CLASS ON

SPOTS
Department of Community
Medicine
Maulana Azad Medical College
 Community Medicine
Practical Examination
• Marks distribution:
– Theory = 150 marks
• 60 marks x 2 papers = 120
• Internal assessment = 20
• Viva Voice = 10
– Practical = 50 marks
• Long case = 20
• Epidemiological cum statistical exercise = 5
• Spots: 1 x 5 = 5
• Internal assessment = 20
 MAJOR AREAS
• Vaccines and associated
equipments
• Nutrition
• Drugs/medicines
• Contraceptives
• Entomology
• Microbiology
• Biostatistics
 IMPORTANT POINTS
• 5 spots
• 2 questions on each spot
• Each question carries ½ a mark
• Time of 1 minute is given for each
spot
• In the examination, either live spots
or spots on LCD projector would be
used.
• Sample questions are given with the
spots. However, do not restrict to
these questions.
• Appropriate instructions will be given
 VACCINES
• Type of vaccine
• Composition
• Immunization schedule
• Age at administration/eligible age
• Dose
• Route
• Site
• Contraindications
• Side effects
• Diluents used, if any
• Precautions/specific instructions
• Efficacy
• Vaccine preventable diseases
• Applied aspects etc.
EVERY ASPECT OF VACCINES IS
BCG
Diluent for BCG- Normal
Saline
OPV

VVM
 Vaccine Vial Monitor (VVM)
Stages

Stage I Stage II Stage Stage

III IV
Hepatitis B Vaccine
DPT Vaccine
DT Vaccine
TT Vaccine
Look here
If label is
missing
MEASLES
MEASLES, MUMPS, RUBELLA (MMR)
Diluent for Measles, MMR- Sterile
water
Typhoid Vaccine – Vi
polysaccharide
HAEMOPHILUS INFLUENZAE b
VACCINE
HEPATITIS- A VACCINE
JAPANESE ENCEPHALITIS VACCINE
POLYVALENT PNEUMOCOCCAL
VACCINE
VARICELLA (CHICKEN POX)VACCINE
DIPHTHERIA
POLIOMYELITIS
MUMPS
MEASLES
 Equipments
• Cold chain equipments
– Vaccine carrier
– Day carrier
– Ice pack
– Household refrigerator
• BCG/ Tuberculin syringe and
needle
• Syringe
– Disposable
– Auto- disable (AD)
– Glass
VACCINE CARRIER
DAY CARRIER

ICE PACK
 Ice
packs
OPV

BCG, OPV,
Measles, MMR

DPT, DT, TT, Hep

B, Typhoid,
Diluent, Returned
vaccines
Water
bottles
BCG/ Tuberculin syringe

26 G needle
Disposable Disposabl
syringe needle
Glass syringe
 NUTRITION
• Food stuff: Cereals, Pulses, Nuts, Oil
seeds, fruits etc.
• Questions:
– Important nutrients per 100 gm
– Limiting amino acids/ Rich source of…
• Salt: Compound used for iodization,
Iodine content, National programme
• Vitamin A: Dose, age, side effects of
excessive dose.
• Growth chart: Interpretation.
• Food adulteration: Toxic principle,
Disease caused, Prevention
• Deficiency diseases: Identify, Cause,
Prevention
CEREALS

Wheat

Rice
PULSES
SUGAR
SALT
CONCENTRATED VITAMIN A
SOLUTION
GROUNDNUT
MUSTARD SEEDS
CITRUS FRUITS
GREEN LEAFY
VEGETABLES
GROWTH CHART
GROWTH CHART
GROWTH CHART
GROWTH CHART
BITOT’S SPOT
RICKETS
 CONTRACEPTIVES
• Advantages
• Disadvantages
• Mechanism of action
• Failure rate
• OCPs: Contents, Dosage schedule,
Side effects, Instructions to user
• Cu T: Time of insertion, Side effects,
Instructions to user
• Condoms: Number used/couple/year
• E pill: Contents, Dosage schedule,
Side effects, Instructions to user
• Saheli: Contents, Dosage schedule,
Side effects, Instructions to user
CONDOM
ORAL CONTRACEPTIVE
PILLS
 EMERGENCY
CONTRACEPTIVE PILL
CENTCHROMAN (SAHELI)
IUCD- Cu T
IUCD- Cu T
 DRUGS/ MEDICINES
• IFA
• ORS
• Chlorine tablets
• Chloroquine tablets
• Anti Tubercular Therapy used in
RNTCP
• Multi Drug Therapy for Leprosy
• Benzyl benzoate
 IRON
AND
FOLIC
ACID
TABLET
ORAL REHYDRATION SALT
CHLORINE TABLETS
CHLOROQUINE TABLETS
BLISTER PACK- ATT
BENZYL BENZOATE
 MISCELLANEOUS
• Horrocks apparatus
• Gloves
HORROCK’S APPARATUS
GLOVES
POPULATION PYRAMID
 ENTOMOLOGY
• Adult forms
– Housefly
– Rat flea
– Sandfly
– Mosquito (Culex, Aedes, Anopheles)
– Others
• Larval forms
– Anopheles/ Anopheline
– Culcine (Culex/Aedes)
 Some questions
• Identify, giving reasons
• Diseases transmitted
• Control measures:
– In general
– Form specific: Larval/ Adult
• National programmes
MOUNTED SPECIMEN IN A
GLASS BOTTLE
 SPECIMENS FIXED ON
SLIDES (shown under a
magnifier)
HOUSEFLY
HOUSEFLY
RAT FLEA
RAT
FLEA
SAND
FLY
CULEX
AEDES
AEDES
ANOPHELES
ANOPHELES
ANOPHELES
ANOPHELES
ANOPHELES
ANOPHELES
AEDES
AEDES
AEDES
CULEX
CULEX
ANOPHELINE LARVA
ANOPHELINE LARVA
ANOPHELINE LARVA
CULCINE LARVA
CULCINE LARVA
CULCINE LARVA
CULCINE LARVA
CULCINE LARVA
CULCINE LARVA

Siphon
tube
 CULCINE LARVA

Siphon
tube

Source: RC Russell
Source: RC Russell
 PARASITOLOGY
• Identify, giving reasons
• Life cycle
• Disease/ Morbidity caused
• Prevention
• Treatment/ Drug of choice
ADULT ROUNDWORM
EGG OF ROUNDWORM
EGG OF HOOKWORM
EGG OF TRICHURIS

BILE
PLUG
MICROFILARIA
MICROFILARIA
MALARIAL PARASITE
 MICROBIOLOGY
• Identify, giving reasons
• Disease/s caused
• Staining method used
• Q’s related to disease
ACID FAST BACILLI
 BIOSTATISTICS
• Identify
• Use
Figure: Distribution of study subjects in
relation to duration of diminished vision
(N=69)
62.3%

21.7% 15.9%

Less than 3 years 3 to 6 years More than 6 years

 Figure: Materials used by study subjects to
90.0
dry hands after washing* (N=151)
83.4
80.0

70.0
% age of study subjects

60.0

50.0 45.7

40.0

30.0

20.5
20.0

10.0

0.0
Personal hand towel Clothes / apron Common hand towel
Materials used
* Responses are not mutually exclusive
 Figure: Relation between body weight and
350.0
time spent in physical exercise
300.0

250.0
Exercise time (min)

200.0

150.0

100.0

50.0

0.0
0 20 40 60 80 100 120 140

Body weight (kg)