Download DNB 2017 Dec FAMILY MEDICINE FLM II Question Paper

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DECEMBER 2017

FAMILY MEDICINE

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PAPER - II

FLM/D/17/08/II

Time: 3 hours

Max. Marks: 100

Important instructions:

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• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.
• Indicate the question number correctly for the answer in the margin space

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• 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/flowcharts wherever appropriate.

Write short notes on:

1. a) Differentiate between arterial, venous and neuropathic ulcers. (4+3+3)

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   b) How will you investigate a person with ulcers in the lower leg?

   c) List the principles of management of bed sores.

2. A 40-year-old lady comes to you for routine breast examination. You find a lump in her right breast. (3+3+4)

   a) List the criteria for urgent referral for her:

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   b) Mention the features of any benign breast disease.

   c) What are the other clinical examinations you will do in her for a preventive health visit?

3. A 50-year-old man comes to you with history of painful swelling of left lower limbs for 4 days duration. (2+2+3+3)

   a) List the differential diagnosis with specific clinical features.

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   b) List risk factors of deep vein thrombosis (DVT).

   c) How will you investigate and treat a person with DVT?

   d) Mention how you can prevent DVT.

4. A 35-year-old male presents to you with a history of shoulder pain for the last one week. (6+4)

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   a) What are the red-flags in history and in examination with reasons?

   b) How will you manage a person with adhesive capsulitis?

5. A 20-year-old girl comes to you with a history of swelling in the anterior neck. (3+3+4)

   a) List differential diagnosis with specific clinical features.

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   b) What are the red-flags in history and examination? List with reasons.

   c) As a family physician, how will you manage her if she has a solitary nodule in her thyroid gland?

6. a) List the causes of a person presenting with a ‘red-eye’. (3+2+5)

   b) What are the red-flags and their causes for urgent referral to an ophthalmologist?

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   c) Describe briefly management of corneal ulcer.

7. A 55-year-old female labourer comes to you with complaints of giddiness. (2+2+6)

   a) What are the red-flags you will elicit from her and why?

   b) How will you investigate her?

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   c) How will you diagnose and treat benign positional vertigo?

8. A 45-year-old peri-menopause lady comes to you with history of brown coloured urine. Her urine dipstick examination shows presence of ‘4+’ blood. (2+3+5)

   a) List the causes of hematuria.

   b) What are the red-flags you will elicit in her?

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   c) How will you manage her with appropriate referral after preliminary investigations?

9. a) List the causes of erectile dysfunction (ED). (2+6+2)

   b) Mention the clinical and investigatory work-up for ED.

   c) Medical management of ED.

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10. You have been requested to do a pre-anesthetic work-up of a 60-year-old patient going for a hernioplasty. (6+4)

    a) Mention the clinical and investigatory work-up you will do with reasons.

    b) What are the complications of spiral anesthesia? How can you prevent them?

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