A patient comes with a history of category 3 dog bites. He received prophylaxis for a monkey bite 6 months back. What is the next step in management?
A government plans to outline tobacco control laws. What is the level of prevention here?
Hand washing during COVID-19 is what level of prevention?
School health service should include all the following except
How much percent of GNP does WHO recommend being spent on the healthcare sector?
Eligible couple registers are maintained at which of the following centres?
An 8-month-old infant is being treated with vitamin A supplementation over 2 consecutive days for Vitamin A deficiency. What is the recommended dose to be given each day?
The shelf life of copper T 380 A is
Confidentiality is maintained in which of the following conditions?
An 8 weeks pregnant woman, working in an industry, consults a doctor. According to the ESI act, what is the duration of maternity leave that she can get?
FMGE 2023 - Community Medicine FMGE Practice Questions and MCQs
Question 11: A patient comes with a history of category 3 dog bites. He received prophylaxis for a monkey bite 6 months back. What is the next step in management?
- A. Wound cleaning only
- B. Wound cleaning+ rabies vaccine on day 0 & 3 (Correct Answer)
- C. Wound cleaning+IM vaccine +RIG
- D. Wound cleaning+rabies vaccine on day 0,3 & 7
Explanation: ***Wound cleaning+ rabies vaccine on day 0 & 3***- Since the patient received prophylaxis 6 months ago, they are considered **previously immunized**, meaning **Rabies Immunoglobulin (RIG)** is *not* required, even for a **Category 3 bite**.- For a previously immunized individual with a Category III exposure, the required management is a **booster regimen** consisting of the rabies vaccine given on **Day 0** and **Day 3** (two doses). *Wound cleaning only*- This action is inadequate for managing a **Category 3 bite**, which involves severe exposure like deep puncture wounds or mucosal contamination.- Even in previously vaccinated individuals, a **booster dose** is necessary to ensure adequate and rapid protective antibody levels against the high viral load typical of a severe animal bite. *Wound cleaning+rabies vaccine on day 0,3 & 7*- While this 3-dose schedule is sometimes used, the **standard recommended booster regimen** for previously immunized individuals with a new Category III exposure is the **2-dose schedule** (Day 0 and Day 3) as per WHO and IAPSM guidelines.- The 2-dose booster is sufficient to rapidly achieve protective antibody titers in individuals who have received complete prior vaccination. *Wound cleaning+IM vaccine +RIG*- The administration of **Rabies Immunoglobulin (RIG)** is unnecessary and contraindicated in patients who have been **previously immunized** with a full course of the rabies vaccine.- RIG is reserved for **unvaccinated** patients with Category II or III exposures to provide immediate passive immunity before the active immune response develops.
Question 12: A government plans to outline tobacco control laws. What is the level of prevention here?
- A. Secondary prevention
- B. Tertiary prevention
- C. Primordial prevention (Correct Answer)
- D. Primary prevention
Explanation: ***Primordial prevention*** - Tobacco control laws represent **primordial prevention** as they are **policy-level interventions** aimed at preventing the emergence of risk factors in the population - This involves creating conditions that minimize hazards to health through **legislative and regulatory measures** - By outlining tobacco control laws, the government prevents the establishment of patterns of tobacco use at the **population level** before individual exposure occurs *Primary prevention* - Refers to interventions targeting individuals who are at risk but haven't developed disease (e.g., smoking cessation programs, health education campaigns) - Operates at the **individual level** rather than policy level *Secondary prevention* - Involves early detection and treatment of disease in asymptomatic individuals (e.g., screening programs) - Not applicable to legislative measures *Tertiary prevention* - Focuses on reducing complications and disability in those already diagnosed with disease (e.g., rehabilitation programs) - Not related to policy formulation
Question 13: Hand washing during COVID-19 is what level of prevention?
- A. Secondary prevention
- B. Tertiary prevention
- C. Primary prevention (Correct Answer)
- D. Primordial prevention
Explanation: ***Primary prevention***- Hand washing is a crucial public health measure that provides **specific protection** by removing SARS-CoV-2 from the skin surface, thereby preventing the entry and establishment of the disease.- This level of prevention focuses on actions taken *before* the onset of disease to reduce the incidence of infection, aligning with efforts like **vaccination** and health education.*Primordial prevention*- This is the earliest stage, aimed at preventing the emergence and establishment of **environmental or social conditions** that may lead to the development of risk factors (e.g., discouraging unhealthy lifestyle trends globally).- It addresses pre-existing **underlying determinants** of health, whereas hand washing directly targets an infectious agent.*Secondary prevention*- This level involves actions aimed at early diagnosis and prompt treatment of an existing condition to halt progression (e.g., large-scale **testing/screening** of asymptomatic cases for COVID-19).- Actions taken at this stage occur *after* the infection has begun but before significant symptoms or complications arise.*Tertiary prevention*- This level focuses on measures taken when the disease has already fully developed, aiming to reduce the severity of **complications**, limit disability, and provide **rehabilitation** (e.g., physical therapy for post-COVID syndrome).- It deals with the management and recuperation phase of established illness, which is not applicable to preventive hygiene practices.
Question 14: School health service should include all the following except
- A. Doctor on premises (Correct Answer)
- B. Dental and eye health services
- C. School health records
- D. Education of handicapped children
Explanation: ***Doctor on premises***- A full-time, dedicated **doctor** is generally not considered an essential or standard component of basic school health services, which are typically managed by a **school health nurse** or auxiliary personnel.- School health services focus on periodic **health screening**, first aid, and referral services, rather than requiring an immediate physician presence for routine needs.*Education of handicapped children*- This falls under the necessary provision of **health promotion** and specialized services to ensure **inclusive education** for all students.- School health services must coordinate resources and adaptive support to facilitate the educational outcomes of children with **special needs**.*Dental and eye health services*- These are crucial components of **health screening** and early detection efforts required in school health services.- Identifying and referring issues like **dental caries** and **visual impairments** prevents academic hindrance and long-term morbidity.*School health records*- Maintaining comprehensive **cumulative health records** is paramount for monitoring the health status of students and ensuring continuity of care throughout their schooling.- These records are essential for tracking **immunization status**, screening results, and medical history, which is critical during emergencies.
Question 15: How much percent of GNP does WHO recommend being spent on the healthcare sector?
- A. 3.5%
- B. 5% (Correct Answer)
- C. 2.5%
- D. 2.0%
Explanation: ***5%***- The **World Health Organization (WHO)** recommends that countries aim to spend at least **5%** of their **Gross Domestic Product (GDP)** or **Gross National Product (GNP)** on health.- This minimum threshold is deemed necessary to establish basic **universal health coverage** and ensure robust primary healthcare services.*2.0%*- Spending only **2.0%** of GNP is drastically low and associated with poor health outcomes and high rates of **out-of-pocket expenses** for citizens.- This level of allocation is insufficient to fund essential public health functions or maintain a functional **healthcare system**.*2.5%*- While slightly better than 2.0%, **2.5%** remains well below the recognized international benchmark required for adequate health investment.- This level fails to provide resources for comprehensive care, including preventative services and necessary **infrastructure development**.*3.5%*- Allocating **3.5%** shows some governmental commitment but still falls short of the WHO's target for sustainable and effective health financing.- The shortfall between 3.5% and 5% often represents a gap in funding for critical areas like **health workforce training** and access to specialized care.
Question 16: Eligible couple registers are maintained at which of the following centres?
- A. District hospital
- B. PHC
- C. CHC
- D. Sub-centre (Correct Answer)
Explanation: ***Sub-centre (Correct Answer)*** - The **sub-centre** is the most peripheral and first contact point between the primary health care system and the community, typically serving 3,000 to 5,000 population - It is the operational unit responsible for maintaining essential household and community registers, including the **Eligible Couple Register**, used for planning and delivering family planning services - The **Auxiliary Nurse Midwife (ANM)** posted at the sub-centre maintains this register as part of grassroots family planning surveillance *PHC (Incorrect)* - A **Primary Health Centre (PHC)** serves a larger population (20,000 to 30,000) and supervises 4-6 sub-centres - Its role is more administrative and higher-level curative care - While the PHC utilizes the data for planning, the actual maintenance of the **Eligible Couple Register** is done at the sub-centre level *CHC (Incorrect)* - A **Community Health Centre (CHC)** functions as a referral center for 4 PHCs, offering specialized services like obstetrics, surgery, and pediatrics - Typically serves 80,000 to 1,20,000 population - CHCs are higher-level referral units and do not maintain ground-level household/couple-specific registers *District Hospital (Incorrect)* - The **District Hospital** is the highest-level facility in the district, focusing on advanced tertiary care, specialist consultation, and training - It is far removed from the grassroots fieldwork and record-keeping required for community health surveillance - Does not maintain individual **Eligible Couple Registers** for specific villages
Question 17: An 8-month-old infant is being treated with vitamin A supplementation over 2 consecutive days for Vitamin A deficiency. What is the recommended dose to be given each day?
- A. 25,000 IU
- B. 50,000 IU
- C. 200,000 IU
- D. 100,000 IU (Correct Answer)
Explanation: ***100,000 IU*** - This is the correct **single dose per day** of Vitamin A for infants aged 6 to 11 months in the therapeutic regimen for Vitamin A deficiency or measles. - According to **WHO guidelines**, the therapeutic protocol for this age group involves administering **100,000 IU on Day 1** and **100,000 IU on Day 2** (and a third dose on Day 14 for severe deficiency). - This dose is both safe and effective for treating deficiency in this specific age group. *25,000 IU* - This dose is significantly lower than the recommended therapeutic level for infants 6-11 months and would be **ineffective** for treating Vitamin A deficiency. - Doses of this magnitude are not part of standardized WHO supplementation protocols for this age group. *50,000 IU* - This is the standard single dose recommended for **infants under 6 months** of age (1-5 months) for both prophylactic and therapeutic purposes. - For an 8-month-old infant (6–11 months age group), 50,000 IU is **insufficient** for effective therapeutic intervention. *200,000 IU* - This is the standard single dose for **children aged 12 months to 5 years** for routine supplementation. - Giving 200,000 IU as a single dose to an 8-month-old infant carries significant risk of **acute hypervitaminosis A toxicity** including symptoms such as bulging fontanelle, nausea, vomiting, and headache.
Question 18: The shelf life of copper T 380 A is
- A. 5 years
- B. 7 years
- C. 10 years (Correct Answer)
- D. 3 years
Explanation: ***10 years*** - The **Copper T 380A** is approved for continuous use for up to **10 years** - This is the longest duration among all copper IUDs due to its large copper surface area (380 mm²) - Endorsed by **FDA, WHO, and ICMR** as a highly effective long-acting reversible contraception (LARC) - Most cost-effective IUD due to its prolonged efficacy *5 years* - This duration applies to **Copper T 200B** (lower copper content) - Also the approved duration for hormonal IUDs like **Mirena** (levonorgestrel-releasing) - Not applicable to Copper T 380A which has extended efficacy *3 years* - Associated with lower-dose hormonal IUDs like **Skyla** or **Jaydess** - Much shorter than Copper T 380A due to different mechanism (hormonal vs copper) - Not relevant to copper-based contraception duration *7 years* - Not a standard approved duration for any commonly used IUD - Some clinical studies suggest efficacy beyond labeled duration, but 7 years is not the official approval for Copper T 380A - The standard maximum approved duration remains **10 years**
Question 19: Confidentiality is maintained in which of the following conditions?
- A. Group discussion
- B. Panel discussion
- C. Seminar
- D. Counselling (Correct Answer)
Explanation: ***Counselling***- **Counselling** is a private, one-on-one interaction where the counselor is ethically and legally bound to maintain the client's information as **confidential**.- The foundation of successful **counselling** relies heavily on establishing trust, which is achieved through adherence to strict **confidentiality** rules.*Group discussion*- *Group discussion* involves multiple participants discussing a topic, making the shared information inherently public among the group members, thus negating **confidentiality**.- While privacy among group members might be implied, there is no formal professional obligation or structure ensuring that information remains strictly private outside the *group discussion*.*Panel discussion*- A *panel discussion* is a public forum where a group of experts discusses a subject in front of a larger audience, meaning all information shared is immediately public and not **confidential**.- The primary goal is dissemination of information and expert opinion to a broad audience, conflicting with the concept of **confidentiality**.*Seminar*- A *seminar* is an educational presentation or meeting, usually involving a presenter and an audience, where information is shared publicly.- The format of a *seminar* is designed for open learning and exchange, preventing the maintenance of **confidentiality** for any data or client-specific details presented.
Question 20: An 8 weeks pregnant woman, working in an industry, consults a doctor. According to the ESI act, what is the duration of maternity leave that she can get?
- A. 4 months
- B. 28 weeks, starting from 4 weeks after delivery
- C. 26 weeks, starting from 8 weeks before delivery (Correct Answer)
- D. 9 months
Explanation: ***26 weeks, starting from 8 weeks before delivery*** - This duration is mandated by the **Maternity Benefit (Amendment) Act, 2017**, which governs the maternity benefits paid through the **ESI scheme** for eligible insured women - This applies for the first two surviving children - The total paid leave entitlement is **26 weeks** (or 182 days), which can be availed for a period not exceeding **8 weeks** immediately preceding the expected date of delivery *4 months* - Four months is approximately **17 weeks**, which is substantially less than the **26 weeks** maximum paid leave guaranteed under the ESI Act and the Maternity Benefit Act - Such a short duration does not comply with current statutory requirements aimed at promoting maternal health and child welfare *28 weeks, starting from 4 weeks after delivery* - The statutory maximum paid maternity leave duration is **26 weeks**, making **28 weeks** an excess entitlement not provided under the current law - The woman is legally entitled to begin her leave up to **8 weeks** prior to the expected delivery date, not just post-delivery, enabling vital pre-natal rest *9 months* - Nine months (approximately **39 weeks**) is significantly longer than the standard paid maternity leave duration of **26 weeks** provided by the ESI Act - While some organizations may offer extended unpaid leave, **9 months** is not the statutory duration for compensated maternity benefit