Community Medicine
6 questionsMost 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?
NEET-PG 2015 - Community Medicine NEET-PG Practice Questions and MCQs
Question 821: 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 822: 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 823: 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 824: 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 825: 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 826: 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**.
Microbiology
1 questionsA woman traveling from Bihar to Delhi is suspected to have Kala-azar. Suitable investigation is?
NEET-PG 2015 - Microbiology NEET-PG Practice Questions and MCQs
Question 821: A woman traveling from Bihar to Delhi is suspected to have Kala-azar. Suitable investigation is?
- A. P24 antigen
- B. Rk-39 test (Correct Answer)
- C. Combo RDT
- D. HRP-2 antigen
Explanation: ***Rk-39 test*** - The **Rk-39 test** is a rapid diagnostic test highly sensitive and specific for detecting antibodies against the **kinesin-related protein K39** of *Leishmania donovani*, the causative agent of **Kala-azar (visceral leishmaniasis)**. - It is particularly useful in **endemic regions** like Bihar for quick and accurate diagnosis, especially in patients with suspected Kala-azar presenting with fever, splenomegaly, and pancytopenia. *P24 antigen* - **P24 antigen** testing is primarily used for the diagnosis of **HIV infection**. - It detects the **core protein p24** of the HIV virus, which is not relevant for the diagnosis of Kala-azar. *Combo RDT* - A **Combo RDT** (Rapid Diagnostic Test), without further specification, typically refers to tests for **malaria**, which detect antigens like **HRP-2** and **aldolase**. - While RDTs are used for parasitic diseases, this general term does not specifically refer to a test for **Kala-azar**. *HRP-2 antigen* - **HRP-2 (Histidine-rich protein 2) antigen** is a specific marker for **Plasmodium falciparum**, used in the diagnosis of **malaria**. - It is not associated with the diagnosis of **Kala-azar**, which is caused by *Leishmania donovani*.
Pharmacology
3 questionsMain function of sodium citrate in ORS?
What is the recommended regimen for post-exposure prophylaxis for HIV?
In areas with chloroquine-sensitive P. vivax, what is the preferred drug for treating the blood stages?
NEET-PG 2015 - Pharmacology NEET-PG Practice Questions and MCQs
Question 821: Main function of sodium citrate in ORS?
- A. To increase absorption of glucose by cotransport
- B. To correct electrolyte imbalance
- C. To correct Acidosis (Correct Answer)
- D. To correct dehydration
Explanation: ***To correct Acidosis*** - **Sodium citrate** provides a source of **bicarbonate** precursor, which helps to correct the **metabolic acidosis** often associated with severe dehydration and diarrhea. - In the body, citrate is metabolized into bicarbonate, raising the blood pH and counteracting the effects of acidosis. *To increase absorption of glucose by cotransport* - The absorption of glucose and sodium is coupled, meaning the presence of **sodium enhances glucose absorption** through the **SGLT1 cotransporter**. - While sodium is essential for glucose absorption, **citrate's primary role is not this direct cotransport mechanism**. *To correct electrolyte imbalance* - ORS formulations contain various electrolytes like **sodium chloride** and **potassium chloride** to rectify electrolyte imbalances caused by diarrhea. - While sodium citrate contributes to sodium levels, its specific function goes beyond just general electrolyte correction to address the **acid-base balance**. *To correct dehydration* - The overall purpose of ORS is to **rehydrate the patient** by providing fluids and electrolytes, which helps restore circulating volume. - While citrate is a component of ORS, **rehydration also depends on the water and other salts** present in the solution, not solely on citrate.
Question 822: What is the recommended regimen for post-exposure prophylaxis for HIV?
- A. Zidovudine + Lamivudine + Lopinavir/ritonavir for 28 days
- B. Tenofovir disoproxil fumarate + Emtricitabine + Raltegravir for 28 days
- C. Single dose Tenofovir + Emtricitabine + Raltegravir
- D. Tenofovir disoproxil fumarate + Emtricitabine + Dolutegravir for 28 days (Correct Answer)
Explanation: ***Tenofovir disoproxil fumarate + Emtricitabine + Dolutegravir for 28 days*** - This is the **current first-line recommended regimen** for **HIV post-exposure prophylaxis (PEP)** according to WHO (2021), CDC, and Indian NACO guidelines. - It includes two **nucleoside reverse transcriptase inhibitors (NRTIs)** and an **integrase strand transfer inhibitor (INSTI)**. - **Dolutegravir** is preferred over Raltegravir due to **superior efficacy, better tolerability, higher barrier to resistance, once-daily dosing**, and fewer drug interactions. - The duration of **28 days** is crucial for effective PEP to cover the window period for potential HIV integration and replication. *Tenofovir disoproxil fumarate + Emtricitabine + Raltegravir for 28 days* - This was the **previous standard PEP regimen** and is still an acceptable alternative if Dolutegravir is contraindicated or unavailable. - Raltegravir requires **twice-daily dosing** compared to Dolutegravir's once-daily regimen, which may affect adherence. - The 28-day duration is correct, but Raltegravir is no longer the first-line INSTI choice in current guidelines. *Single dose Tenofovir + Emtricitabine + Raltegravir* - A **single dose** of these medications is insufficient for **post-exposure prophylaxis (PEP)** as HIV replication needs to be suppressed over an extended period to prevent seroconversion. - PEP typically requires a **28-day course** to be effective. *Zidovudine + Lamivudine + Lopinavir/ritonavir for 28 days* - While this is an older, effective **antiretroviral regimen**, it is **not the preferred first-line PEP regimen** due to a higher incidence of side effects, particularly with zidovudine (anemia, nausea). - Modern guidelines favor regimens with **Tenofovir/Emtricitabine + Dolutegravir** due to better tolerability and superior efficacy.
Question 823: In areas with chloroquine-sensitive P. vivax, what is the preferred drug for treating the blood stages?
- A. Mefloquine
- B. Artesunate
- C. Quinine
- D. Chloroquine (Correct Answer)
Explanation: ***Correct Option: Chloroquine***- **Chloroquine** remains the **first-line treatment** for **chloroquine-sensitive P. vivax** infections due to its high efficacy and safety profile [1, 2].- It rapidly clears **blood-stage parasites**, alleviating acute symptoms of malaria [3].- In areas where P. vivax remains sensitive, chloroquine is preferred due to low cost, good tolerability, and proven effectiveness [1, 2].*Incorrect Option: Mefloquine*- **Mefloquine** is typically reserved for areas with **chloroquine-resistant P. falciparum** or for prophylaxis in such regions.- Its use is generally avoided when less toxic and equally effective options like chloroquine are available for sensitive strains.- Associated with more neuropsychiatric side effects.*Incorrect Option: Artesunate*- **Artesunate** is an **artemisinin derivative**, primarily used for severe malaria or in areas with **multi-drug resistant P. falciparum**.- While effective, it is not the preferred first-line agent for chloroquine-sensitive P. vivax due to the availability of simpler, equally effective treatments.- Typically used in combination therapy (ACT) for resistant strains.*Incorrect Option: Quinine*- **Quinine** is an older antimalarial, often used for **severe malaria** or in cases of **chloroquine-resistant P. falciparum**.- It has a higher incidence of side effects compared to chloroquine (cinchonism, hypoglycemia) and is not the preferred choice for chloroquine-sensitive P. vivax.- Requires longer treatment duration with more monitoring.