#Kathmandu University – University Examination
January/February 2026
Exam: II MBBS
Level: MBBS
Paper: VI Renal – Electrolyte System, Endocrine and Metabolism System
Time: 2 hours 30 minutes
Marks: 50
Date: February 17, 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 histological structures of adrenal gland. [3]
#2.
a. Define and classify blood buffers. Explain why bicarbonate buffer is an important buffer in our body? [2+2=4]
b. Describe the integrated role of parathormone, Vitamin D and Calcitonin in the calcium homeostasis. [3]
#3.
Mention the predisposing factors responsible for development of Post streptococcal glomerulonephritis. Enumerate the streptococcal antibodies detected in PSGN and indicate the most commonly used test. [1+1+2=4]
#4.
a. Write Short note on hydronephrosis [3]
b. Enlist causes of acute renal failure [2]
c. Describe the etiopathogenesis of Hashimoto’s thyroiditis [4]
#5.
Write down the pharmacological basis of:
a. Furosemide in pulmonary oedema [3]
b. Metformin in Type 2 Diabetes mellitus [3]
#6.
Name the hormones secreted by adrenal cortex. Describe the functions of glucocorticoids. [1+2=3]
#SECTION “C” – Problem Based Questions
#Problem – I
A 22-year-old female complains of high fever with chills and rigor along with suprapubic pain for 5 days. She also has increased frequency of micturition with burning sensation and urgency. She also complains of passage of turbid urine which has strong odor than usual. Her general condition is ill looking and per abdominal examination revealed tenderness in suprapubic region most likely due to cystitis.
a. Describe the nerve supply with its applied anatomy of the affected organ. [Anatomy] [3]
b. What is micturition? Draw and label the pathway for micturition reflex. [Physiology] [1+2=3]
c. Outline the laboratory diagnosis of the above case including: urine sample collection method; culture technique and criteria for significant bacteriuria. [Microbiology] [4]
#Problem – II
A 19-year-old lady presented with restlessness, persistent palpitation and heat intolerance for last 6 months. On examination she has exophthalmos, fine tremor and pretibial myxedema. Her thyroid function test shows increased serum T3 and T4 and reduced thyroid stimulating hormone. On the basis of clinical and biochemical findings diagnosis of Grave’s disease was made.
a. Describe the role of TSH in thyroid hormone synthesis. [Biochemistry] [3]
b. Describe the pathogenesis of Grave’s disease. [Pathology] [4]
c. Enlist the drugs used in the above case. Write down the mechanism of action of any one of them. [Pharmacology] [1+2=3]
