Download DNB 2020 June Family Medicne Paper I Question Paper

Download Diplomate of National Board (DNB) 2020 June Family Medicne Paper I Question Paper

FINAL EXAM
NATIONAL BOARD OF EXAMINATIONS
JUNE 2020
FAMILY MEDICNE
PAPER-I
Time: 3 hours
FLM/J/20/08/I
Max. Marks:100
Important Instructions:
Attempt all questions in order.
Each question carries 10 marks.
Read the question careful y and answer to the point neatly and legibly.
Do not leave any blank pages between two answers.
Indicate the question number correctly for the answer in the margin space.
Answer all the parts of a single question together.
Start the answer to a question on a fresh page or leave adequate space between two answers.
Draw table/diagrams/flowcharts wherever appropriate.
Write short notes on:
1. A 65-year-old patient is having fever and dry cough for last three days,
5+5
and difficulty in breathing for last two days. He is a known diabetic and
hypertensive patient.
a) What are your differential diagnosis with clinical justification?
b) What are the current treatment guidelines for Covid-19 patients?
2. A 30-year-old salesman has come to you with heartburn and reflux for the
2+3+3+2
past 2 months. He travels extensively and eats out al the time. He has
gained weight recently due to the junk food that he has been eating. He
admits to smoking and drinking to deal with the stress of work. On
examination, he is found to be hypertensive and he has no abnormalities
except for mild epigastric tenderness.
a) What are the red flags in the history that you would ask for?
b) How you can classify hypertension?
c) What drugs wil you start him on for his various problems?
d) What lifestyle changes would you advise him?
3. A 55-year-old man presents with history of haemoptysis for the past few
3+3+4
days.
a) Write briefly on the common causes of haemoptysis in family practice
b) How will you assess this man with appropriate history, physical
examination and investigations?
c) Discuss briefly diagnosis and management of bronchiectasis
4. A 60-year-old man is brought to you with history of brief episodes of loss
4+3+3
of consciousness over the past week.
a) List the differential diagnosis for this presentation
b) What history and physical examination would you elicit?
c) How wil you investigate this patient?
P.T.O
-1-
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.

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FINAL EXAM
NATIONAL BOARD OF EXAMINATIONS
JUNE 2020
FAMILY MEDICNE
PAPER-I
5. You have a 45-year-old patient whose spirometry showed features of
2+4+4
COPD:
a) What are the difference in obstructive and restrictive spirometry
features?
b) How wil you clinical y approach to this patient including history and
examination?
c) How wil you clinically manage this case?
6. A 45-year-old woman, is seen in the streets, poorly dressed, dirty clothes,
2+6+2
hairs unkempt. She has been like this for the last 10-15 years. She leaves
home in the mornings, takes tea at the local tea shop and returns home in
the evenings. She does not take any responsibilities at home. She stays
awake throughout the night and occasionally passes urine in her room.
Her husband has taken their children to another vil age. Her widowed
mother takes care of her. The latter is known to be using alcohol
occasional y. What are your differential diagnoses? How would you
manage her? What supports or referrals would you like to give her in a
rural area with limited health facilities?
7. Clinical features and management of fol owing conditions in children:
5+5
a) Scabies
b) Head louse infestation
8. a) Explain various indices or tools to define obesity.
5+5
b) What preventive measures you would like to take at individual level
and at community level to prevent obesity?
9. A 25-year-old labourer who was working in the field in the hot sun was
4+2+4
brought to you with altered behaviour. His core temperature was found to
be 1050 F.
a) What is the differential diagnosis?
b) How wil you investigate and manage this patient?
10. Many of the students and adults, because of Covid-19 pandemic, are
(3+2+3)+2
having anxiety disorder:
a) How wil you clinical y diagnose, investigate and manage such anxiety
disorders in this group?
b) When you would like to refer such cases to a psychiatrist?
************
-2-
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.

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