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 I
FLM/D/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 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. Mrs. Meera, a 60-year-old woman, comes with complaints
of bilateral, swelling of feet.
Mention two clinical signs you will look for that will
suggest it is congestive cardiac failure.
List three essential groups of drugs, with an example
that is used in management of congestive cardiac
failure with reasons.
Two weeks later, she comes back with worsening of
symptoms in spite of medical management. List
probable causes of refractory cardiac failure.

2. A 30-year-old male presents to emergency department
with sudden onset of abdominal pain.
List the clinical signs and symptoms of acute
pancreatitis.
What are the diagnostic features of acute pancreatitis
in laboratory investigation?
List steps of management of acute pancreatitis.
List long term complications of acute pancreatitis.

3. Mr. Raju is a 45-year-old male, who is a chronic smoker
for the past 30 years. He has come with history of
worsening breathlessness and frequent episodes of cough
for the past six months.
What are the specific clinical features and
investigatory findings for Chronic Obstructive
Pulmonary Disease
What is the role of the family physician in all levels of
prevention in COPD-Primordial, primary, secondary
and tertiary?
4+6
4. Mr. Ram, an Executive Chairman of a multi-national
company, is brought to you by his wife with complain of
for the past few weeks.
Mention the key features in diagnosis of depression.
How will you assess severity of his depression?
What are the risk factors for suicide in a depressed
person?
List criteria for referral to a psychiatrist in a case of
depression.

5. A 15-year-old boy is brought by his mother, as he is upset
because of his 'pimple on the face' problem:
Mention the life style modifications with regard to acne.
How will you treat various forms of acne according to
severity?
List four systemic causes of acne.

6. Draw the WHO pain management ladder, mentioning
the groups of drugs used with examples and their
common side effects.
How will you manage bladder pain in a patient with
advanced urinary bladder carcinoma?
7+3
7. What are the risk factors for Community Acquired
Pneumonia
What is the investigating work-up for CAP? Mention
reasons.
How will you prognosticate CAP? Mention criteria
used.
List the treatment options for CAP.

8. What are the various forms of urinary tract infection
Mention the etiological agents and their risk
factors.
A 30-year-lady presents with cystitis. Mention the
management plan for treating and preventing UTI in
her.
6+4
9. List the causes of hyponatremia.
Mention the investigating work up for a 60-year-old
man with hyponatremia.
How will you treat a patient with hyponatremia?

10. Mention the risk factors for pulmonary embolism
List the investigatory work-up for PE with reasons.
How will you treat PE?