NEET-PG 2015 - Community Medicine Practice Questions

Q: According to the 2014 guidelines for female sterilization, which of the following is NOT an eligibility criterion for female sterilization?

Should have at least 1 child. ***Should have at least 1 child*** - The 2014 guidelines **removed the previous requirement** for a specific number of children, focusing instead on **informed consent** and **voluntary decision-making**. - The emphasis is now on the client's **autonomous choice**, regardless of their parity. - Having at least one child is **NOT an eligibility criterion** under the revised guidelines. *Age of at least 22 years* - While there is a minimum age requirement (legally 21 years, though some guidelines mention 22 years), this IS a valid eligibility criterion. - The age criterion ensures that individuals are mature enough to make an **informed and irreversible decision** about permanent contraception. - Younger individuals may be at higher risk of **regret** following sterilization. *Being unmarried* - Marital status is **NOT a barrier** to female sterilization under the 2014 guidelines. - Unmarried individuals have the same right to choose this method of contraception based on **informed consent**. - The decision for sterilization rests solely with the individual, irrespective of their **relationship status**. *Partner is not sterilized* - Partner's sterilization status is **NOT a determining factor** for female sterilization eligibility. - The decision is based on the **individual's choice**, health status, and desire for permanent contraception. - The eligibility criteria focus on the client's **informed consent** and understanding of the procedure, not on the partner's reproductive history.

Q: Which of the following is an example of indirect transmission by a living vector?

Transmission by mosquito. ***Transmission by mosquito*** - This is the classic example of **vector-borne transmission**, where a living biological vector (the mosquito) acts as an intermediary to transmit the infectious agent from an infected host to a susceptible one. - The disease-causing microorganism does not pass directly from person to person but is carried and transmitted by the living vector. - Examples include malaria, dengue, and filariasis. *Vertical transmission* - This refers to transmission of disease from a **mother to her child** during pregnancy, childbirth, or breastfeeding. - This is a form of **direct transmission** where the pathogen passes directly between biologically related individuals without an intermediate living vector. *Soil contact* - This represents **vehicle-borne transmission** where soil acts as a non-living vehicle (fomite) carrying pathogens. - While this is technically indirect transmission, it does not involve a **living biological vector** as specified in the question. - Examples include tetanus, hookworm, and ascariasis transmitted through contaminated soil. *Droplet infection* - This is a form of **direct transmission** where infectious droplets are expelled from the respiratory tract of an infected person and directly contact the mucous membranes of a susceptible person. - The droplets travel a short distance in close proximity, representing direct person-to-person transfer without any intermediate vector.

Q: In immediate disaster response management (first 24-48 hours), which of the following is not typically practiced?

Mass vaccination. ***Mass vaccination*** - **Mass vaccination** is typically a strategy for **preparedness/prevention phase** or **post-disaster disease prevention**, not an immediate disaster response activity. - Immediate disaster response focuses on **saving lives, providing emergency medical care, establishing shelter, and restoring critical infrastructure**, rather than large-scale preventative health campaigns. - Mass vaccination requires **planning, logistics, cold chain management**, which are incompatible with chaotic immediate response scenarios. *Triage* - **Triage** is a **critical and immediate** component of disaster response, involving the **prioritization of injured patients** for treatment based on severity and survival likelihood. - It ensures limited resources are allocated effectively to **maximize lives saved** during the acute phase. - Typically uses **color-coded tags** (red-immediate, yellow-delayed, green-minor, black-deceased). *Rehabilitation* - While **rehabilitation** is part of the **recovery phase** (weeks to months post-disaster), **early rehabilitation activities** may begin during the immediate response period. - Basic rehabilitation services like **mobility aids, psychological first aid**, can be initiated alongside acute care. - This makes it partially practiced even in immediate response, unlike mass vaccination which is never immediate. *Search and rescue* - **Search and rescue** is the **primary immediate response activity**, focusing on locating and extracting survivors from disaster-affected areas. - Time-critical operation following the **"golden period"** principle where survival rates decrease rapidly after 72 hours. - Involves specialized teams with equipment for **debris removal, victim location, and emergency extraction**.

Q: Which indicator is used in Horroch's apparatus?

Starch iodine. ***Starch iodine*** - Horroch's apparatus is specifically designed for testing the **sterilizing efficiency of hypochlorite solutions** in dairies. - **Starch iodine** (starch-iodide paper) is used as an indicator because it reacts with residual free chlorine to produce a **blue-black color**, which confirms that adequate free chlorine is present for effective sterilization. - The principle: Free chlorine oxidizes iodide to iodine, which then reacts with starch to give the characteristic blue color. *Bleaching powder* - **Bleaching powder** (calcium hypochlorite) is the active ingredient in hypochlorite sterilizing solutions being tested, not an indicator itself. - It's the substance whose sterilizing efficacy is being evaluated using the apparatus. *Soda-lime* - **Soda-lime** is primarily used as an absorbent for **carbon dioxide (CO2)** and other acidic gases in various laboratory and anesthetic applications. - It has no role as an indicator in Horroch's apparatus for testing hypochlorite solutions. *Potassium permanganate* - **Potassium permanganate** is a strong oxidizing agent often used as an indicator in redox titrations, as its deep purple color disappears when reduced. - It is not suitable for indicating residual chlorine in Horroch's test, which specifically relies on the starch-iodine reaction.

Q: Which of the following is not true about the Vi polysaccharide vaccine for typhoid?

Given at birth. ***Given at birth*** - The **typhoid Vi polysaccharide vaccine is not administered at birth**. It is recommended for individuals **2 years of age**. - Vaccines given at birth protect against diseases with significant **neonatal risk**, such as Hepatitis B and BCG (tuberculosis). - This is the **FALSE** statement, making it the correct answer to this "not true" question. *Single dose is given* - The Vi polysaccharide vaccine is administered as a **single 0.5 mL dose**. - This single dose provides protection against *Salmonella typhi* for approximately 3 years. - This statement is **TRUE**. *Revaccination at 3 years* - For ongoing protection, **revaccination is recommended every 3 years** for individuals at continued risk of typhoid exposure. - The booster dose maintains adequate protective antibody levels. - This statement is **TRUE**. *Given intramuscularly* - The Vi polysaccharide vaccine is administered via the **intramuscular (IM) route**, typically in the deltoid muscle. - This is the standard recommended route of administration. - This statement is **TRUE**.

Q: In water testing from a well using Horrock's apparatus, blue color appears from the 4th cup onwards. What is the amount of bleaching powder required to disinfect 75000 litres of water?

100 gm. ***100 gm*** - In **Horrock's apparatus** test, blue color appearing from the 4th cup indicates a **chlorine demand of 0.4 ppm (0.4 mg/L)** for the water sample. - **Total chlorine required** = 0.4 mg/L × 75,000 L = **30,000 mg = 30 gm** of pure chlorine. - Standard bleaching powder contains **30% available chlorine**, so: **Bleaching powder needed = 30 gm ÷ 0.30 = 100 gm**. - This is the scientifically accurate amount for disinfecting 75,000 liters of water with 0.4 ppm chlorine demand. *1000 gm* - This represents a **10-fold excess** over the actual requirement of 100 gm based on the measured chlorine demand. - Using 1000 gm would result in severe **over-chlorination** (4 ppm instead of 0.4 ppm), causing strong unpleasant taste, odor, and potential health concerns. *1600 gm* - This amount represents **16 times the required dose**, leading to dangerously high chlorine levels in the water. - Such excessive chlorination would make the water unpalatable and potentially toxic to consumers. *2000 gm* - This represents a **20-fold excess**, providing extreme and harmful over-disinfection. - Such excessive amounts could lead to **chlorine toxicity** and would be wasteful and harmful to consumers. *1300 gm* - This amount exceeds the calculated requirement by **13 times**, providing unnecessary and harmful over-disinfection. - The precise calculation based on **0.4 ppm chlorine demand** and **75,000 L volume** yields exactly **100 gm**, not 1300 gm.

Q: Droplet nuclei is a type of ?

Indirect transmission of pathogens. ***Indirect transmission of pathogens*** - **Droplet nuclei** are tiny airborne particles remaining after the evaporation of respiratory droplets, suspended in the air for prolonged periods, allowing pathogens to travel over longer distances. - This mode of transmission is considered **indirect** because it involves an environmental medium (air) rather than direct contact between individuals. *Vertical transmission of pathogens* - This refers to the transmission of a pathogen from a **mother to her offspring**, either during pregnancy, childbirth, or breastfeeding. - Examples include HIV and rubella, which are transmitted directly from parent to child, unlike airborne droplet nuclei. *Direct transmission of infectious agents* - This involves immediate physical contact or exposure between an infected individual and a susceptible host (e.g., touching, kissing, sexual contact). - It does not involve an intermediate environmental vehicle such as airborne particles that travel through the air from their source. *Biological transmission of pathogens* - This type of transmission involves an **arthropod vector** that not only transmits the pathogen but also allows it to multiply or develop within its body before transmission. - Examples include malaria transmitted by mosquitoes or Lyme disease by ticks, which is distinct from airborne droplet nuclei transmission.

Q: Which of the following statements is incorrect regarding the strategic plan for malaria control 2012-2017?

Objective is API < 1 per 10,000. ***Objective is API < 1 per 10,000*** - The correct objective for the **Annual Parasite Incidence (API)** in the 2012-2017 strategic plan for malaria control was to reduce it to **less than 1 per 1,000 population**, not 1 per 10,000, making this statement incorrect. - This metric measures the number of new malaria cases per 1,000 people per year. *50% reduction in mortality by 2017* - A key objective of the **National Framework for Malaria Elimination in India** (which this strategic plan aimed to contribute to) was indeed to achieve a significant reduction in malaria-related mortality. - Specifically, aiming for a **50% reduction in mortality** by 2017 was a stated goal to lessen the disease burden. *Annual incidence < 1 per 1000 by 2017* - One of the primary goals of the **Malaria Control Strategic Plan 2012-2017** was to reduce the annual parasite incidence (API) to **less than 1 per 1,000 population** in all endemic areas. - This target focused on decreasing the occurrence of new malaria cases. *Complete treatment to 100% of patients* - A core component of malaria control strategies emphasizes ensuring that **all confirmed malaria cases** receive complete and effective treatment. - Achieving **100% complete treatment adherence** is crucial to prevent drug resistance and eliminate the parasite reservoir.

Q: Which vaccine is the most widely used globally in childhood vaccination programs, aside from the Oral Polio Vaccine (OPV)?

DPT vaccine. ***DPT vaccine*** - The **DPT (diphtheria, pertussis, and tetanus) vaccine** is the most widely used childhood vaccine globally after OPV, forming the backbone of the **WHO's Expanded Programme on Immunization (EPI)**. - It has **near-universal adoption** across countries worldwide with approximately **86% global coverage** and is administered as a **3-dose primary series** to all children, making it the standard benchmark for measuring immunization program performance. - Its widespread use reflects the global burden of these three bacterial diseases and the vaccine's proven efficacy in preventing severe outcomes and transmission. *BCG vaccine* - The **BCG (Bacillus Calmette-Guérin) vaccine** protects against **tuberculosis** and is widely used, particularly in countries with high TB prevalence. - However, its use is **not universal** – many countries with low TB incidence (such as the USA and several European nations) do not include BCG in routine childhood schedules, limiting its global "universality" compared to DPT. - BCG is typically given as a **single dose at birth**, whereas DPT requires multiple doses throughout infancy. *Influenza vaccine* - The **influenza vaccine** is recommended annually due to antigenic drift of the virus, but its global childhood vaccination coverage is significantly lower compared to standard EPI vaccines like DPT. - It is often prioritized for specific risk groups rather than universal immunization for all children in many parts of the world. *Pneumococcal vaccine* - The **pneumococcal vaccine** targets **Streptococcus pneumoniae**, a cause of pneumonia, meningitis, and other severe diseases. - While increasingly integrated into national immunization schedules, its global adoption (especially as of 2015) was still lower than DPT, with many low- and middle-income countries only recently introducing it.

Q: Which of the following infectious diseases has the highest proportion of asymptomatic chronic carriers?

Hepatitis B. ***Hepatitis B*** - **Hepatitis B** infection has a significant proportion of **chronic asymptomatic carriers**, particularly when infection occurs perinatally or in early childhood. - In adults, approximately **5% develop chronic infection** after acute exposure, and many of these chronic carriers remain asymptomatic while maintaining infectivity. - Chronic carriers can harbor the virus for years or decades without clinical symptoms, making them an important reservoir for transmission. - This is a major public health concern as asymptomatic carriers can unknowingly transmit the virus. *Measles* - **Measles** is highly contagious and typically presents with **symptomatic disease** in nearly all infected individuals. - Clinical features include characteristic maculopapular rash, cough, coryza, conjunctivitis, and Koplik's spots. - Asymptomatic infection is **extremely rare** with measles virus. *Diphtheria* - While **asymptomatic pharyngeal carriage** of *Corynebacterium diphtheriae* can occur, it is not the predominant pattern. - Clinical diphtheria typically presents with pseudomembrane formation, sore throat, and potential systemic toxin effects. - Carrier rates vary but are not as epidemiologically significant as with Hepatitis B. *Rabies* - **Rabies** is almost **100% symptomatic** once the virus reaches the central nervous system. - There is **no chronic asymptomatic carrier state** in humans. - Once clinical symptoms appear (encephalitis, hydrophobia, paralysis), the disease is virtually always fatal.

Question 1

According to the 2014 guidelines for female sterilization, which of the following is NOT an eligibility criterion for female sterilization?

Accepted Answer

Should have at least 1 child

Answer

Partner is not sterilized

Answer

Being unmarried

Answer

Age of at least 22 years

Question 2

Which of the following is an example of indirect transmission by a living vector?

Accepted Answer

Transmission by mosquito

Answer

Vertical transmission

Answer

Soil contact

Answer

Droplet infection

Question 3

In immediate disaster response management (first 24-48 hours), which of the following is not typically practiced?

Accepted Answer

Mass vaccination

Answer

Rehabilitation

Answer

Triage

Answer

Search and rescue

Question 4

Which indicator is used in Horroch's apparatus?

Accepted Answer

Starch iodine

Answer

Potassium permanganate

Answer

Bleaching powder

Answer

Soda-lime

Question 5

Which of the following is not true about the Vi polysaccharide vaccine for typhoid?

Accepted Answer

Given at birth

Answer

Given intramuscularly

Answer

Revaccination at 3 years

Answer

Single dose is given

Question 6

In water testing from a well using Horrock's apparatus, blue color appears from the 4th cup onwards. What is the amount of bleaching powder required to disinfect 75000 litres of water?

Accepted Answer

100 gm

Answer

1600 gm

Answer

2000 gm

Answer

1300 gm

Question 7

Droplet nuclei is a type of ?

Accepted Answer

Indirect transmission of pathogens

Answer

Direct transmission of infectious agents

Answer

Vertical transmission of pathogens

Answer

Biological transmission of pathogens

Question 8

Which of the following statements is incorrect regarding the strategic plan for malaria control 2012-2017?

Accepted Answer

Objective is API < 1 per 10,000

Answer

50% reduction in mortality by 2017

Answer

Complete treatment to 100% of patients

Answer

Annual incidence < 1 per 1000 by 2017

Question 9

Which vaccine is the most widely used globally in childhood vaccination programs, aside from the Oral Polio Vaccine (OPV)?

Accepted Answer

DPT vaccine

Answer

BCG vaccine

Answer

Influenza vaccine

Answer

Pneumococcal vaccine

Question 10

Which of the following infectious diseases has the highest proportion of asymptomatic chronic carriers?

Accepted Answer

Hepatitis B

Answer

Measles

Answer

Rabies

Answer

Diphtheria

NEET-PG 2015 — Community Medicine