Download University of Jaffna MBBS 2013 August Community and Family Medicine Question Paper

UNIVERSITY OF JAFFNA, SRI LANKA

SECOND EXAMINATION FOR MEDICAL DEGREES—AUG 2013

COMMUNITY AND FAMILY MEDICINE

Date: 27.08.2013.

Time: 3 hours

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ANSWER ALL THE SIX QUESTIONS

Answer each Question in separate answer book

1. A study was conducted to determine the Prevalence of anaemia during pregnancy in Anuradhapura district and to evaluate present screening methods available for screening of anaemia. A total of 990 pregnant women participated in the study. In the first, second and third trimesters, prevalence of anaemia was 7.6%, 19.7% and 19.3% respectively. Gestational age adjusted anaemia prevalence among pregnant women in this study population was 14.15 (95% Confidence Interval (CI) 12.0-16.4%). Mean and Median haemoglobin concentrations of the study sample was 11.8g/di (SD 1.02g/di and IQR 11.2-12.501). Sensitivity and Specificity of the haemoglobin colour scale method was 50% (95% CI 20.0-71.0%) and 76.3% (95% CI 66.9-83.7%) respectively. Sensitivity and specificity of conjunctival method in detecting anaemia during pregnancy was 18.8% (95% CI 11.9-28.4) and 69.3% (95% CI 58.2-78.6%)

   Source: Chathurani U et al. Anaemia in pregnancy in the District of Anuradhapura, Sri Lanka need for updating prevalence data and screening strategies: Ceylon Medical Journal. 2012 Sep; 57(3):101-6

   1. What is the study design? (10 Marks)

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   2. Define the terms given in Bold. (35 Marks)
   3. Based on the findings of this study, give 2 recommendations which will be useful to field health staff (20 Marks)
   4. Describe the importance of screening for anaemia in pregnant mothers (35 Marks)
2. 1. Explain "Surveillance Case Definition" (30 Marks)

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   2. Discuss the mechanism of Morbidity and mortality data collection in Sri Lanka (40 Marks)
   3. Mr Kandiah Selvakumaran aged 59 years was admitted to Jaffna Teaching Hospital at 7 pm on 15/07/2013, with a history of severe chest pain and sweating. ECG showed Q waves with ST elevation. He was treated as a patient suffering from Acute Myocardial Infarction. He had been previously treated for Diabetes Mellitus and Hypertension. In spite of treatment he passed away at 8 pm on 18/07/2013 Write a Certificate of cause of Death (30 Marks)

3. During one of your routine home visits you met an 82 years-old retired teacher Mrs. Rajarathinam. She is a widow and is living alone

   1. List Five Health problems Mrs. Rajarathinam may have ( 15 Marks)

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   2. Discuss how you could assess Mrs. Rajarathinam's health status during your home visit (35 Marks)
   3. Briefly describe how you could provide a "coordination of Care" to her. (35 Marks)
   4. List five indications for a home visit (15 Marks)

4. A research study is planned, to assess the association between cigarette smoking and deaths due to coronary heart disease.

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   1. Write the hypothesis for this study (20 Marks)
   2. Write down the most suitable study design to confirm the hypothesis and give reasons (40 Marks)
   3. Briefly describe the plan for data analysis in order to confirm the hypothesis (40 Marks)
5. 1. Describe the types of Hospital waste and discuss the methods of disposal of hospital waste (70 Marks)

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   2. Briefly describe how hospital waste is disposed at Jaffna Teaching Hospital, and suggest improvements needed (30 Marks)

6. Write short Notes on

   1. Smoking cessation programmes (25 Marks)
   2. Natural disasters and their prevention (25 Marks)

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   3. Ethics in medical Practice (25 Marks)
   4. Medical Audit ( 25 Marks)