University of Jaffna, Sri Lanka
Second Examination for Medical Degrees Part II (2nd) December 2013
Community and Family Medicine
Date: 02.12.2013
Time: 03 hours
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Answer all the Six questions
Answer each Question in separate answer book
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1.1. Define communicable diseases. (10 marks)
1.2. List the modes of spread of communicable disease with examples. (20 marks)
1.3. Describe how people could prevent the spread of communicable diseases in their community. (40 marks)
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1.4. As a doctor working in the OPD of a hospital, describe how you would empower the people in the village to prevent the spread of communicable diseases. (30 marks)
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The following data are taken from a study done to investigate the relationship between serum cholesterol and Ischaemic Heart Disease. A total of 400 persons were studied, of whom 100 had Ischaemic Heart Disease and 175 had high serum cholesterol levels. Of the 300 controls 100 had high serum cholesterol levels.
2. 1. What is the type of study done? (20 marks)
2.2. Present the above data in a 2x2 table. (40 marks)
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2.1 Name the statistical testis you would use to decide whether there is an association between Ischaemic Heart Disease and serum cholesterol level. (20 marks)
2.4. How could you assess the risk of high serum cholesterol on Ischaemic Heart Disease? (20 marks)
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"A good consultation always helps the physician to make an appropriate decision making"
3.1. What is your understanding regarding the consultation process in the primary health care set up (25 marks)
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3.2. List the factors involved in consultation. (25 marks)
3.3. Briefly discuss how a decision making process differ in primary health care differ from secondary or tertiary health care .
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Discuss briefly where health services have failed in the following situations. (50 marks)
4.1. A 42 year old mother in her 6th pregnancy dies of a postpartum hemorrhage at a district hospital. (25 marks)
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4.2. A 2 year-old child who died due to dengue hemorrhagic shock in a tertiary health care institution. (25 marks)
4.3. A young dying of rabies. (25 marks)
4.4. A 25 year old university student developed Type 2 Diabetes. (25marks)
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5.1. Define the following rates.
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5.1.1. Perinatal mortality rate. (10 marks)
5.1.2. Neonatal mortality rate. (10 marks)
5.1.3. Infant mortality rate. (10 marks)
5.2. List the common causes for perinatal mortality in Sri Lanka. (20 marks)
5.3. Ministry of health has instructed that in each District, Preinatal Mortality Review meetings should be conducted regularly.
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5.3.1. Name the possible persons who can actively contribute at the above review meeting. (20 Marks)
5.3.2. Discuss the importance of regular conduction of perinatal mortality review meeting in a district. (30 marks)
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6. Write short notes on:
6.1. obesity and health related issues. (25 marks)
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6.2. incidence and prevalence. (25 marks)
6.3. epidemiological studies. (25 marks)
6.4. ethics in medical practice. (25 marks)
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