NEET-PG 2013 - Community Medicine Practice Questions

Q: All of the following are anthropozoonosis except

Schistosomiasis. ***Schistosomiasis*** - This is a **human-to-human** disease, even though it involves an intermediate **snail host**. - Its life cycle does not involve transmission of pathogens from vertebrate animals to humans. *Rabies* - Rabies is a classic **anthropozoonosis**, transmitted to humans primarily through the saliva of infected animals, most commonly **dogs** and **bats**. - It involves a pathogen (rabies virus) that cycles between animals and can be transmitted to humans. *Plague* - Plague is an **anthropozoonosis** caused by *Yersinia pestis*, typically transmitted from **rodents** (e.g., rats) to humans via flea bites. - The disease maintains a natural reservoir in wild rodent populations, making it a prime example of animal-to-human transmission. *Anthrax* - Anthrax is an **anthropozoonosis** caused by *Bacillus anthracis*, transmitted to humans from infected **livestock** (e.g., cattle, sheep). - Humans usually acquire the infection through contact with infected animals or their products, or by inhaling spores.

Q: To achieve neonatal tetanus elimination, the incidence of neonatal tetanus per 1000 live births should be reduced to less than:

1.0. ***1.0*** - The international target for **neonatal tetanus elimination (NTE)** as defined by WHO/UNICEF is an incidence rate of **less than 1 case per 1,000 live births per year** in every district of a country. - This is the globally recognized threshold for declaring that neonatal tetanus has been eliminated as a public health problem. - Countries achieving this target at the district level are considered to have achieved NTE. *0.1* - While 0.1 per 1,000 live births represents an extremely low incidence, this is not the WHO-defined threshold for **neonatal tetanus elimination**. - The elimination target is less stringent at <1 per 1,000 live births, making disease control achievable while still representing a major public health success. *0.2* - An incidence of 0.2 per 1,000 live births, though very low, is not the internationally recognized threshold for **neonatal tetanus elimination**. - The established WHO/UNICEF target is <1 per 1,000 live births in every district. *0.5* - An incidence of 0.5 per 1,000 live births indicates excellent control of neonatal tetanus but is not the specific cut-off value. - The WHO criterion for elimination is less than 1 case per 1,000 live births per year at the district level.

Q: Which day is not included in the pre-exposure prophylaxis dose schedule for the rabies vaccine?

Day 3. ***Day 3*** - The standard pre-exposure prophylaxis (PrEP) schedule for rabies vaccine typically involves three doses given on **Day 0, Day 7, and Day 21 or 28**. - A dose on Day 3 is **not part of the standard recommended PrEP schedule**. *Day 0* - This is the **initial dose** in the pre-exposure prophylaxis series for rabies. - It marks the beginning of the vaccination schedule to build immunity. *Day 7* - This is the **second dose** in the pre-exposure prophylaxis series for rabies. - It follows the initial dose and is crucial for developing a robust immune response. *Day 28* - This dose, along with Day 21, can be the **final dose** in the pre-exposure prophylaxis series for rabies, depending on the specific regimen used. - It completes the primary vaccination course to ensure long-lasting protection.

Q: Most effective preventive measure against rabies

Avoiding contact with infected animals and vaccination. ***Avoiding contact with infected animals and vaccination*** ✓ - The most effective preventive measure against rabies is to **avoid contact with potentially infected animals**, especially wild animals and unvaccinated domestic animals. - **Vaccination** (pre-exposure prophylaxis) is crucial for individuals at high risk of exposure (veterinarians, animal handlers, laboratory workers) and for domestic animals, forming the cornerstone of rabies prevention. - Post-exposure prophylaxis (PEP) with immunoglobulin and vaccine series is highly effective when administered promptly after exposure. *Heat* - While high temperatures can inactivate the rabies virus in a laboratory setting, it is **not a practical or effective preventive measure** against rabies in real-world scenarios. - The virus is transmitted through bites, scratches, and mucous membrane contact with infected saliva; environmental heat does not prevent transmission or infection. *Humidity* - **Humidity does not play a significant role** in the prevention or transmission of rabies. - The rabies virus is labile outside of a host and does not survive long in the environment, regardless of humidity levels. *None of the options* - This option is incorrect because there are highly effective preventive measures against rabies, as detailed in the correct option. - Rabies prevention is well-established through public health interventions (animal vaccination programs, post-exposure prophylaxis) and individual precautions.

Q: In which condition is a night blood survey performed?

Lymphatic filariasis. ***Lymphatic filariasis*** - A **night blood survey** is crucial for diagnosing lymphatic filariasis because the microfilariae of species like *Wuchereria bancrofti* and *Brugia malayi* exhibit **nocturnal periodicity**, meaning they are most abundant in peripheral blood between 10 PM and 2 AM. - Collecting blood at night maximizes the chance of detecting these parasites, which are responsible for the disease. *Typhoid fever* - Diagnosis of **typhoid fever** primarily relies on **blood cultures** taken during the febrile phase, or stool/urine cultures later in the disease. - A night blood survey is not relevant for detecting the causative bacterium, *Salmonella Typhi*. *Malaria infection* - While a **blood smear** is essential for diagnosing malaria, the timing of blood collection is less critical than for filariasis, although peak parasite density can vary. - **Malaria parasites** are typically detected in blood samples taken during symptomatic periods, regardless of specific time of day. *Visceral leishmaniasis* - **Visceral leishmaniasis** is diagnosed by detecting parasites in samples from **bone marrow**, spleen, or lymph nodes, or through serological tests for antibodies. - A night blood survey is not used in the diagnosis of *Leishmania donovani* infection.

Q: Which of the following diseases is not covered under the Integrated Disease Surveillance Project (IDSP)?

Herpes zoster. ***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.

Q: Antiserum is available for passive immunization against ?

Rabies. ***Rabies*** - **Antiserum** (or rabies immune globulin, RIG) provides immediate **passive immunity** against rabies, neutralizing the virus before the body can mount an active immune response. - It is administered in conjunction with the **rabies vaccine** for post-exposure prophylaxis, especially in severe exposures. *Typhoid* - **Typhoid fever** is primarily prevented through vaccination (active immunization) and improved sanitation. - There is no routinely available antiserum for **passive immunization** against *Salmonella typhi* infection. *Measles* - **Measles** is prevented through active immunization with the MMR (measles, mumps, rubella) vaccine. - While immune globulin can be used for passive protection in exposed, immunocompromised individuals, it's not commonly referred to as "antiserum" in the same context as rabies. *Mumps* - **Mumps** is prevented by active immunization with the MMR vaccine. - Similar to measles, there is no commonly used specific antiserum for **passive immunity** against mumps in the clinical setting.

Q: Transovarian transmission is seen in-

Rickettsial diseases. ***Rickettsial diseases*** - **Transovarian transmission** is a key mechanism for the maintenance and spread of **rickettsiae** in arthropod vectors. The bacteria can pass from an infected female arthropod (like a tick or mite) to her offspring via the eggs. - This ensures that the next generation of vectors is already infected and can transmit the disease, even without needing to acquire the pathogen from an infected vertebrate host. *Malaria* - Malaria is transmitted via the bite of an infected **Anopheles mosquito**, which acquires parasites from an infected human. - **Transovarian transmission** does not occur in malaria; mosquitoes are not born with the ability to transmit the parasite. *Filaria* - Filariasis is spread by various **mosquito vectors** (e.g., *Culex*, *Anopheles*, *Aedes*) or **black flies**, which acquire microfilariae from an infected host during a blood meal. - The parasite undergoes development within the insect, but **transovarian transmission** to the insect's offspring does not occur. *None of the options* - This option is incorrect because **rickettsial diseases** do exhibit transovarian transmission, making it a valid answer. - The phenomenon of passing pathogens directly from a female parent to her offspring via the egg is a specific mechanism seen in certain vector-borne diseases.

Q: What is the primary method of primordial prevention for Coronary Artery Disease (CAD)?

Lifestyle change. ***Lifestyle change*** - **Primordial prevention** aims to prevent the development of risk factors themselves, which is best achieved through promoting healthy behaviors like diet, exercise, and avoiding tobacco at the population level. - This approach acts *before* the onset of risk factors, addressing societal and environmental determinants of health. - Examples include promoting healthy eating habits in schools, creating walkable communities, and tobacco-free environments. *Coronary bypass* - **Coronary bypass surgery** is a treatment for established CAD with significant blockages, not a preventive measure. - It falls under the category of **tertiary prevention**, aiming to reduce complications and improve quality of life in existing disease. *Treatment of CAD* - **Treating CAD** (e.g., medications like statins or antiplatelets, procedures like angioplasty) is a form of **secondary** or **tertiary prevention**. - It focuses on managing existing disease or preventing its progression, rather than preventing the initial development of risk factors. *Screening for hypertension* - **Screening** is a form of **secondary prevention** aimed at early detection of risk factors or disease. - While important, it occurs *after* risk factors have already developed, unlike primordial prevention which prevents risk factors from emerging.

Question 1

All of the following are anthropozoonosis except

Accepted Answer

Schistosomiasis

Answer

Rabies

Answer

Plague

Answer

Anthrax

Question 2

To achieve neonatal tetanus elimination, the incidence of neonatal tetanus per 1000 live births should be reduced to less than:

Accepted Answer

1.0

Answer

0.1

Answer

0.5

Answer

0.2

Question 3

Which day is not included in the pre-exposure prophylaxis dose schedule for the rabies vaccine?

Accepted Answer

Day 3

Answer

Day 0

Answer

Day 7

Answer

Day 28

Question 4

Most effective preventive measure against rabies

Accepted Answer

Avoiding contact with infected animals and vaccination

Answer

Heat

Answer

Humidity

Answer

None of the options

Question 5

In which condition is a night blood survey performed?

Accepted Answer

Lymphatic filariasis

Answer

Typhoid fever

Answer

Malaria infection

Answer

Visceral leishmaniasis

Question 6

Which of the following diseases is not covered under the Integrated Disease Surveillance Project (IDSP)?

Accepted Answer

Herpes zoster

Answer

Tuberculosis

Answer

Cholera

Answer

Meningococcal disease

Question 7

Antiserum is available for passive immunization against ?

Accepted Answer

Rabies

Answer

Typhoid

Answer

Mumps

Answer

Measles

Question 8

Which of the following statements best describes the operational definition of onchocerciasis elimination?

Accepted Answer

Transmission of O. volvulus has been reduced to a level where it cannot sustain itself in the population.

Answer

All interventions have been successfully implemented.

Answer

There is no recrudescence of the disease after a defined period.

Answer

All of the options are true.

Question 9

Transovarian transmission is seen in-

Accepted Answer

Rickettsial diseases

Answer

Malaria

Answer

Filaria

Answer

None of the options

Question 10

What is the primary method of primordial prevention for Coronary Artery Disease (CAD)?

Accepted Answer

Lifestyle change

Answer

Coronary bypass

Answer

Treatment of CAD

Answer

Screening for hypertension

NEET-PG 2013 — Community Medicine