Health care System in Egypt 1- The function of any health care system include the following (choose one

or more): a- Production of resources b- Management c- Arrangement of resources into health programs d- Provision of health services e- All the above ( e) 2- The health services in any health care system may be of : a- Primary care level b- Secondary care level c- Tertiary care level d- All of the above e- both a & b (d ) 3- The primary health care in the health care system is the------- as compared with other levels of care (2nd and 3rd levels). a- Less costly for the community and the system. b- Less costly for the community but not for the system. ( a) c- Most costly d- Same costly. -The----------- is the first contact with individuals in any health care system. a- Secondary level of care b- primary level of care (b) c- tertiary level of care.

5-secondary health services need: (Choose either 1 , 2, or 3 ) a- Procedures for diagnosis and treatment b- High degree of skills and technology. c- Some degree of specialization (2 ) d- Complex surgical operations. 1 = a , b, d. 2 = a , c. 3 =c, d 6- Match from below the suitable answer for the above statements ( Choose one or more answers): a- Primary health care services.----------------( 2, 4 ) b- Secondary health care services------------( 1 ) c- Tertiary health care services-----------------( 3 ) 1- It needs some degree of specialization and is costly. 2-It is the less costly health care services 3- It needs a high degree of skills and advanced technology. 4- It is the first contact with individuals in any health care system. 7- The population health needs in Egypt are determined by all the following characteristics EXCEPT : a- Unemployment b- The rate of low socio-economy. c- The excess number of new physicians per year. ( c) d- High incidence of communicable diseases.

8- The followings may determine the population health needs in Egypt (you may choose more than one answer ) a- a high incidence of communicable disease. b- a high number of physicians / 1000 population c- Literacy rate ( a, c, d ) d- Unemployment 9- The following determinants can reflect the population health needs in Egypt : a- Women are about 1/4 of the labor force. b- High infant mortality rate. c- Literacy rate and unemployment ( d) d- All of the above. 10- The maternal mortality rate in Egypt in 2004, is : a- 67.6 / 100 live births. b- 67.6 / 1000 live births c- 67.6 / 100,000 live births ( c) d- 67.6 / 1000,000. live births 11- In Egypt, there are geographic differences between the governorates in infant and child mortality as well in maternal mortality rates. This is considered as :a- A merit in the health care system. b- Defects in the accessibility and equity of the services. ( d) c- Constraints in the Egyptian health care system. d- Both ( b) & ( c )

12- All of the followings are considered constraints in the Egyptian health care system EX C EPT: a- All the citizens have basic rights of accessibility to health services. b- Non-communicable disease preventive programs are not well established. c- High infant and child mortality d- Medical school graduates are two to three times more than needs.--------------( a)

13-In the Egyptian health care system; the number of physicians are: (choose one or more): a- Sufficient for the citizens.------------------------------( a , c ) b- Not sufficient. c- Sufficient and exceeds the needs of the health care system. d- Much more in primary health care doctors (general practitioners) and much less in the specialists. Primary health care 1-The primary health care can be defined as the essential health care based on: a- Practical methods. b- Scientifically sound technologies c- Socially acceptable methods and technologies. d- All the above.--------------------------------------------( d )

2-Primary level of health care is significant than other levels because: a- It is cheap. b- It is the base of secondary and tertiary health care. c- Both of the above. d- It is the key to achieve an acceptable level of health e- All the above.------------------------------- ( e) 3- Primary health care ( PHC) is the first contact between individuals and the health care system. This statement is considered a part of : a- Definition of PHC b- Significance of the PHC--------------------------------------(b) c- Objectives of the PHC 4- The------------- is the cheapest, basic health care services applied for the mothers. a- Secondary level of health care inside the maternal hospitals. b- Maternal health services applied inside health units or centers---------------------(b) c- Psychological management needed after abortion or labor in certain cases. 5-Primary health care objectives include: a- Health promotion of the community b- Prevention and control of the diseases. c- Both ( a )& (b ).----------------------------------(c ) d- Neither (a) nor (b).

6- Immunization of children against major communicable diseases is a measure included as : a- Preventive element in primary health care (PHC) b- Promotive element in PHC c-Curative element in PHC

7- Assurance of proper nutrition specially for mothers and children is a basic --------- measure in primary health care. a- Curative b- Preventive c- Rehabilitative d- Promotive---------------------------------------(d )

8-Accessibility of the health services to all individuals is a basic right in : a- Tertiary health care level b- secondary care level c- primary care level---------------------------------( c) d- All the above

9- All the followings are principles of primary health careEX C EP T: a- It should be accessible b- It should be acceptable

c- it should be comprehensive d- It should be paid much money.----------------------------(d )

10- Primary health care services are available at the following sites: a- Maternal and child health centers (MCH) b- Health offices c- Both ( a) & ( b) d- Rural health units f- All of the above---------------------------------------------( f )

11- Match the most convenient service from below to the above sites applying the service (you can choose more than one ): a- Health office------------------------------------------( 1, 3, 5) b- School health unit--------------------------------------( 2 ) c- Maternal and child health centers. -----------( 4 ) 1- Immunizations for infants 2- Immunizations of 4th primary school children. 3- Monitoring of the environment and sanitation 4- Health care of the pregnant mothers.

12- Family planning services can be applied in: a- Maternal and child health centers b- Urban and rural health centers

c- Both of the above------------------------------------------( c ) d- Urban health centers.

13- Urban health centers provide services for : a- Mothers and their children only b- School children only c- Both ( a ) & ( b ) d- All the residents in the same locality of the center-------------------- (d )

14- The personnel working in-------- include 3 sanitariums, one laboratory technician, two dentists, physicians, .. a- Mothers and their children only. b- Urban health centers-------------------------------------( b ) c- Health office d- Fever hospitals

16- Rural health unit make the following services: a- Maternal and child health services b- Registration of birth and death c- Family planning services d- All of the above--------------------------------------------( d ) 17- Health education is one of the basic services in: a- Maternal child health center

b- Family planning center c- Both a and b d- All the primary health care activities of units and centers---------------------------( d

18- The physicians in primary health care centers or units.. of high specialty and technical skills. a- Must be b- Shouldn't be c- Are not in need to be----------------------------( c )

19- The medical services in the primary health care, can be applied by: a- Highly specialized doctors b- General practitioners-------------------------------( b ) c- Chief nurses d- Non of the above

20- Food inspection is a service which can be introduced through: a- Health office b- Urban health center c- Both a and b----------------------------------( c ) - Non of the above

Investigation of infectious diseases epidemics 1- For investigating an epidemic diseases or food poisoning; the following steps are recommended:a- Verify the clinical and laboratory diagnosis. b- Verify if there is an epidemic c- Both ( a) & ( b ) d- Study an epidemic as regards time, place and persons e- All of the above------------------------------( e ) 2- In the investigation of an infectious disease epidemics, we should study the TIME as respect : a- Time of occurrence of complications. b- Time of onset of symptoms and signs---------------( b ) c- Time of recovery from the disease

3- The followings are required to demonstrate the characteristics of an epidemic or outbreak EXCEPT a- Time of onset of the disease b- Place of the diagnosed cases c- Health care providers-----------------------------------( c ) d- Personal characteristics of the cases 4- When we investigate an outbreak of food poisoning , we should at first do the following: a- Verify the diagnosis clinically and laboratory.--------( a )

b- formulate a hypothesis. c- Test a hypothesis

5- Investigating human or animal sources of infection is an important step in: a- Any infectious disease epidemic b- Any food poisoning outbreaks c- Both ( a ) & ( b)-------------------------------( c ) d-Non of the above

1- The function of any health care system include the following (choose one or more): a- Production of resources b- Management c- Arrangement of resources into health programs d- Provision of health services e- All the above( e)

3- The primary health care in the health care system is the ------- as compared with other levels of care (2nd and 3rd levels). a- Less costly for the community and the system. b- Less costly for the community but not for the system. c- Most costly d- Same costly.----------( a)

8- The followings may determine the population health needs in Egypt (you may choose more than one answer ) a- a high incidence of communicable disease. b- a high number of physicians / 1000 population c- Literacy rate -----( a, c, d ) d- Unemployment 2-Primary level of health care is significant than other levels because: a- It is cheap. b- It is the base of secondary and tertiary health care. c- Both of the above. d- It is the key to achieve an acceptable level of health e- All the above.------------------------------- ( e)

11- Match the most convenient service from below to the above sites applying the service (you can choose more than one ): a- Health office-----------------------------------------( 1, 3, 5 ) b- School health unit--------------------------------------( 2 ) c- Maternal and child health centers. -----------( 4 ) 1- Immunizations for infants 2- Immunizations of 4th primary school children.

3- Monitoring of the environment and sanitation 4- Health care of the pregnant mothers. 17- Health education is one of the basic services in: a- Maternal child health center b- Family planning center c- Both a and b d- All the primary health care activities of units and centers(d

2- In the investigation of an infectious disease epidemics, we should study theTIME as respect : a- Time of occurrence of complications. b- Time of onset of symptoms and signs-----------------( b ) c- Time of recovery from the disease 4- When we investigate an outbreak of food poisoning , we should at first do the following: a- Verify the diagnosis clinically and laboratory.-------( a ) b- formulate a hypothesis. c- Test a hypothesis

true or false on nutrition Proteins are important as blood clotting -4 ( factor and in formation of visual pigments ( T (All enzymes are protein in nature (T -5 Proteins lead to formation of glucose and -6 ( energy ( T Negative protein balance occurs when -7 ( protein intake exceeds protein output( F Milk and meat proteins arc considered as -8 ( reference proteins ( F Infants and young children need 1.5 - 2.0 -9 (gm/Kg .... (T glycogen is an animal from of starch stored -10 (in liver (T Fructose is metabolised to glucose and may -11 ( be converted to glycogen or fat ( T All forms of dietary fibres come form plants -12 ((T Dietary fibres are present in all plants and -13 ( are digested nily in the intestines( F Sugars can spare proteins from use as -14 ( energy as well as prevent ketosis ( T Dietary fibres are helpful in slowing glucose -15 ( absorption( T Type 1 diabetes requires insulin therapy -16 whereas in Type II diabetes the focus is more ( on did conlrol and exercise ( T Diet should be high in complex -17 ( carbohydrates rather than fat ( T I8- Simple sugars added to food should ( provide no more than 10% of total energy ( F

Many foods that are low in suger produce a -19 ( high glycaemic index ( F Fruits and vegetables have a low glycemic -20 ( index ( T Typically, food is of higher fibre diet with -21 ( low fluids ( F Adipose cells can expand abou: 50 times -22 and the body can not form new adipose cells ((F Cholesterol forms a part ofcor icosteroids, -23 ( oestrogen, and testoslerone ( T Cholesterol has a critical role in liver, heart, -24 ( and brain ( T Trans fatty acids are a hazardo is form of -25 SFA and predispose to cardiovascular diseases ((F TfA'S increase LDL and decrease HDL and -26 ( cholesterol ( T Type 2 diabetes is due to enlarged fat cells, -27 poorly bind and poorly responding to insulin ( message to the cell ( T Metabolism of carbohydrate, fat and protein-28 ( gives energy ( T Calories given by combustion of 1.0 gm -29 CHO or protein gives 4 Calories while that of ((T gm fat gives 9 Calories 1.0 Energy expenditure is that required for -30 (non-occupational daily activities (T After the age of 40 years energy -31 requirement should be reduced by 20 % until ( the age of 60 years ( F A, B, D, E, and K are fat soluble vitamins -32 that are stored mainly in the liver and fatty ( tissues (F

Large doses of supplementation with -33 ( vitamin A, and D, are toxic to the body( T Vitamin A is responsible for healthy -34 epithelium especially in the respiratory and ( urinary tracts ( T Vitamin A is necessary for formation of -35 visual purple which is needed for vision in high ( intensity light ( F Carotenes are found in pigments of most-36 ( vegetables and fruits ( T In vitamin A deficiency the cornea may be -37 ( involved ( T excessive intake of Vitamin A leads to -38 ( carotinaemla ( T Vitamin A deficiency is of public health -39 importance alTecling preschool and school children as well as their ( mothers (T Vitamin A programme should be a scpai-alc -40 programme which is concerned with health in ( order to achieve the expected prevention ( F The Bio-availability of vitamin A should be -41 ( increased with low fat content diet ( F There is an interaction between iron and -42 ( vitamin A ( T Vitamin A fortification can be done for -43 sugar, diary products, fats and wheat flour ((T Supplementation of mothers within a -44 month of delivery with 400 l.U. vitamin A ( single dose is important (F Prophylactic vitamin A 100 l.U. in the 9th -45 ( month and 200 l.U. in the 18th month ( F Vitamin D is the natural form of vitamin D -46 produced by irradiation ofdchydro-cholesterol ( of the skin on exposure to the sun ( T

White skin are liable to vitamin D deficiency -47 ((F Vitamin D deficiency may lead to -48 ( osteoporosis or osteomalacia ( T Vitamin E is an antioxidant which reduces -49 ( the risk of cancer ( T Vitamin E is not affected by storing or -50 ( cooking (F Vitamin K is required for synthesis -51 ofprothrombin in the liver and is incorporated ( in its molecule ( F Vitamin K deficiency occurs in impaired fat -52 ( absorption as in biliary dysfunction ( T Thiamine deficiency leads to peripheral -53 ( neuritis, myocarditis and encephalopathy ( T Vitamin B2 is rich in milk, liver, and -54 ( growing leafy vegetables ( T Vitamin B1 is synthesised by bacteria in the -55 ( large intestine ( F Vitamin B1 and niacin is essential in CHO -56 ( and brain metabolism ( F Vitamin B2 deficiency loads to angular -57 stomatitis, cheilosis, and burning sensation of ( the eye ( T folic acid is important for deyclopment of -58 ( red blood cells in the bone marrow ( T folic acid deficiency leads to appearance of -59 ( megaloblasts in blood ( T Folic acid and vitamin B12 are essential for -60 ( DNA formation ( T Vitamin B12 deficiency occuis when the -61 extrinsic factor is lacking as in gastrectomy ( T ( Ascorbic acid is rapidly destroyed by -62 ( oxidation and high temperature ( T

Vitamin C is important for folate coenzyme -63 ( and absorption of iron ( T Vitamin C deficiency leads to haemorrhage -64 ( and delayed wound healing ( T Sodium is essential in regulation -65 ( ofncuromuscular i r r itabilily ( F Most of the phosphate in the body is -66 ( present in bone ( T Absorption of calcium is increased by -67 ( oxalate and decreased by cholecalciferol ( F ( Dried fruits are rich in calcium and iron ( T -68 Hypervitaminosis D may lead to -69 ( hypercalcaemia ( T The body of an ***** contains 3 - 4 gm iron ( -70 (T Selenium helps in immune system and has -71 ( an antioxidant role ( T Copper contributes lo thyroid hormone -72 ( metabolism ( F Some green leaves are a good iodine source -73 ((T Fish, cheese and tea are rich sources of -74 ( fluorine ( T Ingestion of large amounts fluorine leads to -75 ( dental and skeletal fluorosis ( T Fluoride levels below 50 mg/litre lead to -76 ( dental carries ( F Cigarette smoking and environmental -77 pollution lead to increase free radicals in body ((T Selenium, zinc, and copper control the -78 ( enzymatic defence against free radicals ( T Dietary Vitamin E, C, and B ; reduce the -79 ( damaging capacity of free radicals ( T

Some foods contain anti-oxid mt -80 substances e.g. Soya beans, green tea, fruits, ( olives, and onion ( T Oxidative stress is an imbalarce between -81 ( pro-oxidants, and antioxidants ( T Vitamin C is the most import, int -82 ( antioxidant in intracellular fluid ( F Vitamin E, the water soluble vitamin, is the -83 ( major antioxidant in all cell membranes ( F there is syneigistic effect between vitamin -84 ( E and C as well as vitamin E and selenium ( T Antioxidants may lead to regicssion ofpre- -85 malignant lesions or inhibit progression of ( malignancy ( T Antioxidants inhibit transformation of HDL -86 to the oxidized form and so reduce cardiac ( arrhythmia ( T Onion, garlic, red, orange, and yellow fruits -87 and vegetables may reduce cariccr or cardiac ( disease ( T Vitamin A and carotene cross the placenta -88 and if deficient intake they have a ( teratogenic effect ( F Excessive amount of vitamin D during -89 pregnancy is important for both mothers and (babies (F Extra amount of 10 mg vitamin C is -90 recommended for pregnent women to guard ( aganist pre-eclampsia ( T The foetus requires most of its calcium in -91 the first trimester when skeletal growth is ( maximised ( F Iodine deficiency in pregnancy can lead to -92 cretinism and delayed cognitive function in the ( new born ( T

Maternal iron deficiency usually does not -93 ( result in an anaemic infant at birth ( T Iron is a nutrient for which requirement can -94 ( be met by diet alone ( F Colostrum has a relatively high carotene, -95 ( more protein, sugar, and fat content ( F Transitional milk occurs between 3rd and -96 ( 6th day ( T Protein content of milk, lactose and fat are -97 firmly established by the end of the 3rd month ((F Exclusive breast feeding allows giving the -98 baby different types of fluids only after the ( second month ( F Milk contains anti-staphylococcus factor -99 which inhibits systemic staphylococcal ( infection ( T Milk contains laclofcrrin which inhibits iron -100 ( leading lo its decreased amount ( F Weaning starts from the 2nd to 6th month, -101 with supplementary feeding, that is small in ( amount and gradual ( F At the age of one year,the child should -102 receive solid food consisting of pulses, ( vegetables, fruits, chicken and milk ( T :II - Choose one answer only :II - Choose one answer only Artificial feeding of infants and pre-school children include all (but one false answer (answer:a a- Dried milk is safer than fresh milk, but it is not adapted to

simulate human .milk b- Buffalo and cow milk are cheaper, more available, but should be fresh, safe .and from a safe source c- Hypocalcaemia may occur with the risk ofletany if .excessivc dilution of milk occurs d- Iron should be supplemented by the 5th month in the form of green vegetable .soup e- Protein is given in the form of egg yolk, minced .chicken, and liver (Ill - One of the following is false: (answer:a ----------------------------------------a- Deficient protein and energy in school age leads to marasmus and kwashiorkor b- Vitamin A deficiency and B12 .c- Dental carries is predisposed by hygienic lifestyle d- Goitre .e- Impaired growth occurs in chronic deficiencies ,IV - The following is correct about diet in the elderly (Except: (answer:d ---------------------------------------------------------------.a- Adequate intake of protein, calcium and iron .b- Supplementation by vitamins and minerals .c- Low intake of salts saturated fats, and refined sugars d- Extra amounts of ceirtain diet e.g. eggs, full cream .milk, and cheese .e- Psychological and medical care