NEET-PG 2013 - Community Medicine Practice Questions

Q: NVBDCP includes all except ?

Yellow fever. ***Yellow fever*** - Yellow fever is a **viral hemorrhagic fever** transmitted by infected mosquitoes, primarily **Aedes aegypti**. - While a significant public health concern, it is **not included in India's National Vector-Borne Disease Control Programme (NVBDCP)**, as it is not endemic to India. *Filariasis* - **Lymphatic filariasis** (elephantiasis) is a major vector-borne disease in India, caused by parasitic worms transmitted by mosquitoes. - It is a key component of the NVBDCP, which focuses on its elimination through **mass drug administration** and vector control. *Malaria* - **Malaria**, caused by Plasmodium parasites transmitted by Anopheles mosquitoes, is a cornerstone of the NVBDCP. - The program actively implements strategies for **case detection, treatment, vector control**, and preventing outbreaks. *Kala-azar* - **Kala-azar** (visceral leishmaniasis) is a severe parasitic disease transmitted by **sandflies**, making it a vector-borne disease. - It is one of the six diseases targeted by the NVBDCP for elimination, particularly in endemic regions of India.

Q: A patient sustained an injury to the right leg in a road traffic accident and his leg was amputated. This is?

Impairment. ***Impairment*** - An **impairment** refers to a problem in body function or structure, such as the loss of a limb or organ. - The amputation of the leg is a direct loss of a **body part**, fitting the definition of an impairment. *Handicap* - A **handicap** refers to a disadvantage for an individual, resulting from an impairment or disability, that limits or prevents the fulfillment of a role that is normal for that individual. - It describes the **social consequences** of the impairment, not the physical loss itself. *Disease* - A **disease** is a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury. - While the accident caused the injury, the loss of the leg is a direct physical result, not an **ongoing pathological process** like a disease. *Disability* - A **disability** is a restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being, as a result of an impairment. - It describes the **functional limitation** that arises from the impairment, such as difficulty walking, rather than the physical loss itself.

Q: One PHC covers how much population in hilly area?

20000. ***20000*** - In **hilly, tribal, or difficult areas**, one PHC is generally established for a population of **20,000**. - This lower population coverage is due to challenges in accessibility and the dispersed nature of communities in such regions. - As per **Indian Public Health Standards (IPHS)**, PHCs in difficult terrains serve smaller populations to ensure better healthcare access. *50000* - This figure does not correspond to standard PHC or CHC coverage norms. - A **Community Health Centre (CHC)** typically covers a population of **1,20,000** and serves as a referral unit for four PHCs. - CHCs provide specialist services including surgery, obstetrics & gynecology, pediatrics, and medicine. *10000* - This figure does not match the population coverage of any standard health facility under the Indian health system. - A **Sub-Centre** in hilly/tribal/difficult areas covers approximately **3,000 population**, while in plain areas it covers **5,000 population**. - Sub-Centres are the most peripheral contact point between the primary healthcare system and the community. *30000* - This figure represents the population covered by a Primary Health Centre (PHC) in **plain areas**. - The population coverage is higher in plain areas due to better infrastructure, road connectivity, and accessibility compared to hilly regions. - As per IPHS norms, PHCs in plains serve larger populations than those in difficult terrains.

Q: Tuberculin test is positive in general population (immunocompetent individuals with no specific risk factors) if induration is?

>10mm. >10mm - For **immunocompetent** individuals without specific risk factors, a tuberculin skin test (TST) induration of **≥10 mm** is considered positive. - This threshold indicates a likely **exposure to Mycobacterium tuberculosis** and a cellular immune response. *>7mm* - This is not a standard threshold for a positive TST in any risk group. - TST interpretation is based on specific **induration sizes** corresponding to different risk factors. *>5mm* - An induration of **≥5 mm** is considered positive for individuals with compromised immunity, those in close contact with active TB cases, or those with fibrotic changes on chest X-ray. - This lower threshold is used for **high-risk groups** due to their increased susceptibility to developing active tuberculosis. *>2mm* - An induration of **≥2 mm** is not typically used as a positive threshold for the tuberculin test in any established guidelines. - Such a small induration is generally considered **negative** or clinically insignificant.

Q: Descending order of cancer prevalence in males in India?

Lung > oral > pharynx > esophagus. ***Lung > oral > pharynx > esophagus*** - This order represents the **most common cancer prevalence pattern** in Indian males according to **ICMR-NCDIR** population-based cancer registries. - **Lung cancer** ranks highest nationally, strongly associated with **smoking** (bidi and cigarette use). - **Oral cavity cancer** is extremely prevalent in India due to **tobacco chewing, betel quid, and gutka consumption**. - **Pharyngeal cancer** and **esophageal cancer** follow, also linked to tobacco and alcohol use. - Regional variations exist, but this order reflects **national-level data** for Indian males. *Oral > lung > pharynx > esophagus* - While **oral cancer prevalence is very high** in India (competing with lung cancer in some regions), at the **national aggregate level**, lung cancer typically ranks first. - This order may be accurate for **specific regions** with high tobacco chewing prevalence but does not represent the overall national pattern. *Pharynx > lung > oral > esophagus* - **Pharyngeal cancer** is less prevalent than both **lung and oral cancers** in Indian males. - This sequence incorrectly places pharyngeal cancer at the top, which contradicts **Indian cancer registry data**. *Esophagus > oral > stomach > lung* - This order is incorrect as **esophageal and stomach cancers** are significantly less prevalent than **lung and oral cancers** in Indian males. - **Lung cancer consistently ranks at or near the top** in Indian male cancer statistics, making this order epidemiologically inaccurate.

Q: The most important sandfly-transmitted disease in India is-

Kala azar. ***Kala azar*** - **Kala azar**, or **visceral leishmaniasis**, is a severe parasitic disease endemic to India, transmitted primarily by *Phlebotomus argentipes* sandflies. - It is characterized by fever, **splenomegaly**, hepatomegaly, and can be fatal if untreated, making it a major public health concern. *Typhus* - **Typhus** is caused by Rickettsial bacteria and is typically transmitted by lice or fleas, not sandflies. - Symptoms include fever, rash, and headache, differing significantly from the visceral symptoms of Kala azar. *Relapsing fever* - **Relapsing fever** is caused by *Borrelia* bacteria and is transmitted by ticks or lice, not sandflies. - It is characterized by recurring episodes of fever, distinct from the progressive symptoms of Kala azar. *Plague* - **Plague** is caused by *Yersinia pestis* and is primarily transmitted by **fleas** carried by rodents. - It presents with buboes, fever, and sepsis, which are different from the clinical manifestations of sandfly-borne diseases.

Q: In tuberculosis, a 'case' is

Sputum positive. ***Sputum positive*** - In the context of **tuberculosis (TB)**, a 'case' is defined by **bacteriological confirmation**, most commonly through **sputum smear positivity** for acid-fast bacilli (AFB). - According to **RNTCP (Revised National Tuberculosis Control Programme)** guidelines, a sputum smear-positive case is one with at least **two sputum specimens positive for AFB**, or one sputum specimen positive for AFB plus radiographic abnormalities consistent with active pulmonary TB. - A positive sputum smear confirms the presence of **Mycobacterium tuberculosis** in the respiratory tract, indicating active, transmissible infection requiring immediate treatment. *Cough* - **Cough** is a common symptom of tuberculosis but is not sufficient on its own to define a 'case'. - Many respiratory conditions can cause a cough, and it does not confirm the presence of **Mycobacterium tuberculosis** or infectiousness. - Cough lasting more than 2-3 weeks is a screening criterion for TB suspects, not a case definition. *X-ray positive* - A **positive chest X-ray** can show abnormalities consistent with tuberculosis, such as infiltrates, cavities, or hilar lymphadenopathy. - However, radiological findings alone do not definitively confirm a TB diagnosis, as many other conditions can mimic TB on chest X-ray. - Chest X-ray is used for **clinically diagnosed TB cases** when bacteriological confirmation is not possible, but it does not establish active infectivity without microbiological confirmation. *Mantoux positive* - A **positive Mantoux test** (tuberculin skin test) indicates exposure to Mycobacterium tuberculosis and the presence of a cell-mediated immune response. - It signifies **latent TB infection (LTBI)** but does not indicate active, infectious disease. - Many people with positive Mantoux tests never develop active TB and are not considered 'cases'.

Q: Objectives of National Mental Health programme are all except -

Provide free antipsychotic drugs to all. ***Provide free antipsychotic drugs to all*** - While ensuring access to essential medicines is important, the National Mental Health Programme (NMHP) does not explicitly guarantee **free antipsychotic drugs to all** individuals, as the scope of provision can depend on various factors like specific conditions, and availability of resources. - The primary objectives are broader and focus on overall mental health care delivery and promotion, rather than a universal provision of specific medications, especially when the need for such drugs may not apply to "all" individuals in the population. *Provide accessibility of mental health care* - A core objective of the NMHP is to make **mental health care accessible** to all individuals, particularly in rural and underserved areas. - This involves establishing services at primary, secondary, and tertiary care levels. *Promote community participation* - The NMHP aims to foster **community involvement** in mental health awareness, destigmatization, and support for individuals with mental illness. - This includes engaging communities in prevention, promotion, and rehabilitation efforts. *Promote application of mental health knowledge* - A key goal is to enhance the **understanding and application of mental health knowledge** among healthcare professionals, policymakers, and the general public. - This objective supports evidence-based practices and informed decision-making in mental health care.

Q: A child is obese if he/she has weight-for-height according to growth chart standards -

2 SD from median weight for height. ***2 SD from median weight for height*** - According to **WHO growth chart standards**, a child is considered **obese** if their weight-for-height measurement is **≥ +2 standard deviations (SD)** above the median. - This cutoff (weight-for-height Z-score ≥ +2 SD) signifies a high degree of adiposity relative to height, indicating significant risk of obesity-related health issues. - Alternatively, **BMI-for-age ≥ +2 SD** can also be used to define childhood obesity. *1 SD from median weight for height* - A weight-for-height between **+1 SD and +2 SD** above the median typically indicates **overweight** (at risk of obesity), but not yet obesity, according to WHO growth standards. - While concerning and requiring monitoring, it does not meet the criteria for obesity. *3 SD from median weight for height* - A weight-for-height of **≥ +3 SD** above the median is classified as **severe obesity** or **severe acute malnutrition** (if severely underweight). - This represents an even more extreme level of adiposity than the standard definition of obesity. *None of the options* - This option is incorrect because **≥ +2 SD from the median weight for height** is the internationally recognized WHO threshold for classifying obesity in children based on growth charts.

Question 1

NVBDCP includes all except ?

Accepted Answer

Yellow fever

Answer

Filariasis

Answer

Malaria

Answer

Kala-azar

Question 2

A patient sustained an injury to the right leg in a road traffic accident and his leg was amputated. This is?

Accepted Answer

Impairment

Answer

Handicap

Answer

Disease

Answer

Disability

Question 3

One PHC covers how much population in hilly area?

Accepted Answer

20000

Answer

50000

Answer

10000

Answer

30000

Question 4

Tuberculin test is positive in general population (immunocompetent individuals with no specific risk factors) if induration is?

Accepted Answer

>10mm

Answer

>7mm

Answer

>5mm

Answer

>2mm

Question 5

Descending order of cancer prevalence in males in India?

Accepted Answer

Lung > oral > pharynx > esophagus

Answer

Oral > lung > pharynx > esophagus

Answer

Pharynx > lung > oral > esophagus

Answer

Esophagus > oral > stomach > lung

Question 6

The most important sandfly-transmitted disease in India is-

Accepted Answer

Kala azar

Answer

Typhus

Answer

Relapsing fever

Answer

Plague

Question 7

In tuberculosis, a 'case' is

Accepted Answer

Sputum positive

Answer

Cough

Answer

X-ray positive

Answer

Mantoux positive

Question 8

Objectives of National Mental Health programme are all except -

Accepted Answer

Provide free antipsychotic drugs to all

Answer

Promote application of mental health knowledge

Answer

Promote community participation

Answer

Provide accessibility of mental health care

Question 9

A child is obese if he/she has weight-for-height according to growth chart standards -

Accepted Answer

2 SD from median weight for height

Answer

1 SD from median weight for height

Answer

3 SD from median weight for height

Answer

None of the options

NEET-PG 2013 — Community Medicine