FMGE 2024 - Community Medicine PYQs Practice Questions

Q: How does the World Health Organization (WHO) define blindness?

VA < 3/60. ***VA < 3/60*** - This visual acuity (VA) level in the better eye, with the best possible correction, meets the World Health Organization (WHO) definition of **blindness** (Visual Impairment Category 3 or worse). - It signifies that the patient cannot count fingers at a distance of 3 meters (CF 3/60* - Visual acuity *greater* than 3/60 (e.g., 6/60, 6/18) indicates better visual function and therefore does not satisfy the criteria for WHO **blindness**. - Depending on the exact VA, this level of vision may fall into the categories of **moderate** or **mild visual impairment**. *VA > 6/60* - Visual acuity greater than 6/60 (e.g., 6/12) is well above the threshold defined for both **severe visual impairment** and blindness. - An acuity of 6/60 is often the benchmark for severe impairment; vision better than this suggests residual useful vision. [Practice more Community Medicine PYQs on OnCourse]

Q: In the context of a new onset of a morbid disease, how does the change in incidence affect the prevalence of the disease?

Incidence and prevalence will increase. ***Incidence and prevalence will increase*** - **Incidence** is the rate of new cases arising in a population; a "new onset" inherently implies that the occurrence of **new cases** is rising or starting. - Since **prevalence** is the total number of existing cases (P ≈ I × D, where D is duration), a rise in new cases (**incidence**) directly contributes to and increases the total existing burden of the disease. *Prevalence is not related to incidence* - This is incorrect because **incidence** (the inflow of new cases) is the primary determinant, along with duration and mortality/cure, of the overall total number of existing cases (**prevalence**). - Prevalence is mathematically linked to incidence; if incidence rises, prevalence typically rises, and if incidence approaches zero, prevalence will eventually fall (assuming cases are cleared). *Incidence will increase, and prevalence will decrease* - When **incidence** increases (more new cases), it leads to an increased rate of accumulation of cases, which consequently increases **prevalence**. - Prevalence only decreases despite increasing incidence if the removal rate (due to death or cure) drastically exceeds the rate of new cases, which is highly unlikely in a scenario described as a "new onset" morbid disease. *Prevalence will increase with a decrease in the incidence* - A decrease in **incidence** (fewer new cases) leads to a decrease in **prevalence** over time, assuming the duration of the disease remains stable. - Prevalence can increase with decreasing incidence only if the **duration** of the disease or survival time increases significantly (e.g., effective palliative treatment without cure), trapping existing cases in the prevalent pool. [Practice more Community Medicine PYQs on OnCourse]

Q: Calculate the relative risk for the given situation: Developed Malaria | Did Not Develop Malaria | Total Vaccinated 6 | 94 | 100 Non-vaccinated 12 | 88 | 100

0.5. ***Correct: 0.5*** **Relative Risk (RR)** is calculated as: RR = Risk in exposed group / Risk in unexposed group **Step-by-step calculation:** - Risk in **vaccinated group** = 6/100 = 0.06 - Risk in **non-vaccinated group** = 12/100 = 0.12 - **RR = 0.06 / 0.12 = 0.5** **Interpretation:** An RR of **0.5 indicates a protective effect** of vaccination. Vaccinated individuals have **half the risk** (50% reduced risk) of developing malaria compared to non-vaccinated individuals. *Incorrect: 2* This is the **inverse** of the correct RR, calculated as 0.12/0.06 = 2 (risk in non-vaccinated / risk in vaccinated). This would incorrectly suggest vaccination **doubles the risk** of malaria, which contradicts the data showing vaccination is protective. *Incorrect: 1.5* This value does not result from the correct RR formula using the given incidence rates (0.06 vs 0.12). This may arise from incorrect formula application or confusion with other epidemiological measures like the **Odds Ratio**. *Incorrect: 1.7* This is not the result of standard RR calculation based on the incidence rates of 0.06 and 0.12. It represents a **calculation error** and has no epidemiological meaning in this context. [Practice more Community Medicine PYQs on OnCourse]

Q: A study was conducted in 3 communities (across 3 states) to measure the mean blood pressure in each community. Health workers were assigned to visit each house in the 3 communities. The mean blood pressure of each community was then compared. What is the study design called?

Cross-sectional. ***Cross-sectional***- This design takes a **snapshot** of the population (the 3 communities) at a specific time, simultaneously assessing the current status of the outcome (mean **blood pressure**) in each house.- The goal is to determine the **prevalence** of a characteristic (mean blood pressure) within the defined population by studying individuals (each house) within them.*Case-control*- This design requires comparing individuals who have the outcome (**cases**) to those who do not (**controls**) by looking **retrospectively** for past exposure differences.- The current study does not involve selecting groups based on outcome status (e.g., high BP vs. normal BP) to investigate an antecedent exposure.*Cohort*- A **cohort** study follows groups based on their **exposure status** over a period of time to calculate the **incidence** (rate of new cases) of a specific outcome.- This study measures current blood pressure status in a single visit; it does not track individuals longitudinally to see who develops hypertension later.*Ecological study*- This type of study correlates aggregate data (mean outcomes) across different population groups (e.g., states or countries), where the units of analysis are **populations**, not individuals.- Although the final comparison involves community means (ecological data), the design phase involving detailed collection of individual BP data by visiting **each house** is characteristic of a primary **cross-sectional** survey. [Practice more Community Medicine PYQs on OnCourse]

Question 1

How does the World Health Organization (WHO) define blindness?

Accepted Answer

VA < 3/60

Answer

VA < 6/60

Answer

VA > 3/60

Answer

VA > 6/60

Question 2

In the context of a new onset of a morbid disease, how does the change in incidence affect the prevalence of the disease?

Accepted Answer

Incidence and prevalence will increase

Answer

Prevalence is not related to incidence

Answer

Incidence will increase, and prevalence will decrease

Answer

Prevalence will increase with a decrease in the incidence

Question 3

Calculate the relative risk for the given situation:

Developed Malaria | Did Not Develop Malaria | Total
Vaccinated                 6          |          94             |  100
Non-vaccinated            12          |          88             |  100

Accepted Answer

0.5

Answer

1.5

Answer

2

Answer

1.7

Question 4

A gym owner observes that individuals who drink iced tea during their workouts tend to lose more weight. What is the nature of this relationship?

Accepted Answer

Indirect

Answer

Direct

Answer

Spurious

Answer

Relative

Question 5

A study was conducted in 3 communities (across 3 states) to measure the mean blood pressure in each community. Health workers were assigned to visit each house in the 3 communities. The mean blood pressure of each community was then compared. What is the study design called?

Accepted Answer

Cross-sectional

Answer

Case-control

Answer

Ecological study

Answer

Cohort

Question 6

Which of the following is a technology-based surveillance system for tuberculosis (TB) in India?

Accepted Answer

Nikshay

Answer

Dots99

Answer

DOTS

Answer

Nischay

Question 7

Wasting in a child is assessed by which of the following measures?

Accepted Answer

Weight-for-height

Answer

Height-for-age

Answer

Weight-for-age

Answer

Height-for-weight

Question 8

For what population size is an urban Primary Health Centre (PHC) typically intended?

Accepted Answer

1 per 50,000

Answer

1 per 100,000

Answer

1 per 250,000

Answer

1 per 200,000

Question 9

What were the goals for Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) as per India's National Health Policy 2017 intermediate targets?

Accepted Answer

70/30

Answer

100/30

Answer

30/100

Answer

30/70

Question 10

What concentration of fluoride is typically associated with causing crippling fluorosis?

Accepted Answer

> 10 mg/L

Answer

> 1.5 mg/L

Answer

> 3 mg/L

Answer

> 6 mg/L

FMGE 2024 — Community Medicine