NEET-PG 2015 - Community Medicine Practice Questions

Q: Under NTEP, what is the honorarium given to a DOTS provider after the completion of treatment?

500 INR. ***500 INR*** - Under the **National Tuberculosis Elimination Programme (NTEP)**, a **DOTS provider** receives an honorarium of **INR 500** upon the successful completion of tuberculosis treatment for a **new TB patient**. - This incentive, revised from the earlier amount of INR 250, aims to recognize the crucial role of DOTS providers in ensuring treatment adherence and successful outcomes. - The increased honorarium reflects the government's commitment to incentivizing community participation in TB elimination. *150 INR* - This amount is **significantly lower than the stipulated honorarium** for a DOTS provider upon treatment completion under current NTEP guidelines. - The correct incentive for successful completion of treatment is INR 500 for new TB cases. *250 INR* - This was the **earlier honorarium amount** under the previous NTEP guidelines, which has since been **revised upward**. - Under the current NTEP incentive structure, the honorarium for treatment completion has been increased to INR 500. *1000 INR* - This amount is **higher than the designated honorarium** for a DOTS provider upon treatment completion under NTEP. - While this figure may apply to other incentive schemes or different milestones, the standard honorarium for new TB case completion is INR 500.

Q: Which of the following infectious diseases has the highest proportion of asymptomatic chronic carriers?

Hepatitis B. ***Hepatitis B*** - **Hepatitis B** infection has a significant proportion of **chronic asymptomatic carriers**, particularly when infection occurs perinatally or in early childhood. - In adults, approximately **5% develop chronic infection** after acute exposure, and many of these chronic carriers remain asymptomatic while maintaining infectivity. - Chronic carriers can harbor the virus for years or decades without clinical symptoms, making them an important reservoir for transmission. - This is a major public health concern as asymptomatic carriers can unknowingly transmit the virus. *Measles* - **Measles** is highly contagious and typically presents with **symptomatic disease** in nearly all infected individuals. - Clinical features include characteristic maculopapular rash, cough, coryza, conjunctivitis, and Koplik's spots. - Asymptomatic infection is **extremely rare** with measles virus. *Diphtheria* - While **asymptomatic pharyngeal carriage** of *Corynebacterium diphtheriae* can occur, it is not the predominant pattern. - Clinical diphtheria typically presents with pseudomembrane formation, sore throat, and potential systemic toxin effects. - Carrier rates vary but are not as epidemiologically significant as with Hepatitis B. *Rabies* - **Rabies** is almost **100% symptomatic** once the virus reaches the central nervous system. - There is **no chronic asymptomatic carrier state** in humans. - Once clinical symptoms appear (encephalitis, hydrophobia, paralysis), the disease is virtually always fatal.

Q: Which of the following statements about influenza infectivity is correct?

All of the options are correct.. ***All of the options are correct.*** - All statements provided accurately describe aspects of influenza infectivity and epidemiology. - The **communicable period**, the **primary source of infection**, and the potential for **subclinical cases** are all characteristic features of influenza. *Communicable period is 1 day before to 5-7 days after the onset of symptoms* - This statement is accurate, as influenza is transmissible **before symptom onset** and for several days afterward, which contributes to its rapid spread. - Peak viral shedding often occurs just before and in the first few days of symptomatic illness. - Adults typically shed virus from 1 day before to 5-7 days after symptom onset (can be longer in children and immunocompromised individuals). *The primary source of infection is a clinical case.* - This is correct, as **symptomatic individuals (clinical cases) are the PRIMARY source** of influenza virus transmission to others. - Respiratory droplets produced by coughing, sneezing, or talking from an infected person are the main mode of spread. - While subclinical cases can transmit, clinical cases with overt symptoms produce more respiratory droplets and are the major drivers of transmission. *There can be subclinical cases of influenza.* - This statement is correct; many individuals infected with influenza virus experience **mild or asymptomatic infections** (subclinical cases). - These subclinical cases can still transmit the virus, though typically to a lesser extent than symptomatic cases, further complicating control efforts.

Q: Vaccine derived polio virus outbreaks are due to?

Type-2 poliovirus. ***Type-2 poliovirus*** - The **type 2 poliovirus (PV2)** component of the oral polio vaccine (OPV) has historically been associated with the majority of vaccine-derived poliovirus (VDPV) outbreaks. - The **attenuated PV2 strain** in OPV can revert to neurovirulent forms in rare cases, leading to outbreaks, especially in areas with low vaccination coverage. - Type 2 was responsible for **>90% of circulating VDPV (cVDPV) cases**, which led to the global switch from trivalent OPV to bivalent OPV (without type 2) in April 2016. *Type-3 poliovirus* - While **type 3 poliovirus (PV3)** was also part of OPV, **wild type 3 poliovirus was declared eradicated in 2019** (last case in 2012). - VDPV outbreaks due to PV3 are rare compared to PV2. *Type-1 poliovirus* - **Type 1 poliovirus (PV1)** is still endemic in some regions and causes wild poliovirus (WPV) infections. - Although PV1 is included in bivalent OPV, **VDPV outbreaks** from the PV1 component are very rare compared to PV2. *All types of poliovirus* - While all three serotypes of poliovirus were historically included in trivalent OPV, **PV2 is overwhelmingly responsible** for VDPV outbreaks. - **Wild type 2 poliovirus was eradicated in 2015** (last case 1999), but the vaccine strain continued to cause VDPV outbreaks until type 2 was removed from routine OPV.

Q: Which of the following statements regarding polio vaccination is false?

First OPV is given at 4 weeks. ***First OPV is given at 4 weeks*** - The first dose of **Oral Polio Vaccine (OPV)** is typically given at birth, often referred to as the **"zero dose,"** before the 4-week mark. - Subsequent doses are given at 6, 10, and 14 weeks of age as part of the routine immunization schedule, making the statement that the first OPV is given at 4 weeks false. *OPV induces both humoral and intestinal immunity* - **OPV** is a **live attenuated vaccine** that replicates in the gut, thereby stimulating both a systemic **humoral immune response** (producing antibodies in the bloodstream) and **local intestinal immunity** (IgA antibodies in the gut). - This **intestinal immunity** is crucial for preventing viral replication in the gut and reducing transmission. *IPV is given intramuscularly* - The **Inactivated Polio Vaccine (IPV)**, also known as the **Salk vaccine**, is administered via injection, specifically through the **intramuscular route**. - This method ensures systemic absorption and the development of **humoral immunity**. *Both killed and live vaccines are available* - There are two main types of polio vaccines: **Oral Polio Vaccine (OPV)**, which is a **live attenuated vaccine**, and **Inactivated Polio Vaccine (IPV)**, which is a **killed vaccine**. - Both types have been instrumental in polio eradication efforts, each with distinct advantages and disadvantages.

Q: Reservoir of infection in enteric fever?

Man. ***Man*** - Humans are the **sole natural reservoir** for *Salmonella Typhi* and *Salmonella Paratyphi*, the causative agents of enteric fever (typhoid and paratyphoid fever). - The bacteria can persist in the **gallbladder** of asymptomatic carriers, who can then shed the bacteria in their feces, contributing to transmission. *Birds* - Birds are not considered a primary reservoir for the **causative pathogens of enteric fever** (*Salmonella Typhi* or *Paratyphi*). - They are more commonly associated with other *Salmonella* serotypes, such as *Salmonella Enteritidis*, which cause **gastroenteritis** rather than systemic enteric fever. *Cow* - Cows are not a primary reservoir for the organisms responsible for **enteric fever**; these pathogens are specifically adapted to humans. - While cows can carry various *Salmonella* species, they are typically associated with **foodborne outbreaks** of *Salmonella*-induced **gastroenteritis**, not typhoid fever. *Water* - Water is a **vehicle for transmission** of enteric fever, becoming contaminated with human feces containing *Salmonella Typhi* or *Paratyphi*. - It is not a reservoir because the bacteria do not naturally **multiply or persist indefinitely** in water without a human source.

Q: Among the following options, the minimum acceptable Rideal-Walker coefficient for disinfectant used for cholera stool would be?

2. ***2 (Minimum acceptable among given options)*** - The **Rideal-Walker coefficient** measures disinfectant efficacy relative to phenol as the standard reference - A coefficient of **2** means the disinfectant is **twice as effective** as phenol against test organisms (*Salmonella typhi* and *Staphylococcus aureus*) - While higher coefficients are preferred for highly infectious materials like cholera stool, **2 represents the minimum acceptable threshold** among the given options that still provides reasonable disinfection efficacy - Standard practice recommends disinfectants with RW coefficient ≥5 for cholera stool, but among the choices provided, 2 is the lowest that meets basic acceptability criteria *4 (Better choice but not the minimum)* - A coefficient of **4** means the disinfectant is **four times more effective** than phenol - This provides **more robust disinfection** and would be preferred over a coefficient of 2 - However, the question specifically asks for the **minimum acceptable** value, not the optimal value - Among the options, this is not the minimum *7 (Highly effective)* - A coefficient of **7** indicates the disinfectant is **seven times more potent** than phenol - This represents **very good disinfection efficacy** and exceeds minimum requirements - This is well above the minimum acceptable threshold *10 (Excellent efficacy)* - A coefficient of **10** means the disinfectant is **ten times more effective** than phenol - This represents **excellent disinfection power** with a very high safety margin - While ideal for high-risk situations, this far exceeds the minimum acceptable requirement

Q: Behavioral surveillance survey is done in?

AIDS. ***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.

Q: Drug of choice for mass therapy under filariasis control programme?

DEC. ***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.

Q: Which of the following larvicide is used under urban Malaria Scheme?

Abate. ***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 1

Under NTEP, what is the honorarium given to a DOTS provider after the completion of treatment?

Accepted Answer

500 INR

Answer

150 INR

Answer

1000 INR

Answer

250 INR

Question 2

Which of the following infectious diseases has the highest proportion of asymptomatic chronic carriers?

Accepted Answer

Hepatitis B

Answer

Measles

Answer

Rabies

Answer

Diphtheria

Question 3

Which of the following statements about influenza infectivity is correct?

Accepted Answer

All of the options are correct.

Answer

Communicable period is 1 day before to 5-7 days after the onset of symptoms

Answer

There can be subclinical cases of influenza.

Answer

The primary source of infection is a clinical case.

Question 4

Vaccine derived polio virus outbreaks are due to?

Accepted Answer

Type-2 poliovirus

Answer

Type-3 poliovirus

Answer

Type-1 poliovirus

Answer

All types of poliovirus

Question 5

Which of the following statements regarding polio vaccination is false?

Accepted Answer

First OPV is given at 4 weeks

Answer

OPV induces both humoral and intestinal immunity

Answer

IPV is given intramuscularly

Answer

Both killed and live vaccines are available

Question 6

Reservoir of infection in enteric fever?

Accepted Answer

Man

Answer

Birds

Answer

Cow

Answer

Water

Question 7

Among the following options, the minimum acceptable Rideal-Walker coefficient for disinfectant used for cholera stool would be?

Accepted Answer

2

Answer

4

Answer

10

Answer

7

Question 8

Behavioral surveillance survey is done in?

Accepted Answer

AIDS

Answer

TB

Answer

Filaria

Answer

Malaria

Question 9

Drug of choice for mass therapy under filariasis control programme?

Accepted Answer

DEC

Answer

Albendazole

Answer

Ivermectin

Answer

Mebendazole

Question 10

Which of the following larvicide is used under urban Malaria Scheme?

Accepted Answer

Abate

Answer

Malathion

Answer

Parathion

Answer

DDT

NEET-PG 2015 — Community Medicine