FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2017

POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
FAMILY MEDICINE
PAPER II
FLM/D/17/08/II
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 question 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. Differentiate between arterial, venous and neuropathic
ulcers.
How will you investigate a person with ulcers in the
lower leg?
List the principles of management of bed sores.

2. A 40-year-old lady comes to you for routine breast
examination. You find a lump in her right breast.
List the criteria for urgent referral for her.
Mention the features of any benign breast disease.
What are the other clinical examinations you will do in
her for a preventive health visit?

3. A 50-year-old man comes to you with history of painful
swelling of left lower limbs for 4 days duration.
List the differential diagnosis with specific clinical
features.
List risk factors of deep vein thrombosis (DVT).
How will you investigate and treat a person with DVT?
Mention how you can prevent DVT.

4. A 35-year-old male presents to you with a history of
shoulder pain for the last one week.
What are the red-flags in history and in examination
with reasons?
How will you manage a person with adhesive
capsulitis?
6+4
5. A 20-year-old girl comes to you with a history of swelling in
the anterior neck.
List differential diagnosis with specific clinical features.
What are the red-flags in history and examination? List
with reasons.
As a family physician, how will you manage her if she
has a solitary nodule in her thyroid gland?

6. List the causes of a person presenting with a
What are the red-flags and their causes for urgent
referral to an ophthalmologist?
Describe briefly management of corneal ulcer.

7. A 55-year-old female labourer comes to you with
complaints of giddiness.
What are the red-flags you will elicit from her and why?
How will you investigate her?
How will you diagnose and treat benign positional
vertigo?

8. A 45-year-old peri-menopause lady comes to you with
history of brown coloured urine. Her urine dipstick
examination shows presence of blood.
List the causes of hematuria.
What are the red-flags you will elicit in her?
How will you manage her with appropriate referral after
preliminary investigations?

9. List the causes of erectile dysfunction
Mention the clinical and investigatory work-up for ED.
Medical management of ED.

10. You have been requested to do a pre-anesthetic work-up
of a 60-year-old patient going for a hernioplasty.
Mention the clinical and investigatory work-up you will
do with reasons.
What are the complications of spiral anesthesia? How
can you prevent them?
6+4