8th Level Lok Sewa Aayog Solved Exam Paper – Health

8th Level Lok Sewa Aayog Solved Exam Paper Health

Actiology, symptoms, signs, investigations and curative and preventive management of the following health-related problems:

Section A – 30 Marks

General Medicine:

1.1 Respiratory Diseases: Acute Bronchitis, Chronic Obstructive Airway Disease, Bronchial Asthma, Pneumonia, Tuberculosis, Bronchogenic Carcinoma, Bronchiectasis, Occupational Lung Diseases, Respiratory Failure, SARS, Pleuraleffussion, Pneumothorax, Bird Flue
1.2 Cardiovascular Diseases: Rheumatic Fever, Rheumatic Heart Disease (MSMR, AS, AR), Congestive Cardiac Failure, Acute LVF, Ischemic heart disease, Myocardial Infarction, Hypertension, Infective Endocarditis, Congenital Heart Diseases, Cardiomyopathies, Cor pulmonale, Cardiacarrhytmias, Cardiogenic Shok
1.3 Gastrointestinal Disease: Acid Peptic Diseases, Cirrhosis of Liver and ascitis, Hepatitis, Hepatic Coma, Abdominal Tuberculosis, Pancreatitis, WormInfestation, Ulcerative, Colitis, Carcinoma of Gastro-Intestinal Tract, Gastroenteritis, H pylori, Gastro-oesophageal reflux
1.4 Blood and Lymphoreticular Diseases: Anaemia, Leukaemia, PurpuraAgranulocytosis, Polycythemia, Reticulosis, Lymphomas
1.5 Neurological Diseases: Cerebro-Vascular Accident, Meningitis, Encephalitis, Parkinsons Disease, Paraplegia, Multiple Sclerosis, Myasthenia Gravis, Epilepsy, Neuro-cysticercosis, Bells palsy, GBS, Neurosyphilis, ComaHeadache, Spin Bifida, Neurogenic Shok, Coma, Cerebral Malaria
1.6 Endocrine and Metabolic Diseases: Diabetes Mellitus, Non-ketotic Coma, Ketoacidosis, Thyrotoxicosis, Hypothyroidism, Cushings Syndrome, AddisonsDisease, Hyperparathyroidism, Tetany, Hypogonadism, Diabetes Insipidus
1.7 Joint and Collagen Diseases: Rheumatoid Arthritis, Gout, Systemic lupus erythematosus, Osteoarthritis, Osteomalacia and Osteoporosis, Ankylosing, Spondylitis
1.8 Renal Diseases: Urinary Tract Infection, Acute Glomerulonephritis, NephroticSyndrome, Urinary Calculi, Renal Failure, Tuberculosis, Neoplasm, Acidosis, Alkalosis, Hyperkalaemia, Kidney Transplantation
1.9 Tropical Diseases: Cholera, Enteric Fever, Malaria, Filariasis, Kala-azar, Leprosy, Chickenpox, Amoebiasis, Mumps, Snakebite, Rabies, Insect bite, Tuberculosis, Food Poisoning, Tetanus, Scorpion Bite, Hornet Bite

7. Psychiatry: (Units 7& 8 = 10%)
Emotional Disorders (anxiety, depression, sleep disturbance), Neurosis, Psychosis, Psychosomatic Disorders, Anorexia nervosa. Substance abuse (alcohol/drugs/ others)

8: Dermatology and STD:
(i) Dermatology: Urticaria, Scabies, Dermatophytosis, Herpes Simplex, Herpes Zoster, Psoriasis, Lichen Planus, Pemphigoid, Pemphigus, Drug Eruption (ii) STD: Syphilis, gonorrhoea, Non-Specific Urethritis. HIV, AIDS including Universal Precaution

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14. Pharmacology: (Units 14& 15 = 10%)
Poison and Toxicology- Organophosphorus, Barbiturates, Corrosives, Heavy metals, Mushroom poisoning, Drugs in pregnancy and lactation, Prescribing in children and elderly, Dosage, Preparation, Mode of action and side effects of drugs acting on different systems of the body

15. Emergency Medicine:
Management of Acute poisoning, Coma, Acute pain abdominal & chest, StatusEpilepticus, Acute severe asthma Breathlessness, Epistaxis, Vaginal bleeding, Shockincluding anaphylaxis, Multiple trauma including blunt abdominal injury, Haemoptysis, haematemesis and melaena, RTA, Trauma, Cut down Poisoning,m Insect bite, Snakebite, Catheterisation, NG Tube Insertion

Section B – 30 Marks

2. General Surgery: 10%
Sinus, Fistula, Fissure, Polyp, Ulcer, Tumour, Hernia, Hydrocoele, Burn, Shock, PepticUlcer, Pyloric Stenosis, Haematemesis and Malena, Oesophageal Varices, IntestinalObstruction, Paralytic ileus, Acute Abdomen, Ac Appendicitis, Typhoid Perforation, Perforated Peptic Ulcer, Lymphadenitis, Haemorrhoids, Gall Stones, Urinary Stones, Liver Abscess, Hydatid Cyst, cholecystitis, Billary Obstruction, Pancreatitis, PainAbdomen, Pneumothorax, Pleural Effusion, Haemothrorax, Chylothorax, Bronchiectasis, Pulmonary Embolism, Lung Abscess, Brondchogenic Carcinoma, Thrombo-angitisobliterans, Chyluria, Deep Vein Thrombosis, Head Injuries, Phimosis, Para-Phimosis, Pinhole Meatus, Stricture Urethra, Carcinoma Penis, Hydronephrosis, Retention of Urine, Enlarge Prostate, Incontinence of Urine, Vasectomy, Goiter, Tumours of Testis, Lymphomas, rupture spleen, Carcinoma of Bladder, Hydramnios, Breast abscess and Carcinoma breast, Hypovolemia, Oliguria, Ac Retention of Urine, SuprapublicCystosmy, Wounds

9. Ophthalmology Trachoma: (Units 9, 10& 16 = 10%)
Injuries of Eye, Foreign Body in Eye, Conjunctivitis, Refractive Error, Malignancy of Eye, Diabetic and Hypertensive Retinopathy, Stye, Chalazion, Blepharitis, Cellulitis, Cellulitis, Corneal Ulcer, Karatomalacia, Scleritis and Episcleritis, Choroiditis, Eridocyclitis, Cataract, Glaucoma, Trachoma, Vitreous Haemorrhage, Optic Neuritis, Retinal Detachment, Myopia, Hypermetropia, Astigmatism, Presbyopia, Diplopia, Squint, Proptosis Ephiphora, Dacryocystitis, Dacryoadentis, Ocular Hazards in agriculture and Industry

10. Ear, Nose and Throat:
Foreign Bodies in Ear, Nose and Throat, Otitis Media, Otitis Externa, Mastoiditis, Mastoid abscess Rupture of Tympanic Membrane, Meniere’s Disease, Hearing Loss, Rhinitis Nasal Allergy, Polyp, Epistaxis, Sinusitis, Tonsillitis, Peritonsillar Abscess, Pharyngitis, Ludwigs Angina, Hoarseness of Voice, Laryngotracheitis, LaryngealObstruction, Diptheria, Tracheostomy, Carcinoma of Larynx, Wx in Ear, HaematomaAuris, Furunculosis, Septal abscess, Rhinosporidiosis Otomycosis

16. Dental:
Castries, Extraction of teeth, Caries teeth, Gingivitis, Pulpitis, Root abscess, Leucoplakiacarcinoma of gum, Pericoronitis, Dentigerous cyst

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11. Bone and Joint Disease: (Units 11, 12 & 13 = 10%)
Fracture, Dislocation, Crush Injury, Amputation, Osteomyelitis, Tubercular Spine, Septic Arthritis, Erb’s palsy, Synadactily, Poliomyelitis, Rickets, Artificial Limbs, Spondylosis, Physiotherapy

12. Anaesthesiology & Emergency:
Principles of administering safe general anaesthesia, Local Anaesthesia, Pre-anaesthetic history, Pre-anaesthetic drugs, Anaesthetics, Post-anaesthetic complications, Basic life support and cardiopulmonary resuscitation, Lumbar Puncture, Intubation

13. Pathology:
Interpretations of laboratory results, Normal values of biochemical and haematological tests, Aetiology, Pathogenesis, Microscopic and Macroscopic features of different disease entities listed under different subjects and mentioned under heading 1 to 5 and 8 to 11

Section C – 20 Marks

3. Obstetrics and Gynaecology: 10%
Antenatal, Natal and Postnatal care, Pregnancy Induced Hypertension, Eclampsia, Tuberculosis, Diabetes Mellitus and Rheumatic Heart Diseases in relation to Pregnancy, Hyperemesis Gravidarum, Stages of labour, Retained Placenta, Ruptured Uterus, Foetal Distress, Maternal Distress, Prolonged Labour, Obstructed LabourLeucorrhoea, Antepartum and Postpartum Haemorrhage, Abortion, MultiplePregnancy, Hydramnios, Foetal Malformation, Endometriosis, Tumours of GenitalTact, Ovarian cyst, Fibroid, Genital prolapsed, Family Planning

4. Childhood Diseases: 10%
ARI, Measles, Mumps, Pertussis, Poliomyelitis, Diphtheria, Tuberculosis, EntericFever, Diarrhoeal Diseases, Pneumonia, Lung Abscess Cellulitis, Candidiasis, Meningitis, Rheumatic Fever, Worm Infestations, Cyanotic Congenital Heart Disease, Cretinism, Protein-energy Malnutrition, Downs syndrome, Turner Syndrome, rickets, Vitamin A Deficiency, Mental Retardation

Section D – 20 Marks

5. Community Medicine: 10%
Demography, Sociology and social understanding of health, Socio-cultural patterns, Social Problems and Social Changes, Health Economics, Gender and Environmental issues, Effective doctor-patient relationship Sociological research methods, Epidemiology, Investigation of an Epidemic in District, Problem Solving Exercise on the Epidemic of Infection Diseases, Infectious Diseases, Bacterial, Viral, Fungal, Protozoal, Metazoals, Cestode, Nematode, Epidemiology of Non- infectious, and Chronic Diseases, Biostatistics, Safe Water and Sanitation, Food Sanitation, Insects and Rodent Control, Housing, Concept of Health Education, Principles of behaviour change Communication, Group Dynamics, Methods and Media and Health Education, Nutrition and Health, Breast Feeding, Complementary Feeding, Food Hygiene, Adulteration and Food Processing, Nutritional Education and Surveys, RH and SafeMotherhood, CBR. EPI, IMCI, Growth monitoring, School Health, Occupational Health, Health Care Delivery System in Nepal, Problem of the Health Care Delivery System, District Health System, Management and Administrative Requirement of the Job Descriptions as drawn up by the Ministry for Medical Offices

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6. Forensic Medicine and Jurisprudence: (Units 6& 17 = 10%)
Role and Duties of Medical Practitioner, Post-mortem and its Legal Implication, Medical Ethics, Death, Rigor Mortis, Putrefaction, Mummification, Saponification, Wounds, Rape, Infanticide, Abortion, Homicide, Suicide, Procedure for Identifyingliving person and a dead body

17. Acts related to Health and Medical Profession:
Nepal Health Services Act, Nepal Health Service Regulation, National Health Policy, Second Long Term Health Plan, Nepal Medical Council Act, Mothers Milk SubstituteAct, Legalization of abortion, Organ Transplant Act, other health-related acts.

Sample Questions

1. A 12- year-old girl comes to you with severe pain in the right ear since last night She is suffering from Ac. coryza for last 5 days, for which she had some treatment. OnOtoscopy right eardrum is red and bulging. In which quadrant of eardrum will you do myringotomy?
   A) Anterior superior B) Anterioinferior C) Posteriosuperior D) Posterioinferior
   Correct Answer:- (D)
2. In the acute abdomen the first imaging of importance is:
   A) Plain X-ray Abdomen
   B) Barium Meal X-rays
   C) CT scan of Abdomen
   D) MRI of the abdomen
   Correct Answer:- (A)
3. All are true about pressure sores except
   A) Occur over bony Prominence
   B) Are common in Paraplegics
   C) Are caused by injury
   D) Are also called decubitus ulcers
   Correct Answer:- (C)
4. Ringer lactate contains all except
   A) Sodium B) PotassiumC) Bicarbonate D) Chloride
   Correct Answer:- (C)
5. Live Vaccines are usually used for active immunization against
   A) Pertussis
   B) Typhoid fever
   C) Mumps, Measles and rubella
   D) Hepatitis B
   Correct Answer:- (C)
6. In HIV infection
   A) 80% of vertically transmitted infections are transplacental
   B) A child born to an infected mother has a 90% chance of acquiring HIV
   C) Transmission can occur via breast milk
   D) Risk of fetal transmission is unaffected by pre-partum antiviral agents
   Correct Answer:- (C)

(Sample questions)
1. Describe the full form of HIV and AIDS, What are the routes of transmission?
2. How you will manage a case of epistaxis in the primary health care centre?
3. How you will manage a patient with severe chest pain in the District Hospital?
4. Why the maternal mortality rate is so high in Nepal? What will be your steps to bring it down?
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