Community Medicine
7 questionsBased on the type of life cycle, zoonoses are classified into all of the following except -
The international quarantine period for yellow fever as approved by the Government of India is ?
All of the following are anthropozoonosis except
All are features of yellow fever except?
To achieve neonatal tetanus elimination, the incidence of neonatal tetanus per 1000 live births should be reduced to less than:
Which indicator best measures the operational efficiency of a malaria control programme?
Malaria is transmitted in Rural areas by?
NEET-PG 2013 - Community Medicine NEET-PG Practice Questions and MCQs
Question 511: Based on the type of life cycle, zoonoses are classified into all of the following except -
- A. Cyclo-zoonoses
- B. Anthropozoonoses (Correct Answer)
- C. Sporozoonoses
- D. Meta-zoonoses
Explanation: ***Anthropozoonoses*** - This is **NOT a life cycle-based classification** of zoonoses. - It describes the **direction of transmission** (animals to humans), not the complexity or types of hosts required in the parasite's life cycle. - While a valid classification of zoonoses, it is based on **transmission pattern**, not life cycle characteristics. *Cyclo-zoonoses* - These are zoonoses that require **more than one vertebrate host species** to complete their life cycle, but **no invertebrate host** is involved. - This IS a life cycle-based classification. - Examples include **taeniasis** (tapeworm infections) where the parasite cycles between humans and livestock. *Meta-zoonoses* - These zoonoses require **both vertebrate and invertebrate hosts** to complete their life cycle. - This IS a life cycle-based classification. - The **invertebrate host** acts as an essential part of the life cycle for maturation or multiplication of the pathogen (e.g., **arboviruses** transmitted by mosquitoes, **plague** via fleas). *Sporozoonoses* - While this term is **not part of the standard WHO classification** of zoonoses by life cycle, the prefix "sporo-" refers to **spore-forming stages** in parasitic life cycles. - The standard WHO classification includes: **Orthozoonoses** (direct), **Cyclozoonoses**, **Metazoonoses**, and **Saprozoonoses** (requiring inanimate environment). - However, this term relates to life cycle characteristics (spore stages), not transmission direction.
Question 512: The international quarantine period for yellow fever as approved by the Government of India is ?
- A. 6 days (Correct Answer)
- B. 9 days
- C. 10 days
- D. 12 days
Explanation: ***6 days*** - The **incubation period** for yellow fever is typically 3-6 days, and the 6-day quarantine period is internationally accepted to cover this range. - This period is established to prevent the importation and spread of the disease by ensuring that individuals arriving from endemic areas do not develop symptoms after arrival. *9 days* - This duration is **longer than the internationally recognized incubation period** for yellow fever and is not the standard quarantine period. - Implementing a 9-day quarantine would be excessive and not based on the typical disease progression. *10 days* - A 10-day quarantine period is also **not the standard** for yellow fever as approved by international health regulations or by the Government of India. - While some diseases may require a 10-day quarantine, yellow fever's incubation period makes 6 days sufficient. *12 days* - A 12-day quarantine is **significantly longer** than necessary for yellow fever, as virtually all cases would manifest symptoms within the first 6 days. - This period is typically associated with diseases with much longer incubation periods, which is not the case for yellow fever.
Question 513: All of the following are anthropozoonosis except
- A. Rabies
- B. Plague
- C. Anthrax
- D. Schistosomiasis (Correct Answer)
Explanation: ***Schistosomiasis*** - This is a **human-to-human** disease, even though it involves an intermediate **snail host**. - Its life cycle does not involve transmission of pathogens from vertebrate animals to humans. *Rabies* - Rabies is a classic **anthropozoonosis**, transmitted to humans primarily through the saliva of infected animals, most commonly **dogs** and **bats**. - It involves a pathogen (rabies virus) that cycles between animals and can be transmitted to humans. *Plague* - Plague is an **anthropozoonosis** caused by *Yersinia pestis*, typically transmitted from **rodents** (e.g., rats) to humans via flea bites. - The disease maintains a natural reservoir in wild rodent populations, making it a prime example of animal-to-human transmission. *Anthrax* - Anthrax is an **anthropozoonosis** caused by *Bacillus anthracis*, transmitted to humans from infected **livestock** (e.g., cattle, sheep). - Humans usually acquire the infection through contact with infected animals or their products, or by inhaling spores.
Question 514: All are features of yellow fever except?
- A. Caused by vector aedes
- B. IP 3-6 days
- C. 1 attack gives life long immunity
- D. Validity of vaccination begins immediately after vaccination (Correct Answer)
Explanation: ***Validity of vaccination begins immediately after vaccination*** - Yellow fever vaccine is highly effective, but **immunity does not develop immediately**; it typically offers protection starting **10 days after vaccination**. - This delay is crucial for travelers to endemic areas, as they need to be vaccinated well in advance to ensure protection. *IP 3-6 days* - The **incubation period (IP)** for yellow fever is indeed short, usually ranging from **3 to 6 days** after the bite of an infected mosquito. - This brief incubation period contributes to the rapid onset of symptoms once infected. *1 attack gives life long immunity* - Similar to many viral infections, a single bout of yellow fever infection generally provides **lifelong immunity** against future infections. - This is why the vaccine is so effective, as it mimics natural infection to induce comprehensive, long-term protection. *Caused by vector aedes* - Yellow fever is transmitted primarily by **Aedes mosquitoes**, particularly **Aedes aegypti**, which are responsible for urban and jungle cycles of transmission. - These mosquitoes are prevalent in tropical and subtropical regions of Africa and South America.
Question 515: To achieve neonatal tetanus elimination, the incidence of neonatal tetanus per 1000 live births should be reduced to less than:
- A. 0.1
- B. 0.5
- C. 1.0 (Correct Answer)
- D. 0.2
Explanation: ***1.0*** - The international target for **neonatal tetanus elimination (NTE)** as defined by WHO/UNICEF is an incidence rate of **less than 1 case per 1,000 live births per year** in every district of a country. - This is the globally recognized threshold for declaring that neonatal tetanus has been eliminated as a public health problem. - Countries achieving this target at the district level are considered to have achieved NTE. *0.1* - While 0.1 per 1,000 live births represents an extremely low incidence, this is not the WHO-defined threshold for **neonatal tetanus elimination**. - The elimination target is less stringent at <1 per 1,000 live births, making disease control achievable while still representing a major public health success. *0.2* - An incidence of 0.2 per 1,000 live births, though very low, is not the internationally recognized threshold for **neonatal tetanus elimination**. - The established WHO/UNICEF target is <1 per 1,000 live births in every district. *0.5* - An incidence of 0.5 per 1,000 live births indicates excellent control of neonatal tetanus but is not the specific cut-off value. - The WHO criterion for elimination is less than 1 case per 1,000 live births per year at the district level.
Question 516: Which indicator best measures the operational efficiency of a malaria control programme?
- A. Infant parasite rate
- B. Slide positivity rate
- C. Mosquito bite rate
- D. Annual blood examination rate (Correct Answer)
Explanation: ***Annual blood examination rate*** - The **Annual Blood Examination Rate (ABER)** directly reflects the proportion of the population that has been tested for malaria, indicating the reach and effectiveness of surveillance activities. - A high ABER suggests that active case detection and diagnosis are being effectively implemented, which is crucial for operational efficiency in identifying and managing cases. *Infant parasite rate* - The **infant parasite rate** measures the prevalence of malaria infection among infants, serving as an indicator of recent transmission intensity. - While important for assessing disease burden and transmission, it doesn't directly measure the operational effectiveness of interventions like testing or treatment programs. *Slide positivity rate* - The **slide positivity rate (SPR)** is the proportion of positive malaria slides among all slides examined, indicating the likelihood of an individual seeking testing to actually have malaria. - While SPR helps understand disease activity among tested individuals, it doesn't reflect the full operational reach of a program in the general population or the overall testing effort. *Mosquito bite rate* - The **mosquito bite rate** measures the number of mosquito bites per person per night, indicating the level of human exposure to malaria vectors. - This is an entomological indicator of transmission risk and the impact of vector control, but it does not directly assess the operational efficiency of human-centric interventions like diagnosis and treatment programs.
Question 517: Malaria is transmitted in Rural areas by?
- A. Anopheles stephensi
- B. Anopheles dirus
- C. Anopheles culicifacies (Correct Answer)
- D. None of the options
Explanation: ***Anopheles culicifacies*** - **_Anopheles culicifacies_** is the **primary vector of malaria in rural areas of India** and is also found in Southeast Asia. - Its breeding habitats often include **rice fields, irrigation channels, and temporary water collections** common in rural agricultural settings. - It accounts for a major proportion of rural malaria transmission in the Indian subcontinent. *Anopheles stephensi* - **_Anopheles stephensi_** is a significant malaria vector primarily found in **urban and semi-urban areas**, including parts of the Middle East, India, and Iran. - Its preferred breeding sites are **artificial containers found in urban environments**, such as water storage tanks, overhead tanks, and cisterns. *Anopheles dirus* - **_Anopheles dirus_** is a dominant malaria vector in **forested and hilly regions of Southeast Asia**, often associated with forest malaria. - It's known for outdoor feeding behavior and maintaining transmission in relatively undisturbed natural environments. *None of the options* - This option is incorrect because **_Anopheles culicifacies_** is a well-established and significant vector for malaria in rural areas of India. - Identification of a specific primary vector for rural transmission makes this choice invalid.
Internal Medicine
1 questionsIf a claw hand develops in a patient with Leprosy, what is the classification of the deformity?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 511: If a claw hand develops in a patient with Leprosy, what is the classification of the deformity?
- A. Grade 0
- B. Grade I
- C. Grade II (Correct Answer)
- D. Grade III
Explanation: A **claw hand** deformity, characterized by hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints, indicates a significant and **visible disability** but the affected part is still functional to a limited degree. In the context of leprosy, this observable and permanent deformity falls under **Grade II** on the WHO disability grading scale, signifying a clear and established disability. This grade indicates **no disability** or deformity related to leprosy. A patient with a claw hand has an obvious physical deformity and functional impairment, thus not fitting this classification. This grade refers to a **detectable impairment** but **no visible deformity**. A claw hand is a clearly visible deformity, making Grade I an inappropriate classification. While Grades are typically 0, I, and II in the WHO disability grading for leprosy, some classifications might refer to severe, non-functional deformities as higher grades. However, Grade II adequately captures **visible and significant deformities** like a claw hand, and a Grade III is not a standard or commonly used classification for a claw hand in leprosy in the WHO system.
Pharmacology
2 questionsAn Englishman travels to a place which is resistant to chloroquine and mefloquine. What should he take as prophylaxis?
What is the initial loading dose of chloroquine base for treating uncomplicated malaria in children?
NEET-PG 2013 - Pharmacology NEET-PG Practice Questions and MCQs
Question 511: An Englishman travels to a place which is resistant to chloroquine and mefloquine. What should he take as prophylaxis?
- A. Primaquine
- B. Atovaquone-proguanil (Correct Answer)
- C. Doxycycline
- D. Proguanil
Explanation: ***Atovaquone-proguanil*** - This combination, known as **Malarone**, is the most appropriate prophylactic agent for areas with **multi-drug resistant malaria**, including resistance to chloroquine and mefloquine [1], [2]. - It targets multiple stages of the parasite life cycle, providing excellent protection and is generally well-tolerated with specific **WHO and CDC recommendations** for chloroquine and mefloquine resistant areas [1], [3]. *Primaquine* - **Primaquine** is primarily used for **causal prophylaxis** against *P. vivax* and *P. ovale* to prevent relapse, not as primary prophylaxis [2]. - It is not typically recommended as the primary prophylactic agent in areas with **chloroquine and mefloquine resistance** and requires **G6PD testing** due to risk of hemolysis [1]. *Proguanil* - While proguanil is used for malaria prophylaxis, **proguanil alone** is not effective enough for prophylaxis in areas with multi-drug resistant malaria. - It is typically used in **combination with atovaquone** rather than as monotherapy for effective protection [3]. *Doxycycline* - **Doxycycline** is also an effective prophylactic agent for areas with **chloroquine and mefloquine-resistant malaria** and is commonly recommended [1], [2]. - While effective, it can cause **photosensitivity** and **gastrointestinal upset**, making atovaquone-proguanil the preferred first-line choice.
Question 512: What is the initial loading dose of chloroquine base for treating uncomplicated malaria in children?
- A. 5 mg/kg
- B. 10 mg/kg (maximum 600 mg) (Correct Answer)
- C. 15 mg/kg
- D. 25 mg/kg
Explanation: ***10 mg/kg (maximum 600 mg)*** - The standard **initial loading dose** of chloroquine base for uncomplicated malaria in children is **10 mg/kg body weight**, with a maximum cap of **600 mg** to prevent toxicity. - This is followed by **5 mg/kg** at 6 hours, 24 hours, and 48 hours (total course of 25 mg/kg over 3 days). - This represents **WHO-recommended** weight-based dosing for pediatric malaria treatment. *5 mg/kg* - **5 mg/kg** is the dose for the **subsequent doses** (at 6, 24, and 48 hours after the initial dose), not the initial loading dose. - The initial dose must be higher (10 mg/kg) to rapidly achieve therapeutic blood levels. *15 mg/kg* - **15 mg/kg** exceeds the recommended initial dose and increases the risk of **chloroquine toxicity**. - Chloroquine has a narrow therapeutic index, and overdosing can cause serious **cardiovascular** (arrhythmias, hypotension) and **neurological** effects (seizures, visual disturbances). *25 mg/kg* - **25 mg/kg** represents the **total cumulative dose** over the entire 3-day treatment course, not the initial single dose. - Giving this amount as a single dose would result in severe toxicity and is contraindicated.