Download University of Jaffna MBBS 2019 February Community and Family Medicine Question Paper

UNIVERSITY OF JAFFNA, SRILANKA

SECOND EXAMINATION FOR MEDICAL DEGREES — FEBRUARY 2019

COMMUNITY & FAMILY MEDICINE

Date: 11.02.2019

Time: 3 hours

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ANSWER ALL THE SIX QUESTIONS

Answer each question in a separate answer book.

1. A 64 year old woman with diabetes was recently diagnosed with chronic kidney disease stage 3. Detailed clinical review of her revealed that she had poor treatment adherence and irregular clinic follow up.

   1. Define "treatment adherence". (20 marks)
   2. List three (3) factors which influence the treatment adherence of this woman. (30 marks)

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   3. Briefly discuss the measures to improve "treatment adherence" to this kind of diabetic patients at University Family Health Centre, Kondavil. (50 marks)
2. 1. Define the term epidemiology (20 marks)
   2. Discuss the uses of epidemiology in medical practice (40 marks)
   3. A study to assess the relationship between regular use of aspirin and colon cancer has found that the odds ratio for colon cancer among aspirin users is 0.6 with a 95% confidence interval of 0.4-9.
      1. Indicate the possible design used for the study (10 marks)

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      2. Discuss the rationale for the selection of the study design mentioned in 2.3.1. (30 marks)

3. Media reports suggest that over 600 abortions are performed daily in Sri Lanka. According to research carried out in various parts of the country, the most common reasons reported by women for having an abortion are: completion of the family and becoming pregnant too soon after the birth of the last child.

   1. Define 'unmet need for family planning'. (10 marks)

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   2. List five (5) types of health related facilities that provide family planning services. (20 marks)
   3. Describe the Public Health Midwife's role in providing contraceptive services. (30 marks)
   4. Discuss possible ways that community empowerment could be used to reduce the unmet need for family planning in the Nallur MOH Area. (40 marks)

4. A study was conducted to determine the prevalence of glucose intolerance and parameters associated with risk for this in women with Polycystic Ovary Syndrome (PCOS).

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   1. The interquartile range of age of the participants was 18 to 40 years. Interpret this finding. (20 marks)
   2. The prevalence of glucose intolerance was 38.6% (95% CI: 32.7 to 44.7). Interpret this finding. (30 marks)
   3. PCOS women had higher prevalence of glucose intolerance compared to control women (Chi-square = 7.0, degree of freedom - 1,P ¯' 0.01). Giving reason, indicate if the association is significant or not. (20 marks)
   4. PCOS women had higher prevalence of glucose intolerance compared to control women (Odds ratio= 2.76; 95% CI = 1.23 to 6.57). Giving reason, indicate if the association is significant or not.

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5. Hepatitis A is a viral liver disease which affects both children and adults. The severity of the disease could vary from mild to severe. It is a highly contagious disease and can go into outbreak situations easily if the appropriate measures are not taken swiftly.

   1. Define "outbreak". (10 marks)
   2. List the important steps in the investigation of outbreak. (30 marks)
   3. Name three(3) main activities in the prevention of hepatitis A. (20 marks)
   4. Describe in detail on one of the activities mentioned in 5.3. (40 marks)

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6. Write short note on:

   1. Referral in Family practice. (25 marks)
   2. Important aspects of healthy diet. (25 marks)
   3. Palliative care. (25 marks)

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   4. Certification of death. (25 marks)

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