#Kathmandu University
BIRAT MEDICAL COLLEGE
Budhiganga-02, Tankisinuwari, Morang
Level: Final MBBS (Batch: 2021)
Semester: 8th
Examination: End-Semester
Subject: Medicine & Allied Subject (Paper-II)
Time: 2 hrs. 30 mins.
Date: March 13, 2026
Marks: 50
#INSTRUCTION TO THE CANDIDATE
Answer each section in a separate answer book.
Write brief, relevant and legible answers.
Illustrate your answer with well labeled diagrams where required.
All questions are compulsory.
#SECTION ‘B’
#Short Answer Questions [30 marks]
#Medicine
Describe various mechanism of ascites formation. [4]
Define and classify acute liver failure. [2+2=4]
Mention clinical features and complications of Hypokalemia. [2+2=4]
What are the clinical features of cerebellar lesion? [4]
#Psychiatry
Classify different non-organic sleep disorders. Describe the pharmacological and non-pharmacological management of insomnia. [1+2+2=5]
Define suicide. How would you assess and manage a patient presented in emergency department with self-harm attempt? [1+2+2=5]
Enlist different types of Eating disorders. How would you assess and manage a case of Anorexia Nervosa? [1+1.5+1.5=4]
#SECTION ‘C’
#Problem Based Questions/ Modified Essay Questions [2Q × 10 = 20 marks]
#Problem I
A 65-Year-Old male is brought unconscious to emergency department. He is diabetic for 10 years but without follow up. His blood glucose is 650 mg/dl and no ketone body in urine.
a. What is the most probable diagnosis? [1]
b. What are the urgent investigations you will do to diagnose? [2]
c. How will you manage the case? [4]
d. What would be possible complications if no management were done to him? [3]
#Problem II
A 45 years male is brought from Saptari to the BMCTH emergency and presents with a fever for 2 days, headache and vomiting. On physical examination, he is found to have neck stiffness and photophobia.
a. What are your differential diagnosis? [1]
b. What are possible etiological agent causing the disease? [2]
c. What investigations need to be sent to confirm the diagnosis? [3]
d. What are your management plans? [4]