INI-CET 2025 - Community Medicine Practice Questions

Q: Which of the following is not classified under High-Risk Groups for HIV as per NACO guidelines?

Truck drivers. ***Truck drivers*** - While considered a **Bridge Population** or a vulnerable group due to high mobility and potential for engaging in high-risk behavior, they are not categorized as a primary **High-Risk Group (HRG)** by NACO. - **Bridge Populations** facilitate the transmission of HIV between high-risk groups and the general population. ***Men having sex with men (MSM)*** - **MSM** is designated as a core **High-Risk Group (HRG)** due to a significantly higher prevalence of HIV compared to the general population. - The mode of transmission (anal intercourse) carries a higher risk and is considered a key factor in NACO's classification. ***Female sex workers (FSW)*** - **FSW** is classified as a core **High-Risk Group (HRG)** because of high exposure risk and the potential for greater onward transmission to the general population. - They are a major focus of targeted interventions under the National AIDS Control Programme (NACP). ***Injecting drug users (IDUs)*** - **IDUs** are a vital **High-Risk Group (HRG)** primarily due to the sharing of contaminated needles and syringes, leading to immediate blood-to-blood transmission (Parenteral route). - Targeted interventions focus on harm reduction strategies like Needle and Syringe Exchange Programmes (NSEP).

Q: RMNCH+A is a strategy that provides comprehensive healthcare across all life stages. Which of the following is NOT included under RMNCH+A?

Geriatric population. ***Geriatric population*** - The **RMNCH+A** strategy focuses on reproductive, maternal, newborn, child, and adolescent health, spanning from conception through 19 years of age, but does not explicitly include the geriatric population. - Healthcare for the elderly falls under separate programs and initiatives within the national health framework. ***Family planning*** - **'R'** in RMNCH+A stands for **Reproductive health**, which includes comprehensive **family planning** services to ensure safe motherhood and birth spacing. - This component focuses on contraceptive choices and counseling. ***Maternal and Child Health (MCH) care*** - **'M'** (Maternal), **'N'** (Newborn), and **'C'** (Child) are the core components of RMNCH+A, providing continuous care from prenatal to early childhood. - This includes antenatal care, safe delivery, postnatal care, immunization, and nutrition programs. ***Adolescent health*** - **'+A'** in RMNCH+A specifically indicates the inclusion of **Adolescent health**, addressing physical, mental, and social well-being of individuals aged 10-19 years. - Programmes include menstrual hygiene, sexual and reproductive health education, and nutrition.

Q: During the Maha Kumbh Mela, mobile health units were established along with multiple surveillance units. The syndromic surveillance was done based on symptoms like fever and diarrhea. The main purpose of this surveillance is:

To detect potential warning signs of any outbreak. ***To detect potential warning signs of any outbreak*** - **Syndromic surveillance** uses non-specific health indicators (like frequency of symptoms such as fever and diarrhea) to provide an early warning system for potential **disease outbreaks** before laboratory confirmation is available. - This type of surveillance is crucial in large gatherings like the Maha Kumbh Mela for timely public health intervention due to the high risk of **rapid disease spread**. *To provide necessary immediate treatment* - While surveillance data might inform where treatment units are needed, the *primary purpose* of surveillance itself is **data collection and analysis** for early detection, not providing immediate treatment. - Treatment is the role of the healthcare providers in the established mobile units, not the function of the **syndromic surveillance system**. *For immediate quarantine of healthy contacts* - Quarantine is a **control measure** applied *after* an outbreak is confirmed or suspected, based on contact tracing, which typically follows surveillance efforts. - Syndromic surveillance tracks symptom patterns in the population, not the immediate contacts of individuals, making this a secondary, not the primary, goal. *To reduce the need for manpower* - Surveillance programs, especially during large-scale events like the Kumbh Mela, typically **increase** the immediate need for manpower (data collectors, analysts, field workers) to be effective. - The goal is improved public health outcomes through **early warning**, not workforce reduction.

Q: Which of the following is the correct order of steps for conducting a research study? 1. Define the problem/hypothesis 2. Design the study methodology 3. Data collection and execution 4. Data analysis and interpretation

1,2,3,4. **1,2,3,4** - The correct research process begins with **defining the problem or hypothesis (1)**, which sets the foundation and direction for the entire study. - This is sequentially followed by **designing the study methodology (2)**, actual **data collection and execution (3)**, and finally, **data analysis and interpretation (4)**. *1,3,2,4* - Although starting correctly with **defining the research question (1)**, this sequence erroneously jumps to **data collection (3)** before finalizing the **study design (2)**. - Proper research requires the protocol, inclusion criteria, and sample size calculations (all part of **design 2**) to be complete prior to implementation. *2,1,4,3* - This sequence is illogical because it requires designing the study (**step 2**) before knowing what the study aims to achieve (**research question/step 1**). - Furthermore, **data analysis (4)** cannot proceed before all the necessary **data collection (3)** has been performed. *4,3,2,1* - This sequence is the complete reverse of scientific methodology, starting with the final step of **data interpretation and analysis (4)**. - A research study must always originate from a defined **research question (1)** and detailed planning, making this proposed order incorrect.

Q: Which of the following is correctly matched for vectors and diseases? Vector: A. Louse, B. Mite, C. Flea, D. Tick. Disease: I. Scrub typhus, II. Endemic typhus, III. Rocky Mountain spotted fever, IV. Epidemic typhus.

A-IV, B-I, C-II, D-III. ***A-IV, B-I, C-II, D-III (Correct)*** - **Louse (A)** transmits **Epidemic typhus (IV)**, caused by *Rickettsia prowazekii*, typically occurring in overcrowded, unhygienic environments. - **Mite (B)** (chigger) transmits **Scrub typhus (I)**, caused by *Orientia tsutsugamushi*. - **Flea (C)** (rat flea) transmits **Endemic typhus (II)**, caused by *Rickettsia typhi*. - **Tick (D)** transmits **Rocky Mountain spotted fever (III)**, caused by *Rickettsia rickettsii*. *A-I, B-III, C-IV, D-II (Incorrect)* - Incorrectly matches Louse (A) with Scrub typhus (I); scrub typhus is transmitted by **mites** (chiggers), not lice. - Incorrectly matches Mite (B) with Rocky Mountain spotted fever (III); RMSF is transmitted by **ticks**, not mites. *A-II, B-III, C-IV, D-I (Incorrect)* - Incorrectly matches Louse (A) with Endemic typhus (II); endemic typhus is transmitted by **fleas** (rat flea), not lice. - Incorrectly matches Flea (C) with Epidemic typhus (IV); epidemic typhus is transmitted by **lice**, not fleas. *A-IV, B-III, C-I, D-II (Incorrect)* - While A-IV is correct (Louse-Epidemic typhus), this option incorrectly matches Mite (B) with Rocky Mountain spotted fever (III), which is transmitted by **ticks**. - Incorrectly matches Flea (C) with Scrub typhus (I); scrub typhus is transmitted by **mites**, not fleas.

Q: Which of the following ensures safety of medical records as per recent legislation?

The Digital Personal Data Protection Act, 2023. ***The Digital Personal Data Protection Act, 2023*** - This recent central legislation is India's primary framework for defining the obligations of entities (Data Fiduciaries) handling **digital personal data**, which explicitly includes sensitive health data (medical records) - It mandates explicit, informed **consent** from the patient for the processing of their health records and imposes significant penalties for data security **breaches**, thereby ensuring data safety - Enacted in 2023, this is the most recent and comprehensive legislation addressing medical record safety in India *PCPNDT Act* - The **Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994** primarily governs and prohibits sex determination tests to combat female feticide - While it enforces strict confidentiality regarding the results of specific prenatal tests, its scope is narrow and does not cover the general safety and processing of all comprehensive medical records *HIPAA* - **HIPAA (Health Insurance Portability and Accountability Act)** is a key federal law governing the privacy and security of health information (Protected Health Information or PHI) in the **United States** - It sets standards for US healthcare providers and insurers but has no direct legal jurisdiction in India regarding the safety of domestic medical records *MRD Act* - There is no unified, specific central Indian 'Medical Records Department Act' that serves as the overarching legislation for digital data protection and safety - Rules concerning Medical Record Department operations typically cover aspects like record storage, indexing, and retention periods, which are administrative and do not constitute broad statutory data privacy enforcement like the DPDP Act

Q: One of the following is not seen in a worker exposed to mercury in a thermometer manufacturing company:

Basophilic stippling. ***Basophilic stippling*** - **Basophilic stippling** is a characteristic finding in the peripheral blood smear of patients with **lead poisoning**, caused by the inhibition of pyrimidine 5'-nucleotidase, leading to aggregated RNA. - It is **not associated** with chronic mercury exposure, which primarily affects the neurological and renal systems. - This is the correct answer as basophilic stippling is NOT seen in mercury poisoning. *Tremors and Mad Hatter's disease* - **Tremors** (intention tremor) are a classic sign of chronic inhaled elemental mercury exposure, often leading to a condition historically known as **"Mad Hatter's disease"** (erethism). - **Erethism** is a neuropsychiatric syndrome characterized by irritability, shyness, insomnia, emotional lability, and loss of memory, resulting from mercury's neurotoxicity. - This IS seen in mercury-exposed workers. *Mees' lines* - **Mees' lines** (transverse white bands on the fingernails) are classically associated with **arsenic** and **thallium** poisoning, NOT mercury poisoning. - While the original explanation incorrectly linked this to mercury, Mees' lines are not a typical manifestation of mercury toxicity. - Mercury poisoning causes neurological (tremors, erethism) and renal manifestations, not Mees' lines. - This option is somewhat controversial but traditionally NOT considered a classic sign of mercury poisoning. *Peripheral neuropathy* - Exposure to **organic mercury compounds** (like methylmercury) is known to cause severe neurological damage, including **peripheral neuropathy**, visual field constriction, and hearing impairment. - Chronic high-level exposure to elemental mercury vapor can also lead to neuropathic symptoms. - This IS seen in mercury-exposed workers.

Q: Alleles of a gene pool belong to a:

Population. ***Population (Correct)*** - A **gene pool** is the total collection of all alleles and genes within a **population** of a specific species capable of interbreeding - The concept is fundamental to **population genetics** and evolution, measuring overall genetic diversity available to the group - Includes genetic information from **all reproductive members** of the population in a geographical area *Individual (Incorrect)* - An individual possesses only a small subset of alleles from the gene pool (typically two alleles per gene locus) - Represents the **genotype** of a single organism, not the collective genetic diversity - The gene pool requires pooling genetic information from **multiple individuals** *Family (Incorrect)* - A family represents a limited subgroup within a population (related by kinship) - Does not encompass the entire **genetic variability** of the species' local reproductive unit - Too narrow a concept compared to the population-level gene pool *Cell (Incorrect)* - A cell contains the **genome** or **genotype** of an individual organism - The **gene pool** is a population-level concept extending beyond a single cell's genetic material - Represents the smallest unit of genetic information, not the collective diversity

Question 1

Which of the following is not classified under High-Risk Groups for HIV as per NACO guidelines?

Accepted Answer

Truck drivers

Answer

Men having sex with men (MSM)

Answer

Injecting drug users (IDUs)

Answer

Female sex workers (FSW)

Question 2

RMNCH+A is a strategy that provides comprehensive healthcare across all life stages. Which of the following is NOT included under RMNCH+A?

Accepted Answer

Geriatric population

Answer

Family planning

Answer

Adolescent health

Answer

Maternal and Child Health (MCH) care

Question 3

During the Maha Kumbh Mela, mobile health units were established along with multiple surveillance units. The syndromic surveillance was done based on symptoms like fever and diarrhea. The main purpose of this surveillance is:

Accepted Answer

To detect potential warning signs of any outbreak

Answer

To provide necessary immediate treatment

Answer

For immediate quarantine of healthy contacts

Answer

To reduce the need for manpower

Question 4

Which of the following is the correct order of steps for conducting a research study?
1. Define the problem/hypothesis
2. Design the study methodology
3. Data collection and execution
4. Data analysis and interpretation

Accepted Answer

1,2,3,4

Answer

1,3,2,4

Answer

2,1,4,3

Answer

4,3,2,1

Question 5

Which of the following is correctly matched for vectors and diseases? Vector: A. Louse, B. Mite, C. Flea, D. Tick. Disease: I. Scrub typhus, II. Endemic typhus, III. Rocky Mountain spotted fever, IV. Epidemic typhus.

Accepted Answer

A-IV, B-I, C-II, D-III

Answer

A-II, B-III, C-IV, D-I

Answer

A-IV, B-III, C-I, D-II

Answer

A-I, B-III, C-IV, D-II

Question 6

Which of the following ensures safety of medical records as per recent legislation?

Accepted Answer

The Digital Personal Data Protection Act, 2023

Answer

PCPNDT Act

Answer

HIPAA

Answer

MRD Act

Question 7

One of the following is not seen in a worker exposed to mercury in a thermometer manufacturing company:

Accepted Answer

Basophilic stippling

Answer

Tremors and Mad Hatter's disease

Answer

Peripheral neuropathy

Answer

Mees' lines

Question 8

Alleles of a gene pool belong to a:

Accepted Answer

Population

Answer

Cell

Answer

Individual

Answer

Family

INI-CET 2025 — Community Medicine