Professional Documents
Culture Documents
A; Breast milk is almost completely digested and utilized for growth, whereas much of cows milk protein is excreted by the
infants undigested producing whitish curdy stool. Breast milk contains other proteins whose functions are not nutritive, but
anti infective e.g IgG, Lysozyme, living cells, etc. human milk is virtually a living fluid.
Human Milk
ORS
Blood
I/V RL
B;
Comfort zones may be defined as the range of ETs over which the majority of adults feel comfortable. Comfortable thermal
conditions are those under which a person can maintain normal balance between production and loss of heat, at normal
body temperature and without sweating.
Comfort zones evaluated in India are as below:
Corrected effective temperature deg C
1. Pleasant and cool
- 20
2. Comfortable and cool
- 20 25
3. Comfortable
- 25 27
4. Hot and uncomfortable
- 27 28
5. Extremely hot
- 28 +
6. Intolerably hot
- 30 +
Deg C / 4 = F-32 / 9
69 76 F
77 80o F
81 82o F
83 86o F
The prescribed chloride content of drinking water should be below:
B;
Substances and parameters in drinking-water that may give rise to complaints from consumers
Constituents or characteristics
Levels likely to give rise to consumer complaints
Physical parameters
Colour
15 TCU
Taste and odour
Temperature
Turbidity
5 NTU
Inorganic constituents
Aluminium
0.2 mg/L
Ammonia
1.5 mg/L
Chloride
250 mg/L
Copper
1 mg/L
Hardness
Hydrogen sulfide
Iron
Manganese
Dissolved oxygen
pH
Sodium
Sulphate
Total dissolved solids
Zinc
100 mg/lit
200 mg/lit
300 mg/lit
500 mg/lit
Hospital waste product accounts all except: .
0.05 mg/L
0.3 mg/l
0.1 mg/L
200 mg/L
250 mg/L
1000 mg/L
3 mg/L
C;
Average composition of hospital waste in India
Material
% (Wet-wt basis)
1. Paper
15
2. Plastics
10
3. Rags
15
4. Metal (Sharp etc)
1
5. Infectious waste
1.5
6. Glass
4
7. General waste (food waste,
53.5
sweepings from hospital
premises etc)
Paper 15%
Plastic 10%
D; According to the table, 10 new cases of tuberculosis developed among the 500 persons belonging to households with a
case of tuberculosis at the time of the first survey. Because, these 500 persons were followed for 2 years, the number of
person-years of exposure is 1000. Therefore, the incidence rate is calculated as follows:
10 new cases
---------------------- = 10 cases per 1000 person-years
500 persons x 2 years
0.02
0.01
1.0
10
Studies in medicine are designed to identify cause of disease. The ultimate
goal of such studies is to alter the frequency or severity of these diseases. All
of the following are considerations in the determination of causality EXCEPT:
C; Determination of the presence of a cause and its effect at the same time, such as on a cross-sectional survey, does not
support causality. The cause must be shown to precede the effect in time. In some cases, the cause may be years in the
past, such as with radiation exposure and thyroid cancer. In this case, these events would not be apparent at the same
time, yet the relationship would be causal.
Strength of association
7
True statements concerning cohort studies include all the following except:
D; In cohort studies, a group of subjects is defined on the basis of certain baseline characteristics and followed over time
for the development of the disease (or other outcome) under study. The incidence of disease in subjects with various
characteristics can then be compared with the incidence in subjects without those characteristics. If a suitable cohort can
be identified from past records, a retrospective cohort study is possible. Cohort studies are not necessary to estimate
prevalence. The prevalence of disease is the proportion of the population who have it at one point in time. Prevalence can
be estimated from cross-sectional studies.
D; In decision analysis, utilities refer to the relative values placed on various outcomes. For example, perfect health might
be assigned a utility of 100, and death assigned one of 0. What, then, would the utility be for life with moderate back pain?
With careful questioning, one finds that most patients place a higher value on life with disability than would be anticipated.
10
Confounding
Selection bias
Random error
Lead-time bias
Which statement is true concerning measures of central tendency ?
D; The exact proportion of deaths due to pulmonary embolism is not known and could only be determined by a study of a
random sample of all persons who died. This would avoid the problem of selection bias (only certain persons undergo
autopsies). The study should be large enough to avoid random error (perhaps the cited study found emboli in three of five
autopsies), and the investigators should have careful and precise definitions of pulmonary embolism to avoid overdiagnosis of the condition. The association between pulmonary embolism and death may be due to confounding if some
other factor causes both. Thus, pulmonary embolism, though present, may not be the cause of death. Lead-time bias
refers to an apparent increase in survival among persons 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.
B;
When more outlying values are larger than the rest of the values, the data are said to be skewed to the right, and the
median is smaller than the mean. If more outlying values are smaller than the rest, the data are said to be skewed to the
left, and the median is larger than the mean. The median is more robust than the mean because it is less sensitive to
extreme observations and is a more appropriate measure of central tendency when extreme values are part of the data
set. The mode, the mean, and the median are all the same for a symmetrical distribution of data. These distributions can
be illustrated as follows:
If more outlying observations are smaller than the rest of the values , the
data are skewed to the right
If more outlying observation is larger than the rest of the values ,the median will be
smaller than the mean
If the data are skewed to the left , the means is larger than the median
The median is more sensitive than the means to extreme observation
11
B; Matching is a technique used in the design of the study to control for confounding. Subjects enrolled in a study are
matched for age, gender, smoking, or any variable that is not being analyzed. This technique is not used for large cohort
studies as it would often be too time-consuming, restrictive, and expensive to find a match for each subject entering the
study. Controlling for confounding is done in the analysis and a large group is recruited. The technique is mainly used
when dealing with small case-control studies where the number of subjects enrolled would be too small to yield statistical
results if stratified by subgroups. Randomization is used in clinical trials to control confounding (sample size needs to be
large. Matching cannot be used in correlation studies or cross-sectional studies: these are descriptive studies to assess
disease occurrence and they do not have control groups to test a hypothesis
12
The crude death rate in a developed country is 150/100000. The crude death
rate in a smaller, developing country is 75/100000. Based on these data, which
one of the following statement is correct?
D; Comparison of
crude death rates of countries with different population compositions is fruitless. Adjusting both crude
death rates to a standard population gives age-adjusted rates, which can be compared. Developed nations have higher
crude death rates because a larger proportion of their population is elderly and thus has a higher probability of dying.
Since rates account for population size, a larger population can be compared with a smaller one. Death rates are just one
factor in evaluating health care systems.
The health care system of the developing country is far better than that in the
developed country
More people die in the developed country because it has larger population
Death rate in the developing country are the lower due to the emigration effect
A;
14
D;
HALE- Health-adjusted life expectancy): It is the another name given to disability-adjusted life expectancy at birth
(DALE) comprises life expectancy at birth plus time spent in poor health. DALY (Disability-adjusted life year)-It is a
measurement of burden of disease and achievement of intervention in one lost year of healthy life is equal to one DALY.
Health care delivery indicators:
a. Doctor-nurse ratio
b. Doctor-population ratio
c. Population per traditional birth attendant
d. Population per health /sub center
e. Population bed ratio
Socio-economic indicators:
a. Level of unemployment
b. Dependency ratio
c. Rate of population increase
d. Per capita income
e. Family size
f. Literacy rates ,especially female literacy rates
g. Housing: The number of person per room
h. Per capita "calorie" availability
15
Literacy rate
Family size
Housing
Life expectancy at birth
All are true of standardized mortality ratio except:
A;
Observed deaths x 100
Standardized mortality ratio (SMR) =---------------------------------------Expected death
If the ratio had value greater than 100, the risk of mortality rises.
SMR permit adjustment for age and it is of value if the event of interest is occurrence of disease rather than death.
Other standardization techniques
o Life table
o Regression techniques
Multivariate analysis
16
Weight in kg is:
D; Matching variables: Discrete variables as smoking and lung cancer; or exposure and disease for discrete variables the
test of significance usually adopted is the standard error of difference between the two proportions or the Chi-square test.
Continuous variables as age or blood pressure, the test of significance used should be standard error of difference
between two means or 't' test.
p < 0.05 is statistically significant but statistical association (p value) does not imply causation
Odd's ratio: Measure of the strength of the association between risk factor and outcome; derived from a case control study
and used for rare diseases
17
Normal variable
Discrete variable
Confounding variable
Continuous variable
Crossover study is done when:
A;
Crossover Study
Used where patient serves as his own control.
Not suitable
If the drug of interest cures the disease
If the drug is effective only during a certain stages of the disease
If the disease changes radically during the period of time required for the study
18
B;
Reservoir of Infection Human
Animal
Reservoir in non-living things
Human
Subclinical cases: Subclinical infection occurs in most infectious disease, e.g. rubella; mumps; polio hepatitis A and B,
Japanese encephalitis, influenza, diphtheria.
Latent infection: Host does not shed the infectious agent which lies dormant within the host without symptoms. Latent
infection occurs in herpes simplex; Brill-Zinsser disease, infection due to slow viruses, ancylostomiasis, etc.
Carriers
Incubatory carriers: Measles, mumps, polio, pertussis, influenza, diphtheria and hepatitis B.
Convalescent carriers: Typhoid fever, dysentery (bacillary and amoebic), cholera, diphtheria and whooping cough.
Healthy carriers: Poliomyelitis, cholera, Meningococcal meningitis, Salmonellosis and Diphtheria
Animal Reservoir:
- Rabies
- Yellow fever
- Influenza
Reservoir in non-living things
- Tetanus
- Anthrax
- Coccidioidomycosis
19
20
Cholera
Measles
Mumps
Poliomyelitis
Time between entry of the organism and to produce maximum infection is
known as:
Incubation period
Generation time
Serial interval lead
Lead time
Secondary attack rate reflects:
B;
Generation Time
The interval of time between receipt of infection by a host and maximal infectivity of that host.
Incubation period is used for infections that manifest disease whereas generation time refers to transmission of
infection whether clinical or subclinical.
B;
No. of exposed person developing the disease within the range
of the incubation period
Secondary attack rate = --------------------------------------------------------------------------------------------------------Total number of exposed / susceptible contacts
Primary case is excluded from both the numerator and denominator
Severity
Communicability
21
Fatality
Infectivity
All of the following statements concerning meta analysis are true except:
A;
Meta analysis combines result from different studies and through statistical methods, calculate an overall estimate of the
effect.
Ecological studies use data based on groups of people rather than individuals. Associations observed on an aggregate
mat not represent associations on an individual level. (ecological bias or ecological falsy)
A study in which the units of analysis are populations or groups, rather than
individuals
Used to enhance the statistical power of research findings where number in studies
available are too small
Is applied by pooling results of small, randomized, controlled trials when no single
trial has large enough numbers to reach a statistical significance.
It combines results from different studies to obtain a numerical estimate of overall
effect.
22
A;
Swajaldhara was launched on 25th Dec. 2002. Swajaldhara has certain fundamental reform principles, which need to be
adhered to by the state governments and the implementing agencies. Swajaldhara is a community led participatory
programme. Which aims at providing safe drinking water in rural areas, with full ownership of the community.
Swajaldhara has two components: Swajaldhara I (first dhara) is for a gram panchayat or a group of panchayats (at block /
tehsil level) and swajaldhara II (second Dhara) has district as the project area. District water and sanitation mission
sanctions swajaldhra I.
23
B;
Investigation of an epidemic-steps to be followed chronologically are:
(1) Verification of diagnosis
(2) Confirmation of the existence of an epidemic
24
B;
Screening-finding the infections or disease in population who are not seeking health care, e.g. Neonatal screening;
screening for breast cancer.
Uses of screening
1. Case detection
2. Control of disease
3. Research purpose
4. Educational opportunities
Types of screening
1. Mass-screening i.e best to do but not economical and time consuming.
2. High-risk or selective screening i.e economical and results are also good ,so consider beat of all.
3. Multiphasic screening i.e not economical
25
Mass screening
High-risk screening
Multiphasic screening
Any of the above
Which of the following aspect is not a part of the targeted goals described for
National AIDS control program, Phase III:
D;
The National health policy 2002 set an aim for AIDS control to achieve zero level growth by year 2007.\
NAPCP, National AIDS prevention and control program, Phase III is from year 2007 to year 2012.
The goals for NACP, phase III are:
I. Prevention of new infection in high risk groups and general population through:
a.
26
A;
Diphtheria toxoid alone or in combination with pertussis vaccine and tetanus toxoid induces protective levels of antitoxin
that persists for around 10 years. Boosters are required every 10 years.
Antitoxin antibody do not prevent infection of the respiratory tract with C. diptheriae and do not prevent the development of
carrier state.
The antibodies are directed against the exotoxin produced by bacteria and not against the bacteria themselves.
Adverse reactions from the toxoid are infrequent in infants and young children but are more common in adults. Thus
administration of reduced dose of toxoid is recommended for children over 6 yrs of age and adults. The reduced dose is
symbolized as d and may be combined with tetanus toxoid as Td.
27
B;
Complication
Pneumonia
Acute cerebellar ataxia
Encephalitis
Rey's syndrome
------ RAPE
Cutaneous scars
Atrophied limbs
Microcephaly and LBW baby
28
Rey's syndrome
Meningitis
Pneumonia
Encephalitis
Measles vaccine given to a contact of measles case has incubation period of:
C;
Vaccine
All are tissue culture vaccine; HDC -Edmonston Zagreb strain vaccine may protect children from 4-6 months of age.
Diluent to be used is distilled water and reconstituted vaccine should be kept on ice and used within one hour
Measles vaccine has recently been adopted for aerosol administration.
Measles illness is a mild fever and rash developing 5-10 days after immunization
Immunity develops 11-12 days after vaccination
Pregnancy is a contraindication for vaccination other C/I are acute illness, deficient CMI
Toxic shock syndrome result as adverse effect of vaccine because of contamination
Live measles vaccine should be given 8-12 weeks after immunoglobulin.
Incubation period of measles induced by vaccine is 7 days compared with 10 days for natural measles. So that of
susceptible, takes vaccine within 3 days of exposure may be protected against measles.
29
1 day
3 days
7 days
10 days
A list of minimum medicine needs for a basic health care system, listing the
most efficacious, safe and cost-effective medicines for priority conditions is
known as
A;
A list of minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective
medicines for priority conditions is known as core list. Priority conditions are selected on the basis of current and estimated
future public health relevance, and potential for safe and cost effective treatment.
The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring
facilities, and/or specialist medical care, and/or specialist training are needed.
According to WHOs definition, a drug/medicine is counterfeit if it is produced with an intention to cheat. This can include
mislabeling (including fudging expiry date), or no active ingredients, a wrong ingredient, or the correct ingredient in an in
sufficient quantity.
Core list
Complementary list
30
31
Counterfeit Medicines
None of the above
If a biochemical test gives the same reading for a sample on repeated testing,
it is inferred that the measurement is:
Precise
Accurate
Specific
Sensitive
Pie diagram is used to describe:
A;
All these term used as option is criteria of screening test, so lets discuss the criteria of screening test then the answer will
be clear by own.
Criteria of screening test.
1. Acceptability The test should be acceptable to population at which it is going to be apply.
2. Repeatability (Reliability, precision, reproducibility) The test must give consistent result when repeated more
than once on the same individual or material under the same condition.
3. Validity (Accuracy) It refer to what extent the test accurately measure which it purports to measure. (It means it
express the ability of a test to separate or distinguish those who have the disease from those who do not)
accuracy refer to closeness with which measured values agree with true value.
It has two components.
i. Sensitivity Ability of test to identify correcting all those who have disease.
ii. Specificity Ability of test to identify correctly all those who do not have disease.
So, if test give same reading for a sample on repeated testing means test in precise (i.e Reliable, Reproductive,
Repeatable).
B;
32
B;
Beta error is also called type II error
Alpha error is called sampling / Type I error
Inference
Accept It
Reject It
Results
Hypothesis is true
Hypothesis is false
33
Alpha error
Beta error
Gamma error
Delta error
As per The National Socio-Demographic Goals to be achieved by the year
2010, an aim is to reduce in IMR below ___ per thousand live births.
25
28
30
32
C;
34
D;
35
36
Objective
Target
Mission
Goal
All of the following disease have sporadic mode of prevalence except:
Polio
Typhoid
Tetanus
Meningococcal meningitis
In which of the following diseases, successful animal trial has been done for
oral vaccine?
Correct decision
Type II error
Type I error
Correct decision
False positive
False negative
An objective is a planned end point of all activities; it may or may not be achieved.
Target often refers to discrete activity that has to be achieved within a given time frame. These are small
measurable component of the entire goal. They permit the concept of degree of achievement.
Goal is define as the ultimate desired state towards which objectives and resources are directed. Goals are not
constrained by time or the existing resources nor are they necessarily attainable.
Mission in turn refers to attainment of a certain goal within a stipulated time period with added impetus to the
program wherein all resources and activities are to be utilized to its fullest extent to achieve the desired result. Lot of
attention is also given to the supervisory and evaluation aspect; in a nutshell it is the mode in which we function to
attain the target
B;
B;
Oral vaccines: The successful introduction of oral vaccines for the immunization of foxes is a great advancement in the
rabies prophylaxis of wild-life. An attempted live rabies vaccine harmless but immunizing to foxes is placed in baits and
distributed over the foxes habitat. Successful control of wild animals rabies particularly foxes has been achieved in
Canada, Germany and Switzerland by the use of oral vaccine baits. The technique holds much promise for the future
control of rabies not only in foxes but also in other wild-life species.
37
Tetanus
Rabies
Measles
Hepatitis B
Which of the following test is not use to check milk pasteurization :
D;
Phosphatase Test is used to check inadequate pasteurization or the addition of raw milk. It is based on the fact that raw
milk contains an enzyme called phosphatase, which is destroyed on heating at a temperature which corresponds closely
with the standard time and temperature required for proper pasteurization. At 60C for 30 minutes, phosphatase is
destroyed completely.
Standard plate count
It checks bacteriological quality
Western countries enforce of 30,000 bacterial count permit of pasteurized milk
Coliform count
Presence of coliform in pasteurized milk indicate either improper pasteurization contamination
Coliforms should be absent in 1 ml of milk.
Methylene blue reduction test is used to detect contaminated milk.
38
B;
National Health Plan (1983) has proposed reorganization of Primary health centers on the basis of one primary health
center for every 30,000 population in rural population in the plains and one PHC for every 20,000 population in hilly, tribal
and backward areas for more effective coverage.
Health centre and health personal
A subcentre centre a population of
A PHC centre a population of
A community health centre
A health assistant (Male & Female)
A male and female health workers are at
A health guide
An anganwadi workers
A trained dai
39
40
10,000
. 20,000
25,000
30,000
All of the following states are included in Empowered Action Group (EAG)
except?
UP
Rajasthan
Chatissgarh
Gujrat
Rickettsia typhi is transmitted by:
1000 population
1000 population
D;
Empowered Action Group (EAG)
An Empowered Action Group has been constituted in the ministry of health and family welfare, with union minister for
Health and Family Welfare as chairman on 20th March 2001. as 55 percent of the increase in the population of India is
anticipated in the states of Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan, Orissa, Chhattisgarh, Jharkhand and
Uttaranchal, these states are perceived to be most deficient in critical socio-demographic indices. Though EAG, these
state will get focused attention for different health and family welfare programmes.
D;
Rickettsia typhi is maintained in mammalian host/flea cycles, with rats (Rattus rattus and Rattus norvegicus) and the
Oriental Rat FLEA (Xenopsylla cheopis) as the classic zoonotic niche. Fleas acquire R. typhi from rickettsemic rats and
carry the organisms for the rest of their lives. Nonimmune rats and humans get infected when Rickettsia laden flea feces
are "scratched" into pruritic bite lesions. Less frequently, the flea bite itself transmits the organisms. Another possible route
of transmission is the inhalation of aerosols of flea feces.
41
Mite
Tick
Louse
Flea
While managing a case of Dengue haemorrhagic fever (DHF) a rough estimate
of flow is derived from the formula:
A;
The management of DHF during the febrile phase. A rise in hematocrit value indicates significant plasma loss and a need
for parenteral fluid therapy. Serial hematocrit determination, every four to six hours, and frequent recording of vital signs
are recommended for adjusting the fluid replacement in order to assure adequate volume replacement and avoid
overtransfusion. A rough estimate of flow may be derived from the formula:
mi/hour = (drop/min) x 3
42
ml/hour = drop/min x 3
ml/hour = drop/min x 2
ml/hour = drop/min x 4
ml/hour = drop/min x 5
Prevalence rate of leprosy is not high in the state of:
43
Uttar Pradesh
West Bengal
.orissa
Maharashtra
Which of the following toxin present in Crotalaria seeds:
Leprosy is widely prevalent in our country. It accounts for about 60.9% of the global recorded cases. Leprosy shows high
prevalence rate in the states of UP, MP, Bihar, Orissa and West Bengal. These five states contribute about 62% of case
load.
C;
Disease
Agent
Toxin
Aflatoxinism
Aspergillus flavus
Aflatoxins
Neurolathyrism
L. sativus (Khesari dal)
BOAA
Ergotoxinism
Claviceps fusiformis
Ergot toxin
Epidemic dropsy
Argimone Mexicana (seeds)
Sanguinarine (Alkaloid)
Endemic Ascites
Crotolaria seeds (Jhunjhunia)
Pyrrolizidine (Alkaloid)
Fusarium toxinism
Fusarium incamatus
Fusarium toxin
Neurolathyrism is a crippling disease of nervous system. It is characterized by gradually developing spastic paralysis of
lower limbs. It occurs mostly in adults consuming the pulse, Lathyrus sativus in large quantities. The toxin present in
lathyrus seeds has been identified as Beta Oxalyl Amino Alanine (BOAA).
44
BOAA
Sanguinarine
Pyrrolizidine
Aflatoxin
Most common indirect cause of maternal mortality in our country is:
B;
CAUSE OF MATERNAL DEATH
Severe bleeding (MC cause)
PERCENTAGE
25
20
Infection
15
Unsafe abortions
13
Eclampsia
12
Obstructed labor
08
08
Twenty percent of maternal deaths are due to indirect causes, ie the result of pre-existing diseases or disease
that developed during pregnancy, which are not due to direct obstetric cause but are aggravated by the
physiological effects of pregnancy. Of indirect causes, ANEMIA is the most significant cause of maternal death.
Other important indirect causes of maternal mortality are hepatitis, cardiovascular diseases, and diseases of
endocrine and metabolic System.
45
46
47
Hemorrhage
Anemia
Heart disease
Infection
As per WHO all the following are true about management of acute severe
dermatolymphangioadinitis (severe ADLA) except:
Penicillin
Erythromycin
Antifilarial medication
Antipyretic
For effective group discussion, the group should comprise
participants?
3 to 5
6 to 12
13 to 16
.17 to 20
World famous MRFIT trial was done for which of the following disease?
C;
Management of Severe ADLA
a. Give in IV benzylpenicillin
b. In case of allergy to penicillin give IV erythromycin
c. Give analgesic / antipyretic such as paracetamol;
Do not give any antifilarial medicine
B;
For effective group discussion, the group should comprise not less than 6 and not more than 12 members. The
participants are all seated in a circle, so that each is fully visible to all the others. There should be a group leader who
initiates the subject, helps the discussion in the proper manner, prevents side-conversation, encourages everyone to
participate and sums up the discussion in the end.
B;
The multiple risk factor intervention trial (MRFIT) was carried out in USA for CAD, aimed at high risk adult males aged 35
57 years.
Diabetes
.CAD
. HIV
48
TB
Which of the following is the definite host for Echinococcus granulosus:
D;
The life cycle of Echinococcus granulosa is basically a dog sheep cycle with man as an accidental, intermediate host. The
adult tapeworm lives in the small intestine of dogs, which is the definitive host, for 2 to 4 years. Human infection occurs by
ingestion of the eggs of Echinococcus granulosa accidentally with food, unwashed vegetables or water contaminated with
faeces from the infected dog.
Man
Sheep
. Horse
Dog
49
Which of the following is the national level system that provides annual
national as well as state level reliable estimates of fertility and mortality?
D;
Since civil registration is deficient in India, a Sample Registration System (SRS) was started in the mid 1960s to provide
reliable estimates of birth and death rates at the national and state level. SRS now covers the entire country and is a major
source of health information. Since the introduction of this system, more reliable information on birth and death rates, age
specific mortality and fertility rates, infant and adult mortality, etc. have been available
50
Adhoc Survey
Sample Registration System
Which of the following is the nodal ministry for Integrated Child Development
Services Program Center
A;
The Government of India, in the Ministry of Social and Women's Welfare in 1975, initiated Integrated Child Development
Services
Programme
Lunched in
Ministry
1. Vitamin A prophylaxis programme
1970
2. Prophylaxis against nutritional anaemia
1974
3. Iodine deficiency disorders control 1962
Ministry of health and family welfare
programme
1. Special nutrition programme
1970
2. Balwadi nutrition programme
1970
Ministry of social & Womens Welfare
3. ICDS programme
1975
1. Midday meal programme
1961
Ministry of education
At present ICDS programme runs by HRD (Human Resource and Development) ministry.
51
B;
Dietary sources of vitamin c
Mg/100 g
Fruits:
Amla
- 600
Guava
- 212
Lime
- 63
Orange
- 30
Tomato
- 27
Germinated pulses
Bengal gram
- 16
52
Guava
Orange
Lime
Cabbage
As per WHO criteria for diagnosis of rheumatic fever(RF), recurrent attack of
RF in a patient with established RHD is diagnose by:.
Mg/100 g
Vegetables:
Cabbage
Amaranth
Cauliflower
Spinach - 28
Brinjal
Poatoes - 17
Radish
- 124
- 99
- 56
- 12
- 15
C;
WHO criteria for the diagnosis of rheumatic fever and rheumatic heart disease (based on the revised Jones criteria)
1. Primary episode of RE
- Two major or one major and two minor, manifestation plus evidence of a
preceding group A streptococcal infection.
2. Recurrent attack of RF in a
- Two major or one major and two minor, manifestation plus evidence of
patient without established
a preceding group A streptococcal infection
rheumatic heart disease.
3. Recurrent attack of RF in
- Two minor, manifestation plus evidence of a preceding group A
a patient with established
streptococcal infection.
RHD is diagnose by
Two major or one major and two minor, manifestation plus evidence of a preceding
group A streptococcal infection.
Two major manifestation plus evidence of a preceding group A streptococcal
infection.
53
C;
The spectrum of iodine deficiency disorders in approximate order of increasing severity.
Disorders:
Goiter
Hypothyroidism
Subnormal intelligence
Mental retardation
Still births
Strabismus
Voluntary scheme wherein any MBBS doctor can volunteer for providing safe
motherhood services is:
B;
This is a Voluntary scheme wherein any obstetric and gynaec specialist, maternity home, nursing home, lady
doctor/MBBS doctor can volunteer themselves for providing safe motherhood services. The enrolled doctors will
display Vandemataram logo at their clinic. Iron and Folic Acid tablets, oral pills, TT injections etc will be provided by
the respective District medical officers to the Vandemataram doctors/clinics for free distribution to beneficiaries. The
cases needing special care and treatment can be referred to the government hospitals, who have been advised to
take due care of the patients coming with Vandemataram cards.
55
A;
Group
Man
Woman
Pregnancy
Lactation
Infants 0 to 12 months
Retinol (mcg)
600
600
600
950
350
Children
1 to 6 year
7 to 12 years
Adolescents
13 to 19 years
400
600
600
56
750 mcg
900 mg
1200 mcg
1500 mg
Amino acid deficient in wheat is:
C;
All cereals are deficient in lysine amino acid but wheat all deficient in threonine.
Pulses
Cereals
Limiting Amino Acid
Methionine and Cystine
Lysine
Wheat Lysine and threonine
Maize Lysine and tryptophan
Exception: Rice is a cereal which has high lysine content
than other cereals
Leucine
Methionine
57
Lysine
Cystine
True about folic acid and vitamin B12 is all except:
B;
Source
Stability
Body storage
Absorption
RDA
Folic Acid
leafy vegetable, liver meat, egg, dairy product
Heat unstable
5 to 10 mg
in jejunum
Vitamin B12
Liver, kidney, meat, fish, eggs, milk
Heat stable
4 mg (2 mg in liver, 2 mg in other site) for 3 yrs
ilium
- 1 mcg
- 1.5 mcg
- 1.5 mcg
- 0.2 mcg
58
B;
The Government of India started its national Vit. A prophylaxis programme for the prevention of blindness in children in
1970 based on periodic massive dosing of children with 200,000 IU of retinol palmitate in oil every 6 months in preschool
children.
IAP book suggest 2ml of Vit A for Vit. A prophylaxis in preschool children. It means 1ml contains 1 lac IU (b/c 2ml = 200,
000 IV Vit. A)
Prevention and Control of Xerophthalmia
25,000 i.u./ml
1 lakh i.u./ml
3 lakh i.u./ml
59
5 lakh i.u./ml
Which one of the following is not formal managers power?
C;
Managers Power
60
Reward
Coercive
Legitimate
Day off
Universal precaution is applied to:
Position power
Formal power
Legitimate
Employees generally
Accept due to
Position of manger
Employees usually
comply with the work
related directives
issued by manager.
Reward
- Promotion
- Bonuses
- Day off
Personal power
Coercive
- With held rewards
- inflict punishment
C;
The concept of universal precaution emphasizes:
Expert
It arise form
managers special
knowledge, skills
expertise
Referent
It arises in manager
by admiring & respect by
other
.Stool
Sputum
Semen
Urine
61
C;
Optimum concentration of fluorine in drinking water is 0.5-0.8 ppm (mg/lit.)
Deficiency of fluorine leads to dental caries while excess of fluorine causes dental and skeletal fluorosis.
0.1-0.3 mg/lit.
1-1.5 mg/lit.
0.5-0.8 mg/lit.
3-3.5 mg/lit.
62
C;
Japanese encephalitis is transmitted by culicine mosquitoes.
Diseases transmitted by ticks:
Hard ticks transmit
1. Tick typhus (Rocky Mountain spotted fever)
2. Tularemia
3. Kyasanur forest disease
4. Tick paralysis
5. Human babesiosis
6. Colorado tick fever
7. Viral encephalitis
Soft ticks transmit
1. Q fever
2. Kyasanur forest disease
3. Relapsing fever
Kyasanur forest disease is transmitted by a wide variety of ticks including hard as well as soft ticks.
Tularemia
Kyasanur forest disease
Japanese encephalitis
63
Typhus
Natural focus is related to which of the following disease?
C;
Worldwide, rodent plague is still firmly entrenched in its natural foci. A natural focus of plague has been defined as a
strictly delimited area where ecological conditions ensure the persistence of the aetiological agent for considerable periods
of time, and where epizootics and periods of quiescence alternate, without introduction of infection from outside.
64
Rabies
Measles
Plague
HIV
Aflatoxin is produced by:
65
Aspergillus fumigatus
Aspergillus flavus
Aspergillus niger
All of the above
Which of the following is best method for prevention of guinea worm disease:
B;
Aflatoxin is a food toxin produced by fungi, Aspergillus flavus and Aspergillus parasiticus.
B; Man acquires guinea worm disease by drinking water containing infected cyclops.
Thus, the key to eradication of the disease is provision of safe drinking water and educating the people to filter the drinking
water through double thickness cotton cloth
66
Chlorination of water
Which of the following is true about WHO standards recommended for
drinking water;
67
c;
Remember the following composition of ORS-bicarbonate:
Constituents of ORS
WHO ORS (gm)
New WHO ORS (gm)
NaCl
3.5
2.6
KCL
1.5
1.5
Trisodium citrate
2.9
2.9
Glucose
20
13.5
Potable water
1 litre
1 litre
Constituents of ORS
WHO ORS (meq/L)
New WHO ORS (meq/L)
Na+
90
75
Cl80
65
K+
20
20
Citrate
10
10
Glucose
110
75
Osmolarity
310
245
Role of glucose enhances the intestinal absorption of salts and water.
Trisodium Citrate increasing intestinal absorption of Na+ and water
Glucose in new WHO ORS is change from 20gm to 13.5 gm At higher concentration glucose appear in the stools and
takes its osmotic penalty stool vol is increased. Therefore ORS in children with acute noncholera diarrhoea is
improved by reducing Na+ and glucose concentration 75 meq/L and total osmolarity to 245 mosm/L.
68
C;
Serial
Rice
Whole wheat
Dry maize
1.0g%
11.0g%
7.0 g%
Protein content
7
11.8
11.1
69
17g%
Sewage is defined as:
C;
Sewage is defined as waste water from community containing solid and liquid excreta.
"Sullage" is waste water from the community which does not contain human excreta e.g., waste water from kitchens and
bathrooms.
70
B;
A prevalence of trachoma of more than 5% in children below 10 years of age is an indication for mass or blanket
treatment,
The mass treatment for trachoma consists of twice daily application of 1% tetracycline ointment to all children for
5 consecutive days each month for 6 consecutive months; or for 60 consecutive days
1%
71
5%
10%
25%
Which of the following is true about chi-square test:
C;
Chi-square test is used for testing the significance of difference between two proportions. Its advantage is that it can also
be used when more than two groups is to be compared.
72
Both A and B
None of the above
Daily calorie requirement according to ICMR standards in a non pregnant, non
lactating woman employed in hard manual labour is;
D;
Groups
Light work
Moderate work
Heavy work
Reference female
Light work
Moderate work
Heavy work
Pregnancy
1875
2225
2925
+300
Lactation
First 6 months
6-12 months
73
1900
2200
2400
3000
Paris green is useful for killing:
+550
+400
A;
Paris Green kills mainly the anopheles larvae because they are surface feeder. Bottom feeding larvae are also killed when
Paris green is applied as a special granular formation.
74
the Roll Back Malaria global strategic plan for 2005 2015, WHO and RBM adopted
2005 as the baseline for evaluating whether morbidity and mortality had been reduced by 75% by 2015. The baseline
year was changed from 2000 to 2005 because better data were available to make mortality estimates in 2005 (compared
with 2000).
2000
2005
2003
2002
75
A; FIFTH DISEASE or Erythema infectiosum is a mild, moderately contagious disease seen most commonly in children 3
to 12 years old. It is caused by human parvovirus 819. The rash develops after fever has resolved, as a bright blanchable
erythema on the cheeks (slapped cheek appearance) with perioral pallor.
76
Erythema infectiosum
Rubeolla infantum
Dukes disease
Measles
The head quarters of UNESCO is located in:
C; UNITED NATIONS EDUCATIONAL, SCIENTIFIC AND CULTURAL ORGANIZATION (UNESCO), was established in
1946 to encourage collaboration among nation in the areas of science, culture, and communication. Its headquarter is
located in PARIS, France
77
New Delhi
Geneva
Paris
New York
Double blind study means:
C;
78
Mala N contains:
A;
Mala N contains 0.3 mg norgestrel and 0.03 mg ethinyl oestradiol. It is supplied free of cost through Primary Health
Centers and urban family welfare centers.
Mala D is available in market at affordable price but constituents are same.
79
B;
Rajiv Gandhi Shramik Kalyan Yojna
The ESI corporation has launched a new Yojna for the employees covered under the ESI scheme. This scheme
provides an unemployment allowance for the employees covered under ESI scheme whoare rendered unemployed
involuntarily due to retrenchment / closure of factory etc. after fulfilling certain eligibility conditions. The scheme
st
came into effect from 1 April, 2005.
80
A;
Japanese encephalitis is transmitted by a culicine mosquitoes viz. C. tritaeniorhynchus, C. vishnui and C. gelidus. In
India, the most important vector is culex tritaeniorhynchus.
81
Culex tritaeniorhychnus
Culex fatigans
Aedes aegypti
Anopheles culicifacies
According to WHO, which of the following is not a notifiable disease:.
2. Plague
3. Yellow fever
Cholera
Plague
82
Yellow fever
Poliomyelitis
High stationary phase in demography is.
D;
In the late expanding or the third stage of the demographic cycle the birth rate tends to fall but the death rate
declines still further and the population continues to grow as the births exceeds deaths eg: India, China, Singapore etc
High BR & DR-(so population remains stationary) characterize the first stage or high stationary phase of demographic
cycle, eg; India before 1920 (option d).
2nd or early expanding stage: BR remains unchanged & DR begins to decline but population continues to grow as
BR>DR eg: South Asian & African countries (option b)
4th (Low stationary) stage: low BR & DR with the result the population remains stationary eg: Austria, UK, Denmark.
Annual growth rate of population remains zero.
5th (Declining) stage: population begins to decline as the BR is less than DR eg: Hungary & Germany (option c).
83
A; National institute for mentally handicapped (NIMH) was setup in 1984 at Secunderabad. It has regional branches at
Mumbai, New Delhi and Kolkata. The NIMH seres as an apex organization for developing appropriate models for care for
the mentally handicapped.
Secunderabad
Ranchi
Lucknow
84
Banglore
Katathermometer is used to measure:
A; Katathermometer is a device consisting of two thermometers, one a dry bulb and the other a wet bulb. Both
thermometers are heated to 43.3C and the time required for each thermometer to fall from 37.8 to 32.2C is noted. The
dry bulb gives the cooling power by radiation and convection, the wet bulb by radiation, convection, and evaporation
85
86
8 hrs in occupation
8 hrs in bed
8 hrs of sitting
2 hrs in walking
Diphtheria most commonly affects children between the age group of:
87
6 months to 1 year
1 to 5 years
10-12 years
12 to 14 years
All of the following are correct about disinfectants except:
C; An Indian reference man is b/w 20-39 yrs of age & weighs 60 kg. He is free from disease and physically fit for active
work. On each working day he is employed for 8 hrs in occupation that involves moderate activity, spends 8 hrs in bed, 4-6
hrs sitting & moving around & 2 hrs in walking and in active recreation or household duties.
All the parameters for a reference female is the same except that she weighs 50 kgs.
B;
Diphtheria is a rare acute infectious disease characterized by the formation of a false membrane on any mucous
surface and occasionally on the skin. It is caused by Corynebacterium diphtheriae. Diphtheria particularly affects children
between one to five years of age. The disease is rare under 1 year of age.
C; Phenol is not a very effective disinfectant but is used as a standard to compare the germicidal activity of other
disinfectants. However it is effective against gram negative & gram positive bacteria & certain viruses but only slowly
effective against spores & AFB. It is not readily inactivated by organic matter but greatly weakened by dilution. Hence, it
should never be used in strengths less than 10% for disinfection of feces & urine & as a 5% solution can be used for
88
C;Malathion is used in the doses of 100-200 mg square foot for, every three months. It has least toxicity of all
organophosphorus compounds
One month
Two months
Three months
Four months
89
90
91
6
10
30
80
Family size means:
B;
C; Formalin-inactivated vaccine purified from mouse brain is given for prophylaxis of Japanese encephalitis. For primary
immunization two doses of one ml each should be administered subcutaneously at an interval of seven to fourteen days.
(For children under the age of three years 0.5 ml should be given). A booster dose of one ml should be given after a few
months in order to develop full protection. Protective immunity develops in about a month's time after the administration of
second dose.
C;
FAMILY SIZE' means the total number of children, a woman has born at a point in time. Family size depends upon the
following factors:
i. Duration of marriage.
ii. Education of the couple.
iii. Number of live births and living children.
92
B;
93
A;
Infant Parasite Rate is regarded as the most sensitive index of recent transmission of malaria in a locality. It is defined as
"the percentage of infants below the age of one year showing malarial parasites in their blood films". If it is zero for three
successive years in a locality, it is regarded as absence of malaria transmission even though the anopheline vector
responsible for previous transmission may remain
94
D;
95
Aniline industry
Asbestos industry
.Gas industry
Battery industry
Benzidine is associated with:
A;
Cancer of bladder is caused by aromatic amines, which are metabolized in body and excreted in urine. The
possible bladder carcinogens are 2-naphthylamine, 4-aminobiphenyl, and benzidine, auramine and magenta. Dying
industry, rubber, gas and electric cable industries are associated with carcinoma of bladder
Bladder cancer
Skin cancer
Lung cancer
Leukemia
96
D; Under the ICDS scheme, there is one anganwadi worker for a population of 1,000. There are 100 anganwadi workers
in one ICDS project
1,000 children
3,000 children
3,000 population
97
1,000 population
Cyclopropagative biological transmission takes place in:
B;
Biological transmission is of three types
Types of transmission
Description
Examples
1. Propagative
Agent multiplies in vector withPlague, bacilli in rat fleas
out undergoing change in form.
2. Cyclo propagative
Agent multiplies as well as changes
Malaria parasite in mosquito
form in the vector
3. CyclodevelAgent only changes form without Microfilaria in mosquito
opmental
multiplying in the vector
Plague
Malaria
Filaria
98
99
Guineaworm
The vaccine for yellow fever is valid till:
10 years
20 years
40 years
50 years
Which is the latest recommendation by WHO, for intrapartum pregnant women
with HIV needing ART should be treated with?
(AZT=Ziduvidine,3TC=Lamuvidine, NVP=Nevirapine)
A;
170 vaccine is the recommended vaccine for yellow fever. It is a live attenuated vaccine which is prepared from a
nonvirulent strain. It is administered subcutaneously at the insertion of deltoid in a single dose of 0.5 ml. Immunity begins
to appear on the 7th day and lasts for more than 35 years. However. World Health Organization recommends
revaccination after 10 years for international travel.
C; Recommended first line combination antiretroviral treatment regiments for pregnant woman:
Mother
Antepartum
Intrapartum
Postpartum
Sd-NVP+AZT
AZT/3TC
AZT + 3TC + NVP
None of the above
100
D;
Varicella-zoster virus causes two distinct clinical entities: varicella, or chickenpox, and herpes zoster, or shingles.
The incubation period of chickenpox ranges between 10 and 21 days but is usually between 14 and 17 days.
Rash is pleomorphic i.e. different stages of rash are seen at one given time, because rash appears in successive
crops.
Secondary attack rates in susceptible siblings Within a household are between 70 and 90 percent.
Rash has centripetal distribution.
The communicability period of patients ranges from 1-2 days before the appearance of rash and 4-5 days thereafter.
The virus tends to die out before the pustular stage.
101
102
Syphilis
AIDS
Gonorrhea
None of the above
As per ESI Act, sickness benefit acts for:
B; Most of the recently recognized STDs are now referred to as second generation STDs. AIDS, the most recently
recognized, is totally new disease
91 days
30 days
56 days
A;ESI Act 1948 has made provisions for sickness benefit to insured persons. It consists of periodical cash payment to an
insured person in case of sickness, if his sickness is duly certified by an Insurance Medical Officer or Insurance Medical
practitioner. It is payable for a maximum period of 91 days in any continuous period of 365 days and the daily rate being
about 7/12 of average daily wages. However, in addition to 91 days of sickness benefit, insured persons suffering from
certain long-term diseases are entitled to extended sickness benefit.
103
46 days
All of the following rabies vaccines are commercially available except:
104
A; Hardy-Weinberg Rule is a set of algebraic formulas that describe how the proportion of different genes can remain the
same over time in a large population of individuals. Specifically, this rule indicates how often particular alleles, alternate
forms of a particular gene that contain specific information about a trait, should occur in a population. The rule also reveals
how often particular genotypes, the actual combination of genes an organism carries and may pass on to its offspring,
should appear in that same population. By studying these allelic and genotypic frequencies, scientists can identify
populations that are changing genetically, or evolving. British mathematician Godfrey Harold Hardy and German physician
Wilhelm Weinberg independently described the rule in 1908. American mathematician Sewall Wright, British
mathematician Sir Ronald Fisher, and British geneticist John B. S. Haldane then used the Hardy-Weinberg rule to develop
mathematical theories of evolution. These theories formed the basis for a new branch of science known as population
genetics.
Population genetics
Health economics
105
Social medicine
None of the above
In India the natural reservoir of plague is:
D; Wild rodents are the natural reservoirs of plague. In India the wild rodent Tatera indica are the main reservoir, not t the
domestic rat, Rattus rattus as once thought.
Mus maskina
Rattus rattus
Rattus novergicus
Tetera indica
106
107
B;
A; Trickling filter method is used for treating effluent from the primary sedimentation tank. Trickling filters has a zoogleal
layer over the surface and down through the filter. Zoogleal layer is a very complex biological growth consisting of algae,
fungi, protozoa and bacteria-of many kinds. Trickling filters do not need rest pauses, because wind blows freely through
the beds supplying the oxygen needed by the zoogleal flora. The action of the tricking filter is purely biological one, and
not the mechanical one as suggested by the name.
108
A; Dose of malathion used for residual insecticidal action is 100-200 mg/square foot area.
Dose of DDT used for residual insecticidal action is also 100-200 mg. per square foot area.
109
100-200
25-50
10-20
500-1000
Coefficient of correlation is calculated to find:
B;
Coefficient of correlation is calculated to establish or rule out the presence of significant association between two variables.
110
B; Chlorine acts best as a disinfectant when the pH of water is around 7 because of the predominance of hypochlorous
acid, the form which is mainly responsible for the disinfecting action of chlorine.
Orthotolidine test measures both total and free chlorine Polio virus, spores and giarida escapes from the action of
chlorine.
111
C; The main route of spread of polio is faeco-oral route. This route is particularly more important in developing countries.
Transmission of polio virus by droplet infection may occur in the acute phase of the disease when the virus occurs in the
throat but this mode of transmission is important only in developed countries and is not the main route of spread of polio.
112
C; In 1991 census it was decided that the term literacy rate would be used for the population relating to 7 -years age and
above. A person is deemed as literate if he/she can read and write with understanding in any language. The same concept
has been continued in census of 2001 also
113
114
Mifepristone
Progestrone
Ethinyl estradiol
Maximum calories per 100 gm are found in:
C;
Banana
Black gram
Bengal gram
115
Wheat
Which of the following is the richest source of vitamin A:
B;
Amaranth
Halibut liver oil
Green leafy vegetable
Orange
116
D; Propagated Epidemic is generally of infectious origin and it results from person to person transmission of an infectious
agent. It usually shows a gradual rise and trails off over a much longer period of time. The speed of spread depends upon
herd immunity, opportunities for contact and secondary attack rate. Examples of propagated epidemic are epidemics of
hepatitis A and polio.
117
B; Acute flaccid paralysis is defined as paralysis of acute onset (less than 4 weeks) and the affected limb or limbs is/ are
flaccid, and floppy. WHO has recommended immediate reporting and investigation of every case of AFP in children less
than 15 years and collection of two stool samples for analysis in a laboratory accredited by WHO.
118
0-25 years
0-15 years
0-5 years
0-3 years
Not an advantage of case control studies:
.
119
120
80/2100
11/2100
16/2100
96/2100
The following diseases are amenable to eradication except:
c;
Infant mortality rate is defined as 'ratio of infant deaths registered in a given year to the total number of live births
registered in the same year; usually expressed as a rate per 1000 live births.
Number of deaths of children < 1 year of age in a year
Infant mortality rate =
----------------------------------------------------------------------------------- x 1000
Number of live births in the same year
11 + 5
= -------------------21000
16
= -------2100
D; Eradication is termination of all transmission of infection by extermination of the infectious agent through surveillance
and containment. It is an absolute process, an all or none phenomenon, restricted to termination of an infection from whole
world. To date only smallpox has been eradicated. Diseases, which are amenable to eradication, are measles, diphtheria,
polio and guinea worm. In 1988, World Health Assembly adopted a resolution for the global eradication of poliomyelitis.
Poliomyelitis is eradicable because man is the only host. A long-term carrier state is not known to occur. Half-life of
excreted virus in the sewage is about 48 hours and spread can only occur during this period. Oral polio vaccine (OPV) is
easy to administer, relatively cheap and is ideally suited for poliomyelitis eradication strategies because the live vaccine
virus, by multiplying in intestine can interrupt the transmission of wild polioviruses.
121
Measles
Polio
Diphtheria
Tetanus
Biological oxygen demand gives an indication of
C; The strength of sewage is expressed in terms of biological oxygen demand. It is defined as the amount of oxygen
absorbed by a sample of sewage during a specified period, generally 5 days, at a specified temperature, generally 20QC
for the aerobic destruction or use of organic matter by living organisms
Chemicals
Anaerobic bacteria
Organic matter
Bacterial content
122
B; Cereal proteins are poor in nutritive quality, being deficient in the essential amino acid, lysine. Pulse proteins are poor
in methionine and to a lesser extent in cyestein. On the other hand they are rich in lysine. If cereals are eaten with pulses,
cereals and pulse proteins complement each other and provide a more balanced and complete protein intake
123
A; Coronary heart disease (ischemic as heart disease) is defined as impairment of heart function due to inadequate blood
flow to the heart compared to its need, caused by obstructive changes in the coronary circulation to the heart. Pattern of
CHD in our country is as under:
It appears a decade earlier compared with the age incidence in developed countries. The peak period is attained
between 51 - 60 years;
Males are affected more than females
Hypertension and diabetes account for about 40% of all cases; and
Heavy smoking is responsible etiologically in a good number of case
124
A;Tetanus
vaccination protects the body against the toxin produced by the tetanus bacterium, not the bacterium itself.
Because tetanus is often fatal, vaccination is particularly Important. A primary series of 3 injections over a 6 month period
should be administered to any adult who Was not vaccinated in childhood. A booster dose of the vaccine is recommended
every 10 years. Adults receive the tetanus vaccine alone or in combination with a diphtheria vaccine administered in a
single injection. Children receive a combination vaccine against tetanus, diphtheria, and pertussis. Pertussis vaccination is
not necessary for adults.
125
exposure with which of the following particle sizes causes chronic lung
disease
0:5-3 microns
5--10 microns'
3-5 microns
.
A; Dust size within the range of 0.5 - 3 micron is a health hazard and after a variable period of exposure it produces a lung
disease known as pneumoconiosis
126
0.01-0-5 microns
Chronic noise exposure above what level causes deafness:
A;
Noise pollution is exposure of people or animals to levels of sound that are annoying, stressful, or damaging to the
ears.
The effects of noise exposure are of 2 types viz. auditory and non-auditory. Auditory effects include auditory fatigue and
deafness. Deafness is the most serious pathological effect of noise. Temporary hearing loss occur in frequency range
between 4000 and 6000 Hz. Repeated or continuous exposure to noise around 100 decibels may result in permanent
hearing loss. Non-auditory effects include interference with speech, annoyance, reduction inefficiency, and psychological
changes such as rise in BP, rise in intracranial pressure, an increase in heart rate, breathing and sweating.
100 Db
85 Db
70 Db
127
140 Db
As per WHO, tuberculosis is said to be under control when:
C;
Tuberculosis control means reduction in the prevalence and incidence of disease in community. According to WHO
tuberculosis 'control' is said to be achieved when the prevalence of natural infection in the age group 0 - 14 years is of the
order of 1 %. This is about 40% in India.
128
C;
129
Reynolds Ross
Bernard
David Morley
James Holmes
Heat stroke is characterized by all except .
A;
The growth or road-to-health chart was first designed by David Morley and was later modified by the World Health
Organization. It is a visible display of the child's physical growth and development. It is primarily designed for growth
monitoring of a child, so that changes over time can be interpreted. The WHO growth chart has 2 reference curves; the
upper reference curve represents the 50th percentile for boys and the lower reference curve the 3rd percentile for girls.
The space between the 2 growth curves (weight channel) is known as the road-to-health. It is the direction of the growth
curve that is more important than the position of dots on the line.
Heat stroke is attributed to failure of the heat regulating mechanism and it is characterized by very high body
temperature, which may rise to 110F (43.3C) and profound disturbances including delirium, convulsions and partial or
complete loss of consciousness. The skin is dry and hot. Classically, sweating is absent or diminished, but many victims of
clear-cut heat stroke sweat profusely. The outcome is often fatal. Treatment consists of rapidly pooling the body in ice-
water bath till the rectal temperature falls below 102F (38.9C).
130
Profuse sweating
Temperature above 41C
Drowsiness
Decreased consciousness
The breeding place for anopheles mosquito is:
131
132
133
Dirty water
Seawater
Free flowing water
Clean water
Classification of leprosy depends on
Clinical history
Drug response
Morphological Index
Bacteriological index
The organism most commonly causing genital filariasis in most parts of Bihar
and Eastern U.P. is
Wuchereria bancrofti
Brugia malayi
Onchocerca volvulus
Dirofilaria
In calculating dependency ratio, the numerator is expressed as:
D; Leprosy
is a disease bedeviled by classifications, for example the Madrid classification, Ridley-Jopling classification,
Indian classification etc. These classifications are based on clinical, bacteriological, immunological and histological status
of the patients.
A;
Lymphatic filariasis is caused by W. bancrofti, B. malayi, or Brugia timori. The thread-like adult parasites reside in
lymphatic channels or lymph nodes, where they may remain viable for more than 2 decades. Lymphatic filariasis is a major
health problem in India. Heavily infected areas are found in UP, Bihar, Jharkhand, Andhra Pradesh, Orissa, Tamil Nadu,
Kerala and Gujarat. In chronic Bancroftian filariasis, the main clinical features are hydrocele, elephantiasis and chyluria.
Elephantiasis may affect the legs, scrotum, arms, penis, vulva and breasts, usually in that order of decreasing frequency.
The Brugian filariasis is generally similar to Bancroftian filariasis, but strangely the genitalia are rarely involved.
D; The proportion of persons above 65 years of age and children below 15 years of age are considered to be dependent
on the economically productive age group (15 -64 years). The ratio of the combined age groups 0...14 years plus 65 years
and above to the 15 - 65 year age group is referred to as total dependency ratio
134
B; Nuclear or elementary family consists of married couple and their children while they' are still regarded as dependents.
They tend to occupy same dwelling space. The term 'new families' has come recently into trend; it is applied to those
under 10-year duration and consists of parents and children
135
C; The influenza-A virus is unique among the viruses because it is frequently subject to antigenic variation, both major and
minor. When there is a sudden, complete or major change, it is called a shift; and when the antigenic change is gradual
over a period of time, it is called a drift. Antigenic shift results from genetic recombination of human with animal or avian
virus, providing a major antigenic change. This can cause a major epidemic or pandemic involving all age groups.
Antigenic drift involves 'point-mutation' in the gene due to selection pressure by immunity in the host population. Antigenic
changes occur to a lesser degree in group-B influenza viruses; and influenza-C virus appears to be antigenically stable.
Since its isolation in 1933, the major antigenic changes have occurred twice in influenza-A virus; once in 1957 and again
in 1968.
136
A; Pasteurization of milk is 'heating of milk to such temperature and for such period of time as is required to destroy any
pathogens that may be present while causing minimal changes in the composition, flavor and nutritive value.
Pasteurization kills about 90% of the bacteria in the milk including the most heat-resistant tubercle bacillus and the
Q-fever organisms. Pasteurization does not kill thermoduric bacteria not the bacterial spores
137
A;
Protein efficiency ratio (PER) is sometimes used to rate proteins and represents the amount of weight gained (in
grams) relative to the amount of protein consumed (in grams). For example, a PER of 2.5 would mean that 2.5 grams of
weight was gained for every gram of protein ingested. Since it is impossible to measure weight gain in grams in humans,
PER is generally measured in young, growing animals placed on a diet which is 10% protein by weight. This begs the
question of whether young animals, who are growing, provide a good model for adult humans. While the Food and Drug
Administration has suggested the use of PER with casein as a reference model for labeling protein foods, the use of PER
to estimate human protein requirements has been criticized by some author.
138
The percentage of nitrogen absorbed from the protein absorbed from the diet
Iodized salt at production level and at consumer level should be:
A; Salt iodization has been monitored either by assessing the portion of salt iodized at factory level (production level data)
or by testing salt used for cooking at the house level using population-based surveys (consumption level data). Household
consumption of iodized salt is preferable over production level data since it provides a more accurate level of the iodine
status of the population.
Iodine concentration cut-off points - The salt testing kits used to determine whether salt in the household is adequately
iodized have used different cut-off points. UNICEF recommends 15 ppm as the cut-off point and has made standardized
testing kits available free of charge to be used in household surveys for the end decade assessment of progress toward
the goal of IDD elimination.
Iodized Salt: Refined salt is also iodized. Minimum requirement of iodine is 15 ppm (parts per million) at trade level with35
ppm of factory level. Salt is one of the best carrier of iodine. Iodine is one of the key micro-nutrients identified by the World
Health Organization (WHO), deficiency of which in developing countries is of major concern. Iodine deficiency causes
diseases like goiter.
139
140.
B;
C;
Elements of primary health care are:
Education concerning prevailing health problems and methods of preventing and controlling them;
Promotion of food supply and proper nutrition;
Adequate supply of safe water and basic sanitation;
141
142
143.
A; Providing ART is not a preventive strategy as it is directed at people who are already suffering from AIDS.
Following are the objectives & the strategy adopted by the NACP-III for prevention & control of HIV/AIDS
1. Prevention of new infections in high risk groups and general population :
Creating awareness about symptoms, spread, prevention and services available.
Management of STI and RTI
Condom promotion
Providing ART
Treating S.T.D.
Providing Condoms
Behavior change communication
144
A; Randomization is the
use of a predetermined plan of allocation or assignment of subjects to treat ment groups such
that assignment occurs solely by chance. It is used to eliminate bias on the part of the investigator and the subject in the
choice of treatment group. The goal of randomization is to allow chance to distribute unknown sources of biologic
variability equally to the treatment and control groups. However, because chance does determine assignment, significant
differences between the groups may arise, especially if the number of subjects is small. Therefore, whenever
randomization is used, the comparability of the treatment groups should be assessed to determine whether or not balance
was achieved.
145
D;
The correct values for mean, median, and mode are 3.4, 3, and 2. The mean is the average: the sum of the
4,6,2,2,4,3,2,1, and 7. The mean, median, and mode numbers of children per
family are, respectively.
146.
3.4, 2, 3
3, 3.4, 2
3, 3, 2
3.4, 3, 2
A study is undertaken to determine whether drinking more than 8 cups of
coffee a day is associated with hypertension. The blood pressure readings
were taken of persons who drink more than 8 cups and persons who drink no
coffee. The results are as follows:
Hypertension Normal BP
> 8 cups
no coffee
6
2
observations divided by the number of observations. In this case, the mean is 31/9 = 3.4. The median is the middle
observation in a series of ordered observations, i.e., the 50th percentile (when the number of observations is even, it is
midway between the two middle observations). In this case, when the observations are orderedI, 2, 2, 2, 3, 4, 4, 6, 7
the median is 3. The mode is the observation that occurs with greatest frequency; in this case it is 2, which occurs three
times.
C; The chi-square is used if no cell has an expected count less than 1, and no more than 20 percent of the cells have an
expected count less than 5. In this case the expected counts are 4.2 (10 X 8 / 19) for cell a, 5.7 (10 X 11 / 19) for cell b,
3.7(9 X 8 / 19) for cell c, and 5.2 (9 X 11 I 19) for cell d. Because 50 percent of the cells have an expected count of less
than 5, the Fishers exact test is appropriate. In general, it is used when the sample size is small. The McNemars test is
used for paired dichotomous data, the student t for independent continuous data, and the analysis of variance is for
analysis of several independent means.
4
7
Which of the following is the most appropriate test to analyze the data?
147
D; Case-control studies do not involve an observational period, as do cohort studies. The disease in question has already
occurred and the study is interested in examining antecedent exposures. Conducting field operations or pilot studies is
also useful in planning and refining study protocols.
148
D; Body weight, though not an accurate measure of excess fat is a widely used index.
For adults, various other indicators for measurement of excess fat are:
BMI
Ponderal index
Brocas index
Lorentz index
Corpulence index
149
Lorentz index
Ponderal index
Broca index
Obesity index
According to maternal health programme the daily dose of folic acid for
pregnant women should be:
D; Folic acid supplementation during pregnancy has been found to increase birth weight of infants and decrease the
incidence of low birth weight babies Intake values of folic acid recommended by ICMR
Status In mg/Per day
Healthy adults 100
Pregnancy 400
Lactation 150
Children 100
100 mg
200 mg
300 mg
400 mg
150
WHO Regimen for abbreviated multisite schedule for rabies vaccination is?
regimen, one dose is given in the right arm and one dose in the left
arm at day 0, and one dose given intramuscularly in the deltoid region on days 7 and 21. the 2-1-1 schedule induces an
early antibody response and may be particularly effective when post-exposure treatment dose not include administration
of rabies immunoglobulin.
151
0, 3, 7, 14 & 28
0, 7, 21
0,3, 7, 28 & 90
0, 7, 28, 90
Egg has all vitamins except:
152
B1
B6
C
E
Under EMCP (Enhanced Malaria Control Project) launched in 1997,the criteria
for selection of PHCs (Primary Health Center) included the following, EXCEPT:
D; Under EMCP (Enhanced Malaria Control Project) launched in 1997, the criteria for selection of PHCs (Primary Health
Center) include API more than 2 for the last 3 years, Plasmodium falciparum more than 30% of total malaria cases and the
area has been reporting deaths.
153
A; Vaccination strategy
The 1st priority group is women of child bearing age followed by vaccination of all children aged 1-14 years and then
children at one year of age.
Note: MC used strain for rubella vaccine is RA 27/3.
154
A; Form year 2000 onward, SRS included a new method called the RHIME or representative, Re-sampled, Routine
Household interview of Mortality with Medical Evaluation. This is an enhanced form of verbal autopsy which is the key
feature of a prospective study of 1 million deaths within the SRS. RHIME include random re-sampling of field-work by an
independent team for maintaining quality of data
155
A;
"In Area where incidence of neonatal tetanus is high, the primary 2 doses course can be extended to all women of
reproductive age, particularly if the percent coverage of antenatal case is low"
Strategy for neonatal tetanus elimination.
Increase and sustain high coverage levels with two doses or in booster dose of IT in pregnant woman.
Increase proportion of deliveries by trained personnel; intensify dais training.
Implement essential new born care, including cord care, to reduce risks of neonatal tetanus.
Strengthen surveillance system and undertake follow up action in areas from where cases are reported.
Continue IEC activities to promote clean deliveries.
156
B;
157
Palm oil
Dose of iron and folic acid to be given to a pregnant mother under RCH
programme is:
B;
Dose of iron and folic acid to be given to a pregnant mother under RCH programme is 60mg. and 500g daily for 100
days.
158
B;
Trench fever
159
160
Nominal scale
Ordinal scale
Interval scale
Ratio scale
2 drugs were given to population and response was noted are follows.
Drug
Cured
Not cured
B
110
50
Total
620
150
Which study design is most suitable?
B;
Data used in statistics can be of 2 types.
Qualitative data
Quantitative data
Qualitative data:
Data which "Cannot be measured" is termed qualitative
This denotes some characteristics or quality of he variables according to which they can be categorized.
Examples of qualitative data - sex, color. This kind of data can be placed under 2 scales:
(i) Nominal scale
Data cannot be placed in any meaningful order so it is divided into qualitative groups such as black/ white, male/ female
etc.
(ii) Ordinal scale
Date can be placed in a meaningful order e.g. ranking of runners in a race, hardness scale for water etc.
But in this case, there is no information regarding the size of "interval" i.e. the difference between 1st and 2nd or 2nd
and 3rd cannot be judged.
Quantitative data:
Data which "can be measured" e.g. - BP, serum glucose, age etc It can be measured on 2 scales.
(i) Interval scales:
Data is placed in meaningful order with intervals between the variables which" can" be measured.
e.g. - Temperature on Celsius scale (difference between 10 and 20 is some as that between
e.g. - 400 C temperature cannot be said as twice as hot as 20C because OC does not indicate complete absence of
heat.
(ii) Ratio scale:
Similar to interval scale but it has an absolute zero & hence meaningful ratios exist.
e.g. - temperature on Kelvin scale, heart rate, BP etc.
Here a zero indicates absence of heart/pulse/ BP respectively. Hence - a temperature of 200k is twice as hot as look, a
pulse of 120 is twice as fast as 60/ min and a systolic BP of 200 mmHg is twice of a SBP of 100mmHg.
C; Since the data is qualitative as the response noted is in terms of cured and not cured chi square test is most suitable.
More about tests of significance:
Tests of Significance:
Once a hypothesis is made, the next step is to test it by means of various tests (known as tests of significance). These can
be broadly classified as. Parametric tests:
These are - t test, z-test and ANOV A (or F-test) These share few common features:
(i) These hypothesis refers to certain population parameters which is the population mean (in case of t and z tests) or the
population variance (in case of F test)
(ii) These hypothesis concern interval or ratio scale data (e.g. weight, height, BP etc)
(Ill) They assume that the population data are normally distributed.
Nonparametric tests:
e.g. - Chi square test
(i) They do not test hypotheses concerning parameters.
(ii) They do not assume that the population data is normally distributed hence - distribution free tests
(iii) They are used to test nominal or ordinal scale data.
About individual tests:
T -test: (student t-test)
As for all parametric tests, it is used for quantitative data which is normally distributed in the population
(i.e. continuous data such as weight/height etc).
Steps:
1. State the null and alternate hypotheses
2. Select decision criteria a (level of significance)
3. Establish critical values of 't' associated with this criteria (using degree of freedom and corp t value from table of t
scores)
4. Draw a random sample from the population and calculate it's mean
5. Calculate standard deviation and standard error of the mean.
6. Calculate value of t that corresponds to mean of the sample.
7. Compare the calculated value of 't' with the critical value selected above and then accept or reject the null hypothesis.
T -test can be unpaired or paired:
Paired t-test is a special type of t-test used when the data is "paired" e.g. - blood glucose before and after taking a drug
OR
Pulse rate before and after exercise (in the same group).
Z-Test:
Involves the same steps as t-test
Used when the sample is large (n> 100)
T-test though is more important as there is no situation where as Z test can be used and a t-test cannot be but the
vice versa can occur.
ANOVA:
Whereas a T test is appropriate for making just one comparison (between two sample means, or between a sample mean
and a hypothesized population mean), when more than one comparison is being made (i.e. when means of> 2 groups are
being compared), ANOVA (analysis of variance) is the appropriate technique.
ANOV A can be:
1. One way ANOVA - when the groups differ in terms of only one factor at a time.
e.g.: 3 different drugs given to 3 groups of people to compare their effects.
2. Two way ANOVA - If the groups 2 differ in factors at a time
e.g. - If in the above example if each group consists of male and female patients, the researcher may also want to make
comparisons between the sexes, making a total of 6 groups.
Chi-square test:
Used for qualitative data, which is in the form of proportions (percentages). e.g. comparing incidence of a disease in 2
groups of children with one group vaccinated and the other not, OR comparing incidence of Hb < 10 (anemia) in 2 groups
of pregnant women, one taking iron supplements and the other not.
Student T test
161
Paired T test
Chi square test
Bland and Altman test
True about dietary allowance are all except:
162
Adequate intake
R DA
Dietary intake according to food composition
Food intake according to the upper limit of the RDA
Maternal
Mortality
Rate
is
A;
In this context, a variety of terms have been used to define the amount of nutrients needed by the body such as:
optimum requirements, minimum requirements, recommended intakes or allowances, and safe level of intakes. Of theses,
the term recommended daily intake or allowance (RDA) has been widely accepted.
Recommended daily allowance (RDA)
The term recommended daily intake is defined as the amounts of nutrient sufficient for the maintenance of the health in
nearly all people. They are reference standards of nutritional intakes. For all nutrients, except energy, estimates of
allowances are based on the defined minimum required plus a safety margin, often generous , for individual variation
and stress of everyday life. In some cases, this has entailed adding to the observed mean, twice the standard deviation of
the distribution of minimum requirement for the subjects measured. This value will more than meet the requirements of 97.
5 per cent of population .
calculated
by:
B;
According to WHO, a maternal death is defined as "the death of a woman while pregnant or within 42 days of
termination of pregnancy, irrespective of the duration and site of pregnancy, from any cause related to or aggravated by
the pregnancy or its management but not from accidental or incident ill causes" (81),
Maternal mortality rate measures the risk of women dying from "puerperal causes" and is defined as :
Total no. of female death due to complications of pregnancy,
childbirth or within 42 days of delivery from
"puerperal causes" in an area during a given year
=---------------------------------------------------------------------------------1000
Total no of live births in the same area and year
Ideally the denominator should include all deliveries and abortions. ,
The maternal mortality rate should be expressed as a rate per 1000 live births. In developed countries, MMR has declined
significantly. Because of this decline, they use the multiplying factor 100,000 instead of 1000 to avoid fractions in
calculating MMR.
NB : Many students have said that the Questions asked was Maternal Mortality RATIO is calculated by ?
Answer choices were same. Then the answer is (C)
163
B; Irrespective of the duration between the two doses due vaccines can be given. Because the memory cells in the body
164
you
give
now?
B; There are many types of growth charts in common use in different countries. Some have only 2 reference curves, and
others as many as five. The WHO in recent years has made an effort to unify the countless growth charts and curves used
throughout the world.
It has 2 reference curves. The upper reference curve represents the median for boys and the lower reference curve the 3 rd
percentile for girls. Thus the chart can be used for both sexes.
The space between the two growth curves has been called the road to health. This will include the zone of normality for
most populations i.e the weights of 95% of normal healthy children used as a reference fall within this areas. If the child is
growing normally, its growth line will be above the 3rd percentile and will run parallel to the road to health curves. It is the
direction of growth that is more important than the position of dots on the line. Flattening or falling of the childs weight
curve signals growth failure. The objective in child care is to keep the child above the 3rd percentile
Home based
Internationally based
Community based
Nationally based
165
Acculturation means:
A; Acculturation means culture contact. When there is contact between two people with different types of culture, there is
diffusion of culture both ways. There are various ways by which culture contact takes place (1) trade and commerce, (2)
industrialization (3) propagation of religion, (4) education, and (5) conquest.
The radio, the television, the cinemia have been important factors in shaping the cultural behaviour patterns of people.
Culture contact
Study of the various cultures
Movement in socioeconomic states
166
D; The first milk which is called colostrums is the most suitable food for the baby during this early period because it
contains a high concentration of protein and other nutrient the body needs; it is also rich in anti infective factors which
protein the baby against respiratory infections ad diarrhoeal disease. Supplementary feeds are not necessary.
167
Ca
Fat
Fe
cu
Classification of grades of protein energy malnutrition given by India academy
D;
For the purpose of comparison growth charts are provided with reference curves. These curves show the limit of
of pediatrics as adopted:
normal growth. The WHO reference curves are based on extensive cross-sectional data of well-nourished healthy
children, assembled by the national centre for health statistics (NCHS). Malnutrition is defined by WHO as a weight for age
below the median minus two standard deviations of the NCHS reference population .
ICMR standards
Standards developed by national institute of nutrition, Hyderbad
Local standards
NCHS standards
168
169
170
Calcium requirement above the normal during the first six month of lactation
is:
400 K mg/day
550 mg/day
600 mg/day
750 mg/day
Which of the following vitamin is not needed in excess of normal daily
requirements in pregnancy?
Vit. A
Vit D
Vit B12
Vit C
The daily requirement of fat is % of total energy?
172.
C; Group
Calcium mg/d
Man
Woman
Pregnant woman
Lactation
0-6 months
6-12 months
400
400
1000
Infants
Children
500
400
1000
C;
B;
Balance diet in constructing balance diet following principal should be kept in mind.
1. Protein
- 15 20% of daily energy intake
2. Fat
- 20 30% of daily energy intake
3. Carbohydrate Remaining food energy
For Indian set up - % of total energy intake
Protein
= 7 15%
Fats
= 10 30%
Carbohydrate
= 65 80%
10
15
. 20
171
172
173
25
In 20 point programme how many points are related direct or indirectly to
health?
5
6
7
8
In the WHO recommended EPI cluster sampling for assessing primary
immunization coverage, the age group of children to be surveyed is:
0 12 Months
6 12 Months
9 12 Months
12- 23 Months
Pneumococcal vaccine is indicated in all, except
DM
Renal failure
D; At least 8 of the 20 points are related, directly or indirectly to health. These are:
Point 1
- Attack on rural poverty
Point 7
- Clean drinking water
Point 8
- Health for all
Point 9
- Two child norm
Point 10
- Expansion of education
Point 14
- Housing for the people
Point 15
- Improvement of slums
Point 17
- Protection of the environment
The restructured 20 point programme constitute the charter for the countrys socio economic development, it has been
described as the cutting edge of the plan for the poor.
D;
WHO recommends cluster sampling to evaluate immunization (EPI) and Universal immunization programme (UIP),
where only 210 children, taking 7 from each cluster in the age group 12-23 months are to be examined.
Percentage of immunization coverage is obtained by:
210
Coverage = ------------------------------------------------ x 100
Eligible children of surveyed houses
Cystic fibrosis
Sickle cell anaemia
174
Germany
175
Galen
Celsius
Harnel
Charak
Microorganism used as weapon in biological terrorism:
Writer
Harnel
U. C. Dutta
A. C. Chatopadhyay
G. D. Singhal
Bellars
2. Chemical
3. Radiation
Biologic Agent used as Bio weapons.
Category A
Bacteria
Virus
Anthrax (Spore)
- Small Pox
Botulinum (toxin)
- Viral hemorrhagic fever
Plague
Arena virus Lassa
Tularemia
Bunyavirus Rift valley
Filo virus Ebola, Marburg
Flavo virus yellow fever and KFD
Category B
Diseases
Toxin / Ingestion
Brucellosis
Epsilon toxin of Cl. Perfringens
Glanders disease
Staphylococcal enterotoxin B
Melioidosis
Ricin toxin Ricinus communis
Q. fever
food safety threats
Viral encephalitis (Salmonella, E.coli 157: H7, shigella)
Typhus fever
Water safety threats
(V. cholerae; cryptosporidium parvum)
Category C
Emerging infectious disease
Nimpah
Hanta virus
SARS
Influenza C virus
176
C; Reported incidence of LBW babies in some developed and developing countries in 2000 - 2007
Country
China
USA
UK
Switzerland
India
177
Switzerland
USA
China
UK
Live vaccine of influenza is given:
B; Live attenuated vaccine for influenza is based on temp-sensitive (ts) mutants. It has been extensively used in former
USSR. They may be administered as "Nose Drops" into the respiratory tract. They stimulate local as well as systemic
immunity
178
179
Subcutaneous
Intranasally
Intramuscular
Orally
Which of the following grading of IQ has been given by WHO for MODEARTE
mental retardation:
20-34
35-49
50-70
60-80
What is the recommended interval in months between the administration of
whole blood transfusion and MMR vaccine?
B; Live attenuated vaccine for influenza is based on temp-sensitive (ts) mutants. It has been extensively used in former
USSR. They may be administered as "Nose Drops" into the respiratory tract. They stimulate local as well as systemic
immunity.
180
1
3
6
The term AYUSH is related to:
B; For producing skilled human resources, a number of medical and paramedical institutions including Ayurveda, Yoga
and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) institutions have been set up in India.
181
IMR
Alternative Medicine
Life span
MMR
For Mantoux test the standard dose of tuberculin used in India is (TU):
B; Mantoux Test (a type of tuberculin test): It is performed by injecting intradermally on the flexor surface of the forearm 1
TU of PPD in 0.1 ml. The WHO has recommended a preparation known as PPD-RT-23 with Tween 80. The result of the
test is read after 72 hours.
182
0.5
1.0
5.0
10.0
Iron and folic acid supplementation forms:
B; To avoid disease, altogether, is the ideal but this is possible only in a limited number of cases. Some currently available
interventions aimed at specific protection are enumerated below:
Immunization;
Use of specific nutrients;
Chemoprophylaxis;
Protection against occupational hazards;
Protection against accidents;
Protection from carcinogens;
Avoidance of allergens;
Control of specific hazards in general environment; and
Control of consumer product quality and safety of food, drugs, etc.
183
Primary prevention
Specific protection
Health promotion
Primordial prevention
Which one of the following insecticides is not used a larvicides?
D;
Toxicant use as Mosquito larvicidal
Toxicant
Dose
Mineral oils
- 40 90 litres / hectare
Paris green
Abate
Malathion
Fenthion
Chlorophyrifos
184
Abate
Paris green
Fenthion
Dichloros
Which of the following committee has given 3 million plan for PHC?
- 1 kg / Hectare
- 56 112 gm/ hectare
Abate most effective larvicidal at concentration of 1.0 ppm
- 224 672 gm/hectare
- 22 112 gm/hectare
- 11 16 gm/hectare
a; Bhore committee
1. Integration of preventive and curative service.
2. Development of PHC in 2 stage by
a. Short term measure PHC for 40, 000 population.
b. Long term setting primary health unit with 75 beded hospital for 10-20 thousand population.
A long term programme (also called the 3 million plan) of setting up primary health units with 75 bedded hospitals for each
10,000 to 20,000 population and secondary units with 650 bedded hospitals, again regionalized around district hospitals with
2,500 beds.
3.
185
Bhore Committee
Mudaliar Committee
Chaddah Committee
Kartar Singh Committee
Indian factories act prohibits the employment of children below the age of:
B; The Factories Act prohibits employment of children below the age of 14 years and declares persons between the ages
15 and 18 to be adolescents. Child, who has not completed his 14th year of age has been restricted from employment in
any factory
10
14
16
186
18
Minimum air space per worker prescribed by Indian Factory act is:
C; As per Factories (Amendment) Act, 1987, a minimum of 500 cu ft of space for each worker has been prescribed (not
taking into account space more than 14 feet above the ground level). For factories installed before the 1948 Act, a
minimum of 350 cu ft of space has been prescribed.
200 cu ft
300 cu ft
500 cu ft
700 cu ft
187
A; DANIDA
The Government of Denmark is providing assistance for the development of service under national blindness control
programme since 1978.
188
Medical audit
Medical evaluation
189
Performance evaluation
Professional screening
All are included in health sector policy in India except:
A; For the purpose of planning the health sector has been divided in to following sub sectors:
1. Water supply and sanitation
2. Control of communicable disease
3. Medical education, training and research
4. Family planning
5. Medical care
6. Public health service
7. Indigenous system of medicine
190
Nutritional supplements
Medical education
Family welfare programme
Control of communicable disease
All of the following statements are true about mass media education except:
Transmitted message to people even in some test places. Number of people who are reached usually in millions
(reaches to modest population).
Their effectiveness can give high return for the time and money involved (Means rapid and cheap).
To raise the general knowledge in local community.
Mass media is generally less effective in changing human behaviour than individual or group method (in this method
personal habit change more readily.
Be cause of its easy availability mass media has started taking care of problem of local community.
Mass media is more effective with above average intelligence level (personal communication is more influential with
average and below average level
Distorted information
191
D;
If health programme is based an felt need people will gladly participate in programme and only than it is peoples
programme (The health education programme is useless when public is not interested).
Principles of Health education
1. Credibility
2. Interest: Health educator must find out the real health needs of people (Felt need 0 need the people feel about
themselves).
3. Participation: Key word in health education
4. Comprehension: Always communicate in the language people understand
5. Reinforcement
6. Motivation
7. Learning by doing
8. Known to unknown
9. Setting an example
10. Good human relation
11. Feed back
Leader: Leader are agent of change and they can be made use of in health education work. If the leaders are convinced
1st about a given programme. The rest of the task of implementing programme will be easy
B;
193
Case control
ecological
Cohort
Field trials
Nuisance mosquito is:
B; Mosquitoes of the genus culex are the common nuisance mosquitoes which are terrible pests of man. An important
member of this group is culex fatigans, the vector of Bancroftian filariasis in India.
It breeds profusely in drain, cesspools, septic tanks, burrow pits and in fact in all types of water collection. Culex fatigans is
a strong winged mosquito; its dispersal has been found to be 11 km in the rural areas of Delhi.
It enters the house at dusk and reaches maximum density by midnight. The peak biting time is about midnight.
Aedes mosquitoes are easily distinguished by white stripes on a black body. Because of he striped or banded character of
their legs they are sometimes referred to as tiger mosquitoes.
It is the first proved vector of a virus disease yellow fever. Aedes aegypti is widely distributed in India. It breeds in
artificial accumulations of water in and around human dwellings. It lays eggs singly & the eggs are cigar shaped. The
females are fearless biters, and they bite chiefly during the day. They do not fly over long distance usually less than 100
metres. This factor facilitates its eradication. Under the WHO international Health regulations (IHR) all international airport
and seaports are kept free from all types of mosquitoes for a distance of 400 metres around the perimeter of the ports.
Under the international health regulations, aedes aegpti index is defined as the ratio, expressed as percentage, between
the number of houses in a limited well defined areas on the premises of which actual breeding of Ae. aegpti are found,
and the total number of houses examined in that area. This index is kept at zero at all ports.
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Anopheles
culex
Ades
Tsetse fly
Which of the following results gives the reader the most information
concerning statistical significance, sample size, and strength of association?
values for the attribute that is being assessed and is designed in such a
way that this range has a certain probability of including the true value. A 95 percent confidence interval, equivalent to a =
0.05, will include the true value 95 percent of the time. The confidence interval reflects not only the relevant range of
possibilities, but reflects sample size and statistical significance as well. A larger range indicates a smaller sample size. A
confidence interval for a relative risk that includes 1.0 would indicate a nonsignificant statistical association (there is a 95
percent chance that the relative risks would be the same or 1.0). The p value only indicates the probability that the
association occurs by chance. Statistical power only gives the probability of avoiding missing a true difference between
exposure groups (type II, or B, error).
196.
C; A statistically significant test (p < 0.05) rejects the null hypothesis, which states that no differences of effect will be
found. A p < 0.05 indicates that a difference was found and there is <5 percent probability that it occurred by chance. No
test of significance can determine causality or rule out errors or bias as the cause of an association. Neither can it imply
clinical significance. A nonsignificant test may still have valuable clinical implications, such as the need for a larger, more
involved study of a specific association
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studied by obtaining
smoking
histories from women at the time of the prenatal visit and then
subsequently correlating birth weight with smoking histories.
C; This
study is a cohort (prospective) study because the subjects (pregnant women) were categorized on the basis of
exposure or lack of exposure to a risk factor (smoking during pregnancy), and then were followed to determine if a
particular outcome (low-birth-weight babies) resulted. The term cohort refers to the group of subjects who are followed
forward in time to see which one develops the outcome. Clinical trials are prospective studies in which an intervention is
appliedno intervention was mentioned in the question. In a case-control (retrospective) study of the relationship between
low birth weight and maternal smoking, infants would be selected on the basis of low birth weight (cases) and normal birth
weight (controls) and then the frequency of maternal smoking would be compared in the two groups. In cross-sectional
studies exposure and outcome are measured at the same point in time. Correlation studies are used to compare disease
frequencies between entire populations.
198
.
B; As a general rule, it is much easier to get a falsely negative result on a randomized blinded trial than a falsely positive
result. The reason is that errors will tend to affect both treatment groups, making it harder to show a difference between
them. Thus, in this question, inclusion of subjects without the ear effusion (who could not benefit from the intervention) and
incorrect determination of which effusions resolved, would both lead to falsely negative, not falsely positive results.
Similarly, a small sample size is a reason for a falsely negative, but not a falsely positive result. Double blinded trials are
studies where both the subject and the observer are blinded to the treatment. Only chance (random error), a breakdown in
the blinding or randomization process, or a differential loss to follow-up would be causes of a falsely positive result
199
A; The likelihood becoming chronically infected with hepatitis B is inversely related to the age at which the infection
occurs. Up to 90 percent of infants born to HBcAg-positive mothers will become carriers. Between 25 and 50 percent of
children infected before the age of 5 will become carriers. Only 6 to 10 percent of acutely infected adults become
chronically infected. The risk of becoming a chronic carrier is the same for men and women. Parenteral transmission is not
associated with a higher risk of chronic disease compared with sexual transmission. Although antigen dose may affect the
risk of acquiring hepatitis B, it has no impact on chronic carrier status. Immunodeficiency may affect response to vaccine,
but has not been proved to be a risk factor for chronic carrier status following an acute infection
200
200
Age
Gender
Antigen dose
Percutaneous injury
If . is a disease, education is its vaccine, is said for which of the
following condition/disease?
accident
STD
HIV
Drug addiction
4-8 qualified persons deliver a series or speeches on a selected subject. There
is no discussion among the members is an example of:
A; Safety education
There is a widespread belief that accidents are inevitable; this fatalistic attitude must be curbed. Safety education must
begin with school children. The drivers need to be trained in proper maintenance of vehicles and safe driving. Young
people need to be education regarding risk factors, traffic rules and safety precautions. They should also be trained in first
aid. It has been aptly said that if accident is a disease, education is its vaccine.
Symposium
Panel discussion
Workshop
Group discussion