Download University of Jaffna MBBS 2020 September Community Family Medicine Part II Question Paper

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UNIVERSITY OF JAFFNA, SRI LANKA

ECONID EXAMINATION FOR MEDICAL DEGREES - SEPTEMBER 2020

COMMUNITY FAMILY MEDICINE PART II.

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Date 30.09.2920 Time: 9am. 12pm (3 hours)

ANSWER ALL THE SIX QUESTIONS

Answer each question in a separate answer book.

1. A 39 year old bank manager and his wife, 35 year old school teacher, are living with twin children. Recently, parents of the bank manager are also started to living with them. Both children have been diagnosed with autism.

   1. List five (05) health problems this family encounters. (20 Marks)

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   2. Discuss the role of family in handling the problems mentioned in 1.1 (40 Marks)
   3. Discuss the role of family physician in supporting the family to handle the problem mentioned in 1.1. (40 Marks)
2. 1. List five (05) institutions/organizations that provide mental health services in Jaffna District (10 Marks)
   2. Briefly describe the availability and gaps in community-based mental health services in Jaffna (20 Marks)

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   3. Discuss the importance of multi-sectoral collaboration in relation to mental health (30 Marks)
   4. Discuss the mental health impact of the COVID-19 pandemic (40 Marks)

3. Unmet need for family planning is reported to be high among special groups such as single mothers and females of late reproductive age

   1. Define the term 'Unmet need for family planning' (10 Marks)

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   2. List five (05) factors contributing to unmet need among females of late reproductive age. (15 Marks)
   3. Briefly discuss the advantages of reducing unmet need for family planning (35Marks)
   4. Briefly describe the steps of an intervention to reduce Unmet need for family planning in an area if you were the Medical Officer of Health (40 Marks)

4. Chest CT (computerised tomography) is thought to be sensitive but less specific in diagnosing the 2019 coronavirus disease (COVID19).

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   We aimed to compare the performance of CT and initial RT-PCR for clinically Suspected COVID-19 patients outside the epicentre Wuhan, China.

   The sensitivity and specificity were 79% (27/34) and 100% (48/48) respectively for initial RT-PCR and 77% (26/34) and 96% (46/48) respectively for chest CT.” (He et al., 2020)

   1. How would you interpret the sensitivity of 79% for initial RT-PCR to a lay person? (20 Marks)
   2. Present the appropriate data in the table below. (20 Marks)

   	Person with Covid-19	Person without Covid-19	Total
   Chest CT positive for Covid-19
   Chest CT negative for Covid-19

   3. Briefly discuss two (02) consequences of false positive results of these tests. (20 Marks)

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   4. Briefly discuss the most important consequence of false negative results of these tests. (10 Marks)
   5. Which one of the two tests you would choose? Give the reasons for your choice. (30 Marks)

5. High intake of fruit and vegetable is linked with reduced risk of cardiovascular diseases and mortality. A recent meta-analysis indicates a relative risk of 0.89 (95% CI: 0.85-0.93) for cause mortality per 200 g/day increase in the intake of fruit and vegetables.

   1. Define the terms in bold letters (10 Marks)

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   2. Interpret the findings (20 Marks)
   3. Outline a study to test this hypothesis in a MOH area (30 Marks)
   4. Briefly discuss the benefits of systematic review in medical practices (40 Marks)

6. Short Notes

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   1. Red flag signs in primary care (25 Marks)
   2. Fitness for work assessment (25 Marks)
   3. Community based palliative care (25 Marks)
   4. Complementary feeding (25 Marks)

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