Health care System in Egypt

1- The function of any health care system include the following (choose one ormore):a- Production of resourcesb- Managementc- Arrangement of resources into health programsd- Provision of health servicese- All the above ( e)

2- The health services in any health care system may be of :a- Primary care levelb- Secondary care levelc- Tertiary care leveld- All of the abovee- both a & b (d )

3- The primary health care in the health care system is the------- as compared withother 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 costlyd- Same costly.

-The----------- is the first contact with individuals in any health care system.a- Secondary level of careb- 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 treatmentb- 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 services3- 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 followingcharacteristics EXCEPT :a- Unemploymentb- 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 populationc- 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 birthsc- 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 technologiesc- 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 healthe- All the above.------------------------------- ( e)3- Primary health care ( PHC) is the first contact between individuals and the healthcare system. This statement is considered a part of :a- Definition of PHCb- 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 communityb- 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 measureincluded as :a- Preventive element in primary health care (PHC)b- Promotive element in PHCc-Curative element in PHC

7- Assurance of proper nutrition specially for mothers and children is a basic--------- measure in primary health care.a- Curativeb- Preventivec- Rehabilitatived- Promotive---------------------------------------(d )

8-Accessibility of the health

services to all individuals is a basic right in :a- Tertiary health care levelb- secondary care levelc- 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 accessibleb- It should be acceptablec- it should be comprehensived- 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 officesc- Both ( a) & ( b)d- Rural health unitsf- All of the above---------------------------------------------( f )

11- Match the most convenient service from below to the above sites applying theservice (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 infants2- Immunizations of 4th primary school children.3- Monitoring of the environment and sanitation4- Health care of the pregnant mothers.

12- Family planning services can be applied in:a- Maternal and child health centersb- Urban and rural health centersc- Both of the above------------------------------------------( c )d- Urban health centers.

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

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

16- Rural health unit make the following services:a- Maternal and child health servicesb- Registration of birth and deathc- Family planning servicesd- All of the above--------------------------------------------( d )

17- Health education is one of the basic services in:a- Maternal child health centerb- Family planning centerc- Both a and bd- All the primary health care activities of units and centers---------------------------( d

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

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

20- Food inspection is a service which can be introduced through:a- Health officeb- Urban health centerc- 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 arerecommended:-a- Verify the clinical and laboratory diagnosis.b- Verify if there is an epidemicc- Both ( a) & ( b )d- Study an epidemic as regards time, place and personse- All of the above------------------------------( e )

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

3- The followings are required to demonstrate the characteristics of an epidemic or outbreak EXCEPTa- Time of onset of the diseaseb- Place of the diagnosed casesc- Health care providers-----------------------------------( c )d- Personal characteristics of the cases

4- When we investigate an outbreak of food poisoning , we should at first do thefollowing: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 epidemicb- Any food poisoning outbreaksc- Both ( a ) & ( b)-------------------------------( c )d-Non of the above

1- The function of any health care system include thefollowing (choose one or more):a- Production of resourcesb- Managementc- Arrangement of resources into health programs

d- Provision of health servicese- 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 3rdlevels).a- Less costly for the community and the system.b- Less costly for the community but not for the system.c- Most costlyd- Same costly.----------( a)

8- The followings may determine the population health needsin Egypt (you may choose more than one answer )a- a high incidence of communicable disease.b- a high number of physicians / 1000 populationc- Literacy rate-----( a, c, d )d- Unemployment

2-Primary level of health care is significant than other levelsbecause: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 healthe- All the above.------------------------------- ( e)

11- Match the most convenient service from below to theabove sites applying the service (you can choose more

thanone ):a- Health office-----------------------------------------( 1, 3, 5 )b- School health unit--------------------------------------( 2 )c- Maternal and child health centers. -----------( 4 )1- Immunizations for infants2- Immunizations of 4th primary school children.3- Monitoring of the environment and sanitation4- Health care of the pregnant mothers.

17- Health education is one of the basic services in:a- Maternal child health centerb- Family planning centerc- Both a and bd- All the primary health care activities of units and centers(d

2- In the investigation of an infectious disease epidemics, weshould 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 , weshould 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

4 -Proteins are important as blood clotting factor and in formation of visual pigments ( T )

5 -All enzymes are protein in nature (T)6 -Proteins lead to formation of glucose and energy ( T )

7 -Negative protein balance occurs when protein intake exceeds protein output( F )

8 -Milk and meat proteins arc considered as reference proteins ( F )

9 -Infants and young children need 1.5 - 2.0 gm/Kg .... (T)10 -glycogen is an animal from of starch stored in liver (T)

11 -Fructose is metabolised to glucose and may be converted to glycogen or fat ( T )

12 -All forms of dietary fibres come form plants ( T )13 -Dietary fibres are present in all plants and are digested nily

in the intestines( F )14 -Sugars can spare proteins from use as energy as well as

prevent ketosis ( T )15 -Dietary fibres are helpful in slowing glucose absorption( T )16 -Type 1 diabetes requires insulin therapy whereas in Type II

diabetes the focus is more on did conlrol and exercise ( T )17 -Diet should be high in complex carbohydrates rather than fat

( T )I8- Simple sugars added to food should provide no more than 10% of total energy ( F )

19 -Many foods that are low in suger produce a high glycaemic index ( F )

20 -Fruits and vegetables have a low glycemic index ( T )21 -Typically, food is of higher fibre diet with low fluids ( F )

22 -Adipose cells can expand abou: 50 times and the body can not form new adipose cells ( F )

23 -Cholesterol forms a part ofcor icosteroids, oestrogen, and testoslerone ( T )

24 -Cholesterol has a critical role in liver, heart, and brain ( T )25 -Trans fatty acids are a hazardo is form of SFA and

predispose to cardiovascular diseases (F)26 -TfA'S increase LDL and decrease HDL and cholesterol ( T )

27 -Type 2 diabetes is due to enlarged fat cells, poorly bind and poorly responding to insulin message to the cell ( T )

28-Metabolism of carbohydrate, fat and protein gives energy ( T )29 -Calories given by combustion of 1.0 gm CHO or protein gives

4 Calories while that of ( T )1.0 gm fat gives 9 Calories

30 -Energy expenditure is that required for non-occupational daily activities (T)

31 -After the age of 40 years energy requirement should be reduced by 20 % until the age of 60 years ( F )

32 -A, B, D, E, and K are fat soluble vitamins that are stored mainly in the liver and fatty tissues (F )

33 -Large doses of supplementation with vitamin A, and D, are toxic to the body( T )

34 -Vitamin A is responsible for healthy epithelium especially in the respiratory and urinary tracts ( T )

35 -Vitamin A is necessary for formation of visual purple which is needed for vision in high intensity light ( F )

36-Carotenes are found in pigments of most vegetables and fruits ( T )

37 -In vitamin A deficiency the cornea may be involved ( T )38 -excessive intake of Vitamin A leads to carotinaemla ( T )

39 -Vitamin A deficiency is of public health importance alTeclingpreschool and school children as well as their mothers (T )

40 -Vitamin A programme should be a scpai-alc programme which is concerned with health in order to achieve the expected prevention ( F )

41 -The Bio-availability of vitamin A should be increased with low fat content diet ( F )

42 -There is an interaction between iron and vitamin A ( T )43 -Vitamin A fortification can be done for sugar, diary products,

fats and wheat flour ( T )44 -Supplementation of mothers within a month of delivery with

400 l.U. vitamin A single dose is important (F )45 -Prophylactic vitamin A 100 l.U. in the 9th month and 200 l.U.

in the 18th month ( F )46 -Vitamin D is the natural form of vitamin D produced by

irradiation ofdchydro-cholesterol of the skin on exposure to the sun ( T )

47 -White skin are liable to vitamin D deficiency ( F )48 -Vitamin D deficiency may lead to osteoporosis or

osteomalacia ( T )49 -Vitamin E is an antioxidant which reduces the risk of cancer (

T )50 -Vitamin E is not affected by storing or cooking (F )

51 -Vitamin K is required for synthesis ofprothrombin in the liver and is incorporated in its molecule ( F )

52 -Vitamin K deficiency occurs in impaired fat absorption as in biliary dysfunction ( T )

53 -Thiamine deficiency leads to peripheral neuritis, myocarditis and encephalopathy ( T )

54 -Vitamin B2 is rich in milk, liver, and growing leafy vegetables ( T )

55 -Vitamin B1 is synthesised by bacteria in the large intestine ( F )

56 -Vitamin B1 and niacin is essential in CHO and brain metabolism ( F )

57 -Vitamin B2 deficiency loads to angular stomatitis, cheilosis, and burning sensation of the eye ( T )

58 -folic acid is important for deyclopment of red blood cells in the bone marrow ( T )

59 -folic acid deficiency leads to appearance of megaloblasts in blood ( T )

60 -Folic acid and vitamin B12 are essential for DNA formation ( T )

61 -Vitamin B12 deficiency occuis when the extrinsic factor is lacking as in gastrectomy ( T )

62 -Ascorbic acid is rapidly destroyed by oxidation and high temperature ( T )

63 -Vitamin C is important for folate coenzyme and absorption of

iron ( T )64 -Vitamin C deficiency leads to haemorrhage and delayed

wound healing ( T )65 -Sodium is essential in regulation ofncuromuscular i r r

itabilily ( F )66 -Most of the phosphate in the body is present in bone ( T )

67 -Absorption of calcium is increased by oxalate and decreased by cholecalciferol ( F )

68 -Dried fruits are rich in calcium and iron ( T )69 -Hypervitaminosis D may lead to hypercalcaemia ( T )

70 -The body of an ***** contains 3 - 4 gm iron ( T )71 -Selenium helps in immune system and has an antioxidant

role ( T )72 -Copper contributes lo thyroid hormone metabolism ( F )

73 -Some green leaves are a good iodine source ( T )74 -Fish, cheese and tea are rich sources of fluorine ( T )

75 -Ingestion of large amounts fluorine leads to dental and skeletal fluorosis ( T )

76 -Fluoride levels below 50 mg/litre lead to dental carries ( F )77 -Cigarette smoking and environmental pollution lead to

increase free radicals in body ( T )78 -Selenium, zinc, and copper control the enzymatic defence

against free radicals ( T )79 -Dietary Vitamin E, C, and B ; reduce the damaging capacity

of free radicals ( T )80 -Some foods contain anti-oxid mt substances e.g. Soya

beans, green tea, fruits, olives, and onion ( T )81 -Oxidative stress is an imbalarce between pro-oxidants, and

antioxidants ( T )82 -Vitamin C is the most import, int antioxidant in intracellular

fluid ( F )83 -Vitamin E, the water soluble vitamin, is the major antioxidant

in all cell membranes ( F )84 -there is syneigistic effect between vitamin E and C as well as

vitamin E and selenium ( T )85 -Antioxidants may lead to regicssion ofpre-malignant lesions

or inhibit progression of malignancy ( T )

86 -Antioxidants inhibit transformation of HDL to the oxidized form and so reduce cardiac arrhythmia ( T )

87 -Onion, garlic, red, orange, and yellow fruits and vegetables may reduce cariccr or cardiac disease ( T )

88 -Vitamin A and carotene cross the placenta and if deficient intake they have ateratogenic effect ( F )

89 -Excessive amount of vitamin D during pregnancy is important for both mothers and babies (F)

90 -Extra amount of 10 mg vitamin C is recommended for pregnent women to guard aganist pre-eclampsia ( T )

91 -The foetus requires most of its calcium in the first trimester when skeletal growth is maximised ( F )

92 -Iodine deficiency in pregnancy can lead to cretinism and delayed cognitive function in the new born ( T )

93 -Maternal iron deficiency usually does not result in an anaemic infant at birth ( T )

94 -Iron is a nutrient for which requirement can be met by diet alone ( F )

95 -Colostrum has a relatively high carotene, more protein, sugar, and fat content ( F )

96 -Transitional milk occurs between 3rd and 6th day ( T )97 -Protein content of milk, lactose and fat are firmly established

by the end of the 3rd month ( F )98 -Exclusive breast feeding allows giving the baby different

types of fluids only after the second month ( F )99 -Milk contains anti-staphylococcus factor which inhibits

systemic staphylococcal infection ( T )100 -Milk contains laclofcrrin which inhibits iron leading lo its

decreased amount ( F )101 -Weaning starts from the 2nd to 6th month, with

supplementary feeding, that is small in amount and gradual ( F )102 -At the age of one year,the child should 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 allbut one false answer (answer:a)

a- Dried milk is safer than fresh milk, but it is not adapted tosimulate humanmilk.

b- Buffalo and cow milk are cheaper, more available, but should befresh, safeand 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 greenvegetablesoup.

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 kwashiorkorb- Vitamin A deficiency and B12c- Dental carries is predisposed by hygienic lifestyle.

d- Goitree- 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.