KATHMANDU UNIVERSITY
University Examination
January/February 2026
Level: MBBS
Exam: I MBBS
Paper: II – Autonomic Nervous System, Musculoskeletal System and Integumentary System
Time: 2 hours 30 minutes
Marks: 50
Date: February 3, 2026
#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 wherever required.
All questions are compulsory.
#SECTION “B”
#Short Answer Questions
1.
a. Mention the type, ligaments and applied aspects of knee joint. (1+1+1=3)
b. Describe the boundaries and contents of axilla. (2+1=3)
c. Mention the formation of median cubital vein with its applied aspects. (2+1=3)
2.
Outline the steps of synthesis and catabolism of acetylcholine. (2+1=3)
3.
Name three common genera of dermatophytes and one infection associated with each. What is the typical microscopic appearance of dermatophytes in KOH preparation? (2+1=3)
4.
Write short note on Paget’s disease of bone. (3)
5.
a. Write down the pharmacological basis of use of different antidotes in organophosphate poisoning. (3)
b. Define antimicrobial resistance. Briefly discuss the strategies for its prevention. (1+2=3)
c. Differentiate between non-depolarizing and depolarizing skeletal muscle relaxants. (3)
6.
Describe the effects of the sympathetic nervous system on blood vessels of exercising muscle, the cardiac cycle and the bronchioles. (3)
#SECTION “C”
#Problem Based Questions
#Problem – I
7. A 35 years old lady came to the department of dermatology with complaints of loss of sensation in the finger tips. On examination, her eyebrows were found to be very sparse, she had small, painless nodules on her face and hypopigmented anaesthetic patches on the trunk. Biopsy from the lesion revealed diagnosis of leprosy. (3)
a. Describe the histological structure of affected organ. [Anatomy]
b. Describe the different methods of sample collection and its processing in microbiology laboratory. [Microbiology] (1+2=3)
c. Classify leprosy as per Ridley and Jopling classification. Describe histopathological findings in tuberculoid leprosy. [Pathology] (2+2=4)
#Problem – II
8. A 28-year old primary school teacher was presented to the neuro-clinic with a 4-month history of increasing muscle weakness. She experienced generalized muscle fatigue, particularly after prolonged activities with children and while climbing stairs. Family history of autoimmune diseases is absent. Her vital signs were within normal limits. Neurological examination revealed notable ptosis in the left eye, diplopia when looking upward and proximal muscle weakness with normal deep tendon reflexes. After serological test and electromyography (EMG) report the patient was diagnosed as myasthenia gravis and managed by giving Pyridostigmine and Prednisolone. (4)
a. Write down the biochemical mechanism of myasthenia gravis. [Biochemistry] (1+2=3)
b. What is fatigue? List two factors that result into muscle fatigue. [Physiology] (3)
c. What is the rationale of giving neostigmine over physostigmine in the above case? [Pharmacology] (3)
