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1.Among the following is a microorganism which induces gastritis
a)H. pylori
b)Candida albicans
c)Phlegmonous
d)Mycobacterial
e)Syphilis
2.Among the following bacteria causes pleurisy
a)Hepatitis A and B
b)Toxoplama
c)Mycobacterim
d)Isospora belli
e)Vibrio cholera
3.One of the following is the characteristic feature of Grand mal epilepsy
a)Patient doesn’t fall down during the attack
b)Terminal sleep lasts for minutes to one hour
c)Confusion and dysphoric phase occurs after an attack
d)There is clonic-Tonic phase with an aura
e)Sudden loss of consciousness with an aura
4.Lung abscesses with foul smelling sputum is caused by
a)Aspergillussp
b)Anaerobic infections
c)Staphylococcus
d)HIV
e)Chlamydia
5.It can occur at any CD4 level
a)Cryptococcal meningitis
b)Cerebral Toxoplasmosis
c)Kaposis Sarcoma
d)Pneumocystis Jiroveci
e)Cytomegalovirus (CMV) Retinitis
6.In management of urticaria the following medicine is indicated
a)Aspirin
b)Cloxacillin
c)Ibuprofen
d)Codein
e)Cetrizine
7.The following is important in deacreasing the burden of TB in PLHIV
a) Providing an ARV’s
b) Introduction cotrimoxazole preventive therapy
c) Provide HIV councelling
d) Introduce Isoniazid preventive therapy
e) Introducing HIV preventive methods
8.Diarrhoea is a common problem/symptom in PLHIV mainly caused by
a)Plasmodium sp
b)Isospora belli
c)Toxoplasma gondi
d)Salmonelatyphi
e)Shigellasonei
9.Gastric Ulcers (GU)
a) Tends to occur early in life than duodenal lesions
b) Peak incidence reported in the ninth decade.
c) More than half of GUs occurs in females.
d) Are less common than DUs
e) Doesn’t present with complication develops.
10.The medicine of choice for a patient with intractable oral thrus is
a) Fluconazole
b) Clotrimazole lozenges
c) Nystatin
d) I/V antibiotics
e) Steroids
11.A 20 years old boy came to the hospital with the history of sudden onset of dry cough, chest tightness and difficult breathing. The patient reported to have three similar episodes in the past six months. On examination he was severely dypsoneic and there were audible wheezes. What is most likely diagnosis
a)Pulmonary Hypertension
b)Congestive Heart failure
c)Status Athmaticus
d)Severe Pneumonia
e)Upper airway obstruction
12.The following thing may not occur in a patient with shock
a)Increased cellular metabolism
b)Hypotension
c)Tissue hypoxia
d)Death
e)Cellular hypoxia
13.A 40 years old man was brought to your dispensary in a comatose state. The following is the proper management of this patient
a)Give anticonvulsant e.g. Diazepam
b)Do lumber puncture
c)Inset endotracheal tube
d)Immediately refer the patient after initial resuscitation using ABC protocol
e)Do skull x-ray to rule out head injury
14.The following clinical feature is found in both Nephrotic syndrome and chronic renal failure
a)Hyperkalemia
b)Oedema
c) Hypertension
d)Haematuria
e)Lipiduria
15.John was diagnosed to have type II diabetes mellitus. What is likely acute complication Mr. John might suffer
a)Retinopathy
b)Gastroparesis
c)Neuropathy
d)DKA
e)NKHS
16.Regarding the general principles of the management of poison the following statement is NOT CORRECT
a)Prevent poison absorption
b)Administer antidotes
c)Reduce poison elimination
d)Prevent re- exposure
e)Monitor vital signs
17.The following symptom is found in a patient with cystitis
a)Haematuria
b)Anuria
c)Abdominal pain
d)Pyuria
e)Dysuria
18.One of the following is the side effect of Efavirenz
a)Fatigue
b)Vivid dreams (nightmare)
c)Anaemia
d)Steven Johnson’s syndrome
e)Peripheral neuropathy
19.The following can be used to diagnose nephrotic syndrome at primary health care
a)Pelvic ultrasound
b)Renal function test
c)Serum protein
d)Urine dipstick
e)Urinalysis
20.The following is not the predisposing factors for meningitis
a)Cardiovascular disease
b)Sinusitis
c)Malnutrition
d)HIV
e)Otitis media
SECTION B: MULTIPLE TRUE/FALSE QUESTIONS
Write the word TRUE for correct response and FALSE for incorrect response in the space provided. Each correct response weighs 0.5 mark.
1.Differential diagnosis of seizures
a)………… Brain abscess
b)………… Severe pneumonia
c)………Pyrexia
d)………… Cerebral infarction
e)………… Myocardial infarction
2.Muscarinic effects of organophosphate poisoning includes:
a)………… Abdominal cramps
b)………… Decreased bronchial secretions
c)………… Wheezing
d)………… Dry mouth
e)………… Sweating
3.The risk factors for developing cerebrovascular accidents are;
a)………… Alcohol consumption
b)………… Hypoglycemia
c)………… Steroids medicines consumption
d)………… Young age
e)………… Amphetamine consumption
4.Factors which may predispose to developing sinusitis include
a)………… Allergies
b)………… Deviated septum
c)………… Choking
d)………… Smoking
e)………… prior bouts of sinusitis as each instance
5.The following are Neurological manifestation of HIV
a).......................Dementia
b).......................Headache
c)........................Sinusitis.
d)........................Seizures.
e)........................Meningitis.
6. Regarding Diabetic ketoacidosis
a)......................There is kussmal’s breathing.
b).......................Breathes smells acetone.
c)........................There is dehydration.
d).......................Should be given oral hypoglycaemics.
e)........................Hypokalaemia is usual biochemical finding.
7. The following statement is true regarding Lung Abscess.
a)........................ There is production of copious sputum
b)......................... There is pleural rub.
c)........................There is no finger clubbing.
d)........................ There is rapid degeneration of general health.
e)......................... Achalasia is predisposing factor.
8. Common complications of falciparum malaria are:
a).........................Haemoglobinuria
b)........................Renal failure
c)..........................Hepatic encephalopathy.
d)...........................Cerebral malaria.
e)..............................Right ventricular failure.
SECTION C: MATCHING QUESTIONS (10 Marks)
Match the item in Column A that corresponds with Statements in Column B
COLUMN A COLUMN B
QUESTION 1
1.…………….Miosis
2.…………….Lumbar puncture
3.…………….Coma
4.…………….High cholesterol
5.…………….Schizophrenia
A)Statin
B)Anticoagulate
C)Alcohol
D) Metochlopromide
E) Organophosphorus insecticides
F) Hyponatremia
G) Meningitis
H)Neuroleptics
QUESTION 2
Match disease conditions in column A with the correxponding Pre referral management at Mjimwema dispensary in Column B
1.………….Diabetic Ketoacidosis
2.………….Pulmonary edema
3.………….Hypersensitvity reaction
4.………….Status athmaticus
5.………….Hypovolemic shock
A) Aminophylline
B)Intravenous fluids
C) Hydrocortisone
D) Chlopromazine
E) Insulin
F) Cotrimoxazole
G)Frusemide
H) First dose strong antibiotics
SECTION D: SHORT ANSWER QUESTIONS (20 Marks)
Answer all questions
1.A 60 years old man was brought to a health with history of headache , neck stiffness, fever and photophobia. However the informant reported the patient had history of pus discharge from the nose. Lab result MRDT was negative.
A.What is the diagnosis
...............................................................................................................
B.What is the specific investigation to order
..........................................................................................................
C.Mention the predisposing factors(at least three)
i.………………………………………………………………………………
ii.………………………………………………………………………………
iii.…………………………………………………………………………………
2.A. define liver cirrhosis
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..
B. Mention complication of liver cirrhosis
I.……………………………………………………………………………….
II.………………………………………………………………………………..
III.………………………………………………………………………………..
IV.………………………………………………………………………………..
3. Aidan is a known hypertensive 63 years old male presented with 6hours of inability to talk On examination he has global aphasia, power was 2/5 on the left side both in upper and lower limb
A.What is the possible diagnosis?
……………………………………………………………………………………….
……………………………………………………………………………………….
B.List three differential diagnoses
……………………………………………………………………………………….
……………………………………………………………………………………….
……………………………………………………………………………………….
……………………………………………………………………………………….
C.List one confirmatory diagnosis
……………………………………………………………………………………….
……………………………………………………………………………………….
4.33 years old female presented at the OPD complaining with 2 weeks
history of painful and difficult swallowing. She is HIV positive not yet on ART, On examination she has oral thrush.
I.What is likely Diagnosis and WHO stage for this patient
……………………………………………………………………………………
II.List three differential diagnoses
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
III.What drug of choice
…………………………………………………………………………………….
SECTION E: ESSAY QUESTIONS (30MARKS)
1. Write Guided essay regarding nephrotic syndrome
Definition
Causes of nephrotic syndrome primary and secondary
Clinical features
Management at dispensary level
Complication
2. Write an essay on sickle cell disease under the following guide
Definition
Causes of sickle cell disease
Clinical presentation
General management
a)Investigation
b)Treatment
Complications
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