SPM MCQS questions with answers

Safe yield of a water supply source is the yield that is adequate for?
A. 80% of the year
B. 90% of the year
C. 95% of the year
D. The whole of the year

Correct answer : C. 95% of the year

Water for meeting the requirements of a community can be obtained from various sources like rain, surface water and groundwater.
The safe yield of a source of water is defined as the yield that is adequate for 95% of the year.

Ref: Park’s Textbook of Preventive and Social Medicine, 20th edition, p617

Minimum depth for the lining of a sanitary well is?
A. 10 feet
B. 20 feet
C. 35 feet
D. 50 feet

Correct answer : B. 20 feet

The lining of a sanitary well should go down at least 20 feet to ensure that water enters from the bottom and not from the sides of the well.
The lining should extend upwards for about 2-3 feet above the ground.

Ref: Park’s Textbook of Preventive and Social Medicine, 20th edition, p620

Quantity of water available per capita considered adequate to meet the needs of all urban domestic purposes?
A. 100-150 L
B. 150-200 L
C. 200-250 L
D. 250-300 L

Correct answer : B. 150-200 L

2 L is the amount of water required for meeting the physiological requirements of the body everyday.
But water is also required for many other activities of daily life such as cooking, washing, bathing etc.
Taking this into consideration, 150-200 L of water per capita is the amount considered adequate to meet the needs of all urban domestic purposes.

Ref: Park’s Textbook of Preventive and Social Medicine, 20th edition, p617

Screening test specificity is the ability of a test to correctly identify:
A. False positives
B. True positives
C. True negatives
D. False negatives

Correct answer : C. True negatives

Specificity of a test is the ability to correctly identify True negatives. It is calculated as follows:
Specificity = Number of true negatives / (Number of true negatives + Number of false positives )

All are true about randomized control trial except?

A. Baseline characteristics of intervention and control groups must be similar
B. Investigator bias can be minimized by double blinding
C. The sample size depends on the hypothesis tested
D. Drop outs should be excluded from the analysis

Correct answer : D. Drop outs should be excluded from the analysis

Based on Intention to Treat analysis, the drop outs should also be included in the analysis to prevent an error in the result.

Non deliberate cultural practice with anti mosquito effect is?

A. Use of mosquito repellents
B. Use of bed nets
C. Use of alkaline detergent for washing clothes
D. Use of larvicides

Correct answer : C. Use of alkaline detergent for washing clothes

Use of alkaline detergent for washing clothes is a non deliberate cultural practice with anti mosquito effect. Mosquito larva cannot survive in alkaline water.
Mosquito control

Gambusia affinis

Gambusia affinis – larvicidal fish

Anti larval – Source reduction (elimination of mosquito breeding grounds), use of larvicides (surface films – mineral oils, stomach poisons – Paris Green, contact poisons), biological agents like fungi, nematodes and fish (eg: larvicidal fish – Gambusia affinis)
Anti adult – Insecticides like DDT (organochlorine), Malathion (organophosphate) and pyrethroids for space sprays and residual sprays. Genetically modified adults are also used.
Prevention of mosquito bites – Bed nets, mosquito repellents, insect screens for homes.

Resources:

WHO recommendations for insecticide use – http://www.who.int/water_sanitation_health/resources/vector357to384.pdf

A sewage worker with fever and jaundice presented to the emergency department. Lab investigations revealed increased blood urea nitrogen and serum creatinine – indicative of renal failure. Which of the following antibiotics is preferred in this patient?

A. Erythromycin
B. Doxycycline
C. Penicillin G
D. Ciprofloxacin

Correct answer : C. Penicillin G

The history of fever and jaundice in a sewage worker with features of renal failure is suggestive of Weil’s disease
Intravenous penicillin G is the preferred antibiotic for treatment of Weil’s disease
Erythromycin can be used as an alternative
In mild cases of leptospirosis, oral therapy with ampicillin / tetracycline is given
Doxycycline is used for prophylaxis against leptospirosis

Modes of disease transmission by vectors are all except?

A. Regurgitation
B. Biting
C. Ingestion
D. Rubbing of of infected excrement

Correct answer : C. Ingestion

Modes of disease transmission by vectors are:

Biting
Regurgitation of ingested material
Rubbing of of infected excrement
Contamination by body fluids of the vector

Tetracycline is used for the prophylaxis of?

A. Brucellosis
B. Leptospirosis
C. Cholera
D. Meningitis

Correct answer : C. Cholera

Drug of choice for chemoprophylaxis of cholera is tetracycline. Doxycycline can also be used. Chemoprophylaxis is given for household contacts of cholera patients / in case of an outbreak in a closed community. But it is not given in case of mass outbreaks of cholera.

Which is not a synthetic pyrethroid?

A. DDT

B. Proparthrin

C. Cypermethrin

D. Permethrin

Correct answer : A. DDT

DDT is an organochlorine compound. The other 3 are pyrethroids.

Mass chemoprophylaxis in an endemic area is given for all except?

A. Leprosy

B. Yaws

C. Trachoma

D. Filariasis

Correct answer : A. Leprosy

Mass chemoprophylaxis is not given for preventing leprosy.

JSY is an acronym for?

A. Janani Suraksha Yojana

B. Jeevan Suraksha Yojana

C. Jeevan Shakthi Yojana

D. Jan Suraksha Yojana

Correct answer : A. Janani Suraksha Yojana

Janani Suraksha Yojana is a centrally funded scheme launched in 2005 offering maternity benefits. It aims at lowering maternal mortality and infant mortality by encouraging institutional deliveries.

A case of Acute Flaccid Paralysis should be kept under surveillance for residual paralysis for?

A. 30 days

B. 45 days

C. 60 days

D. 90 days

Correct answer : C. 60 days

Juvenile Justice (Care and Protection of Children) Act was passed by the Government of India in?
A. 1984
B. 1993
C. 2000
D. 2004

Correct answer : C. 2000
Juvenile Justice (Care and Protection of Children) Act, 2000

It was passed by the Government of India in the year 2000. It was amended in 2006. (Juvenile Justice Act was passed in 1986).

An Act to consolidate and amend the law relating to juveniles in conflict with law and children in need of care and protection, by providing for proper care, protection and treatment by catering to their development needs, and by adopting a child-friendly approach in the adjudication and disposition of matters in the best interest of children and for their ultimate rehabilitation through various institutions established under this enactment.

Movement across socioeconomic levels is known as?

A. Social insurance

B. Social mobility

C. Social equality

D. Social upliftment

Correct answer : B. Social mobility

The socioeconomic status of an individual / family can change over time due to the change in their literacy, job and income
An individual belonging to a low socioeconomic class can move to a higher class by means of better income
Similarly, an individual in a higher class may move to a lower class due to loss of his job
This change in socioeconomic status of an individual / family over time is known as Social Mobility

Movement across socioeconomic levels is known as?

A. Social insurance

B. Social mobility

C. Social equality

D. Social upliftment

Correct answer : B. Social mobility

The socioeconomic status of an individual / family can change over time due to the change in their literacy, job and income
An individual belonging to a low socioeconomic class can move to a higher class by means of better income
Similarly, an individual in a higher class may move to a lower class due to loss of his job
This change in socioeconomic status of an individual / family over time is known as Social Mobility

The usefulness of a ‘screening test` in a community depends on its :
A. Sensitivity
B. Specificity
C. Reliability
D. Predictive value

Correct answer : A. Sensitivity

A screening test should be sensitive to detect maximum possible cases. Specificity is not as important. After screening, we can apply a confirmatory test with high specificity.

If the grading of diabetes is classified as mild, moderate and severe the scale of measurement used is :
A. Interval
B. Nominal
C. Ordinal
D. Ratio

Correct answer : C. Ordinal

Here data can be arranged in a useful order. But there is no info regarding the size of each interval.

If prevalence of diabetes is 10%, the probability that three people selected at random from the population will have diabetes is:
A. 0.01
B. 0.03
C. 0.001
D. 0.003

Correct answer : C. 0.001

Prevalence of diabetes = 0.1
Probability that any one person selected from the population will have diabetes = 0.1
Probability that 3 people selected from the population will all have diabetes = 0.10.10.1 = 0.001

If the systolic blood pressure in a population has a mean of 130 mm Hg and a median of l40 mm Hg, the distribution is said to be?
A. Symmetrical
B. Positively skewed
C. Negatively skewed
D. Either positively or negatively skewed depending on the Standard deviation

Correct answer : C. Negatively skewed

Median is greater than mean. Hence it is negatively skewed.

lf each value of a given group of observations is multiplied by 10 the standard deviation of the resulting observations is :
A. Original std. Deviation x 10
B. Original std. Deviation /10
C. Original std. Deviation – l0
D. Original std. Deviation itself

Correct answer : A. Original std. Deviation x 10

If we substitute 10x for x in the above formula, we can find that the SN (standard deviation of N values) will become 10 SN. (After squaring and finding square root).

Multi-purpose worker scheme in India was initiated following the recommendation of:
A. Srivastava Committee
B. Bhore Committee
C. Kartar Singh Committee
D. Mudaliar Committee

Correct answer : C. Kartar Singh Committee

Dietary changes advocated by WHO for prevention of heart diseases include all of the following except?
A. A decrease in complex carbohydrate consumption
B. Reduction in fat intake to 20-30 percent of caloric intake
C. Consumption of saturated fats be limited to less than 10% of total energy intake
D. Reduction of cholesterol to below l00mg per kcal per day

Correct answer : A. A decrease in complex carbohydrate consumption

WHO recommends an increase in consumption of complex carbohydrates.

“Five clean practices” under strategies for elimination of neonatal tetanus include all except :
A. Clean surface for delivery
B. Clean hand of the attendant
C. New blade for cutting the cord
D. Clean airway

Correct answer : D. Clean airway

The 5 clean practices are:

Clean hands
Clean delivery surface
Clean cord care
Clean blade for cutting cord
Clean cord tie and no application on cord stump

The National Population Policy of India has set the following goals except :
A. To bring down Total Fertility Rate (TFR) to replacement levels by 2015
B. To reduce the Infant Mortality Rate to 30 per l000 live births
C. To reduce the Maternal Mortality Rate to 100 per 100000 live births
D. 100 percent registration of births, deaths, marriages and pregnancies

Correct answer : A. To bring down Total Fertility Rate (TFR) to replacement levels by 2015

The goal of The National Population Policy of India is to bring down Total Fertility Rate (TFR) to replacement levels by 2010.

The following statements are true about Intrauterine devices (IUD) except:
A. Multiload Cu-375 is a third generation IUD
B. The pregnancy rate of Lippes loop and Cu—T 200 are similar
C. IUD can be used for Emergency Contraception within 5 days
D. Levonorgestrel releasing IUD has an effective life of 5 years.

Correct answer : A. Multiload Cu-375 is a third generation IUD

Multiload Cu-375 is a second generation IUD. Progestasert and Levonova are third generation IUCD’s.

The following statements about breast milk are true except :
A. The maximum milk output is seen at 12 months
B. The coefficient of uptake of iron in breast milk is 70%
C. Calcium absorption of human milk is better than that of cow’s milk
D. It provides about 65 kcals per 100 ml

Correct answer : A. The maximum milk output is seen at 12 months

The maximum milk output is seen at 5-6 months (730ml/day). At 12 months, it is only 525ml/day.

The current recommendation for breast feeding is that :
A. Exclusive breast-feeding should be continued till 6 months of age followed by supplementation with additional foods
B. Exclusive breast-feeding should be continued till 4 months of age followed by supplementation with additional foods
C. Colostrum is the most suitable food for a new born baby but it is best avoided in first 2 days
D. The baby should be allowed to breast—feed till one year of age

Correct answer : A. Exclusive breast-feeding should be continued till 6 months of age followed by supplementation with additional foods

A 10 month old child weighing 8kg has Bitot spots in both eyes. Which of the following is the most appropriate schedule to prescribe vitamin A to this child ?
A. 2 lakh units intramuscular (IM) on day 0, 14
B. 1 lakh units IM on day 0, 14
C. 2 lakh units IM on day 0, 1 and 14
D. 1 lakh units IM on day O, 1 and 14

Correct answer : D. 1 lakh units IM on day O, 1 and 14

WHO treatment schedule for active xerophthalmia:

– Medication given on day 0, 1 and 14
– Same dose on all 3 days
– Oral route preferred
– Age < 1year / any age with weight < 8kg - 50000 IU orally - Age > 1 year – 2 lakh IU orally / 1 lakh IU IM

All of the following statements about leprosy are true except :
A. Multibacillary leprosy is diagnosed when there are more than 5 skin patches
B. New case detection rate is an indicator for incidence of leprosy
C. A defaulter is defined as a patient who has not taken treatment for 6 months or more
D. The target for elimination of leprosy is to reduce the prevalence to less than l per 10,000 population.

Correct answer : C. A defaulter is defined as a patient who has not taken treatment for 6 months or more

The term ‘defaulter’ is used in patients with tuberculosis. They are the ones who return with sputum smear positivity after leaving treatment for atleast 2 months.

All of the following are the mode of transmission of leprosy except?
A. Breast milk
B. Insect bite
C. Transplacental spread
D. Droplet infection

Correct answer : C. Transplacental spread

The following modes are proposed for transmission of leprosy:

Droplet infection
Contact spread – direct (skin to skin) and indirect (fomites)
Others (Breast milk, insect vectors, tattooing)

According to Intemational Health Regulations, there is no risk of spread of yellow Fever if the Aedes aegypti index remains below :
A. 1%
B. 5%
C. 8%
D. 10%

Correct answer : A. 1%

Aedes aegypti index is the percentage of houses and their premises in a limited well defined area that show actual breeding of aedes aegypti larvae. It should be kept below 1%. In addition to this, airports and seaports should be free of aedes aegypti breeding up to 400m from their perimeters.

The most appropriate test to assess the prevalence of tuberculosis infection in a community is :
A. Mass Miniature Radiotherapy
B. Sputum examination
C. Tuberculin Test
D. Clinical examination

Correct answer : C. Tuberculin Test

Tuberculin Test is the only test useful to assess the prevalence of tuberculosis in a community. Sputum examination is used to diagnose tuberculosis in an individual.

A 37 weeks pregnant woman attends an antenatal clinic at a Primary Health Centre. She has not had any antenatal visit till now. The best approach regarding tetanus immunization in this case would be to
A. Give a dose of Tetanus Toxoid (TT) and explain to her that it will not protect the new born and she should take the second dose after four weeks even if she delivers in the meantime
B. Do not waste the TT vaccine as it would anyhow be of no use in this pregnancy
C. Give one dose of TT and explain that it will not be useful for this pregnancy
D. Give her anti-tetanus Immunoglobulin along with the TT vaccine

Correct answer : A. Give a dose of Tetanus Toxoid (TT) and explain to her that it will not protect the new born and she should take the second dose after four weeks even if she delivers in the meantime

Tetans toxoid should be given to a pregnant women irrespective of the month of pregnancy. Second dose must be given atleast 4 weeks later. The newborn will not be protected unless 2 doses are taken. Newborns born to unimmunized mothers can be protected by giving tetanus antitoxin (750IU).

The following statements are true about DPT vaccine except:
A. Aluminium salt has an adjuvant effect
B. Whole killed bacteria of Bordetella pertussis has an adjuvant effect
C. Presence of acellular pertussis component increases its immunogenicity
D. Presence of H. influenzae type B component increases its immunogenicity

Correct answer : D. Presence of H. influenzae type B component increases its immunogenicity

Adjuvants increase the immunogenicity of a vaccine so that a lower quantity of antigen is enough to induce a sufficient antibody response. H.influenzae conjugate vaccine (PRP-D) is not useful for immunization against diphtheria. It does not increase immunogenicity of diphtheria.

A 3.5 year old child has not received primary immunization. Which of the following is the best vaccination advice to such a child?
A. BCG, DPT1 and OPV1. DPT2 and OPV2 after 4 weeks.
B. BCG, DT1, OPV1, measles, vitamin A
C. BCG, DPT1, OPV1, measles, vitamin A
D. DT1, DT2 and booster after 1 year

Correct answer : C. BCG, DPT1, OPV, measles, vitamin A

All of the following are used as proxy measures for incubation period except:
A. Latent period
B. Period of communicability
C. Serial interval
D. Generation time

Correct answer : B. Period of communicability

Period of communicability is the time period during which the person can transfer the infection to another person. It has no relation to the incubation period.

Latent period – Time period between disease onset and detection
Serial interval – Time period between onset of primary case and secondary case
Generation time – Time period between receipt of infection and maximal infectivity in a host

A study began in 1970 with a group of 5000 adults in Delhi who were asked about their alcohol consumption. The occurrence of cancer was studied in this group between 1990-1995. This is an example of :
A. Cross-sectional study
B. Retrospective cohort study
C. Concurrent cohort study
D. Case-control study

Correct answer : C. Concurrent cohort study

In a concurrent study (prospective study), the outcome under study has not yet occurred when the study starts. It requires long term follow up. Attrition is a big problem. It is an expensive study.

Orthotolidine test is used for detecting:
A. Chlorine
B. Nitrites
C. Nitrates
D. Ammonia

Correct answer : A. Chlorine

Which one of the following is not source of manager’s power:
A. Reward
B. Coercive
C. Legitimate
D. Efferent

Correct answer : D. Efferent

Types of power:

Reward power – Ability to give rewards
Coercive power – Ability to withhold rewards or give punishment
Legitimate power (position power) – Power bestowed upon a person by his / her position in an organisation
Expert power – By virtue of one’s own knowledge
Referent power – By virtue of one’s personality

The information technology has revolutionized the world of medical sciences. In which year the Information Technology Act was passed by the Government of India?
A. 1998
B. 2000
C. 2001
D. 2003

Correct answer : B. 2000

Transplantation of Human Organs Act was passed by Government of India in:
A. 1996
B. 1993
C. 1998
D. 1994

Correct answer : D. 1994

WHO defines adolescent age between:
A. 10-19 years of age
B. 10-14 years of age
C. 10-25 years of age
D. 9-14 years of age

Correct answer : A. 10-19 years of age

Under the WHO ‘Vision 2020‘ programme. the ‘SAFE‘ strategy is adopted for which of the following diseases?
A. Trachoma
B. Glaucoma
C. Diabetic retinopathy
D. Onchocerciasis

Correct answer : A. Trachoma

SAFE strategy was devised by WHO for the treatment of trachoma. SAFE stands for:
S – Surgery (of the lids for trichiasis)
A – Antibiotics
F – Facial cleanliness
E – Environmental change

The best indicator for monitoring the impact of Iodine Deficiency Disorders control programme is:
A. Prevalence of goiter among school children
B. Urinary iodine levels among pregnant women
C. Neonatal Hypothyroidism
D. Idoine level is soil

Correct answer : C. Neonatal Hypothyroidism

Total cholesterol level = a + b (calorie intake) + c (physical activity) + d (body mass index); is an example of:
A. Simple linear regression
B. Simple curvilinear regression
C. Multiple linear regression
D. Multiple logistic regression

Correct answer : C. Multiple linear regression

Here, the total cholesterol level is depicted as depending upon multiple independent factors. The relationship is linear and not logarithmic. Hence it is a multiple linear regression.

The diagnostic power of a test to correctly exclude the disease is reflected by:
A. Sensitivity
B. Specificity
C. Positive predictivity
D. Negative predictivity

Correct answer :D. Negative predictivity

The events A and B are mutually exclusive, so:
A. Prob (A or B) = Prob (A) + Prob (B)
B. Prob (A and B) = Prob (A) * Prob (B)
C. Prob (A) = Prob (B)
D. Prob (A) + Prob (B) = 1

Correct answer : A. Prob (A or B) = Prob (A) + Prob (B)

In mutually exclusive events, the probability of at least one of them occurring will be equal to the sum of their individual probabilities.

The Hb level in healthy women has mean 13.5 g/dl and standard deviation 1.5 g/dl, what is the Z score for a woman with Hb level 15.0 g/dl:
A. 9.0
B. 10.0
C. 2.0
D. 1.0

Correct answer : D. 1.0

The value (15g/dl) lies 1 SD (1.5g/dl) above the mean of 13.5g/dl. Hence the Z score is 1.

The PEFR of a group of 11 year old girls follow a normal distribution with mean 300 l/min and standard deviation 20 l/min:
A. About 95% of the girls have PEFR between 260 and 340 l/min
B. The girls have healthy lungs
C. About 5% of girls have PEFR below 260 l/min
D. All the PEFR must be less than 340 l/min

Correct answer : A. About 95% of the girls have PEFR between 260 and 340 l/min

95.4% of values lie within 2 SD (standard deviation) of the mean
Here, SD = 20 l/min
Hence 95.4% of values lie within 300-(2*20) and 300=(2*20)
Which translates into : About 95% of the girls have PEFR between 260 and 340 l/min

The standard normal distribution:
A. Is skewed to the left
B. Has mean = 1.0
C. Has standard deviation = 0.0
D. Has variance = 1.0

Correct answer : D. Has variance = 1.0

A standard normal deviation is not skewed to any side. It is symmetrical
Standard deviation = 1.0
Variance = SD^2 = 1.0

What is the color coding of the bag used in hospitals to dispose off human anatomical wastes such as body parts:
A. Yellow
B. Black
C. Red
D. Blue

Correct answer : A. Yellow

The recommended daily energy intake for an adult woman with heavy work is:
A. 1800
B. 2100
C. 2300
D. 2900

Correct answer : D. 2900 (2925kcal/day)

The following tests are used to check the efficiency of pasteurization of milk except:
A. Phosphatase test
B. Standard plate count
C. Coliform count
D. Methylene blue reduction test

Correct answer : D. Methylene blue reduction test

Methylene blue reduction test is used to detect the presence of microorganisms in milk. It is done before pasteurization.

All of the following methods are antilarval measures except:
A. Intermittent irrigation
B. Paris green
C. Gambusia affinis
D. Malathion

Correct answer : D. Malathion

Malathion is used to kill adult mosquitoes.

Which of the following viral infections is transmitted by tick?
A. Japanese encephalitis
B. Dengue fever
C. Kyasanur forest disease (KFD)
D. Yellow fever

Correct answer : C. Kyasanur forest disease (KFD)

KFD is transmitted by bite of hard ticks
Japanese encephalitis – Culex mosquito
Dengue fever – Aedes mosquito
Yellow fever – Aedes mosquito

Which of the following viral infections is transmitted by tick?
A. Japanese encephalitis
B. Dengue fever
C. Kyasanur forest disease (KFD)
D. Yellow fever

Correct answer : C. Kyasanur forest disease (KFD)

KFD is transmitted by bite of hard ticks
Japanese encephalitis – Culex mosquito
Dengue fever – Aedes mosquito
Yellow fever – Aedes mosquito

Which one of the following statements about influence of smoking on risk of coronary heart disease (CHD) is not true?
A. Influence of smoking is independent of other risk factors for CHD
B. Influence of smoking is only additive to other risk factors for CHD
C. Influence of smoking is synergistic to other risk factors for CHD
D. Influence of smoking is directly related to number of cigarettes smoked per day

Correct answer : B. Influence of smoking is only additive to other risk factors for CHD

Smoking is an independent risk factor. It also has a synergistic effect with other risk factors. (More than just additive effect)

What will be the BMI of a male whose weight is 89 kg and height is 172 cm
A. 27
B. 30
C. 33
D. 36

Correct answer : B. 30

BMI = Weight (in kg) / Height (in m) ^2
=89/1.72^2
=30 (approx)

(We know that the square root of 3 is 1.73. So Square of 1.72 will be approximately equal to 3.)

The most common cancer, affecting Indian urban women in Delhi, Mumbai and Chennai, is:
A. Cervical Cancer
B. Ovarian Cancer
C. Breast cancer
D. Uterine Cancer

Correct answer : C. Breast cancer

Most common cancer in Indian urban women

Delhi – Breast cancer
Mumbai – Breast cancer
Chennai – Cancer cervix

All of the following statements are true about Congenital Rubella except:
A. lt is diagnosed when the infant has IgM antibodies at birth
B. It is diagnosed when IgG antibodies persist from more than 6 months
C. Most common congenital defects are deafness, cardiac malformations and cataract
D. Infection after 16 weeks of gestation results in major congenital defects

Correct answer : D. Infection after 16 weeks of gestation results in major congenital defects

Infection in the first trimester has the greatest risk of congenital anomalies. Infection in second trimester can cause deafness. No major congenital defects are seen in infection after 16 weeks of gestation.

Antibiotic treatment of choice for treating cholera in an adult is a single dose of:
A. Tetracycline
B. Cotrimoxazole
C. Doxycycline
D. Furazolidone

Correct answer : C. Doxycycline

Doxycycline is the drug which is effective as a single dose treatment for cholera in adults.

For the treatment of case a of class III dog bite, all of the following are correct except:
A. Give Immunoglobulins for passive immunity
B. Give ARV
C. Immediately stitch wound under antibiotic coverage
D. Immediately wash wound with soap and water

Correct answer : C. Immediately stitch wound under antibiotic coverage

Immediate stitching of bite wounds is contraindicated. It increases the trauma and increases the spread of virus into deeper tissues.

A 2-year old female child was brought to a PHC with a history of cough and fever for 4 days with inability to drink for last 12 hours. On examination, the child was having weight of 5 kg, and respiratory rate of 45/minute with fever. The child will be classified as suffering from:
A. Very severe disease
B. Severe Pneumonia
C. Pneumonia
D. No Pneumonia

Correct answer : A. Very severe disease

The child is unable to drink water for past 12 hours. It is a danger sign which indicates very severe disease.

All of the following are true about the Herd Immunity for infectious diseases except:
A. It refers to group protection beyond what is afforded by the protection of immunized individuals
B. lt is likely to be more for infections that do not have a sub clinical phase
C. It is affected by the presence and distribution of alternative animal hosts
D. In the case of tetanus it does not protect the individual

Correct answer : B. lt is likely to be more for infections that do not have a sub clinical phase

Herd immunity is more in case of infections with a sub clinical phase

‘Endemic Disease` means that a disease:
A. Occurs clearly in excess of normal expectancy
B. ls constantly present in a given population group
C. Exhibits seasonal pattem
D. Is prevalent among animals

Correct answer : B. ls constantly present in a given population group

An endemic disease is constantly present in a given population group.
Epidemic disease occurs clearly in excess of normal expectancy

Which one of the following is a good index of the severity of an acute disease?
A. Cause specific death rate
B. Case fatality rate
C. Standardized mortality ratio
D. Five year survivial

Correct answer : B. Case fatality rate

Case fatality rate = (Deaths due to the particular disease / Total number of cases of the particular disease) X 100
It represents the killing power of the disease.

Infant mortality does not include:
A. Early neonatal mortality
B. Perinatal mortality
C. Post neonatal mortality
D. Late neonatal mortality

Correct answer : B. Perinatal mortality

Infant mortality includes death within the first year of life. Perinatal mortality includes late foetal deaths (28 weeks of gestation to birth) and early neonatal deaths (birth to 7 days).

Other terms:
Late neonatal mortality – 7 days to 28 days
Neonatal mortality – birth to 28 days (early neonatal mortality + late neonatal mortality)
Post neonatal mortality – 28 days to 1 year

In which of the following year the Transplantation of Human Organs Act was passed by Government of India?
A. 1994
B. 1996
C. 2000
D. 2002

Correct answer : A. 1994

Indian (economic) real GDP growth for the year 2003 is:
A. 6.0
B. 6.5
C. 7.8
D. 10.5

Correct answer : C. 7.8

According to the World Health Report 2000, India’s health expenditure is:
A. 4.8% of G.D.P.
B. 5.2% of G.D.P.
C. 6.8% of G.D.P.
D. 7% of G.D.P.

Correct answer : B. 5.2% of G.D.P.

A Physician, after examining a group of patients of a certain disease, classifies the condition of each one as “Normal’, ‘Mild’, Moderate’ or ‘Severe’. Which one of the following is the scale of measurement that is being adopted for classification of the disease condition?
a) Nominal
b) Interval
c) Ratio
d) Ordinal

Correct answer : d) Ordinal

While applying chi-square test to a contingency table of 4 rows and 4 columns, the degrees of freedom would be:
a) 1
b) 4
c) 9
d) 8

Correct answer : c) 9

Degree of freedom = (no. of rows – 1) * (no. of columns – 1)
=(4-1) * (4-1)
=3 * 3
=9

A diagnostic test for a particular disease has a sensitivity of 0.90 and a specificity of 0.80. A single test is applied to each subject in the population in which the diseased population is 30%. What is the probability that a person, negative to this test, has no disease?
a) Less than 50%
b) 70%
c) 95%
d) 72%

Correct answer : c) 95%

The probability that a person negative to this test has no disease signifies the Negative predictive value of the test.

A randomized trial comparing efficacy of two regimens showed that difference is statistically significant with p< 0.001 but in reality the two drugs do not differ in their efficacy. This is an example of: a) Type-I error (alpha error) b) Type-II error (beta error) c) I alpha d) I betaCorrect answer : a) Type-I error (alpha error)

In all of the following diseases chronic carriers are found except:
a) Measles
b) Typhoid
c) Hepatitis B
d) Gonorrhoea

Correct answer :
a) Measles

All of the following indicators are included in Physical Quality of Life Index (PQLI) except:
a) Infant mortality rate
b) Life expectancy at age one
c) Literacy rate
d) Per capita income

Correct answer : d) Per capita income

The highest percentages of polyunsaturated fatty acids are present in:
a) Groundnut oil
b) Soyabean oil
c) Margarine
d) Palm oil

Correct answer : b) Soyabean oil

Vitamin A deficiency is considered a public health problem if prevalence rate of night blindness in children between 6 months to 6 years is more than:
a) 0.01%
b) 0.05%
c) 0.1%
d) 1.0%

Correct answer : d) 1.0%

Which of the following is an example of Disability limitation?
a) Reducing occurrence of polio by immunization
b) Arranging for schooling of child suffering from PRPP
c) Resting aftected limbs in neutral position
d) Providing calipers for walking

Correct answer : c) Resting aftected limbs in neutral position

The mechanisms by which cholera might be maintained during the intervals between peak cholera seasons is:
a) Carrier status in animals
b) Carrier status in man
c) An environmental reservoir
d) Continuous transmission in man

Correct answer : d) Continuous transmission in man

The following statements are true regarding leptospirosis, except:
a) It is zoonosis
b) Man is the dead end host
c) Man is an accidental host
d) Lice act as reservoirs of infection

Correct answer : d) Lice act as reservoirs of infection

It is true regarding Endemic typhus that:
a) Man is the only reservoir of infection
b) Flea is a vector of the disease
c) The rash developing into eschar is a characteristic presentation
d) Culture of the etiological agent in tissue culture is a diagnostic modality

Correct answer : b) Flea is a vector of the disease

PUFA consumption is associated with
a) Lowering of serum cholesterol, rise in LDL cholesterol
b) Lowering of serum cholesterol, lowering of LDL cholesterol
c) Rise in serum cholesterol, rise in LDL cholesterol
d) Rise in serum cholesterol. lowering of LDL cholesterol

Correct answer : b) Lowering of serum cholesterol, lowering of LDL cholesterol

Which epidemiological study gives the most accurate result
a) Meta analysis
b) Cross-sectional study
e) Randomized control trial with double blinding
d) Cohort study

Correct answer : a) Meta analysis

True about ASHA (accredited social health activist) is
a) Mental health worker
b) Involved in minimum need program
c) Deployed 1/1000 population
d) To replace Anganwadi worker in ICDS

Correct answer : c) Deployed 1/1000 population

True about point source epidemic are all except –
a) The curve has rapid rise and slow decline
b) No secondary curves
c) One single peak only
d) All cases occur in one incubation period

Correct answer : a) The curve has rapid rise and slow decline

Causative toxin for endemic ascites is
a) Pyrrolizidine
b) Beta-oxalyl amino-alanine
c) Ergot
d) Aflatoxin

Correct answer : a) Pyrrolizidine

Specificity of a test refers to its ability to detect
a) True positives
b) True negatives
c) False positives
d) False negatives

Correct answer : b) True negatives

Socialization of medicine leads to all except :
a) Ensures complete utilization of services by all
b) Free medical care supported by state
c) Eliminates the competition among physicians in search of clients
d) Ensures social equity, universal coverage of health services

Correct answer : a) Ensures complete utilization of services by all

Active method to detect undiagnosed cases in apparently healthy people is
a) Case finding
b) Surveillance
c) Screening
d) Monitoring

Correct answer : c) Screening

ln a study in UK, an association was found between sale of antiarrythmic drug and an increase in deaths due to asthma. This is an example of
a) Ecological study
b) Cohort study
c) Case reference study
d) Experimental study

Correct answer : a) Ecological study

Using a new technique, Hb was estimated in a blood sample. The test was repeated for 10 times. The reports were : 9.5, 9.2, 9.4, 9.6, 9.7, 9.9, 10.2. 10.3, 10.5, 12.1. Accurate value of Hb was estimated by standard tests to be 10.2. The new technique has
a) High validity and high reliability
b) Low validity and low reliability
c) High validity and low reliability
d) Low validity and high reliability

Correct answer : b) Low validity and low reliability

In National Water Supply & Sanitation programme a problem village is defined as all except
a) Distance of safe water is greater than 1.6 km
b) Water is exposed to the risk of cholera
c) Water source has excess iron & heavy metals
d) Water infested with Guniea worm

Correct answer : d) Water infested with Guniea worm

Efficiency of a Goitre control programme can be assessed using –
a) Neonatal thyroxine levels
b) Goitre in pregnancy
c) Goitre in age group of 12 to 18 yrs
d) Soil iodine levels

Correct answer : a) Neonatal thyroxine levels

Case finding in RNTCP is based on :
a) Sputum culture
b) Sputum microscopy
c) X-ray chest
d) PCR antibody detection

Correct answer : b) Sputum microscopy

Direct standardization is used to compare the mortality rates between two countries. This is done because of the difference in :
a) Causes of death
b) Denominators
c) Age distributions
d) Numerators

Correct answer : c) Age distributions

All of the following indicatiors are included in Physical Quality of Life Index (PQLI) except
a) Life expectancy at age 1
b) Literacy rate
c) Per capita income
d) lnfant mortality rate

Correct answer : c) Per capita income

You have diagnosed a patient clinically as having SLE and ordered 6 tests. Out of which 4 tests have come positive and 2 are negative. To determine the probability of SLE at this point, you need to know:
a) Prior probability of SLE; sensitivity and specificity of each test
b) Incidence of SLE and predictive value of each test
c) Incidence and prevalence of SLE
d) Relative risk of SLE in this patient

Correct answer : a) Prior probability of SLE; sensitivity and specificity of each test

Any loss or abnormality of psychological, physiological or anatomical structure or function is known as
a) Disease
b) Impairment
c) Disability
d) Handicap

Correct answer : b) Impairment

Revised strategy for NPCB includes all except
a) Fixed facility surgery
b) IOL implantation for cataract
c) Mobile surgical camps
d) Uniform distribution

Correct answer : c) Mobile surgical camps

All are true about communicability of Malaria, except –
a) The number of gametocytes in blood increases with time
b) Gametocytes appear in blood 4-5 days after the appearance of the asexual parasite, in vivax infection
c) Gametocytes appear in blood 10-12 days after the appearance of asexual parasite, in falciparum infection
d) In the early stage of infection, their density may exceed 1000 per cmm of blood

Correct answer : a) The number of gametocytes in blood increases with time

Eicosapentaenoic acid is present in
a) Soyabean oil
b) Corn oil
c) Safflower oil
d) Fish oil

Correct answer : d) Fish oil

Vision 2020 “The right to sight” includes all except
a) Trachoma
b) Epidemic conjunctivitis
c) Cataract
d) Onchocerciasis

Correct answer : b) Epidemic conjunctivitis

Richest source of vitamin D is
a) Milk
b) Egg
c) Green leafy vegetables
d) Fish oil

Correct answer : d) Fish oil

Chlorine demand of water is measured by
a) Horrock’s appratus
b) Chlorimeter
c) Double pot
d) Berkfeld filter

Correct answer : a) Horrock’s appratus

Disease not transmitted by Lice is
a) Relapsing fever
b) Trench fever
c) Q-fever
d) Epidemic typhus

Correct answer : c) Q-fever

True about ASHA are all except
a) One per 1000 rural population
b) Mobiliser of antenatal care
c) Female voluntary worker
d) Skilled birth attendant

Correct answer : d) Skilled birth attendant

Brucella is transmitted by all except
a) Aerosol transmission
b) Ingestion of raw milk
c) Man to man
d) Contact with aborted fetuses

Correct answer : c) Man to man

Which of the following characteristics is not of much importance in a screening test
a) Low cost
b) High safety margin
c) High sensitivity
d) High specificity

Correct answer : d) High specificity

Standard error of mean is calculated by
a) SD/square root of n
b) SD/mean
C) SD/n
d) Mean/SD

Correct answer : a) SD/square root of n

(SD = Standard deviation)

Mean hemoglobin of a sample of 100 pregnant women was found to be 10 mg% with a standard deviation of 1.0 mg%. The standard error of the estimate would be
a) 0.01
b) 0.1
c) 1.0
d) 10.0

Correct answer : b) 0.1

L-J chart (Levey–Jennings chart) is used for monitoring
a) Accuracy
b) Precision
c) Sensitivity
d) Specificity

Correct answer : a) Accuracy and b) Precision

In which of the following disease, the overall survival is increased by screening procedure
a) Prostate Ca
b) Lung Cancer
c) Colon Ca
d) Ovarian Ca

Correct answer : c) Colon Ca

Thiamine deficiency is seen in all except
a) Chronic diarrhoea
b) Chronic alcoholism
c) Homocystinemia
d) Food faddist

Correct answer : c) Homocystinemia

Which of the following is not an accepted method of randomization
a) Computer drawn randomization
b) Odd/even day hospital admission
c) Lottery
d) Random number table

Correct answer : b) Odd/even day hospital admission

Best method to compare new test and gold standard test
a) Correlation study
b) Regressive study
c) Bland and Altman analysis
d) Kolmogorov-Smimov test

Correct answer : c) Bland and Altman analysis

Which of the following statements about lepromin test is not true?
a) It is negative in most children in first 6 months of life
b) It is a diagnostic test
c) It is an important aid to classify type of leprosy disease
d) BCG vaccination may convert lepra reaction from negative to positive

Correct answer : b) It is a diagnostic test

Which of the following is the Least common complication of measles?
a) Diarrhoea
b) Pneumonia
c) Otitis media
d) SSPE

Correct answer : d) SSPE (Subacute Sclerosing Panencephalitis)

Which IUCD acts for 10 yrs
a) Cu-T 200 B
b) Nova—T
c) Cu-T 380A
d) Multi load-250

Correct answer : c) Cu-T 380A

When the confidence level of a test is increased which of the following will happen
a) No effect on significance
b) Previously insignificant value becomes significant
c) Previously significant value becomes insignificant
d) No change in hypothesis

Correct answer : b) Previously insignificant value becomes significant

Comprehensive emergency obstetric care does not include:
a) Manual removal of placenta
b) Hysterectomy
c) Blood transfusion
d) Ceasarean section

Correct answer : b) Hysterectomy

Basic emergency obstetric services
    Parenteral oxytocics
    Antibiotics and anticonvulsants
    Assisted deliveries
    Manual extraction of the placenta
    Removal of retained products
Comprehensive emergency obstetric services
    basic services plus
        Caesarean sections
        Blood transfusions

Which of the following is an example of disability limitation
a) Reducing occurrence of polio by immunization
b) Arranging for schooling of child suffering from PRPP (post polio residual paralysis)
c) Resting affected limbs in neutral position
d) Providing calipers for walking

Correct answer : c) Resting affected limbs in neutral positron

Reducing occurrence of polio by immunization – Specific protection
Arranging for schooling of child suffering from PRPP (post polio residual paralysis) – Rehabilitation
Resting affected limbs in neutral position – Disability limitation
Providing calipers for walking – Rehabilitation

You have diagnosed a Patient clinically as having SLE and ordered 6 tests out of which 4 tests have come positive and 2 are negative. To determine the probability of SLE at this point, you need to know
A. Prior probability of SLE, sensitivity and specificity of each test
B. Incidence of SLE and the predictive value of each test
C. Incidence and prevalence of SLE
D. Relative risk of SLE in the patient

Answer: A. Prior probability of SLE, sensitivity and specificity of eac

A study was conducted to test if use of herbal tea played any role in prevention of common cold. Data was collected on the number of people who developed cold and those who did not develop cold and this data was tabulated in relation to whether they consumed Herbal tea or not. The analytical test of choice to test this study is:
A. Student- t test (unpaired)
B. Student- t test (paired)
C. Chi square test
D. ‘Z’ test

Correct answer : C. Chi square test

The test required is a non parametric test (to compare qualitative data). Chi square test a frequently used non parametric test.

A data is arranged as satisfied, very satisfied, dissatisfied. This is a
A. Nominal data
B. Ordinal data
C. Interval data
D. Ratio data

Correct answer : B. Ordinal data

All of the following are true about cluster sampling except
A. Samples are similar to those in Simple Random sampling
B. ls a Rapid and simple method
C. The sample size may vary according to study design
D. It is a type of probability sample

Correct answer : A. Samples are similar to those in Simple Random sampling

Sampling is cluster sampling is different from that in simple random sampling.

The major purpose of Randomization in clinical trials is to
A. Facilitate double blinding
B. Help ensure that the study subjects are representative of general population
C. Ensure that the groups are comparable on baseline characteristics
D. Reduce selection bias in allocation of treatment

Correct answer : Both C and D are correct!

Direct standardization is used to compare the mortality rates between two countries. This is done because of the difference in
A. Causes of death
B. Numerators
C. Age distributions
D. Denominators

Correct answer : C. Age distributions

If there is not standardisation, the mortality rate calculated will be higher in countries with greater proportion of elderly people.

All can be incinerated except
A. Cytotoxic Waste
B. Sharps
C. Anatomical waste
D. Infectious waste

Correct answer : B. Sharps

Sharps should not be incinerated.

Chlorine demand is measured by
A. Horrock’s apparatus
B. Chlorimeter
C. Double pot
D. Berkfeld filter

Correct answer : A. Horrock’s apparatus

Horrock’s apparatus is used to measure cholrine demand.
Double pot is a method of well water chlorination.
Berkefeld filter is a water filter made of diatomaceous earth or Kieselguhr.

The highest percentages of poly unsaturated fatty acids are present in?
A. Ground nut oil
B. Palm oil
C. Margarine
D. Soya bean oil

Correct answer : D. Soya bean oil

Among the options given, soya bean oil has the highest percentage of poly unsaturated fatty acids.

Compared with cow’s milk, mother’s milk has more
A. Lactose
B. vitamin D
C. Proteins
D. Fat

Correct answer : A. Lactose

Impact and efficiency of iodine control program can be estimated by?
A. Neonatal thyroxine levels
B. Goiter in pregnant women
C. Goiter in children of age 12 to 18
D. Urinary iodine levels in pregnant women

Correct answer : A. Neonatal thyroxine levels

All are common cause of blindness in children in India except.
A. Malnutrition
B. Ophthalmia neonatorum
C. Glaucoma
D. Congenital dacryocystitis

Correct answer : D. Congenital dacryocystitis

On SAFE strategy false is
A. Screening
B. Antibiotics
C. Facial hygiene
D. Environmental modification

Correct answer : A. Screening

Components of safe strategy:
S – Surgery
A – Antibiotics
F – Facial hygiene
E – Environmental modification

True about endemic typhus —
A. Man is the only reservoir of infection
B. Flea is a vector of the disease
C. A rash developing into an eschar is characteristic of the disease
D. Culture is the diagnostic modality

Correct answer : B. Flea is a vector of the disease

Rats are also reservoirs of infection. Eschar is seen in scrub typhus. Serological tests are used for diagnosis.

Which of the following is not transmitted by lice,
A. Q fever
B. Trench fever
C. Relapsing fever
D. Epidemic typhus

Correct answer : A. Q fever

Q fever is transmitted by soft ticks.

Which of the following statements about lepromin test is not true
A. It is negative in most children in first 6 months of life
B. It is a diagnostic test
C. It is an important aid to classify type of leprosy disease
D. BCG vaccination may convert lepra reaction from negative to positive

Correct answer : B. It is a diagnostic test

Lepromin test is not diagnostic of leprosy.

Case finding in RNTCP is based on
A. Sputum culture
B. Sputum microscopy
C. X- ray chest
D. Mantoux test / PCR

Correct answer : B. Sputum microscopy

Patients presenting with symptoms of tuberculosis are screened by sputum smear examination.

Which is true of BCG vaccination ?
A. Distilled water is used as diluent for BCG
B. The site of injection should be cleaned with spirit
C. Mantoux test becomes positive after 48 hours of vaccination
D. WHO recommends Danish 1331 strain for vaccine production

Correct answer : D. WHO recommends Danish 1331 strain for vaccine production

Normal saline is used as a diluent. Site of injection should be cleaned with normal saline. Mantoux test becomes positive after 8 weeks.

Strategies for prevention of Neonatal Tetanus include all of the following except:
A. 5 clean practices
B. Giving penicillin to all the new borns
C. 2 doses of TT to all pregnant women
D. Immunizing all married women

Correct answer : B. Giving penicillin to all the new borns

Giving penicillin to all the new borns is not recommended for prevention of neonatal tetanus.

Under eradication of congenital rubella syndrome program the first priority group for rubella vaccination is
A. All non pregnant women of age 15 to 34
B. All adolescent non pregnant girls 15 to 24 years of age
C. All female children at one year
D. All non pregnant women

Correct answer : All non pregnant women of age 15 to 34

First priority – Women of child bearing age ( All non pregnant women of age 15 to 34 )
Second priority – Children of 1-14 years of age
Third priority – Children at 1 year of age

Least common complication of measles is
A. SSPE
B, Pneumonia
C. Otitis media
D. Keratomalacia

Correct answer : SSPE

SSPE (Sub acute sclerosing panencephalitis) is the least common complication of measles. It is also the most severe.

Chronic carrier state is seen in all except
A. Measles
B. Diptheria
C. Typhoid
D. Gonorrhea

Correct answer : A. Measles

Measles has no chronic carrier state.

Which of the following vaccine is not included in EPI schedule
A. DPT
B. MMR
C. BCG
D. OPV

Correct answer : MMR

All of the following statements are true for Herd immunity except:
A. Herd structure is constant
B. It is mostly due to subclinical infection
C. Can be acquired by immunisation
D. Spread of epidemic is influenced by it

Correct answer : Herd structure is constant

85% of lung cancer among smokers was due to their smoking. This is an example of
A. Attributable risk
B. Relative risk
C. Odds ratio
D. Population attributable risk

Correct answer : Attributable risk

All of the following are included in physical quality of life index except?
A. Infant mortality rate
B. Life expectancy at age 1
C. Literacy rate
D. Per capita income

All of the following are true about cluster sampling except?
A. Samples are similar to those in simple random sampling
B. Is a rapid and simple method
C. The sample size may vary according to study design
D. It is a probability sample

Correct answer : Samples are similar to those in simple random sampling