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Introduction To Community Health Question Paper
Introduction To Community Health
Course:Bachelor Of Medicine And Bachelor Of Surgery
Institution: Moi University question papers
Exam Year:2006
M O I U N I V E R S I T Y
SCHOOL OF MEDICINE
END OF YEAR EXAMINATION (EYE) 2005/2006
COURSE TITLE: INTRODUCTION TO COMMUNITY HEALTH (COBES 1)
COURSE CODE: (CBS 100/MSB 105)
PROGRAMME: M.B.Ch.B. B.Sc NURSING YEAR OF STUDY: 1(ONE)
DATE: 18TH OCTOBER, 2006 TIME: 09.00 A.M. - 12.00 NOON
GENERAL INSTRUCTIONS:-
(i) Write your University Registration Number on every piece of paper you use.
(ii) Do not write your names on any piece of paper you use.
(iii) This paper consists of two (2) sections headed, Section A – Multiple Choice Questions (MCQs) Type II and Section B – Short Answer Questions (SAQs). These are to be answered in a total time of three (3) hours.
(iv) Follow the instructions as indicated in each section.
(v) Questions in each section must be answered in separate answer booklets, so that they can be handed in separately at the end of the examination.
(vi) Read carefully any additional instructions preceding each section.
SECTION A: MULTIPLE CHOICE QUESTIONS (MCQs) 70 minutes
TYPE 2
INSTRUCTIONS
(i) EACH OF THE QUESTIONS IN THIS SECTION HAS A STEM STATEMENT FOLLOWED BY FIVE COMPLETIONS NUMBERED (A) TO (E). A GIVEN COMPLETION, WHEN ADDED TO THE STEM STATEMENT MAY PRODUCE A COMPLETE STATEMENT THAT IS TRUE (T) OR FALSE (F).
(ii) INDICATE AGAINST THE APPROPRIATE NUMBERS IN THE ANSWER SHEETS PROVIDED WHETHER THE COMPLETE STATEMENT IS TRUE (T) OR FALSE (F) BY PRINTING AN (X) IN THE BOX IN THE COLUMN HEADED (T) FOR TRUE OR (F) FOR FALSE.
(iii) IF YOU DO NOT KNOW WHETHER THE COMPLETE STATEMENT IS TRUE OR FALSE, PRINT THE (X) IN THE COLUMN HEADED (D) FOR DO NOT KNOW.
(iv) A CORRECT RESPONSE EARNS YOU PLUS ONE MARK. AN INCORRECT RESPONSE EARNS MINUS ONE - HALF(½) OF A MARK. AN (X) IN THE (D) COLUMN EARNS YOU ZERO MARK. ANY UNANSWERED OPTION ALSO EARNS YOU ZERO MARK.
1. The following is/are true about health records as a data source:
(a) They are a primary sources of data
(b) The data cannot be generalized to the general population
(c) Their data can facilitate important epidemiologic study
(d) Usually their data is of high quality
(e) They are updated through periodic follow-ups.
2. The following are true/false about descriptive studies:
(a) Are good for examining the relationship between an exposure variable and a disease.
(b) Information about disease and exposure status are collected at the same time
(c) They are good for determining cause effect relationship
(d) Entire populations are used because representative samples would be too small.
(e) Control groups are usually assembled at the same time as the study groups.
3. In descriptive epidemiology, the three dimensions considered are person, place and time; about descriptive data on person.
(a) Age and sex are unalterable but essential descriptors
(b) Behavioural and life style characteristics do not fall into these categories.
(c) Variables such as education level, income and occupation can be included
(d) Observed differences in risks of disease between sexes may be a selection of differences in other attributes such as personal habits
(e) Variables present at birth and unalterable overtime such as blood group can be considered as exposure variables in analytical studies.
4. The following interventions(s) can be applied in the primary prevention of disease:
(a) Surveillance
(b) Immunization
(c) Rehabilitation
(d) Exercises
(e) Weighing of children to see if their weights fall into nutrition danger area.
5. Infectivity refers to:
(a) The proportion of infected persons who develop clinical diseases
(b) The proportion of exposed persons who become infected
(c) The proportion of persons with clinical disease who become severely sick or die
(d) The period, between exposure to an infectious agent and the appearance of the signs and symptoms
(e) An introduction of the agent into a setting where it has not been before.
6. The following are various stages of disease:
(a) Primary prevention of disease
(b) Stage of clinical disease
(c) Tertiary prevention of disease
(d) Stage of recovery, disability or death
(e) Secondary level of prevention of disease
7. For the sample 3,1,7,2,2,
(a) The mean is 3
(b) The median is 7
(c) The mode is 2
(d) The range is 1
(e) The variance is 5.5.
8. In statistical terms, a population:
(a) Consists only of people
(b) May consist of things which do not actually exist
(c) Can be only set of things in which we are interested
(d) May be infinite
9. The following are probability sampling techniques:
(a) Snowball sampling
(b) Stratified sampling
(c) Simple random sampling
(d) Convenience sampling
(e) Purposive sampling.
10. The following graphs can be used to show the relationship between two variables:
(a) A histogram
(b) A line graph
(c) A pie chart
(d) A bar graph
(e) Frequency polygon
11. The following are primary sources of data:
(a) Clinical observation
(b) Disease registers
(c) Questionnaires and interviews
(d) Heath records for defined population subgroups
(e) Vital statistics.
12. Select the correct statement(s):
(a) Incidence is a measure of the burden of disease
(b) Prevalence only includes new cases
(c) Incidence = (Prevalence) × (Average duration of disease)
(d) If Prevalence increases, the incidence of disease must also increase
(e) Prevalence only includes old cases
13. Incidence of a disease:
(a) Measures the rate at which people without the disease develop the disease during a specified period of time.
(b) Is a measure of disease mortality.
(c) Used to study disease etiology (Risk).
(d) All individuals must be at risk for the whole period of time.
(e) The denominator must include any individual who has potential to be in numerator.
14. Select the correct statement(s):
(a) Prevalence is a measure of the burden of disease
(b) Prevalence only includes new cases
(c) Incidence = (Prevalence)(Average duration of disease)
(d) If Prevalence increases, the incidence of disease must also increase
(e) Prevalence only includes old cases
15. Of the following mortality rates, which ones use the same denominator?
(a) Infant mortality rate
(b) Neonatal mortality rate
(c) Post neonatal mortality rate
(d) Maternal mortality rate
(e) Crude mortality rate
16. Which of the following statements applies to rates as used in Epidemiology:
(a) Rates tell us how fast the disease is occurring in the population.
(b) A rate is a proportion in which change over time is not considered.
(c) In rates, the numerator is always included in the denominator.
(d) A rate is an expression of a relationship between a numerator and a denominator where the two are distinct and separate quantities.
(e) The denominator in rates consists of the population at the specified time period that are biologically capable of experiencing the event.
17. The objective of epidemiology include:
(a) Studying the natural history of disease.
(b) Evaluating new preventive measures of a disease.
(c) Determining when a clinician should start treatment on a particular patient.
(d) Providing foundation for developing policy ad regulatory decision.
(e) Stating the difference between descriptive and analytical epidemiology.
18. Screening of a disease process for early identification and prompt treatment is an example of;
(a) Primary prevention
(b) Secondary prevention
(c) Tertiary prevention
(d) Both primary and secondary prevention.
(e) Identification of causative agent so that it can be isolated.
19. In epidemiological terms, the period between getting an infection and showing clinical signs and symptoms is referred to as:
(a) Incubation period
(b) Window period
(c) Period prevalence
(d) Period of infectivity
(e) Period of attack
20. Pandemic means that a disease;
(a) Occurs clearly in excess of normal expendancy
(b) Is habitually present in human populations
(c) Affects a large number of countries simultaneously.
(d) Exhibits a seasonal pattern
(e) Is prevalent among animals and can be transmitted to human beings.
21. Disease distribution can be defined in terms of:
(a) Host factors.
(b) Time of occurrence.
(c) Place of occurrence.
(d) Environmental factors.
(e) Persons affected.
22. The following is/are upper respiratory infection disease(s):
(a) Lobar pneumonia.
(b) Tonsillitis.
(c) Pulmonary tuberculosis.
(d) Bronchioasthma.
(e) Bronchitis.
23. UTI is an observation that is commonly reserved for the following disease(s);
(a) Urethral tract infection
(b) Untreated infection
(c) Upper tract infection
(d) Urinary tract infection
(e) Upper teeth infection
24. The stage of a disease in which signs and symptoms usually occur is called:
(a) Stage of subclinical disease
(b) Stage of disability
(c) Stage of clinical disease
(d) Stage of susceptibility
(e) Stage of pre-symptomatic disease
25. The following individuals are the most at risk of contracting malaria:
(a) Pregnant women
(b) Old men
(c) Children
(d) Individuals who had appendectomy
(e) Travellers from non-endemic areas.
26. In hypothesis testing, ? is the probability of commiting an error of Type II. The power of the test 1-? is then
(a) The probability of rejecting when HA is true
(b) The probability of failing to reject H0 when HA is true
(c) The probability of failing to reject HA when HA is true
(d) The probability of rejecting H0 when HA is true
(e) The probability of failing to reject H0
27. Confidence level of 90 percent means that
(a) The expected error rate is equal to 10 percent
(b) The point estimate obtained is within 10 percent of the true population value
(c) There are 90 chances out of 100 that the sample results will not vary from the true characteristics of the population by more than a specified amount
(d) A larger sample size is required than if the desired confidence level were equal to 95 percent
(e) That there is a 90 percent chance that the true value will be contained in the interval
28. Consider the following hypothesis H0:? < 20, Ha:? > 20. The population standard deviation is 10. Use a .05 level of significance. How large a sample should be taken if the researcher is willing to accept a .05 probability of making a Type II error when the actual population mean is 22?
(a) 650
(b) 271
(c) 385
(d) 325
(e) There is not enough information to find the sample size
29. Using random numbers to select a sample
(a) Is required for a variable sampling plan
(b) Is likely to result in an unbiased sample
(c) Results in a representative sample
(d) Allows researchers to use smaller samples
(e) Is always used in random sampling
30. A sample from a population of over 10,000 patients is needed to estimate an error rate. Since a sample size of 250 will satisfy precision and confidence level needs, a sampling interval of 40 is chosen. For ease of implementation, the researcher randomly selected a number between 1 and 40, and then selected each succeeding 40th item. True or false
(a) The sampling strategy is correct
(b) Interval sampling is not an acceptable statistical method
(c) If the population lacks bias, the sample is statistically valid
(d) Interval sampling eliminates the use of auditor judgement
(e) This is systematic simple random sampling
31. Mental illnesses can be classified as
(a) Organic
(b) Neurosis
(c) Functional
(d) Psychoses
(e) Mental retardation
32. Presenting problems in mental illness can be categorized as
(a) Violence to others
(b) Appropriate speech
(c) Abnormal behaviour
(d) Delusional
(e) Anxiousness
33. Mental health can be promoted through the following measures
(a) Physical well-being
(b) Urban environment
(c) Moderate use of alcohol
(d) Adequate housing
(e) Early marriage
34. The following can appropriate strategies for the prevention of mental illness
(a) Minimal health care services
(b) Training of more psychiatrists
(c) Early diagnosis
(d) Integration of mental health in Primary Health Care
(e) Building of more mental hospitals
35. Psychotic illnesses my show the following symptoms
(a) Hallucinations
(b) Illusions
(c) Insight
(d) Delusions
(e) Anxiousness
SECTION B: SHORT ANSWER QUESTIONS (SAQs)
(110 minutes)
INSTRUCTIONS:
I) THERE ARE FIFTEEN (15) QUESTIONS IN THIS SECTION
II) ANSWER ALL THE FIFTEEN (15) QUESTIONS
III) START EACH QUESTION ON A FRESH PIECE OF PAPER.
SAQ 1. Briefly discuss three qualitative research methods outlining the advantages and disadvantages of each
(9 minutes)
SAQ 2. Outline the various information dissemination avenues for research reports
(9 marks)
SAQ 3. Using examples of what you observed in your COBES attachment. Discuss three (3) functions of the health centre in-charge
(10 minutes)
SAQ 4. Briefly describe five (5) prerequisites for primary health care programmes
(10 minutes)
SAQ 5. Define the following terms:
(a) Primary health care
(b) Partnership pentagon of Towards Unity for Health
(c) Role of Village Health Committees
(10 minutes)
SAQ 6. (i) Describe the term medical vectors and name four (4) specific
examples of vectors of human pathogens
(ii) Name one (1) pathogen transmitted by each of the vectors named above
(9 minutes)
SAQ 7. To keep on developments in medicine and allied health profession, there is need to read journal articles, which contain fresh information, including new research results and new recommendations about clinical procedures. Describe how you would locate such information as a student of School of Medicine
SAQ 8. There is so much information available today and so many ways to reach it. Describe THREE major sources of information that a student in COBES I would consult for community entry and mapping knowledge.
SAQ 9. With increasing realization that many of the causes of ill health have roots in individual’s behaviour, community and society, there has been a growth of interest in extending learning in the community, in order to understand the causation of ill health. Describe the type and process of gathering information about community members.
SAQ 10. (i) Name two bacterial diseases which were commonly diagnosed in
the health centre of your attachment
(ii) Briefly describe how the health centre carried out the diagnosis for the bacterial disease named above (i)
(5½ minutes)
SAQ 11. (a) List four (4) parasitic diseases that were commonly encountered at
the health centre during your COBES I placement
(b) Name the combative agents (Genus and species) for each of the parasitic diseases named above (a)
(c) Indicate the specific specimens which were needed in order to diagnose the parasites named above (b)
(5½ minutes)
SAQ 12. (i) Name one viral disease which was common in the community
while on COBES I placement
(ii) Briefly discuss how the community could be advised on preventive and control measures against the disease named above (i)
(3 minutes)
SAQ 13. Briefly describe how you used the following data collection methods in collecting nutrition information of the community of your COBES I placement and for each state the relevant nutrition information collected.
(i) Direct observation
(ii) Semi structured interviews
(iii) Group interviews
(7 minutes)
SAQ 14. (a) State the three services offered to clients when they visit the
MCH/FP clinics
(3 minutes)
(b) Health education is an important aspect in the care of clients attending the MCH/FP clinic. List any four (4) topics you would include in your health education of the pregnant mother.
(4 minutes)
SAQ 15. In a COBES I Community attachment, students found that the three most common sexually transmitted diseases were syphilis, herpes, genitalis and gonorrhoea.
(a) Indicate the causative agent for each
(b) List five other sexually transmitted disease and for each STD listed indicate the causative agent
(c) Outline the different classifications of STDs
(d) Outline interventions to prevent STDs
(14 minutes)
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