NEET-PG 2013 Practice Questions

Q: Which vaccine is associated with a risk of encephalopathy?

Measles. ***Measles*** - Among the options provided, **measles vaccine** has been reported to have a very rare association with **post-vaccination encephalitis/encephalopathy** (approximately 1 per million doses). - **Important note:** The **pertussis vaccine (particularly whole-cell DTP)** is the vaccine most classically associated with encephalopathy risk, but it is not among the options here. - The risk of encephalopathy from the measles vaccine is significantly lower than the risk from natural measles infection itself. - Modern measles vaccines are highly purified and safer than earlier formulations. *OPV* - **Oral Polio Vaccine (OPV)** is associated with **vaccine-associated paralytic poliomyelitis (VAPP)**, not encephalopathy. - VAPP occurs at a rate of approximately 1 case per 2.4 million doses due to reversion of the attenuated virus to a neurovirulent form. - Manifests as flaccid paralysis, not encephalopathy. *Rubella* - **Rubella vaccine** (component of MMR) is very safe with no significant association with encephalopathy. - Rare adverse effects include transient arthralgia (especially in adult women), mild rash, or lymphadenopathy. - Severe neurological complications are extremely rare. *BCG* - **Bacillus Calmette-Guérin (BCG) vaccine** protects against tuberculosis and is not associated with encephalopathy. - Common adverse effects are local reactions: induration, ulceration, scarring, and rarely lymphadenitis. - Disseminated BCG infection can occur in immunocompromised individuals but is distinct from encephalopathy.

Q: Ideal temperature for DPT storage?

4 to 8°C. ***4 to 8°C*** - The ideal temperature for DPT (diphtheria, pertussis, tetanus) vaccine storage is between **+2°C and +8°C** (or 35°F and 46°F), which is the standard refrigerator temperature range. - This temperature range is crucial for maintaining the **potency** and **efficacy** of the vaccine, preventing **degradation** due to excessive heat or cold. *Room temperature* - Storing DPT vaccines at **room temperature** (typically 20-25°C or 68-77°F) for extended periods can lead to a **loss of potency** as heat can degrade vaccine components. - While short-term excursions within this range might be permissible under specific conditions (e.g., during transport), it is not the ideal long-term storage solution. *0 to - 20°C* - DPT vaccines, particularly the **whole-cell pertussis (wP)** component, can be **damaged by freezing**. - Temperatures below 0°C can cause the **adjuvant** (usually aluminum salt) to separate, leading to a loss of efficacy and potential local reactions at the injection site. *None of the options* - This option is incorrect because **4 to 8°C** is indeed the established and recommended ideal storage temperature for DPT vaccines.

Q: Which vaccine is contraindicated in pregnancy?

Measles vaccine. ***Measles vaccine*** - The measles vaccine is a **live attenuated vaccine**, which carries a theoretical risk of causing infection in the fetus. - Live vaccines are generally **contraindicated during pregnancy** due to this potential risk of congenital infection. *Cholera vaccine* - The cholera vaccine is generally considered **safe during pregnancy** if indicated, especially for travel to endemic areas. - While administration in pregnancy should be based on risk-benefit, it is not consistently contraindicated like live vaccines. *Typhoid vaccine* - Both inactivated and live attenuated typhoid vaccines are available; the **inactivated (killed) vaccine** is generally preferred if vaccination is necessary during pregnancy. - The risks of the disease usually outweigh the vaccine risks, and it is not a universal contraindication. *Meningococcal vaccine* - **Meningococcal vaccines** are generally considered safe and can be administered during pregnancy if there is a significant risk of exposure or during outbreaks. - The benefits of maternal and potential fetal protection from meningococcal disease outweigh theoretical risks.

Q: India started 2-dose vaccination strategy for measles, in -

2010. ***2010*** - India implemented the **two-dose measles vaccination strategy** as part of its Universal Immunization Program starting in **2010**. - This decision was based on recommendations to improve immunity and reduce measles incidence, moving from a single-dose to a more effective **two-dose schedule**. *2008* - While important immunization initiatives were ongoing, the specific policy of a **two-dose measles vaccination strategy** had not yet been introduced in India during 2008. - At this time, the focus was primarily on ensuring high coverage of the **first dose** of measles vaccine. *2009* - The year 2009 saw continued efforts to strengthen the Universal Immunization Program, but the official launch of the **two-dose measles vaccination strategy** in India occurred later. - Discussions and planning for the transition were likely underway, but implementation began in the subsequent year. *2011* - By 2011, the **two-dose measles vaccination strategy** was already being implemented across India, having been introduced in 2010. - This year marked a period of expanding coverage and consolidation of the new 2-dose schedule rather than its initial introduction.

Q: Which of the following statements about incidence is false?

Does not include unit of time. ***Does not include unit of time*** - This statement is false because **incidence** is defined as the number of **new cases** of a disease over a specific period of time in a population at risk. - Therefore, it inherently includes a **unit of time** (e.g., per year, per month), making this option incorrect as a characteristic of incidence. *It is a rate* - **Incidence is a rate** because it quantifies the speed at which new cases of a disease occur within a population. - It expresses the number of new events (cases) per unit of population at risk over a specified time period. *Numerator includes new cases* - The **numerator of incidence** specifically counts the number of **new cases** of a disease that develop during a defined observation period. - This distinguishes it from prevalence, which includes all existing cases. *Denominator includes population at risk* - The **denominator for incidence** comprises the **population at risk** of developing the disease during the observation period. - Individuals who already have the disease or are immune are typically excluded from the denominator.

Q: What is a limitation of the case fatality rate?

Time period not specified. ***Time period not specified*** - The **case fatality rate (CFR)** is sometimes presented without a clear time frame, making it difficult to compare across different studies or diseases. - A CFR calculated over **24 hours** is vastly different from one calculated over **30 days** or **one year**, yet both could be presented simply as "CFR" *Not useful in acute infectious disease* - The CFR is highly **useful** in acute infectious diseases, as it directly measures the **severity** and immediate impact of an outbreak. - It helps public health officials understand the **lethality** of an infectious agent and aids in resource allocation and intervention strategies. *Not related to virulence* - **Case fatality rate** is directly related to **virulence**, as it reflects the proportion of affected individuals who die from the disease. - A higher CFR indicates a more **virulent pathogen** or a more severe disease process. *It is not related to survival rate* - The **case fatality rate** is inherently linked to the **survival rate**; they are complementary measures. - If the CFR is X%, then the associated survival rate is (100 - X)%, representing the proportion of cases that do not die from the disease.

Q: Randomization is done to reduce?

Selection bias. ***Selection bias*** - **Randomization** ensures that each participant has an equal chance of being assigned to any study group, which helps to distribute both known and unknown confounding factors evenly. - This process minimizes **selection bias** by promoting comparability between groups, making it more likely that any observed differences are due to the intervention rather than pre-existing differences. *Recall bias* - **Recall bias** occurs when there are systematic differences in the way participants remember or report past exposures or events, often seen in retrospective studies. - While randomization helps control for confounding, it does not directly prevent participants from inaccurately recalling information. *Berksonian bias* - **Berksonian bias** is a form of selection bias where the probability of being admitted to a hospital (or selected into a study) is affected by the presence of a co-morbidity, leading to a distorted association between diseases. - Randomization aims to balance characteristics *within* the study groups once participants are recruited, but it doesn't address biases related to the initial selection into the study population from a larger source. *Reporting bias* - **Reporting bias** refers to selective revealing or suppression of information, either by study participants (e.g., social desirability bias) or by researchers (e.g., only reporting positive findings). - Randomization helps ensure internal validity by creating comparable groups, but it does not prevent individuals from selectively reporting outcomes or experiences.

Q: A person has lost his leg in an accident and is unable to walk. This condition is classified as -

Disability. ***Disability*** - The loss of a limb leading to inability to walk is classified as a **disability** because it significantly impairs a major life activity. - According to the **WHO International Classification of Functioning, Disability and Health (ICF)**, disability is an **umbrella term** encompassing impairments (loss of limb), activity limitations (inability to walk), and participation restrictions. - The scenario describes both an **impairment** (anatomical loss) and an **activity limitation** (functional consequence), which together constitute a **disability**. *Medical condition* - While the accident caused a medical condition (trauma, amputation), the term "medical condition" describes the **disease or injury state** itself, not its functional impact. - The question asks for the **classification** of the inability to walk, which is a functional consequence, not the primary medical diagnosis. *Physical limitation* - This is a **descriptive term** for restricted physical capacity but not a standard **classification** in public health terminology. - In the WHO ICF framework, this would fall under "activity limitation," which is a component of disability rather than a separate classification. *Mobility challenge* - This is a colloquial or lay term describing the **difficulty in moving** but lacks the specificity of formal medical classification. - While accurate descriptively, it does not represent the **standardized terminology** used in Community Medicine and rehabilitation frameworks.

Q: Which of the following conditions does not primarily benefit from secondary level prevention?

None of the options. ***None of the options*** - This is the **correct answer** because all three conditions listed (Coronary heart disease, TB, and Leprosy) DO significantly benefit from **secondary prevention** strategies. - The question uses negation ("does not"), asking which condition does NOT benefit from secondary prevention. - Since all three diseases benefit from secondary prevention, the answer is "None of the options." **Why each condition DOES benefit from secondary prevention:** *Coronary Heart Disease (CHD)* - **Secondary prevention** includes screening for risk factors (hypertension, hyperlipidemia, diabetes), early detection through ECG and cardiac biomarkers, and prompt intervention. - Post-event management with antiplatelets, statins, beta-blockers, and lifestyle modifications prevents recurrence and reduces mortality. - Early detection and treatment of risk factors halt disease progression and prevent complications. *Tuberculosis (TB)* - **Secondary prevention** is crucial through **early case detection** (contact tracing, active case finding, screening high-risk populations) and **prompt initiation of antitubercular therapy**. - Early diagnosis via sputum microscopy, GeneXpert, and chest X-ray prevents disease progression, reduces transmission, and prevents complications like miliary TB or TB meningitis. - Timely treatment ensures cure and prevents development of drug resistance. *Leprosy* - **Secondary prevention** involves **active case detection through surveys** and **prompt multi-drug therapy (MDT)**. - Early diagnosis and treatment prevent irreversible nerve damage, deformities, and disabilities. - Reduces transmission in the community and prevents progression to advanced stages.

Q: Which of the following best defines the concept of 'Quality of Life'?

Subjective feeling of well being. ***Subjective feeling of well being*** - **Quality of Life** is primarily a **subjective measure**, reflecting an individual's personal perception of their well-being and satisfaction with various aspects of their life. - It encompasses physical health, psychological state, social relationships, personal beliefs, and their relationship to their environment. *Standard of living* - **Standard of living** typically refers to the degree of wealth and material comfort available to a person or community. - This is an **objective, economic measure** and does not fully capture the subjective, multi-dimensional aspects of well-being. *Level of living* - The **level of living** is closely related to the standard of living, focusing on the actual conditions of life experienced by individuals, often in terms of material possessions, housing, and access to services. - Like standard of living, it is more about **objective and measurable aspects** of life rather than subjective feelings. *None of the above* - This option is incorrect because "Subjective feeling of well being" accurately defines **Quality of Life**. - **Quality of Life** is a complex, multi-faceted concept that integrates both objective and subjective factors, with the subjective feeling of well-being being central to its definition.

Question 1

Which vaccine is associated with a risk of encephalopathy?

Accepted Answer

Measles

Answer

OPV

Answer

Rubella

Answer

BCG

Question 2

Ideal temperature for DPT storage?

Accepted Answer

4 to 8°C

Answer

Room temperature

Answer

0 to - 20°C

Answer

None of the options

Question 3

Which vaccine is contraindicated in pregnancy?

Accepted Answer

Measles vaccine

Answer

Cholera vaccine

Answer

Typhoid vaccine

Answer

Meningococcal vaccine

Question 4

India started 2-dose vaccination strategy for measles, in -

Accepted Answer

2010

Answer

2008

Answer

2009

Answer

2011

Question 5

Which of the following statements about incidence is false?

Accepted Answer

Does not include unit of time

Answer

It is a rate

Answer

Numerator includes new cases

Answer

Denominator includes population at risk

Question 6

What is a limitation of the case fatality rate?

Accepted Answer

Time period not specified

Answer

Not useful in acute infectious disease

Answer

Not related to virulence

Answer

It is not related to survival rate

Question 7

Randomization is done to reduce?

Accepted Answer

Selection bias

Answer

Recall bias

Answer

Berksonian bias

Answer

Reporting bias

Question 8

A person has lost his leg in an accident and is unable to walk. This condition is classified as -

Accepted Answer

Disability

Answer

Medical condition

Answer

Physical limitation

Answer

Mobility challenge

Question 9

Which of the following conditions does not primarily benefit from secondary level prevention?

Accepted Answer

None of the options

Answer

Coronary heart disease

Answer

Leprosy

Answer

TB

Question 10

Which of the following best defines the concept of 'Quality of Life'?

Accepted Answer

Subjective feeling of well being

Answer

Standard of living

Answer

Level of living

Answer

None of the above