Bank Of Questions | Clinical Skills | CMT NTA 4
1. Which of the following statement concerning therapeutic relationship in history taking is correct?
A) The client needs to be able to talk openly and honestly, and the therapist/ clinician needs to be able to listen and judgmental.
B) It is essential to have the ability to enter the client’s ‘private world’ and understand their thoughts and feelings without judging them.
C) The client needs to trust the therapist/clinician, and the therapist/ clinician needs to trust the client, although building trust should not take time.
D) The therapist/clinician needs to be a ‘real’ human being, an all knowing, all powerful, rigid, and controlling figure.
E) Joking to clients is one among the misconduct in medicine and thus has to be strictly avoided
[DOWNLOAD HERE]
BANK QUESTIONS AND PAST PAPER [CLINICAL SKILLS]
DOWNLOAD NOW PDF
2. Concerning history taking in special situations, the following statements are true. EXCEPT;
A) When patient is becoming silent, watch the patient closely for non-verbal cues such as difficulty controlling emotions
B) For a confused patient, do not spend so much time to get detailed history as you will make the patient and yourself tired and frustrated
C) If patient is too talkative, focus on what seems important to the patient
D) Offer a tissue and wait for the patient to recover if he/she is crying
E) If the patient is not totally deaf, speak at normal volume and rate. Also let your voice trail off at the end of sentences
3. When fever is not one of the reported chief complain by the client, in which system it has to be reviewed?
A) Central nervous system
B) Ophthalmic system
C) Cardiovascular system
D) Ophthalmic balance system
E) Musculoskeletal system
4. Concerning chief complaints during history taking;
A) Must be documented using patient’s own words
B) Every symptoms reported by the patient should be put as chief complain
C) Symptoms with shorter duration normally documented and reported first
D) No importance of hearing from the care giver
E) Should include thoughts and feelings of the patient
5. Which of the following is a NOT common symptom of respiratory system?
A) Shortness of breath
B) Chest pain
C) Cough
D) Myalgia
E) Blood streak sputum
6. The skills needed to handle a talkative patient include the following;
A) Watch the patient closely for non verbal cues
B) Do not spend so much time to get detailed history
C) Check for the responses to see the orientation of the patient
D) Focus on what seem important for the patient
E) Make supportive re
7. This question is asked in extrapolating natal history;
A) Is this child fully immunized?
B) When did your child started eating?
C) Was this pregnancy full term?
D) Did the child had sepsis of the cord?
E) Did the mother receive toxoid tetanus injection?
8. The following question is asked during taking past gynecological history;
A) How many pieces of cigarette do you smoke per day?
B) What was the birth weight of your first child?
C) When did the mother started ant natal clinic during pregnancy
D) have you used any contraceptive method?
E) What is the sex characteristic of your second child?
9. Chronologically, physical examination relies on the following cardinal techniques
A) Inspection, Percussion, Palpation and Auscultation
B) Inspection, palpation, Percussion and Auscultation
C) Inspection, Auscultation, Palpation and Percussion
D) Inspection, Auscultation, Percussion and Palpation
E) Consent, Privacy, Position and Area of exposure
10. The following should be observed when taking blood pressure to a patient EXCEPT;
A) Patient should not have taken caffeine or engaged in vigorous exercise within 30 minutes
B) The place should be quite and the patient should be comfortable and relaxed
C) Proper cuff size is essential to obtain accurate reading
D) Clinician has to maintain eye contact with the patient when taking blood pressure
E) The first appearance of the sound beat the systolic pressure
11. Back-and-forth oscillation of the eyes is called?
A. Paralysis
B. Nystagmus
C. Tremor
D. Ptosis
E. Strabismus
12. One of the following term referred to as deviated gaze or limited eye movement.
A. Paresthesia
B. Nystagmus
C. Strabismus
D. Ptosis
E. Tremor
13. With regard to developmental milestones of a child below 5 years, the smiling begins at which age?
A. 2 years
B. 6 weeks
C. 4 months
D. 1 year
E. 2 days
14. In Expanded program of immunization, BCG vaccine is given at which age?
A. After birth
B. At 6 weeks
C. At 9 month
D. At1 month
E. At 5 years
15. The Glasgow Coma Scale provides a score in the range 3-15; patients with scores of 3-8 are usually said to be in:-
A. Coma
B. Confusion
C. Conscious
D. Amnesia
E. Pain
16. Weber’s test, during examination of vestibulocochlear nerve, vibrating fork should be kept on?
A. Mastoid process
B. Patella
C. Medial malleolus
D. Top of forehead
E. Maxillary bone
17. The fetal movements felt by the mother is called?
A. Somersaults
B. Quickening
C. Kicking
D. Dancing
E. Yoga
18. Number of five or more deliveries are termed as?
A. Nulliparous
B. Primegravidity
C. Grand multiparity
D. Gravidity
E. Parity
19. The number of total pregnancies regardless of how they ended referred to as?
A. Gravida
B. Parity
C. Deliveries
D. Grand multiparty
E. Abortion
20. Being empathetic while creating rapport during obstetric history means?
A. Showing concern
B. Feeling pity and sorrow
C. Greetings
D. Self-introduction
E. Dismayed
21. The period of pregnancy from the LNMP reported in weeks is?
A. Gestation age
B. Menarche
C. Expected date of delivery
D. Puerperium
E. Parturition
22. Establishment of ‘menstrual function’ the time of the first menstrual period is called?
A. Period
B. Cycle
C. LNMP
D. Menarche
E. Menorrhagia
23. A written account of a patient's examination and treatment that includes the patient's medical history and complaints, the clinician's findings, the results of diagnostic tests and procedures, and medications and therapeutic procedures is called?
A. Clinical notes
B. Summary
C. Text message
D. Abstract
E. Laboratory report
24. In gross motor ,by 9–10 months most infants are:-
A. Crawling
B. Smiling
C. Angry
D. Fixing object on vision
E. Climbing up to stairs
25. During abdominal examination you were able to bimanually palpate and ballot one intra-abdominal organ, due to these feature the likely organ is :-
A. Kidney
B. Liver
C. Urinary bladder
D. Spleen
E. Gall bladder
26. During abdominal examination the following suggest presence of enlarged spleen
A. Its palpated beneath right costal margin
B. Be felt as a hard swelling with rough, rounded border.
C. Its bimanually palpable
D. Splenic notch can be felt in the lower medial border
E. One can easily get above it
27. During auscultation of the precordium
A. First sound (s1) corresponds to mitral and tricuspid closure at the onset of systole
B. Second sound (s2) corresponds to aortic and pulmonary valves closure following ventricular closure
C. First sound (s1) corresponds to mitral and tricuspid opening at the onset of systole
D. Second sound (s2) corresponds to aortic and pulmonary valves closure following ventricular closure
E. First sound (s1) corresponds to mitral and pulmonary closure at the onset of systole
28. A 36 woman known hypertensive patient reports to your clinic for general follow-up clinic. Last two days presented with on and off chest pain radiating to the left arm and jaw. Regarding examination of the precordium:
A. Look for a rapid, double (sometimes triple) wave of jugular vein with each heart beat
B. Always examine from the patient's left side
C. Apex is normally located in the fifth intercostal space along the left midclavicular line
D. Percuss the precordium to locate apex beat
E. Auscultation starts at mitral, pulmonary, aortic and tricuspid area
29. A 30 years old male known to have pulmonary tuberculosis, was brought to the hospital with history of gradual onset of difficulty in breathing which has worsen for the last 2 days . On examination has reduced tactile vocal fremitus on the right infra-mammary area. The term “ tactile vocal fremitus “ was assessed during
A. Inspection
B. Percussion
C. Auscultation
D. Palpation
E. Both inspection and palpation
30. The normal shape of the chest is;
A. Oval shape
B. Elliptical shape
C. Barrel shape
D. Scoliosis
E. Kyphosis
31. Which of the following is less significant in Examining the respiratory system
A.Gait
B.Peripheral Cyanosis
C.Apex beat
D.Tattoos
E.Central Cyanosis.
32. The following is true regarding Percusion during physical examination.
A. The thumb strikes the middle phalanx of the same middle finger
B. The middle finger strikes the middle phalanx of the other middle finger
C. The middle finger strikes the middle phalanx of the other index finger.
D. The index finger strikes the middle phalanx of the other index finger
E. The thumb strikes the thumb of the other finger.
33. The following is not included in Motor system during neurological examination.
A. Muscle bulk
B. Muscle tone
C. Coordination
D. Voluntary movements
E. Reflexes.
34. A 10 years old boy was brought to the health centre,and you as a clinician after neurological examination you found that the child has inability to hears.according to that findings ,the carnial nerve affected is ;
A. Cranial nerve number I
B. Cranial nerve number II
C. Cranial nerve number VIII
D. Cranial nerve number V
E. Cranial nerve number III
SECTION B: MULTIPLE TRUE & FALSE QUESTIONS (10 )
Write the word TRUE for a correct response and write word FALSE for incorrect response.
Answers written using letter T and F WILL NOT BE MARKED
There will be a quarter a mark penalty for answers written in small letters
1. The following behaviors are unacceptable in therapeutic relationship (history taking & physical examination);
A. …F……Humour
B. …F……Collaboration
C. …F……Prejudice
D. …T……Neglect
E. …F……Validation
2. Regarding history taking in pediatrics;
A…F…….demographic data that of the mother and the sick child have to be collected
B…T…….In case of twins, history is taken in both even if only one twin is sick
C…F…….When informant is father, natal history is not enquired
D…T…….Family and social history should include occupation of the father
E…F…….For the children who is above 3 years of age, immunization history is not asked
3. The following positive findings can be seen on INSPECTION during general examination
A. …T…Alopecia
B. …F…Enlarged lymph nodes
C. …T…Jaundice
D. …T…Pruritic papular Eruptions (PPE)
E. …F…Tachycardia
4. The following are necessary to be observed before starting performing physical examination;
A…T……Checking equipments if are all available and working
B…T…….Arrange the equipments in a proper sequence of use
C…T…….Setting the bed for the patient comfort
D…F…….Clinician’s mobile phone well switched off for anticipated disturbance
E…T…….Showing concern for privacy and patient modesty
5. The following cranial nerves are of sensory type.
A. TRUE Olfactory
B. TRUE Optic
C. FALSE Oculomotor
D. FASLE Trochlear
E. TRUE Acoustic
6. When initiating rapport consider completing the following components in logical order:
A. TRUE Welcome and greet
B. TRUE Self introduction
C. TRUE Good and clear language
D. TRUE Involve the child in the conversation (if the child is old enough to understand)
E. TRUE The consulting room must have a range of toys suitable for all ages
7. In Rinne's test: Air against Bone Conduction
A. FALSE 512/ 1024 Hz [256 if deaf] vibrating fork on top of patients head/ forehead
B. FALSE Normal reply is midline
C. TRUE 512/ 1024 Hz [256 if deaf] vibrating fork on mastoid behind ear
D. TRUE Normal: air conduction [ear] better than bone conduction [mastoid]
E. TRUE It is the test for examination of cranial nerve number VIII
8. With regards to cranial nerves, the following are of motor types:
A. TRUE Trochlear
B. TRUE Abducens
C. FALSE Glossopharyngeal
D. TRUE Spinal
E. TRUE Hypoglossal
9. The following are components of obstetric history.
A. TRUE Pregnancy index
B. TRUE Menstrual history
C. TRUE Contraception history
D. FALSE Developmental milestone
E. FALSE Neonatal illness
10. Regarding blood pressure measurement
A. FALSE____ High blood pressure define as more than 130/80 mm Hg
B. TRUE___ Patient should not have engaged in vigorous exercise within the last 30 minutes
C. TRUE_______ The place should be quiet and the patient should be comfortable
D. FALSE______ Record the pressure as diastolic over systolic
E. FALSE______ The first appearance of the heart sound diastolic pressure
11. During physical abdominal examination
A. FALSE ______Prone position is most favourable position for the patient
B. FALSE _______Examiner should be in left side of the patient
C.FALSE _______A firm couch or mattress will make examination difficult
D. TRUE _______Site with pain should be palpated last.
E. TRUE ______Consent is important pre requisite before examination
12. With regards to examination of respiratory system
A. TRUE ______Trachea position is assessed during palpation
B.TRUE______ Examination needs comparison between two sides
C. TRUE ______Barrel chest has increased anterior posterior diameter almost 1:1 ratio
D. TRUE ________.Respiratory rate above 20 breaths per minute in adults is known as tachypnea.
E. TRUE______ Unilateral wheezing mainly signifies foreign body on the affected side.
14. In examining Sensory system in Central nervous system (CNS) we do;
A. TRUE _______Light touch
B. FALSE _______Gait
C. FALSE _______Vibration
D. TRUE _______Pain
E. FALSE _______ Coordination
SECTION C: MATCHING ITEMS QUESTIONS (10 )
1. Match the given terminology in column A with the corresponding letter of a correct explanation in column B.
i. | F | Exclusive breast feeding | A | Blood in urine |
ii. | H | Weaning | B | Absence of menstrual cycle |
iii. | G | Menarche | C | Patient does not breath easily |
iv. | A | Hematuria | D | Baby suck milk only from one breast |
v. | C | Dysnoea | E | Coughing sputum stained with blood |
| F | Baby feed only his/her mother’s milk | ||
G | Woman experience menstruation for the first time | |||
H | Baby stop from feeding on his/her mother’s milk | |||
2.Match the symptoms/sign in column A with the corresponding affected system in column B.
i. | C | Fever | A | Respiratory system |
ii. | H | Haematemesis | B | General system |
iii. | E | Mylagia | C | Central nervous system |
iv. | F | Dysuria | D | Nervous system |
v. | A | Cyanosis | E | Musculoskseletal system |
| F | Urinogenital system | ||
G | Cardiovascular system | |||
H | Gastrointestinal system | |||
COLUMN A (TERMS)
|
COLUMN B (EXPLANATION) |
1. Aura | A. Sudden loss of strength, temporary loss of consciousness due to lack of cerebral blood flow. |
2. Syncope | B. Involuntary shaking, vibrating or trembling |
3. Paresthesia | C. Subjective sensation that proceed seizure-Auditory, visual or motor |
4. Vertigo | D. Partial or incomplete paralysis |
5. Tremor | E. Rotational spinning sensation caused by neurological dysfunction or Vestibular apparatus |
| F. Abnormal sensation e.g., burning or tingling |
| G. Loss of motor function due to a lesion in the neurologic or muscular system or loss of sensory innervation |
| H. Inability to control range of motion of muscles |
Match abbreviation in column A against their long form in column B
COLUMN A (ABBREVIATION) |
COLUMN B (LONG FORM)
|
1. BCG | A. Oral Polio Vaccine |
2. DTP | B. Hepatitis B |
3. MMR | C. Bacillus Calmette-Guerin |
4. Hib | D. Varicella |
5. OPV | E. Measles-Mumps-Rubella |
| F. Hemophylus influenza type b |
| G. Diptheria-Tetenus-Persutis |
| H. Diarrhea-Typhoid-Persutis |
|
|
Match abbreviation in column A against interpretation in column B.
COLUMN A (ABBREVIATION) |
COLUMN B (INTERPRETATION)
|
1. Hx, hx | A. On examination |
2. HPI | B. Chief complaints |
3. PMH | C. History |
4. CC | D. Past medical history |
5. O/E | E. History of presenting illness |
| F. Social history |
| G. Past menstrual history |
| H. Diagnosis |
COLUMN A | COLUMN B |
1____E____Massive ascites
| A. Linear nigra |
2.___G_____Direction enlargement is downwards and towards the right iliac fossa
| B. Pfannestrial scar. |
3.____H____Palpated below the right costal margin.
| C. Silent abdomen |
4.____A____Sign of current pregnancy
| D. Hyper resonant percussion note |
5.____C____Generalized peritonitis
| E. Positive fluid thrill |
| F. Tympanic percussion note |
| G. Spleen enlargement |
| H. Liver enlargement |
QN 2.Match the statement in column B with corresponding deformity in column A by writing a letter of correct response in the space provided in column A. Use CAPITAL LETTERS ONLY
COLUMN A | COLUMN B |
1.___H______ Kyphosis
| A. Chest bulging anteriorly
|
2.____E_____ Scoliosis
| B. Centrally depressed chest |
3.____B_____ Pectus excavatum
| C. Paradoxical breathing pattern |
4.____C_____ Flail chest
| D. Lung collapse |
5.___A____ Pectus carinatum
| 5. Lateral bending |
| 6. Barrel chest |
| 7. Gibbus deformity
|
| 8. Forward bending |
1. Briefly explain how chief complain are amplified in history of present illness during history taking (5 )
Onset
Periodicity/Progress
Aggravating factors 1 mark @
Relieving factors
Associating factors
2. Mention five (5) important information’s that are normally enquired in family and social history when taking history from a pediatric patient (1 mark @)
Number of siblings
Hx of familial diseases
Existence/Absence of the parents
Economical status of the parents/care giver
Education level of the parents/care giver
Hx of cigarette smoking or alcohol drinking by the parents/care giver
Condition of the house- rented? Owned? Window size etc
ANY FIVE
3. List four (4) questions that are normally asked in pre natal history when taking history in pediatric (1 mark @)
When did the mother book for the first time (GA)?
How many visits were made?
What services were offered during the visits?
Was there any serious problem during the pregnancy?
4. List four (4) anatomical areas where Cyanosis can be seen during physical examination;
(1 mark @)
Lips
Tongue
Palms ANY FOUR
Soles
Skin
5. Mention four (4) positive findings that can be seen on the HAND during general examination, giving at least one example of possible underlined disease condition
(1.5 @)
Pallor-Anemia from any cause I.e. infections, nutritional deff, neoplasia etc
Jaundice-Malaria, Liver diseases i.e. hepatitis, LC, LF, HCC
Finger clubbing-CHD, PTB, Bronchiectasis, Cystic fibrosis etc ANY FOUR
Cyanosis- resp diseases
Skin lesions- scabies, dermatitis, Impetigo
Coldness- Shock
NB: 1 MARK FOR A SIGN AND 0.5 MARK FOR A DISEASE
6. Mention the vital signs and their respective equipments used to measure each particular vital sign (1.5 @)
Blood Pressure- Sphygmomanometer
Body temperature – Thermometer
Heart rate- Stop watch
Respiratory rate – Stop watch
NB: 1 MARK FOR A SIGN AND 0.5 MARK FOR AN EQUIPMENT
7. Sara is a 5 years old girl who brought to you at the hospital as you was an “on call” doctor on that particular day, Her mother reported to you that over recent few weeks she noticed her daughter to have abdominal swelling that tend to advance as the time goes. You examine Sara and you find her abdomen is grossly distended. What are the possible impressions (at least five) for her complain (1 mark @)
Fluid/Ascites
Flatus
Feaces
Fat
Mass i.e hepatomegally, spleenomegally
8. Mention five (5) groups of lymph nodes that are normally assessed during general examination (1 mark @)
Peri auricular
Post auricular
Sub mental
Sub mandibular ANY FIVE
Cervical
Axillary
Inguinal
9. List FIVE (5) equipment needed for performing neurological examination.
Ans.
· Penlight
· Tongue blade
· Cotton swab
· Cotton ball
· Turning fork (128 Hz r 256 Hz)
· Percussion hammer
10. List FIVE (5) symptoms of nervous system.
Ans.
· Headache
· Dizziness/Vertigo
· Head injury
· Seizures
· Weakness
· Incoordination
· Numbness/Tingling
· Difficulty swallowing
· Difficulty speaking
· Tremors
11. The Glasgow Coma Scale is based on a 15 point scale for estimating and categorizing the level of consciousness on the basis of overall social capability or dependence on others.Write down FIVE (5) characteristics of verbal response and their score.
Ans.
· Oriented - 5 points
· Confused conversation, but able to answer questions - 4 points
· Inappropriate responses, words discernible - 3 points
· Incomprehensible speech - 2 points
· None - 1 point
12. List FIVE (5) components of a good pediatric history that differentiate it with the adult history.
Ans.
Antenatal history
Natal history
Postal history
Developmental milestones
Immunization history
Dietary history
13. During assessment for information and documentation in the antenatal card, (RCH4 Card), the introduction part consist a lot. List FIVE (5) of them of obstetric history importance.
Ans.
· Name,
· Age in years,
· Gravidity,
· Parity,
· LNMP,
· EDD,
· GA
14. You are the first on call doctor at Obstetric Clinic, attending 32 year old female with history of amenorrhea and tender breast. You suspect she could be pregnant and you have to ascertain the expected date of delivery (EDD) of this woman. List FOUR (4) methods you can use to determine the Expected Date of Delivery (EDD).
Ans.
· Naegele’srule:
· Extrapolation from the fundal height at booking
· Ultrasound
· Extrapolation from the first date of quickening
15. List SIX (6) test that the health care provider will order at the first visit during antenatal care of a pregnant woman.
Ans.
· Blood Pressure
· Random blood Glucose
· Urine for proteinuria
· VDRL/Syphilis
· HIV test
· Blood group
· Haemoglobin (Hb) level
· Blood slide for Malaria parasites
16. Enumerate FIVE (5) common complaints of pregnant woman.
Ans.
· No menses (amenorrhea) (All trimesters)
· Nausea with or without vomiting (First trimester)
· Breast tenderness, tingling (First trimester)
· Weight loss (First trimester)
· Fatigue (First/ third trimester)
· Groin/lower abdominal pain (Second trimester (14- 20 weeks))
· Abdominal striae (Late second or third trimester)
· Concentration (Third trimester)
· Loss of mucous plug (Third trimester)
· Oedema (Third trimester)
· Heartburn constipation (All trimesters)
· Backache (All trimesters)
· Urinary frequency (All trimesters)
· Leucorrhoea (All trimesters)
17. Patients’ information required to appear in the medical record incorporate a number of items. Mention FIVE (5) of them.
Ans.
· Date:
· Personal Biographical Data
· Name of Practitioner:
· Problem List:
· Presenting Complaints:
· Physical Findings:
· Allergies and Adverse Reactions:
· Medical History:
· Physical Exams, Treatments, Risk Factors
· Medications:
· Legibility, Dates, Signatures:
· Immunization Record:
· Referrals, Consultations, Test Results:
18. Mention 5 methods of calculating EDD ( 5)
i. Early Obs USS
ii. Extrapolation from first day of quickening
iii. Extrapolation from fundal height
iv. Naegeles Rule
v. Last Normal menstrual period
19. The signs of respiratory distress which can be inspected include. (5)
i. Cyanosis – person turns blue centrally or peripherally
ii. Chest in drawing
iii. Accessory muscle use
iv. Diaphragmatic Paradox – the diaphragm moves opposite of the normal direction on inspiration, suspect flail segment in trauma
20. Outline five (5) possible causes of abdominal distension (5)
i. Fluids
ii. Flatus
iii. Fats
iv. Faeces
vi. Fetus
21. List five (5) common symptoms of the common gastrointestinal conditions (5)
i. Nausea and vomiting
ii. Diarrhea
iii. Abdominal distension
iv. Abdominal pain
v. Heartburn
vi. Difficult in swallowing
vii. Pain on swallowing
viii. Constipation
33. A. Define heart murmurs: (1 )
These are abnormal heart sound caused by turbulent flow within the heart and great vessels heard between the heartbeats, S1 and S2. Murmur may indicate valve disease or abnormal connection between the left and right side of the heart (example: septal defect)
B. Mention and describe briefly four (4) characteristic of the pulse (4) Characteristic of pulse such as
i.Rate: Count the pulse for one minute concretive
Normal pulse rate in adult is 60 to 100 per minute
Less than 60 is Bradycardia and above 100 is Tachycardia
ii.Rhythm: Record whether pulse is regular or irregular
iii.Volume: weak/strong pulse. Weak pulse can indication systemic disease like hypovolemic shock
iv.Synchronicity with other radial pulse
22. A 6 months old boy brought to the hospital by his mother to the hospital presenting with history of poor weight gain, bluish discoularation of mouth and unable to feed. During this history you found positive findings suggestive of cardiovascular disease. Mentions five common cardiovascular symptoms: (5 )
Common symptoms of the cardiovascular system include the following:
i.Chest pain
ii. Palpitations
iii. Shortness of breath (dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea)
iv. Swelling or oedema
v. Cyanosis
23. Outline the five components of motor system examinations in CNS. (5)
i. Muscles bulk
ii.Muscles power
iii. Muscles tone
iv. Reflexes; superficial and deep reflexes
v. Involuntary movements
vi.Coordination
24. A. Mention the three categories of Glasgow coma scale (3)
i. Eye opening responses
ii. Verbal responses
iii. Motor responses
B. Mention two superficial reflexes in neurological examination (2)
i.___ Plantar reflex
ii.___ Abdominal reflexes
1. Chronologically describe the six main components of patient’s history. (10 )
Ø Definition of patient’ history (1 )
A narrative or record of past events and circumstances that are or may be relevant to a patient’s current state of health. OR
It is a comprehensive statement of facts pertaining to past and present health gathered from the patient or relative, by direct questioning
Ø Demographic data (1 mark)
Ø Chief/main complain (s) (1 mark)
Ø History of present illness (2 mark)
Ø Review of other system(s) (1 mark)
Ø Past Medical history (1 mark)
Ø Family and social history (1 mark)
CHRONOLOGY (2 )
2. Describe the common techniques for a skilled interview (10)
• Active Listening
• Guided Questioning
• Non Verbal Communication
• Empathic Responses
• Validation
• Reassurance 1 mark @
• Partnering
• Summarization
• Transition
• Empowering pt
3. Using the following sub headings, describe how general examination is performed
a) Definition (1 mark)
Ø Process by which a healthcare provider investigates the body of a patient for signs of disease.
b) Equipments used and their uses
Ø Examination touch to asses any discharge/bleeding from the body orifices
(1 mark)
Ø Equipment and its uses to measure vital signs (1 mark)
c) Position an area of exposure
Ø Supine or sitting position (1 mark)
Ø Pt to be exposed all the body except the pants (1 mark)
d) Techniques and parameters that are to be assessed
Ø Level of consciousness (1 mark)
Ø Head to toes
· Head- Asses hair i.e. presence, color, distribution and texture
- Asses paleness, cyanosis, jaundice, and discharge from the orifices (1 mark)
· Lymph nodes- auricular, post auricular, submental, submandibular, cervical, axillary and inguinal (1 mark)
· Hands-Asses paleness, cyanosis, jaundice, finger clubbing, skin lesions
(1 mark)
· Lower limb edema (1 mark)
MARKER’S KNOWLEDGE ARE HIGHLY RELIED FOR FLEXIBILITY IN THIS QN
4. Erick Mwakalebela is 25 years man coming to your OPD complaining of severe abdominal pain with diarhoea for five days, on examination she is ill looking and during examination of the affected system you noted an enlarged spleen.
Explain on signs which will held you differentiate between an enlarged spleen and enlarged left kidney
Introduction 1 mark
Ø 1 Spleen has a notch on its medial border, kidney does not (4 )
Ø Spleen enlarges towards right iliac fossa and kidney towards left iliac fossa (4 )
Ø Spleen tends to be dull to percussion and kidney resonant (unless very enlarged with displacement of overlying colon) (4 )
Conclusion 1 mark
5. A 48 years old woman was brought to the health facility presenting with difficulty in breathing , coughing up blood, for almost 3months.also was reported to lose significant amount of weight in a short period of time, excessive night sweats, and low grade fever for almost three months. According to the symptoms of the patient, describe the General physical examination and systemic examination of the affected system in chronological order and state the probable findings of the patient during the physical examination. (15)
ANSWER;
The affected system is respiratory system due to history of difficult in breathing ,coughing up blood for 3months.(1mark)
On general examination ;alert,wasted,febrile,pale ,dyspneic ,cyanotic(-/+),finger clubbing, not jaundiced ,no lymphadenopathy ,no lowerlimb oedema.(2)
On Respiratory system examination:
INSPECTION:observe scars (3)
Prominent ribs
Tachypnea
PALPATION(3)
Trachea is centrally located.or may shift on contralateral side if there is pleural effusion
Asymmetrical chest expansion
No Tenderness
PERCUSSION:(3)
Dullness on the affected side but resonant percussion on the normal lung .
AUSCULTATION;(3)
Vesicular breath sound will be heard on normal lung.
Reduced breath sound on the affected lung.
Wheeze sound may be heard
Crepitation sound may be heard
0 Comments