NEET-PG 2015 - Community Medicine Practice Questions

Q: Which of the following statements about Anganwadi workers is incorrect?

Covers a population of 2000. ***Covers a population of 2000*** - An **Anganwadi center** typically covers a population of **1000** in rural and urban areas, and **700** in tribal areas, not 2000. - This statement is incorrect because the specified population coverage is double the standard norm for an Anganwadi center. *Mostly female* - The vast majority of **Anganwadi workers** are **women** from the local community. - This is a correct statement, reflecting the gender composition of the Anganwadi workforce. *Training for 40 days* - **Anganwadi workers** undergo an initial **training program of 40 days**. - This statement is correct, outlining the standard duration of their foundational training. *Under ICDS scheme* - **Anganwadi centers** are a crucial part of the **Integrated Child Development Services (ICDS) scheme**. - This statement is correct, as the ICDS scheme established and oversees Anganwadi centers to provide health, nutrition, and early childhood education services.

Q: In a town there are 2500 live births within six months. During the same period 5 women died due to peripartum infection, 5 died due to electrocution, 2 died due to obstructed labor and 3 died due to PPH. What is the MMR?

4 per 1000 live births. ***4 per 1000 live births*** - The **Maternal Mortality Ratio (MMR)** is calculated as the number of maternal deaths per 100,000 live births. In this scenario, only deaths directly related to pregnancy or within 42 days postpartum from obstetric causes are considered maternal deaths. - Total maternal deaths = 5 (peripartum infection) + 2 (obstructed labor) + 3 (PPH) = 10. MMR = (10 maternal deaths / 2500 live births) * 1000 = 4. *6 per 1000 live births* - This calculation would incorrectly include deaths from non-obstetric causes, such as the 5 deaths due to electrocution, which are not considered maternal deaths. - Including non-maternal deaths inflates the ratio, leading to an inaccurate representation of obstetric risk. *40 per 1000 live births* - This value is significantly higher, suggesting a miscalculation in either the number of maternal deaths or the live births, potentially by using a multiplier of 100,000 live births instead of 1,000 for this question, or an arithmetic error. - A common error might be to multiply the total number of maternal deaths by 1000 and divide by the number of live births, leading to an incorrect large number if the base is not handled correctly. *60 per 1000 live births* - This result is far too high and indicates a significant overestimation of maternal deaths or a severe miscalculation. - It likely arises from a compounding of errors, possibly including non-maternal deaths and incorrect scaling of the denominator.

Q: Which of the following statements about the Pneumococcal Polysaccharide Vaccine (PPV) is correct?

Recommended for individuals with sickle cell disease. ***Recommended for individuals with sickle cell disease*** - Individuals with **sickle cell disease** are at significantly increased risk of severe and invasive **pneumococcal infections** due to **functional asplenia**. - The PPV is crucial for providing **prophylactic protection** against these life-threatening infections in this vulnerable population. *Administered at birth* - The **Pneumococcal Conjugate Vaccine (PCV)** is part of routine childhood immunizations and is administered at specific ages, but neither PCV nor PPV is given **at birth**. - **PCV** is typically given starting at **2 months of age**, while **PPV** is generally recommended for older children and adults at high risk. *Widely used in the general population* - The **Pneumococcal Conjugate Vaccine (PCV)** is widely used in the general *pediatric* population as part of routine immunization schedules. - The **Pneumococcal Polysaccharide Vaccine (PPV)** is primarily recommended for **adults 65 years and older** and individuals with certain **underlying medical conditions** or compromised immune systems, not the general population. *Derived from live attenuated pneumococcal bacteria* - The **PPV** is a **polysaccharide vaccine**, meaning it is composed of purified capsular polysaccharides from various serotypes of *Streptococcus pneumoniae*. - It is an **inactivated vaccine** and does not contain live attenuated bacteria; such a vaccine would be contraindicated in immunocompromised individuals.

Q: Which of the following larvicide is used under urban Malaria Scheme?

Abate. ***Abate*** - **Abate (temephos)** is an organophosphate larvicide widely used in public health programs, including the urban malaria scheme, due to its effectiveness against mosquito larvae at low concentrations. - It is applied to water storage containers, wells, and other mosquito breeding sites to **prevent the development of adult mosquitoes**. *Malathion* - **Malathion** is an organophosphate insecticide primarily used as an **adulticide** for fogging operations against adult mosquitoes, not specifically as a larvicide in urban schemes. - While it can kill larvae, its primary application and efficacy are geared towards **adult mosquito control**. *Parathion* - **Parathion** is a highly toxic organophosphate insecticide that is generally **not used in public health programs** due to its significant environmental and human health risks. - Its use is largely restricted to agricultural pest control and is **not a recommended larvicide** for urban settings. *DDT* - **DDT (dichlorodiphenyltrichloroethane)** is a persistent organic pollutant whose use has been largely banned or severely restricted globally due to its **environmental impact** and long-term toxicity. - While historically used for mosquito control (both larvae and adults), it is **not used in current urban malaria schemes** due to its banned status in many regions and resistance issues.

Q: Most commonly used blinding technique in epidemiological studies?

Double blinding. ***Double blinding*** - In **double blinding**, neither the **participants** nor the **researchers** administering the intervention and collecting data know who is in the treatment group versus the control group. - This method is widely used to prevent **observer bias** from the researchers and **participant bias** (e.g., placebo effect) from the subjects, thereby strengthening the study's internal validity. *Single blinding* - In **single blinding**, only the **participants** are unaware of their assignment to either the treatment or control group. - While it helps reduce participant bias, the **researchers' knowledge** of group assignments can still introduce **observer bias**, making it less rigorous than double blinding. *Triple blinding* - **Triple blinding** extends double blinding by ensuring that the **data analysts** are also unaware of the participant group assignments. - This technique further minimizes bias in the **interpretation and analysis of results**, but it is less commonly implemented due to its complexity and increased logistical challenges compared to double blinding. *None of the options* - This option is incorrect because **blinding techniques** are fundamental tools in epidemiological studies and clinical trials to ensure the objectivity and reliability of research findings. - **Blinding** helps eliminate conscious and unconscious biases that could otherwise influence study outcomes.

Q: What distance from a water source defines a problem village according to the Government of India?

> 1.6 km. ***> 1.6 km*** - According to the **Government of India's criteria**, a village is designated as a **problem village** if its residents have to travel more than **1.6 kilometers** to access a safe and assured source of drinking water. - This definition is crucial for identifying areas that require specific interventions and programs to improve water access. *> 0.5 km* - While a distance of 0.5 km might be considered inconvenient, it does not meet the **official threshold** set by the Government of India for categorizing a village as "problematic" regarding water access. - This distance is typically much shorter than the criteria used for policy and intervention planning. *> 1 km* - A distance of 1 km, like 0.5 km, falls short of the **established benchmark** of 1.6 km defined by the Government of India for identifying a problem village. - Although it represents a significant walk, it does not trigger the specific **policy responses** associated with problem village status. *None of the options* - This option is incorrect because **1.6 km** is indeed the specific distance recognized by the Government of India for defining a problem village in terms of water source accessibility. - The other options are incorrect as they do not match the official criteria.

Q: Vaccine derived polio virus outbreaks are due to?

Type-2 poliovirus. ***Type-2 poliovirus*** - The **type 2 poliovirus (PV2)** component of the oral polio vaccine (OPV) has historically been associated with the majority of vaccine-derived poliovirus (VDPV) outbreaks. - The **attenuated PV2 strain** in OPV can revert to neurovirulent forms in rare cases, leading to outbreaks, especially in areas with low vaccination coverage. - Type 2 was responsible for **>90% of circulating VDPV (cVDPV) cases**, which led to the global switch from trivalent OPV to bivalent OPV (without type 2) in April 2016. *Type-3 poliovirus* - While **type 3 poliovirus (PV3)** was also part of OPV, **wild type 3 poliovirus was declared eradicated in 2019** (last case in 2012). - VDPV outbreaks due to PV3 are rare compared to PV2. *Type-1 poliovirus* - **Type 1 poliovirus (PV1)** is still endemic in some regions and causes wild poliovirus (WPV) infections. - Although PV1 is included in bivalent OPV, **VDPV outbreaks** from the PV1 component are very rare compared to PV2. *All types of poliovirus* - While all three serotypes of poliovirus were historically included in trivalent OPV, **PV2 is overwhelmingly responsible** for VDPV outbreaks. - **Wild type 2 poliovirus was eradicated in 2015** (last case 1999), but the vaccine strain continued to cause VDPV outbreaks until type 2 was removed from routine OPV.

Q: Which of the following statements about Culex larvae is correct?

Siphon tube present. ***Siphon tube present*** - **Culex larvae** possess a prominent **siphon tube** at their posterior end, which is used for breathing by extending to the water surface. - This **siphon tube** is a key morphological feature that helps distinguish them from *Anopheles* larvae. *Rest parallel to surface water* - **Anopheles larvae** typically rest parallel to the water surface because they lack a long siphon and obtain oxygen directly through spiracles on their dorsal surface. - **Culex larvae**, due to their siphon tube, hang head-down at an angle from the water surface. *Long Palmate hair* - **Palmate hairs** are characteristic structures found on the abdomen of **Anopheles larvae** that help them float horizontally at the water surface. - **Culex larvae** do not possess well-developed palmate hairs. *All are false* - This statement is incorrect because the presence of a **siphon tube** is a defining characteristic of **Culex larvae**.

Q: What is the most common mode of transmission of HIV?

Sexual contact. ***Sexual contact*** - **Unprotected sexual intercourse**, both heterosexual and homosexual, is overwhelmingly the most common way HIV is transmitted globally. - The virus can be exchanged through **bodily fluids** such as semen, vaginal fluids, and rectal fluids during sexual activity. - Accounts for approximately **80% of new HIV infections** worldwide. *Occupational exposure (needle stick injury)* - While a recognised mode of transmission, **needle stick injuries** account for a very small percentage of total HIV infections, primarily affecting healthcare workers. - The risk of transmission per exposure is relatively low (approximately **0.3%**), especially compared to sexual contact. *Perinatal transmission (mother to child)* - **Mother-to-child transmission** can occur during pregnancy, childbirth, or breastfeeding. - Although significant, especially in resource-limited settings, global efforts and **PMTCT programs** have resulted in a significant reduction in this type of transmission. *Transmission via blood and blood products* - This mode was once a major concern but is now extremely rare in countries with robust **blood screening programs**. - While sharing contaminated needles among **intravenous drug users** remains a risk, transfusion-related HIV is largely controlled.

Question 1

Which Diphtheria vaccine is recommended for a 14-year-old girl?

Accepted Answer

Tdap vaccine (Tetanus, Diphtheria, Pertussis)

Answer

DT vaccine (Diphtheria, Tetanus)

Answer

No suitable vaccine

Answer

DPT vaccine (Diphtheria, Pertussis, Tetanus)

Question 2

Which of the following statements about Anganwadi workers is incorrect?

Accepted Answer

Covers a population of 2000

Answer

Training for 40 days

Answer

Under ICDS scheme

Answer

Mostly female

Question 3

In a town there are 2500 live births within six months. During the same period 5 women died due to peripartum infection, 5 died due to electrocution, 2 died due to obstructed labor and 3 died due to PPH. What is the MMR?

Accepted Answer

4 per 1000 live births

Answer

6 per 1000 live births

Answer

40 per 1000 live births

Answer

60 per 1000 live births

Question 4

Which of the following statements about the Pneumococcal Polysaccharide Vaccine (PPV) is correct?

Accepted Answer

Recommended for individuals with sickle cell disease

Answer

Administered at birth

Answer

Widely used in the general population

Answer

Derived from live attenuated pneumococcal bacteria

Question 5

Which of the following larvicide is used under urban Malaria Scheme?

Accepted Answer

Abate

Answer

Malathion

Answer

Parathion

Answer

DDT

Question 6

Most commonly used blinding technique in epidemiological studies?

Accepted Answer

Double blinding

Answer

None of the options

Answer

Single blinding

Answer

Triple blinding

Question 7

What distance from a water source defines a problem village according to the Government of India?

Accepted Answer

> 1.6 km

Answer

> 0.5 km

Answer

> 1 km

Answer

None of the options

Question 8

Vaccine derived polio virus outbreaks are due to?

Accepted Answer

Type-2 poliovirus

Answer

Type-3 poliovirus

Answer

Type-1 poliovirus

Answer

All types of poliovirus

Question 9

Which of the following statements about Culex larvae is correct?

Accepted Answer

Siphon tube present

Answer

Rest parallel to surface water

Answer

Long Palmate hair

Answer

All are false

Question 10

What is the most common mode of transmission of HIV?

Accepted Answer

Sexual contact

Answer

Occupational exposure (needle stick injury)

Answer

Perinatal transmission (mother to child)

Answer

Transmission via blood and blood products

NEET-PG 2015 — Community Medicine