Thursday, February 17, 2011

DIP APR 2009

APRIL 2009
Date : 27th April 2009 Time : 1.00 p.m. - 4.00 p.m.
Answer all questions.
Each question to be answered in a separate book.
1. A 30 year old married woman was referred to the STD clinic by a medical officer
of health (MOH) in her second pregnancy at a period of amenorrhoea (POA) of
20 weeks with a positive VDRL report. Further serological tests done at the STD
clinic confirmed the diagnosis of early latent syphilis. She was given
erythromycin for two weeks as she was allergic to penicillin. She defaulted for
follow up. Later she was referred to the STD clinic by a paediatrician with a three
day old neonate with a skin rash and blood stained nasal discharge.
1.1. Discuss the management. (70 marks)
1.2. Outline the steps that could have been taken by the medical officer in the
STD clinic to prevent the neonate getting affected. (30 marks)
2. HIV / AIDS Surveillance is an important area in a AIDS Control Programme.
2.1. Define surveillance in HIV. (10 marks)
2.2. What is sentinel surveillance in HIV ? (20 marks)
2.3. Outline the importance of HIV surveillance data. (30 marks)
2.4. Discuss second generation surveillance in HIV. (40 marks)
3. A 40 year old man presented to a dermatologist with oral thrush and
difficulty in swallowing. The patient was referred to the Central STD Clinic
with a confirmed positive HIV antibody test. Outline the management of
this patient. (100 marks)
4. A group of 1600 injecting drug users were enrolled in a prospective cohort
study to assess risk behaviours. At the time of enrolment 400 subjects were
found to have at least one STI. During one year of follow up 300 out of the
1200 who were free of STI at baseline, developed an STI.
4.1. Calculate the prevalence of STI at baseline. (15 marks)
4.2. Calculate the incidence rate of STI. (15 marks)
The scientific paper reporting the findings of the above study stated as
“ The relative risk for developing an STI was 2.2 (95% confidence
interval 1.3 to 3.4; p = 0.008) for non condom users compared to
condom users.”
4.3. Explain the meaning of the above statement. (30 marks)
4.4. Describe briefly the problems associated with the conduct of cohort
studies. (40 marks)
5. A 25 year old pregnant woman with a period of amenorrhoea (POA) of 28
weeks presented to the obstetrician with lumpy lesions in the genital area of
three weeks duration. She was referred to a STD clinic and was diagnosed
as having genital warts. Discuss the management. (100 marks)

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