FMGE 2018 — Community Medicine
8 Previous Year Questions with Answers & Explanations
Babesiosis is most commonly transmitted by:
Provision of services at Suraksha Clinic includes
The recommended upper limit for free residual chlorine in drinking water according to WHO guidelines is:
Which of the following is a method for on-site disposal of domestic wastewater?
Disease usually not seen in a country but brought from abroad is:
A well of contaminated water resulting in an epidemic of acute watery diarrhea is a typical example for:
Recommended daily dose of Iodine in a school-age child is:-
Ujjawala scheme is for prevention of
FMGE 2018 - Community Medicine FMGE Practice Questions and MCQs
Question 1: Babesiosis is most commonly transmitted by:
- A. Rats
- B. Sand fly
- C. Pigs
- D. Ticks (Correct Answer)
Explanation: **_Ticks_** - Babesiosis is a **tick-borne illness** caused by *Babesia* parasites, primarily *Babesia microti* in North America. - The main vector is the **deer tick** (*Ixodes scapularis*), which also transmits **Lyme disease**. *Rats* - Rats are known reservoirs for various diseases (e.g., **hantavirus**, **leptospirosis**), but they are not the primary vectors for babesiosis. - While *Babesia microti* can infect rodents, **direct transmission** to humans from rats is not the most common route. *Sand fly* - Sand flies are vectors for diseases like **leishmaniasis** and **Bartonellosis**. - They are not associated with the transmission of *Babesia* parasites. *Pigs* - Pigs can be reservoirs for certain zoonotic diseases (e.g., **cysticercosis**, **trichinellosis**). - They do not typically serve as vectors for babesiosis transmission to humans.
Question 2: Provision of services at Suraksha Clinic includes
- A. Blood transfusion safety services
- B. Immunization services
- C. STI/RTI services (Correct Answer)
- D. Diarrhea control services
Explanation: ***STI/RTI services*** - **Suraksha clinics** are specifically designed under the National AIDS Control Programme (NACP) to provide comprehensive diagnostic, treatment, and counseling services for individuals with **sexually transmitted infections (STIs) and reproductive tract infections (RTIs)** including HIV. - They focus on promoting sexual health and preventing the spread of STIs through education, awareness, and clinical management. *Blood transfusion safety services* - These services are typically handled by **blood banks** and specialized transfusion medicine departments, focusing on donor screening, blood processing, and safe transfusion practices. - They are not a primary service offered by **Suraksha clinics**, which are geared towards STI/RTI management. *Immunization services* - Immunization services are usually provided at **primary health centers**, pediatric clinics, or through public health campaigns aimed at preventing infectious diseases via vaccination. - While important for public health, they are not the core offering of **Suraksha clinics**. *Diarrhea control services* - Diarrhea control services, including oral rehydration therapy and hygiene education, are typically offered by **general practitioners**, community health workers, and maternal and child health programs. - These are distinct from the specialized focus of **Suraksha clinics** on STI/RTI services.
Question 3: The recommended upper limit for free residual chlorine in drinking water according to WHO guidelines is:
- A. 0.4 mg/L
- B. 0.2 mg/L
- C. 0.3 mg/L
- D. 0.5 mg/L (Correct Answer)
Explanation: ***0.5 mg/L*** - The World Health Organization (WHO) recommends maintaining a free residual chlorine level of **0.2-0.5 mg/L** at the point of delivery, with **0.5 mg/L representing the upper end of this recommended range**. - This level provides adequate disinfection throughout the distribution system while minimizing taste and odor complaints. - WHO states there is no health-based upper limit for chlorine, as concentrations used for disinfection are well below levels of health concern, but 0.5 mg/L is commonly cited as the practical upper target for operational purposes. *0.4 mg/L* - While this falls within the acceptable range (0.2-0.5 mg/L), it is not the upper end of the WHO recommended range. - This level provides good disinfection but is not the maximum recommended operational target. *0.2 mg/L* - A free residual chlorine level of **0.2 mg/L** represents the **minimum recommended concentration** at the point of delivery to ensure adequate disinfection. - This is the lower end of the WHO recommended range, not the upper limit. *0.3 mg/L* - This concentration falls in the middle of the WHO recommended range (0.2-0.5 mg/L). - While adequate for disinfection, it is neither the minimum nor the maximum recommended operational level.
Question 4: Which of the following is a method for on-site disposal of domestic wastewater?
- A. Soakage pit (Correct Answer)
- B. Activated sludge process
- C. Oxidation pond
- D. All of the options
Explanation: ***Soakage pit*** - A **soakage pit**, also known as a **seepage pit** or **leach pit**, is an underground chamber that allows treated effluent from a septic tank to seep into the surrounding soil. - It is a common and effective on-site method for the **disposal of domestic wastewater**, particularly in rural or unsewered areas. *Activated sludge process* - The **activated sludge process** is a centralized biological wastewater treatment method used in municipal wastewater treatment plants, not typically for on-site domestic disposal. - It involves aerating wastewater in a tank with suspended microorganisms to consume organic pollutants. *Oxidation pond* - An **oxidation pond**, or **stabilization pond**, is a large, shallow basin where wastewater is treated through natural biological and physical processes. - While it treats wastewater, it is typically a **larger-scale** treatment method for communities or industries, rather than a standalone on-site disposal method for individual domestic units. *All of the options* - This option is incorrect because both the activated sludge process and oxidation ponds are generally larger-scale or centralized treatment methods, not practical for individual on-site domestic disposal. - Only the soakage pit is well-suited for **on-site domestic wastewater disposal**.
Question 5: Disease usually not seen in a country but brought from abroad is:
- A. Exotic (Correct Answer)
- B. Endemic
- C. Epidemic
- D. Zoonotic
Explanation: ***Exotic*** - An **exotic disease** refers to a disease that is not native or usually found in a particular country or region but is introduced from abroad. - This term highlights its **foreign origin** and rarity within the local population. *Endemic* - An **endemic disease** is one that is constantly present in a population or region with a relatively stable prevalence within that population. - It describes a disease that is **native** to a specific area, not typically brought from abroad. *Epidemic* - An **epidemic** signifies a sudden increase in the number of cases of a disease in a population over a particular period, substantially exceeding what is normally expected. - While it can be introduced from abroad, the definition focuses on the **rapid spread** rather than the origin itself. *Zoonotic* - A **zoonotic disease** is an infectious disease that has jumped from an animal to humans. - This term describes the **mode of transmission** from animals, not necessarily its geographic origin or whether it's new to a country.
Question 6: A well of contaminated water resulting in an epidemic of acute watery diarrhea is a typical example for:
- A. Common source, single exposure epidemic (Correct Answer)
- B. Propagated epidemic
- C. Slow epidemic
- D. Common source, continuous exposure epidemic
Explanation: ***Common source, single exposure epidemic*** - A contaminated well is a **classic example of a point source (single exposure) epidemic**, as seen in John Snow's famous Broad Street pump cholera outbreak. - People who drink from the contaminated well are exposed to the pathogen at **roughly the same time or over a short period**. - The epidemic curve shows a **sharp rise in cases within one incubation period**, followed by a rapid decline, creating a characteristic **single peaked curve**. - Even though the well remains accessible, each individual's exposure is typically a **discrete event**, not continuous. *Common source, continuous exposure epidemic* - This occurs when the **source remains contaminated and people are repeatedly exposed over an extended period**, such as persistent sewage leakage into a water supply. - The epidemic curve would show a **prolonged plateau** with cases occurring continuously as long as the exposure continues. - Unlike a contaminated well (discrete exposures), continuous exposure involves **ongoing, repetitive contact** with the pathogen source. *Propagated epidemic* - Involves **person-to-person transmission** where the disease spreads through successive generations of cases. - The epidemic curve shows **multiple peaks** or waves as the infection passes from one individual to another. - Waterborne diarrhea from a well is **not transmitted person-to-person** but through a common environmental source. *Slow epidemic* - This is **not a standard epidemiological classification** based on exposure patterns. - While epidemics can vary in speed, this term doesn't describe the **transmission dynamics** relevant to classifying outbreak patterns.
Question 7: Recommended daily dose of Iodine in a school-age child is:-
- A. 120-200 ug
- B. 30-60 ug
- C. 500 ug
- D. 90-120 ug (Correct Answer)
Explanation: ***90-120 ug*** - The recommended daily intake of iodine for **school-age children (6-12 years)** is 90-120 micrograms (µg), which supports normal growth and thyroid function. - According to **WHO/UNICEF/ICCIDD recommendations**, children in this age group require 120 µg/day for optimal thyroid hormone synthesis. - Adequate iodine intake is crucial for the production of **thyroid hormones**, which regulate metabolism and brain development. *120-200 ug* - This range is higher than recommended for school-age children. - **Adolescents (≥12 years) and adults** require 150 µg/day, and **pregnant/lactating women** require 250 µg/day. *30-60 ug* - This range is **insufficient for children** and well below WHO recommendations. - Even **infants and young children (0-5 years)** require 90 µg/day, making this range inadequate for any pediatric age group. - Such low intake could lead to **iodine deficiency** and impaired thyroid function. *500 ug* - This amount is significantly higher than the recommended daily intake for children and could cause **iodine excess** or toxicity. - High doses of iodine can paradoxically inhibit thyroid function and lead to conditions like **iodine-induced hyperthyroidism** or hypothyroidism. - The **tolerable upper intake level** for children is much lower than this amount.
Question 8: Ujjawala scheme is for prevention of
- A. Child marriage
- B. Child trafficking (Correct Answer)
- C. Child abuse
- D. Child labour
Explanation: **Child trafficking** - The **Ujjawala scheme** is a comprehensive project of the Ministry of Women and Child Development, Government of India, aimed at **preventing, rescuing, rehabilitating, reintegrating, and repatriating victims of human trafficking**, particularly women and children. - It addresses the severe human rights violation of **trafficking** by providing safe shelter, basic necessities, counseling, and vocational training to survivors. *Child marriage* - While child marriage is a serious issue, the primary focus of the **Ujjawala scheme** is on **combating human trafficking**, not specifically child marriage. - Other schemes like the **Prohibition of Child Marriage Act, 2006**, and various advocacy programs specifically target the prevention of child marriage. *Child abuse* - The **Ujjawala scheme** aims to help victims of trafficking, which often includes elements of abuse, but its direct mandate is focused on **trafficking as a whole**, not all forms of child abuse. - Other legislative frameworks and programs, such as the **Protection of Children from Sexual Offences (POCSO) Act, 2012**, directly address child abuse. *Child labour* - Although children involved in trafficking may be forced into child labor, the **Ujjawala scheme's** overarching objective is to tackle **human trafficking** in its entirety. - Specific efforts to combat child labor are primarily addressed by legislation like the **Child Labour (Prohibition and Regulation) Act, 1986**, and various campaigns against child exploitation.