1. What are the four main types of shock and what are their causes? (4 marks)

- Hypovolemic shock: caused by severe blood or fluid loss, such as from trauma, dehydration, or burns.

- Cardiogenic shock: caused by impaired cardiac function, such as from myocardial infarction, arrhythmia,

or heart failure.

- Obstructive shock: caused by obstruction of blood flow, such as from pulmonary embolism, cardiac

tamponade, or tension pneumothorax.

- Distributive shock: caused by abnormal distribution of blood flow, such as from sepsis, anaphylaxis, or

spinal cord injury.

2. What are the signs and symptoms of chronic obstructive pulmonary disease (COPD) and how is it

diagnosed? (4 marks)

- Signs and symptoms of COPD include dyspnea, chronic cough, sputum production, wheezes, crackles,

cyanosis, and barrel chest.

- COPD is diagnosed by spirometry, which measures the forced expiratory volume in one second (FEV1)

and the ratio of FEV1 to forced vital capacity (FVC). A FEV1/FVC ratio of less than 0.7 indicates airflow

limitation consistent with COPD.

3. What are the risk factors and preventive measures for stroke? (4 marks)

- Risk factors for stroke include hypertension, diabetes mellitus, dyslipidemia, smoking, atrial fibrillation,

carotid artery disease, and previous transient ischemic attack (TIA).

- Preventive measures for stroke include lifestyle modifications (such as diet, exercise, weight control, and

smoking cessation), blood pressure control, glucose control, lipid-lowering therapy, antiplatelet therapy,

anticoagulation therapy (for atrial fibrillation), and carotid endarterectomy (for severe carotid stenosis).

4. What are the types and causes of urinary incontinence and how is it managed? (4 marks)

- Types of urinary incontinence include stress incontinence (involuntary leakage of urine with increased

abdominal pressure), urge incontinence (involuntary leakage of urine with a strong urge to void), overflow

incontinence (involuntary leakage of urine due to incomplete bladder emptying), and functional

incontinence (involuntary leakage of urine due to cognitive or physical impairment).

- Causes of urinary incontinence include pelvic floor weakness, detrusor overactivity, bladder outlet

obstruction, neurological disorders, medications, infections, and psychological factors.

- Management of urinary incontinence includes behavioral interventions (such as bladder training, pelvic

floor exercises, fluid management, and toileting assistance), pharmacological interventions (such as

anticholinergics, alpha-blockers, estrogen, and duloxetine), and surgical interventions (such as sling

procedures, urethral bulking agents, and artificial urinary sphincters).