INI-CET 2023 — Community Medicine
4 Previous Year Questions with Answers & Explanations
A person is bitten by a dog. The dog and the person are fully immunized. There is a small abrasion mark on the site of bite. What would you advise to the person?
Match the following: Column A: a. Syphilis b. Chickenpox c. COVID-19 d. Hepatitis A Column B: 1. 6 Days 2. 90 Days 3. 16 Days 4. 28 Days
Match the incubation periods of the following diseases: a. Syphilis b. SARS c. Hepatitis A d. Chickenpox Match with: 1. 10-21 days 2. 21 days (3 weeks) 3. 2-7 days 4. 15-50 days
Blackfoot disease is seen in which of the following?
INI-CET 2023 - Community Medicine INI-CET Practice Questions and MCQs
Question 1: A person is bitten by a dog. The dog and the person are fully immunized. There is a small abrasion mark on the site of bite. What would you advise to the person?
- A. Amoxiclav
- B. Metronidazole
- C. Ciprofloxacin
- D. Observation (Correct Answer)
Explanation: ***Observation*** - This is a **Category II exposure** (minor abrasion/scratch) according to **WHO rabies classification**. With both the dog and person **fully immunized**, the recommended management is **immediate wound washing** with soap and water followed by **observation of the dog for 10 days**. - If the dog remains healthy during the 10-day observation period, no further rabies post-exposure prophylaxis is needed. The person's prior vaccination provides adequate protection. - **Prophylactic antibiotics are NOT routinely indicated** for minor abrasions in immunized individuals when the wound can be properly cleaned. The risk of significant bacterial infection in superficial wounds is low with proper wound care. - This approach follows **WHO and IAPSM guidelines** for rational dog bite management, avoiding unnecessary antibiotic use. *Amoxiclav* - Prophylactic antibiotics like **amoxicillin-clavulanate** are reserved for **high-risk wounds**: deep puncture wounds (Category III), wounds near bones/joints, hand/face wounds, delayed presentation (>8 hours), or immunocompromised patients. - A **small abrasion** in an immunized person does not meet criteria for routine antibiotic prophylaxis. Over-prescription contributes to **antimicrobial resistance**. - The primary concern in dog bite management is **rabies prevention**, not routine bacterial prophylaxis for minor wounds. *Metronidazole* - **Metronidazole** alone has limited coverage against common bite wound pathogens and would not be appropriate even if antibiotics were indicated. - It lacks activity against aerobic organisms like *Pasteurella* and *Staphylococcus* species commonly found in dog bites. *Ciprofloxacin* - **Ciprofloxacin** is not the first-line antibiotic for dog bites even when prophylaxis is indicated, due to limited anaerobic and Gram-positive coverage. - More importantly, antibiotics are **not routinely needed** for this Category II exposure with proper wound care and observation.
Question 2: Match the following: Column A: a. Syphilis b. Chickenpox c. COVID-19 d. Hepatitis A Column B: 1. 6 Days 2. 90 Days 3. 16 Days 4. 28 Days
- A. a-2, b-3, c-1, d-4 (Correct Answer)
- B. a-3, b-4, c-2, d-1
- C. a-1, b-4, c-2, d-3
- D. a-3, b-4, c-1, d-2
Explanation: ***a-2, b-3, c-1, d-4*** - **Syphilis**: 90 days represents the **maximum incubation period** for *Treponema pallidum* (range 10-90 days, typical 21 days). While not the most common presentation time, it remains medically accurate and is the only viable match among available options. - **Chickenpox**: 16 days falls within the typical incubation period for **varicella-zoster virus** (range 10-21 days, commonly 14-16 days). - **COVID-19**: 6 days is consistent with the **median incubation period** for SARS-CoV-2 (range 2-14 days, mean 5-6 days). - **Hepatitis A**: 28 days represents the **typical incubation period** for HAV (range 15-50 days, average 28-30 days). *a-3, b-4, c-2, d-1* - Incorrectly assigns **Syphilis** 16 days (below the 10-90 day range's typical value), **COVID-19** 90 days (far exceeding the 2-14 day range), and **Hepatitis A** only 6 days (well below the minimum 15-day period). *a-1, b-4, c-2, d-3* - Incorrectly matches **Syphilis** with 6 days (insufficient for *T. pallidum* to produce primary chancre), **Chickenpox** with 28 days (exceeds the typical VZV range), and **Hepatitis A** with 16 days (below typical range). *a-3, b-4, c-1, d-2* - Incorrectly assigns **Syphilis** 16 days, **Chickenpox** 28 days (exceeding typical range), and **Hepatitis A** 90 days (inconsistent with acute HAV infection pattern).
Question 3: Match the incubation periods of the following diseases: a. Syphilis b. SARS c. Hepatitis A d. Chickenpox Match with: 1. 10-21 days 2. 21 days (3 weeks) 3. 2-7 days 4. 15-50 days
- A. a-2, b-3, c-4, d-1 (Correct Answer)
- B. a-3, b-4, c-2, d-1
- C. a-2, b-3, c-1, d-4
- D. a-4, b-3, c-1, d-2
Explanation: ***a-2, b-3, c-4, d-1*** - This option correctly matches all incubation periods: **Syphilis (a) = 21 days (3 weeks)** - the average incubation for primary chancre appearance is 21 days (range 10-90 days). - **SARS (b) = 2-7 days** - the typical incubation period for SARS-CoV-1 is 2-10 days, with most cases manifesting within 2-7 days. - **Hepatitis A (c) = 15-50 days** - the standard incubation period averages 28-30 days (range 15-50 days). - **Chickenpox (d) = 10-21 days** - varicella has a well-established incubation of 10-21 days, typically 14-16 days. *a-3, b-4, c-2, d-1* - This incorrectly assigns **2-7 days to Syphilis**, which is far too short for the primary chancre to appear (actual: 21 days average). - **15-50 days for SARS** is excessively long; SARS manifests within 2-10 days. - **21 days for Hepatitis A** is at the lower end but not representative of the typical range (15-50 days). *a-2, b-3, c-1, d-4* - This incorrectly pairs **10-21 days with Hepatitis A**, which has a longer incubation (15-50 days). - **15-50 days for Chickenpox** is too long; varicella's incubation is 10-21 days. *a-4, b-3, c-1, d-2* - This incorrectly assigns **15-50 days to Syphilis** (actual: 21 days average) and **10-21 days to Hepatitis A** (actual: 15-50 days). - While these ranges have some overlap with actual values, they represent inversions of the correct assignments.
Question 4: Blackfoot disease is seen in which of the following?
- A. Mercury
- B. Arsenic (Correct Answer)
- C. Copper
- D. Cadmium
Explanation: ***Arsenic*** - Chronic arsenic exposure can lead to **Blackfoot disease**, a severe peripheral vascular disease causing **gangrene** and limb loss, particularly affecting the lower extremities. - This condition is characterized by **dark pigmentation** and ischemic changes in the affected limbs due to vascular compromise. *Mercury* - Mercury poisoning (e.g., **Minamata disease**) primarily affects the **nervous system** and kidneys, causing symptoms like tremor, neuropsychiatric disturbances, and renal dysfunction. - It does not typically cause **Blackfoot disease** or similar peripheral ischemic conditions. *Copper* - Copper toxicity can lead to **liver damage** (e.g., in Wilson's disease), neurological symptoms, and gastrointestinal issues. - Excessive copper does not cause **Blackfoot disease**. *Cadmium* - Cadmium toxicity primarily targets the **kidneys** (leading to renal tubular dysfunction), bones (**osteomalacia** as seen in Itai-itai disease), and lungs. - It is not associated with **Blackfoot disease**.