FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2017

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
FAMILY MEDICINE
PAPER I
FLM/J/17/08/I
Time 3 hours
Max. Marks 100
Important instructions:
• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.
• Indicate the question number correctly for the answer in the margin space.
• Answer all the parts of a single question together.
• Start the answer to a question on a fresh page or leave adequate space between two answers.
• Draw table/diagrams/flowcharts wherever appropriate.
Write short notes on:
1. Mr. Raju is a 65 year old patient who was diagnosed to have
bronchogenic carcinoma with secondaries. He is on palliative
care now.
List the medical problems Mr. Raju could develop and how
you would manage them?
What are the social issues related to his survival that you as
his family physician would discuss with him?
7+3
2. A 75 year old comes to you to discuss about adult immunization.
What advice would you give him?
Pneumococcal vaccination in adults.
5+5
3. A 50 year old lady presents to you with history of generalised
aches and pains for past 3 months.
List the possible causes for these.
Outline appropriate history, physical examination and
investigations to assess this patient.
3+7
4. A 25 year old lady has come to you with drooping of one side of
the face from morning. She has clinical features of a right sided
lower motor neuron nerve palsy.
List the causes of LMN 7th nerve palsy.
How will you assess her further with history, physical
examination and investigations?
Management of Bell's palsy.

5. Mr. Gobul is an 80 year old businessman who is living alone in an
apartment in a city. His wife passed away a month ago and his
children live abroad. He is on medications for diabetes mellitus,
hypertension, dyslipidemia, ischaemic heart disease and cardiac
failure:
Social issues in the elderly and use of medications for Mr.
Gobul.
What advice will you give him for the safe use of medications?
7+3
6. Mr. prakash is a 45 year old who complains of erectile
dysfunction for the past 2 months.
How will you assess Mr. Prakash with appropriate history,
physical examination and investigations?
Medical management of erectile dysfunction.
5+5
7. Patient centred versus disease-centred medicine.
10
8. History, physical examination findings, investigations and
management of diabetic ketoacidosis.

9. Clinical features of psoriasis.
What aspects of the disease will you discuss with a patient
who has psoriasis?
Management of psoriasis.

10. Xpert MTB/RIF assay to diagnose tuberculosis.
10