Dicm 206:Clinical Methods Question Paper

Dicm 206:Clinical Methods 

Course:Diploma In Clinic Medicine

Institution: Kenya Methodist University question papers

Exam Year:2013



CLINICAL METHODS (DICM 206) 1ST TRIMESTER 2013

KENYA METHODIST UNIVERSITY

END OF 1''ST ''TRIMESTER 2013 EXAMINATION
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : CLINICAL MEDICINE
UNIT CODE : DICM 206
UNIT TITLE : CLINICAL METHODS
TIME : 2 HOURS




INSTRUCTIONS

Write your registration number on each paper
Attempt all questions in Part A, B and C
Multiple choice questions
Correct response earns one mark
You lose one mark for every incorrect response
You do not lose a mark if you do not attempt
Answer all questions on MCQs paper

PART A : ESSAY

Question one

Discuss the history of the present illness in a patient who presented with the following complaints

Vomiting
Abdominal pain
Diarrhea

Question Two

How do you go about the examination of the respiratory system?

PART B: SHORT ANSWER QUESTIONS

Question One

List five areas you examined on the head

Question Two

Indicate which cranial nerve is affected when the patient complains of

Loss of smell
Taste disturbance
Lack of balance
Limitation of neck movement
Difficulty in chewing

Question Three

State the use of the following tools

Tendon harmer
Auroscope
Opthalmoscope
Spatula
Tuning fork

Question Four

Define the following terms

Alopecia
Anorexia
Polyphagia
Syncope
Tinnitus

Question Five

How is the 5th cranial nerve examined?

PART C: MCQs

Question One

While reviewing the skin the following symptoms are of importance

Colour
Sprains
Bleeding
Moisture
Body configuration

Question Two

Symptoms of autonomic system include the following

Urine incontinence
Atrophy
Involuntary movements
Paraesthesia
Erythema

Question Three

The following statements are true

Deviation on the trachea towards the lesion is due to pleural effusion
Neck stiffness may be due to meningitis
The use of accessory muscles of respiration is seen in asthma
Koilonychia means brittleness of the nails
Tinea corporis can cause alopecia

Question Four

Concerning genito-urinary system

Dysuria is an indication of urethral inflammation
A patient with a dysuria may also have urinary frequent
Lumbar pain may be an indication of pyelonephritis
Leukorrhoea is a symptom of menopause
A colicky pain in the lumbar region may be due to biliary stones.

Question Five

The following percussion notes are arranged in accordance with conditions that may produce them

Tympany – pneumothorax
Dullness – pneumonia
Stony dullness – intestinal obstruction
Hyperesonance – emphysema
Resonance – ascites

Question Six

The following statements are true

Vertigo is caused by lack of oxygen in the brain
Discharge from the ears is due to rhinitis
Epistaxis is nasal bleeding
Haematuria may be caused by schistosomiasis mansoni
Running nose may be due to allergy

Question Seven

The importance of family history is that it gives information on;

Hereditary conditions
Marital status
Occupation
Infectious disease
Cigarette smoking

Question Eight

The following statements are either true or false

Bleeding from the gums is due to deficiency of vitB12
Kopliks spots are seen on the mucous membrane of the mouth
Pharyngitis is the inflammation of the tonsils
Smooth tongue is due to iron deficiency
Polyps are growths on the surface of the nose.

Question Nine

Jaundice is best noted on the examination of

Conjunctivae
Frenelum of the tongue
Nail beds
Lips
Palm

Question Ten

The best position of the clinician when examining the

Spine is when seated infront
Respiratory rate, when seated infront
Cervical lymph nodes when seated infront
Chest when standing behind
Thyroid gland, when seated behind

Question Eleven

Under general examination, the following are not noted

Cleanliness
Texture of air
Pallor
Obesity
Koilonychia

Question Twelve

The following are cardio-vascular symptoms

Wheezing
Orthopnoea
Night sweats
Extertional dysponoea
palpitations

Question Thirteen

Central cyanosis is

Due to severe haemorrhage
Examined for on the nail beds
Confirmed by extremities being warm
Confirmed by the lips being blue
Confirmed by the tongue being smooth

Question Fourteen

Concerning the pulse

Tachycardia is when pulse rate is 80 per minute
Tachycardia is seen in a case of severe anaemia
Bradycardia is seen in pregnancy
Collapsing pulse is an indication of essential hypertension
Reduced pulse volume is a sing of shock

Question Fifteen

A patient with history of allergy may present with

Asthma
Goiter
Eezema
Dermatitis
Lymphadenopathy

Question Sixteen

On palpation the following qualities are appreciated

The texture of the skin
The stony dullness
The cardiac impulse
The vocal resonance
The fluid thrill

Question Seventeen

Concerning the examination of the abdomen

Symmetrically distended abdomen may be due to fluid
Visible peristalsis may be due to peritonitis
Caput meduse are seen in patients with cirrhosis of liver
Enlarged organ on the right hypochondrium is possibly the spleen
Visible scars on the abdomen may be surgical or traumatic

Question Eighteen

The reason for percussing the abdomen is

To detect the shape of a mass
To detect the extent of the liver and spleen
To differentiate the spleen from the left kidney mass
To detect muscle rigidity
To detect ascites

Question Nineteen

Retention of urine may occur in the following condition

Acute urethritis
Urethral stricture
Prostatic enlargement
Chronic glomerulonephritis
Schistosomiasis mansoni

Question Twenty

Concerning reflexes

Plantar reflex is a tendon reflex
Abdominal reflex is absent in upper motor neuron lesion
Normal corneal reflex will have one eye blink when touched with cotton wool
Babinskis sign is present when the great to is upward going in response to test
Ankle reflex is diminished in lower moton neuron lesion






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