Q1. Answer the following questions within 750 words.

Q1.1. A 62 yr old female visited the hospital for painful rash on the face since 3 days. Before the appearance of the rash there was burning sensation on left side of the face. she had taken cetirizine 10 mg for the same thinking that it was insect bite reaction. She is a known diabetic and hypertensive since 30 yrs. On examination there were multiple papulo vesicles on the left side of face extending from the tip of nose to medial aspect of upper eyelid. What is your probable diagnosis? What investigations would you like to suggest in this patient? How will you manage this case?

Q1.2. An elderly lady patient 70 years of age, presents with H/O extreme weakness, fatigue, loss of appetite and pain and distension of abdomen. She is a widow, dependent on son and family who were quite impatient with her and abusive. The daughter in law reported that she keeps lying down in bed and is very lazy. He abdomen seems distended because she does not do any physical work. Would you dismiss the case as old age issues and malnutrition and lack of care? Or would you like to investigate some more even though the family is not interested? How will you make this decision? What investigations would you undertake ?

Q2. Answer the following questions within 300 words.

• (a)) What are the signs and symptoms that should raise a suspicion of a malignancy in an older adult? (300 words)
• (b)) What are the risk factors and screening recommendation for prostate cancer in older men. (300 words)
• (c)) Clinical assessment of a case of accident (300 words)
• (d)) Clinical evaluation of a case of poisoning (300 words)
• (e)) Write a short note on acute peritonitis in the elderly. (300 words)
• (f)) Write a short note on lower gastrointestinal bleed in the elderly- causes and investigations. (300 words)