All following are at-risk group adults meriting Hepatitis B vaccination in low endemic areas except for which of the following?
India started 2-dose vaccination strategy for measles, in -
What is the primary causative vector of Vagabond disease?
Which of the following studies has given coronary risk factors?
Best for Incineration of infectious waste?
The arthropod vector BEST KNOWN for transovarian transmission of multiple pathogens is -
The population norm for a trained health aide is:
Ujjawala scheme is for prevention of
NEET-PG 2012 - Community Medicine NEET-PG Practice Questions and MCQs
Question 91: All following are at-risk group adults meriting Hepatitis B vaccination in low endemic areas except for which of the following?
- A. Medical/nursing personnel
- B. Patients with chronic liver disease
- C. Diabetics on insulin (Correct Answer)
- D. Patients on chronic hemodialysis
Explanation: ***Diabetics on insulin*** - This is the correct answer as the exception based on **guidelines at the time of this exam (2012)**. - At that time, diabetics were **not routinely listed** as a standard at-risk group for hepatitis B vaccination in low endemic areas, though the ACIP was beginning to recognize increased risk in this population. - **Current Update (Post-2012):** The **CDC/ACIP now recommends** hepatitis B vaccination for all previously unvaccinated adults with diabetes aged 19-59 years, due to documented increased risk of HBV infection associated with: - Shared blood glucose monitoring devices - Assisted blood glucose monitoring in healthcare settings - Outbreak investigations showing higher transmission rates - For the purpose of this historical exam question, diabetics were the exception among the listed groups. *Medical/nursing personnel* - Healthcare workers are at **high occupational risk** due to frequent exposure to blood and body fluids. - This has been a **standard, long-standing recommendation** for HBV vaccination regardless of endemic status. - The risk remains present even in low endemic areas due to potential exposure to infected patients. *Patients with chronic liver disease* - Individuals with pre-existing chronic liver disease are at risk of **severe outcomes** if they acquire hepatitis B infection. - Superimposed acute HBV infection can lead to: - Rapid progression to cirrhosis - Acute-on-chronic liver failure - Hepatocellular carcinoma - Vaccination is **crucial for prevention** and has been a standard recommendation. *Patients on chronic hemodialysis* - Hemodialysis patients face **elevated risk** of HBV acquisition due to: - Frequent vascular access procedures - Prolonged time in healthcare settings - Potential for nosocomial transmission in dialysis units - Their **immunocompromised state** increases risk of chronic infection and complications. - Vaccination is a **standard preventive measure** in this population.
Question 92: India started 2-dose vaccination strategy for measles, in -
- A. 2008
- B. 2009
- C. 2010 (Correct Answer)
- D. 2011
Explanation: ***2010*** - India implemented the **two-dose measles vaccination strategy** as part of its Universal Immunization Program starting in **2010**. - This decision was based on recommendations to improve immunity and reduce measles incidence, moving from a single-dose to a more effective **two-dose schedule**. *2008* - While important immunization initiatives were ongoing, the specific policy of a **two-dose measles vaccination strategy** had not yet been introduced in India during 2008. - At this time, the focus was primarily on ensuring high coverage of the **first dose** of measles vaccine. *2009* - The year 2009 saw continued efforts to strengthen the Universal Immunization Program, but the official launch of the **two-dose measles vaccination strategy** in India occurred later. - Discussions and planning for the transition were likely underway, but implementation began in the subsequent year. *2011* - By 2011, the **two-dose measles vaccination strategy** was already being implemented across India, having been introduced in 2010. - This year marked a period of expanding coverage and consolidation of the new 2-dose schedule rather than its initial introduction.
Question 93: What is the primary causative vector of Vagabond disease?
- A. Louse (Correct Answer)
- B. Mite
- C. Tick
- D. Black Fly
Explanation: ***Louse*** - Vagabond disease is a term historically used to describe the chronic skin changes (such as **pigmentation**, **lichenification**, and **excoriations**) resulting from persistent **pediculosis corporis** (body lice infestation). - The **body louse** (*Pediculus humanus corporis*) is the causative agent responsible for these chronic dermatological changes through prolonged infestation. - Body lice are also vectors that can transmit other diseases like **epidemic typhus**, **louse-borne relapsing fever**, and **trench fever**, but vagabond disease itself is the direct result of chronic louse infestation rather than a transmitted pathogen. *Mite* - Mites are responsible for various conditions, such as **scabies** (caused by *Sarcoptes scabiei*) and serve as vectors for **scrub typhus** (transmitted by chiggers, the larval form of trombiculid mites). - However, they are not associated with vagabond disease or the chronic dermatological changes caused by body lice. *Tick* - Ticks are known vectors for a wide range of diseases, including **Lyme disease**, **Rocky Mountain spotted fever**, **anaplasmosis**, and **babesiosis**. - These diseases are transmitted through the bite of infected ticks, which are distinct from the louse-related conditions associated with vagabond disease. *Black Fly* - Black flies (*Simulium* species) are vectors for **onchocerciasis** (river blindness), caused by the parasitic nematode *Onchocerca volvulus*. - While they can cause itchy bites and transmit significant disease, they are not involved in the chronic skin condition known as vagabond disease.
Question 94: Which of the following studies has given coronary risk factors?
- A. Framingham (Correct Answer)
- B. Stanford study
- C. MONICA
- D. North Karelia
Explanation: ***Framingham*** - The **Framingham Heart Study** is a landmark prospective cohort study that has identified many of the well-known **risk factors for cardiovascular disease**, including hypertension, high cholesterol, smoking, and diabetes. - This ongoing study, started in 1948, has been instrumental in shaping our understanding of **coronary artery disease** development and prevention strategies. *North Karelia* - The **North Karelia Project** was a comprehensive community-based prevention program in Finland that successfully reduced cardiovascular disease risk factors. - While influential in demonstrating how to **implement prevention strategies**, it applied already-known risk factors rather than discovering new ones. - The program focused on reducing smoking, cholesterol, and blood pressure in the population. *Stanford study* - While Stanford University has conducted numerous influential medical studies, there isn't a single "Stanford study" primarily recognized for giving us the comprehensive list of coronary risk factors. - Many institutions contribute to medical knowledge, but the **Framingham Heart Study** stands out for this specific contribution. *MONICA* - The **MONICA (Monitoring Trends and Determinants in Cardiovascular Disease)** Project was a multinational WHO project that aimed to monitor cardiovascular disease trends and determinants. - While it provided valuable data on the **epidemiology of cardiovascular disease** and its risk factors, it primarily assessed trends in established risk factors rather than initially identifying them.
Question 95: Best for Incineration of infectious waste?
- A. Triple - chamber
- B. Single - chamber
- C. Double - chamber (Correct Answer)
- D. None of the options
Explanation: ***Correct: Double-chamber*** - **Double-chamber incinerators** are considered the best for infectious waste as they allow for complete combustion in two stages. - The first chamber burns the waste at a lower temperature (800°C), while the second chamber burns the remaining gases at a higher temperature (>1050°C), ensuring destruction of pathogens and minimizing emissions. - They are the standard recommendation under **Biomedical Waste Management Rules** for infectious waste disposal. *Incorrect: Triple-chamber* - While more advanced, **triple-chamber incinerators** are often overkill for standard infectious waste and are typically used for more complex or hazardous waste streams, or for very large volumes. - Their additional complexity and cost may not be justified for routine infectious waste disposal compared to double-chamber units. *Incorrect: Single-chamber* - **Single-chamber incinerators** are less efficient in burning infectious waste completely due to inadequate temperature control and gas retention time. - They tend to produce more harmful emissions and ash, making them unsuitable for effective and safe disposal of infectious materials. *Incorrect: None of the options* - This option is incorrect because **double-chamber incinerators** are specifically designed and widely recommended for the effective and safe incineration of infectious waste.
Question 96: The arthropod vector BEST KNOWN for transovarian transmission of multiple pathogens is -
- A. Fleas
- B. Ticks (Correct Answer)
- C. Sandfly
- D. Mosquitoes
Explanation: ***Ticks*** - Ticks are well-known for their diverse modes of pathogen transmission, including **transovarian transmission**, where pathogens are passed from an infected female tick to her offspring through the eggs. - This mechanism is crucial for the maintenance and spread of several tick-borne diseases, such as **Rocky Mountain spotted fever (caused by *Rickettsia rickettsii*)** and **Babesiosis** (caused by *Babesia* species). *Fleas* - Fleas are primarily known for transmitting pathogens such as *Yersinia pestis* (causing **plague**) and *Rickettsia typhi* (causing **murine typhus**) through their bites, but transovarian transmission is not their primary mode. - They typically transmit pathogens through **regurgitation** during feeding or by their **feces** being rubbed into the bite wound. *Sandfly* - Sandflies are vectors for diseases like **leishmaniasis**, caused by parasitic protozoa of the genus *Leishmania*. - They transmit these pathogens through **saliva** during blood meals, but transovarian transmission is not a significant feature of their lifecycle. *Mosquitoes* - Mosquitoes are vectors for a wide range of diseases, including **malaria**, **dengue**, **Zika**, and **West Nile virus**, primarily through the **injection of saliva** during blood feeding. - While some arboviruses can exhibit transovarian transmission in mosquitoes, it is not as prominent or broadly impactful across multiple pathogens as it is in ticks.
Question 97: The population norm for a trained health aide is:
- A. 5000
- B. 100000
- C. 1000 (Correct Answer)
- D. 30000
Explanation: ***1000*** - According to public health guidelines, a single **trained health aide** is typically designated to serve a population of approximately **1,000 individuals**. - This staffing level allows for effective outreach, basic health services, and community engagement in primary healthcare. *5000* - A population of **5,000** would generally require multiple health aides or a more comprehensive primary health unit with a larger staff. - This ratio is too high for a single health aide to provide adequate care and coverage. *100000* - A population of **100,000** is far too large for a single trained health aide to manage, requiring an extensive healthcare system with numerous professionals. - This number represents a district or sub-district level population, not the responsibility of one aide. *30000* - Serving **30,000** people would be an impossible task for one health aide, as it far exceeds the standard allocation for community-level health services. - This population size usually necessitates a full-fledged primary health center or hospital.
Question 98: 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.