Question: If one variable is given then you can find another variable by

Regression Analysis *Regression analysis is a mathematical model to describe the effect of 21 Independent variable on a dependent variable *Linear regression describes effect of one independent variable on a dependent variable *Multiple linear regression describes effect A too or more independent variable on a dependent variable *Non linear regression involves more complex mathematical form including logarithmic functions *Logistic regression describes effects of multiple independent Qualitative Quantitative or mixed variable on dichotomous qualitative variable *Regression coefficient in average change in dependent amiable for each unit of independent variable ref: park 21st ed


Question: Consistency of screening test depends on


Question: In Cu 380A, 380 represents

The numbers included in the names of the devices refer to the surface area (in sq.mm) of the copper on the device. Metallic copper has a strong anti-feility effect.Park 23e pg: 496


Question: The spindle shaped age pyramid denotes

Age pyramids The age structure of a population is best represented as shown in the fig: Such a representation is called an "Age Pyramid". A vivid contrast may be seen in the age distribution of men and women in India and in Switzerland. The age pyramid of India is typical of developing countries, with a broad base and a tapering top. In the developed countries, as in Switzerland,* the pyramid generally shows a bulge in the middle, and has a narrower base Ref: Park 25th edition Pgno : 516


Question: Family size is

In common practice family size refers to total number of persons in a family In demography, family size means total number of children a woman has borne at a point of time Completed family size indicates total number of children born by a woman in her child bearing age Ref: Parks textbook of preventive and social medicine; Edition 23; Pg no: 485

Total number of family members in the family

Total number of female children born in the family

Total number of female children in the family considering the moality

Total number of children a women has borne at a point of time


Question: Most common carcinoma in female worldwide

Global cancer incidence in women Breast cancer was the most common cancer in women worldwide, contributing 25.4% of the total number of new cases diagnosed in 2018. The top three - breast, colorectal and lung cancers - contributed 43.9% of all cancers (excluding non-melanoma skin cancer). Cervical cancer was the fouh most common cancer in women, contributing 6.9% of the total number of new cases diagnosed in 2018. Ref: src=" alt="" width="200" height="314" />


Question: Most common viral disease affecting parotid glands

Mumps is characterised by non suppurative enlargement and tenderness of one or both the parotid glands Reference: Park&;s Textbook of Preventive and Social medicine; 24th edition; Page no.162


Question: World Health Day is observed every year on


Question: Population covered by CHC

Ans. (d) 100,000Ref : K. Park 23rd ed. / 907* CHC is community health Centre. It covers 120,000 population in plain areas and 80,000 population in hilly areas.* Since, 120,000 is not in option, 100,000 is the closest and best answer.Also Know* PHC is considered as Primary level of health care is. It is considered as 1st level of contact.* CHC is considered as secondary level of health care and first referral unit.* Tertiary level of health care is delivered through medical colleges and hospitals.Health Care UnitPopulation coveredPlainHilly/Tribal/BackwardCHC120,00080,000PHC30,00020,000MPW50003000AWW400-800300-800ASHA/VHG/TBA1000


Question: If API>2, the vector is resistant to DDT, the malathion spray should be done every


Question: The optimum floor space recommended per adult person in a house

Optimum floor space recommended per adult person in a house: 70 – 90 sq.ft. (7 – 9 sq.m.)


Question: The Finance Commission derives its authority from the

Ref: 25th Ed K.Park's Textbook Of Preventive and Social Medicine


Question: Denominator of crude birth rate is


Question: Cheopis Index used for

Flea indices Flea indices are useful measurements of the density of fleas. they are also useful in evaluating the effectiveness of a spraying programme.The following flea indices are widely used in rat flea surveysTotal flea indexCheopis indexSpecific percentage of fleasBurrow indexRef: Park; 23rd ed; Pg.no: 294


Question: Most Impoant component of level of living is

Impairment of health always means impairment of the level of living. hence health is the most impoant. Level of living is a parallel term for standard of living used in United Nations. It includes 9 components. Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition - Pgno 16


Question: Sustainable Development Goals is Designed by;

Sustainable development goals are designed by United Nations set in 2015 and intended to be achieved by the year 2030. The five Ps of its agenda are people, planet, prosperity, peace and panership. SDG 3: Ensure healthy lives and promote well-being for all ages. Goal 3 includes 13 targets covering all major health priorities with four targets on the unfinished and expended millennium development goals.


Question: In a stable situation

Ref:Parks 23rd edition pg 61 Prevalence = Incidence x Duration


Question: Keshan cardiomegaly occur due to deficiency of


Question: Health guide works at the level of

Village health guide (VHG)- Preferably a female, who is the permanent resident of the community and has minimal formal education upto 6th standard. -Training at : PHC (200 hours in 3 months) -Duties of VHGs: 1) Treatment of simple ailments 2) First aid 3) Mother and child health (with Family planning) 4) Health education 5) Sanitation -National target : 1 VHG per village (1000 rural population)

Rural & Urban Health Centres, Workers, Norms


Question: Vitamin D is maximum in


Question: Jame Lind is related to the discovery of

James Lind was a pioneer of naval hygiene in the Royal Navy. By conducting the first ever clinical trial, he developed the theory that citrus fruits cured scurvy. He argued for the health benefits of better ventilation aboard naval ships, the improved cleanliness of sailors&; bodies, clothing and bedding, and below-deck fumigation with sulphur and arsenic. He also proposed that fresh water could be obtained by distilling sea water. Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition


Question: Ujjawala scheme is for prevention of

Five impoant components of Ujjawala scheme Prevention Rescue Rehabilitation Reintegration Repatriation UJJWALA Providing LPG connections to women from Below Povey Line (BPL) households. UJJAWALA Prevention of trafficking and Rescue, Rehabilitation and Re-integration of Victims of Trafficking and Commercial Sexual Exploitation UJALA Unnat Jyoti by Affordable LEDs for All. Promote efficient lighting, enhance awareness on using efficient equipment which reduce electricity bills and help preserve environment.


Question: Best for studying the decline in percentage of syphilis in men and women in last 10 years

Ref:Park's Textbook of Preventive and Social Medicine 25th Ed


Question: The frequently occuring value in a data is

Mode is the commonly occurring value in the distribution of data . Advantages : easy to understand and is not affected by extreme values Disadvantages : exact location is unceain and often not clearly defined Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition - Pgno. 847


Question: Primordial prevention is done in a population

Primordial prevention aims at preventing the emergence of risk factors. This is the primary prevention in its purest sense, that is, prevention of emergence or development of risk factors in countries or population groups in which they have not yet appeared. Ref: Park's Textbook of Preventive and Social Medicine; 24th edition - Page no. 45


Question: Protein content in 100 grams of cow milk


Question: The most suitable measure for assessing the etiological role of a factor in a disease is

The relative risk (RR) or risk ratio is the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group. It's a direct measure of the association between suspected cause and effect. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 86


Question: Loss of inter personal communication is managed by

Ref: 25th Ed K.Park's Textbook Of Preventive and Social Medicine


Question: Blood bags are discarded in


Question: Occurence of disease in excess of expected frequency is known as

Endemic: refers to the constant presence of a disease or infectious agent within a given geographic area or population group without impoation from outside. Exotic: diseases which are impoed into a country in which they do not otherwise occur as for example rabies in the UK . Epizootic: an outbreak of the disease in an animal population. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 101


Question: Main purpose of Randomisation is


Question: Iodized salt in iodine deficiency control programme is


Question: Vaccine(s) not to be frozen is/ are

DPT vaccine should not be frozen. They should be stored in a refrigerator between 2 to 8 deg. The vaccine should be used before expiry indicated on the l (refer pgno:162 park 23 rd edition)


Question: The most predominant type of polio virus during epidemics is

Ans. is 'a' i.e., Type I Poliomyelitis o Poliomyelitis is an acute viral infection caused by poliovirus. o There are three types of polioviruses - Type 1 --> Most common and causes most epidemics Type 2 Type 3 o No serotype - 2 (type -2) poliovirus has been detected anywhere in the world since 1999, type 1 and type 3 have been detected. o Peculiar features of different types of virus - Most common cause of epidemic --> Type 1 Most difficult to eradicate --> Type 1 Vaccine induced paralytic polio --> Type 3 Most commonly associated with paralysis Type 3 Most effective antigen --> Type 2


Question: Savlon contains

Savlon is a combination of cetavlon and hibitane. Plastic appliances can be disinfected by keeping them in normal strength savlon for 20 minutes. Savlon 1 in 6 spirit is more effective than savlon in 1 in 20 aquous solution Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 141

Cetrimide + Chlorhexidine + butyl alcohol


Question: Convalescent case of cholera remains infective for

CONVALESCENT CARRIER of cholera The patient who has recovered from an attack of cholera may continue to excrete vibrios, during his convalescence for 2-3 weeks. Convalescent state has been found to occur in patients who have not received effective antibiotic treatment. The convalescent carriers can often become chronic or long-term carriers. Ref : Park 23rd edition Pgno : 230


Question: UNICEF stands for

UNICEF (United Nations International Children's Emergency Fund) was established in 1946 to deal with the rehabilitation of children in war-ravaged countries After emergency functions were over, general assembly gave it a new name "U.N Children's fund" retaining same initials.In early years, UNICEF and WHO worked together on urgent problems such as malaria, tuberculosis and venereal diseases. Later its assistance to countries covered such fields as maternal and child health, nutrition, environmental sanitation, health centres, health education and programmes which would directly or indirectly benefit child health.Park 23e pg: 922

United nations international children's emergency fund

United nations international children's fund

Health care of community & international health


Question: Best way to control house fly


Question: Nearly 3/ 4th of occupational cancers are

Nearly 75% of occupational cancers are skin cancers.


Question: Process of deflouridation of water is


Question: Not a primordial prevention


Question: A person wants to study a disease &;x&; and fat consumption. He obtained data for number of people affected with &;x&; from the government and the details of fat consumption from food industry. Type of study is

Ecological (correlations) study. Unit of study is population (results not applicable to individuals). Done in a small time frame. It is inferior to coho and case control. Reference: Park's textbook of preventive and social medicine,K.Park,21st edition,page no:59 & 22nd edition, pg no.60.


Question: Contraceptive of choice in a women with Rheumatic heart disease.


Question: An indicator is said to valid if

Ans) b (It measures the thing.. ) Ref park 20th ed p 226The term validity refers to what extent the test accurately measures which it purports/ intended to measure.Validity expresses the ability of a test to separate or distinguish those who have the disease from those who do not have.Validity has two components - Sensitivity and specificitySensitivity and specificity together with "predictive accuracy" are inherent properties of a screening test.

It also measures the thing it didn't suppose to measure

It measures the thing it expected to measure

Over value when measured by different method

Under value when measured by different method


Question: Pearl Index of SAHEIL


Question: In Crude death rate the population is taken as on

Ref: Parks 23rd edition pg 57 Mid year population is considered. Hence July 1st is taken.


Question: The regression between height and age follows y=a+bx. The curve is

Ans. is 'c' straight line Regression:If two variables are highly correlated, it then becomes possible to predict the value of the dependent variable from the value of the independent variable by using regression technique .Regression analysis is the mathematical modelling to describe the effect that one or more independent variables have on a dependent variable.Types:Linear regression: The value of one variable (X) is used to predict the value of the other variable (Y) by means of a simple mathematical formula. In linear regression the dependent variable (Y) depends upon a single independent variable (X).The linear regression equation takes the form as the equation for any straight line. y = a + bx where - a = is a constant k/a intercept constant b = is the regression coefficient x = is the independent variable.y = is the dependent variable whose value is to be found out.Multiple regression: More than one variable is used to predict the expected value of Y.Y = a + b1X1 + b2x2 +b1x1 where a = intercept constantb = regession coefficient for independent variable X1 eg. Rubin found that the birth weight of a baby (Y in grams) can be partially predicted from the no. of cigarettes smoked on the daily basis by both the baby's mother and the baby's father (X2). According to multiple regression equation Y = 3385 - 9x1 - 6x2Nonlinear regression: Involves more complicated mathematical forms, including logarithmic functions.


Question: Pearl index is defined as

Accidental pregnancies per 1000 women-years of exposure

Accidental pregnancies per 100 women-years of exposure

Accidental pregnancies per 10 women-years of exposure

Accidental pregnancies per women-years of exposure


Question: Drug of choice for Prophylaxis against Diphtheria is

Control of Diphtheria Prophylaxis of Diphtheria Erythromycin Non-immunized contacts Prophylactic Penicillin/Erythromycin + 1000-2000 units antitoxin + active immunization DOC for carriers Erythromycin DOC for cases Penicillin/Erythromycin (given along with anti-toxin)

Intestinal Infections, Worm Infestations


Question: PAP smear is an example of

Ans. (a) Early diagnosis and treatmentRef : K. Park 23rd ed. / 41, 370* Pap smear is a screening test for cervical cancer. It is an example of secondary level of prevention. The mode of secondary level of prevention is by early diagnosis and treatment.


Question: As per National Immunization Program, route of administration of BCG vaccine is

As per National Immunization Programme, route of administration of BCG vaccine is intradermal. Site - left upper arm. Dose 0.1 ml (0.05 ml until 1 month age) Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition pg 123


Question: Randomized controlled trials are

Experimental studies intervention studies include: Randomized control trials Field trials Community trials Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 70


Question: Recommended iodine dose in pregnancy is

The daily requirement of iodine for adults is placed at 150micrograms. The recommendation of WHO of 250mg per day for iodine during pregnancy have also been adopted. This amount is normally supplied by well-balanced diet and drinking water except in regions where food and water is deficient in iodineRef: Park; 23rd ed; Pg 624


Question: Treatment for pertussis contacts children for


Question: Sample registration survey is conducted every

Ref:Park's Textbook of Preventive and Social Medicine 25th Ed


Question: The best indicator to determine maximum benefit to the community through preventive intervention strategies is

Attributable risk is the difference in the rate of a condition between an exposed population and an unexposed population. It is calculated in coho studies, where individuals are assembled on exposure status and followed over a period of time.


Question: Social Deviance among the following is


Question: Sampling method used in assessing immunization status of children under immunization programme is

Ans. is 'd' i.e., Cluster sampling o In the Expanded programme on Immunization (EPI) cluster technique, a simplified cluster sampling method is used. It is based on ranodm selection of 210 children who are 12-23 months of age. These patients are selected in 30 clusters of 7 children each to estimate immunization coverage levels.


Question: Water based disease is


Question: Waterlow's classification is used in

A. i.e. (Protein energy malnutrition) (508 - Park, 554- Park 20th)CLASSIFICATION OF PEM1. GOMEZ' classification * Based on weight retardation* Prognostic value for hospitalized childrenWeight for age(%)Weight of the child-----------Weight of a normal child of same agexl00* Between 90 and 110%* Between 75 and 89%* Between 60 and 74%* Under 60%: Normal nutritional status: 1st degree, mild malnutrition: 2nd degree moderate malnutrition: 3rd degree - severe malnutrition 2. WATERLOW'S Classification* When a child's age is known, measurement of weight enables almost instant monitoring of growth; measurements of height assess the effect of nutritional status on long term growth m = mean , SD = Standard deviation3. ARM- CIRCUMFERENCE - a relatively reliable estimation of the body *s muscle(i) Arm circumference exceeding 13.5 cm - Satisfactory nutritional status(ii) Arm circumference between 12.5 - 13.5 - Mild to moderate malnutrition(iii) Arm circumference below 12.5 cm - Severe malnutrition* Dharmendra's index and Jopling classification deals with leprosy**


Question: Dengue hemorragic fever occurs in

Ans) c (When type 2 infects a...) Ref park 20th ed p 218-221Dengue haemorragic fever (DHF) is a severe form of dengue fever caused by infection with more than one dengue virus.At least there are four serotypes of dengue virus (1,2,3 and 4)DHF is thought to be due to double infection with dengue viruses - the first infection probably sensitises the patient. While the second appears to produce an immunological catastrophe.Dengue fever is transmitted by Aedes mosquito . Transmission cycle is "man- mosquito-man" type.Bleeding manifestations are not seen in classical dengue fever. It is usually seen in Dengue hemorrhagic fever (DHF) and Dengue shock syndrome(DSS).There is haemoconcentration instead of hemodilution in DHF and DSS due to plasma leakage and thrombocytopenia which results in abnormal hemostasis.Usual rash seen in dengue fever is a maculopapular or scarlentiform rash seen on 3rd or 4th day of disease.lt is accompanied by itching and hyperaesthesia.lt last for 2 hrs to several days and may be followed by desquamation. (Refer Q137 Kerala 2009, Q125 kerala 2008for fur-ther explanation)

When type 2 infects a previously infected person


Question: The vital layer of slow sand filter is

Elements of slow sand filter: supernatant or raw water (1-1.5 metre) a bed of graded sand an under-drainage system a system of filter control valves The surface of the sand bed gets covered with a slimy growth known as "Schmutzdecke", vital layer, zoological or biological layer. The formation of the vital layer is called ripening. It is the hea of the slow sand filter Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 772


Question: Conventional contraceptives are

Conventional contraceptives are those methods that require action at the time of sexual intercourse Examples are condom, spermicide etc. Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 494


Question: Quarantine is related to

Quarantine has been defined as the limitation of freedom of movement of such well persons or domestic animals exposed to communicable diseases for a period of time not longer than the longest usual incubation period of the disease in such manner to prevent effective contact with those not exposed. ( refer pgno:121 park 23 rd edition)


Question: Emporiatrics refers to study of

Travel medicine or ‘Emporiatrics’ is the branch of medicine that deals with the prevention and management of health problems of international travelers.


Question: Community health centre covers a population of

Community health centres were established by upgrading the primary health centres.Cover the population of 80000-1.2 lakh (one in each community development block) with 30beds and specialists in surgery, medicine, obstetrics and gynaecology and paediatrics.Park 23e pg: 907

Health care of community & international health


Question: Spectrum of IDD cretin does not include


Question: Best cha to represent incidence of disease over a period of time

Line diagram:- Trend of a event over a period of time and scatter plot relationship between two quantitative variables Ref:- K Park, 24th ed; pg num:- 883


Question: Headquarters of UNICEF is at


Question: The time interval between invasion of the infection agent and appearance of the first sign or symptom

An infection becomes apparent only after a ceain incubation period which is defined as the time interval between invasion by an epidemiological agent and the appearance of first sign or symptoms. During the incubation period, the infectious agent undergoes multiplication in the host. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 107


Question: To achieve Net Reproduction Rate of 1, the couple protection rate should be

Ans. c (60 %) (Ref. Park PSM 22nd / pg. 454)# Net reproduction rate (NRR)=1 can be achieved only if the CPR exceeds 60%.ELIGIBLE COUPLES (EC)# Refers to a currently married couple wherein the wife is in the reproductive age (15^45 years).# At least 150-180 such couples per 1000 population in India.# 20% of EC are found in the age group 15-24 yrs.# There are about 169 million couples in country (31/3/99).# Average 2.5 million EC are joining the reproductive group every year.COUPLE PROTECTION RATE (CPR)# It is an indicator of the prevalence of contraceptive practice in the community.# It is defined as the percent of eligible couples effectively protected against childbirth by one or the other approved methods of family planning.# Sterilization accounts for over 60% CPR.# During 2002-2003, total number of family planning acceptors by all the methods below was there but about 54% eligible couples are still unprotected:1. Sterilization -4.73 million2. IUD insertion -6.11 million3. Nirodh/Condom users -16.54 million4. Oral pill users -8.24 million


Question: Disability certificate is given for poor vision if visual acuity is 4/60, in tune of visual impairment as a percentage


Question: Level of hardness in soft water

Soft water: < 1 mEq/LModerately hard: 1-3 mEq/LHard water: 3-6 mEq/LVery hard water: >6 mEq/LPark 23e pg: 727


Question: The magnitude of completed family size can be obtained from

Total feility rate represents the average number of children a woman would have if she were to pass through her reproductive years bearing children at the same rate as the women now in each age group.This measure gives an approximate magnitude of &;completed family size&;(Ref:- Park. 23rd ed. Page no 489)


Question: Endemic ascites is caused by

The population that subsist on the millet Panicum miliare, may get contaminated with weed seeds of Crotalaria (Jhunjhunia).Jhunjhunia seeds were found to contain pyrrolizidine alkaloids which are hepatotoxins, cause Endemic ascitesPark23e pg: 658


Question: Maximum recommended number of students in a school class room


Question: If Two screening tests are used in Series, then there will be

Screening tests in series: A population is subjected to one screening test followed by a second screening test ; 2nd screening test is applied only in those in which the 1st screening test is positive. - In this, Combined values of Sensitivity decreases Specificity increases PPV increases NPV decreases

Increased sensitivity and decreased specificity

Increased specificity and decreased sensitivity

Increased sensitivity and increased specificity

Decreased sensitivity and decreased specificity


Question: If mean is less than the median, than the data is said to be

Ans. is 'b' i.e. Negatively skewed Relationship among the three measures of central tendency (ie mean, median and mode) in a skewed curve is an oft repeated question.Lets first see what skewed distribution curve is.* An asymmetrical distribution curve can be of two types:Positive skewed distribution curveNegative skewed distribution curvePositive (or right) and negative (or left) skewed curves are recognized by the location of the tail of the curve (not by the location of the hump - a common error)Positive or Right skewed distribution curve * there curves have a relatively large number of low scores and a small no of very high scores the mean lies towards the extreme right of the curve Negative or left skewed distribution curve.there curves have a large number of high scores and a relatively small number of low scores the mean lies towards the extreme left of the curve.Now lets see the measures of central tendency.Modeis the most frequently occurring valueit lies at the peak of the hump.Meanis the arithmetic averageit is greatly influenced by the relatively small number of very high or very low scoresit liestowards the extreme right in a right (Positive) distribution curve andtowards the extreme left in a left (negative) distribution curve.Medianis the middle valueit lies b/w the mean and mode dividing the curve into two equal halves.Relationship b/w the measures of central tendency* In a symmetrical curveMean = Median = Mode* In a Positive (Right) skewed curveMean > Median > Mode* In a Negative (left) skewed curveMean < Median < Mode

Measures of Central Tendency and Distribution


Question: Isolation is strictly recommended for

Isolation has a distinctive role in the control of some infectious diseases Diphtheria Cholera Streptococcal respiratory disease Pneumonic plague Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 132


Question: CBNAAT is

Caridge Based Nucleic Acid Amplification Test Ref: Park 25th Edition;Pg. No:197

Category Based Nucleic Acid Amplification Test

Case Based Nucleic Acid Amplification Test

Clinical Based Nucleic Acid Amplification Test


Question: Calculate positive predictive value of ELISA test for HIV with sensitivity 99%, specificity 99%. Prevalence of HIV in population is 5/1000.

Ref :Parks 23rd edition pg139 Construct a 2x2 table using the above data. 4.95 9.95 0.05 985.05 PPV = TP / (TP + FP) = 4.95/(4.95+9.95)=0.34


Question: Inanimate objects of transmission is regarded as

Ans) b (Fomite) Ref park 20th ed pg 94Fomites are inanimate articles or substances other than water or food contaminated by the infectious discharges from a patient and capable of harbouring and transferring the infectious agent to ahealthy person.Fomites include linen, handkerchiefs, towels etc.. The fomites play an important role in indirect infection.Diseases transmitted by fomites include diphtheria, typhoid fever, bacillary dysentery, Hepatitis A, eye and skin infections.Vector is defined as an arthropod or any living carrier that transports an infectious agent to a susceptible individual.Vehicle borne transmission implies transmission of the infectious agent through the agency of water, food, ice, blood, serum, plasma, or other biological products such as tissue and organs.


Question: Not a social Evil


Question: Highest fat content of milk

Fat content of milk : Buffalo > Goat > Cow > Human
Energy content of milk : Buffalo > Goat > Cow > Human


Question: International food standards include


Question: Mutation is seen in

A unique feature of the influenza virus is its ability to undergo angenic variaons.
Angenic variability is highest in influenza virus Type A and less in Type B, while it has not been demonstrated in type C.
Surface angens hemagglunin and neurominidase, undergo independent angenic variaons which may be of Two types.

1. Angenic dri

Angenic change is gradual over a period of me
The new angens, though different from the previous angens, are yet related to them,
Angenic dri involves point mutaon in the gene owing to selecon pressure by immunity in the host populaon.
Angenic dri accounts for the periodic epidemics of influenza.
Occurs every 2-3 years in case of Influenza A and every 4-7 years in case of Influenza-B 2.

2. Angenic shi

An abrupt, drasc, disconnuous variaon in the angenic structure,
Result from genec recombinaon of human with animal or avian virus,
Accounts for the major epidemics or pandemics,
Occurs every 10-15 years,
Occurs in influenza ‘A’ only


Question: Phase 4 clinical trial is done as

The phases of clinical research are the steps in which scientists do experiments with a health intervention in an attempt to find enough evidence for a process that would be useful as a medical treatment.


Question: Paralysis in polio is characterized by

Types of Paralytic Poliomyelitis Spinal poliomyelitis (MC type) : Lower motor neurone lesion of the anterior horn cells of spinal cord which affects the muscles of the legs, arms and/or trunk asymmetrically Bulbar poliomyelitis: Involvement of lower cranial nerves Bulbospinal poliomyelitis : Involvement of both Bulbar cranial nerves and spinal cord Ref: Hutchinson's Atlas of pediatric physical diagnosis 1st edition Pgno : 271


Question: Primordial prevention is for

Primordial preventionIt is first prevention in its purest form i.e. prevention of emergence of development of risk factor in countries or population groups in which they have not yet appeared. Effos were taken to discourage children from adopting harmful habits.Primordial prevention is for persons without risk factorsMain intervention is through the individual or the mass education.


Question: Bp of 50 years old man is 144/96 mmHg. He belongs to

He belongs to Hypeension stage I Ref : Park 23rd edition Pgno : 373


Question: For every case of poliomyelitis the subclinical cases of poliomyelitis to be estimated


Question: Incubation period for diptheria and salmonella is

Diphtheria Causative agent : Corynebacterium diphtheriae, a gran positive non-motile organism Diphtheria is an endemic disease in India Source of Infection Carriers are more impoant as source of infection: 95% of total disease transmission Nasal carriers are more dangerous than throat carriers Incidence of carriers in a community : 0.5-1% Immunization does not prevent carrier state Incubation period : 2-6 days Mode of transmission Droplet infection (main mode), directly from cutaneous lesions anf fomites. Ref : Park 25th edition Pgno : 235 Typhoid Causative agent : Salmonella typhi Reservoir of infection : Man (cases and carriers) Source of infection : Faeces, urine of cases/carriers (primary source) and water, food fingers, flies (secondary sources) Incubation period: 10-14 days Mode of transmission : Faeco-oral route, urine-oral route Ref: Park 25th edition Pgno : 174,258


Question: Category 4 and 7 treated by

Color codingType of containerWaste categoryTreatment optionsYellowPlastic bagCat 1, 2, 3 & 6Incineration/deep burialRedDisinfected container/plastic bagCat 3, 6 & 7Autoclaving/Microwaving/Chemical treatmentBlue/White translucentPlastic bag/Puncture proof containerCat 4 & 7Autoclaving/Microwaving/Chemical treatment and Destruction/ShreddingBlackPlastic bagCat 5, 9 & 10 Disposal in secured landfillRef: Park; 23rd ed; Pg 794

Hospital waste and disaster management, Occupational health


Question: The energy requirement of women are increased in first 6 months of lactation is

(550 kcal) (552- Park 20th)* Recommended daily intake of energy GroupBody weightEnergy allowance per day KgKcalMJAdult Ref Males(Light work)60242510.1 (Moderate work) 287512.0 (Heavy work) 380015.8Ref Females(Light work)5018757.8 (Moderate work) 22259.3 (Heavy work) 292512.2Pregnancy + 300+ 1.25Lactation (First 6 months) + 550+ 2.3 (6-12 months) + 400+ 1.68


Question: Urine bags and catheters biomedical waste will be disposed in

Red Category Contain Contaminated, recyclable waste ; plastic /rubber waste . Disposal method - Autoclaving, Micro waving, hydroclaving, F/b destruction & shredding. Final mechanism of Disposal - Road making. - Extra Edge: Plastic covers which are used to pack foley's catheter etc are not considered as biomedical waste. It is general waste & is disposed through black bag. Recyclable general waste is disposed in Green bins. Non-recyclable general waste is disposed in Blue bins.


Question: 'Primordial Prevention' means

Ans. (b) Prevention of emergence of risk factors of the diseaseRef : K. Park 23rd ed. / 41, 370* Primordial prevention refers to prevention of development of risk factors in countries or population groups where they are yet to appear.* For instance, adult health problems like obesity, hypertension etc. take root in childhood, when lifestyles like smoking, eating patterns, physical exercise are formed* As part of primordial prevention, efforts are made to discourage high risk children, adolescents and young adults from adopting harmful lifestyles. The primary intervention is through individual and mass education.

Preventive action taken prior to onset of disease

Prevention of disease from causing complication


Question: Not a member of SAARC region

Members of SAARC region

Afghanistan
Bangladesh
India
Sri Lanka
Nepal
Bhutan
Maldives Islands
Pakistan


Question: Group approach includes

Home visits, Personal letters, personal contact are individual approachTelevision, radio, newspaper, folk methods, internet are mass approaches.Lectures, Demonstrations, Discussion methods (Symposium, conferences, roleplay..etc) are group methods.Park 23e pg: 862


Question: In the demographic study of population, a country with low bih rate & a low death rate is in following phase

Fouh stage of demographic cycle is low stationary Characterised by a low bih and low death rate with the result that the population becomes stationary Reference: Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 479


Question: NACO launched national pediatric initiative on

NACO pediatric HIV/AIDS initiative The National Paediatric HIV/AIDS Initiative launched on November 30, 2006 by Hon'ble Chairperson UPA Smt. ... Mr William J Clinton, former President of the United States of America, was a landmark initiative, for now children living with HIV/AIDS would be able to access generic drugs, A and suppo services Launch Highlights * Phase I of the programme aims to put 10,000 children on A treatment for life. * Initially 36 A centres to provide free A to children. * Seven Regional Paediatric Centres being established across the country. * Free CD4 monitoring for children till 15 years, free DNA PCR test for children upto 18 months, liquid formulations for babies, diagnosis and treatment of oppounistic infections and micro nutrient supplementation will be provided. * The National Paediatric Anti- retroviral Therapy (A), Treatment and Dosing Guidelines developed by IAP with suppo from WHO, UNICEF and Clinton Foundation released. Ref : naco.gov.in


Question: Stage of contraction of family stas at

Ans. is 'c' i.e., Leaving home of first child


Question: Difference b w the incidence in exposed and non exposed group is best given by

attributable risk : Attributable Risk(AR) (sometimes called Attributable Propoion or Attributable Fraction) is a measure of the prevalence of a condition or disease. Given a group of people exposed to a risk, it&;s the fraction who develop a disease or condition. ref : park 21st ed


Question: Cyclops is an intermediate host for


Question: Zero Incidence is not seen in

Control of infection: The reduction of disease incidence, prevalence, morbidity or moality to a locally acceptable level as a result of deliberate effos; continued intervention measures are required to maintain the reduction. Example: diarrhoeal diseases.Elimination of disease: Reduction to zero of the incidence of a specified disease in a defined geographical area as a result of deliberate effos; continued intervention measures are required. Example: neonatal tetanusElimination of infections: Reduction to zero of the incidence of infection caused by a specific agent in a defined geographical area as a result of deliberate effos; continued measures to prevent re-establishment of transmission are required. Example: measles, poliomyelitis.Eradication: Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate effos; intervention measures are no longer needed. Example: smallpox.


Question: Disinfectance used for blood spills

Hypochlorites are most widely used chlorine disinfectant. Liquid form: sodium hypochlorite Household bleach Broad-spectrum of antimicrobial activities Do not leave toxic residues Unaffected by water hardness Inexpensive and fast-acting Remove dried or fixed organisms and biofilm a from surfaces (refer pgno:129 park 23 rd edition)


Question: Not transmitted by mite

Ans. is 'd' i.e., Kyanasur Forest disease Mites are the vectors for the following diseases :-Diseases VectorScabies Itch miteScrub Typhus Trombiculid miteRickettsial pox Trombiculid mite.


Question: Normal safe limit of Fluoride content in drinking water is

The recommended level of fluorides in drinking water in India is accepted as 0.5 to 0.8 mg per literRef: Park; 23rd ed; Pg 625


Question: Cancer control programme was launched in

With the objectives of prevention, early diagnosis and treatment, the national cancer control programme was launched in 1975-76 Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition pg 472


Question: Dengue fever is transmitted by


Question: Usual time for symptoms to appear in Rabid animal,


Question: Prophylaxis of meningococcal meningitis is


Question: Diethyltoluamide is an effective

Diethyl toluimide /deetis an all purpose repellant.
They are used for application on skin, and their chief advantage is short duration of protection.Repellant are contact poisons.
They are used as peraonal protective measure against mosquito bite.
Other neasure are using mosquito nets and screening.
Parks textbook of preventive and social medicine.K Park


Question: Cash benefits in ESI scheme includes


Question: Number of air changes in one hour in a drawing room should be not less than


Question: Papilledema is caused by


Question: Leprosy is not yet eradicated because

Ans is 'a' i.e. No effective vaccine Both "No Effective Vaccine" and "Long incubation period" are the reason behind not being able to fully control Leprosy. But when it comes to eradication, "No Effective Vaccine" is correct answer because only disease eradicated (small pox) was because of effective vaccine.About leprosy Park writes- "Although significant progress has been made in controlling the disease and reducing the disease burden, much remains to be done in order to sustain the gains and further reduce the impact of the disease...One of the long-term needs is to develop reliable diagnostic tests for early diagnosis and an effective vaccine for the prevention of leprosy."The only disease which has been eradicated till now is smallpox. There were many advantageous features of the disease coupled with a highly effective, heat stable vaccine which led to its eradication.The other disease which is a very potential candidate for eradication is Polio. It does not have advantageous features like those possessed by Small pox, still it has a very effective vaccine.Small pox was eradicated and Polio is likely to be eradicated because of the massive global immunization programs launched by WHO.This suggests that most probable reason for non-eradication of leprosy could be absence of an effective vaccine. Other reasons which are also culprits are - long incubation period, highly infectious, large number of infective subclinical cases, difficult to diagnose and animal reservoir.Various definitions:Control:The reduction of disease incidence, prevalence, morbidity or mortality to a locally acceptable level as a result of deliberate efforts; continued intervention measures are required to maintain the reduction.Example: diarrhoeal diseases.Elimination:Reduction to zero of the incidence of a specified disease in a defined geographical area as a result of deliberate efforts; continued intervention measures are required.Example: neonatal tetanus, measles, poliomyelitis.Eradication:Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts; intervention measures are no longer needed.Example: smallpox.Extinction:The specific infectious agent no longer exists in nature or in the laboratory.Example: none. Factors associated with potential for eradication of a communicable disease:There are many factors but the three factors considered to be of primary importance are:An effective intervention is available to interrupt transmission of the agent;Practical diagnostic tools with sufficient sensitivity and specificity are available to detect levels of infection that can lead to transmission; andHumans are essential for the life-cycle of the agent, which has no other vertebrate reservoir and does not amplify in the environment.Factors Associated with Potential for Eradication of a Communicable Disease Factors Associated with the DiseaseEase of diagnosis and treatment Low prevalence of subclinical disease High disease burden and economic impact Immunity is long term or lifelong Disease cannot be reactivated Disease has predictable seasonalityFactors Associated with the Etiologic AgentLack of an animal reservoir or vectorOnly one causative agent or serotypeShort incubation periodFactors Associated with the Host or Target PopulationCorrelates or protection can be demonstratedHost cannot be reinfected with the agentHost cannot shed the organism once infection is resolvedPublic acceptance of the vaccine and other control measures is highFactors Associated with the VaccineCan confer long-lasting protection in a few injectionsMinimal handling and storage requirements (e.g., cold chain)Simple administrationCan be administered simultaneously with other vaccines or adapted to schedules and timing of the national childhood immunization programsFew short- or long-term adverse effectsLow cost to produce and purchase vaccine Epidemiological factors which led to the eradication of smallpox are:No known animal reservoir.No long-term carrier of the virus.Life-long immunity, after recovery from the disease.The detection of the cases was relatively simple as the rashes were characteristic.Persons with subclinical infection did not transmit the diseaseHighly effective, heat stable vaccine, easily administrable and provides long term protection.International cooperation


Question: An infection or infectious disease transmissible under natural condition from veebrate animals to man is known as

Term Definition Zoonoses An infection or infectious disease transmissible under natural condition from veebrate animals to man. Exotic Disease which is impoed into a country, in which it doesn't occur normally. Epizootic Outbreak of disease in animal population. Epornithic Outbreak of disease in bird population.


Question: The North Kerelia project evaluate risk factors of


Question: The interval of time between receipt of infection by a host and maximum infectivity is known as

Ans. c (Generation time) (Ref. Text book of PSM by Park 22nd/96)Generation time: is the time interval between receipt of infection by host and max. infectivity1Median incubation periodTime required for 50% of cases to occur following exposure.2Incubation periodPeriod of entry of organism to appearance of first sign or symptom.3Serial intervalThe gap in onset of primary and secondary case.4Primary caseFirst case in community5Index caseFirst case detected in community (may or may not be primary case)


Question: Most common nosocomial infection is


Question: Toxix shock syndrome occures after one of the following vaccinations

toxic shock syndrome occurs when measles vaccine is contaminated or the same vaccine l is for more than one session on the same day or next day.the vaccine should be used within 4 hours after opening.TSS reflects poor quality of immunisation.other adverse effects include diarrhea,fever,and vomiting. ref:park&;s textbook,22 nd ed,pg 140

Recombinant DNA vaccine against hepatitis B


Question: The failure rate per HWY of Pearl index is given by

The Pearl index is defined as the number of failures per 100 women-years of exposure . This rate is given by the formula:Failure rate per HWY: x 1200The factor 1200 is the number of months in 100yearsRef: PArk; 23rd ed; Pg 510


Question: Food with maximum cholesterol content

Ans. a. Egg Food with maximum cholesterol content is egg. "The yolks of eggs have the most cholesterol of any food with 1234 mg pr 100 gram serving or 411% of the DV. A single egg yolk will provide 210 mg (70% DV) of cholesterol, while a whole egg provides slightly more with 212 mg Impoant points about Egg All the cholesterol in egg is found in the yolkQ Egg white does not have any cholesteroldeg Egg contains all the nutrients except carbohydrates and vitamin CQ. Egg protein is considered the best among food proteins and is the standard against which the quality of other proteins is comparee. NPU of egg protein is 100Q


Question: Type of Growth Chas used by Anganwadi workers (ICDS) for growth monitoring

ICDS GROWTH CHA: In NRHM and ICDS, Government of India has adopted WHO child Growth standards 2006 (also known as MGRS &;Multicenter Growth Reference study&; Standards) Normal zone Below -2SD: Malnutrition Below -3SD: Severe Malnutrition Ref: Park 25th edition PGno: 580-581


Question: Most common cause of low birth wt baby is


Question: Antigenic shift and drift occurs in


Question: Not seen in faecal pollution

The primary bacteriological indicators for faecal contamination are → Coliform gp. of organisms.
Supplementary indicators are →
Streptococci faecalis,
Clostridium perfringens (also k/a cl. welchi)


Question: Children borne by female at the end of reproductive period is


Question: Sullivan index is an index for

Sullivan's index also known as Disability Free Life Expectancy (DFLE) is a method to compute life expectancy free of disability. It is calculated by formula:Life expectancy minus duration of disability Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 26


Question: Iron requirment in a normal mensturating adult female


Question: Of the different epidemiological study designs available to test the association between risk factor and disease, the best design is of

Coho study is also known as incidence study. The cohos are identified prior to the appearance of disease under investigation. The study group so defined are observed over a period of time to determine the frequency of disease among them. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 83


Question: P.Q.L.I is

Physical Quality of Life Index (PQLI) is an attempt to measure the quality of life or well-being of a country. The value is the average of three statistics: basic literacy rate, infant moality , and life expectancy at age one, all equally weighted on a 0 to 100 scale. HDI includes knowledge, income(GNI) and life expectancy at bih. Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition

IMR, Life Expectancy at 1year of age, literacy

IMR, Life expectancy at 1 year of age, SE status


Question: The effective temperature of'comfort zone' is

(77-80degF) (641-Park 20th)Comfort zones - may be defined at the range of effective temperatures over which the majority of adults feel comfortableComfort zones evaluated in India are as below:TypesCorrected Effective Temperature deg- CCorrected Effective Temperature0deg F1 Pleasant and cool20692 Comfortable and cool20-2569-763 Comfortable25-2777-804 Hot and uncomfortable27-2881-825 Extremely hot28+83+6 Intolerably hot30+86+ Predicated four hour sweat rate (P4SR)1 Comfort zone1-.3 litres2 Just tolerable3-4.5 litres3 Intolerable4.5+ litres


Question: Psychrometer is used to measure

• Air humidity can be measured by:
Dry and wet bulb thermometers
Hygrometer
Sling/Whirling Psychrometer
Assman Psychrometer


Question: Pasteurization by Holder method is heating milk at


Question: Rule of halves is seen in

Hypeension is an iceberg disease. Only about half of the hypeensive subjects in general population were aware of the condition, only about half of those aware of the condition was being treated, and only about half of those treated were considered adequately treated.Park 23e pg: 373


Question: Chimney sweeper's cancer is also known as


Question: In the management of leprosy, Lepromin test is most useful for

Uses of Lepromin test:
- Evaluation of CMI status of patients
- Aid to confirm the classification of Leprosy
- Estimation of prognosis of cases


Question: Under stable conditions, the relationship between incidence (I), prevalence (P), and duration (D) is given as

Prevalence = Incidence x Duration of illnessex: if the duration of illness increase (chronic diseases) prevalence increases


Question: Polio virus is shed maximum in stool up to


Question: Zika Virus is transmitted by

Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquitoRef: Park; Pg. No: 293


Question: Requirement of Iodine during Breast feeding

RDA of Iodine in Adults - 150mcg/day
RDA of Iodine during pregnancy and breast feeding is - 250mcg/day


Question: Vaccine of yellow fever is


Question: Biological value of a protein is related to

Ans) a (Nitrogen content) Ref paik 20th ed p 549Biological value of a protein is Retained N2 / Absorbed N2 x 100Protein efficiency ratio = Wt gain in gms / Gram of protein consumedNet protein utilization =Digestibility Coefficent x Biological value100 Aminoacid score =No of mg of one AA/gm of proteinNo of mg of same AA/gm of egg proteinx 100Quality of protein is assessed by comparison to the reference protein which is usually egg protein.


Question: Frequency polygon is obtained by joining the points of

Ans. d (Histogram blocks) (Ref. Park PSM 22nd/ 788; Methods in Bio-statistics, by B. K. Mahajan 6th/p. 23)Quantitative data is presented by the following graphsQualitative or discrete or enumeration data is presented by the following graphs:# Histogram.# Bar diagram# Frequency polygon.# Pie or sector diagram# Frequency curve.# Pictogram# Line chart or graph.# Spot map# Cumulative frequency diagram (Ogive). # Scatter or dot diagram.


Question: GATHER Approach is useful for

G: Greet the clients (make them comfortable, give attention)
A: Ask/ ascertain needs/ problems or reasons for coming
T: Telling different methods/ options/ choices to solve the problem
H: Help client to make voluntary decisions
E: Explain fully the chosen decision/ action/ method
R: Return for follow-up visit


Question: Single most sensitive tool for evaluating the iron status is

Serum ferritin is the single most sensitive tool for evaluating the iron status.It reflects the size of Iron stores in the body. Values below 10 mcg/L indicate an absence of stored iron.Park 23e pg: 623


Question: Socialized medicine is

*State Medicine: Provision of free medical services to the people at government expense*Socialized Medicine: Provision of medical service and professional education by the state, but the programme is operated and regulated by professional groups rather than by the government.*Social Medicine: study of social, economical, environmental, cultural, psychological and genetic factors, which have a bearing on health.

Free medical care at government expense, regulated by professional groups.

Integration of social medicine with Health care.


Question: Isolaion is not carried out in one of the following

.isolation is the oldest communicable disease control measure.it is defined as the seperation,for the period communicability of infected persons or animals from others in such places and under such conditions as to prevent or limit the direct or indirect transmission of the infectious agent from those who are susceptible or who may spread the agent to others.the diseases in which the principle of isolation is helpful include,chickenpox,measles,german measles,cholera,diphtheria,shigellosis,hepatitis A , influenza peussis etc. ref:park&;s textbook,22nd edition,pg no 112


Question: Toxins responsible for epidemic dropsy

Ans. is 'a' i.e. Sanguinarine Epidemic dropsyIs caused d/t contamination of mustard oil with argemone oil (Argemone mexicana or prickly poppy)Active component of argemone mexicana is Sanguinarine. It interferes with the oxidation of pyruvic acid which accumulates in the blood.Symptoms of epidemic dropsySudden, non-inflammatory, bilateral swelling of legs.DiarrhoeaDyspneaCardiac failureGlaucomaEpidemic dropsy may occur at all ages except breast-fed infants.Tests used for the detection of argemone oil in mustard oilNitric acid testPaper chromatography test - This is the most sensitive testRememberFood borne diseasesToxinsLathyrismBeta Oxatyl Amino Alanine (BOAA) found in the seeds of the pulse Lathyrus sativa (Khesari dhal).Epidemic dropsySanguinarine found in argemone oilEndemic ascitesPyrrolizidine alkaloids found in weed seeds of Crotalaria (Jhunjhunia)


Question: Proposed guideline values for Radioactivity in Drinking water is

Key guideline aspects of WHO recommended drinking water quality: –
Colour < 15 true colour units (TCU)
Turbidity < 5 nephlometric turbidity units (NTU)
pH: 6.5 – 8.5
Total dissolved solids (TDS) < 600 mg/litre
Zero pathogenic microorganisms
Zero infectious viruses
Absence of pathogenic protozoa and infective stages of helminthes
Fluorine < 1.5 ppm (0.5 – 0.8 ppm: Optimum level)
Nitrates < 50 mg/litre
Nitrites < 3 mg/litre
Gross alpha radiological activity < 0.5 Bq/litre (New Guideline — WhO)
Gross beta radiological activity < 1.0 Bq/litre (New Guideline — WhO).

Gross a activity 1.0 Bq/L and Gross b activity 10.0 Bq/L

Gross a activity 1.0 Bq/L and Gross b activity 0.1 Bq/L

Gross a activity 0.1 Bq/L and Gross b activity 1.0 Bq/L

Gross a activity 10 Bq/L and Gross b activity 1.0 Bq/L


Question: Emporiatrics is study of

Emporiatrics: Study of Health of international travelers. Mainly for yellow fever. Validity of vaccine ceificate of yellow fever is 10 days - life long. Quarantine period - 6 days


Question: Minimum depth for the lining of a sanitary well is

The lining of a sanitary well should go down at least 6 meters (20 feet) to ensure that water enters from the bottom and not from the sides of the well.The lining should extend upwards for about 60-90cm (2-3 feet) above the ground.Park 23rd edition pg: 709


Question: 100% moality disease, incidence and prevalence relationship will be;

Prevalence = Incidence x Duration Duration= Prevalence/Incidence - longer the duration of the disease, the greater its prevalence. - if the disease is acute and of sho duration either because of rapid recovery or death, the prevalence rate will be relatively low compared with the incidence rate. (P < 1).


Question: Best time for breast self examination screening is


Question: Most effective sterilizing agent


Question: Barrier method

Barrier methods includes Physical, Chemical and Combined methods Physical methods include Condom, Diaphragm and Vaginal sponge Chemical methods include Foams, Creams, Suppositories and Soluble films Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 494, 495


Question: Freshly prepared ORS should be used within


Question: ASHA stands for

In NRHM Cadre of Accredited Social Health Activist (ASHA) is createdASHA must be a women resident of the village, preferably 25-45 years with formal education up to 8 1 ASHA for 1000 population. In tribal, hilly and dese areas the norm could be relaxed to 1 ASHA per habitation.Park 23e pg: 449

Health care of community & international health


Question: According to modified plan of operation, endemic areas were classified based on


Question: Ethambutol is associated with

Ethambutol may cause ‘optic neuritis’ (ocular toxicity): 463 National Health Programmes, Policies and Legislations in IndiaReview of Preventive and Social Medicine
It may lead to ‘red-green color blindness’
Patients may thus develop ‘blue vision’
Thus it is contraindicated in children < 6 years age, as they may not be able to report any deterioration of color vision.


Question: State with highest prevalence of blindness


Question: Normal waist hip ratio of a female is below

WHO CUT-OFF POINTS OF WHR Indicator CUT-OFF points Risk of metabolic complications Waist circumference >94 cm (M) >80 cm (W) Increased Hip cirrcumference >102 cm (M) >88 cm (W) Substantially increased Waist-Hip ratio >= 0.95(M) >= 0.80(W) Substantially increased Ref: Park 23rd edition Pgno : 400 WC & WHR, WHO Consultation 2008


Question: Potential Support Ratio (PSR) is defined as

Number of persons aged 15 to 65 per one older person aged more than or equal to 65 years

Number of persons aged 15 to 65 per children below 15 years

Number of person aged 15 to 65 per one older person aged > 65 and younger person < 15 years

Number of persons aged 15 to 65 per one older person aged >/= 65 years

Number of persons aged 15 to 65 persons older person aged > 60 and younger person < 15 years


Question: The Fourth stage of demographic cycle is know as


Question: The expectation of life, free of disability is known as

Sullivan&;s index or disability-free life expectancy or active life expectancy is the average number of years an individual is expected to live free of disability if the current pattern of moality and disability continue to apply.Park 23e pg:26


Question: Perinatal mortality rate includes

Abortions, Stillbirths, deaths within first week of life

Deaths from 28 weeks to with first week of life


Question: Hormonal contraceptive of choice in a lactating woman is

Progestogen-only pill (POP) This pill is commonly referred to as "minipill" or "micropill". It contains only progestogen, which is given in small doses throughout the cycle. The commonly used progestogens are norethisterone and levonorgestrel. The progestogen-only pills never gained widespread use because of poor cycle control and an increased pregnancy rate. However, they have a definite place in modern- day contraception. They could be prescribed to older women for whom the combined pill is contraindicated because of cardiovascular risks. They may also be considered in young women with risk factors for neoplasia. The evidence that the progestogens may lower the high-density lipoproteins may be of some concern. Ref : Park 25th edition Pgno : 535


Question: IFA tablets given during pregnancy contains.

60mg elemental iron and 500ug Folic acid

100mg elemental iron and 400ug Folic acid

60mg elemental iron and 400ug Folic acid

100mg elemental iron and 500ug Folic acid


Question: Most difficult criterion to establish Causal Association in aetiology of a disease is


Question: Graphical representation of frequency distribution curve is

Ref:Park's Textbook of Preventive and Social Medicine 25th Ed


Question: IUCD most commonly associated with expulsion

The expulsion rate among IUCDs is high for lippes loop (12-20% ) Expulsion can be paial or complete Expulsion usually occurs during the first few weeks following inseion or during menstruation Reference: Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 497, 499


Question: Single disease control strategy done by program known as

Health systems are made up of: * "Horizontal system" of general services, providing prevention and care for prevailing health problems. "Veical programmes" for specific health conditions .


Question: Example of one way communication


Question: Cyclodevelopmental life cycle is seen in

.cyclodevelopmental form of life cycle is the one in which the disease agent undergoes only development but no multiplication.examples include mainly the life of microfilaria in mosquito. ref:park&;s textbook of preventive and social medicine,edition 22,pg no 94


Question: NRHM (National Rural Health Mission) is achieved through creation of

C. i.e. (Accredited social health activist) (364- 365 - Park 19th)* NATIONAL RURAL HEALTH MISSION (NRHM) - launched on 5th april 2005for a period of 7 years (2005-2012) The mission seeks to improve rural health care delivery system.Plan of action to strengthen infrastructure1. Creation of a cadre of Accredited social health activist (ASHA)**2. Strengthenng sub centres, PHC, CHCASHA1. Must be the resident of the village - women (25- 45 years) with formal education upto eighth class2. One ASHA for 1000 population3. The target is to select and train at least 40% of ASHA in the first year* Under the RCH programme a community health centre should be equipped to function as a first Referral Unit (FRU)**


Question: Pearls index

Pearl index is defined as the number of failures per 100 woman years of exposure (HWY) Failure rate per Hundred Women Years = Total accidental pregnancies X 1200/ Total months of exposure Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 510


Question: Quarantine is related to>

Ans. is 'b' i.e. Maximum incubation period Quarantine - has been defined as The limitation of freedom of movement of such well person or domestic animals exposed to communicable disease for a period of time no longer than the longest usual incubation period of the disease in such a manner to prevent effective contact with those not so exposed. "Also KnowIsolation -- It is the oldest communicable disease control measure.- It is defined as "separation for the period of communicability of infected persons or animals from others, as to prevent or limit the direct or indirect transmissions of the infectious agent from those injected to those who are susceptible, or who may spread the agent to others"In contrast to isolation, quarantine applies to restriction on the healthy contacts of an infectious disease. *


Question: Association of Psychomotor learning


Question: Employer's contribution to Employees State Insurance

Hospital waste and disaster management, Occupational health


Question: Hardy Weinberg law is related to

Hardy Weinberg law: states that the genotype frequencies in a population remain constant or are in equilibrium from generation to generation unless specific disturbing influences are introduced.

Genetic equilibrium (HW law) is a basic principle of population genetics; the entire principle is based on Mendelian genetics.
Deviations in HW law:

HW law fails to apply in:

Non-random mating (assortative mating)
New mutations
Genetic drift
Gene flow
Natural selection (mortality selection, fecundity selection)
Small populations migrations
Dynamic populations.

HW law assumes that human population is static, large and has random mating.


Question: Not a component of communication process

Component of communication process :

Sender.
Message.
Receiver.
Feedback.
Channels.


Question: 'Burning Sole Syndrome' is seen in deficiency of

Pantothenic acid deficiency was thought to be cause of 'Burning Feet/Sole syndrome' among prisoners of World War II Pantothenic acid is required by adrenal coex Ref: Harrison's 19th edition Pgno : 465


Question: Concept of multipurpose workers was given by


Question: Best disinfectant for cholera stools is


Question: Sickness absenteeism is an useful index to assess

Sickness absenteeism occurs when employees miss work for reasons stemming from health problems. The rate of sickness absenteeism is linked to the overall health of the workforce and also to specific factors in each individual profession. Ref : Park 23rd edition Pgno : 810


Question: The most impoant function of sentinel surveillance is

Sentinal surveillance It estimates disease prevalence in a population. It's a method for identifying the missing cases and thereby supplementing the notified cases. It provides more detailed information than that which could be obtained from the traditional notification system. Ref: Park's Textbook of Preventive and Social Medicine; 24th edition - Page no. 45

To find the total amount of disease in a population

To determine the trend of disease in a population


Question: Name of mumps vaccine is

Widely used live attenuated mumps vaccine include the jeryl Lynn, RIT 4385, Leningrad-3, L-Zagreb and Urable strains. The current mumps strain (jeryl Lynn) has the lowest associated incidence of post-vaccine aseptic meningitis.


Question: Casal's Necklace is seen in deficiency of

Pellagra Pellagra occurs due to Vitamin B3 (Niacin) deficiency Pellagra is characterized by by 4D's : 1.Diarrhoea 2.Dermatitis 3.Dementia 4.Death. Skin rash in Pellagra may appear as pigmented and scaly in areas exposed to sunlight. Especially neck when it is known as 'Casal's Necklace' Ref: Park 25th edition Pgno : 657 Harrison's 15th edition Pgno : 463


Question: Range of flight of Aedes

Description: Range of flight: Anopheles 3-5 km Culex 11 km Aedes 100 m Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 831


Question: Components of Kuppuswamy scale

Income, occupation and education are components of Kuppuswamy scale. Modified Kuppuswamy scale: Scale of socioeconomic status of Urban families It comprises of 3 components: Education status of head of family Occupation status of head of family Income of family per month It has: Upper middle 16-25 Lower middle 11-15 Upper lower 05-10 Lower 00-04


Question: Burden of disease is detected by

Disability Adjusted Life Years (DALY) is a measure of overall disease burden expressed as a number of years lost due to ill health, disability or early death. Ref: 25th edition Park&;s Textbook of Preventive and Social Medicine, Page no. 26


Question: ROME scheme recommended by


Question: Likelihood ratio for positive results is;

Likelihood ratio for Positive :
       LR+= Sensitivity / (1-specificity)
Likelihood Ratio for Negative :
      LR- = (1-Sensitivity) / Specificity


Question: Denominator of dependency ratio includes population of age


Question: Indicator of Remote contamination of water

Bacteriological Indicators of Water Quality E Coli: Best indicator. Ideally water should be coliform free except large urban water supplies where up to 5% contamination is acceptable if samples are taken up to 1year. For this screening test used is presumptive coliform count, MPN (Most Probable Number) and multiple tube test. Diagnostic test is EIJKMAN'S test. Faecal streptococci: Best tells recent contamination Clostridium perfringens: Best tells remote contamination


Question: Training period of ASHA

Ref:Park's Textbook of Preventive and Social Medicine 25th Ed

Health care of community & international health


Question: Tertiary prevention among the following is


Question: Demographic process includes

Demographic process work on

Marriage.
Fertility.
Mortality.
Migration.
Social mobility.


Question: Best indicators of the pollution


Question: Training duration of Traditional bih attendant (TBA) is

Traditional bih attendant (TBA) Location - village level Population norm - 1/1000 Education - NO Training - 30 days (1 months)

Rural & Urban Health Centres, Workers, Norms


Question: Secondary attack rate (SAR) denominator includes


Question: Under passive surveillance for tuberculosis, indication for sputum microscopy cough is for weeks or more


Question: Epidemic dropsy is caused by


Question: Ujjwala scheme is for prevention of

UJJAWALA SCHEME:

Description: A Comprehensive Scheme for Prevention of Trafficking and Rescue, Rehabilitation and Re-integration of Victims of Trafficking for Commercial sexual exploitation
Ministry: Ministry of Women and Child Development
Launch: 4th December 2007

Target Group/ Beneficiaries (V-V): Women and children, who are
– Vulnerable to trafficking for commercial sexual exploitation
– Victims of trafficking for commercial sexual exploitation
Main Components
– Prevention
– Rescue
– Rehabilitation
– Re-Integration
– Repatriation (Cross-border)


Question: Endemic Acites and Epidemic dropsy caused due to, adulterants respectively

Argemone mexicana oil and Claviceps fusiformis

Crotalaria seeds and Argemone mexicana oil

Claviceps fusiformis and Lathyrus sativus


Question: Subacute combined degeneration of spinal cord is due to deficiency of


Question: KSY is

At present, there are two schemes for adolescent girls &;Kishore shakti yojana&; and &;Nutrition programme for adolescent girls&;Kishore shakti yojana is being implemented using the infrastructure of ICDS. The scheme targets adolescent girls in the age group of 11 to 18 years and address their needs of self-development, nutrition and health status, literacy and numerical and vocational skills.Nutrition programme for adolescent girls also being implemented using the infrastructure of ICDS. Undernourished adolescent girls in the age group 11 to 19 years (<30 in 11-15 ages and <35 in 15 to 19) are covered under the scheme.Park 23e pg: 592

Empowerment of females under maternity benefit scheme

Free and compulsory education for girl child

Child care home scheme female juvenile delinquents


Question: Colours code not used in IMNCI

Integrated management of neonatal and childhood illness Red -urgent referral Yellow - Treated as opd Green - Home management


Question: In the demographic cycle, the contraction of demographic gap starts in


Question: Corpulence Index Normal valve


Question: Under NPCB,screening of school children is first done by

SCHOOL EYE SCREENING PROGRAMME :(According to NPCB) 6-7 per cent of children aged 10-14 years have problem with their eye sight affecting their learning at school. Children are being first screened by trained teachers. Children suspected to have refractive error are seen by ophthalmic assistants and corrective spectacles are prescribed or given free for persons below povey line. Ref: Park's Textbook of Preventive and Social Medicine 25 th Edition Pgno : 458


Question: Acrodermatitis enteropathica is

Inherited disorder of impaired uptake of zinc from body

Inherited disorder of excessive excretion of zinc from body

Inherited disorder of excessive excretion of copper from body

Inherited disorder of impaired uptake of copper from body


Question: A tool for increasing consensus among a large no. of people is


Question: The reference protein is


Question: The noh Kerelia project evaluate risk factors of

Noh kerelia project:Noh Kerelia is a county in the eastern pa of Finland, where CHD is paicularly common. A multiple risk factor intervention trial was staed in 1972. The project had two aims: 1. to reduce the high levels of risk factors for cardiovascular diseases and 2. to promote the early diagnosis, treatment and rehabilitation of patients with cardiovascular disease. Ref: Park; 23rd ed; Pg 371


Question: Association of cause and effect testing in different stting by different methods to assess

Ans. is 'c' i.e., Consistency Consistency of association The association is consistent if the results are replicated when studies in different settings and by different methods. For example, different studies in different settings have proved smoking as one of the cause for lung cancer - Smoking has consistent association with lung cancer.


Question: The systemic study of human disease and social conditions/factors is known as

SOCIAL PATHOLOGY The term "social pathology" is given a restricted interpretation linking it to povey, crime, delinquency and vagrancy. In the modern context, the term is also used to describe the relation between disease and social conditions. The social pathology of accidents, diabetes, cardiovascular disease, cancer, chronic bronchitis have all been subject of recent investigations in medical literature. Social pathology is uncovered by "social surveys". Ref : Park 25th edition Pgno : 710

Social science, Mental health & Genetics


Question: Acute Hepatitis B marker(s) is/ are


Question: Besides 3 D’s (Diarrhoea, Dermatitis & Dementi(a) of Niacin deficiency, 4th D indicates


Question: "Secular trends' relates with

(C) Time > The term secular trends implies changes in the occurrence of disease i.e. a progressive increase or decrease over a long period of time generally several years or decades> Cyclic trends : refer to diseases occurring in cycles spread over short period of time which may be days, weeks, months or years> Seasonal tread: refers to diseases due to seasonal variation


Question: Failure rate of Pomeroy's technique is

Pomeroy method The most popular technique of tubal ligation is the Pomeroy operation. The fallopian tube is identified on each side, brought out through the incision, and the middle poion is formed into a loop which is tied at the base with catgut and excised. Thefailurerateis only0.4% and it is mainly due to spontaneous canalization. The operation is simple, requires sho hospitalization, does not require sophisticated and expensive equipment like a laparoscope, and can be performed in primary health centre by a doctor trained in this procedure. It is surgically reversible. Ref: Shaw textbook of gynecology 16th edition Pgno : 282


Question: Most reliable test for screening of diabetes mellitus


Question: Physical Quality of life Index Components

Components of PQLI:Infant Moality Life expectancy at age oneLiteracyPQLI is scaled from 0 to 100.


Question: Population count is taken on

The decennial Census of India has been conducted 15 times, As of 2011. While it has been conducted every 10 years, beginning in 1872, the first complete census was taken in the year 1881. Post 1949, it has been conducted by the Registrar General and Census Commissioner of India under the Ministry of Home Affairs, Government of India.
All the census since 1951 are conducted under 1948 Census of India Act.
The last census was held in 2011 and next census will be held in 2021.


Question: The completed family size may be estimated by

Total feility rate represents the average number of children a woman would have if she were to pass through her reproductive years bearing children at the same rates as the women now in each age group It gives the appropriate magnitude of completed family size Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 489


Question: Denominator in maternal mortality rate (MMR) is

Total no of females in Reproductive age group


Question: An example of a two way discussion

One way communication
Two way communication

DIDACTIC METHOD
Examples :

Lecture method
Radio
TV
News paper

SOCRATIC METHOD
Examples :

Symphosium
Panel discussion
Four group discussion


Question: Economic benefits of any programme are compared with the costs incurred in

Cost-benefit analysis, in which benefits are compared to cost of the program. The benefits are expressed in monetary termsThe main drawback with this technique is that benefits in the health field, as a result of a paicular programme, cannot always be expressed in monetary terms.Park 23e pg:871


Question: Iodine RDA is

Requirement of iodine The daily requirement of iodine for adults is placed at 150 micrograms. The recommendations of WHO of 250 mcg per day for iodine during pregnancy have also been adopted. This amount is normally supplied by well- balanced diet and drinking water except in regions where Food and water are deficient in iodine. Ref:Park's Textbook of Preventive and Social Medicine 25th Ed Pgno : 662


Question: In sample registration system independent survey is done at every

SRS is a dual record system initiated to provide reliable estimates of bih and death rates.It consists of a continuous enumeration of bihs and deaths by an enumerator and an independent survey every 6 months by an investigator-supervisor.Park 23e pg: 841


Question: For a given population, minimum no. of newborns to be examined for calculating percentage of LBW of babies

Low bih weight (LBW): Bih weight less than 2500grams (2.5 kg) . It includes both pre-term (<37 weeks POG) and full-term (>37 weeks POG) babies. Prevelence of LBW: 15% (World); 18% (India); If cutoff for LBW is reduced to 2.0 kg, expected prevelence of LBW inn India will be 5.5% LBW is regardless of gestational age. Depending on the population, the percentage of LBW be based on measurements of atleast 500 babies. Goal for LBW in National Health Policy 1983: Reduce LBW to <10% by 2000. Ref: Park 22th edition Pgno: 495


Question: Types of Growth Chas used by Anganwadi workers (ICDS) for growth monitoring

ICDS GROWTH CHA: In NRHM and ICDS, Government of India has adopted WHO Child Growth Standards (also known as MGRS 'Multicentre Growth Reference Study' Standards) Normal zone - Road of health Below -2 SD: Malnutrition Below -3 SD: Severe Malnutrition


Question: Holder method of pasteurization is not effective to kill

All nonsporing pathogens like Mycobacterium, Brucellae and salmonella are destroyed by pasteurisation Coxiella burnetti is relatively heat-resistant and may survive Holder method Ref: Essential of microbiology by Kumar 1st edition Pgno : 27 Pasteurization of milk Pasteurization may be defined as the heating of milk to such temperatures and for such periods of time as are required to destroy any pathogens that may be present while causing minimal changes in the composition, flavour and nutritive value (WHO, 1970). There are several methods of pasteurization. Three are widely used : (1) Holder (Vat) method : In this process, milk is kept at 63-66 deg C for at least 30 minutes, and then quickly cooled to 5 deg C. Vat method is recommended for small and rural communities. In larger cities, it is going out of use. (2) HTST method : Also known as "High Temperature and Sho Time Method". Milk is rapidly heated to a temperature of nearly 72 deg C, is held at that temperature for not less than 15 seconds, and is then rapidly cooled to 4 deg C. This is now the most widely used method. Very large quantities of milk per hour can be pasteurized by this method. (3) UHT Method : Also known as "ultra-high temperature method." Milk is rapidly heated usually in 2 stages (the second stage usually being under pressure) to 125 deg C for a few seconds only. It is then rapidly cooled and bottled as quickly as possible. Pasteurization is a preventive measure of public health impoance and corresponds in all respects to the modern principles of supplying safe milk. Pasteurization kills nearly 90 per cent of the bacteria in milk including the more heat-resistant tubercle bacillus and the Q fever organisms. But it will not kill thermoduric bacteria nor the bacterial spores. Therefore, despite pasteurization, with subsequent rise in temperature, the bacteria are bound to multiply. In order to check the growth of microorganisms, pasteurized milk is rapidly cooled to 4 deg C. It should be kept cold until it reaches the consumer. Hygienically produced pasteurized milk has a keeping quality of not more than 8 to 12 hours at 18 degC. Ref: Park 25th edition Pgno : 692


Question: Drug of choice for cholera chemoprophylaxis is


Question: Acceptable safe dose of radiation during pregnancy is

Exposure to radiation is a positive danger to the developing fetus. The most common source of radiation is abdominal X-ray during pregnancy.Leukemias are significantly seen in children exposed to intrauterine X-ray in addition to congenital malformationsX-rays should be carried out only for definite indications with dosage kept to a minimum Ref: Park; 23rd ed; Pg 527


Question: CBNAAT stands for

Caridge-based nucleic acid amplification test (CBNAAT) is a recently introduced polymerase chain reaction (PCR) based method for detection of TB. It also detects rifampicin resistance as it targets the rpoB gene of mycobacteria. CBNAAT is a Mycobacterium tuberculosis-specific automated, caridge-based nucleic acid amplification assay, having fully integrated and automated amplification and detection using real-time PCR, providing results within 100 minutes. It is a highly specific test as it uses 3 specific primers and 5 unique molecular probes to target the rpoB gene of M. tuberculosis, which is the critical gene associated with rifampicin resistance.

Caridge based nucleic acid amplification test

Computer based nucleic acid amplification test

Chromatograohy based new amino acid test


Question: Chiggerosis is due to


Question: The source of endogenous radiation is

Ans. is 'b' i.e.. Potassium o Radiation is pa of man's environment.


Question: After birth, care of eye of newborn is by


Question: Nalgonda technique is used in


Question: Maize is pellagragenic due to excess content of

Amino acid imbalance caused by an excess of leucine is the cause of pellagra in maize (also jowar), eaters.Excess of leucine appears to interfere in the conversion of tryptophan to niacin.Park 23e pg: 619


Question: Most common cancer world wide

Most common cancer in males in India → Oro-pharyngeal Ca (Aero-digestive Ca).
Most common cancer in males in world → Lung Ca. o Most common cancer in females in India → Cervical cancer,
Most common cancer in females in world → Brast Ca. o Most common overall cancer in the world (combined male & female) → Lung cancer,
Most common cancer related death in males in India & in world → Ca lung, o Most common cancer related death in females in India & in world → Breast cancer.


Question: IPV is given at

As a pa of Polio endgame strategy, Inactivated Polio Vaccine (IPV) vaccine has been introduced across all the states of the country. IPV is provided either as a single dose at 14 weeks of age or as two fractional doses at 6 weeks and 14 weeks of age.Park 24e pg no: 218


Question: John snow;s discovery of cholera is an example

.John Snow&;s map of cholera outbreaks from nineteenth century London changed how we saw a disease.John Snow who famously identified a pump as being the source of a cholera outbreak in 1854. Dr. Snow believed sewage dumped into the river or into cesspools near town wells could contaminate the water supply, leading to a rapid spread of disease. In August of 1854 Soho, a suburb of London, was hit hard by a terrible outbreak of cholera. Dr. Snows himself lived near Soho, and immediately went to work to prove his theory that contaminated water was the cause of the outbreak. "Within 250 yards of the spot where Cambridge Street joins Broad Street there were upwards of 500 fatal attacks of cholera in 10 days," Dr. Snow wrote "As soon as I became acquainted with the situation and extent of this irruption (sic) of cholera, I suspected some contamination of the water of the much-frequented street-pump in Broad Street." Dr. Snow worked around the clock to track down information from hospital and public records on when the outbreak began and whether the victims drank water from the Broad Street pump. Snow suspected that those who lived or worked near the pump were the most likely to use the pump and thus, contract cholera. His pioneering medical research paid off. By using a geographical grid to cha deaths from the outbreak and investigating each case to determine access to the pump water, Snow developed what he considered positive proof the pump was the source of the epidemic.


Question: Screening for breast cancer using mammography is

Secondary prevention is the identification and treatment of premalignant or subclinical cancers. Screening by means of mammography is a typical example of secondary prevention. Teiary prevention is defined as symptoms control and rehabilitation. Screening for breast cancer There is evidence that screening for breast cancer has a ourable effect on moality from breast cancer. The basic techniques for early detection of breast cancer are : (a} breast self-examination (BSE) by the patient (b) palpation by a physician (c) thermography (d) mammography. All women should be encouraged to perform breast self- examination. Breast cancers are more frequently found by women themselves than by a physician during a routine examination. Although the effectiveness of BSE has not been adequately quantified, it is a useful adjuvant to early case detection. In many countries, BSE will probably be the only feasible approach to wide population coverage for a long time to come. Palpation is unreliable for large fatty breasts. Thermography has the advantage that the patient is not exposed to radiation. Unfounately, it is not a sensitive tool. Mammography is most sensitive and specific in detecting small tumours that are sometimes missed on palpation. The use of mammography has three potential drawbacks: (i) exposure to radiation. This may amount to a dose of 500 milliroentgen compared to a 30-40 milliroentgen dose received in chest X-ray. Therefore, there has been concern about exposure to radiation from repeated mammographies and the risk of breast cancer developing as a result (ii) mammography requires technical equipment of a high standard and radiologists with very considerable experience - these two factors limit its more widespread use for mass screening purposes, and (iii) biopsy from a suspicious lesion may end up in a false-positive in as many as 5-10 cases for each case of cancer detected. Although recent evidence points to the superiority of mammography over clinical examination in terms of sensitivity and specificity, medical opinion is against routine mammography on the very young. Women under 35 years of age should not have X-rays unless they are symptomatic or a family history of early onset of breast cancer Ref : Park 23rd edition Pgno : 387


Question: The 10days rule is related to

The "10-day rule" recommended that, in women of child-bearing potential, non-urgent x-ray examinations that entailed pelvic irradiation should be restricted to the first 10 days of the menstrual cycle. Its rationale was to avoid irradiating a fetus before the mother realised that she was pregnant. In 1984, however, the International Commission on Radiological Protection repoed that there was little, if any, the risk of damaging the fetus during the first two weeks of gestation--that is before the first period was missed.


Question: Highest Contraceptive failure is repoed in

- Spermicidal methods has pearl index of 10-25 / HWY ( Highest ). - Contain chemical - Non oxynol 9 - MOA - By rupture of plasma membrane of Acrosomal cap.


Question: Duration of maternal benefit under ESI acts is

Ans. is 'c' i.e., 12 wks Maternity benefit For confinement, the duration of benefit is 12 weeks. o For miscarriage it is 6 weeks. o For sickness arising out of confinement it is 30 days. o The benefit is allowed at about full wages.


Question: Chemical used in vaginal sponge is

Vaginal sponge is a small polyurethane foam sponge saturated with spermicide, nonoxynol-9 It comes under barrier method of contraception Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 495


Question: Berkesonian bias refers to

Ans. is 'a' i.e., different rates of admission to the hospital Bias is any systematic error in the determination of the association between the exposure and diseaseMany varieties of bias are seen: a) Bias due to confounding : This bias arises because of the confounding factors."A confounding factor is defined as one which is associated with both exposure and disease and is distributed unequally in study and control groups *. More specifically a confounding factor is one that although associated with exposure under investigation is itself independent of any such associations, a risk factor for the disease." * This bias can be removed by matching in case control study.Memory or recall bias : When cases and controls are asked questions about their past history, it may be for the cases to recall the existence of certain events or factors than the controls who are healthy personsSelection Bias: The cases and controls may not be representative of cases and controls in the general population.Interviewer bias: Bias may also occur when the interviewer knows the hypothesis and also knows who the cases are. This prior information may lead him to question the cases more thoroughly than controls regarding a positive history of the suspected causal factor. This type of bias can be eliminated by double blinding.Lead time bias: This leads to an apparent increase in survival among patients whose disease is detected by screening. For example 5 year survival of cancer patients identified on screening might appear to be prolonged simply as a result of starting to count the survival time earlier in the course of disease.Berksonian Bias: It's a special example of bias termed after Dr. Joseph Berkson who recognized this problem. The bias arises because of the different rates of admission to hospitals for people with different diseases.

Different rates of admission to the hospital

Systematic difference in characteristic cases and controls


Question: For the yellow fever control, distance around airport to be kept free of Aedes breeding is


Question: Program for screening developmental delay, deficiency and neonatal genetic defects

Rashtriya Bal Swasthya Karyakram - RBSK (Child Health Screening and Early Intervention Services) is an initiative aiming at early identification and early intervention for children from bih to 18 years to cover 4 'D's viz. Defects at bih, Deficiencies, Diseases, Development delays including disability. Selected Health Conditions for Child Health Screeniong & Early Intervention Services Defects at Bih Deficiencies 1. Neural tube defect 2. Down' Syndrome 3. Cleft Lip & Palate / Cleft palate alone 4. Talipes (club foot) 5. Developmental dysplasia of the hip 6. Congenital cataract 7. Congenital deafness 8. Congenital hea diseases 9. Retinopathy of Prematurity 10. Anaemia especially Severe anaemia 11. Vitamin A deficiency (Vitot spot) 12. Vitamin D Deficiecny, (Rickets) 13. Severe Acute Malnutrition 14. Goiter Diseases of Childhood Developmental delays and Disabilities 15. Skin Conditions (Scabies, fungal infection and Eczema) 16. Otitis Media 17. Rheumatic hea disease 18. Reactive airway disease 19. Dental conditions 20. Convulsive disorders 21. Vision Implairment 22. Hearing Impairment 23. Neuor-motor Impairment 24. Motor delay 25. Cognitive delay 26. Language delay 27. Behaviour disorder (Autism) 28. Learning disorder 29. Attention deficit hyperactivity diorder 30. Congenital Hypothyroidism, Sickle cell anemia, Beta thalassemia (Optional) Rashtriya Kishor Swasthya Karyakram : Development of adolescent population (10-19 yrs); Weekly supplementation of 60mg of iron & 500 mcg Folic Acid. Develop menstrual hygiene by giving a pack of 6 sanitary napkins for 6 Rs by ASHA. Enhancement of mental health; prevention of violence, abuse.

Rashtriya Bal Swasthya karyakaram (RBSK)


Question: Iron requirement per day in pregnant woman is

Iron intake per day in Non-Pregnant woman is 21mg/day
Iron required per day in Non-pregnant woman is 1.6mg/day
Iron intake per day in Pregnant woman is 35mg/day
Iron requirement per day in pregnant woman is 2.8mg/day
Total iron requirement in pregnancy is 1000mg


Question: Primary prevention includes

Primary prevention is defined as action taken prior to the onset of the disease which removes the possibility that a disease will ever occur. It includes health promotion and specific protection. Health promotion includes health education + environmental modifications+ nutritional interventions+ lifestyle and behavioral changes. Specific protection- fundamental public health measures and activities such as sanitation; infection control; immunization; protection of food, milk, and water supplies; environmental protection; and protection against occupational hazards and accidents, chemoprophylaxis, use of specific nutrients. Reference: Park's Textbook of Preventive and Social Medicine, 24th edition, Page no. 47


Question: Treatment of recently sputum positive case of pulmonary TB is

Ans. c (RMP + INH + PZM + ETM); (Ref. Park PSM 22nd/pg. 175)Treatment categories and sputum examination schedule in DOTS chemotherapy in IndiaTREATMENT REGIMENSPUTUM EXAMINATIONS FOR PULMONARY TBCategory of treatmentType of patientRegimenPret- reat- ment sputumTest at monthIF: result is-----THEN:New cases Category I Red BoxNew sputum smear-positiveNew sputum smear-negativeNew extra-pulmonary**New others2(HRZEE)3+4(HR)3+2-Start continuation phase, test sputum again at 4 and 6 months +Continue intensive phase for one more monthComplete the treatment in 7 monthsPreviouslyTreatedCategory IIBlue BoxSputum smear positiveRelapse***Sputum smear-positiveFailure***Sputum smear-positive treatment after default others2(HRZES)3+1(HRZE)3+5(HRE)3+3-Start continuation phase, test sputum again at 5 months 6 months, completion of treatment + + Continue intensive phase for one more month, test sputum again at 4 months if sputum is positive send sputum for culture and drug sensitivity as it might be a case of MDR-TB* The number before the laetters refers to the number of months of treatment. The subcript after the letters refers to the number of doses per week. H; Isoniazid (600 mg), R: Rifampi (450 mg), Z: pyrazinamide (1500 mg), E: Ethambutol (1200 mg), S: Streptomycin (750 mg).Patients who weigh more than 60 kg receilve additional Rifampicin 150 mg. Patients more than 50 years old receive streptomycin 500 mg.Patients in categories I and II, who have a positive sputum smear at the end of the initial intensive phase, receive an additional month of intensive phase treatment.** Examples of seriously ill extra-pulmonary TB cases are meningitis, disseminated TB, tuberculous pericarditis, peritonitis, bilateral or extensive pleurisy, spinal TB with neurological complications and intestinal and genito-urinary TB.*** In rare and exceptional cases, patients who are sputum smear-negative or who have extra-pulmonary disease can have relapse or failure. This diagnosis in all such cases should always be made by an MO and should be supported by culture or histological evidence of current, active tuberculosis. In these cases, the patient should be categorized as 'Other' and given Category II treatment. Any patient treated with Category I who has a positsive smear at 5 months of treatment should be considered a failure and started onCategory II treatment, afresh. If category I sputum smear-ve case fails to improve or if patient develops pulmonary signs and positive smear at the end of intensive phase, it is considered treatment failure. Start category II treatment and confirm failure by culture and perform DST.


Question: According to Motor vehicle Act 1988, punishable quantity of Alcohol in blood is

(A) 30 ml In 100 ml of blood> I.P.C. Sec. 185 Driving by a drunken person or by a person under the influence of drugs. - Whoever, while driving, or at- tempting to drive, a motor vehicle -(a) has, in his blood, alcohol exceeding 30 mg Per 100 ml. of blood detected in a test by a breath analyser, or(b) is under the influence of a drug to such an extent as to be incapable of exercising proper control over the vehicle.> shall be punishable for the first offence with imprisonment for a term which may extend to six months, or with fine which may extend to two thousand rupees, or with both; and for a second or subsequent offence, if committed within three years of the commission of the previous similar offence, with imprisonment for a term which may extend to two year, or with fine which may extend to three thousand rupees, or with both.> Explanation - For the purposes of this section, the drug or drugs specified by the Central Government in this behalf, by notification in the Official Gazette, shall be deemed to render a person incapable of exercising proper control over a motor vehicle. Corresponding Law. - Section 185 corresponds to section 117 of the Motor Vehicles Act, 1939. Objects and Reasons. - Clause 185 provides for punishment or driving under the influence of drink or drug


Question: Regressiom between height and age follows y=a+bx.THe curve is

Ref:Park's Textbook of Preventive and Social Medicine 25th Ed


Question: Giving Benzathine penicillin in RHD is a type of

Ans. is 'b' i.e. Secondary prevention Primary prevention is action taken prior to the onset of disease.Secondary prevention is action which halts the progress of the disease at its incipient stage and prevents complications.Thus giving Benzathine pencillin in RHd is a type of secondary prevention.


Question: The following rodent is the natural reservoir of plague


Question: RCH 1 does not include

Ref:Park's Textbook of Preventive and Social Medicine 25th Ed