4th BHMS Winter 2022 PRACTICE OF MEDICINE / MEDICINE / HOMOEOPATHIC THERAPEUTICS -I [Solved Paper]

 2. Short Answer Questions (Solve any 4 Out of 6) ,

a) Kiinefelter's syndrome 

b) Causes and clinical features Irritable bowel disease 

c) Causative organism and clinical features of viral Hepatitis. 

d) Causes and clinical features of Community aquired pneumonia 

e) Differential diagnosis of Hemoptysis 

f)- Frost bite,  

3. Short Answer Questions (Solve any 4 Out of 6) :- [4 x = 201 

 Indications of Natrum Suipli in Bronchiectasis

 b) Indications of Hepar Suiph in Chilblains

 c) Indications of Bryonia in Sjogren's syndrome

 d)- Indications of Chelidonium in acute Cholecystitis 

--or

 Indications of Rumex in acute Bronchitis 

e) Indications of Phosphorus in Hematemesis 

4. Long Answer Questions (Solve any 2 Out o14) 

a) Describe portal hypertension with respect to causes and complications with indications of Cardus Mur and Hellaborus and for it. 

( b) Describe Systemic Lupus Erythematosus with indications of Rhus Tox and Causticum for it -

 Describe Gastroesophageal reflux disease in respect to causes and clinical features and indications of Lycopodium and Nux Vomica for it.  

Describe primary Pulmonary Tuberculosis and indications of Tuberculinum and Silicea for the same. 

Long Answer Questions 

5. Describe in detail Bronchial Asthma with respect to types, clinical features, investigations, Scope and limitations of Homoeopathy and miasmatic understanding_ 

6. Describe in detail Ulcerative Colitis with respect to causes, Clinical features, Chronic prescribing and miasmatic understanding. 

 7. Discuss in detail Chronic Pancreatitis with respect to causes, clinical features, miasmatic background and auxilliary background. 

✅ Q.2 – Short Answer Questions (All 6 Solved)

[6 × 5 = 30 Marks]

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a) Klinefelter's Syndrome

• A genetic disorder in males caused by presence of an extra X chromosome (47, XXY).

Clinical Features:

• Tall stature, long limbs

• Small testes, infertility, gynecomastia

• Low testosterone levels

• Learning disabilities, social immaturity

• Sparse facial/body hair

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b) Causes and Clinical Features of Irritable Bowel Disease (IBD)

Causes:

• Genetic predisposition

• Autoimmune dysregulation

• Environmental triggers (e.g. infections, stress)

• Smoking (Crohn’s), NSAIDs

Clinical Features:

• Abdominal pain

• Chronic diarrhea with/without blood

• Weight loss

• Fatigue

• Extraintestinal: arthritis, uveitis, skin rashes

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c) Causative Organism and Clinical Features of Viral Hepatitis

Type	Common Virus
Hep A	HAV (RNA) – fecal-oral
Hep B	HBV (DNA) – blood/sex
Hep C	HCV (RNA) – blood
Hep D	HDV (RNA) – with HBV
Hep E	HEV (RNA) – fecal-oral

Clinical Features:

• Fever, malaise

• Anorexia, nausea, vomiting

• Jaundice, dark urine

• Hepatomegaly

• Elevated liver enzymes

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d) Causes and Clinical Features of Community Acquired Pneumonia (CAP)

Causes (Pathogens):

• Streptococcus pneumoniae (most common)

• Haemophilus influenzae

• Mycoplasma pneumoniae

• Viruses: Influenza, RSV

Clinical Features:

• Sudden high-grade fever

• Productive cough, purulent sputum

• Dyspnea, chest pain

• Tachypnea, crackles on auscultation

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e) Differential Diagnosis of Hemoptysis

1. Infective: Tuberculosis, pneumonia, lung abscess

2. Neoplastic: Bronchogenic carcinoma

3. Cardiac: Mitral stenosis

4. Vascular: Pulmonary embolism

5. Others: Bronchiectasis, trauma, anticoagulants

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f) Frostbite

• Cold-induced injury to skin and deeper tissues due to prolonged exposure.

Stages:

1. Frostnip – reversible, red or pale skin

2. Superficial frostbite – clear blisters

3. Deep frostbite – hemorrhagic blisters, necrosis

Management:

• Rapid rewarming

• Avoid refreezing

• Analgesics, wound care

• Amputation in severe necrosis

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✅ Q.3 – Short Answer Questions (All 6 Solved)

[6 × 5 = 30 Marks]

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a) Natrum Sulphuricum in Bronchiectasis

• Indications:

  • Greenish, thick, ropy expectoration

  • Asthma < damp weather, near sea

  • Cough with bilious vomiting

  • Aggravation in mornings and wet weather

• Miasm: Sycosis

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b) Hepar Sulph in Chilblains

• Painful, sensitive skin swellings in cold

• Ulceration tendency

• < Cold air, touch

• Warm applications

• Suppuration in glands or ulcers

• Miasm: Psora-syphilis

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c) Bryonia in Sjogren’s Syndrome

• Dry mucous membranes (dry mouth, dry eyes)

• Pain < motion, > rest

• Irritable, wants to be left alone

• Arthritic symptoms

• Miasm: Psora

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d) Chelidonium in Acute Cholecystitis

• Right-sided pain radiating to scapula

• Constant nausea, bitter vomiting

• < Pressure, motion

• Yellow tongue, desire for hot drinks

• Miasm: Psora-sycosis

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e) Rumex in Acute Bronchitis

• Dry, tickling cough with rawness in trachea

• < Touching throat, cold air

• Barking cough

• Expectoration scanty or absent

• Miasm: Psora

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f) Phosphorus in Hematemesis

• Bright red blood vomiting

• Craving for cold water

• Burning sensation in stomach

• Easily exhausted

• Bleeding tendency from various sites

• Miasm: Tubercular (mixed)

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✅ Q.4 – Long Answer Questions (All 4 Solved)

[4 × 10 = 40 Marks]

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🔷 a) Portal Hypertension

Definition:
Elevated pressure in the portal venous system (normal <12 mmHg).

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Causes:

• Pre-hepatic: Portal vein thrombosis

• Hepatic: Cirrhosis (most common)

• Post-hepatic: Budd-Chiari syndrome

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Complications:

1. Esophageal varices → hematemesis

2. Splenomegaly

3. Ascites

4. Caput medusae

5. Hepatic encephalopathy

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Homoeopathic Remedies:

1. Carduus Marianus

• Liver enlargement and pain

• Jaundice, varices, nausea

• < Lying on left side

2. Helleborus Niger

• Dropsical conditions (ascites)

• Low reaction, stupor

• < Motion, cold exposure

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🔷 b) Systemic Lupus Erythematosus (SLE)

Definition:
Autoimmune disease with multisystem involvement and ANA positivity.

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Clinical Features:

• Malar rash (“butterfly”)

• Photosensitivity

• Oral ulcers

• Arthritis

• Nephritis

• CNS symptoms (seizures, psychosis)

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Homoeopathic Remedies:

1. Rhus Tox

• Muscular pain, stiffness < rest, > movement

• Vesicular eruptions, itching

2. Causticum

• Paralysis, joint affections

• Emotional, sympathetic

• Urinary and skin issues

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🔷 c) Gastroesophageal Reflux Disease (GERD)

Causes:

• LES dysfunction

• Hiatal hernia

• Obesity, alcohol, spicy food

• NSAIDs, smoking

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Clinical Features:

• Heartburn, especially post-meal

• Regurgitation

• Cough, hoarseness

• Dysphagia in chronic cases

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Homoeopathic Remedies:

1. Lycopodium

• Flatulence, bloating

• Craves sweets

• Sour eructations

• Aggravated 4–8 pm

2. Nux Vomica

• Sedentary life, spicy food

• Constipation, irritability

• < Morning, coffee

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🔷 d) Primary Pulmonary Tuberculosis

Definition:
Initial infection by Mycobacterium tuberculosis in lungs.

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Clinical Features:

• Low-grade evening fever

• Chronic cough

• Hemoptysis

• Weight loss, night sweats

• Hilar lymphadenopathy (in primary TB)

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Homoeopathic Remedies:

1. Tuberculinum

• Recurrent URTI

• Emaciation despite good appetite

• Desire for cold air, change

2. Silicea

• Suppuration tendency

• Weak, chilly, sensitive

• Helps expel foreign material

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✅ Q.5 – Bronchial Asthma

[20 Marks]

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Definition:

Chronic inflammatory airway disease with reversible obstruction and bronchial hyper-responsiveness.

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Types:

1. Allergic (extrinsic)

2. Non-allergic (intrinsic)

3. Occupational

4. Drug-induced (aspirin, beta-blockers)

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Clinical Features:

• Wheezing

• Dyspnea

• Cough (especially at night)

• Chest tightness

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Investigations:

• Spirometry → Decreased FEV1, FEV1/FVC

• Peak expiratory flow rate

• Chest X-ray (if complicated)

• IgE and eosinophil count

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Scope of Homoeopathy:

• Controls acute attacks (e.g., Ipecac, Antimonium tart)

• Reduces frequency and severity

• Constitutional treatment reduces hypersensitivity

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Limitations:

• Not effective during status asthmaticus

• Needs long-term treatment

• Avoid suppression with palliatives

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Miasmatic Understanding:

• Psora: Allergic, functional component

• Sycosis: Hyperplasia, mucus

• Tubercular: Changeable, recurrent, inherited

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✅ Q.6 – Ulcerative Colitis

[20 Marks]

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Definition:

Chronic inflammatory bowel disease limited to colon and rectum.

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Causes:

• Unknown (autoimmune)

• Genetic susceptibility

• Stress, NSAIDs, infections

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Clinical Features:

• Chronic bloody diarrhea

• Abdominal pain

• Tenesmus

• Fatigue, weight loss

• Extraintestinal: arthritis, eye inflammation

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Chronic Prescribing:

• Constitutional remedy based on generalities, mentals

• Sulphur: Diarrhea in morning, burning anus

• Merc sol: Tenesmus, mucus, blood

• Nux vomica: Irritable, sedentary, ineffective urging

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Miasmatic Understanding:

• Psora: Functional inflammation

• Sycosis: Mucous overproduction

• Syphilis: Ulceration, bleeding

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✅ Q.7 – Chronic Pancreatitis

[20 Marks]

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Definition:

Progressive inflammatory disease causing irreversible damage to pancreas.

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Causes:

• Alcoholism (most common)

• Hyperlipidemia

• Obstructive (gallstones)

• Hereditary pancreatitis

• Autoimmune

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Clinical Features:

• Recurrent epigastric pain

• Fatty stools (steatorrhea)

• Diabetes mellitus

• Jaundice (if biliary obstruction)

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Miasmatic Background:

• Psora: Functional digestive disorders

• Sycosis: Inflammatory glandular pathology

• Syphilis: Destructive degeneration

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Auxiliary Management:

• Avoid alcohol

• Low-fat diet

• Pancreatic enzyme supplements

• Vitamin ADEK supplementation

• Blood sugar control

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