FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
APRIL 2016

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
FAMILY MEDICINE
PAPER I
FLM/APRIL/16/08/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.
1. A 30 year housewife, mother of 2 kids gives a history of recurrent
hospitalization times in last 1 year) with severe diarrhea,
vomiting collapse. Each time she got better with intravenous
fluids.
What relevant history would you ask for?
What clinical findings would you specially look for?
What investigations would you order?
What advise would you give to her family members?
2.5x4
2. A 44 year old man gives a history of hypertension detected few
years ago and is in treatment. He gives history of haematuria
recently and also 1 year ago. There is a history of vague flank
pain for the last few years. There is a family history of
hypertension in his siblings.
How would you investigate this patient?
What relevant histories would you enquire for?
What is the implication of the family history for the future
generation?
How would you manage the whole problem?

3. A 65 year old ex-smoker has shortness of breath, pedal oedema
and cough for last 1 year. Investigation reveals an EF of a
creatinine of 2.7 mg and hyperinflated lungs, and an HbA1c of
8%.
How would you start his treatment?
What investigations would you do keeping in view of his future
requirement possibilities?
What prophylactic measures must be taken?

4. What are the causes of reversible dementia? What investigations
are relevant for diagnosis?
4+6
5. What is common cold? Describe how weather is related to
increased susceptibility to viral infections. How will your treatment
attitude differ within a family with adults, children elderly
persons?

P.T.O.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
APRIL 2016

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
FAMILY MEDICINE
PAPER I
6. A young lady is recently diagnosed with moderate anaemia with
detection of thalassemia trait in her HPLC. How would you
proceed further with respect to the index patient and her family?
What advice would you give the patient with regard to her
marriage motherhood in future?
6+4
7. What are the clinical features and investigation findings in a
patient suffering from vascular Parkinsonism? What features will
distinguish the patient from idiopathic Parkinson's disease?

8. A 14 year old girl has fever for 2 weeks with painful red spots on
her skin. She also has a few cervical enlarged lymph nodes. How
would you proceed to investigate her further? What advice would
you give to the family?
7+3
9. A 15 year girl is diagnosed to have high blood sugar. There is no
history suggestive of keto-acidosis. She has a long history of
recurrent pain abdomen not requiring hospitalization over many
years.
What investigations are needed for her further evaluation?
How would you start her therapy?
5+5
10. What are the common causes of dilated cardiomyopathy? Briefly
outline management in an elderly patient with dilated
cardiomyopathy.
5+5