REPUBLIQUE DU CAMEROUN REPUBLIC OF CAMEROON

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MINISTÈRE DE L’ENSEIGNEMENT SUPÉRIEUR MINISTRY OF HIGHER EDUCATION

COMMISSION NATIONALE D’ORGANISATION NATIONAL COMMITTEEE FOR THE ORGANIZATION

DES EXAMENS OF EXAMS

NATIONAL EXAM OF HIGHER NATIONAL DIPLOMA 2023 SESSION

Field: Biomedical Sciences
Specialty/Option: NUS, MLS, MID and MIT
Paper: Public health
Credit value: 6 Time Allowed: 3 hours
Instructions to Candidates: This paper is divided into sections A; multiple choice questions, Section B,
Structural and Section C Essay questions

SECTION A: MULTIPLE CHOICE QUESTIONS (25 MARKS)

1. Diphtheria is a highly infectious disease of

A. Upper respiratory tract

B. Lower respiratory tract

C.Upper and lower respiratory tract

2. Pertussis is most infectious during the …….phase

A. Catarrhal phase

B. Paroxysmal phase

C. Convalescent phase

3. Bronchopneumonia is a type of…… that causes inflammation in the aveoli

A. Pneumonia

B. Bronchitis

C. Tuberculosis

4. To help avoid contracting and spreading COVID-19, you should wash your hands
frequently with soap and water for a least seconds.

A. 10
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 B. 15

C. 20

D. 30

5. An intestinal inflammation primarily of the colon is

A. Typhoid fever

B .Dysentery

C. Diarrhoea

6. If you use an alcohol-based disinfectant solution, it should contain at least %alcohol.

A. 50

B. 60

C. 70
D. 99

7. Chicken pox is also called

A. Pertussis

B. Varicella

C. Lockjaw

8. The purpose is to limit the incidence of disease by controlling causes and risk factors

A. Primordial prevention
B. Primary prevention
C. Secondary prevention

D. Tertiary prevention

9. Which of the following is not a respiratory disease

A. Tonsillitis

B. Pneumonia

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 C. Diphtheria

D. Dysentery.

10. A study that measures the number of persons with influenza in a calendar year
A. Cohort study
B. Case control
C. Cross sectional
D. Case report

11. The most common complication of bronchitis is ;

A. Chancre

B. Pneumonia

C. Varicella

12. An infected person is less likely to encounter a susceptible person when a large proportion of
the members of the group are immune
A. Active immunity
B. Passive immunity
C. Herd immunity
D. Specific immunity

13. Leading cause of Diarrheal disease

A. Enterotoxigenic Escherichia coli
B. Salmonella (non-typhoid)
C. Rotavirus
D. Campylobacter jejuni

14. A vaccine-preventable disease which does not spread from person to person is ;

A. Mumps

B. Tetanus

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 C. Measle

15.The probability of rejecting the null hypothesis when it is true

A. Type 1 error
B. Type 2 error
C. Power of a statistical test
D. Level of significance

16. Meningitis is an inflammation of the;

A. Meninges

B. Meaningis

C. Head

17. Flu is caused by;

A. Mump virus

B. Influenza virus

C. Rubella virus

18. The property of a test to identify the proportion of truly ill persons in a population who are
identified as ill by a screening test
A. Sensitivity
B. Specificity
C. Positive predictive value
D. Negative predictive value

19.When handling human waste or sewage, one of the recommended PPE items is

A. cloth coveralls.

B. liquid repellant coveralls.

C. Nomex coveralls.

D. none of the above.

20. If you are sick of flu you should

A. take an over the counter cold and flu medication.

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 B. avoid close contact with people at work.

C. stay home and avoid close contact with other people.

D. monitor your blood pressure at least every four hours.

21. Who is responsible for the patient record problem list?

A. Hospital admission staff

B. Attending physician
C. Nursing staff
D. Billing clerk?
22. Frequently touched surfaces, such as should be cleaned and disinfected daily.

A. tables, doorknobs, and lights witches

B. countertops, handles, desks, keyboards, and telephones

C. toilets, faucets, and sinks

D. all the above

23.Rubella measles is also called

A. English measles

B. German measles

C. French measles

24. Epidemiologists define disease occurrence in terms of:

A. Agent
B. Host
C. Environment
D. All of the above

25. Virulence is the: B. Ability to cause immune

A. Ability to cause severe disease response
clinical disease C. The ability to D. All of the above
evoke an

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SECTION B: SHORT ANSWER QUESTIONS (25 MARKS)
1.Give the similarity and differences between bronchitis and pneumonia. 5marks

2.List the four stages of syphilis infection. 4marks

3.Give 2 differences between cold and flu. 4marks

4.a) Define occupational health.2marks

b) What are the three main objectives of occupational health? 6marks

5.list 4 uses of PPE at work place.4marks

SECTION C: ESSAY (50 MARKS)

1. A 2year old child is brought to your clinic presenting with muscle spasm that spread to the
neck and throat causing difficulty swallowing. Patient often has spasm in their facial muscle,
stiffness, breathing difficulty. The past medical history shows that the child did not complete his
childhood vaccines.

a) What is the most likely diagnosis for the child? 5marks

b) State the causes and risk factors.8marks

c) State the mode of spread.5marks

d) Briefly explain reasons why the child was infected with the disease.4marks

e) How can we prevent the disease? 5marks

f) State 3 complications of the disease.3marks

2. a) Define primary health care.5marks

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b) List the elements of primary health care.8marks

c) What are the basic principles of primary health care.7marks

MARKING GUIDE

SECTION A: MULTIPLE CHOICE QUESTIONS (25 MARKS)

1. A

2. A

3. A

4. C

5. B

6. C

7. B

8. B

9. D

10. C

11. B

12. C

13. C

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14. B

15. A

16. A

17. B

18. A

19. B

20. C

21. B

22. D

23. B

24. D

25. B

SECTION B: SHORT ANSWER QUESTIONS (25 MARKS)

1. Similarity;

Symptoms ;Both cause cough, fever, fatigue, and a heavy feeling in your chest.
Differences
First, bronchitis involves the bronchial tubes, while pneumonia affects the alveoli, or the air
sacs in the lungs.

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Second, pneumonia symptoms are usually much worse while those for bronchitis are less
severe. In addition, pneumonia can be life-threatening, especially in older people and other
vulnerable groups.

2. Primary syphilis
 secondary syphilis
 Latent syphilis
 tertiary syphilis

3. Differences between common cold and flu

Symptom Cold Flu

Fever Uncommon Usually present, high

(38°C to 40°C or 100°F
to 104°F); lasts 3 to 4
days

Headache Uncommon Very common

Aches and Slight Common and often

pains severe

Fatigue and Mild Can last 2 to 3 weeks

weakness

Extreme Never Very common at the

exhaustion start

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 Stuffy nose Common Sometimes

Sneezing Common Sometimes

Sore throat Common Sometimes

Chest Mild to Common

discomfort moderate,
and cough hacking cough

4. Occupational health can simply be defined as providing, preventing, promoting and curative
services in the work environment
OR
Occupational health is a specialized branch of medicine focusing on health in work place.It is
concern with mental and physical wellbeing of employees.
b.Three main objectives of occupational health
 The maintenance and promotion of workers health and working capacity.
 Improvement of working environment and work to become conducive to safety and
health.
 Development of work organization and working culture in a direction which support
health and safety at work, and in so doing promote a positive social climate and smooth
operation is promoted and productivity enhance.
5. Gloves, Goggle, glasses, helmet, aprons, safety foot wear, mask.

SECTION C SECTION C: ESSAY (50 MARKS)

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 1. a) Tetanus

b) It is caused by Clostridium tetani

Risk factors include
Puncture wounds — including from splinters, body piercings, tattoos, and injection drugs
 Gunshot wounds, Compound fractures, Burns, Surgical wounds, Injection drug use
 Animal or insect bites, Infected foot ulcers, Dental infections
 Infected umbilical stumps in newborns born of inadequately vaccinated mothers
People with diabetes or a history of immunosuppression and intravenous drug users may be at
higher risk for tetanus

c) Mode of spread
Common ways of contracting tetanus include: wounds that have been contaminated with saliva
or feces, burns, crush injuries, wounds that include dead tissue, puncture wounds
Clostridium tetani enters the body mainly through skin cut or puncture wounds
Rare ways of contracting tetanus include: surgical procedures, superficial wounds, insect
bites, compound fractures

 intravenous drug use, injections into the muscle, dental infections

d) Because the child did not complete his childhood vaccines

e) Vaccination with DTaP Vaccine

Avoid contact with dirty material such as rusted nails
If you have a minor wound, these steps will help prevent tetanus:

 Control the bleeding. Apply direct pressure to control bleeding.

 Keep the wound clean. After the bleeding stops, rinse the wound thoroughly with clean
running water. Clean the area around the wound with soap and a washcloth

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 Use antibiotics. After you clean the wound, apply a thin layer of an antibiotic cream or
ointment. These antibiotics won't make the wound heal faster, but they can discourage
bacterial growth and infection.
 Cover the wound. Exposure to the air might speed healing, but bandages can keep the wound
clean and keep harmful bacteria out. Blisters that are draining are vulnerable. Keep them
covered until a scab forms.
 Change the dressing. Apply a new dressing at least once a day or whenever the dressing
becomes wet or dirty to help prevent infection.
f) Fractures: Sometimes, in severe cases, the muscle spasms and convulsions may lead to
bone fractures.
 Aspiration pneumonia: If secretions or contents of the stomach are inhaled, a lower
respiratory tract infection can develop, leading to pneumonia.
 Laryngospasm: The voice box goes into a spasm which can last up to a minute and cause
breathing difficulties. In severe cases, the patient can suffocate.
 Tetanic seizures: If infection spreads to the brain, the person with tetanus can
experience fits.
 Pulmonary embolism: A blood vessel in the lung can become blocked and affect
breathing and circulation. The patient will urgently need oxygen therapy and anti-
clotting medication.
 Severe kidney failure (acute renal failure): Severe muscle spasms can result in the
destruction of skeletal muscle which can cause a muscle protein to leak into the urine.
This can cause severe kidney failure.

2.a) Primary health care is; essential health care based on practical, scientifically sound and
socially accepted methods and technology made universally accessible to individuals and
families in the community through their full participation and at a cost that the community and
country can afford to maintain at every stage of their development in the spirit of self-reliance
and self-determination.

b.) Elements of primary health care.

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 Education concerning prevailing health problems and the methods of preventing and
controlling them;
 Promotion of food supply and proper nutrition
 Adequate supply of safe water and basic sanitation;
 Maternal and child health care,including family planning;
 Immunization against the major infectious diseases;
 Prevention and control of locally endemic diseases;
 Appropriate treatment of common diseases and injuries
 Provision of essential drugs

c.) Basic principles of primary health care

 Primary health care should be an integral part of the national health system
 Maximum involvement of the local population in formulation and implementation of
health care activities.
 Reliance on available resources.
 Use of integrated approach of preventive, promotive, curative and rehabilitative
services for the individual, family and community.
 Inter-sectoral collaboration.
 Rationalization of health services (appropriate technology, financing and
management)
 Decentralization of health interventions to the most peripheral level possible
(accessibility)

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