4. Mr. Chima presents with long standing
nonhealing leg ulcer and increased frequency of
urination. Take focused history.
Mrs. Ekanem, a known hypertensive patient presents
with weakness of her right limb. Take focused history.
Ms Chinwe presents with an anterior neck
mass. Take focused history.
5. This patient was admitted from casualty with
exertional dyspnoea and cough. What additional
information would you like to obtain?
Take a history from this 18 year old boy with 2
weeks of periorbital and pedal swellings.
Clerk a patient who presents with nose bleeds and
fever.
6. Mrs. Hanifa, a 48-year-old woman, has presented to
hospital with sclera jaundice and upper abdominal
swelling. Take a focused history.
Take a focused history from this patient who presents
with cough of 5 weeks duration and excessive night
sweats.
Take a focused history from Mrs. Uloma who presents
with her 5-year-old daughter with loss of consciousness
(LOC) that lasted for 2 hours and fever of 3 days
duration.
7. Take a focused history from this patient who
presents with cyesis.
Mrs Obire presents with hard lump on her right
breast. There is also noticeable suppurative
ulcerations. Take a focused history from her.
Mr. Agu, a carpenter presents with difficulty
in passing urine of 5 days duration. Take a
focused history.
10. Mrs. Nini, accompanied by her friend wants to carry a HIV
screening test. You have been asked by the consultant to counsel
her.
Mrs. Aisha a 35 year old trader presents with a history of heavy &
painful menstruation, intermenstrual spotting and lower abdominal
swelling. You have been tasked to counsel her about her diagnosis
(fibroid) and available treatment option.
Counsel this primipara with a 2 day old infant on the importance
of breastfeeding.
11. Mrs. Joy, accompanied by her husband presents to the fertility
clinic with complaint of inability to have a child in their 5 years of
marriage. You have been asked to counsel them.
Mr. Emeka is a bricklayer who has just been diagnosed with
systemic hypertension. Counsel him on nonpharmacological
management of his condition.
Mrs. Oge accompanied by her mother presents to the hospital for
immunization of her newborn. Counsel her on the importance of
vaccination.
12. Mrs. Ujunwa, a sexually active 27 years old student with a
history of three abortions presents to the family clinic. She
wants advice on the best contraceptive to use. Counsel her.
Mrs. Modesta, a G2P1+0 1A presents for routine antenatal
care. Talk to her on the importance of malaria prophylaxis.
Mrs. Faiza, G1P0+0 presents for routine antenatal care at 29
weeks. She has been diagnosed with rachitic pelvis. Your task is
to obtain informed consent to book her for CS at 38 weeks.
13. IMPORTANT TO NOTE
• FEBRILE CONVULSION
• HEPATITIS B
• SICKLE CELL ANEMIA
• SMOKING CESSATION
• ORAL REHYDRATION THERAPY
18. • List the Levels of Prevention
• Apply it to the management of the Covid-19.
• List the causative agents of the following infectious diseases.
• Lassa fever
• Ebola
• Diptheria
• Elephantiasis
• Acute Cerebrospinal Meningitis
• Cholera
• Covid-19
• Mention five recent epidemics in Nigeria
19. Define the following terms:
Communicable diseases
Immunization
Give 5 examples of communicable diseases.
Give 2 reasons for immunization failure
List 3 vaccine preventable diseases and their
vaccine.
20. Define the following term:
• Refuse
• List 5 methods of refuse disposal
• List 5 diseases associated with poor refuse disposal.
21. Answers:
1. Refuse or solid waste can be defined as substances produced in our daily activities at homes, agricultural and livestock activities, in industries.
2. Methods of Refuse disposal:
· Controlled tipping or sanitary Landfill
· Composting
· Incineration
· Sea disposal or berging
· Mechanical destructor
· Indiscriminate dumping on farmlands
· Burying
· Indiscriminate burning
3. Diseases Associated with refuse disposal
Water-borne: Cholera, Typhoid, Dysenteries (E. coli, Rota virus etc), Infective hepatitis (A & E), Poliomyelitis etc
Food borne: Ascariasis, Trichuriasis
Skin penetration: Schistosomiasis, ankylostomiasis (hookworm)
29. • A 9 month old child presents to the outpatient clinic with a 5
day history of fever, cough, catarrh, and a 3 day history of
diarrhea. Examination reveals an infant weighing 5kg, temp
390C, pulse 140b/min, respiratory rate 60c/min, sunken
eyeballs, intercostal recessions, bilateral crepitations and
hepatosplenomegaly.
• Name 4 systems that may be involved in this child’s illness (4
marks)
• Choose any 3 system of and for each system, list 10
symptoms each (15 marks)
• Most likely diagnosis? (6 marks)
30. • This mother of a 9-day-old infant presents to the clinic due
to complaints of inconsolable cry, abnormal body movement
of upper and lower limbs often triggered by touch or noise
and inability to feed of 2 days duration. The mother did not
receive any antenatal care and delivered at village clinic.
• What is the most likely diagnosis?
• In short sentences, apply the Levels of prevention to the
above diagnosis.
• What is the causative agent?
31. An 8 year old known sickle cell patient was brought to your clinic. He
presents with fever and a painful, swollen, tender limb of 4 days
duration. Initial treatment involved certain herbal concoction.
• What is the diagnosis of the patient?
• List 4 peripheral stigmata of this patient?
• List 4 Sickle cell crisis you know.
• List 4 systemic complication that can arise in this case?
• State the treatment plan?
32. • A sexually active 23-year-old woman is brought to the emergency
department because of acute bilateral lower quadrant abdominal
pain. She has a history of multiple sexual partners. Her temperature is
102°F (38.9°C). Bimanual vaginal exam shows cervical exudate and
tenderness on cervical motion. Her β-HCG is within normal limits.
•
• What 4 systems are affected? 4 Marks
• List 10 symptoms for each of the affected systems. 20marks
• What is the likely diagnosis? 1 mark
34. A 5 day old child was brought in by the mom with
complain of yellow discoloration of sclera and skin.
Lab was given
Total bilirubin 28.6mg/dl
Direct 6.8mg/dl
WBC 16.0 X 109/L
Neutrophils 88%
1. List three questions you will ask the mother. 6 marks
2. What is the most likely diagnosis? 2 marks
3. List two ways you will treat the child. 2 marks
35. answer
.
1. Preterm delivery; was your baby born before term
Trauma during the delivery (instrumental delivery) ; was your baby born through assisted instrument like forceps, ventous delivery
ABO incompatibility; Do you know the ABO compatibility of you and your child
Rh incompatibility
2. neonatal sepsis
3.
- Phototherapy
- Exchange blood transfusion
36. Mr. Adamu is a 43-year-old farmer who
presents to the hospital with complaints
of nausea, vomiting, dizziness and
generalized body weakness. He reports
that the symptoms began about a month
ago. Below is the result of his Full Blood
Count.
• List all abnormalities on his laboratory
result. (12 marks)
• What is the most likely diagnosis? (3 marks)
• What is the most likely cause of his
diagnosis? (3 marks)
