Fourth B.H.M.S. Winter - 2021 PRACTICE OF MEDICINE - |

2. Short Answer Questions (

a) AIDS related complex (ARC)

b) Down’s syndrome

c) Sleep Apnoea

d) Hypothermia

e) Cause of Hematemesis and Malaena

f) Causes and clinical features of Hepatic Encephalopathy

3. Short Answer Questions 

a) Indications of Opium in Constipation

b) Indications of Aconite in Bronchopneumonia |

c) Indications of Hepar Sulph in Liver abscess 

d) Indications of Ant Tart in Bronchitis.

e) Indications of Nat Carb in Sunstroke.

: f) Indications of Chelidonium in Hepatitis B.

4, Long Answer Questions 

a) Discuss Cholelithiasis with respect to clinical features, complications,

miasmatic background and chronic prescribing

} OR

b) Discuss Irritable Bowel Syndrome with respect to causes and clinical

features. Add note on miasmatic background

c) Discuss Pneumonia with respect to Aeitology, clinical features, miasmatic

background and indication of two homoeopathic drugs :

| OR

d) Discuss in details Hepatitis B with respect to clinical features and

complications with concept of susceptibilty.

Long Answer Questions 

5. Discuss in detail Ulcerative Colitis with respect to clinical features,

investigations, miasmatic understanding and scope and limitations.

‘6. Discuss in details Bronchial Asthma with respect to defination and types,

Investigations in detail, scope and limitations, acute prescribing.

7. Discuss in details Ascites with respect to causes, symptoms and signs, acute

prescription and auxillary mode of treatment

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✅ Q.5 – Ulcerative Colitis

[20 Marks]

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🔹 Definition:

Ulcerative colitis (UC) is a chronic, inflammatory bowel disease that affects the mucosa of the colon and rectum, leading to ulceration and bleeding.

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🔹 Clinical Features:

1. Diarrhea with mucus and blood

2. Abdominal pain (usually lower left quadrant)

3. Tenesmus

4. Urgency and incontinence

5. Weight loss and fatigue

6. Periods of remission and relapse

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🔹 Investigations:

• CBC: Anemia, raised ESR

• Stool test: Occult blood, pus cells

• Colonoscopy: Friable mucosa, ulcers

• Biopsy: Confirms diagnosis

• Sigmoidoscopy: Visualizes rectum and distal colon

• CRP and Calprotectin: Inflammatory markers

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🔹 Miasmatic Understanding:

• Psora: Functional symptoms, alternating diarrhea/constipation

• Sycosis: Chronic inflammation, mucous discharge

• Syphilis: Ulceration, hemorrhage, destruction of mucosa

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🔹 Scope and Limitations of Homoeopathy:

Scope:

• Effective in controlling flare-ups

• Improves general health and immunity

• Prevents recurrence in early cases

Limitations:

• Not effective in emergency or fulminant colitis

• Surgical care required in complications (perforation, toxic megacolon)

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🔹 Homoeopathic Remedies:

• Mercurius corrosivus: Tenesmus, blood and mucus in stool

• Phosphorus: Weakness after stool, bright red blood, sensitive rectum

• Nux vomica: Ineffectual urging, constipation alternating with diarrhea

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✅ Q.6 – Bronchial Asthma

[20 Marks]

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🔹 Definition:

A chronic inflammatory airway disorder characterized by reversible airway obstruction, bronchial hyper-responsiveness, and wheezing.

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🔹 Types:

1. Extrinsic (Allergic): IgE mediated, childhood onset

2. Intrinsic (Non-Allergic): Adult onset, triggered by infection, stress

3. Occupational

4. Exercise-induced

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🔹 Investigations:

• Peak Expiratory Flow Rate (PEFR): ↓ during attack

• Spirometry: ↓ FEV1, ↑ RV

• Chest X-ray: Hyperinflated lungs

• IgE levels: Elevated in allergic asthma

• Sputum eosinophilia

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🔹 Scope and Limitations of Homoeopathy:

Scope:

• Useful in early stages and mild/moderate asthma

• Improves immunity and reduces frequency of attacks

• Addresses allergic predisposition

Limitations:

• In acute severe asthma, life-saving bronchodilators and steroids are essential

• Not recommended for status asthmaticus as primary line

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🔹 Acute Prescribing:

• Ipecac: Constant cough with no expectoration, wheezing, nausea

• Antimonium tart: Rattling cough, inability to bring up phlegm

• Arsenicum album: Anxiety, restlessness, dyspnea worse at midnight

• Sambucus: Nocturnal attacks with suffocation, especially in children

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✅ Q.7 – Ascites

[20 Marks]

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🔹 Definition:

Ascites is the abnormal accumulation of fluid in the peritoneal cavity, typically due to portal hypertension or hypoalbuminemia.

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🔹 Causes:

• Liver Cirrhosis (most common)

• Nephrotic syndrome

• Heart failure

• Malignancy

• Tuberculosis peritonitis

• Pancreatitis

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🔹 Symptoms:

• Abdominal distension

• Shifting dullness

• Weight gain

• Ankle edema

• Respiratory distress (if massive)

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🔹 Signs:

• Fluid thrill

• Everted umbilicus

• Dull percussion notes

• Pleural effusion (hepato-pleural syndrome)

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🔹 Acute Prescribing:

• Apis mellifica: Shiny, tense abdomen with scanty urine; thirstless

• Arsenicum album: Restlessness, edema, weakness, burning pain

• China officinalis: Ascites from chronic liver issues with weakness

• Lycopodium: Liver pathology with tympanitic distension, right-sided complaints

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🔹 Auxiliary Mode of Treatment:

1. Low sodium diet

2. Fluid restriction

3. Diuretics (when necessary)

4. Therapeutic paracentesis (in extreme cases)

5. Monitoring electrolytes, albumin levels

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