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YEAR 3 MODULE PAPERS Faculty Of Medicine, University Of Peradeniya
 

YEAR 3 MODULE PAPERS Faculty Of Medicine, University Of Peradeniya

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This document contains essay questions given from 2007 Year 3 & 4: all the para-clinical modules (pathology & pharmacology) Examination For Medical Degree, Faculty Of Medicine, University Of ...

This document contains essay questions given from 2007 Year 3 & 4: all the para-clinical modules (pathology & pharmacology) Examination For Medical Degree, Faculty Of Medicine, University Of Peradeniya. You may add recent papers & share. Thanks

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    YEAR 3 MODULE PAPERS Faculty Of Medicine, University Of Peradeniya YEAR 3 MODULE PAPERS Faculty Of Medicine, University Of Peradeniya Document Transcript

    • [Type the document title] Faculty of Medicine, Peradeniya Page 1
    • YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREEMARCH 2008 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA FOUNDATION MODULE AND FOUNDATION TO CLINICAL PRACTICE - PAPER II Duration: 1 ½ hours Answer all questions Each part to be answered in a separate answer book PART A 1. 1.1. List five types of necrosis and give one example for each type mentioned (40 marks) 1.2. List five clinical manifestations of necrosis (20 marks) 1.3. Briefly describe the microscopic features of a necrotic cell (40 marks) PART B 2. 2.1. List three characteristic features of chronic inflammation (15 marks) 2.2. List three causative factors of chronic inflammation (15 marks) 2.3. Describe the morphological appearance of the lesion caused by the factors mentioned in 2.2 (40 marks) 2.4. List three complications of chronic inflammation giving examples (30 marks) PART C 3. 3.1. What is an infarct? (20 marks) 3.2. List the factors that that will determine the extent of an infarct (30 marks) 3.3. Briefly describe the morphological appearance of different types of infarcts giving examples (50 marks) PART D 4. 4.1. Define the term thrombosis marks) (10
    • 4.2. List the main factors that influence the pathogenesis of thrombosis giving two examples for each factor (40 marks) 4.3. How would you differentiate antemortem thrombus from postmortem clot (50 marks) 5. The table given below shows the results of laboratory tests of three patients named A B C. Identify the likely errors in specimen collection and transport, in each patient giving reasons. (100 marks) Patiet History Serum Na+ (mmol/L) Serum K+ (mmol/L) Blood urea (mmol/L) Serum creatinine (mmol/L) Blood glucose (mmol/L) Total protein g/l Albumin g/L Serum Ca+2 Serum phosphate A 76 year old female from medical ward 97 B 79 years old male from an intensive care unit C 40 year male attending a renal clinic Normal 142 145 132-144 2.8 2.5 10.5 5.5 7.6 8.3 3.1-4.8 3.0-8.0 0.07 0.09 0.23 0.06-0.12 65 6.5 4.8 3.0-5.5 48 25 - 77 46 1.05 - 72 41 5.0 64-84 37-52 2.15-2.55 0.60-1.25 PART E 6. 6.1. List the mechanisms by which drug molecules are transported across the cell membrane (20 marks) 6.2. What are the advantages and disadvantages of the oral (ingestion) route of drug administration (30 marks) 6.3. Define the term “bioavailability” of a drug (20 marks) 6.4. Explain the clinical significance of the apparent volume distribution of a drug (30 marks)
    • 7. 7.1. Define the following terms in relation to receptor ligand interaction 7.1.1 Full agonist 7.1.2 Partial agonist 7.1.3 Competitive reversible antagonist 7.1.4 Inverse agonist (50 marks) 7.2 Draw semi logarithmic dose response curves for the following situations 7.2.1 Full agonist 7.2.2 Full agonist in the presence of a fixed amount of competitive reversible antagonist 7.2.3Full agonist in the presence of a fixed amount of non-competitive antagonist 7.2.4 Full agonist in the presence of a fixed amount of partial agonist (50 marks) 8. 8.1. State one class of antimicrobial agents as an example for each of the following mechanism of action 8.1.1 Interference with bacterial cell wall synthesis 8.1.2 Inhibition of bacterial protein synthesis 8.1.3 Interference with bacterial nucleic acid metabolism (30 marks) 8.2 What are the factors that determine the route of administration of an antibacterial drug? (40 marks) 8.3 List the adverse effects of quinine (30 marks)
    • 1. 1.2 2. 2.2 2.3 3. 3.2 4. 5. -– 6. 6.2 6.2.1 6.2.2 7.
    • 7.2 8. FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEPTEMBER 1 EXAMINATION FOR MEDICAL DEGREES- APRIL 2010 FOUNDATION FOR CLINICAL PRACTICE ESSAY QUESTIONS RECOMENDED ALLOCATION OF TIME 30 minutes for question 1 (pathology) 15 minutes each for questions 2, 3, 4 (pathology) 15 minutes each questions 5, 6, and 7(pharmacology) Total time 2 hours Answer all questions Each question in a separate book. 1. 1.1. What is a tumour? (50 marks) 1.2. Write an account on the differences between a benign and malignant tumour. (150 marks) 2. 2.1. Define the term “ chronic inflammation” (10 marks) 2.2. Name three (3) types of chronic inflammation giving examples. (30 marks) 2.3. Briefly describe the histological appearances of any one mentioned in 2.2 (60 marks) 3. Describe the stages in the formation of an abscess in the skin, and mention its sequelae. (100 marks) 4. 4.1. List laboratory tests that are include in liver function test. (20 marks) 4.2. Indicate which liver function is assessed by each test mentioned in 4.1 (40 marks) 4.3. Describe the pattern of the results of liver function tests, in 4.3.1. Acute viral hepatitis (20 marks) 4.3.2. Obstructive jaundice (20 marks)
    • 5. Discuss the advantages and disadvantages of the oral route of administration of drugs (100 marks) 6. Explain the clinical significance of zero-order pharmacokinetics (100 marks) 7. Describe the mechanisms by which drugs adverse effects (100 marks) YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREEMAY 2011 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA FOUNDATION MODULE AND FOUNDATION TO CLINICAL PRACTICE - PAPER II You may use 30 minutes for question 1 & 15 minutes each for all other questions. Part A 1. 1.1. Describe the composition of an acute inflammatory exudate. (20 marks) 1.2. Discuss the undesired effects of acute inflammation & their clinical manifestations giving examples. (80 marks) 2. Write a note, giving examples, on the general pathological processes that cause oedema of a limb. (50 marks) 3. 3.1 What is thrombosis? (6 marks) 3.2 Cite the factors that constitute “virchow‟s triad” in thrombus formation. (9 marks) 3.3. Explain how the factors mentioned in 3.2 play their role in the formation of the following: a) Vegetations (12 marks) b) Atrial thrombi (11 marks) c) Ventricular thrombi (12 marks) 4. What are the differences between benign & malignant tumors? (50 marks) Part B
    • 5. Discuss the clinical significance of idiosyncratic adverse effects of drugs. (50 marks) 6. Explain “competitive antagonism” of receptors. (50 marks) 7. Explain the mechanisms responsible for drug-drug interactions. (50 marks) – 1. 1.2 1.2.1 1.2.2 1.3 2. 2.2 O
    • 1. 1.1.1 1.1.2 1.2 - 2. - 1.1 1.2 1.3
    • - 2. 2.1. List three classes of bronchodilators, giving one example for each class (3 class mentioned in 2.1. (7 –- - - 1. 1.2 1.3 2. 2.2 2.3
    • 3. 3.2 3.3 3.4 - 4. - 1.1 1.2 1.3 -- -
    • 1.4 - - 1. 2. 2.2. FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEPTEMBER 2 EXAMINATION FOR MEDICAL DEGREES- SEPTEMBER 2008 LOCOMOTION MODULE-PAPER II Answer all questions -
    • Duration: 30 minutes Answer each part in a separate book. PART A 1. 1.1. Name the different types of bone. (10 marks) 1.2. Name the different cells found in bone, (excluding the bone marrow), and explain their role in the healing of a simple fracture of bone. (90 marks) PART B 2. 2.1. List two (2) cytokines that mediate synovial inflammation in rheumatoid arthritis. (10 marks) 2.2. List the disease modifying anti-rheumatic drugs (DMARDS) used in the treatment of rheumatoid arthritis. (30 marks) 2.3. Explain the mechanism of action of bisphosphonates in osteoporosis. (60 marks) FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEPTEMBER 2 EXAMINATION FOR MEDICAL DEGREES- SEPTEMBER 2008 (The examination conducted by the Faculty of medicine, University of Peradeniya on behalf of the faculty of medicine, university of Jaffna) LOCOMOTION MODULE-PAPER II Answer all questions Duration: 30 minutes Answer each part in a separate book. PART A 1. 1.1. Name two causes for a pathological fracture. (10 marks) 1.2. Name the different cell found in bone, (excluding the bone marrow), and explain their role in the healing of a simple fracture of a bone. (90 marks) PART B
    • 2. 2.1. List two (2) cytokines that mediate synovial inflammation in rheumatoid arthritis. (10 marks) 2.2. List the disease modifying anti-rheumatic drug (DMARDS) used in the treatment of rheumatoid arthritis. (30 marks) 2.3. Explain the mechanism of action of bisphosphonates in osteoporosis. (60 marks) YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREEOCTOBER 2009 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA LOCOMOTION MODULE - PAPER II Duration: 1 ½ hours Answer all questions Each part to be answered in a separate answer book PART A 1. Imaging plays a major role in the evaluation of patients with arthropathies 1.1. Give two indications for imaging in the evaluation of arthropathies (20 marks) 1.2. Describe the advantages of magnetic resonance imaging (MRI) over plain radiography in imaging in arthropathies (50 marks) 1.3. State two radiological features on plain radiograph of hands that would favour the diagnosis of rheumatoid arthritis (30 marks) PART B 2. A two year old boy was presented with fever, malaise and limited movements in the right arm. On examination, the lower right lower forearm region, above the wrist joint was red, warm and tender. The clinical diagnosis was acute osteomyelitis. 2.1. Name the most common route of bacterial entry onto bone in this age group (10 marks) 2.2. Blood was sent to culture. Name two common organisms that are likely to be isolated in blood from this patient. (20 marks) 2.3. Outline the mechanism of bone necrosis in osteomyelitis (40 marks) 2.4. State, giving reasons , the clinical significance of bone necrosis in osteomyelitis (30 marks)
    • YEAR 3 SEPTEMBER 1 EXAMINATION FOR MEDICAL DEGREES- APRIL 2010 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA LOCOMOTION MODULE-PAPER II Time: 30 minutes 1.1. Name two malignant tumors that give rise to sclerotic bone metastases. (10 marks) 1.2. Describes how bone metastases occur. (40 marks) 1.3. Describe the effects of metastatic tumor deposits in the vertebral bones. (30 marks) 1.4. List the laboratory investigations that are helpful in diagnosis of bone metastases. (20 marks) YEAR 3 SEPTEMBER 1 EXAMINATION FOR MEDICAL DEGREES- MAY 2011 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA LOCOMOTION MODULE-PAPER II Duration: 30 minutes 1. A 19 year old boy presented to the surgical clinic with swelling of the right knee joint of a duration of one month. X-ray revealed a metaphyseal tumor with Codman‟s triangle. 1.1. What is the most likely tumor? (20 marks) 1.2. Explain the reasons for your diagnosis. (30 marks) 1.3. Describe the macroscopic appearances of the tumor mentioned in 1.1 (30 marks) 1.4. Describe the microscopic features of the tumor mentioned in 1.1 (20 marks)
    • 1. 1.2 2. 2.2 3. 3.2 3.3 4. FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEPTEMBER 2 EXAMINATION FOR MEDICAL DEGREES- SEPTEMBER 2008 ENDOCRINE, HOMEOSTASIS AND METABOLISM MODULE PAPER II Answer all the questions Duration: 1hour Use separate books for each question 1. Name 5 causes for enlarged thyroid gland, and describe the macroscopic appearance of any one condition mentioned (100 marks) 2. 2.1. State the abnormalities in this arterial blood gas report, and indicate the diagnosis.
    • pH =7.2 pCO2 =54mmHg PaO2 =91mmHg HCO3 =30 m mol/L Base excess =6 m mol/L 2.2. Write four possible causes for this condition (20 marks) 2.3. How does the patient compensate for the condition mentioned in 2.1? (40 marks) 3. A 70 year old patient suffers from diabetes mellitus and chronic obstructive airway disease. He takes metformin, pioglitazone and lente insulin for his diabetes. 3.1. Name two pharmacological actions for each of the following. 3.1.1. Metformin (15 marks) 3.1.2. Lente insulin (15 marks) 3.2. Name one pharmacological action of pioglitazone on each of the following tissues. 3.2.1. Liver (10 marks) 3.2.2. Adipose tissue (10 marks) 3.2.3. Skeletal muscle (10 marks) 3.3. State the drug which has the most beneficial effect on HbA1C levels in this patient. (10 marks) 3.4. The patient develops a respiratory tract infection and is treated on an out-patient basis with steroid and antibiotics. Briefly describe what advice you would give this patient regarding the management of his diabetes during this period of illness? (30 marks) 4. A patient with chronic adrenal cortical failure is on long term steroid replacement therapy. 4.1. Name three synthetic glucocorticoids in increasing order of strength (30 marks) 4.2. Briefly describe the mechanism of action of glucocorticoids on the -target cell (15 marks) 4.3. Briefly describe how long term glucocorticoids use could be give rise to the following conditions. 4.3.1. Hypertension (10 marks) 4.3.2. Herpes zoster infection ( 10 marks) 4.4. Name three situations which may precipitate an acute adrenal crisis in this patient. (15 marks)
    • 4.5. Briefly describe what advice you would give a patient who is to be commenced on long term glucocorticoid therapy. (20 marks) FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEPTEMBER 2 EXAMINATION FOR MEDICAL DEGREES- SEPTEMBER 2008 ENDOCRINE, HOMEOSTASIS AND METABOLISM MODULE (The examination conducted by the Faculty of medicine, University of Peradeniya on behalf of the faculty of medicine, university of Jaffna) PAPER II Answer all the questions Duration: 1 hour Use separate books for each question 1. Name 5 causes for an enlarged thyroid gland, and describe the macroscopic appearances of any one condition mentioned. (100 marks) 2. 2.1. State the abnormalities in this arterial blood gas report, and indicate the diagnosis. pH pCO2 PaO2 HCO3 Base excess =7.2 =54mmHg =91mmHg =30 m mol/L =6 m mol/L 2.2. Write four possible causes for this condition (20 marks) 2.3. How does the patient compensate for the condition mentioned in 2.1? (40 marks) 3. A 70 year old patient suffers from diabetes mellitus and chronic obstructive airway disease. He takes metformin, pioglitazone and Lente insulin for his diabetes. 3.1. Name two pharmacological actions for each of the following. 3.1.1. Metformin (15 marks) 3.1.2. Lente insulin (15 marks) 3.2. Name one pharmacological action of pioglitazone on each of the following tissues.
    • 3.2.1. Liver (10 marks) 3.2.2. Adipose tissue (10 marks) 3.2.3. Skeletal muscle (10 marks) 3.3. State the drug which has the most beneficial effect on HbA1C levels in this patient. (10 marks) 3.4. The patient develops a respiratory tract infection and is treated on an out-patient basis with steroid and antibiotics. Briefly describe what advice you would give this patient regarding the management of his diabetes during this period of illness? (30 marks) 4. Describe the action of cortisol (100 marks)
    • FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEPTEMBER 1 EXAMINATION FOR MEDICAL DEGREES- APRIL 2010 ENDOCRINE, HOMEOSTASIS AND METABOLISM MODULE PAPER II Answer all the questions Duration: 1hour Answer each question in a separate book PART A 1. Describe the mechanisms of action of metformin in the treatment of type 2 diabetes (100 marks) PART B 2. Write a brief account on Hashimoto‟s thyroiditis. (100 marks) PART C 3. 3.1. List the mechanisms that regulate the extracellular fluid osmolality and sodium concentration (40 marks) 3.2. Explain how any one of the above mechanisms operates (60 marks) FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEPTEMBER 1 EXAMINATION FOR MEDICAL DEGREES- MAY 2011 ENDOCRINE, HOMEOSTASIS AND METABOLISM MODULE PAPER II Answer all the questions Duration: 1hour Answer each question in a separate book PART A 1. 1.1. Discuss briefly the aetiology of type II diabetes mellitus (Non insulin dependent diabetes mellitus) (25 marks) 1.2. List acute & chronic complications of uncontrolled type II diabetes mellitus. (25 marks) 1.3. Discuss the vascular changes seen in long term uncontrolled type II diabetes mellitus. (25 marks) 1.4. How does urine analysis help in diagnosis of type II diabetes mellitus & its complications? (25 marks)
    • Part B 2. Discuss the measures that could be taken to minimize the adverse effects of long term glucocorticoid therapy. (100 marks) YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREEMARCH 2008 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA ALIMENTATION MODULE - PAPER II Duration: 1 ½ hours Answer all questions Each part to be answered in a separate answer book 1. 1.1. List four macroscopic lesions that can occur in the anal canal (20 marks) 1.2. Give one aetiological factor for each of the lesions mentioned in 1.1 (30 marks) 1.3. Briefly describe the microscopic appearance of any lesion listed in 1.2 (50 marks) 2. 2.1. List five premalignant lesions of gastrointestinal tract (30 marks) 2.2. How would you macroscopically differentiate a peptic ulcer from a malignant ulcer in the stomach (50 marks) 2.3. List four complications of chronic gastric ulcer (20 marks) 3. Describe briefly the important features of the history and physical examination of a patient suspected to have chronic liver disease (100 marks) 4. 4.1. Mention one drug that could be used as antiemetic in each of the following clinical situations 4.1.1Motion sickness (10 marks) 4.1.2 Vomiting due to cancer chemotherapy (10 marks) 4.1.3 Vomiting in an acute attack of migraine (10 marks) 4.1.4 Vomiting in acute gastroenteritis (10 marks)
    • 4.2. Name two classes of that could be used in the treatment of inflammatory bowel disease (10 marks) 4.3. Name two adverse drug effects of mesalazine (10 marks) 4.4. Briefly explain the mechanism of action of the following drugs 4.4.1 omeprazole (20 marks) 4.4.2 aluminum hydroxide (20 marks) - 1. 1.1 1.2 1.3 1.4
    • - 1. A 40 year old male presented with a mass in the right iliac fossa. Colonoscopy revealed a malignant tumour. 1.1 Describe the possible macroscopic appearances of the tumour mentioned. (30 marks) 1.2 Describe the possible microscopic appearances of the tumour mentioned. (20 marks) 1.3 Name four (4) other conditions that would lead to a mass in the right iliac fossa in a male & describe the microscopic appearances in each condition mentioned. (50 marks) YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREEMARCH 2008 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA EXCRETION AND REPRODUCTION MODULE - PAPER II Duration: 1 ½ hours Answer all questions Each part to be answered in a separate answer book PART A 1. 1.1. List five causes of vaginal bleeding in a post menopausal women (25 marks) 1.2. Briefly explain the morphological appearance of any 03 conditions you mentioned in 1.1 (75 marks) 2. An eight year old boy presented with periorbital oedema and oliguria of two days of duration. On inquiry he gave a history of taking treatment for itching skin rash on both legs three weeks ago. Urine collected for inspection showed smoky urine. 2.1. What is the most likely diagnosis (10 marks) 2.2. What other important features you would look for in this patient (10 marks) 2.3. List four investigations you would perform on this patient (20 marks)
    • 2.4. Explain the pathological basis of the clinical and investigation findings (60 marks) PART B 3. 3.1. What is the cell of origin in renal cell carcinoma (10 marks) 3.2. List three main clinical manifestations of renal carcinoma and explain the pathogenesis of each manifestation (40 marks) 3.3. Briefly describe the macroscopic appearance of the kidney in renal cell carcinoma (50 marks) PART C 4. 4.1. List three causes of acute renal failure in Sri Lanka (30 marks) 4.2. List clinical features of acute renal failure (40 marks) 4.3. List five laboratory investigations that will be useful in the diagnosis of acute re al failure (30 marks) PART D 5. Describe the causes , the consequences and the prevention of injury to the female genital tract (100 marks) 6. Explain why the normal labour should be conducted in a supervised environment (100 marks) FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEMESTER 2 EXMAINATION FOR MEDICAL DEGREES – MARCH 2010 EXCRETION AND REPRODUCTION MODULE PAPER 11 Duration: 1hour Answer all the questions. Answer each part in a separate book Part A 1. Discuss pathology of haematuria, citing common examples (100 marks)
    • Part B 2. Discuss the cause for tubo-ovarian masses, including the morphological features of each condition. (100 marks) YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGREES – SEPTEMBER 2010 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA EXCRETION AND REPRODUCTION MODULE PAPER 11 Time: One hour Answer both questions. Please use separate books for each question. 1 1.1 List four clinical features of nephrotic syndrome (20 marks) 1.2 List four causes of nephrotic syndrome (20 marks) 1.3 Write a brief account of the macroscopy, microscopy and pathogenesis of any two mentioned in 1.2 (60 marks) 2. 2.1 List five causes for pervaginal bleeding in a 49 year old female (20 marks) 2.2 Describe the macroscopic and microscopic features of any one condition mentioned in 2.1 (50 marks) 2.3 Briefly mention the methods that are commonly used for diagnosis of gynaecological pathology (30 marks) YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGREES – DECEMBER 2011 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA EXCRETION AND REPRODUCTION MODULE PAPER 11 Time: One hour Answer both questions. Please use separate books for each question.
    • 1. 1.1 Discuss the diagnostic value of cells & casts in a urinary sediment. (40 marks) 1.2 Describe the macroscopic & microscopic features of the kidney in acute pyelonephritis & its complications. (60 marks) 2. A 38 year old female presents with a palpable lump in the left breast of 2 week duration. 2.1 Name 5 possible pathological lesions. (25 marks) 2.2 Describe the macroscopic & microscopic features of any one condition mentioned in 2.1 (60 marks) 2.3 Write 3 tests that are available to diagnose the lesions you mentioned in 2.1. (15 marks) FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEMESTER 2 EXMAINATION FOR MEDICAL DEGREES – MARCH 2010 GROWTH DEVELOPMENT, NUTRITION & AGING MODULE PAPER 11 Duration: 30 minutes Answer all the questions. Answer part A and part B in separate answer books Part A 1. 1.1. Write notes on „National Nutritional Status of Sri Lanka‟. (40 marks) 1.2. Describe the link between the National Nutritional Status and the economy of a country (60 marks) Part B 2. 2.1. What do you understand by „Growth‟ in a child? (7 marks) 2.2. What do you understand by „development‟ in a child? (8 marks) 2.3. List factors that may affect the Growth of a child giving one clinical outcome for each factor. (40 marks)
    • 2.4. List factors that may affect the Development of a child giving one clinical outcome for each factor. (45 marks) YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGREES SEPTEMBER 2010 FACULTY OF MEDICINE UNIVERSITY OF PERADINYA GROWTH, DEVELOPMENT, NUTRITION AND AGNING MODULE PART II SAQ Answer all the questions Duration: 1 hour Answer part A and part Bin separate answer books. PART A 1. 1.1. List the available national nutritional programs in Sri Lanka. (20 marks) 1.2. Write notes on “ comprehensive Maternal and Child health Care package” (80 marks) PART B A three year old boy was bought to the hospital by his 19 year old illiterate mother, for delayed walking. The baby was born at 35 weeks of gestation by normal vaginal delivery. He did not cry at birth but recovered with bag and mask ventilation. His birth weight was 2.8kg (50th centile for gestational age) and his head circumference (OFC) 29cm (3rdcentile for the gestational age). The mother had a febrile illness with rash when she was 20 weeks pregnant. The mother says it is very difficult to feed this child. She gives this baby only liquids. She avoids giving foods of animal origin because she believes that these foods are cause for recurrent respiratory tract infections and diarrhoeas in this child. Now the child can stand with support but unable to walk. He reaches for objects but is unable to transfer them from one hand to the other. He can speak only two words. He weighs 8kg and his head circumference is 32cm.
    • 1.3. List 5 problems related to growth and development(40 marks) 1.4. Find out the possible causes within the given scenario for each problem (60 marks) YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGREES DECEMBER 2011 FACULTY OF MEDICINE UNIVERSITY OF PERADINYA GROWTH, DEVELOPMENT, NUTRITION AND AGNING MODULE PART II SAQ Answer all the questions Duration: 30 minutes. Answer part A and part B in separate answer books. PART A 1. List four (4) causes for each of the following conditions. 1.1 Short stature 1.2 Failure to thrive 1.3 Development delay 1.4 Obesity (25 marks) (25 marks) (25 marks) (25 marks) PART B 2. 2.1 Describe how you would advice a mother of an infant about complementary feeding. (50 marks) 2.2 Explain why a national nutritional programme is needed for Sri Lanka. (35 marks) 2.3 List three (3) casual factors in a child presenting with malnutrition in Sri Lanka. (15 marks) YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES OCTOBER 2009 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA NEVOUS CONTROL BEHAVIOUR & SPECIAL SENSE MODULE 1 hour Answer all the questions Please use a separate answer book for each question PART A
    • 1. Describe the postmortem appearance of the brain and contents of the cranial cavity of a 60 year old man who has died of a cerebral infarct (100 marks) PART B 2. Describe the mechanisms of action, pharmacokinetics, clinical uses and adverse effects of sodium valproate (100 marks) FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEMESTER 2 EXMAINATION FOR MEDICAL DEGREES – MARCH 2010 NERVOUS CONTROL, BEHAVIOUR & SPECIAL SENSES MODULE PAPER 11 Duration: one hour Answer all the questions Answer part A and part B in separate answer books PART A 1. 1.1. Explain how the entry of orally- administered levodopa into the brain could be increased in the drug treatment of Parkinson‟s disease. (50 marks) 1.2. Describe the adverse effects of levodopa (50 marks) PART B 2. 2.1. Describe the physiological lesions that are expected to be seen in the cranial cavity in tuberculosis. (50marks) 2.2. What are the cerebrospinal fluid findings in tuberculous meningitis? (30 marks) 2.3. List five complications of tuberculosis meningitis. (20 marks)
    • YEAR 3 SEMESTER 2 EXMAINATION FOR MEDICAL DEGREES – DECEMBER 2011 NERVOUS CONTROL, BEHAVIOUR & SPECIAL SENSES MODULE PAPER 11 Duration: one hour Answer all the questions Answer part A and part B in separate answer books. PART A 1. Explain the mechanisms of actions of drugs used in the treatment of epilepsy. (100 marks) PART B 2. A 32 year old male patient presented to the neurosurgical casualty unit with increased intracranial pressure due to a space occupying lesion in the intracranial cavity. 2.1 Name four (4) possible causes of raised intracranial pressure in this patient. (20 marks) 2.2 Describe the microscopic appearances of those mentioned in 2.1 (40 marks) 2.3 Enumerate the events that might occur in his leading to the death of this patient, if the intracranial pressure is not relieved. (40 marks) YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES OCTOBER 2009 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA INFECTION MODULE 1 hour Answer all the questions Please use a separate answer book for each question PART A 1. A 26 year old woman was admitted to the general hospital Vavniya. She gave a history of intermittent fever with chills and rigors for 10 days. On examination she was pale and jaundiced, Her spleen was palpable and tender. 1.1. Name the most likely parasitic disease (10 marks) 1.2. Describe the pathogenesis of this clinical presentation (60 marks)
    • 1.3. List the laboratory tests that will help to confirm your clinical diagnosis (30 marks) 2. A recent survey of stray dogs carried out at Hindagala showed 1:5 ratio of dog to human population. 2.1. List the parasitic diseases that may be transmitted to people in the area (20 marks) 2.2. State the mode of transmission of these diseases to human (40 marks) 2.3. List the measures that are useful in controlling the spread of these diseases to humans. (40 marks) PART B 3. 3.1. Name three herpes viruses that cause disease in human (30 marks) 3.2. List the diseases caused by viruses named in 3.1 (30 marks) 3.3. State how you would confirm the diagnosis of diseases listed in 3.2 (40 marks) 4. Explain, using a flow diagram, the evaluation of Human Immunodeficiency virus (HIV) infection (pathogenesis) leading to AIDS FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA YEAR 3 SEMESTER 2 EXMAINATION FOR MEDICAL DEGREES – MARCH 2010 INFECTION MODULE PAPER 11 Answer all the questions Answer each question in a separate answer book. Duration 30 minutes 1. A 40 year old tourist was admitted with a 3day history of low grade fever and diarrhoea. Her faeces, on examination was watery with very little faecal matter. 1.1. Name three (3) likely causes of her illness. (30 marks) 1.2. Sate briefly four (4) questions to be asked which may give clues to the possible aetiology. (20 marks) 1.3. A study done using faecal cultures to determine the pathogens in 130 tourists in the previous year gave the following results.
    • Number of tourists who visited the city Number of tourists who developed diarrhoea Positive faecal pathogens in those without diarrhoea Positive faecal pathogens in those with diarrhoea 280 130 15 40 What is the positive and negative predictive value of faecal culture in determining the aetiology of diarrhoea in this group (50 marks) 2. 2.1. How will you advise a 28 year old pregnant woman with acute urinary tract infection, to collect sample of urine for culture and identification of bacteria? (50 marks) 2.2. What measures will you take when you send a sample of CSF for isolation and identification of viruses causing encephalitis? (50 marks) YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREE – APRIL 2010 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA INFECTION, IMMUNITY AND BERRIER TISSUES SAQ PAPER Duration: one hours Answer all the questions PART A 1 1.1 Name four viruses that cause infections in the respiratory tract (20 marks) 1.2 One respiratory virus change its virulence through antigenic shift and drift. Explain the mechanisms associated with pandemics due to this virus. (80 marks) 2 2.1 State the methods of laboratory diagnosis of each of the infections mentioned below a) Hepatitis A b) Rabies in a dog c) Genital Herpes simplex infection d) Rota virus diarrhea e) Encephalitis caused by Japanese encephalitis virus (50 ) 2.2 State one disadvantage of each of the methods you have mentioned in 2.1
    • 3 3.1 3.2 (50 ) A 15yr old girl presented to the dermatologist with a large ring like lesion on her arm. On examination she was found to have deformity of her nails. The dermatologist request fungal examination from the laboratory. Write briefly on what samples should be taken from this patient and how these samples should be transported to the laboratory (70 ) Name three drugs used in treatment of superficial fungal infections (30 ) PART B 4 4.1 4.2 4.3 5 Name three Herpes viruses that cause disease in humans (30 List the diseases caused by viruses named in 3.1 (30 State how you would confirm the diagnosis of diseases list in 4.2 (40 ) ) ) Explain, using a flow diagram, the evolution of human immunodeficiency virus (HIV) infection (pathogenesis) leading to AIDS. (100 ) YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGEREES SEPTEMBER 2010 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA IFFECTION MODULE PAPER II Time: 1 Hour Answer all questions. Answer part A and B in separate books. PART A 01 A 23 year old man who underwent a kidney transplant an year ago presented with a history of watery diarrhea for one month. 1.1 List FOUR organisms that could be responsible for the diarrhea. (20 marks) 1.2 How will you confirm the etiology of this man‟s diarrhea? (80 marks) 02 2.1 Name the parasites known to cause malaria in Sri Lanka (10 marks) 2.2 Describe the principles of management of diseases due to each of the parasites named in 2.1 (60 marks)
    • 2.3 List the methods of prevention and control of malaria in Sri Lanka marks) (30 PART B 03 Several children admitted to a pediatric ward for respiratory related illnesses became seriously unwell with severe bronchiolitis 2-3 days after using the in-ward nebulizer. Nasopharyngeal aspirates (NPA) from 3 patients were sent to the laboratory for investigation. 3.1 What laboratory investigations will be required to identify the etiology? (40 marks) 3.2 How would you explain the occurrence of severe bronchiolitis in these Children? (20 marks) 3.3 What should be done to prevent this occurring in the pediatric unit? (40 marks) 04 What measures would you take in the following situations on specimen collection handling and transport for microbiological investigations to maximize the yield of relevant pathogens. 4.1 Blood sample from a 50 year old man with suspected endocarditis (40 marks) 4.2 Sputum sample from a 70 year old woman with suspected pneumonia (30 marks) 4.3 Cerebrospinal fluid (CSF) sample from a 12 year old school boy with suspected Viral encephalitis (30 marks) YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGREEOCTOBER 2009 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA DIS STREAM - PAPER II Duration: 2 hours Answer all questions Each part to be answered in a separate answer book PART A 1.1. Over the past few decades in Sri Lanka, the acceptance of Ligation and Resection of tubes (LRT) as a family planning method has reduced while the acceptance of Depo medroxy progesterone (DMPA) has increased according to demographic and health surveys. Explain the reasons for this. (60 marks)
    • 1.2. List the activities that could be carried out by the Medical officer of Health (MOH) to reduce the suicide rate among adolescents in his area (40 marks) PART B 2. 2.1. List five functions of National Institute of Safety and Health (NIOSH) (25 marks) 2.2. A total of 130 male carpenters of 25 to 30 years of age , were followed up from 1st January 1990 to 31st December 2009. During the period of study, 25cof them died of cancer. Number of deaths occurred as follows: Period Number of deaths 1990 to 1994 4 1995 to 1999 6 1999 to 2004 7 2004 to 2009 8 If age specific national mortality rates (per 1000) for above said specific periods are found to be 4.5, 5.3, 6.2 and 6.5 respectively, 2.2.1. Calculate the person years at risk for each period, stating your assumptions if you have made any (25 marks) 2.2.2. Calculate standardized mortality ratio (SMR) due to carcinoma for carpenters (25 marks) 2.2.3. State your interpretation (25 marks) PART C 3. 3.1. What measures would you as the Medical officer of health (MOH) of a city, take to prevent human rabies in your area? (50 marks) 3.2. What are the targets of the “National programme for Tuberculosis and control of chest diseases” to achieve control of tuberculosis in Sri Lanka (50 marks) PART D 4.
    • 4.1. Write an account of the “role of the medical witness in providing expert evidence in court” with emphasis on preparation of reports , submission of reports and presentation in court (50 marks) 4.2. A patient has died after a laparotomy in hospital. The relative allege medical negligence. On what basis would you determine whether there is a cause for medical malpractice? (50 marks) PART E 5. The magistrate orders the exhumation of a body buried surreptitiously one and a half years ago. 5.1. What are the steps in conducting the exhumation? (70 marks) 5.2. What features of the pelvis in the above skeleton would indicate a male sex? (30 marks) PART F 6. A group of prisoners alleged that they have been tortured during the last three weeks 6.1. Describe the injuries and other physical signs that you may find to support their allegation (60 marks) 6.2. Briefly explain the role of the medical officer at a scene of a suspected murder (40 marks) YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES APRIL 2010 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA DOCTOR IN SOCIETY (DIS STREAM) 2 hours Answer all the questions Please use a separate answer book for each question PART A 01 1.1 Explain the importance of pre-pregnancy counseling (40 marks)
    • 1.2 Describe six important activities carried out at community level to reduce maternal morbidity and mortality in Sri Lanka (60 marks) PART B 02 2.1 Explain the criteria on which a “disaster” can be declared 2.2 Give three examples of “emergencies” in the context of a disaster 2.3 Explain the term “vulnerabilities” in emergencies PART C 03 3.1 What do you understand by the term “ergonomic hazards” 3.2 List five situations where agricultural workers are ergonomic hazards 3.3 State the health outcomes of the ergonomic hazards mentioned in 3.2 3.4 What strategies would you adopt to prevent the effects of ergonomic hazards in agricultural workers? (50 marks) (30 marks) (20 marks) (25 marks) (20 marks) (25 marks) (25 marks) PART D 04 4.1 List the medico-legal significance of defense injuries 4.2 Describe the injury pattern/s seen in self-inflicted injuries 4.3 How do you differentiate ante-mortem from post-mortem burns at autopsy? (10 marks) (40 marks) (50 marks) PART E 05 5.1 Define the term “contusion” 5.2 List the factors that determine the appearance of a contusion 5.3 What forensic information can be gathered by examination of an abrasion (20 marks) (30 marks) ( 50 marks) PART F 06 6.1 Discuss how you would classify blunt injuries to the head, for legal purpose (80 marks) 6.2 Describe the autopsy technique/s that would be necessary to identify the injuries to the brain (20 marks) YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES MARCH 2010 FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYA DOCTOR IN SOCIETY (DIS STREAM) 2 hours Answer all the questions
    • Please use a separate answer book for each question PART A 1. A 25 year old mother of one child comes to the poly clinic held in the Medical Officer of Health (MOH) area to get advice on family planning. 1.1. If you are the MOH, what further information should you gather from this female for proper counseling on family planning. Give reasons for your answer. (70 marks) 1.2. Explain the importance of educating the Sri Lankan youth on “Emergency contraception” (30 marks) PART B 2. 2.1. Describe common health problems among the elderly (50 marks) 2.2. Explain “comprehensive geriatric assessment“ (50 marks) PART C 3. A cohort of 500 ceramic factory workers who were aged 35 years were followed up from 1st January 1990 to 31st December 2009.Deaths were recorded when they occurred as follows. Period Deaths (n) 1990-1994 0 1995-1999 5 2000-2004 7 2005-2009 10 Following table gives national mortality rates (per 1000 population) specific for age group and calendar period: Period 1990-1994 1995-1999 2000-2004 2005-2009 Age group 35 to 39 40 to 44 45 to 49 50 to 54 3.3 3.8 4.2 4.3 3.1 3.4 3.4 3.9 2.7 2.9 3.2 3.7 2.5 2.7 2.9 3.5 Calculate the total number of person years contributed to the study by the workers (25 marks) Calculate the expected number of deaths for each period (25 marks) Calculate the SMR (Standardized Mortality Ratio) (25 marks)
    • How would you interpret your results in 3.3 (25 marks) PART D 4. Discuss the role of the judicial medical officer at the scene of a crime Explain the terms; 4.2.1 Testimonial capacity 4.2.2 Testamentary capacity (60 marks) (20 marks) (20 marks) PART E 5. What constitute medical negligence (40 marks) What are the defenses a medical officer would have , if accused of medical negligence? (60 marks) PART F 6. A medical officer prescribes contraceptive to a 15 year old school girl to prevent pregnancy. Describe the ethical and legal issues arising from this situation. (100 marks) – 1. 2. 2.2 2.3 3.
    • 3.2 4. 4.2 4.2.1 4.2.2 4.3 5. 5.2 5.3 6. 6.2 –
    • 1. 1.1.2 How can the effects of each of these hazards be prevented? 1.2 Explain how the health of the community is protected by proper implementation of legal measures relating to health. 2. 2.1 Describe lifestyle factors that contribute to the increase of cardiovascular diseases in Sri Lanka. 2.2 What advice would you give a woman to minimize the risk of breast cancer? 3. Explain the importance of; 3.1 Ante natal care given at the community level 3.2 Maternal death investigation 4. 4.1 A 25 year old female was admitted to the Emergency Medical Unit following a blow to her abdomen. Describe possible injuries which may be “fatal in ordinary course of nature” in this patient. 4.2 A 12 year old female domestic helper was beaten with blunt weapons & killed by manual strangulation following sexual assault. State with reasons one autopsy dissection technique to establish each of the following; i. Blunt weapon trauma ii. Manual strangulation iii. Sexual assault 5. A Medical Officer conducting an autopsy examination of a child who fell from the fourth floor of a children‟s home, identified fresh & healing injuries on external examination. 5.1 Describe 3 types of fresh injuries which may be seen on this child. 5.2 Describe the pattern of injuries you would expect to see if the death was due to the fall. 5.3 List 4 methods you would apply for dating of injuries.
    • 6. A charred body of an adult male is found in a burnt house. This police suspect assault & disposal by burning. 6.1 List 5 medico-legal issues that need to be considered by a Medical Officer when investigating this case. 6.2 Describe the autopsy findings that would indicate that the person was alive during the fire. FACULT OF MEDICINE UNIVERSITY OF PERADENIYA YEAR 4 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES, AUGEST 2010 COMMUNICATION, LEARNING AND RESEARCH (CLR) STREAM Question no 6 On 18th of August, 2010 Mr. Asoka Jayawardena, a 48 year old teacher attached to a school in Gampola was admitted with retrosternal chest pain for 2 hours. On admission his blood pressure was 180/110mmHg. He was on treatment for hypertension and type 2 diabetes mellitus. His ECG showed ST segment elevation in L1 L11 AVF. The Consultant in charge of ward 2 of Gampola Base Hospital, Dr. Rohana Dissanayake made the diagnosis as Acute Inferior Myocardial Infarction in this patient. Mr. Jayawardena was given Streptokinase 1.5 Mega Units over 1 hour without delay. As his blood sugar was 220mg/dl, he was treated with soluble insulin 15 units 8 hourly. He was given Aspirin 150mg daily, Clopidogrel 75mg daily, Atorvastatin 20mg daily and Isosorbide Mononitrate 20 mg twice a day. His chest X-ray was normal. Echocardiography revealed EF 60%. Urine Full report was normal. Serum Creatinine was 0.8mg/dl. Mr. Jayawardena was discharged 6 days later with same oral drugs. He was asked to continue Lente Insulin 30 units daily. He was requested to attend the medical clinic on Wednesday at 8.00 am 2 weeks later.
    • Write a diagnosis card for this patient – 1. Outline the developmental pathway of B & T lymphocytes to explain the maturation of these cells in humans. 2. Two days after a scratch injury of his arm, a one year old baby developed redness & swelling at the scratch site & swollen lymph nodes in the axilla. He also developed fever. Although no specific treatment was given, the baby recovered completely within one week. Explain the immune mechanisms responsible for the clinical features & complete recovery.