FMGE 2026 - Community Medicine Practice Questions

Q: An immunization session where 40 children are scheduled to be vaccinated in 2 hours by 2 ANMs is planned. Due to overcrowding, there is long waiting time, missed opportunities, and increased vaccine wastage. Which of the following is the most appropriate measure to reduce missed opportunities and vaccine wastage?

Assign one ANM for documentation and one for vaccination. ### ***Assign one ANM for documentation and one for vaccination*** - Dividing roles allows one staff member to focus on the systematic **screening, counseling, and record-keeping** (documentation/HMIS entry), while the other focuses exclusively on **safe and efficient vaccine administration**. - This streamlining reduces bottlenecks, minimizes **waiting time** for caregivers, ensures compliance with **cold chain protocols** through better oversight, and ultimately decreases **vaccine wastage** by optimizing the flow of beneficiaries. *Increase the number of cold-chain carriers and extend the session time* - Extending session time is often logistically difficult in routine outreach settings and does not address the fundamental issue of workflow inefficiency. - Simply adding equipment (cold chain carriers) does not fix the bottleneck caused by the documentation process, which is the primary cause of delays and missed opportunities. *Limit the number of children to 20 per session* - Placing an arbitrary limit on the number of children ignores the goal of high coverage (universal immunization) and may lead to increased **missed opportunities** for those not reached. - Efficient management of the existing workload is preferred over reducing quotas, as long as staff capacity allows for the current load when properly organized. *Increase the dose per vial* - This is not a feasible or safe medical intervention; vaccine dosages are strictly determined by formulation, safety, and efficacy studies. - Altering dosages is prohibited and would not address the operational issues of overcrowding or administrative bottlenecks.

Q: The following data show systolic blood pressure (SBP) values and the number of patients corresponding to each value: SBP (mmHg) Salt intake 120 3.2 130 4.1 140 5.1 150 6.2

Scatter diagram. ***Scatter diagram*** - A **scatter diagram** (or scatter plot) is the most appropriate graphical method to represent the relationship between **two quantitative variables**, such as blood pressure and salt intake. - It allows visual assessment of the **correlation** or trend (positive, negative, or no correlation) between the two continuous variables. *Line graph* - A **line graph** is typically used to represent **trends over time** (e.g., mortality rates over different years). - It is not suitable for displaying the direct correlation between two distinct quantitative variables like systolic blood pressure and salt intake. *Ogive* - An **ogive** is used for plotting **cumulative frequency** distributions of quantitative data. - It helps in determining the **median** or quartiles, rather than showing independent relationships between two separate variables. *Pie chart* - A **pie chart** is used to represent **proportions or percentages** of a single categorical variable (e.g., distribution of blood types in a population). - It is entirely unsuitable for displaying the relationship between two continuous variables.

Q: An HIV-positive patient with a suspected airborne infection is seated in a consultation room.Based on the direction of airflow (green arrows) shown in the image, where should the doctor sit to have the least chance of infection?

B. ***B*** - In a clinical setting with airborne precautions, the doctor should position themselves **upstream** or between the source of infection and the clean air source to minimize exposure to droplet nuclei. - Sitting at position B, assuming unidirectional airflow from the clean air intake towards the patient (as is standard in ventilated rooms), ensures the healthcare worker is not in the **direct path of contaminated air** emanating from the patient. *A* - Position A is located **downstream** from the infected patient, meaning that any bioaerosols generated by the patient will be carried by the airflow directly toward this location. - Occupying this position significantly increases the risk of inhaling infectious particles, as the room ventilation is designed to move air **away from** the patient and toward the exhaust. *A & B* - This option is incorrect because the risk profile for positions A and B is vastly different due to the **unidirectional nature** of the airflow depicted. - Position A is a high-risk zone for exposure to airborne pathogens, whereas Position B represents a cleaner, safer zone in this specific airflow configuration. *None of the above* - The principles of **infection control** dictate that spatial positioning relative to airflow is a critical determinant of exposure risk for airborne pathogens. - Since airflow dynamics provide a clear distinction between the upstream and downstream zones, there is a distinct, verifiable answer choice among those provided.

Q: A rural health program has led to an increase in vaccination coverage, institutional deliveries, and access to healthcare services. However, when compared to urban areas, the overall health indicators are still significantly lower. Which pillar of Primary Health Care is most likely being compromised?

Equitable distribution. ***Equitable distribution*** - This pillar centers on the premise that healthcare services should be accessible to all individuals based on their needs, regardless of their geographical location or socioeconomic status. - The persistence of significant health disparities between rural and urban populations despite improvements in specific services indicates a failure to achieve balance in access and resource allocation. *Community participation* - This involves the involvement of local populations in planning, monitoring, and evaluating healthcare programs to ensure cultural relevance and local ownership. - While crucial, there is no evidence in the scenario suggesting that the rural residents were excluded from participating or that local engagement was the primary barrier to closing the urban-rural gap. *Appropriate technology* - This refers to the use of methods, procedures, techniques, and equipment that are scientifically valid, adapted to local needs, and acceptable to those who use them and those who provide them. - The issue is primarily one of disparities in access and health outcomes rather than an inefficiency or inappropriateness of the medical technology being utilized. *Intersectoral coordination* - This principle emphasizes that health is influenced by factors outside the health sector, such as housing, sanitation, agriculture, and education, requiring a collaborative approach. - Since the scenario specifically highlights healthcare delivery metrics (vaccinations, deliveries) rather than broad systemic infrastructure failures (roads, water, electricity), equitable distribution is the most direct answer.

Q: An anemic woman in the 2nd trimester of pregnancy is receiving iron and folic acid under the Anemia Mukt Bharat program. Which of the following should be added to improve the efficacy of iron therapy?

Vitamin C. ***Vitamin C*** - Ascorbic acid (**Vitamin C**) acts as a reducing agent in the gut, which converts ferric iron (Fe3+) into ferrous iron (Fe2+), the form that is more easily absorbed by the small intestine. - Supplementing with Vitamin C alongside oral iron therapy significantly enhances its **bioavailability** and absorption rate by preventing the formation of insoluble iron complexes. *Albendazole* - This is an **anthelmintic** agent used for deworming, which is part of the Anemia Mukt Bharat strategy but is administered to treat helminthic infections rather than to directly increase the absorption of iron. - While treating soil-transmitted helminths improves iron status by reducing blood loss, it does not chemically enhance the absorption of the iron supplement itself. *Green leafy vegetables* - While these are rich sources of dietary iron, they contain **phytates** and **oxalates** which can actually bind to non-heme iron and inhibit its absorption. - Relying solely on dietary sources during pregnancy is insufficient to meet the increased iron demands, and adding them does not pharmacologically improve the efficacy of the iron supplement provided. *Non-vegetarian food* - Meat, poultry, and fish provide heme iron, which is absorbed better than non-heme iron, but they do not specifically act as absorption enhancers for the supplemental iron pill prescribed. - While protein-rich, they are not the standard adjuvant used in public health programs to maximize the bioavailability of the specific iron supplements provided in antenatal care.

Q: How should expired medications be disposed of as per Biomedical Waste Management guidelines?

Incineration. ***Incineration*** - According to **Biomedical Waste Management Rules**, discarded or **expired medicines** (Category 5) must be disposed of via **incineration** at high temperatures to ensure complete destruction and prevent environmental contamination. - It is the preferred method because it safely converts hazardous pharmaceutical compounds into non-toxic ash and flue gases. *Deep burial* - **Deep burial** is primarily reserved for specific isolated cases where common bio-medical waste treatment facilities are unavailable, and it is generally reserved for solid waste contaminated with blood or body fluids. - It is not the standard or approved method for handling **pharmaceutical waste** due to the risk of leaching into **groundwater**. *Recycling* - Expired medications cannot be **recycled** as they pose significant health risks if re-introduced into the supply chain or environment. - Unlike paper or plastic medical waste, chemical compounds in drugs lack any safe mechanism for reclamation. *Chemical disinfection* - **Chemical disinfection** is typically used for items like **laboratory waste**, microbiological cultures, or liquid waste, but it is ineffective for the complex chemical structure of solid pharmaceutical medications. - It does not achieve the necessary degradation required for **pharmaceutical disposal** to ensure safety.

Q: What is the calorie and protein supplementation given to a child aged 6 –72 months under ICDS programme of India?

500 kcal, 12–15 g protein. ***500 kcal, 12–15 g protein*** - Under the **Integrated Child Development Services (ICDS)** scheme, this is the prescribed **supplementary nutrition** mandated for children aged 6 to 72 months who are in the general category. - This nutritional support aims to bridge the gap between the Recommened Dietary Allowance (RDA) and Actual Dietary Intake, specifically targeting the prevention of **protein-energy malnutrition**. *600 kcal, 18–20 g protein* - This caloric and protein level is higher than the standard ICDS recommendation for this specific age group. - These amounts are often associated with therapeutic feeding protocols for **severely acute malnourished (SAM)** children rather than routine supplementary nutrition. *800 kcal, 20–25 g protein* - This caloric density exceeds the national guidelines for supplementary feeding under the ICDS program for children. - Providing such high caloric supplementation is typically reserved for aggressive clinical recovery programs or inpatient management of severe malnutrition, not the standard **community-based nutrition** program. *400 kcal, 10 g protein* - This amount represents an outdated or incorrect figure often confused with historical supplementary standards. - It falls below the established **nutritional standard** set by the Ministry of Women and Child Development for the growth and development of children during these critical formative years.

Q: In a study, 100 patients were telephoned and asked whether they exercise daily (exposure), and whether they have coronary artery disease now or ever before (outcome). Identify the study design.

Cross-sectional study. ***Cross-sectional study*** - This design measures **exposure** and **outcome** simultaneously at a single point in time, commonly referred to as a **prevalence study** or 'snapshot' study. - Because it assesses status at one moment, it cannot determine **temporality** or causality, making it ideal for determining disease prevalence rather than incidence. *Cohort study* - In a cohort study, researchers start with **exposure** status and follow participants over time to observe the development of an **outcome**. - It assesses incidence and is longitudinal, requiring a **follow-up period** which is absent in this scenario. *Case–control study* - This design involves identifying participants based on the presence of the **outcome** (cases) versus those without it (controls) and then looking back for past **exposures**. - Since the study described begins by asking about exercise habits without grouping participants by disease status first, it is not a retrospective case-control study. *Randomized controlled trial (RCT)* - An RCT is an **experimental study** where the investigator **actively intervenes** by randomly assigning patients to treatment or control groups. - This scenario is an **observational study** where the researcher only observes existing habits, rather than assigning exercise regimens.

Q: Arrange the following in sequence. 1. Evaluation 2. Execution 3. Planning 4. Delegation

3, 2, 4, 1. ***3, 2, 4, 1*** - The administrative/management cycle in public health follows a logical progression starting with **Planning** (identifying objectives and strategies), followed by **Execution** (the active implementation phase). - This is sequentially followed by **Delegation** (assigning tasks to appropriate personnel) and finally **Evaluation** (assessing outcomes against initial objectives to close the loop). *1, 3, 4, 2* - This sequence incorrectly positions **Evaluation** at the beginning, whereas evaluation must occur after the activity has been executed. - Placing **Execution** at the end ignores the need for systematic delegation and assessment before the project concludes. *3, 1, 2, 4* - Starting with **Planning** is correct, but placing **Evaluation** immediately after it is premature since no implementation has occurred yet. - This order fails to recognize the necessary sequence of active **Execution** before performance can be reviewed or delegated effectively. *3, 1, 2 , 4* - Similar to the previous incorrect option, it erroneously skips the implementation and delegation phases before jumping to evaluation. - **Evaluation** is a retrospective monitoring process and cannot logically precede the functional implementation or delegation of tasks.

Question 1

An immunization session where 40 children are scheduled to be vaccinated in 2 hours by 2 ANMs is planned. Due to overcrowding, there is long waiting time, missed opportunities, and increased vaccine wastage. Which of the following is the most appropriate measure to reduce missed opportunities and vaccine wastage?

Accepted Answer

Assign one ANM for documentation and one for vaccination

Answer

Increase the number of cold -chain carriers and extend the session time

Answer

Limit the number of children to 20 per session

Answer

Increase the dose per vial

Question 2

The following data show systolic blood pressure (SBP) values and the number of patients corresponding to each value: SBP (mmHg) Salt intake 120 3.2 130 4.1 140 5.1 150 6.2

Accepted Answer

Scatter diagram

Answer

Line graph

Answer

Ogive

Answer

Pie chart

Question 3

An HIV-positive patient with a suspected airborne infection is seated in a consultation room.Based on the direction of airflow (green arrows) shown in the image, where should the doctor sit to have the least chance of infection?

Accepted Answer

B

Answer

A

Answer

A & B

Answer

None of the above

Question 4

A rural health program has led to an increase in vaccination coverage, institutional deliveries, and access to healthcare services. However, when compared to urban areas, the overall health indicators are still significantly lower. Which pillar of Primary Health Care is most likely being compromised?

Accepted Answer

Equitable distribution

Answer

Community participation

Answer

Appropriate technology

Answer

Intersectoral coordination

Question 5

An anemic woman in the 2nd trimester of pregnancy is receiving iron and folic acid under the Anemia Mukt Bharat program. Which of the following should be added to improve the efficacy of iron therapy?

Accepted Answer

Vitamin C

Answer

Albendazole

Answer

Green leafy vegetables

Answer

Non-vegetarian food

Question 6

How should expired medications be disposed of as per Biomedical Waste Management guidelines?

Accepted Answer

Incineration

Answer

Deep burial

Answer

Recycling

Answer

Chemical disinfection

Question 7

What is the calorie and protein supplementation given to a child aged 6 –72 months under ICDS programme of India?

Accepted Answer

500 kcal, 12–15 g protein

Answer

600 kcal, 18–20 g protein

Answer

800 kcal, 20–25 g protein

Answer

400 kcal, 10 g protein

Question 8

In a study, 100 patients were telephoned and asked whether they exercise daily (exposure), and whether they have coronary artery disease now or ever before (outcome). Identify the study design.

Accepted Answer

Cross-sectional study

Answer

Cohort study

Answer

Case–control study

Answer

Randomized controlled trial (RCT)

Question 9

Define net reproduction rate

Accepted Answer

Total number of girl children born during the reproductive age of a woman taking into account mortality/Average no of female children a newborn girl will bear during her reproductive age assuming age specific fertility and mortality rates

Answer

Total number of children born during the reproductive age of a woman

Answer

Total number of girl children born during the reproductive age of a woman

Answer

Average number of live births per woman during her reproductive lifespan

Question 10

Arrange the following in sequence. 1. Evaluation 2. Execution 3. Planning 4. Delegation

Accepted Answer

3, 2, 4, 1

Answer

1, 3, 4, 2

Answer

3, 1, 2, 4

Answer

3, 1, 2 , 4

FMGE 2026 — Community Medicine