YEAR 3 MODULE PAPERS Faculty Of Medicine, University Of Peradeniya

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YEAR 3 MODULE PAPERS

FACULTY OF MEDICINE

UNIVERSITY OF PERADENIYA

Faculty of Medicine, Peradeniya Page 1

YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREE-MARCH 2008

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAFOUNDATION MODULE AND FOUNDATION TO CLINICAL

PRACTICE - PAPER II

Duration: 1 ½ hours Answer all questionsEach part to be answered in a separate answer book

PART A1.

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 C3.

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 D4.

4.1. Define the term thrombosis (10 marks)

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 A B C NormalHistory 76 year old

female from

medical ward

79 years old male from an intensive care

unit

40 year male attending a renal clinic

Serum Na+

(mmol/L)97 142 145 132-144

Serum K+ (mmol/L) 2.8 10.5 7.6 3.1-4.8Blood urea (mmol/L)

2.5 5.5 8.3 3.0-8.0

Serum creatinine (mmol/L)

0.07 0.09 0.23 0.06-0.12

Blood glucose (mmol/L)

65 6.5 4.8 3.0-5.5

Total protein g/l 48 77 72 64-84Albumin g/L 25 46 41 37-52Serum Ca+2 - 1.05 - 2.15-2.55Serum phosphate - - 5.0 0.60-1.25

PART E6.

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 agonist7.1.2 Partial agonist7.1.3 Competitive reversible antagonist7.1.4 Inverse agonist

(50 marks)

7.2 Draw semi logarithmic dose response curves for the following situations7.2.1 Full agonist7.2.2 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 synthesis8.1.2 Inhibition of bacterial protein synthesis8.1.3 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)

YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES- OCTOBER 2009

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAFCP AND FM3 – FOUNDATION MODULE

PAPER IIAnswer all eight questions.

In Part A each question should be answered in a separate book and five books must be submitted for Part A.

PART A

1. 1.1 Describe the microscopic appearance of a tuberculous granuloma. (30 marks)

1.2 Describe the macroscopic appearance of tuberculous lesions in the thoracic cavity, in a patient who has died of disseminated tuberculosis.

(70 marks)

2. 2.1 Define the term embolism. (10 marks)2.2 Name five(5) types of emboli. (20 marks)2.3 Describe the pathogeneis of any one mentioned in 2.2,and describe

the clinico pathological effects caused by it. (70 marks)

3. 3.1 Describe the stages of healing of a clean surgical wound. (20 marks)

3.2 List the complications of wound healing. (80 marks)

4. A 36 years old obese female has had a lower segment caesarean section. She develops pain and swelling of right lower limb on the 5th postoperative day.Deep vein thrombosis is suspected.4.1 Name a test/investigation that will confirm the clinical diagnosis.

(20 marks)4.2 Describe the pathogenesis of thrombois in this patient and explain why she is prone to thrombosis. (70 marks)4.3 Name one hereditory condition that predisposes to venous thrombosis.

(10 marks)

5. Write an account on the adverse effects of chronic inflammation.(100 marks)

PART B

Answers to questions in Part B have to be submitted as one bunble

6. 6.1 List four (4) molecular targets in the human body on which drugs act. (20 marks)

6.2 Explain the following concepts in relation to ligand-receptor interaction6.2.1 efficacy (40 marks)6.2.2 potency (40 marks)

7. 7.1 Define the term “therapeutic index” of a drug. (30 marks)

7.2 Briefly explain the clinical significance of therapeutic index. (70 marks)

8. Explain why the analgesic effect of morphine progressively diminishes with long-term administration

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAYEAR 3 SEPTEMBER 1 EXAMINATION FOR MEDICAL

DEGREES- APRIL 2010FOUNDATION 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 DEGREE-MAY 2011

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAFOUNDATION MODULE AND FOUNDATION TO CLINICAL

PRACTICE - PAPER IIDuration : 30 minutesAnswer all questionsYou may use 30 minutes for question 1 & 15 minutes each for all other questions.

Part A1.1.1. 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)

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAYEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES –

MARCH 2008RESPIRATION AND GAS EXCHANGE MODULE

PAPER IIDuration : 30 minutes

Answer all questions

1. 1.1 List the classes of bronchodilators and give one example for each class (30 marks)

1.2 List the adverse effects of 1.2.1 Salbutamol tablets (10 marks)1.2.2 Aminophylline intravenous injection (10 marks)

1.3 Why are regular inhaled corticosteroids considered the mainstay of treatment of chronic asthma in adults? (50 marks)

2. 2.1 List four clinical manifestations of bronchial carcinoma. (20 marks)

2.2 Briefly describe the macroscopic appearance of a lung in a patient with bronchial carcinoma. (80 marks)


FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYARESPIRATION AND GAS EXCHANGE MODULE

PAPER IIDuration: 30 minutes

Answer all the questions.

Answer Part A and Part B in separate answer books.

PART A

1. 1.1 Describe the mechanism of action of the following drugs in the treatment of asthma

1.1.1 Salbutamol. (30 marks)1.1.2 Ipratropium bromidde. (30 marks)

1.2 1.2.1 List the first-line drugs used in the treatment of pulmonary tuberculosis in Sri Lanka. (20 marks)1.2.2 State the important adverse effect of each of the drugs mentioned in 1.2.1 (20 marks)

PART B

2. 2.1 What is an abscess. (10 marks)2.2 Describe the aetiopathogenesis of lung absess. (60 marks)2.3 Name five complicatios of a lung abscess. (30 marks)

YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES- APRIL 2010


PAPER IIDuration: 30 minutesAnswer all the questions. Answer each part in a separate book

Part A

1.1 List five conditions which give rise to a mass lesion in the lung (20 marks)

1.2 Describe the pathology of any one condition mentiioned in 1.1 (50 marks)

1.3 Write the methods available for the diagnosis of the condition mentioned in 1.2 (30 marks)

Part B

2 Explain the basis of using inhaled glucocorticoids in the long term treatment of asthma (100 marks)

YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES- MAY 2011


PAPER IIDuration: 30 minutesAnswer all the questions. Answer each part in a separate bookPart A1.1.1. Name the two anatomical distribution patterns of pneumonia (10 marks)1.2. Describe the macroscopic & microscopic appearances of any one, mentioned in 1.1 (90 marks)

2.2.1. List three classes of bronchodilators, giving one example for each class (30 marks)2.2. Describe the mechanism of action of any one class mentioned in 2.1. (70 marks)


MARCH 2008BLOOD AND CIRCULATION MODULE

PAPER IIDuration : 1 hour

Answer all four questions. Answer each part in a separate book

PART A

1. 1.1 What are low molecular-weight heparins? (20 marks)1.2 How do low molecular-weight heparins differ from unfractionated

heparin with respect to the mechanism of action? (30 marks)1.3 What are the advantages of using low molecular-weight heparins over

unfractionated heparin in clinical practice? (50 marks)

PART B

2. 2.1 How do organic nitrates act as anti-anginal drugs? (40 marks)2.2 List the adverse effects of glyceryl trinitrate (GTN) (20 marks)2.3 Why are thiazide type diuretics considered better antihypertensive

drugs than loop diuretics? (40 marks)

PART C

3. 3.1 List four types of effusions seen in pericarditis (20 marks)3.2 Describe the macroscopic appearance of each of the fluids listed in 3.1

(50 marks)3.3 Give one example for each of the effusions mentioned in 3.1

(20 marks)3.4 Name two sequelae of pericarditis (10 marks)

PART D

4. A 50 years old person died within one hour of onset of severe chest pain. The post-mortem examination revealed complete occlusion of the anterior descending coronary artery.4.1 What is the most probable diagnosis (20 marks)4.2 Name two complications of the condition you mentioned in 4.1

(20 marks)4.3 Explain why patients with longterm hypertension are at a higher risk of developing ischaemic heart disease. (60 marks)

YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREESOCTOBER 2009

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYABLOOD AND CIRCULATION MODULE

PAPER II- ESSAYDuration: 1 hourAnswer all the questions. Write each part in a separate book

Part A

1.1 List the factors that affect the extent of a myocardial infarction without treatment (20 marks)

1.2 Describe the post-mortem appearances of the heart and pericardium 4-5 days after myocardial infarction (30 marks)

1.3 Write a brief account on laboratory diagnosis of myocardial infarction (30 marks)

1.4 List the complications of myocardial infarction (20 marks)

Part B

2. Describe the mechanisms of action, clinical uses and adverse effects of angiotensin converting enzyme (ACE) inhibitors. (100 marks)

YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES- APRIL 2010


PAPER IIDuration: one hour

Answer each question in a separate answer book.

1. Write an essay on the post mortem appearance of the heart in a 60 years old male who has died of ischaemic heart disease. (100 marks)

2. 2.1. List four(4) classes of lipid-regulating drugs. (20 marks)2.2. Describe the mechanism of action and adverse effects of one of the

classes mentioned in 2.2. (80 marks)

YEAR 3 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES- MAY 2011


PAPER IIDuration: one hourAnswer all the questions.

Part A1.Describe the post mortem findings in the chest cavity & thoracic organs of a 60 year old patient who died of ischaemic heart disease. (100 marks)

Part B2.Describe the mechanism of action, pharmacokinetics & clinical uses of low molecular weight heparins. (100 marks)


DEGREES- SEPTEMBER 2008LOCOMOTION MODULE-PAPER II

Answer all questions

Duration: 30 minutesAnswer 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)


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 questionsDuration: 30 minutesAnswer 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 DEGREE-OCTOBER 2009

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYALOCOMOTION MODULE - PAPER II


PART A1. 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 B2. 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 PERADENIYALOCOMOTION 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 PERADENIYALOCOMOTION MODULE-PAPER II

Duration: 30 minutes1. 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)


FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAENDOCRINE, HOMEOSTASIS AND METABOLISM MODULE

PAPER II- SAQDuration: 1 hour

Answer Parts A,B and C each in separate books. Three answer books to be submitted

PART A

1. 1.1 Classify insulins based on their duration of action giving one example for each class. (40 marks)1.2 Explain the mechanism of action of sulphonylureas. (60 marks)

2. 2.1 List the drugs used in the treatment of hyperthyroidism (30 marks)2.2 State the mechanism of action of two drugs mentioned in 2.1 (70

marks)

PART B

3. 3.1 State two(2) causes of metabolic acidosis. (20 marks)3.2 Explain the pathogenesis of metabolic acidosis in one of the conditions

you have named. (50 marks)3.3 State three(3) features which can be used to dignose metabolic acidosis

(30 marks)

PART C

4. 4.1 List three(3) pathological conditions that could give rise to a solitary nodule of thr thyroid gland. (30 marks)4.2 Describe the microscopic appearance of any two of the conditions mentioned. (70 marks)


DEGREES- SEPTEMBER 2008ENDOCRINE, HOMEOSTASIS AND METABOLISM MODULE

PAPER II

Answer all the questions

Duration: 1hour

Use separate books for each question1. 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 =7.2pCO2 =54mmHgPaO2 =91mmHgHCO3 =30 m mol/LBase 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)


DEGREES- SEPTEMBER 2008ENDOCRINE, 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 IIAnswer all the questions

Duration: 1 hourUse 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 =7.2pCO2 =54mmHgPaO2 =91mmHgHCO3 =30 m mol/LBase 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. Describe the action of cortisol (100 marks)


DEGREES- APRIL 2010ENDOCRINE, HOMEOSTASIS AND METABOLISM MODULE

PAPER IIAnswer all the questionsDuration: 1hourAnswer 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 B2. Write a brief account on Hashimoto’s thyroiditis. (100 marks)

PART C3.

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)


DEGREES- MAY 2011ENDOCRINE, HOMEOSTASIS AND METABOLISM MODULE

PAPER IIAnswer all the questionsDuration: 1hourAnswer each question in a separate book

PART A1.1.1. 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 B2. Discuss the measures that could be taken to minimize the adverse effects of long term glucocorticoid therapy. (100 marks)


FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAALIMENTATION MODULE - PAPER II


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 situations4.1.1Motion 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)

YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGREES- MARCH 2010

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAALIMENTATION MODULE


1. A forty years old female presented with loss of appetite and loss of weight. A gastric carcinoma was suspected and an investigation was done. A report of adenocarcinoma was made and was followed by a gastrectomy.1.1 What is the investigation that was done to confirrn the diagnosi?

(20 marks)1.2 Describe the macroscopic appearances that would have been seen in the

gasterctomy specimen. (40 marks)

1.3 Briefly describe the microscopic appearances of gastric carcinoma. (20 marks)

1.4 Briefly describe the modes of spread of gastric carcinoma. (20 marks)

YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGREES SEPTEMBER 2010


PAPER IIDuration: 30 minutes1.1.1 List five(5) causes of colonic ulcers. (30 marks)1.2 Discuss the macroscopic and microscopic features of the listed causes highlighting the features which are helpful in distinguishing them from each other.

(70 marks)

YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGREES- December 2011



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)


FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAEXCRETION AND REPRODUCTION MODULE - PAPER II

Duration: 1 ½ hours Answer all questions

Each part to be answered in a separate answer bookPART 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 renal 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 PERADENIYAYEAR 3 SEMESTER 2 EXMAINATION FOR MEDICAL DEGREES –

MARCH 2010EXCRETION AND REPRODUCTION MODULE

PAPER 11Duration: 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 PERADENIYAEXCRETION AND REPRODUCTION MODULE

PAPER 11Time: One hourAnswer both questions. Please use separate books for each question.

11.1 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 PERADENIYAEXCRETION AND REPRODUCTION MODULE

PAPER 11Time: One hourAnswer 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)


MARCH 2010GROWTH DEVELOPMENT, NUTRITION & AGING MODULE

PAPER 11Duration: 30 minutesAnswer 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 PERADINYAGROWTH, DEVELOPMENT, NUTRITION AND AGNING MODULE

PART II SAQAnswer all the questions

Duration: 1 hourAnswer part A and part Bin separate answer books.

PART A1.

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 PERADINYAGROWTH, DEVELOPMENT, NUTRITION AND AGNING MODULE

PART II SAQAnswer all the questions

Duration: 30 minutes.Answer part A and part B in separate answer books.

PART A1. List four (4) causes for each of the following conditions.1.1 Short stature (25 marks)1.2 Failure to thrive (25 marks)1.3 Development delay (25 marks)1.4 Obesity (25 marks)

PART B2.2.1 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 PERADENIYANEVOUS CONTROL BEHAVIOUR & SPECIAL SENSE MODULE

1 hourAnswer all the questionsPlease use a separate answer book for each question

PART A1. 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 B2. Describe the mechanisms of action, pharmacokinetics, clinical uses and

adverse effects of sodium valproate (100 marks)


MARCH 2010NERVOUS CONTROL, BEHAVIOUR & SPECIAL SENSES

MODULEPAPER 11

Duration: one hourAnswer all the questionsAnswer 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 MODULEPAPER 11

Duration: one hourAnswer all the questionsAnswer part A and part B in separate answer books.

PART A1. Explain the mechanisms of actions of drugs used in the treatment of epilepsy. (100 marks)

PART B2. 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 PERADENIYAINFECTION MODULE

1 hourAnswer all the questionsPlease use a separate answer book for each question

PART A1. 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


MARCH 2010INFECTION MODULE

PAPER 11Answer all the questionsAnswer 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 280 Number of tourists who developed diarrhoea 130Positive faecal pathogens in those without diarrhoea 15Positive faecal pathogens in those with diarrhoea 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 PERADENIYAINFECTION, IMMUNITY AND BERRIER TISSUES

SAQ PAPER

Duration: one hoursAnswer all the questions

PART A

11.1 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 belowa) Hepatitis Ab) Rabies in a dogc) Genital Herpes simplex infectiond) Rota virus diarrheae) Encephalitis caused by Japanese encephalitis virus (50 marks)2.2 State one disadvantage of each of the methods you have mentioned in 2.1 (50 marks)3 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.

3.1 Write briefly on what samples should be taken from this patient and how these samples should be transported to the laboratory (70 marks)

3.2 Name three drugs used in treatment of superficial fungal infections (30 marks)

PART B

44.1 Name three Herpes viruses that cause disease in humans (30 marks)4.2 List the diseases caused by viruses named in 3.1 (30 marks)4.3 State how you would confirm the diagnosis of diseases list in 4.2 (40

marks)

5 Explain, using a flow diagram, the evolution of human immunodeficiency virus (HIV) infection (pathogenesis) leading to AIDS. (100 marks)

YEAR 3 SEMESTER 2 EXAMINATION FOR MEDICAL DEGEREESSEPTEMBER 2010

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYAIFFECTION MODULE

PAPER IITime: 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)

022.1 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 (30 marks)

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 DEGREE-OCTOBER 2009

FACULTY OF MEDICINE, UNIVERSITY OF PERADENIYADIS STREAM - PAPER II

Duration: 2 hours Answer all questionsEach part to be answered in a separate answer book

PART A1.

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 deaths1990 to 1994 41995 to 1999 61999 to 2004 7 2004 to 2009 8If 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 C3.

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 D4.

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 E5. 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 F6. A group of prisoners alleged that they have been tortured during the last three

weeks6.1. 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 PERADENIYADOCTOR IN SOCIETY (DIS STREAM)

2 hoursAnswer all the questionsPlease use a separate answer book for each question

PART A011.1 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 B022.1 Explain the criteria on which a “disaster” can be declared (50 marks)2.2 Give three examples of “emergencies” in the context of a disaster (30 marks)2.3 Explain the term “vulnerabilities” in emergencies (20 marks)

PART C033.1 What do you understand by the term “ergonomic hazards” (25 marks)3.2 List five situations where agricultural workers are ergonomic hazards (20 marks)3.3 State the health outcomes of the ergonomic hazards mentioned in 3.2 (25 marks)3.4 What strategies would you adopt to prevent the effects of ergonomic hazards in agricultural workers? (25 marks)

PART D044.1 List the medico-legal significance of defense injuries (10 marks)4.2 Describe the injury pattern/s seen in self-inflicted injuries (40 marks)4.3 How do you differentiate ante-mortem from post-mortem burns at autopsy? (50 marks)

PART E055.1 Define the term “contusion” (20 marks)5.2 List the factors that determine the appearance of a contusion (30 marks)5.3 What forensic information can be gathered by examination of an abrasion ( 50 marks)

PART F06

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 PERADENIYADOCTOR IN SOCIETY (DIS STREAM)

2 hoursAnswer all the questionsPlease use a separate answer book for each question

PART A1. 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 B2.

2.1. Describe common health problems among the elderly (50 marks)

2.2. Explain “comprehensive geriatric assessment“ (50 marks)

PART C3. 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 01995-1999 52000-2004 72005-2009 10

Following table gives national mortality rates (per 1000 population) specific for age group and calendar period:

Period

Age group

1990-1994 1995-1999 2000-2004 2005-2009

35 to 39 3.3 3.1 2.7 2.540 to 44 3.8 3.4 2.9 2.745 to 49 4.2 3.4 3.2 2.950 to 54 4.3 3.9 3.7 3.5

3.1 Calculate the total number of person years contributed to the study by the workers (25 marks)3.2 Calculate the expected number of deaths for each period (25 marks)3.3 Calculate the SMR (Standardized Mortality Ratio) (25 marks)3.4 How would you interpret your results in 3.3 (25 marks)

PART D4.

4.1 Discuss the role of the judicial medical officer at the scene of a crime(60 marks)

4.2 Explain the terms;4.2.1 Testimonial capacity (20 marks)4.2.2 Testamentary capacity (20 marks)

PART E5.

5.1 What constitute medical negligence (40 marks)5.2 What are the defenses a medical officer would have , if accused of medical negligence? (60 marks)

PART F6. 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)


SEPTEMBER 2008DOCTOR IN SOCIETY

Answer all 6 questions

Answer each question in a separate answer book. Time : 2 hours

1. State the different strategies used for the prevention and control of a mosquito borne disease. (100 marks)

2. 2.1 Name five main functions of the Division of Occupational Hygiene, Department of Labour. (25 marks)2.2 Explain the relevance of “biological monitoring” in occupational

hygiene. (45 marks)2.3 List three reasons for conducting regular medical examinations for

employees of a garment factory. (30 marks)

3. 3.1 A 30 year old mother of two children comes to the Medical Officer of Health (MOH) to get advise on family planning. What other information should you gather from the history and examination in order to counsel this female to select an appropriate family planning method? Give reasons for your answer.

(70 marks)3.2 Acceptance of Ligatiion and Resection of Tubes (LRT) as a method of

family planning has reduced over the past few decades.Give reasons for the above. (30 marks)

4. 4.1 What do you understand by the term ‘Scene of crime’? (10 marks)4.2 You are called to visit a scene of a burnt house with a burnt dead body

in the house4.2.1 Describe how you would determine whether the individual was

alive or dead at the time of burning. (40 marks)4.2.2 State the medicolegal significance of a ‘defense injury’on this

victim. (10 marks)4.3 Describe with examples the different methods available to determine

the time at which a particular injury was inflicted. (40 marks)

5. 5.1 Describe what is meant by the term ‘proffesional misconduct’(30 marks)

5.2 List the factors necessary to prove ‘civil medical negligence’(20 marks)

5.3 Explain four defences available to a medical practitioner who has been charged with medical negligence. (50 marks)

6. A bomb explosion has occurred with many deaths

6.1 State the role of the police in assisting the medical officer investigating the scene. (20 marks)6.2 State the possible hazards that a member of the investigating team can

be exposed, at the scene. (20 marks)6.3 Describe the medicolegal duties of a medical officer who visits the scene. (60 marks)


MAY 2011DOCTOR IN SOCIETY

Answer all questionsAnswer each question in a separate answer book. Time : 2 hours1.1.1.1 List five common occupational hazards that could occur in a ceramic factory. (15 marks)1.1.2 How can the effects of each of these hazards be prevented? (35 marks)

1.2 Explain how the health of the community is protected by proper implementation of legal measures relating to occupational health. (50 marks)

2.2.1 Describe lifestyle factors that contribute to the increase of cardiovascular diseases in Sri Lanka. (50 marks)2.2 What advice would you give a woman to minimize the risk of breast cancer? (50 marks)

3.Explain the importance of;3.1 Ante natal care given at the community level (60 marks)3.2 Maternal death investigation (40 marks)

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. (70 marks)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 (10 marks)ii. Manual strangulation (10 marks)

iii. Sexual assault (10 marks)

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. (50 marks)5.2 Describe the pattern of injuries you would expect to see if the death was due to the fall. (30 marks)5.3 List 4 methods you would apply for dating of injuries. (20 marks)

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. (25 marks)6.2 Describe the autopsy findings that would indicate that the person was alive during the fire. (75 marks)

FACULTY OF MEDICINE UNIVERSITY OF PERADENIYAYEAR 4 SEMESTER 1 EXAMINATION FOR MEDICAL DEGREES,

AUGEST 2010COMMUNICATION, 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


MAY 2011DEFENSES OF THE BODY MODULE

Answer both questionsDuration : 1/2 hours

1. Outline the developmental pathway of B & T lymphocytes to explain the maturation of these cells in humans. (100 marks)

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. (100 marks)

Health & Medicine

YEAR 3 MODULE PAPERS Faculty Of Medicine, University Of Peradeniya