FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2018

POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
FAMILY MEDICINE
PAPER-I
FLM/J/18/08/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. Ashok is a 27-year-old salesman who comes to you with the
complaint that he has increased frequency of defecation for the
past one month.
List the differential diagnoses.
Outline history, physical examination findings, investigations
which will be of help to differentiate between common
causes of increased frequency of bowel movement of recent
onset.
When will you entertain the diagnostic possibility of Irritable
Bowel syndrome? How do you manage it?

2. Rani is a 45-year-old lady presents with tiredness and fatigue.
She has not attained menopause. On examination, you find
that she is pale.
What are the causes for anaemia you would consider in
this patient?
What all specific points you would elicit in history and
physical examination in this patient to get a clinical
diagnosis?
What are the useful findings in haemogram in iron
deficiency anaemia and B12 deficiency?
How will you manage iron deficiency anaemia?

3. Lokesh is a 50-year-old businessman with a BMI of 35. He has
come to you for a health checkup.
How will you assess the health of this patient? Mention the
rationale for the investigations you would ask for.
What complications of obesity would you expect in him and
explain to him?
What advise will you give him to lose weight?

4. Write short note on the following vaccines for the adult
population:
Influenza vaccine
Pneumococcal vaccine
Hepatitis B vaccine
Human papilloma virus vaccine
Varicella vaccine

P.T.O.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2018

POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.

5. Clinical features and management of chronic plaque psoriasis.
5+5
6. Ramesh is a 30-year-old truck driver who has come with his
wife to discuss about his drinking habit.
Outline the CAGE questionnaire and it's use.
What treatment is given if he requires admission for alcohol
de-addiction?
What investigations will you order for his assessment?
What is your role as a Family Physician to help Ramesh
stay sober?

7. Role of Family Physician as the leader of the health care team.
10
8. Mrs Rajini is an 80-year-old lady on treatment for diabetes
mellitus and hypertension. She has come with her daughter
who is concerned that her mother fell the previous day. She
was not hurt as she fell on to a soft bed. The daughter would
like you to assess the risk for falls for her mother and wants
you to visit their house also as part of the assessment.
Describe briefly how you would make an assessment of the risk
of falls for Mrs Rajini:
History and physical examination
Assessment at home
6+4
9. Sandeep is a 24-year-old farmer whom you have diagnosed to
have pulmonary TB. He is sputum positive for AFB and stays
with his wife and 2 children aged 7 and 5 in a thatched house.
As his Family Physician, what would be your concerns and
role as a Family Physician in the management of
Sandeep?
Outline the common side effects of anti-tuberculous drugs
and how you would manage them
What is the role of nutrition in the management and
prevention of Tuberculosis?

10. Pradeep is a 40-year-old construction worker. His work
involves lifting heavy objects, carrying cement bags and
bending steel rods. He works from 8 am till 5 pm, most of which
is in the outdoors. The work area is also very dusty and noisy
and there are heavy machinery and sharp tools being used in
the site.
What are the occupational hazard risks that Pradeep
faces?
Write briefly on how to reduce the risk of harm to him due
to his work.
5+5