NEET-PG 2020 - Community Medicine Practice Questions

Q: A 5-year-old unimmunized child developed diphtheria. He has a 3-year-old immunized sibling contact, who received the last booster 18 months back. What should be done with the contact?

Single dose of toxoid vaccine. ***Single dose of toxoid vaccine*** - In the context of this question, this is the **best available option** among the choices provided. - For a close contact of diphtheria who was immunized but received their last booster **18 months ago**, guidelines recommend a **booster dose if more than 5 years** have elapsed since the last dose. - However, some protocols recommend a booster for **close contacts regardless of timing** to ensure maximum protection. - **Important note**: The PRIMARY management for diphtheria close contacts is **antibiotic prophylaxis** (Erythromycin 40-50 mg/kg/day for 7 days or single-dose Azithromycin) plus surveillance for 7 days, which is not mentioned in the available options. *No vaccine needed* - This is incorrect because as a **close contact of an active diphtheria case**, prophylactic measures are required. - Even though the child received a booster 18 months ago, additional protection through either antibiotics (primary) or a booster dose may be recommended. - Close contacts require active intervention to prevent secondary transmission. *Three doses of conjugate vaccine* - This represents a **complete primary series**, which is not appropriate for an already immunized child. - The child has already completed primary immunization and received boosters; they do not need to restart the vaccination schedule. - **Conjugate vaccines** (like Hib conjugate) are different formulations, though DTaP is technically a conjugated form of diphtheria toxoid. *Two doses of polysaccharide vaccine* - **Polysaccharide vaccines** are not used for diphtheria prevention. - Diphtheria vaccines are **toxoid-based** (inactivated diphtheria toxin), not polysaccharide-based. - This option represents an incorrect vaccine type for diphtheria prophylaxis.

Q: Indicators of air pollution are:

Sulphur dioxide, smoke, particulate matter. **Correct Option: Sulphur dioxide, smoke, particulate matter** - **Sulphur dioxide (SO₂)** is a major gaseous air pollutant indicator, primarily from fossil fuel combustion and industrial processes - **Smoke** (composed of small solid and liquid particles) is a visible indicator of air pollution - **Particulate matter (PM2.5 and PM10)** represents suspended particulate matter (SPM), significant contributors to air pollution causing respiratory and cardiovascular issues - These three parameters are the **standard indicators** used for air quality monitoring as per NAAQS (National Ambient Air Quality Standards) *Incorrect: Sulphur dioxide, lead, particulate matter* - While SO₂ and particulate matter are correct indicators, **lead** is a toxic heavy metal pollutant but not a standard indicator for routine air quality monitoring - Lead pollution is typically measured separately as a specific hazardous pollutant *Incorrect: Sulphur dioxide, hydrogen sulphide, carbon monoxide* - SO₂ and CO are air pollutants, but **hydrogen sulphide (H₂S)** is more associated with specific industrial emissions and sewage decomposition - This combination misses the critical indicators of **smoke and particulate matter** which are more ubiquitous and routinely monitored *Incorrect: Carbon dioxide, hydrogen sulphide, lead* - **Carbon dioxide (CO₂)** is primarily a greenhouse gas contributing to climate change, not a conventional air pollution indicator for local air quality - H₂S and lead are pollutants but not standard routine indicators - This option lacks the key indicators: SO₂, smoke, and particulate matter

Q: Vector for Zika virus disease is:

Aedes Aegypti. ***Aedes aegypti*** - The **Aedes aegypti mosquito** is the primary vector responsible for transmitting the Zika virus to humans. - This mosquito species is also known to transmit other arboviruses, including **dengue** and **chikungunya** viruses. *Culex* - **Culex mosquitoes** are known vectors for diseases such as **West Nile virus** and **Japanese encephalitis**. - They are generally not considered primary vectors for the Zika virus. *Phlebotomus* - **Phlebotomus (sandflies)** are vectors for parasitic diseases, most notably **leishmaniasis**. - They are not involved in the transmission of viral infections like Zika. *Anopheles stephensi* - **Anopheles mosquitoes**, particularly *Anopheles stephensi*, are the main vectors for **malaria**. - They do not play a role in the transmission of the Zika virus.

Q: Nosocomial infections are diagnosed after how many hours of hospitalization / admission?

48 hours. ***48 hours*** - Nosocomial infections, also known as **hospital-acquired infections (HAIs)**, are defined as infections that develop at least **48 hours** after hospital admission. - This time frame helps differentiate infections acquired in the hospital setting from those the patient was incubating upon admission. *96 hours* - A 96-hour threshold is **too long** for the standard definition of a nosocomial infection. - Infections emerging after this extended period would almost certainly be considered hospital-acquired, but the conventional diagnostic window is shorter. *72 hours* - While 72 hours might capture many HAIs, it is **not the universally accepted or most common cutoff** for defining a nosocomial infection. - The 48-hour mark is more widely used for epidemiological and diagnostic purposes. *24 hours* - Infections diagnosed within **24 hours** of admission are typically considered to have been present or incubating **prior to hospitalization**. - This short timeframe is generally insufficient to classify an infection as hospital-acquired.

Q: Which of the following is a Category A bioterrorism agent?

Bacillus anthracis. ***Bacillus anthracis*** - **_Bacillus anthracis_** (causing anthrax) is a classic example of a **Category A bioterrorism agent** due to its high mortality, ease of dissemination, and potential for major public health impact. - Category A agents are considered the **highest priority** because they pose a significant risk to national security. *Brucella* - **_Brucella_** species are classified as **Category B bioterrorism agents**. - They are moderately easy to disseminate and can cause moderate morbidity but generally have a **low mortality rate**. *Nipah virus* - **Nipah virus** is categorized as a **Category C bioterrorism agent**. - These are emerging pathogens that could be engineered for mass dissemination in the future, but their current risk is lower than Category A or B. *Coxiella* - **_Coxiella burnetii_** (causing Q fever) is classified as a **Category B bioterrorism agent**. - It is relatively easy to disseminate and can cause high morbidity but has a **low mortality rate**.

Q: Liquid chemical waste is discarded in:

Yellow bag. ***Yellow bag*** - **Liquid chemical waste** including laboratory reagents, disinfectants, and expired chemicals must be segregated and collected in a **yellow bag or container** as per **Bio-Medical Waste Management Rules, 2016 (India)**. - Yellow bags are designated for **infectious and hazardous waste** including chemical waste, expired medicines, and anatomical waste. - This ensures proper handling through **incineration or chemical treatment** to prevent environmental contamination. *Red bag* - **Red bags** are used for **contaminated waste (recyclable)** including items contaminated with blood or body fluids that are not highly infectious. - This includes tubing, bottles, intravenous sets, and catheters that can be autoclaved and recycled. - Red bag waste undergoes **autoclaving/microwaving** followed by shredding before disposal. *White bag* - **White or translucent puncture-proof containers** are designated for **sharps waste** including needles, syringes, scalpels, and blades. - These containers prevent needlestick injuries and ensure safe handling of sharp objects. - Not suitable for liquid chemical waste which requires yellow bag disposal. *Blue bag* - **Blue/white puncture-proof containers** are used for **sharps including metallic body implants** and glassware that may cause injury. - In the Indian BMW system, blue and white containers serve similar purposes for sharps waste. - Not designated for liquid chemical waste, which belongs in yellow bags.

Q: A study was conducted to investigate the relationship between COPD and smoking. Data was collected from government hospital records on COPD cases and cigarette sales records from finance and taxation departments. What is the study design?

Ecological study. ***Ecological study*** - This study uses **aggregate data** (COPD cases from hospital records, cigarette sales from taxation departments) at the population level, not individual data. - It investigates the relationship between exposure (smoking) and outcome (COPD) across different populations or groups. *Cross-sectional study* - A **cross-sectional study** collects data on exposure and outcome at a **single point in time** from individuals, which is not the case here as aggregate data is used. - It describes the prevalence of a disease and exposure in a population, but does not examine the relationship using population-level aggregates. *Operational study* - An **operational study** focuses on evaluating the effectiveness and efficiency of health services or programs in real-world settings. - It typically involves assessing how well interventions are implemented and their impact, rather than investigating the relationship between disease and exposure using aggregate data. *Case-control study* - A **case-control study** compares individuals with a disease (cases) to individuals without the disease (controls) and looks back retrospectively to identify exposures. - This design relies on individual-level data and is not suitable when only population-level aggregate data is available.

Q: Which of the following is classified as a Category A bioterrorism agent?

Bacillus anthracis. ***Bacillus anthracis*** - **Anthrax**, caused by *Bacillus anthracis*, is a prime example of a Category A bioterrorism agent due to its high mortality, ease of dissemination, and potential for major public health impact. - Category A agents pose the **greatest threat** to public health and national security. *Clostridium perfringens* - *Clostridium perfringens* is classified as a **Category B bioterrorism agent**. - While it causes **gas gangrene** and food poisoning with moderate severity, it lacks the **high transmissibility** and widespread impact characteristic of Category A agents. *NIPAH virus* - **Nipah virus** is classified as a Category C priority pathogen. - It has the potential for high morbidity and mortality, but its **epidemiological characteristics** (e.g., lower transmissibility than Category A agents) preclude its inclusion in Category A. *Coxiella burnetii* - *Coxiella burnetii*, the causative agent of **Q fever**, is classified as a Category B bioterrorism agent. - Category B agents are moderately easy to disseminate and can cause **moderate morbidity** and low mortality, which is less severe than Category A agents.

Question 1

A 5-year-old unimmunized child developed diphtheria. He has a 3-year-old immunized sibling contact, who received the last booster 18 months back. What should be done with the contact?

Accepted Answer

Single dose of toxoid vaccine

Answer

No vaccine needed

Answer

Three doses of conjugate vaccine

Answer

Two doses of polysaccharide vaccine

Question 2

Indicators of air pollution are:

Accepted Answer

Sulphur dioxide, smoke, particulate matter

Answer

Sulphur dioxide, lead, particulate matter

Answer

Sulphur dioxide, hydrogen sulphide, carbon monoxide

Answer

Carbon dioxide, hydrogen sulphide, lead

Question 3

"MONICA Project" is associated with:

Accepted Answer

Monitoring of trends and determinants in cardiovascular disease

Answer

Risk factor intervention trials for CVD

Answer

Lipid research clinics study

Answer

Oslo diet/smoking intervention study

Question 4

Vector for Zika virus disease is:

Accepted Answer

Aedes Aegypti

Answer

Culex

Answer

Phlebotomus

Answer

Anopheles stephensi

Question 5

Nosocomial infections are diagnosed after how many hours of hospitalization / admission?

Accepted Answer

48 hours

Answer

96 hours

Answer

72 hours

Answer

24 hours

Question 6

Which of the following is a Category A bioterrorism agent?

Accepted Answer

Bacillus anthracis

Answer

Brucella

Answer

Nipah virus

Answer

Coxiella

Question 7

Liquid chemical waste is discarded in:

Accepted Answer

Yellow bag

Answer

Red bag

Answer

White bag

Answer

Blue bag

Question 8

Which vaccine protocol is recommended for health workers in disaster scenarios?

Accepted Answer

Tetanus toxoid, typhoid, and hepatitis A vaccines are recommended

Answer

Only routine immunization vaccines are needed

Answer

Cholera vaccine alone is sufficient for health workers

Answer

Tetanus toxoid alone provides adequate protection

Question 9

A study was conducted to investigate the relationship between COPD and smoking. Data was collected from government hospital records on COPD cases and cigarette sales records from finance and taxation departments. What is the study design?

Accepted Answer

Ecological study

Answer

Cross-sectional study

Answer

Operational study

Answer

Case-control study

Question 10

Which of the following is classified as a Category A bioterrorism agent?

Accepted Answer

Bacillus anthracis

Answer

Clostridium perfringens

Answer

NIPAH virus

Answer

Coxiella burnetii

NEET-PG 2020 — Community Medicine