Global Response to Emerging Infections — MCQs
All are provisions of WHO mental health Gap Action Programme (mhGAP), except:
Disease not under integrated disease surveillance project is?
Disease usually not seen in a country but brought from abroad is:
All of the following conditions are immediate priorities in the WHO's "Vision -2020: The Right to sight" except:
A district reports increasing syphilis cases despite standard interventions. Which program response is most appropriate?
Disease not included under International surveillance
Which disease does not have a known animal reservoir?
Which of the following diseases is not covered under the Integrated Disease Surveillance Project (IDSP)?
Which of the following diseases is not under surveillance in the Integrated Disease Surveillance Project (P-Form)?
All are ophthalmological emergencies except -
Global Response to Emerging Infections Indian Medical PG Practice Questions and MCQs
Question 1: All are provisions of WHO mental health Gap Action Programme (mhGAP), except:
- A. Communication regarding care
- B. Human rights
- C. Screening family members (Correct Answer)
- D. Social support
Explanation: ***Screening family members*** - The **WHO mhGAP** primarily focuses on scaling up care for **priority mental, neurological, and substance use disorders** in low- and middle-income countries. It does not explicitly include the provision of routine screening of family members of affected individuals. - While family support is crucial, direct screening of asymptomatic family members for psychiatric disorders is not a core component of the program's defined interventions for service delivery. *Communication regarding care* - **Effective communication** is a fundamental aspect of the **WHO mhGAP** to ensure patients and their families understand their condition and treatment plan. - It emphasizes **patient-centered care** and informed decision-making, which rely heavily on clear and empathetic communication from healthcare providers. *Human rights* - **Human rights** are a foundational principle of the **WHO mhGAP**, ensuring that individuals with mental disorders receive care without discrimination and with respect for their dignity and autonomy. - The program advocates for policies and practices that protect the rights of people with mental health conditions. [1] *Social support* - **Social support** is a crucial component promoted by the **WHO mhGAP**, recognizing its role in recovery and well-being for individuals with mental health conditions. - The program encourages interventions that strengthen social ties and community integration to reduce isolation and improve outcomes.
Question 2: Disease not under integrated disease surveillance project is?
- A. Herpes Zoster (Correct Answer)
- B. Meningoencephalitis
- C. TB
- D. Cholera
Explanation: ***Herpes Zoster*** - **Herpes Zoster**, also known as shingles, is a viral disease that is typically not included in the list of diseases under routine surveillance by the Integrated Disease Surveillance Project (IDSP) in many regions. - The IDSP primarily focuses on diseases with **epidemic potential** or high public health impact for early detection and rapid response. *Meningoencephalitis* - **Meningoencephalitis** (inflammation of the brain and meninges) is a serious condition with epidemic potential, making it a key disease for surveillance under projects like IDSP. - Early detection of clusters can help prevent widespread outbreaks and manage severe neurological outcomes. *TB* - **Tuberculosis (TB)** is a major public health concern due to its high prevalence, chronic nature, and potential for transmission, especially drug-resistant forms. - It is consistently included in surveillance programs like IDSP for consistent monitoring, case finding, and treatment adherence. *Cholera* - **Cholera** is an acute diarrheal disease with high epidemic potential due to rapid transmission, particularly in areas with poor sanitation. - It is a critical disease for surveillance to enable quick identification of outbreaks, implementation of control measures, and prevention of mass fatalities.
Question 3: Disease usually not seen in a country but brought from abroad is:
- A. Exotic (Correct Answer)
- B. Endemic
- C. Epidemic
- D. Zoonotic
Explanation: ***Exotic*** - An **exotic disease** refers to a disease that is not native or usually found in a particular country or region but is introduced from abroad. - This term highlights its **foreign origin** and rarity within the local population. *Endemic* - An **endemic disease** is one that is constantly present in a population or region with a relatively stable prevalence within that population. - It describes a disease that is **native** to a specific area, not typically brought from abroad. *Epidemic* - An **epidemic** signifies a sudden increase in the number of cases of a disease in a population over a particular period, substantially exceeding what is normally expected. - While it can be introduced from abroad, the definition focuses on the **rapid spread** rather than the origin itself. *Zoonotic* - A **zoonotic disease** is an infectious disease that has jumped from an animal to humans. - This term describes the **mode of transmission** from animals, not necessarily its geographic origin or whether it's new to a country.
Question 4: All of the following conditions are immediate priorities in the WHO's "Vision -2020: The Right to sight" except:
- A. Cataract
- B. Epidemic conjunctivitis (Correct Answer)
- C. Onchocerciasis
- D. Trachoma
Explanation: ***Epidemic conjunctivitis*** - While **epidemic conjunctivitis** can cause significant discomfort and temporary vision impairment, it is generally **self-limiting** and rarely leads to permanent blindness. - It was not identified as one of the top five global causes of avoidable blindness targeted by the Vision 2020 initiative. *Cataract* - **Cataract** is the **leading cause of blindness** globally, accounting for approximately half of all cases. - It is a highly treatable condition through surgery, making it a critical priority for Vision 2020. *Onchocerciasis* - Also known as **river blindness**, onchocerciasis is a parasitic disease that causes severe visual impairment and blindness. - It is a significant public health problem in several regions, particularly in Africa, and was a key focus of Vision 2020 due to its widespread impact and the availability of preventive chemotherapy. *Trachoma* - **Trachoma** is the **leading infectious cause of blindness** worldwide, caused by *Chlamydia trachomatis*. - Given its preventable and treatable nature, and its prevalence in many impoverished areas, it was designated as one of the priority diseases under Vision 2020.
Question 5: A district reports increasing syphilis cases despite standard interventions. Which program response is most appropriate?
- A. Mass treatment campaign
- B. Enhanced surveillance with targeted outreach and screening (Correct Answer)
- C. Increasing clinic hours only
- D. Public awareness campaign only
Explanation: ***Enhanced surveillance with targeted outreach and screening*** - This approach specifically addresses the rise in cases by actively finding and treating infected individuals and their contacts, which is crucial for **controlling outbreaks** of sexually transmitted infections like **syphilis**. - **Targeted outreach** ensures high-risk populations are reached, and **enhanced surveillance** allows for better understanding of transmission patterns to guide interventions. *Mass treatment campaign* - **Mass treatment** campaigns are generally reserved for diseases with high prevalence and potential for rapid spread in a community, and are typically not the first response for **syphilis**, which often requires individual diagnosis and partner notification. - While it might reduce prevalence, it doesn't address ongoing transmission dynamics or identify specific **risk factors** at an individual level. *Increasing clinic hours only* - While increased clinic access is beneficial, it is a passive approach that does not actively identify cases or reach individuals who may not seek care, especially those who are **asymptomatic** or face barriers to accessing healthcare. - It might improve access for those already motivated to seek care but won't effectively address an increasing trend in cases by itself. *Public awareness campaign only* - A public awareness campaign can improve knowledge but does not directly lead to diagnosis and treatment, which are essential for controlling an active increase in syphilis cases. - It's a supportive measure but insufficient as a primary response to an **epidemic trend** without accompanying diagnostic and therapeutic services.
Question 6: Disease not included under International surveillance
- A. Common cold
- B. Tension headache (Correct Answer)
- C. Rabies
- D. Malaria
- E. Yellow fever
Explanation: ***Tension headache*** - **Tension headaches** are a common, benign, and typically self-limiting condition that does not pose a public health threat requiring international attention. - They are **not communicable** and do not have the potential for widespread international spread. - This is a **non-infectious neurological symptom** with no epidemic potential. *Common cold* - While the **common cold** is highly contagious and caused by various respiratory viruses, it is **not under formal international surveillance**. - It is generally a mild, self-limiting illness that does not meet the criteria for International Health Regulations (IHR) reporting. - However, severe acute respiratory syndromes (like SARS or COVID-19) are under international surveillance due to their pandemic potential. *Rabies* - **Rabies** is a fatal zoonotic disease included under **WHO International Health Regulations (IHR)** surveillance. - It requires international monitoring due to high case-fatality rate (nearly 100%) and potential for cross-border transmission through animal movement. - WHO coordinates global surveillance to track animal reservoirs, implement vaccination programs, and prevent human deaths. *Malaria* - **Malaria** is a major disease under **WHO Global Malaria Programme** surveillance with mandatory reporting requirements. - International surveillance tracks disease burden, drug resistance patterns, vector control effectiveness, and progress toward elimination goals. - It causes significant morbidity and mortality, particularly in tropical and subtropical regions. *Yellow fever* - **Yellow fever** is a mosquito-borne viral hemorrhagic disease explicitly listed under **WHO International Health Regulations (IHR)**. - Countries must report outbreaks and maintain vaccination requirements for international travel from endemic areas. - International surveillance prevents epidemic spread and guides vaccination campaigns.
Question 7: Which disease does not have a known animal reservoir?
- A. Brucella melitensis
- B. Francisella tularensis
- C. Bordetella pertussis (Correct Answer)
- D. Pasteurella multocida
Explanation: ***Bordetella pertussis*** - **Bordetella pertussis**, the causative agent of whooping cough, is unique among these options as it has **no known animal reservoir**. It is exclusively a human pathogen. - Transmission occurs directly from person to person via respiratory droplets, highlighting its **anthroponotic** nature. *Brucella melitensis* - **Brucella melitensis** is primarily associated with **goats and sheep**, acting as a significant animal reservoir. - Humans typically acquire brucellosis through contact with infected animals or consumption of unpasteurized dairy products. *Pasteurella multocida* - **Pasteurella multocida** is a common commensal bacterium found in the oral flora of various animals, including **cats and dogs**. - Human infections usually result from **animal bites or scratches**, demonstrating clear zoonotic transmission. *Francisella tularensis* - **Francisella tularensis**, which causes **tularemia**, has numerous animal reservoirs, including **rabbits, rodents, and ticks**. - Humans can contract tularemia through direct contact with infected animals, insect bites, or inhalation of contaminated aerosols.
Question 8: Which of the following diseases is not covered under the Integrated Disease Surveillance Project (IDSP)?
- A. Tuberculosis
- B. Cholera
- C. Herpes zoster (Correct Answer)
- D. Meningococcal disease
Explanation: ***Herpes zoster*** - **Herpes zoster** (shingles) is not included in the Integrated Disease Surveillance Project (IDSP) as it is neither an epidemic-prone disease nor a notifiable disease under the program. - IDSP focuses on diseases with significant public health impact, epidemic potential, or those requiring immediate public health response. - While herpes zoster can cause morbidity in immunocompromised individuals, it does not pose a widespread public health threat requiring national surveillance. *Tuberculosis* - **Tuberculosis (TB)** is explicitly covered under IDSP as a major notifiable disease due to its high burden in India and significant public health importance. - TB surveillance under IDSP helps monitor disease trends, detect outbreaks, and evaluate the effectiveness of the National Tuberculosis Elimination Programme. - Regular reporting and surveillance are essential for achieving TB elimination goals. *Cholera* - **Cholera** is a priority disease under IDSP as an epidemic-prone disease with potential for rapid outbreaks and high mortality if untreated. - It is part of the core surveillance list due to its ability to cause severe dehydration and waterborne epidemics. - Early detection through IDSP enables timely implementation of control measures including safe water supply and oral rehydration therapy. *Meningococcal disease* - **Meningococcal disease** (acute bacterial meningitis) is covered under IDSP due to its high case fatality rate, epidemic potential, and need for urgent public health response. - Surveillance is critical for early outbreak detection and implementation of preventive measures such as mass vaccination and chemoprophylaxis. - Close monitoring helps identify circulating serotypes and guide vaccination strategies.
Question 9: Which of the following diseases is not under surveillance in the Integrated Disease Surveillance Project (P-Form)?
- A. Snake bite (Correct Answer)
- B. Acute respiratory tract infections
- C. Tuberculosis
- D. Leptospirosis
Explanation: ***Snake bite*** - While a public health concern, **snake bites** are generally not included in the list of diseases under routine surveillance by the Integrated Disease Surveillance Project (IDSP) P-Form, which focuses on infectious diseases with epidemic potential. - The IDSP primarily monitors for **communicable diseases**, outbreaks, and other public health threats requiring rapid detection and response. *Acute respiratory tract infections* - **Acute respiratory tract infections (ARIs)**, including severe acute respiratory infections (SARIs), are a major focus of IDSP surveillance due to their high transmissibility and potential for large-scale outbreaks. - Surveillance helps in detecting trends, identifying new pathogens, and implementing timely control measures. *Tuberculosis* - **Tuberculosis (TB)** is a priority disease for surveillance under the IDSP due to its high prevalence, chronic nature, and the need for continuous monitoring of incidence, prevalence, and treatment outcomes. - The IDSP plays a role in tracking TB cases and drug resistance patterns to inform national control programs. *Leptospirosis* - **Leptospirosis** is an emerging infectious disease with epidemic potential, especially in areas with poor sanitation and during floods, making it a crucial disease for IDSP surveillance. - Surveillance helps in early detection of outbreaks and implementation of control measures to prevent spread.
Question 10: All are ophthalmological emergencies except -
- A. Endophthalmitis
- B. CRVO (Correct Answer)
- C. Acute congestive glaucoma
- D. CRAO
Explanation: ***CRVO*** - Central Retinal Vein Occlusion (CRVO) is characterized by painless **vision loss** due to retinal hemorrhage and edema, but it is generally *not* considered an immediate, vision-threatening emergency in the same vein as the other options. - While it requires prompt evaluation and management to preserve vision, CRVO allows for a less urgent intervention compared to conditions that can lead to permanent vision loss within hours. *Endophthalmitis* - **Endophthalmitis** is a severe inflammation of the intraocular fluids and tissues, typically caused by infection, and can lead to rapid and irreversible vision loss if not treated urgently. - It presents with pain, redness, reduced vision, and hypopyon (pus in the anterior chamber), necessitating immediate antibiotic treatment and surgical intervention. *Acute congestive glaucoma* - **Acute congestive glaucoma** (acute angle-closure glaucoma) involves a sudden increase in intraocular pressure, causing severe pain, redness, corneal edema, and profound vision loss. - If left untreated, the high pressure can cause irreversible damage to the optic nerve within hours, making it a true ocular emergency. *CRAO* - **Central Retinal Artery Occlusion (CRAO)** is a sudden, painless loss of vision in one eye due to blockage of the central retinal artery, leading to retinal ischemia. - It is an ocular emergency because irreversible retinal damage and vision loss can occur within 90-120 minutes of the occlusion, requiring immediate intervention to restore blood flow.
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