KATHMANDU UNIVERSITY
University Examination
January/February 2026
Level: MBBS
Exam: I MBBS
Paper: III – Haemopoietic and Cardiovascular system
Time: 2 hours 30 minutes
Marks: 50
Date: February 5, 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. Describe the interior of right atrium. (2)
2.
a. Write the absorption, transport & storage of iron in the body. (3)
b. Sketch the pathway of Heme biosynthesis. How is this pathway regulated? (3+1=4)
3.
Name two common causative organisms of subacute bacterial endocarditis.
Describe pathogenesis of subacute bacterial endocarditis. (1+2=3)
4.
a. Write down the lab diagnosis of sickle cell anemia. (4)
b. Describe the pathogenesis of atherosclerosis. (3)
5.
a. Write the advantages of low molecular weight heparin over unfractionated heparin. (2)
b. Discuss the pharmacological basis of using nitrates in angina pectoris. (3)
6.
a. Draw and label the normal tracing of electrocardiogram (ECG). Write the significance of ‘P’ wave, QRS complex and ST segment in ECG. (2+2=4)
b. List the functions of platelet. (2)
P.T.O
#SECTION “C”
#Problem Based Questions
#Problem – I
7. A 21-year-old man presented to the Emergency department with 3 hours of constant chest pain. He described the pain as 8/10 on the pain scale, located in the substernal area and radiating throughout his entire chest. On physical examination, vital signs were stable with a temperature of 36.4°C, blood pressure 128/74 mm Hg, pulse 58 beats/min, respiratory rate 18 breaths/min, and pulse oximetry 98% on room air. Laboratory test showed increased total blood cholesterol & LDL cholesterol but decreased HDL cholesterol. Based on Electrocardiogram (ECG) changes and clinical features diagnosis of Myocardial infarction was made and prompt treatment were planned.
a. Describe the arterial supply of the affected organ. [Anatomy] (3)
b. Describe how LDL-C plays role in the development of atherosclerosis. Explain why LDL increases in familial hypercholesterolemia. [Biochemistry] (2+2=4)
c. Write down the different pharmacological approaches for this patient. [Pharmacology] (3)
#Problem – II
8. A 28-year-old male presents to the emergency department with a two-day history of high-grade fever, chills, sweating, and severe headache. He recently returned from a two-week business trip to India. On examination, he is febrile (39.5°C), pale, and appears jaundiced. He complains of abdominal pain, and his heart rate is elevated at 110 beats per minute. Laboratory tests reveal severe anemia, thrombocytopenia, elevated bilirubin, and mildly elevated liver enzymes. A rapid diagnostic test for malaria showed positive for LDH and HRP II antigens.
a. Which species of Plasmodium is associated with the above case? What are the stages of parasite seen in peripheral blood smear? [Microbiology] (1+2=3)
b. What is tachycardia? What factor in the above case resulted into sinus tachycardia? [Physiology] (1+2=3)
c. Define anemia. Write down the etiological classification of anemia. [Pathology] (1+3=4)
