Most common route of nosocomial infection [Hospital-acquired infection]?
Behavioral surveillance survey is done in?
Drug of choice for mass therapy under filariasis control programme?
Which of the following larvicide is used under urban Malaria Scheme?
In the context of malaria control, when is regular insecticidal spray recommended based on the Annual Parasite Index (API)?
Which condition has the maximum relative risk attributed to obesity?
According to the 2014 guidelines for female sterilization, which of the following is NOT an eligibility criterion for female sterilization?
Which state has the lowest Infant Mortality Rate (IMR) in India?
What does the Gross Reproduction Rate (GRR) measure?
In a town there are 2500 live births within six months. During the same period 5 women died due to peripartum infection, 5 died due to electrocution, 2 died due to obstructed labor and 3 died due to PPH. What is the MMR?
NEET-PG 2015 - Community Medicine NEET-PG Practice Questions and MCQs
Question 31: Most common route of nosocomial infection [Hospital-acquired infection]?
- A. Droplet transmission
- B. Direct contact (Correct Answer)
- C. Indirect contact
- D. Vehicle transmission
Explanation: **Direct contact** - **Direct contact** with colonized or infected patients is the predominant mode of transmission for many common nosocomial pathogens like **MRSA** and **VRE**. - This often involves healthcare workers' hands becoming contaminated and then touching other patients. *Droplet transmission* - Involves the transmission of infectious agents through **respiratory droplets** produced during coughing, sneezing, or talking. - While significant for some infections (e.g., influenza, pertussis), it is not the most common route overall for nosocomial infections. *Indirect contact* - Occurs when an infectious agent is transferred via a **contaminated intermediate object** or person. - Although important (e.g., contaminated medical devices), it is generally less frequent than direct patient-to-patient transmission. *Vehicle transmission* - Involves transmission through **contaminated inanimate vehicles** like food, water, medications, or surgical instruments. - While outbreaks can occur via this route (e.g., contaminated endoscopes), it is not the most common day-to-day transmission mechanism in hospitals.
Question 32: Behavioral surveillance survey is done in?
- A. AIDS (Correct Answer)
- B. TB
- C. Filaria
- D. Malaria
Explanation: ***AIDS*** - Behavioral surveillance surveys are crucial for understanding and monitoring behaviors related to **HIV transmission**, such as sexual practices and drug use, among at-risk populations. - These surveys help in designing and evaluating **prevention programs** by identifying trends in risky behaviors and knowledge, attitudes, and practices (KAP) concerning HIV. *Filaria* - Surveillance for filaria primarily involves **entomological surveys** (mosquito monitoring) and **parasitological surveys** (blood examinations for microfilariae). - Behavioral aspects are less central to direct surveillance compared to disease vectors and infection rates. *TB* - Tuberculosis surveillance mainly focuses on **case detection**, **treatment outcomes**, and monitoring **drug resistance** through clinical and laboratory data. - While patient adherence to treatment involves behavior, there isn't a dedicated "behavioral surveillance survey" method specifically for TB. *Malaria* - Malaria surveillance involves monitoring **parasitemia rates**, **vector populations**, and **antimalarial drug resistance**. - Behavioral components like bed net usage are important, but the primary surveillance methods are not termed "behavioral surveillance surveys" in the same structured way as for HIV.
Question 33: Drug of choice for mass therapy under filariasis control programme?
- A. Albendazole
- B. Ivermectin
- C. DEC (Correct Answer)
- D. Mebendazole
Explanation: ***Correct: DEC*** - **Diethylcarbamazine (DEC)** is the drug of choice for **mass drug administration (MDA)** campaigns aimed at eliminating lymphatic filariasis. - It effectively kills **microfilariae** and has some action on adult worms, reducing transmission. - In India's National Filariasis Elimination Programme, DEC is administered along with Albendazole in annual MDA campaigns. *Incorrect: Albendazole* - While **Albendazole** is co-administered with DEC in MDA programs, it is not the sole drug of choice for mass treatment of filariasis. - Its primary role is to provide **macrofilaricidal** activity (killing adult worms) and co-treatment for other helminth infections. - It enhances the effect of DEC but is not used alone. *Incorrect: Ivermectin* - **Ivermectin** is used in MDA programs for filariasis, particularly in areas co-endemic with **onchocerciasis** or where **Loa loa** is prevalent (as DEC is contraindicated in these areas). - However, in India and most lymphatic filariasis endemic areas, **DEC** remains the primary drug. *Incorrect: Mebendazole* - **Mebendazole** is an anthelminthic primarily used for treating **intestinal nematode infections** like ascariasis, trichuriasis, and hookworm. - It is **not used** in lymphatic filariasis mass treatment programs.
Question 34: Which of the following larvicide is used under urban Malaria Scheme?
- A. Malathion
- B. Parathion
- C. DDT
- D. Abate (Correct Answer)
Explanation: ***Abate*** - **Abate (temephos)** is an organophosphate larvicide widely used in public health programs, including the urban malaria scheme, due to its effectiveness against mosquito larvae at low concentrations. - It is applied to water storage containers, wells, and other mosquito breeding sites to **prevent the development of adult mosquitoes**. *Malathion* - **Malathion** is an organophosphate insecticide primarily used as an **adulticide** for fogging operations against adult mosquitoes, not specifically as a larvicide in urban schemes. - While it can kill larvae, its primary application and efficacy are geared towards **adult mosquito control**. *Parathion* - **Parathion** is a highly toxic organophosphate insecticide that is generally **not used in public health programs** due to its significant environmental and human health risks. - Its use is largely restricted to agricultural pest control and is **not a recommended larvicide** for urban settings. *DDT* - **DDT (dichlorodiphenyltrichloroethane)** is a persistent organic pollutant whose use has been largely banned or severely restricted globally due to its **environmental impact** and long-term toxicity. - While historically used for mosquito control (both larvae and adults), it is **not used in current urban malaria schemes** due to its banned status in many regions and resistance issues.
Question 35: In the context of malaria control, when is regular insecticidal spray recommended based on the Annual Parasite Index (API)?
- A. < 1
- B. < 2
- C. > 2 (Correct Answer)
- D. > 1
Explanation: ***> 2*** - Regular insecticidal spray, particularly **Indoor Residual Spraying (IRS)**, is a key malaria control measure recommended when the **Annual Parasite Index (API) is greater than 2**. - An API greater than 2 indicates **high endemicity** with a significant burden of malaria transmission in the community, necessitating aggressive vector control strategies. - According to **NVBDCP (National Vector Borne Disease Control Programme) guidelines**, API > 2 defines high-risk areas where routine IRS is implemented as a core intervention. *> 1* - An API between 1-2 represents **moderate endemicity**, where the focus is primarily on **active case detection, prompt treatment, and targeted interventions** rather than universal spraying. - While vector control remains important, routine widespread IRS is not the standard recommendation at this threshold. *< 2* - An API of less than 2 (which includes both moderate and low endemic areas) does not routinely warrant universal insecticidal spraying programs. - In areas with API < 2, **case management, surveillance, and selective vector control** are prioritized over widespread IRS campaigns. *< 1* - An API of less than 1 indicates **low endemicity**, where malaria transmission is minimal and sporadic. - In such areas, **surveillance, prompt case detection and treatment, and targeted interventions** are the mainstay, with IRS reserved only for focal outbreaks or high-risk pockets.
Question 36: Which condition has the maximum relative risk attributed to obesity?
- A. Hypertension
- B. CHD
- C. DM (Correct Answer)
- D. Cancer
Explanation: ***DM*** - Obesity is a major risk factor for Type 2 Diabetes Mellitus (T2DM), with a **relative risk often exceeding 3-7 times that of normal-weight individuals**, and even higher for severe obesity. - The link is primarily due to **insulin resistance** caused by increased adipose tissue. *Hypertension* - Obesity significantly increases the risk of hypertension, with a relative risk typically in the range of **2 to 3 times higher** than normal-weight individuals. - The mechanisms involve increased **blood volume**, **sympathetic nervous system activity**, and **renal sodium reabsorption**. *CHD* - Obesity is a strong independent risk factor for Coronary Heart Disease (CHD), contributing to a relative risk of approximately **1.5 to 2.5 times higher** than normal weight. - It often acts by exacerbating other risk factors like **hypertension**, **dyslipidemia**, and **diabetes**. *Cancer* - Obesity is linked to various cancers, including endometrial, esophageal adenocarcinoma, renal cell, and breast cancer in postmenopausal women, with relative risks typically ranging from **1.2 to 2 times higher** for specific cancers. - The pathways include **chronic inflammation**, altered **hormone levels** (e.g., estrogen), and **insulin-like growth factor signaling**.
Question 37: According to the 2014 guidelines for female sterilization, which of the following is NOT an eligibility criterion for female sterilization?
- A. Partner is not sterilized
- B. Being unmarried
- C. Should have at least 1 child (Correct Answer)
- D. Age of at least 22 years
Explanation: ***Should have at least 1 child*** - The 2014 guidelines **removed the previous requirement** for a specific number of children, focusing instead on **informed consent** and **voluntary decision-making**. - The emphasis is now on the client's **autonomous choice**, regardless of their parity. - Having at least one child is **NOT an eligibility criterion** under the revised guidelines. *Age of at least 22 years* - While there is a minimum age requirement (legally 21 years, though some guidelines mention 22 years), this IS a valid eligibility criterion. - The age criterion ensures that individuals are mature enough to make an **informed and irreversible decision** about permanent contraception. - Younger individuals may be at higher risk of **regret** following sterilization. *Being unmarried* - Marital status is **NOT a barrier** to female sterilization under the 2014 guidelines. - Unmarried individuals have the same right to choose this method of contraception based on **informed consent**. - The decision for sterilization rests solely with the individual, irrespective of their **relationship status**. *Partner is not sterilized* - Partner's sterilization status is **NOT a determining factor** for female sterilization eligibility. - The decision is based on the **individual's choice**, health status, and desire for permanent contraception. - The eligibility criteria focus on the client's **informed consent** and understanding of the procedure, not on the partner's reproductive history.
Question 38: Which state has the lowest Infant Mortality Rate (IMR) in India?
- A. Maharashtra
- B. Tamil Nadu
- C. Kerala (Correct Answer)
- D. Uttar Pradesh
Explanation: ***Kerala*** - Kerala consistently has achieved the **lowest Infant Mortality Rate (IMR)** in India, demonstrating significant progress in public health and maternal-child care. - This is primarily attributed to its robust **healthcare infrastructure**, high literacy rates, and effective implementation of health programs. *Maharashtra* - While Maharashtra has made progress in reducing IMR, its rate remains **higher than Kerala's**, reflecting varying healthcare access and quality across the state. - There are regional disparities in health outcomes, despite significant economic development. *Tamil Nadu* - Tamil Nadu has a commendable healthcare system and has significantly reduced its IMR over the years, yet it **does not consistently achieve the lowest rate** when compared to Kerala. - Its focus on **universal healthcare access** and nutrition programs has been instrumental in its improvements. *Uttar Pradesh* - Uttar Pradesh typically reports one of the **highest Infant Mortality Rates (IMR)** in India, due to challenges such as limited access to healthcare, malnutrition, and poor sanitation. - Significant efforts are underway to improve maternal and child health indicators, but the state still lags behind the national average and other states like Kerala.
Question 39: What does the Gross Reproduction Rate (GRR) measure?
- A. Number of female children a woman would have during her reproductive years, assuming no mortality (Correct Answer)
- B. Number of total children a woman would have during her reproductive years (both male and female), assuming no mortality
- C. Number of live births per 1000 women in a given year
- D. Number of male children a woman would have during her reproductive years, assuming no mortality
Explanation: ***Number of female children a woman would have during her reproductive years, assuming no mortality*** - The **Gross Reproduction Rate (GRR)** specifically measures the average number of **daughters** a woman is expected to have over her lifetime. - It assumes no mortality among women through their reproductive years, indicating the potential for a new generation of mothers. *Number of total children a woman would have during her years of reproduction (both male and female), at the current age-specific fertility rates, assuming no mortality* - This definition describes the **Total Fertility Rate (TFR)**, which includes all live births (male and female) per woman. - While both GRR and TFR assume no mortality, the GRR is explicitly focused on the female offspring. *Number of live births per 1000 women in a given year* - This statement defines the **General Fertility Rate (GFR)**, which is a cross-sectional measure for a specific year. - GRR is a longitudinal measure that considers a woman's entire reproductive lifespan. *Number of male children a woman would have during her reproductive years, assuming no mortality* - The GRR is specifically interested in the **female offspring** as they are the ones who can potentially reproduce and replace the current generation of mothers. - Male offspring are not directly counted in the GRR calculation.
Question 40: In a town there are 2500 live births within six months. During the same period 5 women died due to peripartum infection, 5 died due to electrocution, 2 died due to obstructed labor and 3 died due to PPH. What is the MMR?
- A. 6 per 1000 live births
- B. 40 per 1000 live births
- C. 60 per 1000 live births
- D. 4 per 1000 live births (Correct Answer)
Explanation: ***4 per 1000 live births*** - The **Maternal Mortality Ratio (MMR)** is calculated as the number of maternal deaths per 100,000 live births. In this scenario, only deaths directly related to pregnancy or within 42 days postpartum from obstetric causes are considered maternal deaths. - Total maternal deaths = 5 (peripartum infection) + 2 (obstructed labor) + 3 (PPH) = 10. MMR = (10 maternal deaths / 2500 live births) * 1000 = 4. *6 per 1000 live births* - This calculation would incorrectly include deaths from non-obstetric causes, such as the 5 deaths due to electrocution, which are not considered maternal deaths. - Including non-maternal deaths inflates the ratio, leading to an inaccurate representation of obstetric risk. *40 per 1000 live births* - This value is significantly higher, suggesting a miscalculation in either the number of maternal deaths or the live births, potentially by using a multiplier of 100,000 live births instead of 1,000 for this question, or an arithmetic error. - A common error might be to multiply the total number of maternal deaths by 1000 and divide by the number of live births, leading to an incorrect large number if the base is not handled correctly. *60 per 1000 live births* - This result is far too high and indicates a significant overestimation of maternal deaths or a severe miscalculation. - It likely arises from a compounding of errors, possibly including non-maternal deaths and incorrect scaling of the denominator.