Coc revision

The Novel Coronavirus is;

O An RNA virus

O A DNA virus

O A non-enveloped positive st1rand RNA virus

O An enveloped positive strand DNA virus

Concerning aplast1c anem1ia:

O Azathioprine can correct it

O Farmers using ins,ecticides are at risk

O The defi:nitive management is blood tra:ns

O Pregnancy is protectiv,e
About Asthma:

O Theophylline derivatives ( Franol tablets), are used in combination with salbutamol tablets to achieve better outcomes

O The difference in asthma and COPD is the irreversibility of the airway

O For acute asthmatic attack salbutamol inhaler is helpful

O Oxygen administration is of no value in status asthmaticus

One of the following is NOT a criteria for diagnosiis of rheumatoid arthritis

O Evening stiffness

O Arthritis of three or more joint areas

O Arthritis of hand joints

O Rheu:matoid nodules
Cerebrospinal fluid (CSF) resullts interpretation:

O In viral meningitis protein may be normal or increased

O In the pres,ence of subarachnoid hemorrhage opening pressure wrn be decreased

O In acute bacterial meningitis glucose is increased

O CSF collor is cloudy in viral meningitis

Deficien,cy of zinc results in the folllowing conditions:

O Growth and mental 1retardation

O Renall failure

0 Hepatitis
=piglottitis:

O Can be safely examined by depressing the tongue

O Presents with drooling of saliva

O Rhonchi are audible on auscultation

O Responds well to antiviral agents

Meningitis in the neonatal period:

O Is best treated with double the dose of Benzyil Penicirnn in a 3 day old baby

O CSF analysiis mostly yields negative results thus it is not necessary

O Is mostly caused by group B beta hemolytic streptococcus

O Is a known cause for congenital hydrocephalus

Which of the folllowing is a common problem of prematurity?

O Hyperglyce:mia

O Cerebral pallsy

O Temperature instability

O Poor weight gain

Rajab is 14 months old, weighs 12 kgs has the following complains by the mother; diarrhoea for 21 days, fever for 4 days. He comes from high malaria risk zone. On further assessment Rajab
h temperature of 37.5 degrees Celsius. He is irritable and restless, drinks eagerly when offered a drink and skin pinch return takes 1-2 seconds. The classification for Rajab is;

O Some dehydration with malaria

O Some dehydration, with malaria and persistent diarrhea

O Some dehydration, severe persistent diarrhoea and malaria

O Some dehydration and fever, malaria unlikely

Rajab is 14 months old, weighs 12 kgs has the following complains by the mother; diarrhoea for 21 days, fever for 4 days. He comes from high malaria risk zone. On further assessment Rajab has
temperature of 37.5 degrees Celsius. He is irritable and restless, drinks eagerly when offered a drink and skin pinch return takes 1-2 seconds. The classification for Rajab is;

O Some dehydration with malaria

O Some dehydration, with malaria and persistent diarrhea

O Some dehydration , severe persistent diarrhoea and malaria

O Some dehydration and fever, malaria unlikely

't'ou have been posted to a surgical ward for your internship at Kimangu Sub County Hospital. A patient in that ward is due for an emergency exploratory laparotomy. Which of the following is not a
mandatory investigations to do?

O Blood for full hemograms

O Liver Function Tests

O Blood for grouping and cross-match

O Blood for urea and electrolytes

Free air under the diaphragm is a sign of;

O P,erforated peptic ulce1r

O z,ollinger EIUson syndro,m1e

O Gast1ric carcinoma

O Gast1ric volvulus
Skeletal traction is one of the orthopedic appliances used in the management of fractures. If the traction is to be applied at the tibial tuberosity /tibial tubercle, which of the following is true;

O It is inserted from medial to lateral

O It is inserted from lateral to medial

O It can cause damage to perinea! nerve

O It can cause damage to popliteal artery

some tractures cannot heal on conservative management tor various reasons. Which ot the toIIowing is a primary indication tor open reduction and internal t1xation ot tractures;

O Multiple injured patient

O Fracture dislocation

O Fractures in children

O Fracture of the phalanges of the hand

A 40 year old female who presents with none progressive dysphagia to both solids and liquids is likely to be having;

O Cancer of the esophagus

O Esophageal stricture

O Achalasia of the cardia

O Reflux esophagitis
In patients identified to be at risk of Gestational Diabetes Mellitus (GDM), Which laboratory screening test is used for early detection?

O Random Blood Sugar

O Fasting Blood Sugar

O Oral Glucose Tolerance Test

O Serum Insulin levels

In assessing BISHOP score before cervical ripening for induction of labor, which of the following cervical characteristics is NOT assessed?

O Effacement

O Position of presenting part and position of the cervix

O Cervical dilatation

O Color of the cervix

Hae1mophilus ducreyi is a causative organis'm for which of the following disease?

O Ghancroid

O Chancre

O Lym1phogranuloma venereum

0 Syphilis
Metrorrhagia:

O Is irregular and intermenstrual bleeding

O Is frequent menstruation

O Is common in the postmenopausal population

O Is heavy and prolonged menstruation

Regarding the pathophysiology of placenta previa, which of the following statements is FALSE?

O Placental implantation is initiated by the embryo adhering in the lower uterus

O Bleeding is thought to occur in association with the development of the lower uterine segment in the third trimester

O Thrombin is not released from the bleeding sites

O Placental attachment is disrupted as the lower uterine segment gradually thins in preparation for the onset of labor.
erosols in TB transmission is generated through:

O Eating

O Over crowding

O Poor ventilation

O Sneezing
Which of the following statements is true about definition of occupational diseases:

O They are illnesses which gets cured or get better when one gets a job

O It's an illness resulting from job-related exposure

O It's an illness that occurs when one is in the working area but disappears once you go away

O It's an illness that comes when one does not like the job they are doing
Regarding nutrition during pregnancy

O The weight of a woman prior and during pregnancy has no bearing on the outcome

O Energy requiirements are much higher during the first trimester

1

O !inadequate intake of proteins is associated with prematurity and low birth weight

O Craving during pregnancy has no cultural and behavioral aspects

The following is true about primary health care

O Is the first level of contact of the individuals and families to the health care system

O Communities participate through their representatives

O The cost of maintaining it is not an i'mportant consideration

O Government has no role to play

Which of the following is an advantage of Home Based care?

O It evokes feelings of ownership and accountability

O It ensures that non-health needs are met

O It does not allows people to spend their days in familiar surroundings

O It promotes duplication of tasks between stakeholders

People do not voluntarily accept any responsibiUty under the;

0 YTheory

O XTheory

O Herzberg's theory

O Maslow Theory
As a Clinical Officer, you may be required to go to court to give evidence. Which of the following statements is true?

O The evidence should be of a person you never treated or examined

O The court will ask about your opinion on the particular case

O Carefully written and detailed notes are a prerequisite for a good evidence

O It's always possible to remember the circumstances of the case once summoned
Which of the following members does not belong to the County health management team?

O County Clinical Officer

O The Director of Medical Services (DMS)

O County Medical Officer of Health

O County Public Health Nurse

One of the major challenges facing delivery of quality healthcare services in Kenya is;

O Effective referral system

O Majority of the sick population live in urban areas

O Chronic shortages of medical supplies at public facilities

O Experts well distributed in the country

An objective of job appraisal includes:

O Providing a basis for removing unproductive workers

O Creating a favorable impression about the organization in the new employee

O Helping the new empfloyee adjust to the job quickly

O ldentifying employee strengths and weaknesses

1) Mr. DW 24 years old has been admitted to the medical ward. He complains of palpitations, easy fatigability, and chest tightness. His mother says DW has been unwell sine
after a sore throat, she tells you DW has been getting monthly injections at the nearest dispensary. An echocardiogram done one year ago shows mitral valve damage. He is
Temperature of 39 degrees. He has a splinter hemorrhage. On auscultation, you hear a grade 3 murmur. Blood cultures show Streptococci Viridans and Staphylococcus aun

a) What was the diagnosis 15 years ago (2 marks)

b) What is the likely diagnosis at this admission {2 marks)

:::) List 4 relevant investigations in this admission (4 marks)

:l) What is the definitive treatment for DW? {2 marks)

e) List four (4) possible complications of this condition ( 2marks)

Home-based care (HBC) is a contemporary concept in the management of patients with chronic illnesses such as cancer, PTB, and HIV/AIDS

a) What is home-based care (HBC)? (2 marks)

b) Identify four (4) key players in HBC (4 marks)

c) State four (4) reasons why HBC is important (4 marks)

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