NEET-PG 2015 - Community Medicine Practice Questions

Q: Horrock's apparatus is used to measure?

Chlorine demand. ***Chlorine demand*** - Horrock's apparatus is specifically designed for determining the **chlorine demand** of water, which is the amount of **chlorine** consumed by impurities before a **free chlorine residual** is established. - This apparatus is crucial in **water treatment processes** to ensure effective **disinfection** by adjusting chlorine dosages. *Wind velocity* - **Wind velocity** is typically measured using an **anemometer**, a device with rotating cups or a propeller that spins in response to wind. - Horrock's apparatus has no components or mechanisms for detecting or quantifying wind movement. *Humidity* - **Humidity** is measured by instruments such as **hygrometers** or **psychrometers**, which assess the amount of water vapor in the air. - These devices utilize properties like **condensation** or changes in **electrical resistance**, which are unrelated to the function of Horrock's apparatus. *Cooling power* - **Cooling power** refers to the rate at which heat can be removed from a system and is measured using devices like **catathermometers** or specialized **calorimeters**. - Horrock's apparatus is a **chemical testing device** and does not have the capability to measure thermal properties or cooling rates.

Q: Which indicator is used in Horroch's apparatus?

Starch iodine. ***Starch iodine*** - Horroch's apparatus is specifically designed for testing the **sterilizing efficiency of hypochlorite solutions** in dairies. - **Starch iodine** (starch-iodide paper) is used as an indicator because it reacts with residual free chlorine to produce a **blue-black color**, which confirms that adequate free chlorine is present for effective sterilization. - The principle: Free chlorine oxidizes iodide to iodine, which then reacts with starch to give the characteristic blue color. *Bleaching powder* - **Bleaching powder** (calcium hypochlorite) is the active ingredient in hypochlorite sterilizing solutions being tested, not an indicator itself. - It's the substance whose sterilizing efficacy is being evaluated using the apparatus. *Soda-lime* - **Soda-lime** is primarily used as an absorbent for **carbon dioxide (CO2)** and other acidic gases in various laboratory and anesthetic applications. - It has no role as an indicator in Horroch's apparatus for testing hypochlorite solutions. *Potassium permanganate* - **Potassium permanganate** is a strong oxidizing agent often used as an indicator in redox titrations, as its deep purple color disappears when reduced. - It is not suitable for indicating residual chlorine in Horroch's test, which specifically relies on the starch-iodine reaction.

Q: In water testing from a well using Horrock's apparatus, blue color appears from the 4th cup onwards. What is the amount of bleaching powder required to disinfect 75000 litres of water?

100 gm. ***100 gm*** - In **Horrock's apparatus** test, blue color appearing from the 4th cup indicates a **chlorine demand of 0.4 ppm (0.4 mg/L)** for the water sample. - **Total chlorine required** = 0.4 mg/L × 75,000 L = **30,000 mg = 30 gm** of pure chlorine. - Standard bleaching powder contains **30% available chlorine**, so: **Bleaching powder needed = 30 gm ÷ 0.30 = 100 gm**. - This is the scientifically accurate amount for disinfecting 75,000 liters of water with 0.4 ppm chlorine demand. *1000 gm* - This represents a **10-fold excess** over the actual requirement of 100 gm based on the measured chlorine demand. - Using 1000 gm would result in severe **over-chlorination** (4 ppm instead of 0.4 ppm), causing strong unpleasant taste, odor, and potential health concerns. *1600 gm* - This amount represents **16 times the required dose**, leading to dangerously high chlorine levels in the water. - Such excessive chlorination would make the water unpalatable and potentially toxic to consumers. *2000 gm* - This represents a **20-fold excess**, providing extreme and harmful over-disinfection. - Such excessive amounts could lead to **chlorine toxicity** and would be wasteful and harmful to consumers. *1300 gm* - This amount exceeds the calculated requirement by **13 times**, providing unnecessary and harmful over-disinfection. - The precise calculation based on **0.4 ppm chlorine demand** and **75,000 L volume** yields exactly **100 gm**, not 1300 gm.

Q: Which category waste is disposed in red bags?

Contaminated recyclable waste (Category 3). ***Contaminated recyclable waste (Category 3)*** - **Red bags** are specifically designated for the disposal of **contaminated recyclable waste**, which includes items like tubing, catheters, intravenous sets, and soiled plastic bottles. - This waste is often contaminated with blood or body fluids but can be sterilized and recycled after proper treatment. *Human anatomical waste (Category 1)* - **Human anatomical waste**, such as tissues, organs, body parts, and fetuses, is typically disposed of in **yellow bags**. - This category usually requires incineration or deep burial due to its biological hazard. *Glassware and metallic implants (Category 2)* - **Glassware** (e.g., broken glass, used vials) and **metallic implants** (e.g., orthopedic implants) are typically disposed of in puncture-proof containers, often **blue** or transparent bins, for safe handling and potential recycling. - These items are separated to prevent injuries and facilitate specific recycling or treatment methods. *Pharmaceutical waste (Category 4)* - **Pharmaceutical waste** includes discarded medicines, expired drugs, and cytotoxic drugs, and it is usually collected in **yellow bags** or designated labeled containers. - Its disposal requires specific chemical treatment, incineration, or secure landfilling to prevent environmental contamination.

Q: Which of the following is not typically incinerated?

Broken thermometers. ***Broken thermometers*** - **Broken thermometers** often contain **mercury**, which, when incinerated, releases **toxic mercury vapor** into the atmosphere. - This poses a severe environmental and health hazard, requiring them to be handled as **hazardous waste** and recycled or disposed of in specialized facilities to prevent mercury release. *Human anatomical waste* - **Human anatomical waste**, including body parts, tissues, and recognizable organs, is highly infectious and poses significant biohazard risks. - **Incineration** is the preferred method for its disposal to ensure complete destruction of pathogens and reduce environmental contamination. *Animal waste* - **Animal waste** from research or healthcare settings (e.g., infected animal carcasses, bedding with animal excreta) is considered **biohazardous**. - **Incineration** effectively neutralizes pathogens and reduces the volume of such waste, preventing disease transmission. *Infected solid waste* - **Infected solid waste**, such as bandages, swabs, and disposable medical devices contaminated with blood or bodily fluids, carries a high risk of spreading infectious diseases. - **Incineration** at high temperatures ensures sterilization and safe disposal of these materials, destroying pathogenic microorganisms.

Q: In immediate disaster response management (first 24-48 hours), which of the following is not typically practiced?

Mass vaccination. ***Mass vaccination*** - **Mass vaccination** is typically a strategy for **preparedness/prevention phase** or **post-disaster disease prevention**, not an immediate disaster response activity. - Immediate disaster response focuses on **saving lives, providing emergency medical care, establishing shelter, and restoring critical infrastructure**, rather than large-scale preventative health campaigns. - Mass vaccination requires **planning, logistics, cold chain management**, which are incompatible with chaotic immediate response scenarios. *Triage* - **Triage** is a **critical and immediate** component of disaster response, involving the **prioritization of injured patients** for treatment based on severity and survival likelihood. - It ensures limited resources are allocated effectively to **maximize lives saved** during the acute phase. - Typically uses **color-coded tags** (red-immediate, yellow-delayed, green-minor, black-deceased). *Rehabilitation* - While **rehabilitation** is part of the **recovery phase** (weeks to months post-disaster), **early rehabilitation activities** may begin during the immediate response period. - Basic rehabilitation services like **mobility aids, psychological first aid**, can be initiated alongside acute care. - This makes it partially practiced even in immediate response, unlike mass vaccination which is never immediate. *Search and rescue* - **Search and rescue** is the **primary immediate response activity**, focusing on locating and extracting survivors from disaster-affected areas. - Time-critical operation following the **"golden period"** principle where survival rates decrease rapidly after 72 hours. - Involves specialized teams with equipment for **debris removal, victim location, and emergency extraction**.

Q: Which of the following statements about Anganwadi workers is incorrect?

Covers a population of 2000. ***Covers a population of 2000*** - An **Anganwadi center** typically covers a population of **1000** in rural and urban areas, and **700** in tribal areas, not 2000. - This statement is incorrect because the specified population coverage is double the standard norm for an Anganwadi center. *Mostly female* - The vast majority of **Anganwadi workers** are **women** from the local community. - This is a correct statement, reflecting the gender composition of the Anganwadi workforce. *Training for 40 days* - **Anganwadi workers** undergo an initial **training program of 40 days**. - This statement is correct, outlining the standard duration of their foundational training. *Under ICDS scheme* - **Anganwadi centers** are a crucial part of the **Integrated Child Development Services (ICDS) scheme**. - This statement is correct, as the ICDS scheme established and oversees Anganwadi centers to provide health, nutrition, and early childhood education services.

Q: Most common cause of goiter in India is

Diffuse Endemic Goitre. ***Diffuse Endemic Goitre*** - **Iodine deficiency** is the leading cause of goiter globally, particularly in areas with poor iodine intake like some regions in India, leading to **diffuse endemic goiter** - In response to low iodine, the thyroid gland undergoes **hypertrophy** and **hyperplasia**, increasing in size in an attempt to capture more iodine for thyroid hormone synthesis - Despite the **Universal Salt Iodization (USI) program**, iodine deficiency disorders remain a significant public health concern in several Indian states *Papillary Carcinoma* - While it can cause a thyroid mass, **papillary carcinoma** is a malignant neoplastic condition, not the most common cause of generalized goiter - It presents as a **solitary or dominant nodule** and is not typically associated with widespread iodine deficiency - Accounts for only a small percentage of thyroid enlargements *Toxic Multinodular Goitre* - This condition involves multiple autonomously functioning nodules and primarily causes **hyperthyroidism**, not just goiter as a primary common presentation - More common in **elderly patients** and in regions with prior iodine deficiency (Jod-Basedow phenomenon) - Does not represent the most widespread cause of goiter in the general population of India *Hashimoto's Thyroiditis* - Hashimoto's is an **autoimmune disease** causing chronic lymphocytic thyroid inflammation and often hypothyroidism - While it can cause goiter, it typically produces a **firmer, less diffuse enlargement** than that seen with **iodine deficiency** - Not the most common cause of goiter in India, though its prevalence is increasing in urban areas

Q: Japanese encephalitis vaccine in routine schedule is given in how many doses -

Two doses (at 9-12 months and 15-18 months). ***Two doses (at 9-12 months and 15-18 months)*** - The **routine JE vaccination schedule in India** as per NTAGI and IAP recommendations involves **two doses**. - **First dose** is given at **9-12 months** of age. - **Second dose** is administered at **15-18 months** (or up to 24 months), approximately **6-12 months after the first dose**. - This provides adequate long-term protection against Japanese encephalitis in endemic areas. *Single dose vaccine* - A single dose does **not provide adequate long-lasting protection** against Japanese encephalitis. - The **immune response** from a single dose is insufficient for routine immunization. - Two doses are required to ensure protective antibody levels. *Three doses 1 month apart followed by a booster if needed* - This schedule is **not part of the routine immunization program** for JE in India. - The standard routine schedule involves **only 2 primary doses**, not three. - Rapid three-dose schedules may be used in specific outbreak situations but not for routine immunization. *Three doses with the second dose 1 month and 3rd dose 6 months after the first dose* - This three-dose schedule is **not the routine JE vaccination schedule** in India. - This may be confused with schedules for other vaccines or older JE vaccine protocols. - The current **routine schedule requires only 2 doses** at specified age intervals.

Q: Reduced osmolarity ORS does not contain which of the following ions?

Lactate. ***Lactate*** - The **reduced osmolarity ORS** formulation replaced **bicarbonate** with **citrate** and does not contain lactate. - **Citrate** is preferred over lactate / bicarbonate due to its stability, longer shelf life, and ease of dissolution. *Sodium* - **Sodium** is a crucial component of ORS, as it is co-transported with glucose into enterocytes, facilitating water absorption through **solvent drag**. - Reduced osmolarity ORS has a **lower sodium concentration** (75 mEq/L) compared to standard ORS (90 mEq/L) to minimize hypernatremia risk and enhance water absorption. *Potassium* - **Potassium** is included in ORS to replace intestinal losses, as **diarrhea** leads to significant potassium depletion. - Maintaining adequate **potassium levels** is essential for normal cellular function and preventing hypokalemia-related complications. *Citrate* - **Citrate** is a component of ORS that serves as an **alkalinizing agent** to correct metabolic acidosis often associated with dehydration in diarrheal diseases. - It also enhances the absorption of sodium and water in the intestine.

Question 1

Horrock's apparatus is used to measure?

Accepted Answer

Chlorine demand

Answer

Wind velocity

Answer

Humidity

Answer

Cooling power

Question 2

Which indicator is used in Horroch's apparatus?

Accepted Answer

Starch iodine

Answer

Potassium permanganate

Answer

Bleaching powder

Answer

Soda-lime

Question 3

In water testing from a well using Horrock's apparatus, blue color appears from the 4th cup onwards. What is the amount of bleaching powder required to disinfect 75000 litres of water?

Accepted Answer

100 gm

Answer

1600 gm

Answer

2000 gm

Answer

1300 gm

Question 4

Which category waste is disposed in red bags?

Accepted Answer

Contaminated recyclable waste (Category 3)

Answer

Glassware and metallic implants (Category 2)

Answer

Human anatomical waste (Category 1)

Answer

Pharmaceutical waste (Category 4)

Question 5

Which of the following is not typically incinerated?

Accepted Answer

Broken thermometers

Answer

Animal waste

Answer

Infected solid waste

Answer

Human anatomical waste

Question 6

In immediate disaster response management (first 24-48 hours), which of the following is not typically practiced?

Accepted Answer

Mass vaccination

Answer

Rehabilitation

Answer

Triage

Answer

Search and rescue

Question 7

Which of the following statements about Anganwadi workers is incorrect?

Accepted Answer

Covers a population of 2000

Answer

Training for 40 days

Answer

Under ICDS scheme

Answer

Mostly female

Question 8

Most common cause of goiter in India is

Accepted Answer

Diffuse Endemic Goitre

Answer

Papillary Carcinoma

Answer

Toxic Multinodular Goitre

Answer

Hashimoto's Thyroiditis

Question 9

Japanese encephalitis vaccine in routine schedule is given in how many doses -

Accepted Answer

Two doses (at 9-12 months and 15-18 months)

Answer

Single dose vaccine

Answer

Three doses 1 month apart followed by a booster if needed

Answer

Three doses with the second dose 1 month and 3rd dose 6 months after the first dose

Question 10

Reduced osmolarity ORS does not contain which of the following ions?

Accepted Answer

Lactate

Answer

Sodium

Answer

Potassium

Answer

Citrate

NEET-PG 2015 — Community Medicine