ICM 2219: COMMUNICABLE/INFECTIOUS DISEASES Past Paper

W1-2-60-1-6
JOMO KENYATTA UNIVERSITY
OF
AGRICULTURE AND TECHNOLOGY
UNIVERSITY EXAMINATIONS 2014/2015
EXAMINATION FOR THE DEGREE OF BACHELOR OF SCIENCE IN CLINICAL MEDICINE (MATURE ENTRY/UPGRADING)

ICM 2219: COMMUNICABLE/INFECTIOUS DISEASES
DATE: AUGUST 2014 TIME: 2 HOURS

INSTRUCTIONS:
This paper has two THREE sections
SECTION 1: Answer ALL questions
INSTRUCTIONS: Indicate true or false against each provided choices. A half mark will be deducted for each incorrect response. No mark will be deducted or given where there is no response
1. The following statements about communicable diseases are true;
a) They are not common
b) They cause death and disability
c) Have a potential of causing epidemics
d) Can be agents of terrorism
e) Do not affect infants and children
2. The classification of communicable diseases include;
a) Contact diseases
b) Sexually transmitted diseases
c) Diabetes mellitus and hypertension
d) Helminthic diseases
e) Airborne diseases
3. The following are examples of communicable diseases
a) Anthrax
b) Dysentery
c) Leshmaniasis
d) Malaria
e) Plague
4. Which of the following are determinants of disease factors
a) Agent
b) Host
c) Environment
d) Politics
e) Vectors
5. The following are main transmission roots of communicable diseases
a) Direct contact
b) Vectors
c) Faecal oral
d) Airborne
e) Trans placental
6. The high prevalence of STD (Sexual transmitted diseases) among females 14-19 years can be attributed to;
a) Females at this age are more careless than males
b) Girls become sexually active earlier than boys
c) The genital tract of young girls is especially vulnerable to infection
d) Girls tend to have sex with old male partners who have more sexual experience
e) Their immunity is generally low
7. The risk factors for sexually transmitted illnesses include
a) Social factors
b) Behavioral factors
c) Biological factors
d) Economic factors
e) Age
8. These are complication of sexually transmitted illnesses except
a) Infertility in women
b) Infertility in men
c) Blindness in infants
d) Intestinal obstruction
e) Genital cancer
9. Which of the following are advantages of the syndromic approach in management of STI’s
a) It is able to respond to patient lymptoms
b) It increases access to STI care
c) It is highly specific
d) It is highly sensitive
e) It is time consuming
10. A diagnosis of STD can be confirmed by;
a) Urethral smear for men
b) High vaginal swab
c) Urinalysis for microscopy
d) Rectal swab
e) Pelvic x-ray
11. The following microorganisms can cause meningitis
a) Viruses
b) Bacterial
c) Fungi
d) Parasites
e) All of the above
12. The predisposing factors to developing meningitis include
a) Mastoiditis
b) Head injury
c) Malnutrition
d) HIV
e) Overcrowding
13. Indicate True or False
a) Csf glucose is high in bacterial meningitis
b) Csf glucose is warmed in viral meningitis
c) Csf protein is low in fungal meningitis
d) Csf protein is low in tuberculosis meningitis
e) Protein is low in acute viral meningitis
14. HIV 1 and HIV 2
a) Both types can be sexually transmitted
b) HIV 2 is more aggressive than HIV 1
c) HIV 2 is common in the East African region
d) None of the above is true
e) Both types can be transmitted transplacenally
15. The following are examples of opportunistic infections in HIV
a) Kaposis sarcoma
b) Non Hodgkins Lymphoma
c) Herpes simplex
d) Squamous cell carcinoma of the conjunctiva
e) Tuberculosis
16. The HIV disease clinical staging is meant to assist the clinician achieve
a) Monitoring of the patient
b) Determine prognosis
c) Inform the patient their likely time of death
d) Determine timing of ARV therapy
e) Assessment of clinical response
17. The following conditions are in stage III WHO (WHO) disease clinical staging for HIV
a) Tuberculosis
b) Hairy oral leukoplakia
c) Hepato splenomegaly
d) Oral thrush
e) Pneumolystics jiroveci pneumonia
18. Match the organisms in column A with the likely disease in column B
A B
a) Cryptosporidium parvum Space occupying lesions
b) Toxoplasma Retinitis
c) Leshmania donnovani Visceral leshmaniasis
d) Cytomegalo virus (CMV) Chronic diarrhea
e) Herpes simplex muco-ulcerative lesion
19. The following intervention strategies have been put by the government of Kenya to reduce HIV transmission
a) Promotion of voluntary counselling and testing
b) Post exposure prophylaxis
c) Isolation
d) Safe blood supply
e) Promotion of condoms for safer sex
20. Scabies is associated with the following
a) Immune compromised patients
b) Neurological disorder like dementia
c) The elderly
d) Patients on steroids
e) Higher social economic status
21. Scabies can be spread through skin to skin contact between;
a) Sex partners
b) Children playing together
c) Health workers providing care
d) Farmer milking a cow
e) Mother and child
22. The following factors contribute to development of TB;
a) Poverty
b) Having received BCG vaccination
c) Sexual contact
d) History of recent measles
e) Metabolic disorder e.g. Diabetis mellitus
23. The following factors increase the risk of TB
a) HIV/AIDS
b) Malnutrition
c) Leukemia
d) Chemotherapy
e) Silicosis
24. The following are late signs and symptoms of TB;
a) Haemoptysis
b) Lymphadenopathy
c) Gibbus deformity
d) Loss of weight
e) Fatigue
25. The differential diagnosis of PTB includes;
a) Lung abscess
b) Lung cancer
c) Sarcoidosis
d) Bronchtectasis
e) Fungal pneumonia
26. In management of tuberculosis the following drugs can be used;
a) Ofloxacein
b) Ethembutol
c) Rifompuin
d) Isoniazid
e) Streptomycin
27. DOTS strategy in management of TB ensures
a) Adequate supply of anti-TB drugs
b) Each patient is on correct treatment
c) Prompt defaulter tracing
d) Consolidation phase of treatment under supervision
e) Accurate patient record keeping
28. Before embarking on vector control a full understanding of the following vectors information is important;
a) Breeding places
b) Nesting places
c) Feeding pattern
d) None of the above
e) All of the above
29. The main was of vector control include;
a) Targeting adult vector using insecticides
b) Targeting the larvae stage using larvicides
c) Preventing breeding of the vector through environmental interventions
d) Targeting adult vectors using larviades
e) Protecting susceptible host
30. The following are examples of vector borne diseases;
a) Malaria
b) HIV/AIDS
c) Onchocerciasis
d) Trypanosomiasis
e) Tetanus
31. The following drugs are used in management of visceral leshmaniasis;
a) Amikacin
b) Sodium stibogluconate
c) Ampotencin B
d) Tenofovir
e) Lamivudine
32. The following statements about leshmaniasis are true;
a) Diagnosis of cutaneous leshmanias is by doing a splenic aspirate
b) Visceral leshmanias is exacerbated by HIV
c) Cutaneous leshmaniasis is also known as oriental sore
d) Cutaneous leshmanias is the commonest
e) Education of the population is important
33. The following statements about hand washing are true;
a) Warm water enhances action of soap
b) Wash hands for 1-2 minutes only
c) Soap can kill some microorganism
d) Wash hands with your fewellery on
e) Use of cloth towel to dry your hands is recommended
34. When is it most appropriate to do Hygienic hand washing
a) Before handling food, eating and feeding patients
b) After visiting the toilet
c) Before and after nursing the patient
d) Before and after touching wounds
e) Before and after touching urethral catheters
35. The following are examples of upper respiratory tract infection;
a) Common cold
b) Flu
c) Pharyngitis
d) Laryngitis
e) Larngotracheo bronchitis
36. The upper airway comprises the following;
a) Turbinates
b) Adenoids
c) Tonsils
d) Larynx
e) Bronchi
37. Symptom of upper respiratory tract infection commonly include;
a) Audible wheeze
b) Running nose
c) Sneezing
d) Fever
e) Cough
38. The complication of coryze include
a) Sinusitis
b) Pneumonia
c) Otitis media
d) Meningitis
e) Urinary tract infection
39. The prevention strategies for flu include;
a) Hand washing
b) No kissing on the mouth
c) Immunization
d) Isolation
e) Antibiotic treatment
40. Travel predisposes someone to the following diseases;
a) Influenza
b) Cholera
c) Yellow fever
d) Intussuspection
e) HIV/AIDS
SECTION II: ANSWER ALL QUESTIONS. Each question carries 5 marks
1. Outline the control and prevention strategies for communicable diseases (5marks)
2. Outline the three levels of disease prevention (5marks)
3. What kind of behavior determines the risk of getting an STD (5marks)
4. Briefly discuss the advice you will give your patients to reduce the likelihood of exposure to STDs (sexually transmitted illnesses) (5marks)
5. List examples of bacterial that cause acute bacterial meningitis (5marks)
6. List the factors that predispose the population to meningitis (5marks)
7. Briefly discuss the precaution you can take to protect yourself from occupational exposure to HIV (5marks)
8. Briefly discuss the relationship between nutrition and HIV (5marks)
9. Outline the various modes of HIV transmission with a brief explanation of their contribution to the global HIV epidemic (5marks)
10. Explain the common side effects of common anti TB drugs (5marks)
11. List the various ways that HIV influences TB (5marks)
12. List the complication of acute bacterial sinusitis (5marks)
SECTION III: ESSAY QUESTIONS – ANSWER ANY ONE QUESTION
1. Discuss the epidemiology, risk factor, clinical presentation and treatment of gonorrhea (30marks)
2. Discuss the epidemiological zones and the modes of malaria transmission (30marks)
3. Discuss the clinical presentation, prevention and control strategies for cholera (30marks)

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