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Hch 100 Community Health Question Paper
Hch 100 Community Health
Course:Bachelor Of Medicine & Surgery
Institution: Kenyatta University question papers
Exam Year:2009
KENYATTA UNIVERSITY
UNIVERSITY EXAMINATIONS 2008/2009
FOURTH YEAR EXAMINATION FOR THE DEGREE OF BACHELOR OF
MEDICINE AND BACHELOR OF SURGERY
HCH : (100 – 103, 200- 205, 300 – 305, 400 – 405)
COMMUNITY HEALTH - PAPER I
----------------------------------------------------------------------
=================================================================
DATE: TUESDAY 1ST SEPTEMBER 2009
TIME: 8.00 A.M. – 10.30 A.M.
INSTRUCTIONS
Answer ALL MCQs Questions in Section A. (Time 60 minutes)
Answer Question 1 – 5 and any other Three from 6 – 15. (Time 1hr 30 minutes)
Indicate the correct answer by ticking against it.
The correct answer earns a (+1) mark and incorrect answer earns (-1/2 ) mark.
1.
The following are encouraged for medical practitioners during consultation with
patients, except;
a) Be
empathetic
b) Listening
c) Improve
communication
d) Be
sympathetic
Page 1 of 16
2. Three of the following are means through which patients can participate directly in health
needs identification except;
a)
During consultations with the doctor
b)
In the electoral process
c)
In comparative needs analysis
d)
In management arrangement for actual operations of health services
Indicate by ticking whether the following are true or false.
3.
Home based care is the future of health care in terms of cost effectiveness
TRUE
FALSE
4.
Causality is multifactorial in behavioral sciences
TRUE
FALSE
5.
Social support is the core of the care for the terminally ill patients
TRUE
FALSE
6.
Kenya has a policy for the integration of modern and traditional medicine.
TRUE
FALSE
7.
Patients social class is not important in disease aetiology
TRUE
FALSE
8.
Perceived threats to illness increases the likelihood of seeking health care.
TRUE
FALSE
Page 2 of 16
9.
The best definition of health is: Pick the correct one-
a)
The absence of disease
b) The soundness of body and mind
c) The absence of mental illness
d) A state of complete physical, mental and social well being
10.
Exposure to occupational hazards:- Pick the odd one out.
a) Varies with individual susceptibility to the harmful effects of the hazards agents.
b)
May be measured and assessed by an occupational hygienist.
c) Is most reliably measured by placing personal sampling device on the worker
while at work.
d) Will result in irreversible effects on health if the legal occupational exposure
limit cannot result in adverse health effects.
11.
Water related diseases are typically:- Pick the odd one out
a)
Water-related insect vectors diseases
b)
Water-washed diseases
c)
Water-based diseases
d)
Waterborne
diseases
e)
Diarrheal diseases
12.
Toxics added in the water distribution systems includes:- Pick odd one out
a)
Metals released by corrosion of pipes.
b)
By products of chemicals used to disinfect and treat water
c)
Additive to prevent corrosion
d) Biological
contaminations
e)
Natural organic pollution e.g. decaying vegetable matter.
Page 3 of 16
13.
Which of the following is not among the responsibilities of an occupational health
units?
a)
Health prevention services in work settings
b)
Work safely preventions
c)
Following up the health and safety conditions in work setting.
d)
Preventing any interruption in product
e)
Giving outpatient clinic services in work setting.
14. Which of the following best represents the environmental related responsibilities of a
general practitioner who works in health centre?
a)
Waste control and giving education to correct misapplications.
b)
Analyzing and chlorination drinking water, control of potable water
c) Controlling
and
improving the condition of toilets
d)
Coordination of conduction of above mentioned services by auxiliary
personnel of health centre
e)
All of the statements above are true.
15.
Environmental audit objective typically entails?:- Pick the odd one out
a)
Verification
of
legislative and regulatory compliance
b)
Assessment of internal policy and procedural
c)
Establishment of current practice status
d)
Identification of improvement opportunities
e)
Environmental
risk
assessment.
16.
Hazards arise from? Pick odd one out
a)
Biological, chemical, physical, mechanical and psychological agents.
b)
The work environment
c)
The use of machinery and substances
d)
Poor work supervision
e)
Inappropriate systems and procedures
Page 4 of 16
17.
Psychology’s major concern is? Pick the correct one
a) Human
interaction
b) Human
behavior
c)
Human
mind
d)
Education
18.
Thresh hold Limit Value (TLV) refers to? Pick the correct one-
a) The time one is supposed to be in work place (8 hours)
b) The limit at which a worker should be exposed to a hazard
c) The limit, which a worker can manage to finish the assigned work.
d) The limit a worker can endure pressure of work.
e) .None of above.
19.
Occupational Hygiene is? Pick the odd one out
a)
Mostly Preventive
b)
Mostly curative
c)
Mostly palliative
d)
Mostly
promotive
e)
Mostly
Rehabilitative
20.
By reducing sickness absence. Pick the correct one
a)
You reduce man hours lost
b)
You create an industrial unrest
c)
You increase the number of malingerers
d)
You decrease productivity
21.
The following are occupational hazards apart from one:-
a)
Physical – Dust, light, heat, noise
b) Chemical-sprays
c) Biological-virus,
bacteria, protozoa
d)
Physical-stress at work
e)
Singing-music,
hymns.
Page 5 of 16
22.
Noise is:- One is not. Pick the odd statement out
a)
Nuisance
b)
Breaks communication
c)
Makes people more stressful
d)
Increases productivity
e)
Can cause irreversible noise induced deafness
23.
The process which gas passes thro’ the alveoli/capillary wall is known as? Pick
correct
one
:-
a)
Osmosis
b)
Filtration
c) Diffusion
d) Sedimentation
e)
Absorption
24.
The number of alveoli of the two lobes are? Pick the correct one
a) 30
million
b) 3
million
c) 300
million
d) 0.3
million
e)
None
of
the
above
25.
In the Factory Act, the allowed level of noise in a factory or other working places is?
Pick the correct one.
a)
70
dB
b)
85
dB
c)
100
dB
d)
75
dB
e)
105
dB
Page 6 of 16
26.
What does a sampling frame mean? Pick correct one out.
a)
The sample required to produce representative results
b)
The total number of the target population upon which a sample will be drawn
c)
The sample size for the survey
d)
The total number of clusters contained in a sample drawn for the survey
27.
Which statement best describes clinical research? Pick the correct one.
a)
It considers the frequency and causes of ill-health
b)
It considers functioning of the health system and the quality of services
provided.
c) It focuses on how the body works and the biological processes, structures and
functions within an organism
d)
It focuses on the response of the body to various preventive, diagnostic and
therapeutic
interventions
28.
Give the natural equation of population. Pick the correct one
a)
Po = Im+B-Om+D
b)
Po = Births – Om + D-Im
c)
Po = Births + Om + Im + Deaths
d)
Po = B-D+Out Migration (OM) + IM (In migration)
29.
Categorical
variables
in research refer to
a)
Those that represent discrete rather than incremental placement variables.
b)
Those that represent incremental rather than discrete variables
c)
Those that describe inherent characteristics
d)
Those that are experimental variables
30.
Which of the following is a key characteristic of qualitative research techniques?
a) Involves
numbers
b)
Answers questions of how often
c)
Involves generation of information on the significance of events under study
d)
Deals with subjective assessment of opinions
Page 7 of 16
31.
Plan for data processing and analysis does not involve? Pick odd one out
a) Performing
quality-control
checks
b)
Sorting data
c) Data
collection
d)
Data analysis
32.
The following are part of malnutrition. Pick the odd one out.
a) Kwashiorkor
b) Marasmus
c) Obesity
d) Tuberculosis
33.
The study design compasses the following except our:-
a)
Definition of the study sample
b)
Sample
size
c)
Method of treatment allocation
d)
Type of statistical designs e.g. randomized or cross – over.
e)
Data validation (cleaning)
34.
The following are used in frequency distribution except one.
a) Arrays
b) Range
c) Intervals
and
mark
d)
Limits and boundaries
e) Dispersion
and
regression
Page 8 of 16
35.
The following are used in measures of Dispersion except one
a)
Standard Deviation and Mean Deviation
b) Variance
c) Semi-interquantile
range
d) Regression
e)
Coefficient of variation
36.
Moments are used in:-
a)
In grouped data
b)
Can be calculated same as computing mean and Standard Deviation
c)
Validating the raw data
d)
Have an existing relationship about the mean
e)
The r moment about any origin A is Zero
37. Skewness
is:-
a)
Degree of symmetricity of a distribution
b)
Degree of (symmetricity)
c)
The mean tends to lie on the same side of mode
d)
If the tail is longer towards the right , it is called positive skewness
e)
If the tail is longer towards the left, it is called negative skewness.
39.
The degree of peakedness of a distribution is known as:-
a) Mode
b) Median
c) Moment
d) Mean
e) Kurtosis
Page 9 of 16
40.
Sample must be:- Pick out the odd one out:-
a)
Normal Distribution (Gaussian)
b) Binomial
Distribution
c) Poisson
Distribution
d) Random
Distribution
e) Multinomial
Distribution
41.
Sample must be:- Pick the correct one out.
a)
As far as possible be a true representation of a reference population
b)
Can be different from the reference population
c)
It is picked randomly
d)
It helps to eliminate bias if randomly selected
e)
It can be with or without Replacement
42.
Null hypothesis means:- Pick the correct definition.
a)
There is a marked difference between the expected and observed
b)
There is minimal difference between two observations
c)
There is no difference between observed and expected
d)
The difference is only in expected observations
e)
The observed difference hardly make any difference in analysis and inference.
43.
The incidence rate is:- Pick the correct one from the following:-
a)
Number of new cases in a community (population)
b)
The number of acute cases in a community
c)
The number of reported cases in a given time
d)
The number of recurring cases in time
e)
None of the above.
Page 10 of 16
44.
The prevalence rate is:- Pick the correct one from the following definitions:-
a)
The existing number of cases at a given time in a community
b)
The chronic cases in a community
c)
The number attending various health institutions in a given time
d)
The same as endemicity of a disease in a country
e)
The existing plus new cases (incidence in a given calendar time.
45.
The incidence rate of a disease is five times greater in women than in men but the
Prevalence rates show no sex difference. The best explanation is that:-
a)
The crude all-cause mortality rate is greater in women
b)
The case fatality rate for this disease is greater for women.
c)
The case fatality rate for this disease is lower in women
d)
The duration of this disease is shorter in men
e)
Risk factors for developing the disease are more common in women
46.
A screening test is used in the same way in two similar populations, but the
proportion of FALSE POSITIVES results among those who test POSITIVE in
population A is lower than that among those who test POSITIVE in population B.
What is the likely explanation for the finding?
a)
It is impossible to determine what caused the difference
b)
The specificity of the test is lower in Population A.
c)
The prevalence of a disease is lower in Population A.
d)
The prevalence of disease is higher in Population A.
e)
The specificity of the test is higher in Population B.
47. Which of the following is/are a good index of the severity of a short-term
acute
disease:-
a) Case-specific
death
rate
b)
5-year survival rate
c)
Case fatality rate
d) Standardized
mortality
ratio
e)
None of above
Page 11 of 16
48.
The 5-year survival rate is:- Pick the right one:-
a)
The time one gets a disease (Biologic onset of disease) to the outcome (death)
b)
The time Diagnosis and treatment begin to the time of death.
c)
It is not fixed since we have new screening test which can diagnose a disease
earlier and therefore 5-year survival is not fixed.
d)
It is the time the disease is discovered in some members of community to the
time all of them die of the disease
e)
It is the time when some members who had a disease survive after others have
died before give years.
49.
The major purpose of random assignment in a clinical trial is to:-
a)
Help ensure that study subjects are selected in a skewed manner.
b)
Facilitate
measurement of outcome variables.
c)
Facilitate double blinding
d)
Try to have the study groups comparable on baseline characteristics.
e)
Reduce selection bias in allocation of treatment
50.
The purpose of double blind or double-masked study is to:- Pick the correct one out.
a)
Achieve comparability of treated and untreated subjects
b)
Reduce the effects of sampling variation
c)
Avoid observer and subject bias
d)
Avoid observer bias and sampling variation
e)
Avoid subject bias sampling variation
51.
In a randomized trial, a planned cross-over design
a)
Eliminate the problem of a possible order effect
b)
Must take into account the problem of possible residual effects of the first
therapy
c)
Requires a stratified randomization
d)
Enhance the generalizability of the results of the study
e)
Eliminates the need for monitoring compliance and non-compliance.
Page 12 of 16
52.
Retrospective Cohort Study is characterized by all of the following except:- Pick the
odd one out.
a)
The study groups are exposed and non-exposed
b)
Incidence rates may be computed
c)
The required sample size is smaller than that needed for a concurrent cohort
study.
d)
The required sample size is similar to that needed for a concurrent cohort
study.
e)
They are useful for rare exposures
53.
In a study of a disease in which all cases that developed were ascertained, if the
relative risk for the association between a factor and the disease is equal TO or less
than (one) 1.0, THEN:-
a)
There is no association between the factor and the disease
b)
The factor protects against development of the disease
c)
Either matching or randomization has been unsuccessful
d)
The comparison group used was unsuitable and a valid comparison is not
possible
e)
There is no association or a negative association between the factor and the
disease.
54.
Several studies have found that approximately 85% of cases of lung cancer are due to
cigarette smoking. This measure is an example of:-
a)
An incidence Rate
b)
An Attributable Risk
c)
A
Relative
Risk
d)
A Prevalence Risk
e)
A proportionate mortality ratio
55.
Economic is concerned with scarcity
TRUE
FALSE
Page 13 of 16
56.
Microeconomics deal with aggregates
TRUE
FALSE
57.
Revenue is expressed by : R=PxQ
TRUE
FALSE
58.
Competitive equilibrium occurs at the intersection of the demand curve and
supply curve
TRUE
FALSE
59.
The type of imperfect competition is;
a) Market
supply
b) Monopoly
c) Market
demand
d) Oligopoly
e)
Product different ion
60.
Infant mortality is represented by? Pick the correct answer
a)
The number of infants between 1-5 years dying x1000
Total mid year population
b)
The number of infants dying of a particular disease x1000
Mid year population
c)
The number of infants dying below 1 year x1000
The population of women of reproductive age
d)
The number of deaths of infants below 1 year x1000
The number of live births
Page 14 of 16
SHORT ANSWER QUESTIONS:
INSTRUCTIONS:
ANSWER ALL QUESTIONS
(TIME: 1 Hr . 30 Min.)
1.
Explain three (3) roles of the following in community health:
(i)
Medical
sociology
(3
mks)
(ii)
Medical
anthropology
(5
mks)
2.
Explain the meaning of participatory approach as a strategy in resource mobilization
(5 mks).
3.
a)
Explain the following concepts
(10
mks)
i) PCBNs
ii)
Furans
iii)
Toxicity
iv)
Carcinogens
v)
Bioxins
b)
Explain the main routes of hazard exposures and give examples in each case
(5 mks).
4.
What is environmental risk assessment.
(10 mks).
5.
Define
ergonomics.
(5
mks)
6.
In Evaluation, describe how you use Epidemiology to Evaluate Health Services
(5 mks)
7.
Briefly comment on the following.
(10 mks)
i)
Herd immunity
ii)
Primary prevention
iii)
What is secondary prevention
iv) Outbreak investigation
Page 15 of 16
8.
(i)
Draw a natural History of a disease and some sources of data.
(5 mks)
(ii)
Which are the most importantly indicators of status of health of a country?
(5 mks)
9.
(i)
What are the two components of Diagnostic and Screening Test? (2 mks)
(ii)
Mention a work about reliability (Repeatability) of these tests and mention
about
various
variations
encountered
(5
mks).
10.
Explain the theory of competitive equilibrium. Illustrate your answer by figure.
(3 marks)
11. Outline the main instruments in health economics appraisal
(3 marks)
12.
Describe the process of establishing cases of malnutrition
(5 mks)
13.
Outline key methods in effective health education
(5 mks)
14.
List
five
principles
of
management
(5
mks)
15.
Identify 5 key managerial skills
(5 mks)
Page 16 of 16
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