Download DNB 2019 June FAMILY MEDICINE FAMILY MEDICINE PAPER 1 Question Paper

Download Diplomate in National Board (DNB) 2019 June FAMILY MEDICINE FAMILY MEDICINE PAPER 1 Previous Question Papers

FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2019
FAMILY MEDICINE
PAPER-l
Time: 3 hours FLM/J/19/08/l
Max. Marksz100
Important Instructions:
Attempt all questions in order.
Each question carries 10 marks.
Read the question carefully and answer to the point neatly and legib/y.
Do not leave any blank pages between two answers.
Indicate the question number correctly for the answer in the margin space.
Answer all the parts of a single question together.
Start the answer to a question on a fresh page or leave adequate space between two answers.
Draw table/diagrams/f/owcharts wherever appropriate.
Write short notes on:
1.
A 50-year-old patient comes to you with shortness of breath for the 2+4+2+2
past 5 days. He is a diabetic and a hypertensive but has not been
regular in his visits to the doctor. He has a history of smoking for the
past 25 years and has been coughing on and off for the past 2
months.
a) What are the possible causes of his shortness of breath?
b) The clinical approach to this patient including history and
physical examination.
c) Investigations to assess this patient with justification for each.
d) Describe the pharmacological management of each of the
causes of symptoms you have listed.
A 24-year-old bus driver is brought to you by his family with history 2+4+4
of episodes of sudden and unexplained behaviour lasting for a few
hours after which he is normal.
a) State the likely differential diagnosis you would consider.
b) What historical points will you elicit to substantiate your
diagnosis?
c) Discuss the role of investigations to establish the diagnosis.
A 25-year-old lady presents to you with history of hemi?cranial 2+2+2+4
headache for the past 2 days. She has been having similar
symptoms since the age of 15 years.
a) List the common causes of headache in family practice.
b) What clinical features will you look for in this patient to arrive at a
diagnosis?
c) How will you manage the current symptoms?
d) How will you counsel her to prevent further attacks?
P.T.O.
-1-
POSSESSION/USE OF CELL PHONES ORANYSUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL

FINAL EXAM
JUNE 2019
10.
NATIONAL BOARD OF EXAMINATIONS
FAMILY MEDICINE
PAPER-I
Etiology, clinical features, investigations and management of post
streptococcal glomerulonephritis.
A 40-year-old labourer in the local market presents to you with
history of generalised pruritus for the past 1 week. Discuss the
approach to this patient including significant history, physical
examination, investigations and management.
A 40-year-old businessman with a busy work schedule visits you as
he has a family history of diabetes mellitus, heart disease and high
cholesterol and is concerned about his health. He has a BMI of 35.
a) Comment on the significance of BMI and how reducing it will
affect other co-morbidities.
b) Discuss the various methods of weight reduction you will advise.
a) Clinical features, investigations and management of depression
in family practice.
b) List the indications for referral to a psychiatrist.
Describe the common symptoms and their management in a
terminally ill patient suffering from breast cancer.
A 55-year-old woman presents to you with history of fatigue, weight
gain and day-time drowsiness for the past 3 months.
a) List 3 possible causes for her symptoms giving reasons.
b) Describe in detail the clinical approach to this patient in the light
of the above possibilities.
A 55-year-old lady who has been a diabetic for the past 8 years,
complaints of burning and pricking sensation of her feet.
Her standing systolic blood pressure is 30 mm Hg lower than when
she is sitting.
a) What specific physical examination points will establish the likely
diagnosis?
b) Discuss the mechanism of low standing blood pressure.
c) List other abnormalities she is likely to have in the light of the
blood pressure abnormality.
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-2-
1+2+2+5
3+2+2+3
5+5
(3+2+3)+2
1O
5+5
4+2+4
POSSESSION/USE OF CELL PHONES ORANYSUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL

This post was last modified on 17 April 2020