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Dicm 333 :Medicine Ii Question Paper

Dicm 333 :Medicine Ii

Course:Clinical Medicine

Institution: Kenya Methodist University question papers

Exam Year:2014

KENYA METHODIST UNIVERSITY

''END OF1ST ''TRIMESTER 2014 (FQE) EXAMINATION
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : CLINICAL MEDICINE
UNIT CODE : DICM 333
UNIT TITLE : MEDICINE PAPER I
TIME : 3 HOURS

INSTRUCTIONS

1. Read the instructions carefully

2. Write your University umber (Not name)

3. Number all the questions correctly

4. Attempt all questions

5. Answer part A and B separately (Use different examination answer books)

6. Do not use a pencil

PART A

Question 1

Discuss pulmonary tuberculosis under the following headings

Clinical features
Complications
Management

Question 2

A sixty year old patient comes to your clinic with history of awareness of his heart beat, getting tired easily especially when he walks upstairs and difficulty in breathing which is worse on lying down on his bed.

What is the likely diagnosis?
Which signs will you find on examination of this patient?
Outline the management of this condition.

Question 3

Describe three types of jaundice, the cause of each type and the clinical features of one type (specify).

Question 4

Mr. Owino a 55 year old man presents to you with history of progressive dysphagia, He explains that it started with difficulty in swallowing solid food and now he cannot take fluids.

What is the most likely diagnosis of Mr. Owino?
List three etiological factors
What are the differential diagnosis
What diagnostic test will you carry out

Question 5

A patient comes to you at outpatient clinic with a history of passing out loose stool mixed with blood and mucous.

List the differential diagnosis of this case
Which investigations will you order to confirm the diagnosis
How do you manage/treat one of your differential diagnosis – (specify which).

PART B

Question 1

Define coma.

(2 Mks)

List five complications expected in a comatosed patient.

(2½ Mks)

Discuss in detail the management of a patient in coma.

(5½ Mks)

Question 2

Discuss malaria under the following headings:

Define complicated malaria

(2 Mks)

List four clinical features of complicated malaria

(4 Mks)

How do you manage a case of cerebral malaria?

(4 Mks)

Question 3

A 35 year old male presents with the following features palpitations, severe pallor and dizziness.

What is the most likely diagnosis

(2 Mks)

How would you investigate the patient?

(4 Mks)

Discuss how you would treat the patient.

(4Mks)

Question 4

Outline the differential diagnosis of a patient suffering from diabetes.

(2 Mks)

What investigations would you conduct for a patient with diabetes mellitus and indicate the reason for the chosen investigations.

(4 Mks)

Discuss how you would manage a patient who comes with diabetes ketoaedosis.

(4 Mks)

Question 5

A 40 year old female comes to the outpatient with inability to pass urine for one day. She complains of previous onset of the following symptoms before the inability to pass urine, painful flanks, painful menstruation and turbid urine for one week.

What are your likely differential diagnoses? (List 5 differential diagnosis)

(2½ Mks)

Describe 5 investigations that you would conduct on this woman and give reasons for the chosen investigation.

(2½ Mks)

How would you manage your patient?

(5 Mks)

Dicm 333 :Medicine Ii Question Paper

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