UNIVERSITY OF SRI LANKA
EXAMINATION FOR MEDICAL DEGREES PART-II (2nd)
NOVEMBER 2014
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COMMUNITY & FAMILY MEDICINE
Date: 04.11.2014 Time: 3 hours
ANSWER ALL SIX QUESTIONS
Answer each question in separate answer book
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You are a medical officer attached to a medical ward at a tertiary care institution. You have observed that a fair amount of diabetic patients have not achieved their targeted diabetic control. You are planning to find out the reasons for this.
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- List the reasons why conducting a research study is essential to find out the reasons for the above problem (20 marks)
- Outline the epidemiological study designs? (20 marks)
- Which epidemiological design is most appropriate to elucidate the explanations for this type of problem? (10 marks)
- Briefly describe the essential steps that are needed to conduct a research study (30 marks)
- How will you use the research findings to improve the above situation? (20 marks)
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An 18 month old child was brought to the Out Patient Department of a Primary care institution with the history of seven days of fever, vomiting and difficulty of breathing. Weight of the child was 8.0 kg (Birth weight was 3.0kg). Child previously had similar kind of episodes.
- List the problems that the particular child had. (15 marks)
- Briefly describe where and how the health system failed to prevent the occurrence of the above problems. (25 marks)
- Briefly describe the referral pathway to manage the particular child effectively in order to prevent further episodes. (30 Marks)
- How could the available health records help you to improve the child's health status (30 marks)
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After a local festival, several people developed acute gastroenteritis and were admitted to your ward. You have found that this is a usual occurrence in that area.
- List the possible reasons for recurrent outbreak of acute gastroenteritis (20 marks)
- Describe the ways in which the environmental sanitation could lead to this outbreak (30 marks)
- Briefly describe how a medical officer working in a healthcare institution help to improve the situation (30 marks)
- Describe the method of chlorinating a well (20 marks)
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You are a Medical officer in charge of a Rural Hospital. The local School principal has requested you to take three classes of one hour each to 20, GCE O/L students (Boys and Girls) on Reproductive Health as there are no teachers proficient in Biology in the school.
- List the educational methods you will use (10 marks)
- Write the list of topics you would discuss (20 marks)
- Prepare a lesson plan (40 marks)
- List the educational aides you propose to use (30 marks)
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Manoharan is a longstanding patient at your primary care hospital, he is 47-years-old and was diagnosed two years ago with stage 5 chronic kidney disease due to accelerated hypertension. He also has asthma and is Hepatitis B positive. You have not seen Manoharan for around six months, and he is now attending a routine clinic with you.
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Doctor patient relationship is the key element in patient management.
- List five factors influencing the doctor patient relationship. (20 marks)
- Explain how doctor patient relationships influence on the management of the above patient in your primary health care setup (30 marks)
- How can you improve the doctor patient relationship? (20 marks)
- How could you use the available health resources to ensure the regular clinic visits of the patient. (30 marks)
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Write short notes on:
- Social mobilization for Dengue control (25 marks)
- Specificity of a screening test (25 marks)
- Geriatric care in family practice (25 marks)
- Well Woman Clinics (25 marks)
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