Download DNB 2020 December FamIly MedIcIne Paper I Question Paper

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FAMILY MEDICINE

PAPER-I

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Time: 3 hours FLM/D/20/08/1

Max. Marks: 100

Important Instructions:

• You are provided with 5 answer sheet booklets. Each individual answer sheet booklet consists of 10 pages excluding the covering jackets.
• Answers to all the questions must be attempted within these 5 answer sheet booklets which must be later tagged together at the end of the exam.

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• No additional supplementary answer sheet booklet will be provided.
• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.

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• 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:

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1. A 60-year-old lady, known diabetic since a few years, did not take her medicines a few months and presents with abdominal pain, vomiting and fever in your primary care clinic. 2+3+5

   1. Write 4 differential diagnosis.
   2. What investigation would you like to do, with reasons for each?
   3. How would you manage each condition?

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2. A 17-year-old girl is concerned about her acne. What are the various presentations of acne? What are the treatments available? How would you counsel her? 3+5+2

3. An 18-year-old woman, presents with left sided massive pleural effusion. What are your differential diagnosis? What specific tests would you need to confirm your diagnosis? She turns out to be HIV positive. How would you explain to her and her widowed mother? 3+5+2

4. A 24-year young man, presents with fever and dry cough since 3 days with no localizing symptoms. List the common differentials. How would you manage? When would you decide to investigate this patient? When would you advise admission? 3+3+2+2

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5. Over the years, there are many women who visit your OP who are overweight or obese. What are the definitions of obesity? Obesity is a risk factor for many diseases, name four. What are the personal measures you would suggest to reduce weight? What are the community measures you would suggest to reduce obesity? 2+2+4+2

6. A 30-year-old salesman has come to you with heartburn and reflux for the past 2 months. He travels extensively and eats out all 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, his BMI is 34 and he has no abnormalities except for mild epigastric tenderness. 2+3+5

   1. What are the red flags in the history that you would ask for?

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   2. What is the most probable diagnosis and what drugs will you start him on?
   3. What life style changes would you advise him?

7. A 55-year-old man presents with history of hemoptysis for the past few days. 3+3+4

   1. Write briefly on the common causes of hemoptysis in family practice.

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   2. How will you assess this man with appropriate history, physical examination and investigations?
   3. Diagnosis and management of bronchiectasis.

8. A 60-year-old man is brought to you with history of brief episodes of loss of consciousness over the past week. 4+3+3

   1. List the differential diagnosis for this presentation.

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   2. What history and physical examination would you elicit?
   3. How will you investigate this patient?

9. You have a 45-year-old patient whose spirometry showed features of COPD. Discuss how you will help him to quit smoking. 10

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10. A 25-year-old labourer who was working in the field in the hot sun was brought to you with altered behaviour. His core temperature was found to be 105° F. What is the differential diagnosis? How will you manage this patient? 10

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