NEET-PG 2015 Practice Questions

Q: Most common route of nosocomial infection [Hospital-acquired infection]?

Direct contact. **Direct contact** - **Direct contact** with colonized or infected patients is the predominant mode of transmission for many common nosocomial pathogens like **MRSA** and **VRE**. - This often involves healthcare workers' hands becoming contaminated and then touching other patients. *Droplet transmission* - Involves the transmission of infectious agents through **respiratory droplets** produced during coughing, sneezing, or talking. - While significant for some infections (e.g., influenza, pertussis), it is not the most common route overall for nosocomial infections. *Indirect contact* - Occurs when an infectious agent is transferred via a **contaminated intermediate object** or person. - Although important (e.g., contaminated medical devices), it is generally less frequent than direct patient-to-patient transmission. *Vehicle transmission* - Involves transmission through **contaminated inanimate vehicles** like food, water, medications, or surgical instruments. - While outbreaks can occur via this route (e.g., contaminated endoscopes), it is not the most common day-to-day transmission mechanism in hospitals.

Q: Behavioral surveillance survey is done in?

AIDS. ***AIDS*** - Behavioral surveillance surveys are crucial for understanding and monitoring behaviors related to **HIV transmission**, such as sexual practices and drug use, among at-risk populations. - These surveys help in designing and evaluating **prevention programs** by identifying trends in risky behaviors and knowledge, attitudes, and practices (KAP) concerning HIV. *Filaria* - Surveillance for filaria primarily involves **entomological surveys** (mosquito monitoring) and **parasitological surveys** (blood examinations for microfilariae). - Behavioral aspects are less central to direct surveillance compared to disease vectors and infection rates. *TB* - Tuberculosis surveillance mainly focuses on **case detection**, **treatment outcomes**, and monitoring **drug resistance** through clinical and laboratory data. - While patient adherence to treatment involves behavior, there isn't a dedicated "behavioral surveillance survey" method specifically for TB. *Malaria* - Malaria surveillance involves monitoring **parasitemia rates**, **vector populations**, and **antimalarial drug resistance**. - Behavioral components like bed net usage are important, but the primary surveillance methods are not termed "behavioral surveillance surveys" in the same structured way as for HIV.

Q: Drug of choice for mass therapy under filariasis control programme?

DEC. ***Correct: DEC*** - **Diethylcarbamazine (DEC)** is the drug of choice for **mass drug administration (MDA)** campaigns aimed at eliminating lymphatic filariasis. - It effectively kills **microfilariae** and has some action on adult worms, reducing transmission. - In India's National Filariasis Elimination Programme, DEC is administered along with Albendazole in annual MDA campaigns. *Incorrect: Albendazole* - While **Albendazole** is co-administered with DEC in MDA programs, it is not the sole drug of choice for mass treatment of filariasis. - Its primary role is to provide **macrofilaricidal** activity (killing adult worms) and co-treatment for other helminth infections. - It enhances the effect of DEC but is not used alone. *Incorrect: Ivermectin* - **Ivermectin** is used in MDA programs for filariasis, particularly in areas co-endemic with **onchocerciasis** or where **Loa loa** is prevalent (as DEC is contraindicated in these areas). - However, in India and most lymphatic filariasis endemic areas, **DEC** remains the primary drug. *Incorrect: Mebendazole* - **Mebendazole** is an anthelminthic primarily used for treating **intestinal nematode infections** like ascariasis, trichuriasis, and hookworm. - It is **not used** in lymphatic filariasis mass treatment programs.

Q: Which of the following larvicide is used under urban Malaria Scheme?

Abate. ***Abate*** - **Abate (temephos)** is an organophosphate larvicide widely used in public health programs, including the urban malaria scheme, due to its effectiveness against mosquito larvae at low concentrations. - It is applied to water storage containers, wells, and other mosquito breeding sites to **prevent the development of adult mosquitoes**. *Malathion* - **Malathion** is an organophosphate insecticide primarily used as an **adulticide** for fogging operations against adult mosquitoes, not specifically as a larvicide in urban schemes. - While it can kill larvae, its primary application and efficacy are geared towards **adult mosquito control**. *Parathion* - **Parathion** is a highly toxic organophosphate insecticide that is generally **not used in public health programs** due to its significant environmental and human health risks. - Its use is largely restricted to agricultural pest control and is **not a recommended larvicide** for urban settings. *DDT* - **DDT (dichlorodiphenyltrichloroethane)** is a persistent organic pollutant whose use has been largely banned or severely restricted globally due to its **environmental impact** and long-term toxicity. - While historically used for mosquito control (both larvae and adults), it is **not used in current urban malaria schemes** due to its banned status in many regions and resistance issues.

Q: In the context of malaria control, when is regular insecticidal spray recommended based on the Annual Parasite Index (API)?

> 2. ***> 2*** - Regular insecticidal spray, particularly **Indoor Residual Spraying (IRS)**, is a key malaria control measure recommended when the **Annual Parasite Index (API) is greater than 2**. - An API greater than 2 indicates **high endemicity** with a significant burden of malaria transmission in the community, necessitating aggressive vector control strategies. - According to **NVBDCP (National Vector Borne Disease Control Programme) guidelines**, API > 2 defines high-risk areas where routine IRS is implemented as a core intervention. *> 1* - An API between 1-2 represents **moderate endemicity**, where the focus is primarily on **active case detection, prompt treatment, and targeted interventions** rather than universal spraying. - While vector control remains important, routine widespread IRS is not the standard recommendation at this threshold. *< 2* - An API of less than 2 (which includes both moderate and low endemic areas) does not routinely warrant universal insecticidal spraying programs. - In areas with API < 2, **case management, surveillance, and selective vector control** are prioritized over widespread IRS campaigns. *< 1* - An API of less than 1 indicates **low endemicity**, where malaria transmission is minimal and sporadic. - In such areas, **surveillance, prompt case detection and treatment, and targeted interventions** are the mainstay, with IRS reserved only for focal outbreaks or high-risk pockets.

Q: Which condition has the maximum relative risk attributed to obesity?

DM. ***DM*** - Obesity is a major risk factor for Type 2 Diabetes Mellitus (T2DM), with a **relative risk often exceeding 3-7 times that of normal-weight individuals**, and even higher for severe obesity. - The link is primarily due to **insulin resistance** caused by increased adipose tissue. *Hypertension* - Obesity significantly increases the risk of hypertension, with a relative risk typically in the range of **2 to 3 times higher** than normal-weight individuals. - The mechanisms involve increased **blood volume**, **sympathetic nervous system activity**, and **renal sodium reabsorption**. *CHD* - Obesity is a strong independent risk factor for Coronary Heart Disease (CHD), contributing to a relative risk of approximately **1.5 to 2.5 times higher** than normal weight. - It often acts by exacerbating other risk factors like **hypertension**, **dyslipidemia**, and **diabetes**. *Cancer* - Obesity is linked to various cancers, including endometrial, esophageal adenocarcinoma, renal cell, and breast cancer in postmenopausal women, with relative risks typically ranging from **1.2 to 2 times higher** for specific cancers. - The pathways include **chronic inflammation**, altered **hormone levels** (e.g., estrogen), and **insulin-like growth factor signaling**.

Q: A woman traveling from Bihar to Delhi is suspected to have Kala-azar. Suitable investigation is?

Rk-39 test. ***Rk-39 test*** - The **Rk-39 test** is a rapid diagnostic test highly sensitive and specific for detecting antibodies against the **kinesin-related protein K39** of *Leishmania donovani*, the causative agent of **Kala-azar (visceral leishmaniasis)**. - It is particularly useful in **endemic regions** like Bihar for quick and accurate diagnosis, especially in patients with suspected Kala-azar presenting with fever, splenomegaly, and pancytopenia. *P24 antigen* - **P24 antigen** testing is primarily used for the diagnosis of **HIV infection**. - It detects the **core protein p24** of the HIV virus, which is not relevant for the diagnosis of Kala-azar. *Combo RDT* - A **Combo RDT** (Rapid Diagnostic Test), without further specification, typically refers to tests for **malaria**, which detect antigens like **HRP-2** and **aldolase**. - While RDTs are used for parasitic diseases, this general term does not specifically refer to a test for **Kala-azar**. *HRP-2 antigen* - **HRP-2 (Histidine-rich protein 2) antigen** is a specific marker for **Plasmodium falciparum**, used in the diagnosis of **malaria**. - It is not associated with the diagnosis of **Kala-azar**, which is caused by *Leishmania donovani*.

Q: Main function of sodium citrate in ORS?

To correct Acidosis. ***To correct Acidosis*** - **Sodium citrate** provides a source of **bicarbonate** precursor, which helps to correct the **metabolic acidosis** often associated with severe dehydration and diarrhea. - In the body, citrate is metabolized into bicarbonate, raising the blood pH and counteracting the effects of acidosis. *To increase absorption of glucose by cotransport* - The absorption of glucose and sodium is coupled, meaning the presence of **sodium enhances glucose absorption** through the **SGLT1 cotransporter**. - While sodium is essential for glucose absorption, **citrate's primary role is not this direct cotransport mechanism**. *To correct electrolyte imbalance* - ORS formulations contain various electrolytes like **sodium chloride** and **potassium chloride** to rectify electrolyte imbalances caused by diarrhea. - While sodium citrate contributes to sodium levels, its specific function goes beyond just general electrolyte correction to address the **acid-base balance**. *To correct dehydration* - The overall purpose of ORS is to **rehydrate the patient** by providing fluids and electrolytes, which helps restore circulating volume. - While citrate is a component of ORS, **rehydration also depends on the water and other salts** present in the solution, not solely on citrate.

Q: In areas with chloroquine-sensitive P. vivax, what is the preferred drug for treating the blood stages?

Chloroquine. ***Correct Option: Chloroquine***- **Chloroquine** remains the **first-line treatment** for **chloroquine-sensitive P. vivax** infections due to its high efficacy and safety profile [1, 2].- It rapidly clears **blood-stage parasites**, alleviating acute symptoms of malaria [3].- In areas where P. vivax remains sensitive, chloroquine is preferred due to low cost, good tolerability, and proven effectiveness [1, 2].*Incorrect Option: Mefloquine*- **Mefloquine** is typically reserved for areas with **chloroquine-resistant P. falciparum** or for prophylaxis in such regions.- Its use is generally avoided when less toxic and equally effective options like chloroquine are available for sensitive strains.- Associated with more neuropsychiatric side effects.*Incorrect Option: Artesunate*- **Artesunate** is an **artemisinin derivative**, primarily used for severe malaria or in areas with **multi-drug resistant P. falciparum**.- While effective, it is not the preferred first-line agent for chloroquine-sensitive P. vivax due to the availability of simpler, equally effective treatments.- Typically used in combination therapy (ACT) for resistant strains.*Incorrect Option: Quinine*- **Quinine** is an older antimalarial, often used for **severe malaria** or in cases of **chloroquine-resistant P. falciparum**.- It has a higher incidence of side effects compared to chloroquine (cinchonism, hypoglycemia) and is not the preferred choice for chloroquine-sensitive P. vivax.- Requires longer treatment duration with more monitoring.

Question 1

Most common route of nosocomial infection [Hospital-acquired infection]?

Accepted Answer

Direct contact

Answer

Droplet transmission

Answer

Indirect contact

Answer

Vehicle transmission

Question 2

Behavioral surveillance survey is done in?

Accepted Answer

AIDS

Answer

TB

Answer

Filaria

Answer

Malaria

Question 3

Drug of choice for mass therapy under filariasis control programme?

Accepted Answer

DEC

Answer

Albendazole

Answer

Ivermectin

Answer

Mebendazole

Question 4

Which of the following larvicide is used under urban Malaria Scheme?

Accepted Answer

Abate

Answer

Malathion

Answer

Parathion

Answer

DDT

Question 5

In the context of malaria control, when is regular insecticidal spray recommended based on the Annual Parasite Index (API)?

Accepted Answer

> 2

Answer

< 1

Answer

< 2

Answer

> 1

Question 6

Which condition has the maximum relative risk attributed to obesity?

Accepted Answer

DM

Answer

Hypertension

Answer

CHD

Answer

Cancer

Question 7

A woman traveling from Bihar to Delhi is suspected to have Kala-azar. Suitable investigation is?

Accepted Answer

Rk-39 test

Answer

P24 antigen

Answer

Combo RDT

Answer

HRP-2 antigen

Question 8

Main function of sodium citrate in ORS?

Accepted Answer

To correct Acidosis

Answer

To increase absorption of glucose by cotransport

Answer

To correct electrolyte imbalance

Answer

To correct dehydration

Question 9

What is the recommended regimen for post-exposure prophylaxis for HIV?

Accepted Answer

Tenofovir disoproxil fumarate + Emtricitabine + Dolutegravir for 28 days

Answer

Zidovudine + Lamivudine + Lopinavir/ritonavir for 28 days

Answer

Tenofovir disoproxil fumarate + Emtricitabine + Raltegravir for 28 days

Answer

Single dose Tenofovir + Emtricitabine + Raltegravir

Question 10

In areas with chloroquine-sensitive P. vivax, what is the preferred drug for treating the blood stages?

Accepted Answer

Chloroquine

Answer

Mefloquine

Answer

Artesunate

Answer

Quinine

NEET-PG 2015

Community Medicine

Microbiology

Pharmacology