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1

Which of the following is a living fluid?

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

Comfort zone which is comfortable has corrected effective temperature:

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%

Infectious waste 15%


RAGS 15%
The result of a study of the incidence of T.B. in a village are given the table
below. All persons in the village are examined during two surveys made 2
years apart, and the number of new cases was used to determine the
incidence rate.
Category of Household Number of
Number of
at First Survey
Persons
new cases
With culture-positive case
500
10
Without culture-positive case
10,000
10
What is the incidence of new cases per 1000 person-years in house-hold that had a
culture-positive case during the first survey?

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.

Temporal sequence causative agents must precede their consequences


Biological gradient dose response curve
Concurrency cause and effect are found at the same time

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.

Cohort studies are longitudinal in design


Subjects are selected on the basis of characteristics present before the onset of the
condition being studied

Subjects are observed over time to determine the frequency of occurrence of


the condition under study
Cohort studies are necessary to estimate the prevalence of disease

Decision analyses often include a patients utilities in the determination of the


best decision. These utilities measure

Whether a patient favors one decision over another


Whether a physician favors one decision over another
The difference between a patients decision and the physicians decision

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

The relative value a patient places on a particular outcome


The authors of a study state that careful autopsies show that 60 percent of all
persons who die have evidence of recent or previous pulmonary embolism
and conclude that pulmonary embolism is the leading cause of death in India
possible reasons for disagreeing with the conclusion include all the following
except:

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

The use of matching as a technique to control for control for confounding is


most appropriate for which type of study ?.

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

A large-scale cohort study


A case-control study with a small number of cases
A clinical trial with a factorial design
A cross-sectional study with multiple variables

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

Crude death rate are usually higher in developed countries because of a


higher proportion of older person in the population
13

PQLI includes all except:

A;

physical quality of life index


Combines the infant mortality, life expectancy at age one and literacy
It is also scaled from 0 to 100 and objective is to attain PQLI of 100. It measures the outcome of social, economic and
political policies and does not replace GNP.
Human development index
Adult literacy rate and mean years of schooling and life expectancy at birth.
Its value ranges from 0 to 1
Income as real GDP per capita in purchasing power (in dollars)
Actual value - Minimum value
Calculation of Indices = ------------------------------------------------------Maximum value - Minimum value
Established fixed minimum and maximum values of indicators are:
25 yrs and 85 yrs for life expectancy at birth.

0% and 100 % for adult literacy rate


0% and 100 % for combined gross enrolment ratio
100 and 40,000-real GDP per capita
HDI is average of all three indices

14

Per capita income


Life expectancy at age 1 year
Literacy
Infant mortality
Which one of the following is NOT a socio-economic indicator:

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

Expressed as rate per year


Can be adjusted for age
Can be used for events other than death
Ratio of observed deaths to expected deaths

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

Control and case are the same


Case and control are different
Control is same and case is different
Case is the same and control is different
Incubatory carriers are not an important source of transmission in the
following disease:

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

Which of the following is true about Swajaldhara?

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.

It is a community led participatory programme


Swajaldhara I has district as the project area
Swajaldhara II is for a gram panchayat or a group of panchayat
All are true

23

First step in investigation of epidemic:

B;
Investigation of an epidemic-steps to be followed chronologically are:
(1) Verification of diagnosis
(2) Confirmation of the existence of an epidemic

(3) Defining the population at risk


(4) Rapid search of all cases and their characteristics
(5) Data analysis
(6) Formulation of hypothesis
(7) Testing of hypothesis
(8) Evaluation of ecological factor
(9) Further investigation of population at risk
(10) Writing the report

24

Find the source


Confirm diagnosis
Confirm epidemic
Defining population at risk
Which is most economical and best screening:

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.

Saturation of coverage of high risk groups with targeted interventions

b. Scaled up interventions in the general population


II. Increasing proportion of people living with HIV/AIDS who receive care and support and treatment
III. Strengthening infrastructure, systems human resources in prevention and treatment programs at district, state and
national level
IV. Strengthening nation wide strategic information management systems

Prevention of new infection in high risk groups


Increasing proportion of people living with HIV/AIDS who receive care and support
and treatment

Strengthening infrastructure, systems human resources in prevention and treatment


programs at district, state and national level
Safe, controlled and easy blood supply

26

Immunization of preschool children with diphtheria toxoid results in :

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.

Detectable antitoxin for about 10 years.


Protection against diphtheria carrier state.
Frequent adverse reactions
Protection against infection of the respiratory tract by corynebacterium diphtheriae.

27

Following are complication of chickenpox except:

B;
Complication
Pneumonia
Acute cerebellar ataxia
Encephalitis
Rey's syndrome

------ RAPE

Foetal wastage and birth defects:

Cutaneous scars
Atrophied limbs
Microcephaly and LBW baby

Vaccine under trial-live attenuated OKA strain

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;

Quantitative data of a group of patients.


Qualitative data of a group of patients

32

Data collected on nominal scale


Data collated on ordinal scale
If false hypothesis is accepted, error committed is :

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

In a programme discrete activity that has to be achieved within a

D;

given time frame is called

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

Standard plate count


Phosphatase test
. Coliform count
Methylene blue reduction test
National Health Plan (1983) has proposed one primary health center for
every. population in hilly areas:

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

Population and Area


5000 in general 3000 in hilly, tribal and backward area.
30000 in general 20000in hilly, tribal and backward area.
80000 to 1.2 lakh
30,000 in general or at population of 20,000 in hilly or
backward area
5000 in general 3000 in hilly tribal backward area
1000 population

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

Indirect cause (anemia, malaria, heart disease)

20

Infection

15

Unsafe abortions

13

Eclampsia

12

Obstructed labor

08

Other direct causes (ectopic pregnancy, embolism, anesthesia related)

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

Civil Registration System


Census

50

Adhoc Survey
Sample Registration System
Which of the following is the nodal ministry for Integrated Child Development
Services Program Center

Ministry of social & Womens Welfare


Ministry of Rural Development
Ministry of Health and Family Welfare

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

Ministry of Social Justice


Poorest source of vitamin C among following is:

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

Two minor manifestation plus evidence of a preceding group A streptococcal


infection
Two major or one major and two minor, manifestation
Iodine deficiency is associated with all except:

C;
The spectrum of iodine deficiency disorders in approximate order of increasing severity.
Disorders:
Goiter
Hypothyroidism
Subnormal intelligence

Delayed motor milestones


Mental deficiency
Hearing defects
Speech defects
Strabismus (squint)
Nystagmus
Spasticity (extrapyramidal)
Neuromuscular weakness
Endemic cretinism
Intrauterine death
(Spontaneous abortion, miscarriage

Mental retardation
Still births

High infants mortality rates


54

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.

Janani suraksha yojna


Vandemataram scheme
NHRM
RCH II

55

The recommended daily requirement of vitamin A for pregnant woman is:

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

Healthy adults 100 mcg


Pregnancy 400 mcg
Lactation 150 mcg
Children 100 mcg

- 1 mcg
- 1.5 mcg
- 1.5 mcg
- 0.2 mcg

FA Is heat unstable while vit B12 is heat stable.


Recommended daily allowances for folic acid is 1000 micro grams

58

Vegetarians have vitamin B12 deficit


Deficiency of both causes megaloblastic anaemia
The vitamin a supplement administered in Prevention of nutritional blindness
in children programe contain:

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

Short term action


Administration of large dose of Vit. A
orally in recommended dose to
vulnerable group on periodic basis
1. Children < 12 mo 1 lac IU once
every 4 6 mo
2. Children > 12 mo 2 lac IU once
every 4-6 months
3. New born 50, 000 IU at birth
4. Women of child bearing age 3 lac
IU within one month of giving birth
5. Pregnant and lactating women
5000 IU daily or 20,000 IU weekly

Medium term action


Vitamin A fortification of certain food
eg. Addition of vitamin A to dalda.

Long term action


Reduce factor contributing to ocular
disease. Eg.
1. Promote consumption of green
leafy vegetable or other vit. A rich
food.
2. Promote breast feeding
3. Immunization against infection
disease e.g. measles
4. Prompt treatment of diarrhoea
5. Social and health education etc.

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

Prevention of needle stick injuries.


The use of traditional barrier such as glove and gowns.
The use of mask and eye covering
The use of individual ventilation devices.
The CDS (centre of disease control and prevention) recommended that universal precaution apply to blood, semen and vaginal
secretion, amniotic, cerebrospinal, pericardial, peritoneal, pleural and synovial fluid and to other body fluid contaminated with blood

.Stool
Sputum
Semen
Urine

61

Safe limit of fluorine in drinking water is:.

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

Tick transmits all, EXCEPT:

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

Active search for new cases


Use of cotton cloth to filter the water
Use of mosquito repellents

66

Chlorination of water
Which of the following is true about WHO standards recommended for
drinking water;

Hardness of water below 300 mg/litre

A; The maximum recommended concentration of nitrates in drinking water is below 50 mg/lit.


Constituents
Lead
Nitrate
Nitrite
Manganese
Fluoride
Hardness

Recommended maximum concentration in drinks water (mg/lit)


0.01
50
3
0.5
1.5
300

Lead below 0.1 mg/litre

67

Nitrates below 0.01 mg/litre


Nitrites below 50 mg/litre
According to WHO, the conventional oral rehydration solution (ORS) besides
glucose 20g/lit. and sodium; chloride 3.5g/lit, also contains:
.

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.

3.5g calcium chloride and 2.5 g potassium chloride


2.9 g sodium hydroxide and 1.5g sodium acetate
2.5 g sodium bicarbonate and 1.5g potassium chloride
1 g potassium hydroxide and 1.5g potassium chloride

68

Protein content of rice is:

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.

Discarded waste arising from man's activities


Waste matter arising from preparation, cooking and consumption of food
Waste water from community containing solid and liquid excreta
Waste water which does not contain human excreta

70

Mass treatment is given in trachoma if prevalence of moderate and severe


trachoma in children below 10 years of age is more than:

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.

Tests the significance of difference between two proportions


Also be used when more than two groups are 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

Energy allowance per day (in kcals)


Reference male
2425
2875
3800

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

Anopheline larvae only


Culicine larvae only
Adult mosquitoes
None
Base line year for Roll Back Malaria Global Strategic plan is

B; With the publication in 2005 of

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

Which is known as Fifth disease is:

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;

Observer is blind about the study


Person or groups being observed are blind about the study
Both observer and observed group is blind
Interpreters and analyzers are blind about study

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.

Norgestrel 0.3 mg + ethinyl oestradiol 0.03 mg

79

Medroxyprogesterone acetate 150 mg


Levonorgestrel 0.25 mg + ethinyl oestradiol 0.03 mg
Desogestrel 0.3 mg + ethinyl oestradiol 0.03 mg
Rajiv Gandhi Shramik Kalyan Yojna came into effect from

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

2ND October 2005


st
1 April 2005
TH
14 Nov 2005
15TH Aug 2005
In India, the most important vector for Japanese encephalitis is;.

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:.

D; The diseases notifiable to WHO are


1. Cholera

2. Plague

3. Yellow fever

Diseases under international surveillance are


1. Relapsing fever
2. Malaria
3. Polio
4. Rabies
5. Influenza
6. Salmonellosis
7. Louse-borne typhus

Cholera
Plague

82

Yellow fever
Poliomyelitis
High stationary phase in demography is.

B.R. in low D.R. v. low


B.R. static D.R.

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

B.R. less than D.R.


B. R. High D. R. High
National institute for mentally handicapped (NIMH) is located at:

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

Cooling power of air


Maximum temperature
Minimum temperature
Body temperature
Cut off of Indian reference man are all except:

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

mopping floors & cleaning drains.


Ethylene oxide is 3rd generation disinfecting agent. Heat sensitive articles may be sterilized at 55-60 degrees C by
ethylene oxide which kills bacteria, spores (eg: tetanus spores) and also viruses. Glutaraldehyde is effective in destroying
the viruses

Glutaraldehyde- virus killing


Ethylene oxide is 3rd generation disinfecting agent
Phenols are ineffective against organic matter

88

Autoclaving is not suitable for sterilization of plastics & sharp instruments.


Malathion spray is effective for:

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

Multiload device is:

First generation IUCD


Second generation IUCD
Barrier contraceptives
Oral contraceptive
Immunity develops indays, after the administration of Japanese
encephalitis vaccine:

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.

iv. Preference for male children.


v. Desired family size complete family size: indicates the total number of children born by a woman up to the end of her
child bearing age (between 15-45 years):

Number of members in a family


Number of daughters born in a family
Number of children that will be born by a female
Number of daughters that will be born by a female as per prevailing mortality rate

92

Mid-day meals provided in schools is:


. One half of calories and one half of protein

B;

One-third of calories and one half of protein


One-half of calories and one-third of protein
One-third of calories and one-fourth of protein

93

Which of the following is the most sensitive index of recent transmission of


malaria:

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

Infant parasite rate


Proportional case rate
Parasite rate
Parasite density index
Wrist drop may be caused by working in:

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

One anganwadi worker is for

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

AZT + 3TC + NVP twice daily


AZT + 3TC + NVP twice daily
AZT + 3TC + NVP twice daily

Sd-NVP+AZT
AZT/3TC
AZT + 3TC + NVP
None of the above

100

Which of the following is true regarding Varicella-zoster virus infection:

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.

Rash has centrifugal distribution


Incubation period is of 30-100 days

101

Secondary attack rate is about 50%


Scales are not infectious
Which is a second generation STD?

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:

B; Rabies vaccines currently in use are:


1. Nervous tissue vaccines
Derived from adult animal nervous tissue (sheep)
Derived from suckling mouse brain
2. Duck embryo vaccine
3. Cell culture vaccine
Human diploid cell vaccine
Second generation tissue culture (animal cell) vaccines
Veracillin vaccine

104

Duck embryo vaccine


Recombinant glycoprotein vaccine
HDCV
Killed sheep brain vaccine
Hardy-Weinberg Rule is related to:

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

A person is said to be under weight if his BMI is less than


18
18.50
19
17.50
Which of the following is true regarding trickling filter

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

It has biological zoogleal layer


.
It acts purely as a mechanical filter
It is used for primary treatment of sewage
It needs rest pauses for cleaning
Dose of malathion used for residual insecticidal action is (mg/square foot) :

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.

The correlation coefficient has a value between -1.0 and +1.0.

Value of other variable if the value of one variable is known


Whether there is significant association between two variables
Difference between two proportions
Standard deviation

110

Which of the following is true about chlorination

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.

Orthotolidine test measures free chlorine


Acts best when pH is around 7

111

Kills bacteria, viruses and spores


Disinfecting action is mainly due to hypochlorite ions
Which of the following is not true about polio?

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.

Type 1 strain is responsible for epidemics of paralytic polio


Type 2 strain is most immunogenic
Transmission is mainly by droplet infection
Man is only reservoir of infection

112

In census literacy rate is assessed by:

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

Attended literacy classes for one year


Ability to write signature
Ability to read and write
Ability to read newspaper
In vaginal sponge the chemical used is:
Nonoxynol

A; TODAY (vaginal sponge) is a small polyurethane foam sponge measuring 5 cm


spermicide, nonoxynol-9.

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;

x 2.5 cm, and it is saturated with the

Amaranth
Halibut liver oil
Green leafy vegetable
Orange

116

Which of the following is false regarding propagated epidemic:

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

It shows gradual rise and falls of very slowly


Herd immunity reduces transmission
Spreads from person to person
Secondary waves are absent
Acute flaccid paralysis is reported in a child aged

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:
.

C; Advantages of case control studies:

Cost effective and inexpensive


Odds ratio can be calculated

Relatively easy to carry out.


Rapid and inexpensive.
Requires comparatively few subjects.
Particularly suitable to investigate rare diseases or diseases about which little is known.
No risk to subjects.
Allows the study of several different etiological factors.
Risk factors can be identified and rational prevention and control programs can be established
Odds ratio (OR) can be derived from a case control study. Odds ratio is a measure of the strength of the association
between risk factor and outcome.
No attrition problems, because case control studies do not require follow up of individuals into the future.
Ethical problems are minimum.

119

120

Relative risk can be calculated


Useful in rare diseases
In an area, the number of live births for the year was 2100. The number of
stillbirths (> 20 weeks) was 80, the number of deaths in neonates was 11, and
number of deaths in children under the age of 1 year was 5. The IMR for this
community is:

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

Cereals and proteins are considered complementary because:

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

Both cereals and pulses contain threonine


Cereals are deficient in lysine and pulses are deficient in methionine

123

Cereals are deficient in methionine and pulses are deficient in lysine


cereals are deficient in methionine
Which of the following is false regarding ischemic heart disease in India as
compared to other more developed countries?

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

India has a lower prevalence of CAD as compared to the developed countries


It is often associated with insulin resistance

124

Males are more commonly affected


It occurs in decade earlier in India as compared to the developed countries
In a patient who has suffered through a deep penetrating wound has received
tetanus booster 10 years back. The treatment required in this patient is:

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.

Compete tetanus toxoid course and immunoglobulins


Tetanus toxoid and immunoglobulins
Tetanus toxoid only
Nothing to be done

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.

<1 % population is tuberculin positive

128

<1 % population is sputum positive


. <1% infection in children less then 14 years
< 5% TB cases
Road-to-health growth chart-was discovered by:

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:

D; In general, the anopheline prefer clean water for breeding;


the culicines prefer dirty and polluted water;
the Aedes prefer artificial collections of water.
The Mansonia breeds in water containing certain types of aquatic vegetation.

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

Population under 10 years and 60 and above


Population under 15 years and 60 and above
Population under 10 years and 65 and above
Population under 15 years and 65 and above
The following is true about the term 'new families':

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

It is applied to all nuclear families of more than 10 years duration


It is applied to all nuclear families of less than 10 years duration
is a variant of the joint family
It is applied to all nuclear families of less then 2 years duration

135

Which of the following is false regarding antigenic drift?

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

occurs every 10- 12 years


occurs under pressure from immunity
occurs only in influenza A
It is responsible for epidemics of influenza"
Which of the following is true regarding pasteurization of milk?

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

Bacterial count is reduced by 90%


Kills all bacteria and spores
Kills all bacteria and no spores
Kills all bacteria except thermoduric bacteria

137

The protein efficiency ratio (PER) is defined as

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.

The gain in weight of young animals per unit weight of protein-consumed


The product of digestibility coefficient and biological value
The percentage of protein absorbed into the blood

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.

35 ppm and 15 ppm

139

140.

30 ppm and 15 ppm


40 ppm and 20 ppm
20 ppm and 10 ppm
For vitamin A deficiency, all of the following are considered as epidemiological
markers except
Night blindness
Conjunctival xerosis
Bitot's spots
xerophthalmia
Elements of primary health care include all of the following except

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

adequate supply of safe water and basic sanitation


Providing essential drugs
Sound referral system
Health education
True statement about RDA:
.

Maternal and child health care including family planning;


Immunization against major infectious diseases;
Prevention and control of locally endemic diseases;
Appropriate treatment of common diseases and injuries; and
Provision of essential drugs.

B; Some imp facts about RDA:


It is defined as the amount of the nutrient sufficient for the maintenance of 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 requirement plus a safety margin often generous. In some cases this has entailed adding to the observed
mean, twice the SD of the distribution of the minimum requirement for the subjects measured. It is important to emphasize
that the RDA of nutrients does not apply to sick people

Average daily requirements of all nutrients


Average daily requirements of all nutrients except calories 2SD

142

143.

Indicates adequacy of dietary intake


Applies to even sick people
At risk babies are all of the following except:

Failure to gain weight for 3 consecutive months


Artificial feeding
Birth order 2nd or more
Birth weight less then 70 percentile
Which Of The Following is not part of targeted intervention in preventive
strategy in spread of AIDS?

C; The basic criteria for identifying 'at-risk' babies are as under:


Birth weight < 2.5 kg;
Twins;
Birth order 5 and more;
Artificial feeding;
Weight < 70% of the expected weight (i.e. II and III degrees of malnutrition);
Failure to gain weight during 3 successive months;
Children with PEM, diarrhea; and
Working mother / single parent

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

Integrated Counseling and Testing (ICT)


(provider-initiated testing and counselling of patients)
Promotion of safe practices and infection control.
BCC through peer and outreach.
Building enabling environment Community organizing and ownership building. (CBOs).
Linking HIV related care and support services
PPTCT.
PEP.
Promotion of voluntary blood donation and access to safe blood.

2. Providing greater care, support and treatment to larger number of PLHA :


Under NACP-II, focus was given on low cost care, support and treatment of common OIs.
ART programme was launched in 2004 in 8 institutions in 6 high prevalence states and Delhi.
As on 31st May 2006, a total of 54 ART centres were functional with 33,638 patients (including 1352 children)
receiving free Anti Retroviral Therapy at these centres.
However, this constitutes only 10 per cent of the estimated eligible patients
300,000 patients on ART by the end of 2011 through approximately 250 ART centres
Strategy:
o Identification of institutions,
o Strengthening referral linkages for CD4 testing,
o Capacity building of ART teams and
o Procurement of ARV drugs
(Priority being accorded to women & children referred from TIs and those below poverty line)

Providing ART
Treating S.T.D.
Providing Condoms
Behavior change communication

144

Randomization is a procedure used for assignment or allocation


of subjects to treatment and control groups in experimental
studies. Randomization ensures .

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.

That assignment occurs by chance


That treatment and control groups are alike in all respects except treatment
That bias in observation is eliminated

145

That placebo effects are eliminated


In nine families surveyed, the numbers of children per family were

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

Chi square test


McNemars test
Fishers exact test
Student t test
All the following are steps necessary to plan and conduct a case control
study EXCEPT:

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.

Developing and testing research instruments


Defining the disease and exposure of interest
Selecting cases and defining a control group

148

Determining the duration of the observational (study) period.


Which of the following indices is not an index of measurement of obesity?

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?

B; In the abbreviated multisite schedule, the 2-1-1

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:

C; Egg contains all the nutrients except carbohydrate and vitamin C.


An egg weighing 60 grams contains 6 g of protein, 6 g of fat, 30 mg of calcium and 1.5 mg of iron, and supplies about 70
kcal of energy. Egg protein have all the nine essential amino acids needed by the body in right proportions. Nutritionists
consider egg protein as the best among food proteins. In fact, egg protein is the standard against which the quality of other
proteins is compared. Except for vitamin c, egg contains all the fat-soluble and water soluble vitamins in appreciable
amounts.
Net protein utilization (NPU) which combines in a single value the biological value and digestibility is 100 for egg
compared to 80 for meat and 75 for milk

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.

API more than 2 for the last 3 years


Plasmodium falciparum more than 30% of total malaria cases
The area has been reporting deaths
The area has been reporting epidemics

153

1st Priority group during rubella vaccination is:

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.

All females of child bearing age


All non married pregnant female

154

All pregnant females


Infants
True about RHIME?

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

It is an enhanced form of Verbal autopsy


It is a retrospective study about diarrhea related disease in children

155

It is prospective study about risk factor for CAD


It is a retrospective study about nutritional deficiency related disease in children
For prevention of Neonatal tetanus, all of the following are effective except:

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.

Supply disposable delivery kits to ensure clean


practices for domiciliary deliveries.

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.

Five Clean Practices


Clean surface for delivery
Clean hands of the attendant
Clean blade for cutting the cord
Clean cord tie
No applicants on the cut stump of the cord (clean cord)

Give 2 doses of IT to pregnant women

156

Immunize all woman of reproductive age group with 2 doses of TT


Practice 5 cleans
Give penicillin to all newborns
Highest percentage of poly unsaturated fatty acid are seen in:
Ground nut oil
Soya bean oil
Coconut oil

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.

100 mg and 100 g daily for 100 days


60 mg and 500 g daily for 100 days
60 mg and 100 g daily for 60 days

158

60 mg and 500 g daily for 180 days


All of the following disease spread by louse as a vector except.
Relapsing fever
Q fever
Epidemic typhus

B;

Trench fever

159

160

Results of a test were given as very satisfied, satisfied, dissatisfied it


represents

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

Maternal deaths/1000 total birth


Maternal deaths/1000 live births
Maternal deaths/100000 live births
Maternal deaths/100000 total birth
A 18 month old child come to you with history of immunization taken only for a

B; Irrespective of the duration between the two doses due vaccines can be given. Because the memory cells in the body

164

single dose of OPV and DPT. What will


.
Re-start the immunization according to age
Give BCG, Measles, and second doses of OPV and DPT
Give BCG, Measles and booster doses of OPV and DPT
Give Measles and booster doses of OPV and DPT
WHO growth chart is:

you

give

now?

keep the immunity intact from the first dose

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

None of the above


Colostrum contains more of ---- than milk:

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

C; Indications of pneumococcal vaccination


1. Most important Anatomical and Functional Asplenia
2. Over Age of 65
3. CSF leak, diabetes mellitus, alcoholism, cirrhosis, CRF
4. Immunocompromised Multiple myeloma, lymphoma, Hodgkin lymphoma, HIV infection

Cystic fibrosis
Sickle cell anaemia
174

Sushruta smhita was translated by:.

C; Sushruta Samhita was translated


Language
English

Germany

175

Galen
Celsius
Harnel
Charak
Microorganism used as weapon in biological terrorism:

Small pox virus


Rabies virus
Human Parvovirus

Writer
Harnel
U. C. Dutta
A. C. Chatopadhyay
G. D. Singhal
Bellars

A; Bioterrorism 3 types 1. Microbial

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

Which of the following country has lowest percentage of LBW babies?

C; Reported incidence of LBW babies in some developed and developing countries in 2000 - 2007
Country
China
USA
UK
Switzerland
India

177

Percentage of live births


2
8
8
6
28

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; The WHO has given the following classification of mental retardation:


Category
IQ
Mild mental retardation
50-70
Moderate mental retardation
35-49
Severe mental retardation
20-34
Profound mental retardation
< 20

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:

Change in Medical Educa. Which include 3 month training in PSM.

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

In DANIDA, Denmark government provides assistance for?

A; DANIDA
The Government of Denmark is providing assistance for the development of service under national blindness control
programme since 1978.

National blindness control programme


National TB control programme
National Malaria control programme
National Leprosy control programme

188

Retrospective evaluation of medical performance is known as:

A; Generally there are 3 type of evaluation


1. Evaluation of structure
2. Evaluation of process The way in which the various activities of programme is carried out is evaluated by comparing
with predetermined standard. An objective and systemic way of evaluating the physician performance is known Medical
Audit.
3. Evaluation of outcome Diseases, Discomfort, Dissatisfaction, Disability and Death (5D)

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:

C; Distorted information is feature propaganda not that of mass media education.


Mass media is one way communication

192. 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. Symposium
B. Panel discussion
C. Workshop
D. Group discussion

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

Rapid and speedy


High reach

Distorted information
191

Meets local community needs


The most important step in health education of a community is:

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

Contact with doctors


Community discussion
Announcements to the community by loud

Knowledge of local needs.


192

Population is unit of studies in:

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.

194

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?

A; A confidence interval is a range of possible

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).

A relative risk of 2.5 with a 95 percent confidence interval of 2.0 to 3.1


A p value of 0.0004 and an internal of 0.05

196.

A relative risk of 5.0 with a 95 percent confidence interval of 0.1 to 9.8


A p value of <0.05 and a relative risk of 2.5
All the following statements concerning statistical inference are true EXCEPT:

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

A test of statistical significance does not prove causality


statistically significant test assesses the probability of a chance occurrence

A statistically significant test supports the null hypothesis


A confidence interval does not address whether an association is due to bias.

197

The association between low birth weight and maternal smoking


during pregnancy can be

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.

What type of study is this


Clinical trial
Cross-sectional
Cohort (Prospective)
Case- control ( retrospective)

198
.

A randomized, double-blinded trial finds that oral corticosteroids


are superior to placebo in hastening the resolution of otitis media
with effusion. Possible reasons why this study, might have given

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

a falsely positive result include:

The sample size may have been too small


apparent effect might be a result of chance
Lax inclusion criteria may have led to inclusion of some subjects in the study who
did not really have otitis media with effusion

199

None of the above


What is the most important risk factor for becoming a chronic carrier following
an acute episode of hepatitis B?

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.

A; Method of group approaches in health communication


1. Chalk and talk (Lecture)
It is a carefully prepared oral presentation of facts organized thoughts and ideas by a qualified person the chalk lends
the visual component.
The group should not be more than 30 and the talk should not exceed 15 20 minute.
2. Group discussion.
A group is an aggregation of people interacting in a face to face situation.
A group should not comprise less than 6 and not more than 12 members.
3. Panel discussion:
In a panel discussion, 4 to 8 qualified persons talk about a topic and discuss a given problem in front of large group or
audience.
4. Symposium:
A symposium is a series or speeches on a selected subject. There is no discussion among the symposium members
like in panel discussion.
5. Workshop:
It consists of a series of meeting usually four or more with emphasis on individual work within the group with the help of
consultants and resource personnel the total workshop may be divide into small group and each group will solve and
discuss a problem with the help of consultants.
6. Role playing
Role playing is a sociodrama based on assumptions that may values in a situation cannot be expressed in words and
the communication can be more effective if situation is dramatized by the target group.
Teaching about ORS in slums is best done by demonstration.
7. Conferences and seminars

Symposium
Panel discussion
Workshop
Group discussion

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