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Dicm 221: Medicine Ii Question Paper
Dicm 221: Medicine Ii
Course:Clinical Medicine & Surgery
Institution: Kenya Methodist University question papers
Exam Year:2011
MEDICINE II (DCMC 221) 3RD TRIMESTER 2011
KENYA METHODIST UNIVERSITY
END OF 3''RD ''TRIMESTER 2011 EXAMINATIONS
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : CLINICAL MEDICINE & SURGERY
UNIT CODE : DICM 221
UNIT TITLE : MEDICINE II
TIME : 3 HOURS
Instructions: Attempt ALL Questions
Question One
Examples of calcium channel blochers include
Amlodipine
Enalapril
Captopril
Lorsatan
Carvedilal
Question Two
Features of the virchows triad include:
Damaged endothelium
Oral contraceptive pils
Hyper coagulability
Anaemia
Stasis
Question Three
Functions of angistensin 2 include
Potent vasodilator
Stimulates aldosterone production
Water and fluid retention
Inccreases sodium excretion
Increased potassium retention
Question Four
Major criteria in diagnosis of rheumatic fever include:
Fever
Subataneous nodules
Erythema marginatum
Arthralgia
Pancarditis
Question Five
Causes of upper GIT bleeding include;
Portal hypertension
Mallory weiss tears
Peptic ulcer disease
Colerectal carcinoma
Overdose with nonsteroidal anti-inflammatory drugs
Question Six
Hepatitis B virus:
Mainly transmitted feco-orally
Commonest cause of hepatits
Associated with hepatocelullar carcinoma
Is an RNA virus
Mainly treated by use of cefuroxime
Question Seven
Complications of peptic ulcer disease (PUD) include:
Obstruction
Haemorrhage
Perforation
Usually become malignant in 50% of cases pulmonary oedema
Pulmonary oedema
Question Eight
Features of a pneumothorax include
Story dullness on percussion
Increased air entry on auscultation
Hyperresonance
Tracheal deviation toward the side with a pneumothorax
Dysponoea
Question Nine
Features of raised intracranial pressure include:
Pappiloedema
Anisochorea
Non projectile vomiting
Diarrhoea
Persistent cough
Question Ten
Major Modifiable factors in development of hypertension include:
Alcohol
Cigarette smoking
Diabetes mellitus
Hyperlipidaemia
Use of oral contraceptive pills
Question Eleven
Causes of pre-renal acute renal failure include:
Acute glomerylonephritis
Severe burns
Severe gastroenteritis
Posterior urethral valves
Renal artery stenosis
Question Twelve
Clinical features of congestive cardiac failure include:
Paroxysmal nocturnal dyspnoea
Tender splenomegaly
Raised jugular venous pressure
Unilateral, tender pedal oedema
Massive poteinuria
Question Thirteen
Macrovascular complications of diabetes include
Diabetic nephropathy
Cerebro vascular accident
Diabetic neuropathy
Peripheral arterial disease
Diabetic retiropathy
Question Fourteen
Type 2 diabetes Mellitus
Has a stronger genetic factor than type 1 diabetes
Patients commonly present in diabetic ketoacidosis
Insulin has no role in its management
Lifestyle modification plays a major role in its management
Rarely present in HHS (Hyperosmolar Hyperglycaemil State) as compared to type 1 diabetes mellitus.
Question Fifteen
Acute pancreatitis
Associated with alcohol intake.
Presents commonly with suprapubic pain
Associated with raised levels of amylase and lipase levels
Main mode of treatment is surgical
May occur due to cholelithiasis.
Question Sixteen
Risk factors for developing cerbrovascular accidents (CVA) include;
Hypertension
Diabetes mellitus
Malnutrition
Cigarette smoking
Use of oral contraceptive pills
Question Seventeen
Predisposing factors to development of diabetic Ketotoacidosis (DKA) include:
Insulin overdose
Myocardial infarction
Infections
Non compliance to medication
All of the above
Question Eighteen
First line drugs in management of pulmonary tuberculosis include;
Ethambutol
Rifampicin
Rifabutin
Isoniaziod
Ciprofloxacin
Question Nineteen
Metabolic complications of hepatic failure include:
Hepatic encephalopathy
Infertility
Bleeding tendancies
Pulmonary oedema
Hyperphosphataemia
Question Twenty
Concerning HIV/AIDS
A CD4 of 300 is an indication for initiating ARV’s
Zidovudine is known to cause Bone Marrow suppression
May lead to renal failure
Monotherapy is the main principles of management
Co-trimoxazole plays no role in management
SAQ (5 MARKS EACH)
Question One
Classify hypertension according to JNC-7.
Question Two
Briefly discuss the clinical features of peptic ulcer disease.
Question Three
List FIVE predisposing factors to development of congestive cardial failure
Question Four
Briefly discuss investigations and expected findings in diabetic Ketoacidosis.
Question Five
List FIVE conditions which are a feature of stage 4 HIV/AIDS
Question Six
Briefly discuss the crisis associated with sickle cell disease
Question Seven
State the Dukes criteria in diagnosis of infective endocarditis
Question Eight
Briefly discuss the various CSF (Cerebrospinal Fluid) parameters and expected findings in a patient with meningitis.
Question Nine
Classify the antiretroviral drugs while giving examples of each group.
Question Ten
Classify the complications of diabetes while giving examples in each.
LAQ (20 MARKS EACH)
Question One
Discuss clinical presentation, examinations, investigations and treatment options in a patient with acute leukaemias.
Question Two
Discuss clinical presentation, examination, investigations and treatment of a patient with suspected pulmonary tuberculosis.
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