Que. 1. When the India was declared smallpox free?

Ans. 1. April 1977.

Que. 2. When did the world achieve the goal of smallpox eradication?

Ans. 2. 8th May 1980.

Que. 3. When was the world’s last case of smallpox found and where?

Ans. 3. October 1977 in Somalia.

Que. 4. When was the smallpox vaccination discontinued from world?

Ans. 4. By 1982.

Que. 5. What is the causative organism of chickenpox & herpes zoster?

Ans. 5. Varicella –Zoster Virus.

Que. 6. What is the Secondary attack rate of chickenpox?

Ans. 6. Around 85 percent.

Que. 7. What do you mean by pleomorphism & in which disease is the characteristic feature of rash?

Ans. 7. Pleomorphism of rash means that in a given area of body, all stages of rash (papules, vesicles & crusts) may be seen simultaneously at one time. It is the characteristic feature of rash in chickenpox.

Que. 8. What are the complications of chickenpox?

Ans. 8. Pneumonia, hemorrhages, encephalitis, acute cerebellar ataxia, Reye’s syndrome, Retinal necrosis & secondary bacterial infections.

Que. 9. What are the control measures for chickenpox?

Ans. 9. Control measures are – 

• Notifications
• Isolation till 6 days after rash
• Disinfection of articles soiled by discharges
• Anti-viral drugs e.g. acyclovir etc.

Que. 10. When varicella infection in pregnancy may cause congenital varicella syndrome in the foetus?

Ans. 10. Varicella infection during first 5 months of pregnancy.

Que. 11. Where does first varicella rash appear?

Ans. 11. On the trunk.

Que. 12. When varicella vaccine is used for post-exposure prophylaxis?

Ans. 12. Within 5 days of exposure to rash, if there is no contraindication for the vaccine in the recipients.

Que. 13. What are the main strategies for measles-rubella (MR) elimination?

Ans. 13. The main strategies are – 

1. 95% coverage with MR vaccination
2. Case-based MR surveillance
3. Adequate lab support.

Que. 14. How will you make clinical diagnosis of measles?

Ans. 14. Clinical diagnosis of measles is based upon the typical rash and koplik’s spots on oral mucosa.

Que. 15. What are the characteristics of rash of Measles?

Ans. 15. Measles rash is macular or maculopapular rash which starts in post auricular area and then spreads rapidly to face, neck & other parts of the body.

Que. 16. Why all cases of severe measles should be treated with Vitamin A?

Ans. 16. As many children may develop acute deficiency of vitamin A.

Que. 17. What is the course of vitamin A in severe measles cases?

Ans. 17. A high dose of vitamin A is given immediately on the day of diagnosis of measles and repeated the next day.

Children <1 year age ———- 1 lakh unit /dose

Children >1 year age ———- 2 lakh units per dose.

Que. 18. Measles tend to occur in epidemics when the proportion of susceptible children reaches about  ———————————————– percent.

Ans. 18. Forty (40).

Que. 19. What is the elimination of measles?

Ans. 19. It is the absence of endemic measles for a period of more than 12 months in the presence of adequate surveillance.

Que. 20. What are the stages in which countries will fall in relation to measles program implementation?

Ans. 20. Three stages are – 

1. Control
2. Out-break prevention
3. Elimination

Que. 21. What is three-part vaccination strategy for measles elimination as per WHO?

Ans. 21. CATCH UP, KEEP UP & FOLLOW UP

Que. 22. What should be priorities of countries aiming for measles control?

Ans. 22. Priorities should be – 

1. Improve routine vaccination coverage to at least 90 percent.
2. Active coverage of more than 90% with routine 2nd dose of measles-rubella vaccine.
3. Establish surveillance of each case with lab confirmation of suspected cases and virus isolation from all possible sources of infection.
4. Conduct supplementary vaccination campaign together with administration of vitamin A in high- risk areas.

Que. 23. What is the period of communicability in case of measles?

Ans. 23. Around 4 days before & 5 days after the appearance of rash.

Que. 24. What are the most common complications of measles?

Ans. 24. Diarrhea, Pneumonia, otitis media & other respiratory complications, malnutrition (Vit. A   deficiency).

Que. 25. Which is the most common life-threatening complication in measles?

Ans. 25. Pneumonia.

Que. 26. Which are the neurological complications associated with measles?

Ans. 26. – Febrile convulsions, encephalitis & Sub-acute sclerosing pan-encephalitis (SSPE).

Que. 27. Which infection in early pregnancy may result serious congenital defects?

Ans. 27. German measles (rubella)

Que. 28. Why rubella infection in pregnancy may cause congenital malformations and low birth weight in the newborn?

Ans. 28. As rubella infection inhibits cell division.

Que. 29. What is the classical triad of congenital rubella syndrome?

Ans. 29. Deafness, Cardiac malformations & Cataract.

Que. 30. When rubella infection in a woman may cause multiple congenital anomalies and may result in miscarriage and still birth?

Ans. 30. Just before conception to first 8-10 weeks of pregnancy.

Que. 31. Which are the most sensitive tests for the rubella diagnosis?

Ans. 31. ELISA & Radio-immune assay.

Que. 32. What investigations tell that congenital rubella infection has occurred?

Ans. 32. 1) Infant has IgM rubella infection soon after birth.

               2) If IgG antibodies persist for more than 6 months.

Que. 31. What are the immunization strategies to prevent congenital rubella infection?

Ans. 31. 1) Immunization of all women of child bearing age.

               2) Immunization of all children.

Que. 32. How will you recognize mumps clinically?

Ans. 32. Disease is characterized by non-suppurative enlargement & tenderness of one or both the parotid glands.

Que. 33. What is the secondary attack rate of Mumps?

Ans. 33. 86%.

Que. 34. What are the common complications of mumps?

Ans. 34. Common complications of mumps are –

1. Orchitis
2. Ovaritis
3. Pancreatitis
4. Meningo-encephalitis
5. Thyroiditis
6. Neuritis
7. Hepatitis &
8. Myocarditis.

Que. 35. What type of influenza virus does cause Influenza?

Ans. 35. A, B & C (Influenza virus).

Que. 36. What type of influenza virus was responsible for all known pandemics of influenza?

Ans. 36. Influenza virus –A strains.

Que. 37. What are the unique features of influenza epidemics?

Ans. 37. 1) Suddenness with which they arise & spread.

                2) Ease with which they spread.

Que. 38. What are the factors responsible for rapid spread of influenza virus in the community?

Ans. 38. The factors responsible are – 

1. Short incubation period (18-72 hours).
2. Large no. of subclinical cases.
3. High proportion of susceptible population
4. Short duration of immunity
5. Absence of cross immunity.

Que. 39. What happens to influenza virus during inter- epidemic period?

Ans. 39. Not exactly known. Possible explanations are – 

1. Transmission to extra human reservoirs (Pigs, birds, horses)
2. Latent infection in humans
3. Continuous transfer from one human to other.

Que. 40. Which avian influenza virus has potential to infect & cause disease in humans?

Ans. 40. Influenza virus H5 N1.

Que. 41. What are the surface antigens found in both A & B influenza virus?

Ans. 41. Hemagglutinin (H) Antigens & Neuraminidase (N) Antigens

Que. 42. What are the functions of H & N antigens present in influenza virus?

Ans. 42. H antigen help initiate infection after attachment of the virus to susceptible cells while N antigen is responsible for the release of the virus from the infected cells.

Que. 43. What do you mean by antigenic shift & antigenic drift?

Ans. 43. When there is sudden complete or major antigenic change, it is called a SHIFT and when the antigenic change is gradual over a period of time, it is called a DRIFT.

Que. 44. What is the period of infectivity in influenza?

Ans. 44. One to two days before and one to two days after onset of symptoms.

Que.45. Which are the laboratory tests for confirmation of diagnosis of influenza?

Ans. 45. Virus isolation & Paired sera.

Que. 46. Which are the drugs used in treatment of influenza cases?

Ans. 46. Oseltamivir & Zanamivir.

Que. 47. What is the incubation period of swine flu?

Ans. 47. 1-4 days.

Que. 48. What is the incubation period of avian influenza?

Ans. 48. 2-5 days.

Que. 49. How can diagnosis of swine flu be confirmed in lab?

Ans. 49. By RT-PCR, Viral Culture & 4 fold rise in influenza A (H1N1) virus specific neutralizing antibodies.

Que. 50. Which is the drug of choice for chemoprophylaxis of influenza?

Ans. 50. Oseltamivir. It should be given till 10 days since last exposure.

Que. 51. What is the case fatality rate in untreated cases of diphtheria?

Ans. 51. Average 10%.

Que. 52. What is the characteristic features in diagnosis of diphtheria?

Ans. 52. 1) Formation of false grayish or yellowish membrane over tonsils, pharynx or larynx. Membrane is with well-defined edges with marked surrounding edema and congestion and membrane cannot be wiped away.

2) Enlargement of regional lymph nodes.

3) Signs and symptoms of toxemia.

Que. 53. What are the types of carriers in diphtheria infection?

Ans. 53. Temporary or chronic and nasal or throat carriers. Nasal carriers are more dangerous than throat carriers.

Que. 54. What is the incidence of carriers in diphtheria infection in a given community?

Ans. 54. 0.1 to 5%.

Que. 55. In diphtheria, when will you say a case or carrier non-communicable?

Ans. 55. When at least 2 cultures obtained from nose & throat, at 24 hours interval, are negative for the diphtheria bacilli.

Que. 56. Schick test is used in _________________.

Ans. 56. Diphtheria.

Que. 57. What level of herd immunity is considered necessary to prevent epidemic spread of diphtheria?

Ans. 57. 70% (others believe 90%).

Que. 58. What is the susceptible age group for diphtheria?

Ans. 58. 1 to 5 years.

Que. 59. What is the treatment of a diphtheria case?

Ans. 59. 1) Diphtheria antitoxin IM/IV

               2) Penicillin/ Erythromycin for 5-7 days

Que. 60. What is the treatment of a diphtheria Carrier?

Ans. 60. Oral Erythromycin for 10 days.

Que. 61. Why do epidemics of diphtheria are more common?

Ans. 61. Mainly due to decreasing immunization coverage among infants and children.

Que. 62. In which disease, characteristic bull necked appearance is seen?

Ans. 62. Diphtheria.

Que. 63. What are the discharge criteria of a diphtheria case from the isolation ward of a hospital?

Ans. 63. At least two consecutive nose & throat swab, taken 24 hours apart, should be negative.

Que. 64. Which disease is also called a hundred-day cough?

Ans. 64. Whooping cough.

Que. 65. What are the main control measures of whooping cough (Pertussis)?

Ans. 65. Early diagnosis, isolation, treatment of cases & disinfection of discharges from nose and throat are the main control measures of pertussis.

Que. 66. What is the secondary attack rate of Whooping cough?

Ans. 66. 90% in unimmunized household contacts. 

Que. 67. What are the main complications of whooping cough?

Ans. 67. Bronchitis, Bronchopneumonia & bronchiectasis.

Que. 68. What is the case fatality rate of meningococcal meningitis?

Ans. 68. In untreated cases ———- 50% while in being treated cases ——— 8 – 15%

Que. 69. What is the drug of choice for treatment of cases and carriers in meningococcal meningitis?

Ans. 69. For cases, DOC is Penicillin while for carriers, RIFAMPICIN is the DOC.

Que. 70. What is the case fatality rate (CFR) of untreated & treated meningococcal meningitis cases?

Ans. 70. CFR in untreated meningococcal meningitis cases —– 50%

CFR in treated meningococcal meningitis cases ———————- 8-15%

Que. 71. Whether cases are the most important source of infection in meningococcal meningitis?

Ans. 71. No, carriers are the most important source of infection.

Que. 72. What do you mean by term Acute Respiratory Infections (ARI)?

Ans. 72. It is the inflammation of respiratory tract anywhere from nose to alveoli caused by various micro-organisms and manifest with various symptoms & signs.

Que. 73. What are the risk factors for ARI?

Ans. 73. The risk factors for ARI are – 

            1) Climate

            2) Housing – overcrowding

            3) Poor nutrition

            4) Low birth weight

            5) Indoor smoke pollution

            6) Level of Industrialization

            7) Socio-economic developments

Que. 74. Which is the causative organism of severe Acute Respiratory Syndrome (SARS)?

Ans. 74. New strains of corona virus.

Que. 75. What is the case fatality rate of SARS?

Ans. 75. 10%.

Que. 76. What are the characteristics of chest X –ray findings in SARS?

Ans. 76. Initially a small U/L patchy shadowing which progress in 1-2 days to B/L and generalized with interstitial/ confluent infiltration.

Que. 77. What is the mode of transmission in SARS?

Ans. 77. By close contact with the patient & infected materials.

Que. 78. What are the preventive measures for SARS control?

Ans. 78. Preventive measures for SARS control are – 

1. Prompt identification of cases with SARS & their contacts.
2. Effective isolation of cases.
3. Appropriate protection of medical staff taking care of cases.
4. Comprehensive identification and isolation of suspected cases.
5. Screening of international travelers
6. Timely and accurate reporting with sharing of information.

Que. 79. What do you mean by BOVINE TUBERCULOSIS?

Ans. 79. Sometimes tuberculosis affects cattle this is known as bovine tuberculosis which sometimes may be transmitted to humans.

Que. 80. What was the target of DOTS program?

Ans. 80. 1) A cure rate of 85% of new smear positive cases.

               2) New detection rate of 70% of such cases.

Que. 81. For what period, WHO has launched global plan for STOP TB STRATEGY?

Ans. 81. 2006-2015 with the objective to reduce incidence of tuberculosis.

Que. 82. Which disease does cause one third of female infertility in India?

Ans. 82. Tuberculosis.

Que. 83. In which year, was TB declared global emergency by WHO?

Ans. 83. 1993.

Que. 84. Where are MTB complexes generally found in the lungs?

Ans. 84. In the well aerated upper lobes of the lungs.

Que. 85. What is the route of transmission of TB?

Ans. 85. Primarily by airborne droplets. It spreads by speaking, sneezing & coughing.

Que. 86. Who are classified as great transmitters of TB?

Ans. 86. The great transmitters of TB are as follows – 

1. People with bad cough
2. Smear positive patients
3. Untreated patients
4. Patients who have just started treatment
5. Cases with poor response to treatment

Que. 87. Which are the major body parts involved by TB?

Ans. 87. TB affects primarily lungs but can involve any part of the body except hair & nails.

Que. 88. What do you mean by smear positive tuberculosis?

Ans. 88. At least two initial sputum-smear positive for AFB or one AFB positive smear and one positive culture or one sputum smear positive for AFB and radiographic abnormalities in relation to active pulmonary Tuberculosis.

Ans. 89. What do you mean by smear negative tuberculosis?

Ans. 89. At least two negative sputum smears, but tuberculosis suggestive symptoms and x-ray abnormality or positive culture.

Que. 90. What is the nature of immunity in case of tuberculosis?

Ans. 90. In humans, immunity is acquired either by natural infection by tuberculosis or BCG vaccination.

There is no inherited immunity.

Que. 91. What are the social factors related with tuberculosis?

Ans. 91. Poor quality of life, poor housing, overcrowding, population explosion, undernutrition, lack of education, large families, lack of awareness etc.

Que.92. Who did discover tuberculin test?

Ans. 92. Von- Pirquet (1907).

Que. 93. How will you perform Monteux test?

Ans. 93. Monteux test is performed by giving one TU of PPD in 0.1 ml on the flexor aspect of the forearm intradermally. The result of the test is read after 72 hours.

Que. 94. How will you measure results of Monteux test and what does it indicates?

Ans. 94. Induration is measured in millimeters using calipers or transparent plastic ruler.

1. Reactions equal to or > 10 mm — Positive
2. Reactions <6 mm   — Negative
3. Reactions 6-9 mm  — Doubtful

Que. 95. What is the mode of transmission of tuberculosis?

Ans. 95. By Droplet infection & droplet nuclei generated by a sputum positive case.

Que. 96. How will you control tuberculosis?

Ans. 97. 1) Case Finding

               2) Treatment of cases

               3) BCG Vaccination.

Que. 97. What is WHO definition of TB Elimination?

Ans. 97. In comparison to 2015 base line data, 90% reduction in mortality, 80% reduction in new cases & zero catastrophic expenditure due to TB.

Que. 98. What is WHO definition of a case of microbiologically confirmed TB?

Ans. 98. A patient whose sputum is positive for tubercle bacilli, or molecular test is positive or culture suggestive of M. tuberculosis.

Que. 99. How many sputum samples are required from pulmonary tuberculosis suspect in TB elimination?

Ans. 99. Two.

Que. 100. Under NTEP, to which patients first priority is given for direct smear examination of sputum?

Ans. 100. Chest Symptomatic or patient presenting with following symptoms –

1. Persistent cough of about 2 weeks duration
2. Continuous fever
3. Chest pain
4. Hemoptysis

Que. 101. Which is the main tool of case finding under NTEP?

Ans. 101. Sputum smear examination under direct microscopy.

Que. 102. For what reasons, mass miniature radiography (MMR) was discontinued under RNTCP?

Ans. 102. Reasons are –

1. Lack of definitiveness
2. High cost
3. Varying interpretation of films
4. Low yield of cases in comparison to effort involved.

Que. 103. What is the role of chest x-ray in NTEP?

Ans. 103. For diagnosis of pulmonary tuberculosis Chest X-ray has no role. It’s only suggestive.

Que. 104. What do you mean by bactericidal Drugs? Give examples used in NTEP.

Ans. 104. Bactericidal drugs have power to kill the bacilli in vivo. Commonly used 1st line bactericidal drugs in RNTCP are –

1. Rifampicin
2. INH
3. Pyrazinamide.

Que. 105.what do you mean by Bacteriostatic drugs? Give examples used in NTEP.

Ans. 105. Bacteriostatic drugs have a power to inhibit the multiplication of the bacilli & let the destruction by the immune system of the host. e.g. Ethambutol etc.

Que. 106. What are the important adverse reactions caused by individual anti tubercular drugs?

Ans. 106. Hepatitis, Renal Failure, Shock, Thrombocytopenia — Rifampicin.

           Peripheral Neuropathy — INH

           Retro-bulbar neuritis — Ethambutol

           Hepatitis — Pyrazinamide

Que. 107. What is the dose of Rifampicin & INH in childhood tuberculosis?

Ans. 107. Rifampicin — 10 mg/ Kg 

                  INH — 10-15 mg/Kg 

Que. 108. In which type of tuberculosis, PMDT is an initiative?

Ans. 108. Drug resistant tuberculosis.

Que. 109. What are the measures of prevention of drug resistance?

Ans. 109. The measures of prevention of drug resistance are – 

          1) Treatment with two or more drugs in combination.

          2) Using drugs to which the bacteria are sensitive.

          3) Ensuring complete, regular & adequate treatment.

Que. 110. What were the main components of RNTCP?

Ans. 110. 1) Achieving 85% cure rate among infectious Tuberculosis cases — Short course Chemotherapy.

2) Detecting 70% of the estimated TB cases — Direct sputum microscopy

3) NGOs involvement

4) DOTS (Directly observed therapy Short term).

Que. 111. By whom & when END TB STRATEGY was launched?

Ans. 111. By WHO in 2016-2017. 

Que. 112. When is the targets of END TB STRATEGY to be achieved?

Ans. 112. 2035.

Que. 113. Acute Flaccid Paralysis (AFP) surveillance covers children less than ——————– years.

Ans. 113. Fifteen (15).

Que. 114. What are the indicators to evaluate AFP Surveillance?

Ans. 114. The indicators to evaluate AFP surveillance are – 

            1) Sensitivity of reporting

            2) Completeness of specimen collection

Que. 115. What is the epidemiological basis for poliomyelitis eradication?

Ans. 115. The epidemiological basis for Poliomyelitis eradication are – 

1. Man is the only host.
2. No long-term carrier state.
3. Highly effective oral polio vaccine 
4. No extra human reservoir.
5. Virus cannot survive more than 48 hours in sewage.

Que. 117. What is the mode of transmission of poliomyelitis?

Ans. 117.  1) Faecal oral route — Predominant mode.

                  2) Droplet infections.

Que. 118. What is the different clinical spectrum of polio?

Ans. 118. The different clinical spectrum of polio is – 

           1) In apparent infection

           2) Abortive polio.

           3) Non- paralytic polio

           4) Paralytic polio.

Que. 119. What were the strategies for polio eradication in India?

Ans. 119. The strategies for polio eradication in India were 

             1) Pulse polio immunization.

             2) High –routine immunization coverage

             3) AFP Surveillance

             4) Mop-up rounds of immunization

Que. 120. Most of the epidemics of paralytic polio are due to which polio virus?

Ans. 120. Polio Virus type 1(P1) (RNA virus).

Que. 121. What are the important steps of AFP Surveillance?

Ans. 121. Important steps are – 

1. Finding and reporting children with AFP
2. Transporting stool samples for analysis
3. Isolating polio virus
4. Mapping the polio virus

Que. 122. Whether vaccine associated paralytic polio is most frequently associated with Sabin 3 (60% of cases) followed by Sabin 2 & Sabin 1?

Ans. 122. Yes, it’s true.

Que. 123. What is the predominant mode of transmission of Viral Hepatitis A?

Ans. 123. Faecal –oral route.

  Other modes – Parenteral route & sexual transmission.

Que. 124. What is the result of persistent HBV infection?

Ans. 124. Chronic active hepatitis & Hepatocellular Carcinoma.

Que. 125. Appearance of which antigen is the first evidence of infection with HBV?

Ans. 125. Surface Antigen (HBsAg)

Que. 126. What is the mode of transmission of Hepatitis B Virus?

Ans. 126. The mode of transmission of Hepatitis B virus is 

           1) Parenteral Route

           2) Perinatal transmission

           3) Sexual Transmission

           4) Other routes (Child to child contact)

Que. 127. How Hepatitis C is transmitted from one person to other?

Ans. 127.  Through transfusion of contaminated blood & Blood products.

Que. 128. Since when in India, screening for HCV has been made mandatory for all blood banks?

Ans. 128. July 1, 1997. 

Que. 129. Which drug has been found effective in the treatment of HCV infection?

Ans. 129. Interferon.

Que. 130. Which kind of disease is Hepatitis E?

Ans. 130. Water-borne diseases.

Que. 131. Which hepatitis is more dangerous in pregnant women?

Ans. 131. Hepatitis E.

Que. 132. How HDV infection can be prevented?

Ans. 132. By vaccinating HBV susceptible persons with Hepatitis B Vaccine.

Que. 133. What is the probable mode of transmission of Hepatitis G?

Ans. 133. Blood Transfusion (parenteral). 

Que. 134. How specific lab diagnosis of Hepatitis A may be established?

Ans. 134. By demonstration of HAV particles in the faeces, bile & blood and detection of IgM specific anti HAV in the blood of acutely infected patients.

Que. 135. How will you disinfect faeces for control of hepatitis A?

Ans. 135. By using 0.5% sodium hypochlorite.

Que. 136. Why isolation is not recommended in hepatitis A?

Ans. 136. Because of faecal shredding of virus during incubation period and early phase of illness and occurrence of large number of subclinical cases.

Que. 137. Which morphological form of Hepatitis B virus is considered infectious?

Ans. 137. Dane particles.

Que. 138. Which serological markers do indicate acute viral hepatitis B?

Ans. 138. Raised HBsAg, IgM anti-HBC & HBeAg.

Que. 139. Which serological marker does indicate vaccination with hepatitis B?

Ans. 139. Raised anti- HBs.

Que. 140. What is the aim of global health sector strategy on viral hepatitis 2016-2020?

Ans. 140. Aim is to eliminate viral hepatitis B & C by 2030.

Que. 141. What does elimination of viral hepatitis mean?

Ans. 141. Elimination of viral hepatitis means reducing new cases of HBV & HCV infection by 90% & reducing deaths by viral hepatitis by 65%.

Que. 142. How will you confirm the diagnosis of HCV infection?

Ans. 142. The hepatitis C virus recombinant immune-blast assay (RIBA) & Hepatitis C virus RNA Testing are used to confirm the diagnosis.

Que. 143. How hepatitis E virus is transmitted to humans?

Ans. 143. Through the faecal-oral route.

Que. 144. Which is the most common cause of diarrhea in children aged less than 5 years?

Ans. 144. Rota Virus.

Que.145. What is the route of transmission in diarrheal diseases?

Ans. 145. Faecal – oral Route.

Que. 149. What are intervention measures suggested by WHO to control Diarrheal diseases?

Ans. 149. 1) Appropriate Clinical Management

• Oral Rehydration Therapy/ Intravenous Therapy
• Breastfeeding/ Complementary feeding 
• Chemotherapy
• Zinc

2) Better MCH care practices

3) Preventive strategies

–  Sanitation

–  Health Education

–  Immunization

–  Fly control

4)  Strengthening of Epidemiological Surveillance.

Que. 150. For Mild to moderate dehydration which is the best therapy?

Ans. 150. Oral Rehydration Therapy.

Que.151. For severe dehydration, which is the best therapy?

Ans. 151. Intravenous Rehydration Therapy.

Que. 152. What is the composition of recommended Oral Rehydration Salt Solution?

Ans. 152.

Que. 153. What is composition of ORS solution in mmol / Liter?

Ans. 153. 

Que. 154. What are the solutions recommended by WHO for intravenous rehydration?

Ans. 154. Ringer lactate solution & Diarrhea treatment solution (DTS)

Que. 155. What is the recommended dose of IV fluids in Intravenous rehydration?

Ans. 155. 100ml/kg

             First give 30ml/Kg — in 30 minutes (<1 Year)

            Then give 70 ml/kg — in 2 & ½ hours (<1 Year).

Que. 156. Which are the most common viral & bacterial causes of acute diarrhoea in children?

Ans. 156. Viral —- Rota virus; Bacterial —– Enterotoxigenic E.coli.

Que. 157. What is the drug of choice in cholera & shigella?

Ans. 157. For Cholera — Doxycycline/ Tetracycline

                  For Shigella — Ciprofloxacin.

Que. 158. What is the role of Zinc in diarrhea treatment?

Ans. 158. Zinc given during an episode of diarrhea, reduces the episode’s duration & severity.

• < 6 months — 10 mg –10-14 days
• 6 months — 20 mg — 10-14 days

Que. 159. What is the case fatality rate of cholera in untreated cases?

Ans. 159. 30 – 40 %.

Que. 160. What is the fate of V. Cholerae in inter-epidemic period?

Ans. 160. Possible explanations are – 

1. Exists as long-term carriers
2. Exists as asymptomatic cases involving continuous transmission but at low level.
3. Exists as free living/ altered form in the environment.

Que. 161. How one can differentiate V. cholera Eltor from classical vibrio?

Ans. 161. V. cholera Eltor can be differentiated from classical vibrio by 

            1) Eltor vibrio agglutinate chicken and sheep erythrocytes.

            2) They are resistant to classical phase IV.

            3) They are resistant to polymyxin B-50- unit discs, and

            4) The VP reaction & hemolytic test do not give consistent results.

Que. 162. What are the modes of transmission for cholera?

Ans. 162. The mode of transmission for cholera are – 1) faecally contaminated water and

                  2) Contaminated food & drinks

                  3) Direct contact —–

                 – Through contaminated fingers

                 – Contaminated linen & fomites.

Que. 163. Clinically a typical case of cholera shows how many stages?

Ans. 163. The stages shown by a typical case of cholera are – 

                  1) Evacuation stage

                  2) Collapse stage

                  3) Recovery. 

Que. 164. What are the suggested sanitation measures to control cholera?

Ans. 164. The suggested sanitation measures to control cholera are – 

                1) Provision of safe water

                2) Proper excreta disposal

                3) Food sanitation

                4) Disinfection of faeces, vomitus & clothes

Que. 165.Which is drug of choice for chemoprophylaxis of cholera?

Ans. 165. Tetracycline.

Que. 166. What are the types of cholera carriers?

Ans. 166. A cholera carrier may be incubatory carrier, healthy carrier & chronic carrier.

Que. 167. What are the factors which influence the onset of typhoid fever in man?

Ans. 167. The factors influencing the onset of typhoid fever in man are – 

                  1) Infecting dose

                  2) Virulence of organism

                  3) Cell mediated immunity of host.

Que. 168. What do you mean by chronic carriers in typhoid fever?

Ans. 168. Persons who after a clinical attack excrete the bacilli for more than a year are called chronic carriers. In such persons, the organisms persist in gall bladder and in biliary tract.

Que. 169. In how many persons, chronic carrier state may be expected to develop?

Ans. 169. 2 to 5 % of cases.

Que. 170. What are the different types of carrier states found in typhoid fever?

Ans. 170.  Temporary, incubatory, convalescent & chronic carriers.

Que. 171. What is the peak incidence of typhoid fever in terms of seasons?

Ans. 171. July – September (Rainy season & increase in fly population).

Que. 172. What is the mode of transmission of typhoid fever?

Ans. 172. Faecal –oral route or urine –oral route, via contaminated water, food, soil, fingers or through flies.

Que. 173. Which is the drug of choice for typhoid fever?

Ans. 173. Fluoroquinolones (ciprofloxacin).

Que. 174. Which is the drug of choice for treatment of carrier state in typhoid?

Ans. 174. Amoxicillin / ampicillin with probenecid for 6 weeks.

Que. 175. Which are the recent tests for the diagnosis of typhoid fever?

Ans. 175. Typhi dot, Dipstick test & IDL tubax test.

Que. 176. What are the essential measures to interrupt transmission of typhoid fever?

Ans. 176. Protection & purification of drinking water supplies, improvement in basic sanitation & promotion of food hygiene.

Que. 177. What are the characteristic features of food poisoning?

Ans. 177. The characteristic features of food poisoning are – 

                  1) H/O ingestion of common food.

                  2) Attack too many persons at the same time.

                  3) Similarity of signs and symptoms in majority of cases.

Que. 178. What are the bacteria responsible for salmonella food poisoning out breaks?

Ans. 178. S. typhimurium, S. Cholera –Suis & S. enteritidis.

Que. 179. What is the mechanism of salmonella food poisoning?

Ans. 179. On ingestion, bacilli multiply in intestine & causes acute enteritis & colitis.

Que. 180. What is the mechanism of staphylococcal Food poisoning?

Ans. 180. Food poisoning is caused by ingestion of preformed toxins in the food which has become growing place of bacteria. The toxins act on intestine & CNS resulting in variable clinical manifestations.

Que. 181. What is the usual story in Cl. Perfringens food poisoning?

Ans. 181. Food is prepared 24 hours or more before consumption and then cooled slowly at room temperature & then heated immediately before eating. This allows germination of spores & produce toxins which in turn cause food poisoning.

Que. 182. What is the differential diagnosis of food poisoning?

Ans. 182. Cholera, Acute Bacillary Dysentery & Chemical (Arsenic) poisoning.

Que. 183. Which is the mode of transmission for Amoebiasis?

Ans. 183. 1) Faecal –oral route ————– through contaminated water, food & fingers.

                 2) Sexual contact ——————- In MSM.

                 3) Vectors —————————– carrying cysts & contaminated food & drink.

Que. 184. Which is the drug of choice in Amoebiasis?

Ans. 184. Metronidazole/ Tinidazole.

Que. 185. In which disease chandler’s index is used?

Ans. 185. In epidemiological studies of hookworm disease.

Que. 186. In hookworm infection, in which part of GIT, hookworms live?

Ans. 186. Jejunum (small intestine).

Que. 187. In ascariasis, in which part of GIT the adult worm lives?

Ans. 187. In lumen of small intestine.

Que. 188. What is the drug of choice for ascariasis?

Ans. 188. Albendazole.

Que. 189. In India, which hookworm infection is widely prevalent?

Ans. 189. Necator americanus in South India while Ancylostoma duodenale in North India.

Que. 190. Which are the diseases which has been eradicated from India?

Ans. 190. 1) Small pox.

                  2) Dracunculiasis/ Guinea worm disease.  

                  3) Poliomyelitis 

                  4) Yaws

Que. 191. Which parasite does cause guinea worm disease?

Ans. 191. By nematode Dracunculus medinensis.

Que. 192. Which are the main vectors of dengue fever?

Ans. 192. Aedes aegypti/ Aedes albopictus.

Que. 193.  What are the criteria for clinical diagnosis of dengue hemorrhagic fever?

Ans. 193. 1) Fever

                  2) Hemorrhagic manifestations including at least a positive tourniquet test

                  3) Enlargement of liver.

Que. 194. What are the findings in lab diagnosis of dengue hemorrhagic fever?

Ans. 194. 1) Thrombocytopenia (1,00,000/ Cubic mm or less)

                  2) Haemoconcentration, haematocrit increased by 20% or more.

Que. 195. What are measures suggested for control of Dengue fever?

Ans. 195. 1) Proper diagnosis & treatment of cases.

                  2) Mosquito control measures

                  3) Isolation under bed net during first few days.

                  4) Personal prophylactic measures against mosquito bites.

Que. 196. What kind of disease is malaria?

Ans. 196. A protozoal disease caused by parasite plasmodium & transmitted to man by bite of certain species of infected female Anopheles mosquitoes.

Que. 197. What are the causes of childhood death in malaria?

Ans. 197. Cerebral Malaria & Anemia.

Que.198. Which is the main vector in urban malaria?

Ans. 198. Anopheles stephensi (Anopheles culicifacies in rural area).

Que.199. How many species of malaria parasite are responsible for malaria in humans?

Ans. 199. Four (P. vivax, P. falciparum, P. malariae & P. ovale).

Que. 200. Which malarial parasite is minimally prevalent in India?

Ans. 200. Plasmodium ovale.

Que. 201. In malaria, man is which type of host?

Ans. 201. Intermediate host as asexual cycle takes place in man.

                  While mosquito is the definitive host.

Que. 202. Which form of parasite is infective to mosquito in malaria?

Ans. 202. Gametocytes (M & F).

Que. 203. Which form of parasite is infective to humans in malaria?

Ans. 203. Sporozoites.

Que. 204. Why newborn infants have considered to resistant to infection with P. falciparum?

Ans. 204. There is high concentration of fetal hemoglobin during the first few months of life which inhibits the development of P. Falciparum.

Que. 205. Persons with sickle cell trait have a milder illness of which type of malarial infection?

Ans. 205. Plasmodium falciparum.

Que. 206. Which persons are resistant to P. vivax infection?

Ans. 206. Persons with Duffy negative red blood cells.

Que. 207. What are the breeding habits of vectors of malaria?

Ans. 207. Moving water ———An. fluviatilis

                  Brackish water ———An. sundaicus

                  Wells, Cisterns, fountains & overhead tanks ——— An. stephensi.

Que. 208. What are the important modes of transmission of malaria?

Ans. 208. 1) Vectors

                  2) Blood transfusion, IDU

                  3) Congenital Malaria

Que.209. What is the incubation period of Malaria?

Ans. 209. More than 10 days.

• P. vivax — 14 days
• P. falciparum — 12 days
• P. Malariae — 28 days
• P. ovale — 17 days

Que.210. What are the three stages in clinical manifestations of malaria?

Ans. 210. 1) Cold stage ——–chills & rigors

                  2) Hot stage

                  3) Sweating stage.

Que.211. How is lab diagnosis of malaria is established?

Ans. 211. Demonstration of malarial parasite in blood by making thick & thin films.

            For P. falciparum & vivax, a rapid & simple diagnostic dipstick assay is available.

Que. 212. Which were the measures of malaria in pre-eradication era?

Ans. 212. 1) Spleen rate

                  2) Average enlarged spleen

                  3) Parasite rate

                  4) Infant parasite rate

                  5) Proportional case rate

Que.213. Which are the current measures of malaria?

Ans. 213. 1) Annual Parasite incidence (API)

            2) Annual Blood Examination Rate (ABER)

            3) Annual Falciparum incidence (AFI)

            4) Slide positivity Rate (SPR)

            5) Slide falciparum Rate (SFR)

Que. 214. What do you mean by API?

Ans. 214. API= Confirmed cases during one year/ population under surveillance *100.

It is a better measure of malarial incidence in a community.

Que. 215. In modified plan of operation, what is the recommendations related to ABER?

Ans. 215. Minimum ABER recommended is 10% of the population in a year.

Que. 216. How will you calculate ABER?

Ans. 216. ABER = No. of slides examined/Population* 100.

Que. 217. What are the important vector indices in relation to malaria?

Ans. 217. 1) Human blood index

            2) Sporozoites rate

            3) Mosquito density

            4) Man biting rate

            5) Inoculation rate

Que. 218. What are basic approaches for malaria control?

Ans. 218. 1) Management of cases of malaria &

                  2) Active intervention to control malaria transmission with community participation.

Que. 219. When will you consider mass drug administration for malaria control?

Ans. 219. In high endemic areas (API more than 5 per 1,000 population).

Que. 220. On what basis, endemic areas in India have been divided under modified plan of operation?

Ans. 220. Annual Parasite Incidence (API)

1. Areas with API < 2
2. Areas with API > 2.

Que. 221. What are the vector control strategies in Malaria?

Ans. 221. 1) Anti- adult Measures – 

• Residual spray
• Space spraying
• Individual protection

2) Anti – larval measures – 

–        Larvicides

–        Source reduction

–        Integrated control.

Que. 222. When was the Roll Back Malaria initiative was launched & by whom?

Ans. 222. In 1998 by WHO, UNICEF, UNDP & World bank.

Que.223. Which are the causative nematode worms for lymphatic filariasis?

Ans. 223. W. bancrofti, B. malayi & B. timori. All these infections are transmitted to man by bites of infective mosquitoes.

Que. 224. At what time in night maximum density of microfilaria is found in blood?

Ans. 224. 10 PM to 2 AM.

Que. 225. For Bancroftian & Brugian filariasis, which is the definitive host?

Ans. 225. Man is the definitive host while mosquitoes are intermediate host.

Que.226. Where are the adult worms found in lymphatic filariasis?

Ans. 226. In lymphatic system of man.

Que. 227. Who is the source of infection in humans for lymphatic filariasis?

Ans. 227. A person with circulating Micro-filaria in peripheral blood.

Que.228. Which are the social factors responsible for spread of lymphatic filariasis?

Ans. 228. The social factors responsible for spread of lymphatic filariasis are – 

          1) Urbanization & Industrialization

          2)  Migration of people

          3)  Illiteracy

          4)  Poverty

          5)  Poor sanitation.

Que. 229. What are the main vectors for lymphatic filariasis?

Ans. 229. Culex quinquefasciatus (C. Fatigans) ————- Bancroftian filariasis.

                  Mansonia Annulifera & M. uniformis ————- Brugian filariasis.

Que. 230. Breeding of which mosquitoes is associated with certain aquatic plants such as Pista stratiotes?

Ans. 230. Mansonia mosquitoes.

Que. 231. Which is the most commonly used method for epidemiological assessment of filariasis?

Ans. 231. Thick film of capillary blood.

Que. 232. How is Zika virus transmitted?

Ans. 232. By the bite of an infected Aedes Aegypti mosquito.

Que. 233. How is diagnosis of Zika virus disease confirmed?

Ans. 233. RT-PCR & virus isolation from the blood samples.

Que. 234. For the surveillance of Aedes mosquito, what is the norm of Aedes aegypti index?

Ans. 234. Aedes aegypti index should not be more than 1 in towns & seaports in endemic areas to ensure freedom from yellow fever.

Que. 235. How does the transmission of NIPAH virus infection occur to humans?

Ans. 235. By direct contact with infected bats, infected pigs, from other virus infected people or care givers of the patients.

Que. 236. What is the incubation period of NIPAH virus infection?

Ans. 236. 4-14 days.

Que. 237. What is the case fatality rate of NIPAH virus infection?

Ans. 238. 40-75%.

Que. 239. How will you define a rabies free area?

Ans. 239. A rabies free area has been defined as the area or geography in which no case of indigenously acquired rabies has occurred in man or animal for 2 years.

Que. 240. What do you mean by Zoonoses?

Ans. 240. Zoonoses are disease transmitted by various modes between infected vertebrate animals & man.

Que. 241. In India, which are the states / UTs where rabies not found?

Ans. 241. Lakshadweep & Andaman & Nicobar Islands.

Que. 242. What is the shape & type of causative agent of rabies?

Ans. 242. Bullet shaped, RNA containing virus.

Que. 243. What do you mean by term STREET VIRUS?

Ans. 243. Viruses derived from naturally occurring cases of rabies is called STREET VIRUS. It is pathogenic for all animals & has long incubation period (20-60 days in dogs). May cause rabies.

Que. 244. What do you mean by FIXED VIRUS?

Ans. 244. It is of short incubation period (4-6 days) and when injected intra cerebrally does not form Negri bodies. It is derived by serial brain to brain passage of street virus in rabbits. 

Que. 245. Which type of rabies virus is used in preparation of anti-rabies vaccine?

Ans. 245. Fixed virus.

Que. 246. What are the three epidemiological forms in which rabies exists?

Ans. 246. 1) Urban rabies

                  2) Wild life rabies

                  3) Bat rabies

Que. 247. Which disease in men forms dead end infection?

Ans. 247. Rabies & JE.

Que. 248. What is the mode of transmission of Rabies?

Ans. 248. The mode of transmission of rabies are – 

                  1) Animal bites

                  2) Licks

                  3) Aerosols

                  4) Person to person – by bites

                                               –  By transplants

Que. 249. Which is the causative organism of yellow fever?

Ans. 249. Group B Arbo virus, Flavivirus fibricus.

Que. 250. Which disease shows trans-ovarian transmission of infection?

Ans. 250. Yellow fever infection

Que. 251. What is the causative organism of Japanese Encephalitis & which is the vector responsible?

Ans. 251. Group B Arbovirus (Flavivirus). Vector responsible is culicine mosquitoes. It is a zoonotic disease.

Que. 252. Which extra human hosts were infected by JE Virus?

Ans. 252. Animals (e.g. pigs) & birds (Ardeid bird). The disease is transmitted to man by the bite of infected mosquitoes. Man is an incidental dead-end host. No man-to-man transmission occur.

Que. 253. Which animal is considered as amplifiers of the JE Virus?

Ans. 253. Pigs.

Que. 254. Where does the Culex tritaeniorhynchus mosquitoes generally breed?

Ans. 254. In irrigated rice fields (most important breeding places), shallow ditches & pools.

Que. 255. What are the important species of culicine mosquitoes responsible for transmission of JE virus?

Ans. 255. Culex tritaeniorhynchus, C. Vishnui & C. gelidus.

Que. 256. For JE transmission, which is the most important vector in South India?

Ans. 256. Culex tritaeniorhynchus.

Que. 257. What are the three stages of course of the JE disease?

Ans. 257. Stages of course of the disease in JE are – 

           1) Prodromal stage

           2) Acute Encephalitic stage

           3) Late stage & sequel.

Que. 258. What is the case fatality rate in JE?

Ans. 258. 20 – 40 %

              The average period between the onset of illness & death is usually 9 days.

Que. 259. What are the characteristics of Kyasanur forest disease (KFD)?

Ans. 259. The characteristic features of KFD are – 

            1) Febrile disease associated with hemorrhages.

            2) Caused by Arbo virus Flavivirus.

            3) Transmitted to man by bite of infected ticks.

            4) Incubation period —– 3 to 18 days.

Que. 260. Which is the causative organism of chikungunya fever?

Ans. 260. Group A Arbovirus (chikungunya Virus)

Que. 261. What are the vectors of Chikungunya fever?

Ans. 261. Vectors are Aedes (especially A. aegypti), Culex & Mansonia mosquitoes.

Que. 262. Which is the most effective method of vector control in chikungunya fever?

Ans. 262. Aerosol spray of ULV (ultra-low volume) quantities of malathion/sumithion (250 ml/hectare).

Que. 263. Which is the causative organism of West Nile fever?

Ans. 263. Group B Arbovirus.

Que. 264. How does West Nile fever is transmitted?

Ans. 264. By bite of infected Culex mosquitoes.

Que. 265. What are the main reservoirs of human Brucella infection?

Ans. 265. Cattle, sheep, goats, swine, buffaloes, horses & dogs.

Que. 266. Which human group is at risk to brucellosis due to occupational exposure?

Ans. 266. Farmers, shepherds, Butchers, Abattoir workers, Veterinarians & lab workers.

Que. 267. What is the mode of transmission of brucellosis?

Ans. 267. 1) Contact infection ———— most commonly by direct contact.

                  2) Food borne infection ——   milk, cheese etc.

                  3) Air borne infection.

Que. 268. What is the drug of choice of human brucellosis?

Ans. 268. Tetracycline.

Que. 269. Which is the spirochetal disease caused by Leptospira?

Ans. 269. Leptospirosis.

Que. 270. Which disease is transmitted by environmental contamination with urine & faeces of infected animals?

Ans. 270. Leptospirosis.

Que. 271. Which is the drug of choice in human leptospirosis?

Ans. 271. Penicillin (Alternative drugs—— Tetracycline/ Doxycycline).

Que. 272. Which bacteria exhibit bipolar staining with special stains — Wayson’s stain?

Ans. 272. Yersinia pastis.

Que. 273. What is the source of infection in human plague?

Ans. 273. Infected rodents & Fleas & case of pneumonic plague.

Que. 274. Which is the commonest vector of Plague?

Ans. 274. Rat Flea (X. cheopis)

1. astia, X. brasiliensis & Pulex irritans (human flea) can transmit the infection.

Que. 275. Which flea is more dangerous in transmitting the plague?

Ans. 275. A partially blocked flea.

Que. 276. Which flea indices are commonly used in rat flea surveys?

Ans. 276. 1) Total flea index

            2) Cheopis index

            3) Specific percentage of flea

            4) Burrow index

Que. 277. What are the types of human plague?

Ans. 277. Three types – 

• Bubonic plague
• Pneumonic plague
• Septicemic plague

Que. 278. What is incubation period of different types of plague?

Ans. 278. 1) Bubonic plague —————- 2 to 7 days

            2) Septicemic plague ———- 2 to 7 days

            3) Pneumonic plague ———–1 to 3 days

Que. 279. What is the DOC for treatment of human plague?

Ans. 279. Streptomycin (30 mg/KBW/DAY) I/M

                  Alternative drug ——————- Tetracycline orally

Que. 280. Which food is considered to be the primary source of salmonellosis?

Ans. 280. Food of animal origin especially commercially prepared foods.

Que. 281. What are the modes of transmission of human salmonellosis?

Ans. 281. The mode of transmission of human salmonellosis are as follows – 

             1) By ingestion of contaminated food or drink

             2) Direct contact with domestic animals

             3) Man to man by faecal oral route.

Que. 282. What are the different syndromes manifesting in human Salmonellosis?

Ans. 282. The different manifestations of human salmonellosis are as follows – 

              1) Enteric fever

              2) Salmonella gastroenteritis

              3) Septicemia with focal lesions

Que.283. What are the causative organism and insect vectors responsible for typhus group Rickettsial diseases?

Ans. 283.                                                          Typhus Group

Que. 284. What are the causative organisms & insect vectors responsible for spotted fever group of Rickettsial disease?

Ans. 284.

Que. 285. What is the causative agent & insect vector responsible for Q fever & Trench fever?

Ans. 285. 

Que. 286. In which Rickettsial disease, rodents act as reservoir of infection?

Ans. 286. Rodents as reservoir of infection

• Endemic (Murine) Typhus.
• Scrub typhus
• Indian tick typhus
• Rocky mountain spotted fever
• Rickettsial pox.

Que. 287. Which is the reservoir of infection in Q fever?

Ans. 287. Cattle, sheep & goats.

Que. 288. Humans act as reservoir of infection in which Rickettsial diseases?

Ans. 288. Humans act as reservoir in following rickettsial diseases – 

            1) Epidemic typhus

            2) Trench fever

             In both insect vector being louse.

Que. 289. Which is the most common Rickettsial disease?

Ans. 289. Scrub typhus.

Que. 290. Which is the DOC in treatment of Scrub & Murine Typhus?

Ans. 290. Tetracycline.

Que. 291. Which is the DOC in treatment of Q fever?

Ans. 291. Tetracycline.

Que.292. Which is the definitive host in taeniasis?

Ans. 292. Humans.

Que.293. Which is the intermediate host in Taeniasis?

Ans. 293. T. Saginata   — Cattle (C. bovis)

1. solium      — Pig (C. cellulosae)

Que. 294. When infected with larval stage of T. solium, humans can develop which diseases?

Ans. 294. Muscular, ocular & cerebral cysticercosis.

Que. 295. What are the modes of transmission in taeniasis?

Ans. 295. The mode of transmission in taeniasis are – 

              1)  Ingestion of undercooked beef & pork

             2)  Ingestion of contaminated food, water or vegetables with eggs.

             3)  Retro-peristalsis.

Que. 296. What is the treatment of Cysticercosis?

Ans. 296. DOC——– Albendazole & steroids in presence of fatty meals.

Que. 297. What is the mode of transmission in Hydatid disease?

Ans. 297. The mode of transmission in hydatid disease are as follows – 

                  1) By ingestion of contaminated food, vegetables with the egg of Echinococcus.

                  2) Through water contaminated with faeces from infected dogs.

                  3) While handling or playing with infected dogs.

Que. 298. Which is the most common site of cysts of Hydatid Disease?

Ans. 298. Right lobe of liver

Que. 299. What is characteristics of leishmaniasis?

Ans. 299. A group of protozoal disease caused by parasite leishmania & transmitted to man by bite of female phlebotomine sand-fly (P. argentipes).

Que. 300. Aldehyde test of Napier is most widely used test for diagnosis of ______________.

Ans. 300. Kala-azar.

Que. 301. What are the drugs commonly used in treatment of leishmaniasis?

Ans. 301. The drugs commonly used in the treatment of leishmaniasis are as follows – 

                  1) Sodium stibogluconate

                  2) Miltefosine

                  3) Amphotericin B.

Que. 302. For what percentage of blindness & visual impairment, Trachoma is responsible in India?

Ans. 302. Trachoma was eliminated as public health problem from India in 2024.

Que. 303. Till when trachoma is infectious?

Ans. 303. Trachoma is not infective after complete cicatrization. It is infective till the presence of active lesions in the conjunctiva.

Que. 304. Which disease is characterized by Herbert’s pits?

Ans. 304. Trachoma.

Que. 305. Which is the antibiotic of choice in treatment of trachoma?

Ans. 305. 1% ophthalmic ointment of tetracycline.

          Alternative ———— Erythromycin ointment.

Que. 306. What do you mean by blanket treatment in trachoma?

Ans. 306. When treatment for trachoma is given after identification to entire community is called mass/ blanket treatment. It is indicated when prevalence of severe & moderate trachoma in under 10 children is more than 5.

Que. 307. What is the indication of selective treatment for trachoma?

Ans. 307. In low to moderate prevalence communities, treatment is given to selective persons after case finding.

Que.308. What is the mortality rates in tetanus?

Ans. 308. 40 to 80%.

Que.309. When will you say that neonatal tetanus (NT) is eliminated from the community?

Ans. 309. When incidence of neonatal tetanus will be less than 1 case per 1000 live births in given community. Maternal & Neonatal tetanus was eliminated from India in 2015.

Que. 310. What are the behavioral practices contributing to NT disease incidence?

Ans. 310.  – Hand washing

• Delivery practices
• Traditional birth customs
• Interest/ disinterest in immunization.

Que. 311. Which was the main season of occurrence of neonatal tetanus in India?

Ans. 311. July to September (NOW ELIMINATED).

Que.312. Tell me the important features of Cl. Tetani?

Ans. 312. – Gram –positive

• Anaerobic
• Spore bearing (drum stick appearance)
• Spores produce tetanospasmin, a potent exotoxin, after germination under anaerobic conditions.

Que. 313. Which is the natural habitat of tetanus organism?

Ans. 313. Soil & Dust.

Que. 314. Tell me one disease in which herd immunity has no role to play?

Ans. 314. Tetanus.

Que.315. What is the course of immunization of tetanus toxoid in adults?

Ans. 315. Two doses of 0.5ml of tetanus toxoid adsorbed given I/M at interval of 1-2 months.

             1st Booster ————- After one year of initial doses

             2nd Booster ———— 5 years after 1st Booster.

Que. 316. How you can protect a newborn from NT, born from unimmunized/partially immunized mother?

Ans. 316. By giving injection of antitoxin, 750 IU, within 6 hours of birth.

Que. 317. In leprosy which part of the body is most commonly affected?

Ans. 317. Peripheral nerves.

Que. 318. Which sensation is the earliest to be affected in leprosy?

Ans. 318. Light touch.

Que. 319. In which year, India eliminated leprosy as a public health problem?

Ans. 319. 2005 (December).

Que. 320. Which peripheral nerve is most commonly affected in leprosy?

Ans. 320. Ulnar Nerve.

Que. 321. What are the diagnostic criteria of leprosy?

Ans. 321. The diagnostic criteria of leprosy are – 

               1) Hypo-pigmented patches with definite loss of sensation.

               2) Involvement of peripheral nerves with loss of function.

               3) Presence of acid-fast bacilli in the skin or nasal smears.

Que. 322. By which name Leprosy is popularly called in India?

Ans. 322. Kustha roga.

Que. 323. Who did discover the M. Leprae?

Ans. 323. Hansen (1873) from Norway.

Que. 324. What was the reason for change in strategy of treatment of leprosy from Dapsone monotherapy to Multi Drug Therapy?

Ans. 324. Due to emergence of Dapsone resistant strains of M. Leprae.

Que. 325. What is the treatment of choice of Leprosy?

Ans. 325. Multi Drug Therapy (MDT).

Que. 326. Leprae bacilli has affinity for which type of cells?

Ans. 326. Schwann cells in peripheral nerves & cells of the Reticulo-endothelial system.

Que. 327. In which type of leprosy, bacterial load is highest?

Ans. 327. Lepromatous leprosy.

Que. 328. Which is the specific M. Leprae antigen?

Ans. 328. Phenolic glycolipid (PGL)

Que. 329. How is currently large no. of M. Leprae being produced?

Ans. 329. By multiplication in the 9- banded armadillo & foot pad of nude mouse.

Que. 330. Does M. Leprae bacilli grow in artificial medium?

Ans. 330. Never.

Que. 331. Which is the source of infection in the community in leprosy?

Ans. 331. Multi-bacillary cases mainly. Though all cases with active leprosy must be considered infectious.

Que. 332. What is the pathogenicity of Leprae bacilli?

Ans. 332. Highly infectious with low pathogenicity.

Que. 333. What does a high prevalence of infection (M. Leprae) in children indicate?

Ans. 333. That the disease is active & spreading.

Que. 334. A single dose of rifampicin kills how many bacilli?

Ans. 334. 99.99%.

Que. 335. Which environmental factors increase the risk of transmission of M. leprae bacilli?

Ans. 335. – Hot & Humid Climate

• Overcrowding
• Poor ventilation
• Poor housing

Que. 336. Which is the predominant mode of transmission of leprosy?

Ans. 336. Droplet infection.

Que. 337. Why it is not possible to eradicate leprosy?

Ans. 337. 1) Long variable incubation period up to 40 years.

                  2) Presence of extra human reservoirs

                  3) Absence of potent vaccine.

Que. 338. What is the duration of treatment of MDT in MB & PB leprosy?

Ans. 338. PB Leprosy ———————– 6 months

                  MB Leprosy ———————– 12 months

Que. 339. What are the main objectives of multi drug therapy (MDT) in leprosy?

Ans. 339. Main objectives of MDT in leprosy are – 

              1) To interrupt transmission of the infection.

              2) To ensure early treatment of cases to prevent deformities

              3) To prevent drug resistance.

Que. 340. Who is a case of leprosy?

Ans. 340. A case of leprosy is a person showing clinical signs of leprosy with or without bacteriological confirmation of the diagnosis and who has not yet completed a full course of treatment with MDT.

Que. 341. Who is a case of Pauci-bacillary (PB) leprosy/ Multi bacillary (MB) leprosy?

Ans. 341. PB leprosy – A person having 1-5 skin lesions and /or no nerve involvement.

             MB leprosy – A person having 6 or more skin lesions and /or nerve involvement.

Que. 342. What is the definition of a defaulter case?

Ans. 342. A defaulter is a leprosy patient on MDT, who has not collected MDT for 12 consecutive months.

Que. 343. What are the drugs used in MDT?

Ans. 343. Dapsone, Rifampicin & Clofazimine

Que. 344. Which is the only bactericidal drug given in MDT?

Ans. 344. Rifampicin.

Que. 345. Which drug in MDT does cause brownish discoloration of the body?

Ans. 345. Clofazimine.

Que. 346. Which drug in MDT does cause reddish discoloration of urine?

Ans. 346. Rifampicin.

Que. 347. Which drug in MDT does cause Hepatitis?

Ans. 347. Rifampicin & Dapsone.

Que. 348. What do you mean by lepra-reaction?

Ans. 348. It is an acute or subacute inflammation occurring during course of leprosy which is immunologically mediated and affects mainly nerve trunks causing disabilities.

Que. 349. What is DOC in lepra-reaction?

Ans. 349. Prednisolone.

Que. 350. What do you mean by DPMR initiative?

Ans. 350. Disability Prevention and Medical Rehabilitation.

Que. 351. What do you mean by RCS?

Ans. 351. Re-Constructive Surgery (RCS) for correction of deformities & disabilities.

Que. 352. Opposition of fingers & abduction of thumb is lost when —————- nerve is damaged.

Ans. 352. Median Nerve.

Que. 353. Foot Drop results from damage to which nerve?

Ans. 353. Lateral Popliteal Nerve

Que. 354. Wrist drop results from damage to which nerve?

Ans. 354. Radial Nerve.

Que. 355. In type II lepra reaction, which is an alternative drug to prednisolone?

Ans. 355. Clofazimine

Que. 356. What is the fate of MDT if lepra reaction occurs during treatment?

Ans. 356. Continue MDT in addition to prednisolone.

Que. 357. Which are the classical venereal / sexually transmitted diseases?

Ans. 357. Syphilis, Gonorrhea, Chancroid, Lymphogranuloma Venereum & Donovanosis.

Que. 358. Whether HIV/AIDS is a sexually transmitted infection?

Ans. 358. Yes, definitely.

Que. 359. What is the prevalence of STI in India?

Ans. 359. 6% of the sexually active population.

Que. 360. In which age group highest rates of incidence of STI is found?

Ans. 360. 20-24 years’ age group.

Que. 361. Name few demographic factors which contribute to increase in STIs in India?

Ans. 361.  – Population explosion

• Increase in the no. of young people.
• Migration to urban areas.
• Industrialization.
• Delay in marriage in females.

Que. 362. Which diseases are caused by STI Neisseria Gonorrhoeae?

Ans. 362. Gonorrhea, Urethritis, cervicitis, epididymitis, salpingitis, PID, Neonatal conjunctivitis.

Que. 363. Which diseases are caused by STI, Chlamydia Trachomatis?

Ans. 363. LGV, Urethritis, cervicitis, proctitis, Epididymitis, Infant pneumonia, Reiter’s Syndrome, PID, Neonatal Conjunctivitis.

Que. 364. What do you mean by Reproductive Tract Infections?

Ans. 364. Any infection of the reproductive tract in males & females is called RTI. It may or may not occur with sexual contact.

Que. 365. What do you mean by STIs?

Ans. 365. Sexually transmitted infections as name suggests are the infections caused by germs and passed from one person to another mainly through sexual contact.

Que. 366. Syndromic diagnosis is used in which infection?

Ans. 366. Sexually transmitted infections (STIs).

Que. 367. What is safer sex?

Ans. 367. Safer sex refers to those practices that allow couples to reduce their chances of getting pregnant as well as transmitting a STI.

Generally safer sex practices prevent contact with genital sores as well as the exchange of body fluids such as semen, blood & vaginal secretions.

Que. 368. What are the factors contributing to STI/RTI spread?

Ans. 368. Human behavior ——— high risk behavior

• Lack of access to health care
• Lack of awareness about STI/RTIs
• Migrant population
• Health care providers not adequately trained
• Poor medical services.
• Hygiene & environmental factors
• Hormonal factors
• Socio-economic & other factors.

Que. 369. Whether women are at a higher risk of STIs/RTIs?

Ans. 369. Definitely yes.

Que. 370. Why STIs/RTIs are a public health problem?

Ans. 370. Reasons are as follows – 

• Major cause of ill health in country
• Cause serious complications in men & Women
• Increase risk of HIV transmission
• Responsible for reproductive loss
• Increase cost to health system

Que. 371. Which disease is also called SLIM DISEASE?

Ans. 371. Acquired Immuno-Deficiency Syndrome (AIDS).

Que. 372. What kind of virus is human immune-deficiency virus (HIV)?

Ans. 372. Lentivirus (Retrovirus).

Que. 373. HIV/AIDS is the modern pandemic. Is it true?

Ans. 373. Definitely as it has no geographical boundary.

Que. 374. What is the prevalence of HIV/ AIDS in India?

Ans. 374. 0.26% (2015).

Que. 375. How many people in India are living with HIV/AIDS?

Ans. 375. 2.17 million (2015).

Que. 376. Which type of HIV epidemic is the Indian Epidemic?

Ans. 376. Concentrated HIV epidemics (HIV prevalence is consistently over 5% in at least one defined subpopulation but is below 1% in pregnant women in urban areas).

Que. 377. What are the different kinds of HIV epidemic?

Ans. 377. The different kinds of HIV epidemics are as follows – 

                 1) Low level HIV epidemics

                 2) Concentrated HIV epidemics

                 3) Generalized HIV Epidemics

Que. 378. What do you mean by Generalized HIV Epidemics?

Ans. 378. HIV prevalence consistently over 1% in pregnant women.

Que. 379. What do you mean by low level HIV epidemics?

Ans. 379. HIV prevalence has not consistently exceeded 5% in any defined sub population.

Que. 380. What is the predominant route of transmission of the HIV?

Ans. 380. Unprotected heterosexual route.

Que. 381. What is the route of transmission of the HIV?

Ans. 381. The route of transmission of the HIV is – 

                 1) Unprotected sex 

                 2) Infected needles & syringes

                 3) Mother to child transmission

                 4) Unsafe blood transfusions.

Que. 382. Is malaria incidence & severity increases in adults infected with HIV?

Ans. 382. Yes.

Que. 383. Who launched the 3 by 5 target?

Ans. 383. WHO & UNAIDS on 1st December 2003. Purpose was to provide antiretroviral treatment (ART) to 3 million people living with HIV/AIDS in developing countries by the end of 2005.

Que. 384. Which is the most common infection among HIV infected individuals?

Ans. 384. Tuberculosis. It is also leading cause of death in patients with HIV/AIDS.

Que. 385. What are the different kinds of HIV Virus?

Ans. 385. HIV 1 & 2. HIV 1 is most widely prevalent.

Que. 386. Which age group is most commonly affected in HIV/AIDS?

Ans. 386. 20-49 years’ age group (Sexually active population).

Que. 387. Which is the best investigation used in national program to tell the progression of disease?

Ans. 387. CD4 T-cell percentage.

Que. 388. Which is the screening test in HIV/AIDS?

Ans. 388. Rapid test & ELISA.

Que. 389. Which investigation in HIV/AIDS indicate active HIV replication?

Ans. 389. P 24 antigen.

Que. 390. Which is the best method of prevention of HIV/AIDS?

Ans. 390. Education to masses.

Que. 391. Antiretroviral treatment (ART) is used in the treatment of which disease?

Ans. 391. HIV/AIDS.

Que. 392. When did the first case of HIV/AIDS occur in India?

Ans. 392. 1986 in Tamil Nadu.

Que. 393. What is the drug of choice for chemoprophylaxis of plague?

Ans. 393. Tetracycline.

Que. 394. What was the incubation period of COVID 19 disease?

Ans. 394. 2-14 days.

Que. 395. Which are the risk factors associated with severe COVID 19 disease?

Ans. 395. Age more than 60 years, suffering from NCDs (DM, HT etc.) & smoking.

Causative organism & incubation period of various communicable diseases

Suggested Further Readings – 

• K. Park; Park’s textbook of Preventive & Social Medicine, 26th edition, 2021

• R. Bhalwar; textbook of public health & Community Medicine, AFMC-WHO, 1st edition, 2009

• Mahajan & Gupta; Textbook of Preventive & Social Medicine; 4th edition

• AH Suryakantha; Community Medicine with Recent Advances, 3rd Edition