causes of loud S1. (5)
a- Increased cardiac output.
b- Large stroke volume.
c- Mitral stenosis.
d- Short P-R interval.
e- Atrial myxoma.

25- Causes of S3. (6)
a- Healthy young adults.
b- Athletes.
c- Pregnancy.
d- Fever.
e- Large, poor contracting left ventricle.
f- Mitral reflux.

(Click Here for Questions: 1 - 26)