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MEDICINE VIVA 2018

1ST HALF

#medicine jototuk mne ase... jodio ami pai nai.boli o nai.

Long case:copd.nazmul sir..salient feature..kno bolso d/d te aplastic anaemia bolchi sudhi.
copd kno bronchial asthma na..xamination finding..kno Q chilo:present ur case?why acute
barrel shape.liver border koi...cardiac area bolsilam leukaemia?clinically kivabe bujhcho eita acute
oblitered..sir aita check korse..ekta invstgn leukaemia-anaemia causing exertional breathlessness,
bolo..spiromtry te ki pabo superficial bleeding due to thrombocytopaenia,deep
Short case...nazmul sir..neck node chlo dd ki..ki inv seated bleeding hole abar coagulation abnormalityr
dike jay...tai hemathrosis,haemoptysis eigula je nai ta
Enayet sir...sir etto cute chilen ajk..pulse dekhau..sinus bola lagbe)
tachy cz..carotid a ki dekhi d/d ki? aplastic na keno?(previous viral infection like
Mrinal sir...paraplegia cz..UMN LMN a ki paba..ekta HBV,HCV) eigular history chilo na,bony
examination bolo..cz ki ki..gbs type inv n treatmnt tenderness,organomegaly,L.N pulpable.
Paedi...provat sir-NS chilo..abdomen examination.. then bolchen( registrar Mursalin sir er dike takaye) eita
Rashed sir..general xaminatn..jaundice chlo..cz ask CLD na keno,amar kache to CLD mone hoy?(eita
korsen.hate ki dekhi bolche most probably confuse korar jonno(than amar
positive findings gula abar bollam).
Viva:nazmul sir xray MR.. data CMlL CLD ar AML/leukaemia alada korba kivabe?(CBC
Mrinal sir .rheumatoid arthritis.. drugs methotrexate diye-anaemia,thrombocytopaenia,leukocytosis ar
kivave dey... upper abdominal pain..r mne nai atypical cell(sir er kache keu blast cell boilo na).
Enayet sir:ecg mi Af dutai..data: agn scenario food ar ki korba-PBF.
poisoing ..kon type poisoning..cz of toxic food confirm kivabe korba-bone marrow study.
posoing..autosomal dominant disease nam bolo ki ashe koro-blast cell more than 20%.cellularity ki
koyekta paba-hypercellular.Aplastic anaemia te ki paba-
Rashed sir..leukaemia...poisoinig..rheumaic fever..Epi hypocellular,more than 50% space is occupied by fat
schedule... cell.
Provat sir...xray rickets...bone marrow aspiration than liver palpate korte bolchen.
needle..qstn.. poisoningr mne nai ei patient er fever er history nicho?-nichi sir,nai.
Skin mamun sir...urethritis conversion disorder r thakte pare naki pare na?-pare.(due to abnormal
hallucinations..r mne nai� leukocyte)
Shobai paedi te chocolate niye jais case clear cut chilo.pt o school tecaher.so,ei case niye
r nam n code likhe base lagiye jais keu tension koiro na.amio prothom bar dichi AML.but
Enayet sir onek benign chilen.ar mursalin sir boila
Alhamdulillah.Exam shesh.� dichilen je organimegaly ache,bony tenderness
#Medicine . ache.so,methodical hoilei hoilo.COPD ke jodi asthma
Exam start hoiche exact 8.15 theke.lotary kore khata o banao,kintu defend korte paro taile sir problem
tulchi,khatay bed number deya chilo.8.55 er sir ra ber korben na.onnoder case chilo-Only pneumonia,pleural
kore dichen room theke(academic corner er pashe effusion,stroke,nephrotic,copd...baki gula jani na.oder
choto ekta room e 10 minutes rakhchen) post tkeke dekhe neio.
er por lotary onujai nazmul sir 5 jon, mrinal sir 5 jon er
enayet sir 4 jon er exam nichen.so,je first person hobe
se khub kom shokoy pay,tai taratari kora lagbe Short case:eksathe 5 jon er nichen.
sobaikei cz lotary onujai rool 5 o emon hoile pare je ami second person.
kunu sir er kache prothome viva deya lagte pare.eita tai first Enayet sir er board e first chilo.
sesh hoar por 5 jon kore short case er jonno Q-inspect the chest of this patient.
dakchen.11.30 er dike short case sesh hoiche. 30 er por auscultate.
minutes oi chutu room e porar shomoy dichen, er por amar patiend er mone hoy upore pneumonia ar nicher
viva shuru hoiche tana 6 ta board. dike pleural effusion chilo.exam er shomoy PE er
findings khub valo pai nai...tar por o sir khub beshi
LONG CASE:shomoy khub e olpo paoa jay.10 jhamela koren nai.percussion koraye ar pleural
minutes er moddhe dx ar exam kora na gele salient effusion er cause dhoraye chere dichen.
feature porjonto likha possible na. er por pacdi.
amar case chilo AML. provat sir.NS er case chilo.
name:jitu mia,36. Q-examine the abdomen and do relevant.
symptomps:1.breathlessness for 1 months. ki paicho-NS er feature gula.
2.bleeding per nose and gum bleeding for 10 days. amader patient er fluid thrill ar shifting dullness duitai
g/e te bony tenderness,multiple petechia,anaemia positive chilo.
chilo. ar ki dekhte chao-bed side urine for protein.BP,onno
systemic exam:spleen 4 cm chilo.liver palpable chilo kuno jaygay oedema ache kina,JVP,cvs examination ar
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stigmata of CLD bolchi. respiratory,GIT,haematology,hepatoly chilo.

then d/d ask korchen. Q-45 or eirokom yr er smoker low grade
er por paedi arekta board.external sir mone hoy jahid fever,cough,respiratory distress niye asche.cxr e rt
sir ba oirokom namer keu hobe. lower lobe e opacity ache-how will you approach to
Q-do the G/E of this patient. dx?
jaundice chilo. ami TB ar carcinoma dhore history,exam,investigation
boshaye L.N pulpate kora pordonto korchi than hct,bp eigula bolchi.
ar anthropomometry korte chai bolchi. most probably atypical pneumonia o d/d te ashbe.(sir
Q-positive findings ki?-jaundice derke ask kore sure hoye neio)
ki hote pare-heriditary haemolytic most probably Q-26 years male with recurrent upper abdominal
thalasaemia,acute viral hepatitis,liver abscess,cld pain...how will you approach?
eigula bolchi. ami PUD,chronic cholecystitis ar chronic pancretitis
left shoulder e ki jekhla-BCG mard. bolchi.er history,exam bolchi.
kivabe dey-intra dermal. confirm korba kivabe-endoscopy,usg ar pancreas er
er por nazmul sir. jonno contrast enhanched ct bochi sir manen nai then
Q-pulpate the abdomen.spleenomegaly chilo.-13 cm s.lipase bochi.sir bollen koto din pore lipase barbe(pari
from costal margin. nai)
d/d ki-ami cml,thalasaemia,malaria,kala- Q-cld patient with oesophageal varies niye asche..what
azar,myelofibrosis,cld with portal hypertention eigula is ur approach?
bolchi. ami history te stigmata,exam e signs of portal
than Cervical lymph node dekhte bolchen. hypertension eigula bolchi.
pulpabe chilo ar exta theke biopsy o neya hoiche. ar ekta AGN er urine R/M/E report chilo most
then ami bolchi I want to add on my d/d as lymphoma probably.ar ekta ECG chilo mone hoy extensive
and disseminated TB. anterior MI.
pore bollo kunta bolba-ami lymphoma bolchi.(most
probably matted chilo,TB hote pare) er por viva enayet sir .
er por mrinal sir...female chilo flacid paraparesis er first e ECG chilo.
.(chelera female attendent ar kotha bolte vule jaio na). Infero-lateral MI.(ST elevation in 2,3 aVF,V4,V6)
bollo inspection e jodi akta jinish dekhte chao taile ki ekta urine R/M/E. oita mone hoy AGN chilo.
dekhba? Q-paraperesis niye ashle lession koi hobe eirokom type
-ami fassiculation bolchi to differentiate between GBS q.ki ki paba-niche UMNL er signs pabo ar upore ekta
ar MND.but sir sunte chan power.inspection ei naki sensory level pabo.jodi hand involve na kore ar higher
power dekha jay. psychic function alter na hoy taile koi lession -thorasic
jai hok er por power dekhte bolche.power chilo 2.than segment e.
bollo ki hote pare-bolla Multiple sclerosis,GBS,spinal Q-16 years boy comes with high grade intermittent
cors trauma ,TB eigula. fever for 10 days with constipation ? dx ki-Enteric
Multiple sclerosis ar GBS er moddhe kivabe parthokko fever.
korba-flacid ar spastic paraperesis hobe.jark
exagerated ar absent paro.planter extensor pabo. Mamun sir: kichu bolen nai sudhu question diye
jerk dekhao-absent chilo.keu jendrassik maneuvre takaye thaken bujha o jai na right hocche naki wrong
korte vhuilo na. hocche.
then ask korche ekhon ki hote pare-GBS,diabetic skin theke 3 ta question
amayotropi,peripheral neuropathy due to any pause. 1.scabies er complication aro 2 ta q chilo oikhane.
GBS kibabe dx korba?-nerve conduction study . 2.gonococcal urethritis er scenario.
ki paba-conduction block paro. cause ki?
ki type er lession hoy-axonal,demyelinating. tx ki?
eikhane sensory loss hoy?-na sir except AMSAN ar ki hote pare?
veraity. 3.HAART ki?koi deya hoy?
treatment ki diba-IVIg,plasmapherssis. psychi theke-1.MDD er scenario.
dx ki?ki tx?ki risk ache?(suicidal)
viva: eksathe 7 jon er nichen.1 first e nazmul sir.,ami 2.childhood psychiatric disorder koekta nam bolo.
mrinal sir,3 enayet sir,4 mamun sir,5 paedi external,6 autism er dxtic criteria.
srovat sir.ar 7 rsst e chilo.5 minutes pore 6 rest e geche schizophrenia er DMS-4 criteria .
eirokom hoiche.nazmul sir er board e view box chilo-x
ray ar data .mrinal sir ECG ar data.enayet sir ecg ar paedi external sir-first urine R/M/E dichen ekta-NS
data.mamun sir mone hoy 10 trs ager toiri kora skin er chilo.
3 ta ar psychi er 2 ta question niye boschen.paedi acute leukaemia er cbc chilo.lymphoblast beshi chilo.
external data ar provat sir instrument ar view box niye 12 yrs girl with knee joint swelling fever and recently
boschen. developed Pansystolic marmur.
Amar first viva:board A2- dx-acute rheumatic fever with carditis
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jones critesia major- e pin diye lagaye rakhte.

tx ki? Duar dorkhastho thaklo shobar kache abaro.
acute viral hepatitis er ekta scenario chilo
MEDICINE;
Provat sir-sir ekta kotha o bollen nai.registrar ma'am long case:NS (mrinal sir)
pashe chilen. salient feature bolo,dx,ki investigation, ki diye confirm
first rickets er xray korba,aetiology bolo,ei pt er risk factor ki,herbal
severe penumonia er ekta scenario-15 months,R/R- medication r history obosshoi nbi,dm er oral drugs,ei
74,fever,feeding problem. pt e konta dbo,konta valo,ckd pt k metformin dbo
IMCI classification? kkina,konnta dile vlo,oitar class ki, ckd pt anemia niye
ar kun kun danger ign dekhba-baki 3 ta ashe kno?ki treatment dbo?NS e ki treatment
tx ki? dbo?somogi effect ki?rkta ki jno dhorchilo vule gchi
ar mone nai.
short case:
ar mrinal sir er board e RA er dx,tx,dxtic criteria Gbs(mrinal sir):power dkho,ki paicho,flaccid kina
dhoraiche.-criteria box er ta na. bujhba kvbe,reflex dkho,finding, ki hote pare,dd ki,ki
6-7 ta je point ache oigula. investigations, treatment,kno continuous monitoring?

shob sheshe boss nazmul sir- Back of chest(najmul sir);examination,ki paicho

prothome ekta xray.
cardiomegaly ar increased vascular markings chilo.dx radial pulse(enayet sir):ki paicho,ki ki dkhcho,sinus
is MR. bradycardia r 2ta cz
cz-cardiomegaly MS e hobe na.MR e hobe.
ami incresed broncho vascular markings bolate sir ask
paedi:general examination, abdomen examination, dd,
korche bronchia markings kemn dekha jay(radiolucent
shadow pabo bronchial wall er karone ar er moddhe air
er karone radioopaque shadow pabo.ar vascular viva:
markings hobe puratai white mane radioopaque) najmul sir: xray(malignant lung abscess wd metastatic
so,keu broncho-vascular boilo na .shudhu increased lesion) lab report(aplastic anemia,ki niye asbe)
vascular markings boilo.
MS e kun chamber enlarge hoy-Lt atrium mrinal sir:ecg(AF),RA dx,treatment, investigation, ro
MR e kun chamber enlarge hoy-Lt atrium and Lt 2/3ta chilo mne porteche na
ventricle.
Er por CBC- enayet sir:ecg(ant.inf mi),lab report:AGN
Hb-9.6 spastic paraplegia r lesion koi,ki investigation diye
MCV,MCH,MCHC normal. confirm korbo,1ta clinical sign jeta diye flaccid r
leukocyte cound 3,50,000/ml spastic alada korba,opc poisoning er antidote,kmne
platelet-1,70,000/ml dei,enteric fever er ekta scenario sir
myelocyte-46% bolchen,investigation,treatment, autosomal recessive
blast cell-5% disorder er nam bolo
Dx-CML
clinically koyta phase ache?-3 mamoon sir;MDD,treatment, ki complications hote
ta.chronic,accelerated,blast crisis. pare,schizophrenia dsm 4 criteria,anxiety disorder nam
ekhon kun phage e ache-accelerated phage e. HAART ki,indication, scabies er complication,std niye
sir mainly blast crisis e je nai oita jante chan. onk kichu chilo, eta pore jas
ami sir er board e jaoar age rest e chilam tokhon ekta
xray chilo.saiful sir ke ask korle sir bolchen eita naki external paedi:ARF,investigation, treatment, AML,
bronchiectasis.jai hok vaggo valo je oita pore investigation, ki sign pabo,
nai.onekei oitake penumonia or tb bolche.
ar amar MR diagnosis korteo onek kosto hoiche. provat sir: xray (TOF),acute viral hepatitis,very severe
so,sir er board e kichu kharap hoite pare..but eitar pneumonia, treatment
jonno onno board jate kharap na hoy oidike kheyal
raikho.Nazmur sir er question common phalano jabe এই ,, �
na.na parleo uni sunchi pass mark dey.
& All the best! �
shobai valo moto exam edio.
300 taka niye jaoa lagbe,11 tar dike kichu khabar dey
,nijeo kichu nite paro. amr mone thake na joto tuku mone ase dilam
sir ra bolche er poren shobai code number likhe Apron long case :decompensate cld with PT
keno bollam,findings, ab pain thakle ki bole,spleen
palpate korte bolsen.keno Cld,investigation, SAAG
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mane ki,treatment. (2)enayet sir:ecg silo MI r data AGN.scenario sir

short case: mukhe bolsilo enteric fever er.rx ki diba.bed side a
1.examination of head nd neck,lymphnode spastic r flaccid kmne alada kore.autosomal dominant
chilo,fever,anemia chilo.diagnosis. disease er nam
2.pleural effusion.back examination nd findings (3) pedi:thalassaemia photograph r data NSr
3.paedi: ascitis chilo. ab examination, finding, card:AGN,rheumatic fever er scenario.childhood
diagnosis. psychiatric disorder ki ki,autism er criteria,rx,current
4.paedi:general examination EPI schedule
5.lowe limb er power dekhte bolsen,diagnosis if power (4)pedi:xray rickets r card:SAM,viral hepatitis er
2/5(paraplegia). causes of paraplegia, gbs er typ. scenario,IMCI,accidental cause in pedi.kerosene
viva: poisoning
nazmul sir: data of pancytopenia,types of (5)nazmul sir:xray ssilo d/d ki ki bolsi TB r pneumonia
pancytopenia, aikhane kunta. r data silo CML er
cardiomegaly r x-ray chilo.left broder dekhaite treatment,complication,presentation. sir ki 1ta scenario
bolsen.LVH er cause. disilo past MI ro ki ki bujhini.wht is angina equivalent
mrinal sir : Ecg Af,RA citeria, ar mone nai. (6)mrinal sir:ecg silo AF.card a silo RA er
enayet sir: rx,diagnostic criteria,DMARD.methotrexate er dose
ecg: MI, enteric fever er scenario, common
poison,sylhet e kun sanke common , lower limb e ro onk kisu dhorse vitore maximum e amr mone nai
spastic paralysis hole lession kuthay.
mamun sir: leprosy, HAART,genital ulcer,urethral Long case: Stroke with left sided hemiparesis (Mrinal
discharge er cause,hallucination, type sir)
paedi viva: . present ur case
rashed sir: RF,ALL,measels r features, complication. . positive findings
provat sir:X-ray TOF .dx ki
insturment ambu bag,kerosine poisioning, .knee jerk & planter reflex dekhaw
complication of kerosine poisioning, acute viral . sensory kmn chilo?
hepatitis. .Lesion koi
aro chilo bt mone nai shob... . ki dhoroner stroke
ar shobai obboshoi chocolate niya jabi. paedi r baccha . ki inv korba?
der dite hoy. . Hemisection of spinal cord at the level of L1 hole
sensory ki hobe? koi lost hobe?
#long case:
(najmul sir)CLD short case:
kno bolso d/d ki kinta kno.spleen dekhao a) paedi( Rashed sir)
#short case: . do general examination
mdcn .ki findings( jaundice)
:(1)enayet sir:rt sided PE:cause ki hote pare ai age .r ki ki korte chaw
a?investigations .dx ki (acute viral hepatitis)
(2)nazmul sir:rt sided consolidation:auscultate chest . ki ki virus er jnno hoy
from back nd findings bolo.cause ki hote pare
(3)mrinal sir:flaccid paraparesis:inspection koro.sir b) paedi( provat sir)
bolse inspection o naki power dekha jay.patient k hatu . palpate abdomen
na venge upre tulte bolbo.eta kora jay inspection a .ki findings
bollo.jerk dekhao.ki test korba.ekhane nerve .ki dx
conduction study sunte chay.2ta variety ase bolsilo
axonal r myelin(dekhe jeo aita).ki treatment diba. c) Flaccid paraparesis(Mrinal sir)
(4)pedi:ascitis dekhao . see power, knee jerk & planter reflex of the patient
(5)pedi:general examination:jaundice er . ki findings
cause.meningitis er type.bed side a LP puncture a .koi lesion
pyogenic meningitis er findings ki hobe.pressure besi . ki cause hote pare
bed side a kmne bujhba.(speed a asbe.jet flow na kijani .GBS er rx
bolsilo)
#viva:
d) plapate abdomen( nazmul sir)
(1)skin:card a silo scabies er
. findings ki
complications,diagnosis,urethritis er cause,gonococcal
.ki cause hote pare
urthritis er scenario silo.treatment,HAART r psychi
silo hallucination, schizophrenia,depressive er disorder
er scenario e) pleural effusion ( enayet sir)
2 . inspect from back, ki findings
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.auscultate from back, ki findings pulmonary opacity chillo), pancytopeniar data, cause!
. percuss koro, ki findings Baki sob viva board 95% same question sobar.tai r
.ki dx likhlam na.
All the best sobaike...
( ই ই,
) 1.Code ekta kagoje likhe apron er shathe lagaye ashbi
:p
viva: Paedi (Brd1+2) 2.Paedi baccha der jonno chocolate niye ashbi
.acute rheumatic fever er scenario (fever, joint
swelling, systolic murmur), dx criteria, tx Long case: Ns (najmul sir)
. kerosene poisoning, SAM, severe pneumonia, Positive findings (ascites,leukony)
instrument: bone marrow needle, use. Dd ami 4 tai bolchilam but sir got annoyed. He likes to
xray -rickets. data AGN hear cld :/
Why ns not cld
viva. nazmul sir. Confirm kivabe
. read the xray, Pulmonary tb chilo, Eta ki type disease
. 65 yrs male, h/o of old mi, now present with Cause ki
breathlessness, ki d/d. Kemne bujhla primary cause?
what is angina equivalent Amar case relapse er chilo, so explain korsi koybar
. data: cml holo and all

viva.: mrinal sir Short case

.Ecg, AF Head and neck ( lymph node chilo ter o pai nai -_- )
. cause of upper abdominal pain Lower limb (gbs)
.Diagnostic criteria of RA Abd (pai nai kichu)
Back of chest(pleural effusion)
viva: enayet sir Paedi gen ex
. ECG, inf, lateral mi Paedi ascites
. data. agn
. causes of flaccid paralysis Viva
. common poisoning
. opc poisoning er antidote, sign of atropinization. Mdd
Enteric fever Hallucination
Genital ulcer
viva: skin( Mamun sir) Upper abd pain evaluation
.scabies er 3 complications Spastic paraplegia cause, koi lesion
. type of leprosy Poisoning ki ki ache
.gonococcal urethritis er scenario, rx Opc antidote
. genital ulcer er cause Ecg Allah jane ki chilo acute ant MI ar AF bole ashchi
.HAART? indication Xray TOF
psychi: schizophrenia, anxiety disorder,, hallucination UMBO

long case- CLD Amar memory khub weak mone porlei edit kore dibo
Case presentation, porer din severe pain hole ki
suspect korbe? Kivabe confirm korbe? Rx ki dibe? Edited: HAART ki, indication
Portal HTN kivabe bujhba? Endoscopy kore grape like Urethritis scenerio, ki ki cause
structure pele ki ki bujhba? Rx ki dibe? Patient er f/up ALL data features
dite giye jodi dekho pt ultapalta kotha boltese dx ki? Scabies complications
Oi pt ke mutton, egg ki amount e khete bolbe? Kon RA criteria
drugs dibena? Ascities examination dekhao
Short case- Onk kicchu vule gesi..jototuku mone ase
1. Examine head nd neck (nazmul sir): lump node
chilo Long case: pnumonic consolidation (nazmul sir nisen.
2. Radial pulse (enayet sir) Unar question bujha jay na.)
3. Lower leg er power nd jerk ( mrinal Sir) Dx ki? Ki consolidation? ( pulmonary) kno bolso? Ki
4. General examination: jaundice er cause, relevant, rx coz? Thn sir pt examination kore bolsen amr mone
3. Abdominal examination : ascities er cause hocche mass lession with collapse with patent
Viva: bronchus. Amk wrong prove kore tumr ta establish
nazmul sir: brochial carcinaoma xray (PE, peripheral
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koro �. Aita ki TB hote pre na? Kno na? Single treatment konta kokhon dei?Cat 1 er duration ar drug
investion that will exclude TB nd confirm pneumonia. name bolo.Gene expert..
R ki inves? X ray te konta te ki findings.
Short case----
Short case: paedi: 1.Examine the lower limb(Mrinal sir)
NS: common ques chilo. Examine the power of muscle.power koto?ei dui paye
General examination : jaundice chilo. Ki coz? Konta power 2/5 eke ki bolba?ar ki ki dekte chaw.Jerk ki
kmne confirm korba expected,jerk dekaw.eita kon typer lesion.ar ki dekte
Short case: Medicine chaw.ki expected? cause ki ki?
1.flaccid paraperesis.. Coz ask korsen. GBS kmne GBS er type,diagnosis inv,treatment.
confirm. Ki treatment
2. Do the general examination of head of neck region. 2.Palpate the abdomen(Nazmul sir)
( aita khub faltu disi.) nazmul sir nisen Ki findings.(18cm splenomegaly chilo),cause ki ki
3. Plural effusion hote pare.kon Leukemia?
Viva!
Board 1. Nazmul sir. 3.Examine the radial pulse(Enayet sir)
X ray : MR Ami pulse exam kore sob dekchi.Radio femoral delay
Data:CML porjonto dekbi.ami left hand e pulse pai nai tai na
Board 2: mrinal sir ( sir vlo onk) bolchi.pore sir absent pulse er cause jiggas
ECG : AF korche.Tracheal position dekhaite bolche.
Data: acute leukemia
Ques: mone korte prtesi na ( sorry) 4.Pedi--Provat sir.
Board 3: mamun sir.. Examine the abdomen.
Scabies, MDD, schizophrenia, r mone nai Findings ki? cause ki hote pare.pore basa koi jiggasa
Board 4: enayet sir kore amake dekiye marks diche(8.5/10)
ECG : acute ant inf MI Provat sir somvoboto 8 er niche kawkei dey nai.
Data: AGN
Scenario: enteric fever 5.Pedi(Rashed sir)Do the general Examination of the
Paraplagia baby.
Board 5: Jaundice,arr mild Anaemia chilo.Jaundice er provable
ARF cause.ki ki virus Jaundice kore?Anthropoimetry ki ki
R mone nai. dekhi?HCT te kon condition e proteinuria paba?
Board 6: x ray : rickets
Scenario : severe pnumonia, kerosine poisoning,
Board Viva
Sorry amr kno jni kichu e mone portese na..topics gula
o thikmoto mone nai. � pore mone korle post kore
dibo.. Sobai doa kris..R toder jonne o onk onk doa. Vlo 1.Nazmul sir
hobe in sha allah ☺ Xray (Cardiomegaly),Data (Pancytopenia),cause

2.mrinal sir
Long case---(Mrinal sir,Alhamdulillah besh valo
ECG--AF,Data --Acute leukemia
hoiche)
Echara Sceenario--ARF,Recurrent upper abdominal
Left sided Parapneumonic pleural effusion
pain -- 3 cause,3 inv, aro 3 ta chilo common e
Present your case.
3.Mamun sir
Why pleural effusion?
Psychi--Scenario,Diagnosis,Schizophrenia DSM
Possible cause.Establish your diagnosis.
Criteria,Anxiety disorder types,Risk of the
Tubercular hole ki paita?
patient,Treatment,
Bronchigenic na keno?
Skin VD--Scabies,Gonococcal urethritis
Suppose eiI pt er hemoptysis ar clubbing
Scenerio,other causes of Urethritis.Genital ulcer cause.
ache,diagnosis ki bolba?
Clubbing er ar ki ki cause ache?
Consolidation na keno tomar Case. 4.Anayet sir.
Pneumothorax e percussion note kemon hobe? ECG--MI,Lab data---AGN
ei patient er lymph node thakle ki inv korta? Nervous theke 1 ta ques korche,common
Investigation dara kivabe alada korba TB ar poisining,OPC poisoning er antidote,kivabe dey
pneumonia?Bronchogenic e ki expect koro? kotokkon,autosomal recessive disease name
pleural fluid study te kontar colour ki?Protein kemon
thakbe? ar ki inv korba(ADA),Chest x ray te ki (5+6)--Rashed sir, provat sir.
findings.ei sobgular por o na manle tumi ki Acute leukemia data,TOF xray,Umbo Bag.
korba?Category 1 TB treatment ar category 2 TB Structured question sobar eki chilo.
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Prothom kotha- Kalke theke shobai bacchar jonno short case: pedi Rashed Sir thalassemia(liver,spleen
choclate nia jaish. Provat sir naile mind korte pare. palpable chilo,kivabe bujchi spleen,keno kidney
na,hepatospelomegaly cz ki,fever sathe thakle ki hoito)
Ditio kotha- Gynae te jerokom code likha kagoj er ns(examination related common qst,heat coagulation
badge porsish, shobaike erokom pore ashte bolsen. test niye ektu details ask korsen provat sir)
Tobuo Redwan sirer shathe beparta confirm kore nish. examination of face: Mrinal Sir (bell's palsy
chilo,rx,umn hole ki hoto,facial nerve er
-Long case- Stroke with right sided hemiparesis course,nucleus koi thake)
Salient features examination of face: nazmul sir( plethoric or redness
Differentiate from ICSOL in eye,cz? sathe cyanosis o chilo eta miss korsi)
Show me the planter response examination of radial pulse: enayet sir, bradycardia
Examine the peripheral pulses of lower limb cz,ekta scenario bolsilo pulse related,diagnosis chilo a-
Stroke er ki ki risk patient er paiso? v block)

-Short case 1- Flacid paraparesis viva: Pedi: � Both board was easy qst,& Provat
Causes sir,Rashed sir both are joss
GBS er types & Tx
skin,psyche: Mamun sir ghumai thaken,keu unake
-Short case 2- Do the general examination of head jaganor try koro na �
neck region (Lymphadenopathy, anemia chilo.) ja paro icchamoto boila jaba
DD (ALL,CLL,Lymphoma ar TB bolsi)
Tubercular lymphadenopathy kemon hobe palpation e? mrinal sir: Af er ecg,af er cause,lymphadenopathy
cz,chest pain cz aro ki ki chilo mone nai but
-Short case 3- Pleural Effusion scenario/qst ez chilo
Causes
Ki ki examination korte chao cause determine korte? Enayet sir: MI er ecg,microcytic hypochromic anemia
Ki investigation korba? er data,er cz,middle age female hole ekhetre kisher
history nibo,
-Short case 4 (Paediatrics)- Ascitis sir mukhe mukhe kisu scenario banaise,just jhotpot
Causes diagnosis bolte bolse
NS hole diagnosis er jonno ki investigation korba? ekta chilo RA,Tb tb er diag kemne korbo,inv,rx arekta
scenario mone nai
-Short case 5 (Paediatrics)- Do general examination demyelinating koekta disease er nam
(Jaundice chilo)
Causes Nazmul sir: Xray: interpret
Signs of meningial irritation ki ki ache? ami bolsi rt sided pneumothorax,increased
Causes of bony tenderness bronchovascular margin
sir ar kisu bole nai
-Viva- (Card shobar same chilo. Je questiongula ektu scenario chilo chikungunya,snake venom related kisu
different ogula likhbo) qst chilo
Angina equivalent ki? venom gular nam ask korse,pari nai
X ray te fibrosis ar consolidation alada korba kivabe? ar mone nai
Food posioning keno hoy?
koyekta bacteriar nam jara food e toxin release kore Best of luck to all
(Bacillus cereus, Clostridium botulinum bolsi.)
long case:cld (nazmul sir)
long case:Nazmul sir dx ki? kno blsi? d/d ki? testis palpate kora lgbe.ami
pneumonia kore kichu bujhi nai..tai sir rag krsen.nd sir nij pt k
case shob clear cut thake na,so history likhar age must examine koren.cld te fever kokhn hoi? complication of
examination kore confirm kore nibi cld.
sir eshe direct ask korsen diagnosis,then bolsen
history,examination theke points in favour bolte,then short case:
sir ekta chart korsen amar findings gular,& nije 1/radial pulse (enayet sir)
examination kore milaisen bradycardia r cz
sir confuse korsen onek diagnosis ar findings niye,but
finally establish korte parsilam pneumonia � 2/facial palsy: mrinal sir
erpor investigation,Rx ektu ask kore chere dise funding ki,rx ki?
so,beware abour ur findings,banai na dewai valo 3/
face inspection (nazmul sir)
 8

findings ki? pursed lip breathing) Then just inspect the hand.
4/ general examination(pedi) (clubbing and flapping tremor) what's your dx. Ami
findings. COPD with type 2 respiratory failure bolchi. Hoi nai.
5/thalassemia( spleenomegaly, hepatomegay r cz) DPLD hbe.

viva:1/ nazmul sir Mrinal sir:Bell 's palsy Tx, dx(side bolte vule gechi Sir
hydropneumothorax onk mind korchen.. Left side LMN type facial nerve
chikungunia r senerio. palsy bolbi) facial nerve pons theke ber hoye koi jai?
common poison r nam. Facial canal a.
venomus snake name
Viva:Nazmul sir: Allah r nam nea chara kichu kore lav
2/ mrinal sir. nai!!Tora parbi inshaallah, Ami mukh tao khulte Pari
Af r ecg.cz of AF. nai. Sir onk onk birokto chilen amr upr ��� Doa
hypertension r cz,nonpharmacological Rx, r bki gula korish.
mne portese na. Hydropnemothorax chilo.
Scenario:70 year old lady with 3 days fever, first ankle
3/ mamun sir pain then shoulder pain then erythema nodusum. Dx
ki. Chikungunya hbe. Ami Dengue, SLE, Septic
urethritis,rx ki? arthritis bolchilm.
genital ulcer r cz,scabies r complication.
schezophrenia r criteria, rx. Mrinal sir:Hypothyroidism
Lymadenoathy
Paedi
4/ pedi... ( topics)
TOF
diarrhoea
Diarrhoea
dehydation,rx
AGN r report
instrument chinte dei
perinatal asphyxia
Mamun sir: Genital ulcer r cause
tof r xray
Urethritis r cause.
nephritic syndrome.
Ami psychiatry ques dekhi nai ��kichu boli nai.. Sir
picture of SAM,down syndrome
ghumai chilen. Uni o kichu bolen nai
Allah vorosha. Just Allah r nam niye pore Ja.. Amra
r kichu mnene nai apatoto shobai pass korbo inshaallah!
dua korish sobai.
Sorry for being late. Long case COPD with cor
long case - NS (enayet sir )
pulmunale.
case present koro ,,,
Mrinal sir chilen.
CLD keno bolla na ??
Ami first person chilm.kicchu likhte Pari nai..Sir kichu
kototuk protein gele NS bolba? albumin koto??
bolen nai. Just history nichi ar examination korchi 2
r ki karone ascietes hote pare ??
system.Notun patient dey. Even in short case patient
CLD, NS ki aksathe hote pare ?? ( ha,,hep B,C)
repeat kore nai��
NS er pt er hematuria hobe kokhon ?? ( complication
Question :salient feature. Kno bolcho?? Chronic
hoye renal artery thrombosis hole)
bronchitis kake bole? Kivabe asthma theke exclude
korcho? Tx( both COPD and heart failure).
Amk yamin sir dx bole dichiln. Confusion thakle sir sir family history details shunte chay - koy jon family
der k must jiggas koris. member ,,,ki disease ache

Short case: Paedi. urine RME te kon cast pele NS bolba ?? (pari nai )
Ascites dekhbao. Clinically kom ascites thakle kn fluid thrill dekhao,, investigations, SAAG ki ,treatment
method a dekhi(Pari nai) aro 2/3 tata ques korsilo, ,,mone korte partrsina
Palpate the abdomen. short case,,table viva : sobai k same dhorse
DD of hepato splenomegaly. Treatment of thalassemia.
First e long case (case number lekha copy tulte hoy
Medicine:Enayet sir like suegery)
Radial pulse dekhao. Collapsing pulse dekhle sir
khushi hon. Bradycardia r cause. (old age a heart My case: asthma
block) Niyechen enayet sir..
Ami first e chilam tonnir moto, kono time i
Nazmul sir. Inspect the face(ami bolchi eye congested, paini....shobai examination ta khub fast koro n
no jaundice, plethoric face and central cyanosis with complete koro jate amar moto na hoy karo :( :(
 9

Questions asked :History presentation, why asthma, severe dehydration

inspect then examine the precordium Q: how will you catagorize this according to IMCI
(this means just classifcation of diarrhoea)
Then short case Management of this patient

Paedi short case: Complication of thalassemia

1) do the general examination (patient er ascites chilo)
Ques : diagnosis.. Xray of tof, components
Nephrotic 4 components
Instrument indentification ( bm needle, lp needle,
2) palpate the abdomen tongue depressor)
Ques: findings
No 6. Paedi scenario: pt with smoky urine pressure
Medicine short cases deya chilo dx : agn
Investigation of agn
1) nazmul sir : do the general examination of the Complications of agn
"face" of the patient
Then findings bolo: eyes congested (sir plethoric What is growth, development, domains of
shunte chan,patient cyanosed. pursed lip breathing ta development
ami bujhi ni )
Then sir tells than look at the hands of this patient Scenario: pt with cyanosis, fatigue with ejection
Tell me the findings: clubbing chilo systolic murmur in the left lower sternal area, dx?
What is your most likely dx? Then shobar mon ja chay Cyanotic congetinal heart disease (tof)
boleche n tokhon i sir er exam neya shesh hoye jay Principal duita components
:p dx was dpld
No. 1 e giyechilam
2) enayet sir Nazmul sir
Xray of, hydropneumothorax
Inspect the chest of this patient Scenario : woman with jonit pain with fever and rash
Asymmetry chilo both sides e ...ekside depressed chest jeta koik din por onno joint affect kore ..sir gave us
arek pash ta bulged chilo clues, jodi dhaka theke patient hoy (dengue,
Ques: tomar mone hoy kon side e pathology chikungunya,)
Examine the position of the trachea
No 2
3) mrinal sir Mrinal sir
Ecg of af
Ques: examine the face of this patient Causes of af

(Female bosha, tar right side e facial paralysis chilo, No 3

face was deviated to the left) Mamoon sir
Psychi
Findings bolo, diagnosis: right sided lower motor type Scenario: female with loss of enjoyment, apetite,
of facial nerve palsy faillure to perform daily activities erokom
Other name of this : bell's palsy Dx: mdd
Treatment of bell's palsy Dd of this diagnosis
Is this reversible Treatment

Then viva Dsm criteria of schizo

7 jon kore dhukay last er jon pasher bed e wait kore
then turn change hote thake (osper moto kore) Hallucination def type
(viva te time thake, keu purotuk jete pereche keu
pareni.. ami amr face kora ques gulo bolchi, ar amar Skin :
board e boshar serial wise bolchi) Complication of scabies
Gonorrhea, scenario : pt with urethral discharge,
No 7. Paedi scenario : meingitis, csf findings treatment
Causes of genital ulcers
Scenario (15 months baby e diarrhea for 3 days er What is HAART? Indication of HAART
moto patient lethargic dx: acute watery diarrhoea with
 10

No.4 Enayet sir: Data-Dx ki (Hypothyroidism), kivabe

Enayet sir bujhla, primary naki secondary, ecg-dx ki
Data of thyroid profile (Inferiolateral MI), amoebic & bacillary dysentry k
Dx : primary hypothyroidism clinically kivabe differentiate korbo, scenerio-dx ki
Treatment (pulmonary tb), investigation, treatment, kon regimen
Ecg: infero lateral mi dibo, ki ki drugs dibo
Scenario: young boy with dysentry, how will you
prove this is bacillary dysentry Rashed sir: X ray- Findings ki, dx ki (TOF),
Young boy with high fever chest pain cough complication ki, scenerio-dx ki (acute watery diarrhoea
Dx, investigation, sputum e ki examination korbe with severe dehydration), r ki ki type diarrhoea ase,
(gram stain and c/s) persistent koto din thake, dehydration er types, severe
dehydration k ki treatment dibo, 15 month er baccha k
Sorry eto late holo, shobar jonno onek onek dua koto khon dhore rehydration korbo, scenerio- dx ki
thaklo. May Allah have mercy on all of us (Meningitis), investigation, pyogenic er khetre CSF
study te ki pawa jabe, Instrument-Bone marrow
Assalamualaikum ! aspiration neddle, lumber puncture neddle, er
therapeutic use ki
Long case (Mrinal sir): Hereditary haemolytic
anaemia-case present, dx, points in favour, why Provat Sir: Picture-dx ki (SAM with dermatosis, down
hepatosplenomegaly in thalassemia, types of syndrome, diptheria), scenerio-dx ki (AGN),
thalassemia, thalassemia te main defect ta kothay hoy, investigation, complication, ns theke alada korbo
Hb F ki, kokhon bare, treatment of thalassemia, kivabe, scenerio-dx ki (TOF), components,
complication complcation, scenerio-dx ki (ALL), kivabe bujhla,
leukemia te ki ki feature pawa jay
Short case: Paedi (Rashed sir)-Palpate the
abdomen,findings ki (hepatosplenomegaly), Nazmul sir: X ray-Findings ki, dx ki
describe..sir bolsen hepatic bruit r splenic rub dekhte (Hydropneumothorax), hyper translucent area dekhao,
hobe na short case a..then ask korsen clinically spleen r hyper translucent kon kon khetre pawa jay, scenerio-
kidney kivabe differentiate korbo dx ki (Chikunguniya), ami dengue bolsi..sir kisu bolen
nai, bd er koyekta venomous snake er nam & tader
Provat sir: Ascitis-Sir amake kono examination korte dara produced venom er nam
den nai..shudhu ques korsen..ei patient er ascitis er
cause ki hote pare, ki investigation kore bujhba eta Mrinal sir: ECG-dx ki (AF), cz ki, hypothyroidism a ki
nephrotic syndrome, ki findings pawa jabe, heat ki clinical feature pawa jay, treatment ki dibo,
coagulation test kivabe korte hoy, kototuku urine nite hypertension er secondary cz, non pharmacological ki
hoy, heat kothay dite hoy, heat dile ki pawa jay, kon ki treatment dibo...that's all
reagent add kore amra protein theke others kono
ingredient k alada korte pari, protein chara r ki ekhane Sobai dua korish amar jonno...toder sobar jonneo onek
thakte pare, acetic acid dile konta disappear hobe, cld onek dua roilo...best of luck �
er investigation, serum ALP barbe naki kombe, r kon
disease a bare Case :stroke(enayat )
Present, dx, where is d lesion,risk factor,inv, rx ai pt
Medicine (Enayet sir): Ki examination korte jnno... Xm jerk,arterial dorsalis pedis ai pt
chaw..pulse naki chest..ami bolsi pulse..then radial
only lower limb e weakness clo lesion medial surface
pulse dekhaite bolsen, findings ki, bradycardiar cz ki,
of cerebral hemisphere r sir inquary krclo j BP both
kokhon amra kono pulse pabo na, ventricular rate koto
hand e measure krc kina,r family history in details
likhis sir details sunte chai members koi jn, ami
Nazmul sir: General examination of face, findings ki, actually 1st e xm diace so history fully complete krte
plethoric face with purse lip chilo..eta bujhi nai Pari ni salient feature o likhi ni.. Jst
systemic(Nervous+Cvs) prjnto thn salient feature
Mrinal sir: Bell's palsy-Inspect the face, findings ki,
jnno gap dx r d/d diaclm.
facial nerve examination, lesion kothay, dx ki

Viva (Mamun sir): Psychiatry-MDD, treatment, most Short case:

risky complication ki hote pare, hallucination ki, 1.lower limb(faccid)
schizophreniar criteria, treatment, anxiety disorder er 1ta sign differ krte kn type(planter reflex)
types, Skin-Scabies er complication, gonorrhoear Thn cause of faccid
treatment, HAART ki, kothay dewa hoy, urethritis er Differ GBS & peripheral neuropathy(position sense)
cz, genital ulcer er cz 1 history
 11

2.Inspect&Palpate abdomen(hepatospleenomegaly) 2.AFP def, cause, rx of GBS

Dd 3.OPC poisoning:rx
4.ALL data
3.palpate abdomen(spleen) Instruments:AMBU, bone marrow needle
See lymphnode
Dd Rashad sir:
Differ leukemia & lymphoma 1.TB lymphadenopathy, history te r ki niba
2.VSD, complication
Pedi 3.neonatal jaundice deu to RH, inv, rx
4. abdomen(ascitis) 4.JIA,inv,rx
Dd, clinically differ agn&ns Xray:Ricket, rx
Cause of swelling in agn Picture:Oral candidiasis, organism, rx
Cause of swelling in ns
SIR onk helpful sobai..
5.General xm(edema) dua koris ই amr jnno �
Dd
Clinically differ agn&ns
Ai pt ar urin side e clo oita high colour so aiber dx ki LONG CASE- ( Mrinal sir)
CLD with portal HTN
present ur case, positive findings ki ki ache, cld
Viva:
stigmata ki ki, portal HTN keno bolso, cld er
Nazmul sir:
complications exclude korar jonno tmi history te ki ki
Xray:Cardiomegaly
niso, complications dekhar jonno ekta difinitive
Cause
examinations ki korso, kore dekhao, Abdomen e ki ki
Scenario:1.haemostasis+cause
positive findings paiso, patient er liver kmn paba,
2 Dd, 2 clinical findings to differ it
spleen palpate koro, keno eta spleen prove koro, testis
2.epIgastric pain
palpate korso, ki paiso, testis ta kmn thakbe, umbilicus
Dd, differ it from history
er charpasher vessels gula ki bole, portal HTN er
3.45 yrs dm+joint swelling
features ki, patient severe abdominal pain niye ashlo
2 dd, inv
dx ki hbe, ki tx diba, SBP er clinical findings ki paba,
rupture esophageal varices er positive findings ki, pt er
Enayat : immunization er history ki niso, D/d ki, inv ki ki, pt
Ecg:AF ascitic fluid er colour kemon chilo ki bolse, r ki ki
Data: microcytic anemia colour hote parto, ascitic fluid study te r ki ki dekhi,
Ai data nia middle ekjn famale এ protine kmn paba ekhane, keno kom paba, kothay
data:Hypothyroidism kothay protine beshi thakbe, ascitic fluid e r ki dekhi,
Type(primary) rx cld er cause ki, ki ki virus diye hoy, hepatitis ki ki
Scenario:1.MI aslo Intern krba tumi, rx, virus ache(hepatitis G porjonto sir shunte chay) konta
ai pt 3din pr chest pain nia aslo precordium e ki dangerous, keno dangerous, mutant virus ki.
hbe(pericarditis)
2.RBS 200mg/dl SHORT CASE
Dm blba( aro xm krbo) Enayet sir
1) GBS
ankel jark, planter dehkhao, findings ki, dx ki, ekta
sir: history niye dx confirm koro
Ecg:ant mi
Scenario:1.limb weakness +fever 1wk back Nazmul sir
Dd(GBS), dx kivbe krba 2)palpate the abdomen
findings- acitis, keno bolla, cause ki ki hote pare, NS
2.OCP keno hobe, CCF keno hobe na ekhane, bed side e ki
Rx korba, ki paba, ascitic fluid er colour ki ki paba, konta
kisher jonno paba.
3.AIDS natural history
Mrinal sir
4 geriatric disease name, support 3) palpate the abdomen
findings - spleenomegaly
Pedi cause ki ki
Provat sir: examine the nack - findings - rt sided
1.IMCI def, component, bd te childhood survival lymphodenopathy, tahole akhon cause ki ki hote pare,
barate program ekta inv bolo confirm korar jonno, CBC te lymphoma
 12

te ki paba, leukemia te ki paba, leukemia te cell Instruments - AMBU bag, tounge depressor, bone
increased eta ke ki bole, leukaemoid reaction ki. marrow aspiration niddle(just identification)

Pedi- Nazmul sir-

Rashed sir X-ray- cardiomegaly, causes.
4)G/E (sir G/E e neck rigidity dekha pochondo koren, card-
neck rigidity dekhte vule geleo r ki ki korte chaw ask 1)scenario - fever, clubbing, cough with haemoptysis.
korle oi shomoy bolleo hoy) 2ta d/d, other positive c/f ki ki pabo duitar khetre.
r ki ki korte chaw, positive findings ki(jaundice) cause 2)severe acute upper abdominal pain
ki ki, jaundice present tahole relevant r ki dekhte chaw, 3d/d, alada vabe shbgular presentation bolo, pt ki ki
1ta tender 1ta non tender hepatomegaly er cause bolo, complaint niye ashbe
viral hepatitis ki ki ache, kon kon virus er vaccine (aro ekta chilo mone porche na)
ache, hepatitis b er vaccination schedule ta bolo,
patient k ki advice korba. Mrinal Sir
ECG- Anterior MI
Provat sir Card-
5) palpate the abdomen and confirm the ascitis 1)opc poisoning, mx
cause ki ki, ns keno bolso, agn na keno, agn hole ki ki 2)AIDS er definitive condition (ki j chilo eta bujhi ny,
thakto, examination e ki ki peta, ns er cardinal ami prodromal phase, acute infection r asymptometic
features, inv. fluid trill e majkhane hat keno rakhso. bole diye ashchi :/ ) AIDS er drugs gular nam
3) down syndrome er genetic defect ki, C/F
Viva 4) geriatric disease ki ki ache, patient care kivabe niba
Skin psychi- previous card
Sesh..... �
Enayet sir- [ chocolate, 300tk, code number gynea er moto likhehe
ECG- Inferior MI niye jete hobe, r pedi te growth chart shate rakhle sir ra
intern doctor hishebe pt ke tmi kivabe mx korba khushi hon, r parle shhobai shokal 8tar moddhe chole
Data- NS jais, polash sir ajke boltesio shobai taratari chole ashle
keno bolso, r ki positive findings ache, AGN na keno. sir ra naki 8.10 e xm shuro kore dey....5min xtra tiime
shudhu data dekhe confirm NS boa jabe kina.(Yes) pawa jay.. time khub e kom pawa jay. khatai likha
sir arekta data mukhe mukhe boltesilo DM niye je complete na thakleo sir ra temon mind kore na but
RBS 200, pt diabetic r non diabetic duita kivabe history examination niya must complete kore rakhte
confirm korba(ami question ta valo kore bujhar agei hbe, r jader swelling er case porbe tara history
bell pore gese, Allah bachaise :P ) examination korar shate shate pt ke urine er jonno test
tube niye pathai dibi, strip diye dey, 2min por e colour
Pedi- change dekhe nibi, nahoy pore mone thake na dekhte,
Rashed sir oi room theke shobaike ber kore deya hoy, r kichu na
1) scenario - dx- Tubercular Lymphodenopathy parle pichone sir der dike takabi,sir ra pichone darai
history te r ki ki positive findings paba, inv thake, sir ra khub helpful, onk kichu ishara kore korei
2) scenario - Dx -VSD bole dey � )
inv
complications shobar jonno onk onk doa roilo... �
3) scenario -dx- neonatal jaundice
inv, tx
4) Scenario - dx- JIA, inv, tx
Xray- rickets (just dx)
picture - white patches in tongue, causes

Provat sir
1)scenario - d/d - ITP, Leukemia
inv for both D/d, inv findings in ITP
2)Define IMCI
components
erokom govt er r ki ki program ache?
3)Define AFP
Examples
4) scenario - OPC poisoning
dx, tx
Data- ALL