NEET-PG 2021 — Community Medicine
9 Previous Year Questions with Answers & Explanations
After the admission of a road traffic accident (RTA) case, there is a spillage of blood on the hospital floor. Which disinfectant should be used to clean the floor?
There is an outbreak of buboes in a community. What is the vector responsible for transmitting the causative agent?
Which of the following is not included in the Global Hunger Index?
In a 10-year-old school child under the school health program, which vaccine should be administered?
In an outbreak of encephalitis in a community, according to the Universal Immunization Schedule, what is the route of administration for the vaccine likely used for the infection?
Low air velocity will be measured by
At which level is the School Health Service typically provided?
In a post-Diwali air pollution index chart, an AQI value of 470 was recorded. What level of air pollution does this indicate?
A 55-year-old patient from Chhattisgarh presents with progressive muscle weakness, stiffness of both lower limbs, and complete paralysis. What is the most important history that should be asked?
NEET-PG 2021 - Community Medicine NEET-PG Practice Questions and MCQs
Question 1: After the admission of a road traffic accident (RTA) case, there is a spillage of blood on the hospital floor. Which disinfectant should be used to clean the floor?
- A. Formaldehyde
- B. Chlorhexidine
- C. Ethyl alcohol
- D. Sodium Hypochlorite (Correct Answer)
Explanation: ***Sodium Hypochlorite*** - **Sodium hypochlorite** is highly effective against a broad spectrum of microorganisms, including **viruses, bacteria, and fungi**, making it ideal for blood spills. - Its **oxidizing action** denatures proteins and nucleic acids, effectively decontaminating surfaces potentially contaminated with bloodborne pathogens. *Formaldehyde* - Primarily used as a **sterilant** or for **tissue preservation**, not typically for general surface cleaning due to its toxicity and strong odor. - Its slow action and **irritating fumes** make it unsuitable for routine decontamination in a clinical setting. *Chlorhexidine* - Primarily an **antiseptic** used for skin disinfection and surgical scrubs due to its residual activity. - It has limited efficacy against some viruses and is not the first choice for large-scale surface decontamination of blood spills due to potential staining and cost. *Ethyl alcohol* - Effective as a **disinfectant** for small surfaces and medical equipment, but evaporates quickly, limiting its contact time for thorough disinfection of large spills. - It is flammable and can damage certain materials, making it less suitable for blood on floors.
Question 2: There is an outbreak of buboes in a community. What is the vector responsible for transmitting the causative agent?
- A. Human flea
- B. Sand fly
- C. Xenopsylla [Rat Flea] (Correct Answer)
- D. Tsetse fly
Explanation: ***Xenopsylla [Rat Flea]*** - The presence of **buboes** is characteristic of the **bubonic plague**, caused by *Yersinia pestis*. - *Xenopsylla cheopis*, the **rat flea**, is the primary **vector** responsible for transmitting *Yersinia pestis* from rodents to humans. *Human flea* - While human fleas (*Pulex irritans*) can bite humans, they are not the primary or most efficient vector for transmitting **bubonic plague**. - Their role in widespread outbreaks is generally considered minor compared to the **rat flea**. *Sand fly* - **Sand flies** are vectors for diseases such as **leishmaniasis** and **sandfly fever**. - They are not associated with the transmission of **bubonic plague** or the formation of **buboes**. *Tsetse fly* - The **tsetse fly** is the vector for **African trypanosomiasis** (sleeping sickness). - This disease presents with fevers, headaches, and neurological symptoms, not **buboes**.
Question 3: Which of the following is not included in the Global Hunger Index?
- A. Undernourishment
- B. Under 5 mortality rate
- C. Child undernutrition
- D. Infant Mortality Rate (IMR) (Correct Answer)
Explanation: ***Infant Mortality Rate (IMR)*** - The **Infant Mortality Rate (IMR)** measures deaths of infants under one year of age and is an indicator of overall community health and access to medical care, but it is **not directly included** in the GHI calculation. - While related to health and well-being, the GHI focuses on direct measures of **food insecurity** and its immediate consequences on children. *Undernourishment* - **Undernourishment**, defined as the proportion of the population that is consuming insufficient caloric energy, is a **direct component** of the GHI. - It reflects the overall **food supply** and access at the population level. *Under 5 mortality rate* - The **Under-5 Mortality Rate** (child mortality) is a key indicator in the GHI, reflecting the fatal consequences of a combination of **inadequate nutrition** and unhealthy environments. - It captures deaths of children before their fifth birthday, which can be heavily influenced by **nutritional status**. *Child undernutrition* - **Child undernutrition** is represented in the GHI by two indicators: **child stunting** (low height for age) and **child wasting** (low weight for height). - These are crucial measures reflecting **chronic** and **acute undernutrition** in children, respectively.
Question 4: In a 10-year-old school child under the school health program, which vaccine should be administered?
- A. DPT
- B. BCG
- C. Td (Correct Answer)
- D. MMR
Explanation: ***Td (Tetanus-Diphtheria)*** - For a 10-year-old child under the school health program in India, the recommended vaccination is a booster dose of **Td (tetanus-diphtheria)**. - This ensures continued **protection against tetanus and diphtheria**, as immunity from the primary series may wane over time. - **Td is preferred over TT** (tetanus toxoid alone) as it provides protection against both tetanus and diphtheria. - This is administered at **10 years and 16 years** as per the Indian Academy of Pediatrics immunization schedule. *DPT* - **DPT (diphtheria, pertussis, tetanus)** is administered in infancy and early childhood (at 6, 10, and 14 weeks, with boosters at 16-24 months and 4-6 years). - The **pertussis component is not given** in later childhood or adolescence due to increased reactogenicity in older children. *BCG* - **BCG (Bacille Calmette-Guérin)** vaccine protects against tuberculosis and is given **at birth** in endemic areas like India. - It is **not routinely administered** to a 10-year-old unless there are specific risk factors or documented non-vaccination status. *MMR* - **MMR (measles, mumps, rubella)** vaccine is given as **two doses**: first at 9-12 months and second at 16-24 months (or 4-6 years). - A 10-year-old child would have **already completed** their MMR vaccination schedule.
Question 5: In an outbreak of encephalitis in a community, according to the Universal Immunization Schedule, what is the route of administration for the vaccine likely used for the infection?
- A. Live & subcutaneous
- B. Killed & intramuscular
- C. Live & intramuscular (Correct Answer)
- D. Killed & subcutaneous
Explanation: ***Live & intramuscular*** - The most common cause of encephalitis in outbreaks included in the Universal Immunization Schedule is **Japanese Encephalitis (JE)**, for which the **live attenuated SA 14-14-2 vaccine** is administered **intramuscularly**. - As per the **National Immunization Schedule of India (current UIP)**, JE vaccine is given via **IM route** at 9-12 months of age. - **Live attenuated vaccines** stimulate a strong, long-lasting immune response, often with a single dose. *Incorrect: Live & subcutaneous* - While the older **inactivated JE vaccine** (used before 2013) was given subcutaneously, the **current live attenuated SA 14-14-2 vaccine** used in India's UIP is administered **intramuscularly**. - Subcutaneous route was appropriate for the older killed vaccine formulation but not for the current live vaccine. *Incorrect: Killed & intramuscular* - The current JE vaccine in India's UIP is **live attenuated, not killed**. - While killed vaccines are often given intramuscularly (e.g., inactivated polio), the primary vaccine for encephalitis outbreaks is the **live SA 14-14-2 vaccine**. - Killed vaccines typically require **multiple doses** and boosters to achieve adequate immunity. *Incorrect: Killed & subcutaneous* - Although the **older inactivated (killed) JE vaccine** was given subcutaneously before 2013, this has been replaced in the UIP. - The **current standard** is the live attenuated vaccine given intramuscularly, which provides better immunogenicity and requires fewer doses.
Question 6: Low air velocity will be measured by
- A. Beckmann thermometer
- B. Globe thermometer
- C. Kata thermometer (Correct Answer)
- D. Wet bulb thermometer
Explanation: ***Kata thermometer*** - A **Kata thermometer** is specifically designed to measure **low air velocities** by assessing the cooling power of the air. - It measures the rate of heat loss from a heated bulb, which is influenced by air movement, providing an indirect measure of low air speed. *Beckmans thermometer* - A **Beckmann thermometer** is used for precise measurement of **small temperature differences** and changes, not air velocity. - It has a large range of mercury in its reservoir and can be adjusted to different starting temperatures, making it unsuitable for air flow. *Globe thermometer* - A **globe thermometer** primarily measures **radiant heat** in an environment. - It consists of a thermometer bulb inside a black sphere, used to assess the mean radiant temperature and effective temperature, not air velocity. *Wet thermometer* - A **wet-bulb thermometer** is part of a psychrometer used to measure **humidity**. - It measures the temperature of evaporation and is used to determine the **dew point** and **relative humidity**, not air velocity.
Question 7: At which level is the School Health Service typically provided?
- A. Subdistrict
- B. Subcentre
- C. District
- D. PHC (Correct Answer)
Explanation: ***Correct Option: PHC*** - The **Primary Health Centre (PHC)** is the most common and appropriate level for providing the School Health Service. - PHCs serve as the first point of contact for healthcare in India, making them ideal for reaching a large number of schools within their catchment area for **preventive and basic curative care**. - Under the School Health Program (part of Ayushman Bharat initiative), PHCs are designated to provide comprehensive health services to schools in their catchment areas. *Incorrect Option: Subdistrict* - The subdistrict level, which typically includes Community Health Centers (CHCs) and Taluka hospitals, provides more specialized services than PHCs. - While it can support school health programs, it's not the primary or most frequent point of service delivery for routine school health activities. *Incorrect Option: Subcentre* - Subcentres are the most peripheral health facilities, offering basic care and outreach services, often managed by ANMs and ASHA workers. - While they contribute to community health, their capacity is generally limited for comprehensive School Health Services, which often require a broader range of resources available at a PHC. *Incorrect Option: District* - The district level oversees the entire health system within its jurisdiction and provides tertiary or advanced care through district hospitals. - School Health Services are coordinated at this level, but direct provision of routine health checks and services mainly occurs at the more localized PHC level.
Question 8: In a post-Diwali air pollution index chart, an AQI value of 470 was recorded. What level of air pollution does this indicate?
- A. Moderate
- B. Very poor
- C. Poor
- D. Severe (Correct Answer)
Explanation: ***Severe*** - An **AQI value of 470** falls into the **401-500 range**, which is classified as severe according to most air quality index standards. - This level indicates a high risk of respiratory effects on healthy people and serious health impacts on those with lung diseases. *Moderate* - The moderate category typically spans AQI values from **51 to 100**, indicating acceptable air quality with some risk for sensitive individuals. - An AQI of 470 is significantly higher than this range. *Very poor* - The very poor category generally ranges from AQI values of **301 to 400**, suggesting health warnings of emergency conditions. - While concerning, an AQI of 470 exceeds this level, indicating an even more critical situation. *Poor* - The poor category usually covers AQI values from **201 to 300**, signifying a likely impact on the health of vulnerable groups. - An AQI of 470 is much higher than the poor category, indicating a more hazardous level of pollution.
Question 9: A 55-year-old patient from Chhattisgarh presents with progressive muscle weakness, stiffness of both lower limbs, and complete paralysis. What is the most important history that should be asked?
- A. Medical history
- B. History of present illness
- C. Dietary history (Correct Answer)
- D. Socioeconomic history
Explanation: ***Dietary history*** - In a patient from **Chhattisgarh** with progressive muscle weakness and paralysis, a detailed **dietary history** is crucial to investigate potential **lathyrism**. - **Lathyrism** is a neurotoxic disorder caused by the consumption of **Lathyrus sativus (Khesari dal)**, a legume common in this region, especially during famines or droughts. *Medical history* - While important for general assessment, a broad medical history might not immediately pinpoint the specific dietary toxin relevant to progressive paralysis in this region. - It would likely cover existing conditions and medications, but not specifically focus on the unique risk of **lathyrism** from regional food consumption. *History of present illness* - This history would detail the onset, progression, and characteristics of the muscle weakness and paralysis. - While essential for understanding the clinical course, it would not inherently identify the underlying cause without specifically probing dietary factors that could lead to such symptoms in this geographical context. *Socioeconomic history* - This history can provide context about living conditions and access to food, which might indirectly suggest dietary patterns. - However, it does not directly ask about specific food intake or the consumption of potentially toxic staples like **Khesari dal**, which is a more direct and critical line of questioning.