NEET-PG 2020 - Community Medicine Practice Questions

Q: A 5-year-old unimmunized child developed diphtheria. He has a 3-year-old immunized sibling contact, who received the last booster 18 months back. What should be done with the contact?

Single dose of toxoid vaccine. ***Single dose of toxoid vaccine*** - In the context of this question, this is the **best available option** among the choices provided. - For a close contact of diphtheria who was immunized but received their last booster **18 months ago**, guidelines recommend a **booster dose if more than 5 years** have elapsed since the last dose. - However, some protocols recommend a booster for **close contacts regardless of timing** to ensure maximum protection. - **Important note**: The PRIMARY management for diphtheria close contacts is **antibiotic prophylaxis** (Erythromycin 40-50 mg/kg/day for 7 days or single-dose Azithromycin) plus surveillance for 7 days, which is not mentioned in the available options. *No vaccine needed* - This is incorrect because as a **close contact of an active diphtheria case**, prophylactic measures are required. - Even though the child received a booster 18 months ago, additional protection through either antibiotics (primary) or a booster dose may be recommended. - Close contacts require active intervention to prevent secondary transmission. *Three doses of conjugate vaccine* - This represents a **complete primary series**, which is not appropriate for an already immunized child. - The child has already completed primary immunization and received boosters; they do not need to restart the vaccination schedule. - **Conjugate vaccines** (like Hib conjugate) are different formulations, though DTaP is technically a conjugated form of diphtheria toxoid. *Two doses of polysaccharide vaccine* - **Polysaccharide vaccines** are not used for diphtheria prevention. - Diphtheria vaccines are **toxoid-based** (inactivated diphtheria toxin), not polysaccharide-based. - This option represents an incorrect vaccine type for diphtheria prophylaxis.

Q: Indicators of air pollution are:

Sulphur dioxide, smoke, particulate matter. **Correct Option: Sulphur dioxide, smoke, particulate matter** - **Sulphur dioxide (SO₂)** is a major gaseous air pollutant indicator, primarily from fossil fuel combustion and industrial processes - **Smoke** (composed of small solid and liquid particles) is a visible indicator of air pollution - **Particulate matter (PM2.5 and PM10)** represents suspended particulate matter (SPM), significant contributors to air pollution causing respiratory and cardiovascular issues - These three parameters are the **standard indicators** used for air quality monitoring as per NAAQS (National Ambient Air Quality Standards) *Incorrect: Sulphur dioxide, lead, particulate matter* - While SO₂ and particulate matter are correct indicators, **lead** is a toxic heavy metal pollutant but not a standard indicator for routine air quality monitoring - Lead pollution is typically measured separately as a specific hazardous pollutant *Incorrect: Sulphur dioxide, hydrogen sulphide, carbon monoxide* - SO₂ and CO are air pollutants, but **hydrogen sulphide (H₂S)** is more associated with specific industrial emissions and sewage decomposition - This combination misses the critical indicators of **smoke and particulate matter** which are more ubiquitous and routinely monitored *Incorrect: Carbon dioxide, hydrogen sulphide, lead* - **Carbon dioxide (CO₂)** is primarily a greenhouse gas contributing to climate change, not a conventional air pollution indicator for local air quality - H₂S and lead are pollutants but not standard routine indicators - This option lacks the key indicators: SO₂, smoke, and particulate matter

Q: Vector for Zika virus disease is:

Aedes Aegypti. ***Aedes aegypti*** - The **Aedes aegypti mosquito** is the primary vector responsible for transmitting the Zika virus to humans. - This mosquito species is also known to transmit other arboviruses, including **dengue** and **chikungunya** viruses. *Culex* - **Culex mosquitoes** are known vectors for diseases such as **West Nile virus** and **Japanese encephalitis**. - They are generally not considered primary vectors for the Zika virus. *Phlebotomus* - **Phlebotomus (sandflies)** are vectors for parasitic diseases, most notably **leishmaniasis**. - They are not involved in the transmission of viral infections like Zika. *Anopheles stephensi* - **Anopheles mosquitoes**, particularly *Anopheles stephensi*, are the main vectors for **malaria**. - They do not play a role in the transmission of the Zika virus.

Q: Liquid chemical waste is discarded in:

Yellow bag. ***Yellow bag*** - **Liquid chemical waste** including laboratory reagents, disinfectants, and expired chemicals must be segregated and collected in a **yellow bag or container** as per **Bio-Medical Waste Management Rules, 2016 (India)**. - Yellow bags are designated for **infectious and hazardous waste** including chemical waste, expired medicines, and anatomical waste. - This ensures proper handling through **incineration or chemical treatment** to prevent environmental contamination. *Red bag* - **Red bags** are used for **contaminated waste (recyclable)** including items contaminated with blood or body fluids that are not highly infectious. - This includes tubing, bottles, intravenous sets, and catheters that can be autoclaved and recycled. - Red bag waste undergoes **autoclaving/microwaving** followed by shredding before disposal. *White bag* - **White or translucent puncture-proof containers** are designated for **sharps waste** including needles, syringes, scalpels, and blades. - These containers prevent needlestick injuries and ensure safe handling of sharp objects. - Not suitable for liquid chemical waste which requires yellow bag disposal. *Blue bag* - **Blue/white puncture-proof containers** are used for **sharps including metallic body implants** and glassware that may cause injury. - In the Indian BMW system, blue and white containers serve similar purposes for sharps waste. - Not designated for liquid chemical waste, which belongs in yellow bags.

Q: A study was conducted to investigate the relationship between COPD and smoking. Data was collected from government hospital records on COPD cases and cigarette sales records from finance and taxation departments. What is the study design?

Ecological study. ***Ecological study*** - This study uses **aggregate data** (COPD cases from hospital records, cigarette sales from taxation departments) at the population level, not individual data. - It investigates the relationship between exposure (smoking) and outcome (COPD) across different populations or groups. *Cross-sectional study* - A **cross-sectional study** collects data on exposure and outcome at a **single point in time** from individuals, which is not the case here as aggregate data is used. - It describes the prevalence of a disease and exposure in a population, but does not examine the relationship using population-level aggregates. *Operational study* - An **operational study** focuses on evaluating the effectiveness and efficiency of health services or programs in real-world settings. - It typically involves assessing how well interventions are implemented and their impact, rather than investigating the relationship between disease and exposure using aggregate data. *Case-control study* - A **case-control study** compares individuals with a disease (cases) to individuals without the disease (controls) and looks back retrospectively to identify exposures. - This design relies on individual-level data and is not suitable when only population-level aggregate data is available.

Q: Which of the following is classified as a Category A bioterrorism agent?

Bacillus anthracis. ***Bacillus anthracis*** - **Anthrax**, caused by *Bacillus anthracis*, is a prime example of a Category A bioterrorism agent due to its high mortality, ease of dissemination, and potential for major public health impact. - Category A agents pose the **greatest threat** to public health and national security. *Clostridium perfringens* - *Clostridium perfringens* is classified as a **Category B bioterrorism agent**. - While it causes **gas gangrene** and food poisoning with moderate severity, it lacks the **high transmissibility** and widespread impact characteristic of Category A agents. *NIPAH virus* - **Nipah virus** is classified as a Category C priority pathogen. - It has the potential for high morbidity and mortality, but its **epidemiological characteristics** (e.g., lower transmissibility than Category A agents) preclude its inclusion in Category A. *Coxiella burnetii* - *Coxiella burnetii*, the causative agent of **Q fever**, is classified as a Category B bioterrorism agent. - Category B agents are moderately easy to disseminate and can cause **moderate morbidity** and low mortality, which is less severe than Category A agents.

Q: All are true regarding Japanese encephalitis disease except:

Man acts as reservoir. ***Man acts as reservoir*** - Humans are considered **dead-end hosts** for Japanese encephalitis; they do not develop sufficiently high viremia to transmit the virus back to mosquitoes. - The primary reservoirs for the Japanese encephalitis virus are **pigs** and **wading birds**. *Pig vaccination control transmission* - **Vaccinating pigs** is an effective strategy to control Japanese encephalitis transmission because pigs are significant amplifier hosts, producing high levels of viremia. - By reducing the viral load in the pig population, pig vaccination helps **break the transmission cycle** between mosquitoes and humans. *Vector is Culex vishnui* - The primary vector involved in the transmission of Japanese encephalitis is indeed **Culex mosquitoes**, with **Culex vishnui complex** being a significant group responsible for its spread in many endemic regions. - These mosquitoes primarily breed in **rice paddies** and other stagnant water sources, which are common in areas where the disease is prevalent. *None of the options are true* - This option is incorrect because the statements regarding **pig vaccination** and the **Culex vishnui** vector are true in the context of Japanese encephalitis. - The initial premise that "Man acts as reservoir" is the false statement, making it the correct answer to the "except" question.

Q: Blood bag is discarded in:

Yellow bag. ***Yellow bag*** - The **yellow bag** is designated for **infectious waste** including human anatomical waste, soiled waste, expired medicines, and **items contaminated with blood and body fluids**. - **Blood bags** are disposed in yellow bags as they contain blood and body fluids, making them **infectious/biohazardous waste**. - According to Biomedical Waste Management Rules, items contaminated with blood fall under Category 1 (Yellow bag) waste. - This ensures safe handling and disposal of potentially infectious materials to prevent pathogen transmission. *Red bag* - The red bag is used for **contaminated recyclable plastic waste** such as tubing, IV sets without fluids, catheters, and plastic bottles. - While blood bags are plastic, their **biohazardous content (blood)** classifies them as infectious waste rather than recyclable contaminated plastic. - Red bag items undergo recycling after disinfection, which is not appropriate for blood-contaminated items. *White bag* - A **white/translucent bag** is used for **sharp waste** including needles, syringes with fixed needles, scalpels, and blades. - Blood bags are not sharp objects and do not pose puncture risk, hence not disposed in white bags. *Blue bag* - The **blue bag** is used for **glassware waste** including broken/unbroken contaminated glass vials and ampoules. - Blood bags are made of plastic, not glass, and their primary hazard is infectious content, not material type.

Question 1

A 5-year-old unimmunized child developed diphtheria. He has a 3-year-old immunized sibling contact, who received the last booster 18 months back. What should be done with the contact?

Accepted Answer

Single dose of toxoid vaccine

Answer

No vaccine needed

Answer

Three doses of conjugate vaccine

Answer

Two doses of polysaccharide vaccine

Question 2

Indicators of air pollution are:

Accepted Answer

Sulphur dioxide, smoke, particulate matter

Answer

Sulphur dioxide, lead, particulate matter

Answer

Sulphur dioxide, hydrogen sulphide, carbon monoxide

Answer

Carbon dioxide, hydrogen sulphide, lead

Question 3

"MONICA Project" is associated with:

Accepted Answer

Monitoring of trends and determinants in cardiovascular disease

Answer

Risk factor intervention trials for CVD

Answer

Lipid research clinics study

Answer

Oslo diet/smoking intervention study

Question 4

Vector for Zika virus disease is:

Accepted Answer

Aedes Aegypti

Answer

Culex

Answer

Phlebotomus

Answer

Anopheles stephensi

Question 5

Liquid chemical waste is discarded in:

Accepted Answer

Yellow bag

Answer

Red bag

Answer

White bag

Answer

Blue bag

Question 6

Which vaccine protocol is recommended for health workers in disaster scenarios?

Accepted Answer

Tetanus toxoid, typhoid, and hepatitis A vaccines are recommended

Answer

Only routine immunization vaccines are needed

Answer

Cholera vaccine alone is sufficient for health workers

Answer

Tetanus toxoid alone provides adequate protection

Question 7

A study was conducted to investigate the relationship between COPD and smoking. Data was collected from government hospital records on COPD cases and cigarette sales records from finance and taxation departments. What is the study design?

Accepted Answer

Ecological study

Answer

Cross-sectional study

Answer

Operational study

Answer

Case-control study

Question 8

Which of the following is classified as a Category A bioterrorism agent?

Accepted Answer

Bacillus anthracis

Answer

Clostridium perfringens

Answer

NIPAH virus

Answer

Coxiella burnetii

Question 9

All are true regarding Japanese encephalitis disease except:

Accepted Answer

Man acts as reservoir

Answer

Pig vaccination control transmission

Answer

Vector is Culex vishnui

Answer

None of the options are true

Question 10

Blood bag is discarded in:

Accepted Answer

Yellow bag

Answer

Red bag

Answer

White bag

Answer

Blue bag

NEET-PG 2020 — Community Medicine