Psychosocial Support in Disasters — MCQs
Which of the following is NOT a core component of the WHO's global STI control strategy?
What is the primary purpose of the World Health Organization's International Health Regulations?
In an accident case, after the arrival of medical team, all should be done in early management except;
In immediate disaster response management (first 24-48 hours), which of the following is not typically practiced?
You are working in a primary health center (PHC) situated in a high seismic zone. Which of the following actions should you take as part of preparedness for an emergency?
Which of the following is not done in the primary survey of trauma?
Post-traumatic stress disorder is characterized by all except:
Ambulatory patients after a disaster are categorized into what color of triage?
Provision of the Mental Health Act 2017, based on WHO guidelines, includes all, except:
Patients are categorized on the basis of chances of survival in Disaster management:
Psychosocial Support in Disasters Indian Medical PG Practice Questions and MCQs
Question 1: Which of the following is NOT a core component of the WHO's global STI control strategy?
- A. Case management
- B. Universal mandatory screening (Correct Answer)
- C. Strategic information systems
- D. Prevention services
Explanation: ***Universal mandatory screening*** - While screening is part of STI control, **universal mandatory screening** for all STIs in the general population is not a core component of the WHO's strategy due to feasibility, cost, and ethical considerations. - The strategy emphasizes **targeted screening** for at-risk populations and opportunistic screening. *Case management* - **Case management**, including accurate diagnosis and effective treatment, is a critical component for managing current infections and preventing further transmission. - This involves syndromic or etiologic approaches to treatment and partner notification. *Strategic information systems* - **Strategic information systems** are essential for monitoring trends, evaluating interventions, and informing policy decisions related to STI control. - This includes surveillance data, program monitoring, and research. *Prevention services* - **Prevention services** are a cornerstone of the WHO's strategy, aiming to reduce the incidence of new infections. - These services encompass health education, condom promotion and distribution, vaccination, and pre-exposure prophylaxis (PrEP).
Question 2: What is the primary purpose of the World Health Organization's International Health Regulations?
- A. To establish global health standards
- B. To coordinate international health responses
- C. To prevent the spread of diseases across borders (Correct Answer)
- D. To provide financial aid to countries in need
Explanation: ***To prevent the spread of diseases across borders*** - The **International Health Regulations (IHR)** are a legally binding international instrument designed to help countries work together to prevent and respond to **acute public health risks** that have the potential to spread globally. - Their core purpose is to prevent, protect against, control, and provide a public health response to the **international spread of disease** in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade. *To establish global health standards* - While the IHR contribute to global health safety, their primary focus is on **risk management and response** rather than setting broad global health standards. - Other WHO initiatives and agreements are more specifically dedicated to establishing **global norms and standards** for health systems and services. *To coordinate international health responses* - The IHR provide a framework for coordination, but their fundamental purpose is to enable countries to **detect, assess, notify, and respond** to public health events of international concern. - Coordination is a means to achieve the goal of preventing international spread, rather than the primary goal itself. *To provide financial aid to countries in need* - The IHR do not involve the direct provision of **financial aid**; their scope is limited to public health measures and reporting. - Financial assistance for health initiatives typically falls under the purview of other **international development organizations** or specific funding mechanisms.
Question 3: In an accident case, after the arrival of medical team, all should be done in early management except;
- A. Glasgow coma scale
- B. Check BP (Correct Answer)
- C. Stabilization of cervical vertebrae
- D. Check Respiration
Explanation: ***Check BP*** - In the **immediate/early management** of trauma (primary survey), while circulation assessment is crucial, the **initial assessment of circulation** focuses on: - **Pulse rate and quality** (radial, carotid) - **Capillary refill time** - **Skin color and temperature** - **Active hemorrhage control** - **Formal blood pressure measurement** with a cuff, while important, is typically recorded during or after these rapid initial assessments, as it takes more time to obtain an accurate reading. - In the context of this question, among the four options listed, BP measurement is relatively less immediate compared to the other life-saving priorities (airway protection, breathing assessment, C-spine stabilization, and GCS). - **Note:** This is a nuanced distinction - BP is assessed during primary survey, but the other three options have more immediate life-threatening implications if not addressed. *Glasgow coma scale* - **GCS assessment** is part of the **"D" (Disability)** step in the ATLS primary survey. - It is performed early to assess neurological status and level of consciousness. - GCS <8 indicates need for **definitive airway protection** (intubation). - This is a critical early assessment that guides immediate management decisions. *Stabilization of cervical vertebrae* - **C-spine immobilization** is part of the **"A" (Airway)** step - "Airway with cervical spine protection." - It is performed **simultaneously** with airway assessment using a **rigid cervical collar**. - This is the **first priority** in trauma management to prevent secondary spinal cord injury. - All trauma patients should be assumed to have C-spine injury until proven otherwise. *Check Respiration* - **Respiratory assessment** is part of the **"B" (Breathing)** step in the ATLS primary survey. - This involves checking: - **Respiratory rate and pattern** - **Chest wall movement** - **Air entry bilaterally** - **Signs of tension pneumothorax or flail chest** - This is an immediate life-saving priority and must be assessed early.
Question 4: In immediate disaster response management (first 24-48 hours), which of the following is not typically practiced?
- A. Rehabilitation
- B. Triage
- C. Mass vaccination (Correct Answer)
- D. Search and rescue
Explanation: ***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**.
Question 5: You are working in a primary health center (PHC) situated in a high seismic zone. Which of the following actions should you take as part of preparedness for an emergency?
- A. Ensure all financial and other resources are available for disaster preparedness.
- B. Increase public awareness through campaigns and loudspeakers.
- C. Follow instructions given over the phone or radio by higher officials.
- D. Conduct a simulation for the disaster and assess the response. (Correct Answer)
Explanation: ***Conduct a simulation for the disaster and assess the response.*** - **Simulation exercises** are crucial for testing the effectiveness of a disaster preparedness plan and identifying weaknesses in the response system. - This allows for refinement of protocols, training of personnel, and ensuring that all team members understand their roles during an actual emergency. *Ensure all financial and other resources are available for disaster preparedness.* - While important for effective disaster management, simply "ensuring" resources are available is not an action of preparedness, but rather an **enabling condition**. - This statement focuses on the availability of resources rather than a proactive step to prepare the PHC for an emergency. *Increase public awareness through campaigns and loudspeakers.* - **Public awareness campaigns** are vital for community preparedness, but this action is primarily for the general population and not a specific preparedness action for the PHC itself in terms of its operational readiness. - While a PHC might be involved in public awareness, its core preparedness involves internal actions to ensure its functionality during a disaster. *Follow instructions given over the phone or radio by higher officials.* - This describes a reaction during or immediately before a disaster, rather than a proactive **preparedness measure**. - Relying solely on real-time instructions from higher officials during an emergency without prior planning can lead to delays and inefficiencies.
Question 6: Which of the following is not done in the primary survey of trauma?
- A. Intubation
- B. NCCT head (Correct Answer)
- C. ICD drainage
- D. CXR
Explanation: ***NCCT head*** - A **Non-Contrast CT (NCCT) head** is typically performed during the **secondary survey** once the patient is hemodynamically stable and life-threatening conditions have been addressed. - The primary survey focuses on immediate **life-saving interventions** for airway, breathing, circulation, disability, and exposure. *Intubation* - **Intubation** is a critical intervention during the primary survey, specifically under the **'A' (Airway)** component, to establish and secure a patent airway in a compromised patient. - Failure to establish an airway can rapidly lead to **hypoxia** and death. *ICD drainage* - **Intercostal drain (ICD) drainage** is an urgent intervention in the primary survey, falling under **'B' (Breathing)**, to manage conditions like **tension pneumothorax** or massive hemothorax. - These conditions can severely compromise ventilation and circulation, requiring immediate relief. *CXR* - A **Chest X-ray (CXR)** is a rapid and essential diagnostic tool in the primary survey, also under **'B' (Breathing)**, to identify life-threatening thoracic injuries such as pneumothorax, hemothorax, or mediastinal shift. - It provides quick information crucial for immediate management decisions.
Question 7: Post-traumatic stress disorder is characterized by all except:
- A. Flashback and nightmare
- B. Re-experiencing stressful events
- C. Exposure to traumatic events
- D. It doesn't develop after 6 months of stress (Correct Answer)
Explanation: ***It doesn't develop after 6 months of stress*** - This statement is **FALSE** and is therefore the correct answer to this "EXCEPT" question. - **PTSD can develop at any time** following a traumatic event, including months or even years later - there is no upper time limit for symptom onset. - The **DSM-5 includes a "delayed expression" specifier** for cases where full diagnostic criteria are not met until at least 6 months after the trauma. - While most cases develop within **3 months of the traumatic event**, delayed onset is well-documented and clinically recognized. - This distinguishes PTSD from **Acute Stress Disorder**, which by definition occurs within 3 days to 4 weeks after trauma exposure. *Flashback and nightmare* - **Flashbacks** (dissociative reactions where the person feels the traumatic event is recurring) and **nightmares** are core symptoms of PTSD. - These belong to the **re-experiencing/intrusion symptom cluster** (Criterion B in DSM-5). - These involuntary recollections cause significant distress and are hallmark features of the disorder. *Re-experiencing stressful events* - **Re-experiencing symptoms** are one of the four main symptom clusters required for PTSD diagnosis. - This includes intrusive memories, traumatic nightmares, flashbacks, and intense psychological/physiological reactions to trauma reminders. - These symptoms reflect the **inability to integrate the traumatic memory** properly, leading to involuntary reactivation. *Exposure to traumatic events* - **Criterion A: Exposure to actual or threatened death, serious injury, or sexual violence** is the essential prerequisite for PTSD diagnosis. - This exposure can be through direct experience, witnessing, learning it happened to a close other, or repeated/extreme exposure to aversive details. - Without documented trauma exposure, PTSD cannot be diagnosed regardless of symptom presentation.
Question 8: Ambulatory patients after a disaster are categorized into what color of triage?
- A. Red
- B. Yellow
- C. Green (Correct Answer)
- D. Black
Explanation: ***Green*** - **Green tag** is for the walking wounded, meaning those with minor injuries who can move independently and do not require immediate medical attention. - These patients can often assist with **their own care** or aid others, and their treatment can be delayed. *Red* - **Red tag** patients have critical, life-threatening injuries that require immediate intervention to save life or limb. - This category includes conditions like **severe bleeding**, shock, or airway compromise. *Yellow* - **Yellow tag** is assigned to patients with serious injuries that are not immediately life-threatening but require definitive treatment within a few hours. - Examples include **stable fractures**, moderate burns, or significant but controlled bleeding. *Black* - **Black tag** indicates patients who are deceased or have injuries so severe that survival is unlikely even with maximal medical care. - Resources are diverted from these patients to those with a higher chance of survival, to **maximize overall saved lives**.
Question 9: Provision of the Mental Health Act 2017, based on WHO guidelines, includes all, except:
- A. Social support
- B. Screening family members (Correct Answer)
- C. Human rights
- D. Communication regarding care and treatment
Explanation: ***Screening family members*** - The Mental Health Act 2017 focuses on the **rights, treatment, and support of individuals with mental illness**, not routine screening of their family members. - The Act does not contain provisions mandating **screening of asymptomatic family members**, though family history may be relevant for clinical assessment. - This is **not a provision** outlined in the Act based on WHO guidelines. *Human rights* - The Act is explicitly grounded in the **protection and promotion of human rights** for persons with mental illness (Chapter I). - Ensures care with **dignity, respect, and freedom from discrimination** as core principles. - Aligns with WHO's mental health action plan and human rights framework. *Communication regarding care and treatment* - **Section 4** emphasizes the right to information and **informed consent** for all treatment decisions. - Patients must receive clear communication about their **diagnosis, treatment options, and care plans**. - Includes provisions for **advance directives** and involvement in treatment decisions. *Social support* - **Chapter V** addresses rehabilitation and community-based services, emphasizing the role of **social support systems**. - Promotes **community integration** and access to social resources for recovery. - Recognizes family and community support as essential for long-term mental health management.
Question 10: Patients are categorized on the basis of chances of survival in Disaster management:
- A. Tagging
- B. Triage (Correct Answer)
- C. Mitigation
- D. Surge capacity
Explanation: ***Triage*** - **Triage** is the process of sorting and prioritizing patients based on the severity of their injuries and their chances of survival, especially in mass casualty incidents or disasters. - This system ensures that limited resources are allocated to maximize the number of survivors and provide the most effective care. *Tagging* - **Tagging** refers to the physical labeling of patients after they have been triaged, using color-coded tags (e.g., red for immediate, yellow for delayed, green for minor, black for expectant). - It is a result of the triage process, not the process of categorization itself. *Mitigation* - **Mitigation** involves measures taken to reduce the impact of a disaster or emergency, such as constructing earthquake-resistant buildings or developing flood control systems. - It focuses on preventing or lessening the severity of a disaster before it occurs, rather than categorizing patients. *Surge capacity* - **Surge capacity** is the ability of a healthcare system to expand its services and resources in response to an unexpected influx of patients, such as during a pandemic or mass casualty event. - It refers to the operational capability of the system, not the method of patient categorization.
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