Guidelines to prepare for ERPM (ACT 16 Exams)
- The purpose of the ERPM examination is to assess whether a candidate:
- Can approach medical practice with the appropriate intellectual skills of enquiry, clinical reasoning, critical thinking and decision making
- Possessing sufficient knowledge of the basic and clinical sciences, and an understanding of the underlying principles of scientific method
- The ability to create a differential diagnosis and rationalize a treatment plan for common clinical situations prevalent in Sri Lanka
- The candidates should also be able to apply the knowledge of basic sciences to explain the aetio-pathogenesis of disease conditions.
- They should demonstrate an understanding of the principles of essential procedural skills and the ability to perform such procedures.
- They should be able to communicate with patients respecting their dignity, rights, fears and anxieties, taking into consideration the socio-economic, cultural, religious and educational background of the patients.
- have a good knowledge of the normal and abnormal structure and function of the human body and of changes occurring during the life cycle.
- have knowledge of signs and symptoms of disease, be able to take a good history, conduct an examination of the patient, order the relevant investigations, arrive at a differential diagnosis and diagnosis, and know the non-pharmacological and pharmacological management of diseases.
- know to manage medical emergencies.
- know about disability, rehabilitation and handicap.
- know the role of the family and extended family, about inter-relationships and interactions with the society, and be aware of cultural and ethnic differences about the perception and response to illnesses.
- demonstrate good communication skills e.g. breaking bad news, informing relatives of results of investigations and informing them of the patient’s condition.
- Understand the concepts of patient confidentiality, privileged communication and when to breach patient confidentiality; the importance of informed consent; concept of medical negligence, civil and criminal liability.
- demonstrate knowledge of medical ethics, and behave in an ethical manner.
- understand the concepts of evidence based medicine
- know basic statistics.
- understand the concepts of self learning and lifelong learning
- know about the importance of record keeping.
- demonstrate ability to work as part of a team
- know about doctor patient relationship, patients rights and the necessity to use a chaperone when examining adults of the opposite sex.
- be able to educate patients and the public with a view to health promotion and disease prevention.
Sample ERMP questions
- The answers are given at the end of each question in sequential order: T = true; F = false
1. ERPM MCQ sample in IM: Characteristic features of aortic stenosis include (FFTTF)?
- pansystolic murmur at the apex
- loud second heart sound
- exertional syncope
- heaving apex beat
- early onset of symptoms
2. ERPM MCQ sample in IM: False-negative Mantoux test is known to occur in (TTFFT)?
- miliary tuberculosis
- HIV infection
- patients treated with conventional antibiotics
- infection with multi-drug resistant tuberculosis
- recent measles infection
3. ERPM MCQ sample in Surgery: In a patient who had a history of intermittent claudication – the following conditions need urgent surgical intervention to improve the limb circulation (TTFFF)?
- painful ulcer at the tip of a toe
- severe continuous pain of the affected calf requiring regular opioid analgesics
- claudication distance of 100 yards
- prominent varicose veins
- recurrent attacks of transient cerebral ischaemia (TIA)
4. ERPM MCQ sample in Surgery: A 55-year old man presents with symptoms suggestive of obstructive jaundice. He has a palpable gall bladder. Following is/are likely cause/s in this patient (TFFFT)?
- carcinoma of the head of the Pancreas
- Gall stones
- Cholangiocarcinoma of the common hepatic dust
- uncomplicated choledochal cyst
- periampullary carcinoma
5. ERPM MCQ sample in OBG: During the antenatal period (TTTFF)?
- an intrauterine pregnancy is recognized by transvaginal ultrasound scan at six weeks of amenorrhoea
- the uterine fundus is palpable at the symphysis pubis at 14 weeks of amenorrhoea
- maternal perception of fetal movements first occur between 18-20 weeks
- VDRL test is done as a diagnostic test for syphilis
- maternal serum triple test is offered to exclude Trisomy 21
6. ERPM MCQ sample in OBG: Anaemia complicating pregnancy (TFTTF)?
- is a risk factor for intra-uterine growth retardation (IUGR)
- is defined if the haemoglobin is below 9 g%
- in Sri Lanka is predominantly due to iron deficiency.
- due to iron deficiency is treated with parenteral iron when close to term
- is associated with preterm labour
7. ERPM MCQ sample in Pediatrics: Causes of neonatal jaundice on the fourth day of life include (TFTTF)?
- physiological jaundice
- breast milk jaundice
- congenital spherocytosis
7. ERPM MCQ sample in Pathology: The following are features of apoptosis (FFTTF)?
- Hydropic swelling of the affected cell
- Inflammatory reaction in the surrounding tissue
- Chromatin condensation at the periphery of nucleus.
- Formation of apoptotic bodies
- Death of a large area of a tissue
9. ERPM MCQ sample in FM: The following are true regarding abdominal injuries (FTTFF)?
- they are the commonest cause of death in road traffic accidents
- subcapsular liver ruptures causes sudden collapse
- a stab injury of the gall bladder is categorized as “fatal in the ordinary course of nature”
- ascites is a common complication
- effects of a blast wave are commonly seen in the liver and the kidney
- Dr Nilukshi Abeysinghe – Senior Lecturer in Forensic Medicine, Faculty of Medicine, University of Colombo
- Dr Deepika Attygalle – Consultant Community Physician, Family Health Bureau, Ministry of Healthcare and Nutrition
- Dr A.P. de Silva, Senior Lecturer, Department of Medicine, Faculty of Medicine, University of Kelaniya.
- Prof. Mohan de Silva – Professor of Surgery, Faculty of Medical Sciences, University of Sri Jayawardenepura
- Prof Nilanthi de Silva, Head, Medical Education Centre, Faculty of Medicine, University of Kelaniya.
- Dr Lalindra Gunaratne, Senior Lecturer in Pathology, Faculty of Medicine, University of Colombo.
- Dr Nalika Gunawardene – Senior Lecturer in Community Medicine, Faculty of Medicine, University of Colombo
- Dr H.M.S.S.D. Herath – Consultant Community Physician, Assistant Registrar, Sri Lanka Medical Council.
- Prof. Jayantha Jayawardana – Professor of Obstetrics & Gynaecology, and Dean, Faculty of Medical Sciences, University of Sri Jayawardenepura
- Prof. Lalitha Mendis – Emeritus Professor University of Colombo and President, Sri Lanka Medical Council
- Dr Nihal Nonis – Consultant Physician and Registrar, Sri Lanka Medical Council
- Dr Niranthi Perera – Senior Lecturer in Pathology, Faculty of Medicine, University of Colombo
- Dr Gominda Ponnamperuma, Lecturer in Medical Education, Faculty of Medicine, University of Colombo
- Prof. A.P. Premawardena, Head and Professor, Department of Medicine, Faculty of Medicine, University of Kelaniya.
- Prof. M. P. Senanayake, Professor in Paediatrics, Faculty of Medicine, University of Colombo
- Prof. A.R. Wickremasinghe, Dean and Professor of Public Health, Faculty of Medicine, University of Kelaniya.
- Dr S.S. Williams, Senior Lecturer and Head, Department of Psychiatry, Faculty of Medicine, University of Kelaniya.
- Community medicine theory 1 MCQ discussion from the youtube channel “ERPM Sri Lanka”
- ERPM Pediatric emergency viva from the Youtube channel “Dr V & A Health tips”
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