NEET-PG 2015 - Community Medicine Practice Questions

Q: Vanaspati Ghee is fortified with ?

Vitamin A. ***Vitamin A*** - **Vanaspati Ghee** is commonly fortified with **Vitamin A** to improve its nutritional value and address deficiencies. - Fortification helps to combat **Vitamin A deficiency disorders**, such as **night blindness**. *Iodine* - **Iodine** is typically used to fortify **table salt** to prevent **goiter** and **iodine deficiency disorders**. - It is not commonly added to Vanaspati Ghee. *Iron* - **Iron** is commonly used to fortify foods like **flour** and **cereals** to combat **anemia**. - Vanaspati Ghee is not a common vehicle for iron fortification. *Calcium* - **Calcium** is often added to dairy products or certain beverages to support **bone health**. - It is not a standard fortification for Vanaspati Ghee.

Q: Waste Sharps should be disposed in ?

Yellow bag. ***Yellow bag (Historical answer per BMW Rules 1998)*** - Under the **Biomedical Waste Management Rules 1998** (applicable at the time of NEET-PG 2015), **sharps waste** including needles, syringes, and scalpels were disposed in **yellow puncture-proof containers**. - This was the correct answer when this question was asked in the 2015 examination. - **Current Guidelines (BMW Rules 2016):** Sharps are now disposed in **white/translucent puncture-proof containers**, NOT yellow bags. Yellow bags are currently used for soiled infectious waste like dressings and body fluid-contaminated materials. *Black bag* - **Black bags** are used for **general non-hazardous waste** that poses no biological risk. - Disposing of sharps in black bags creates serious **risk of needlestick injuries** and potential transmission of bloodborne pathogens. *None of the options* - This is incorrect because there is a specific, regulated method for disposing of sharps in healthcare settings. - Proper waste segregation is **mandatory** for safety and regulatory compliance. *Blue bag* - **Blue bags** (per BMW Rules 2016) are used for disposal of **glassware** (broken or discarded) and **metallic body implants**. - Under older guidelines, blue bags were for certain pharmaceutical waste. - They are not designated for sharps disposal.

Q: Which of the following is an example of a case-control study?

PVC exposure and angiosarcoma of the liver. ***PVC exposure and angiosarcoma of the liver*** - This is a classic example of a **case-control study** where individuals with a rare disease (angiosarcoma of the liver) are identified (cases) and compared to a control group without the disease to determine past exposures (PVC). - The study looked back in time to identify differences in exposure between cases and controls. *Framingham heart study (cohort study)* - The Framingham Heart Study is a well-known **prospective cohort study** that has followed participants over time to observe the development of cardiovascular disease. - In a cohort study, researchers identify a group of individuals and follow them forward in time to see who develops the outcome of interest, making it different from a case-control design. *Doll & Hill Study (cohort study)* - The Doll & Hill study is a landmark **cohort study** that investigated the association between smoking and lung cancer by following a group of British doctors over several years. - This study started with healthy individuals and observed them over time to see who developed lung cancer, which is characteristic of a cohort design. *Thalidomide exposure and its association with teratogenicity* - While the thalidomide tragedy led to crucial epidemiological investigations, the initial identification of the association was often through **case series** or **descriptive epidemiology**, noting an unusual clustering of rare birth defects among infants whose mothers took thalidomide. - Subsequent studies might have incorporated case-control elements, but the prompt asks for an example of a case-control study, and this event itself is generally cited for its role in pharmacovigilance and observational studies rather than a single, classic case-control study example in the way "PVC and angiosarcoma" is.

Q: What is the most important criterion in a causal relationship hypothesis?

Temporal association. ***Temporal association*** - This is the **sine qua non** of causality, meaning the exposure or cause must always precede the outcome or effect in time. - Without the exposure occurring before the disease, a causal link cannot be established, even if other criteria are met. *Coherence of association* - This refers to the consistency of findings with current scientific knowledge and **biological plausibility**. - While important for supporting causality, a coherent explanation is not sufficient in itself to prove causation and may even be misleading if current knowledge is incomplete. *Specificity of association* - This criterion suggests that a single exposure should lead to a single outcome, or a single outcome should be caused by a single exposure. - However, many diseases have **multiple causes**, and many exposures can lead to multiple effects, making this a weak criterion in modern epidemiology. *Strength of association* - A **strong association**, often measured by a high relative risk or odds ratio, makes a causal relationship more likely but does not guarantee it. - Strong associations can still be due to **confounding factors** or bias, and weak associations can be causal.

Q: What is the caloric requirement for an adult male engaged in heavy physical work?

3500 kcal/d. ***3500 kcal/d*** - Adult males engaged in **heavy physical work** have significantly higher energy demands due to increased **metabolic expenditure**. - This level of caloric intake is necessary to support physical activity, maintain muscle mass, and prevent weight loss in individuals with demanding occupations. *2000 kcal/d* - This caloric intake is typically recommended for adult females who are **sedentary** or for adult males engaging in light activity, which is insufficient for heavy physical work. - It would likely lead to a **caloric deficit** and weight loss for an individual performing heavy labor. *2500 kcal/d* - This level of intake is more appropriate for moderately active adult males, but it would often be **insufficient** for those performing heavy physical work. - Individuals engaged in heavy labor require additional energy to fuel their intense activities to maintain **energy balance**. *3000 kcal/d* - While a higher intake, 3000 kcal/d might still be **borderline** or insufficient for an adult male engaged in very heavy or sustained physical work. - This value might be appropriate for moderately heavy work, but heavy work often necessitates an even higher **caloric intake** to meet energy demands.

Q: Skin fold thickness is measured in all of the following places, EXCEPT:

Suprapubic. ***Suprapubic*** - The **suprapubic** region is not a standard site for measuring **skinfold thickness** in body composition assessment. - Skinfold measurements are typically taken from areas with subcutaneous fat that are easily accessible and standardized. *Mid triceps* - The **mid-triceps** is a common and important site for measuring skinfold thickness due to its relatively consistent subcutaneous fat distribution. - It is used to estimate total body fat and is a good indicator of **nutritional status**. *Biceps* - The **biceps** region is also a recognized site for skinfold thickness measurements, providing data on upper arm subcutaneous fat. - It is often measured alongside the triceps to give a more comprehensive picture of fat distribution in the arm. *Suprailiac* - The **suprailiac** region, located just above the iliac crest, is a standard site for skinfold measurements. - This site is particularly useful for assessing abdominal fat and is included in many body composition models.

Q: Which is the most common tumor leading to death in adults?

Lung cancer. ***Lung cancer*** - **Lung cancer** is the most common cause of cancer-related death in both men and women worldwide [1], [2]. - Its high mortality is attributed to its aggressive nature, late diagnosis, and limited treatment options for advanced stages [3]. *Prostate cancer* - While **prostate cancer** is very common in men, it typically has a slower progression and a relatively high survival rate compared to lung cancer. - Early detection through screening often leads to successful treatment and a good prognosis. *Colorectal cancer* - **Colorectal cancer** is a significant cause of cancer mortality but ranks behind lung cancer in overall deaths [2]. - Improved screening methods like colonoscopies allow for early detection and removal of precancerous polyps, reducing mortality. *Leukemia* - **Leukemia** refers to cancers of the blood and bone marrow, and while serious, they are less common causes of cancer death than solid tumors like lung, colorectal, or prostate cancer [2]. - Advances in chemotherapy, stem cell transplantation, and targeted therapies have significantly improved survival rates for many types of leukemia.

Q: Japanese encephalitis vaccine in routine schedule is given in how many doses -

Two doses (at 9-12 months and 15-18 months). ***Two doses (at 9-12 months and 15-18 months)*** - The **routine JE vaccination schedule in India** as per NTAGI and IAP recommendations involves **two doses**. - **First dose** is given at **9-12 months** of age. - **Second dose** is administered at **15-18 months** (or up to 24 months), approximately **6-12 months after the first dose**. - This provides adequate long-term protection against Japanese encephalitis in endemic areas. *Single dose vaccine* - A single dose does **not provide adequate long-lasting protection** against Japanese encephalitis. - The **immune response** from a single dose is insufficient for routine immunization. - Two doses are required to ensure protective antibody levels. *Three doses 1 month apart followed by a booster if needed* - This schedule is **not part of the routine immunization program** for JE in India. - The standard routine schedule involves **only 2 primary doses**, not three. - Rapid three-dose schedules may be used in specific outbreak situations but not for routine immunization. *Three doses with the second dose 1 month and 3rd dose 6 months after the first dose* - This three-dose schedule is **not the routine JE vaccination schedule** in India. - This may be confused with schedules for other vaccines or older JE vaccine protocols. - The current **routine schedule requires only 2 doses** at specified age intervals.

Q: Most common cause of goiter in India is

Diffuse Endemic Goitre. ***Diffuse Endemic Goitre*** - **Iodine deficiency** is the leading cause of goiter globally, particularly in areas with poor iodine intake like some regions in India, leading to **diffuse endemic goiter** - In response to low iodine, the thyroid gland undergoes **hypertrophy** and **hyperplasia**, increasing in size in an attempt to capture more iodine for thyroid hormone synthesis - Despite the **Universal Salt Iodization (USI) program**, iodine deficiency disorders remain a significant public health concern in several Indian states *Papillary Carcinoma* - While it can cause a thyroid mass, **papillary carcinoma** is a malignant neoplastic condition, not the most common cause of generalized goiter - It presents as a **solitary or dominant nodule** and is not typically associated with widespread iodine deficiency - Accounts for only a small percentage of thyroid enlargements *Toxic Multinodular Goitre* - This condition involves multiple autonomously functioning nodules and primarily causes **hyperthyroidism**, not just goiter as a primary common presentation - More common in **elderly patients** and in regions with prior iodine deficiency (Jod-Basedow phenomenon) - Does not represent the most widespread cause of goiter in the general population of India *Hashimoto's Thyroiditis* - Hashimoto's is an **autoimmune disease** causing chronic lymphocytic thyroid inflammation and often hypothyroidism - While it can cause goiter, it typically produces a **firmer, less diffuse enlargement** than that seen with **iodine deficiency** - Not the most common cause of goiter in India, though its prevalence is increasing in urban areas

Question 1

Vanaspati Ghee is fortified with ?

Accepted Answer

Vitamin A

Answer

Iodine

Answer

Iron

Answer

Calcium

Question 2

Waste Sharps should be disposed in ?

Accepted Answer

Yellow bag

Answer

Black bag

Answer

None of the options

Answer

Blue bag

Question 3

Which of the following is an example of a case-control study?

Accepted Answer

PVC exposure and angiosarcoma of the liver

Answer

Framingham heart study

Answer

Doll & Hill Study

Answer

Thalidomide exposure and its association with teratogenicity

Question 4

What is the most important criterion in a causal relationship hypothesis?

Accepted Answer

Temporal association

Answer

Coherence of association

Answer

Specificity of association

Answer

Strength of association

Question 5

What is the caloric requirement for an adult male engaged in heavy physical work?

Accepted Answer

3500 kcal/d

Answer

2000 kcal/d

Answer

2500 kcal/d

Answer

3000 kcal/d

Question 6

What is the definition of a reservoir in the context of infectious diseases?

Accepted Answer

Person, animal or substance in which infectious agent lives and multiplies

Answer

Person, animal or object from which infectious agent is transmitted to host

Answer

Person or animal in which infectious agent causes a disease

Answer

Person or animal that transmits the infectious agent mechanically

Question 7

Skin fold thickness is measured in all of the following places, EXCEPT:

Accepted Answer

Suprapubic

Answer

Mid triceps

Answer

Biceps

Answer

Suprailiac

Question 8

Which is the most common tumor leading to death in adults?

Accepted Answer

Lung cancer

Answer

Prostate cancer

Answer

Colorectal cancer

Answer

Leukemia

Question 9

Japanese encephalitis vaccine in routine schedule is given in how many doses -

Accepted Answer

Two doses (at 9-12 months and 15-18 months)

Answer

Single dose vaccine

Answer

Three doses 1 month apart followed by a booster if needed

Answer

Three doses with the second dose 1 month and 3rd dose 6 months after the first dose

Question 10

Most common cause of goiter in India is

Accepted Answer

Diffuse Endemic Goitre

Answer

Papillary Carcinoma

Answer

Toxic Multinodular Goitre

Answer

Hashimoto's Thyroiditis

NEET-PG 2015 — Community Medicine