*Small is an acute infectious disease caused by VARIOLA VIRUS and clinically characterized by a sudden onset of fever, headache, backache, vomiting and sometimes convulsions, especially in children.
*On the third day of fever, a typical rash appears which is centrifugal in distribution and passes through successive stages of macule, papule, vesicle, pustule and scab with subsequent scarring.
*IMPORTANT DATES ASSOCIATED WITH SMALL POX :
- May 17, 1975 = The last indigenous case of small pox occured in India (Bihar).
- May 24, 1975 = India's last known case of small pox, an importation from Bangladesh occured.
- July 5, 1975 = India was proclaimed as no longer to be small pox endemic.
- April, 1977 = India was declared small pox free by INTERNATIONAL COMMISSION FOR ASSESSMENT OF SMALLPOX ERADICATION.
- October 26, 1977 = World's last case of Small pox occured in Somalia.
- 1978 - Lab accident results in small pox.
- May 8, 1980 = WHO declared that small pox has been eradicated completely.
*Epidemiological factors which have led to the eradication of small pox - these could form the basis for the eradication of other similar diseases :
1. No long-term carrier of the virus
2. No known animal reservoir
3. Life-long immunity after recovery from the disease
4. The detection of cases comparatively simple because the rash was so characteristic and occured in visible parts of the body
5. Persons with sub-clinical infection didnot transmit the disease
6. Vaccine is highly effective; easily administered, heat stable and confers long-term protection.
7. International co-operation.
*As small pox is now eradicated it is often asked, why keep the causative agent and take the risk of laboratory-associated infection? The answer lies in the fact that there exists, in various parts of the world, a number of poxviruses (eg: monkeypox, cowpox, camelpox, tanapox, tateropox) that closely resemble smallpox viurs and can producehuman infections. Other new pox viruses may yet be discovered . The natural histories of these viruses have not yet been delineated, and it is not known whether these agents can someday replace the eradicated smallpox virus. It is necessary to conduct comparative studies on these animal poxviruses.
*To protect from future attacks, vaccine stocks and bifurcated needles for vaccination of about 300 million people are maintained indefinitely by WHO in Geneva, Toronto and New Delhi.
Sunday, August 1, 2010
Monday, March 1, 2010
61 - Cold chain and Reverse Cold chain
The 'cold chain' is a system of storing and transporting vaccines at recommended temperatures from the point of manufacture to the point of use. That is, the role of the cold chain is to maintain the potency of vaccines. There is also a concept called 'reverse cold chain', which is a system of storing and transporting samples at recommended temperatures from the point of collection to the laboratory.
Essential elements:
*Personnel to manage vaccine distribution
*Equipment for vaccine storage & transport
*Maintenance of equipment
*Monitoring
The equipment included in the so-called 'cold chain' is expected to provide 'EPI standard' vaccine storage. The capacity needs to provide for transport and storage of all vaccines required for routine immunization of all children under 1 years of age (4%) and all women of childbearing age, groups that constitute 4% and 23% of the total population in Ethiopia, respectively. The cold chain is also expected to provide for the needs related to various supplementary immunisation activities at any given time.
In August/September 2002, the Ministry of Health in collaboration with the World Health Organization, carried out a national inventory exercise in Ethiopia. The inventory was analysed mid-2003 and the following is a summary of the findings:
1.Only 66% of the cold chain equipment was found functional at the time of the inventory. Excluding 3% of the equipment for which no record was available, 31% of the equipment was therefore not available to support immunization activities.
2.Of the 31% non-functional equipment, over 600 units were reportedly awaiting spare parts and repair work.
3.Of the non-functional units, 522 are over 10 years of age, thus making them uneconomical to repair. The average lifespan of EPI cold chain equipment is 7 to 10 years depending on environment and use.
4. 51 different manufacturers account for the 4,833 equipment inventoried - a situation that makes it difficult to maintain adequate spare part stock for maintenance.
Three key observations/recommendations are included at the end of the report, based on analysis of the inventory and technical considerations. They revolve around three key issues established in the report; the need for:
1.Standardization of equipment,
2.Development of a five-year rehabilitation plan and,
3.Establishment of sustainable equipment maintenance system and guidelines.
The three recommendations have been incorporated into the WHO/EPI Logistics work plan for 2004 with intention to address them in collaboration with the Ministry of Health over the next five years. In addition, a four-week training of 35 regional cold chain technicians has recently been conducted by the Ethiopian Science and Technology Commission (ESTC) on behalf of the Ministry of Health in collaboration with UNICEF and WHO. This training is expected to further enhance the capacity of the regions to independently run effective maintenance of their cold chain equipment.
Multiple Choice Questions in Epidemiology and Community Medicine (Revision MCQs)
Essential elements:
*Personnel to manage vaccine distribution
*Equipment for vaccine storage & transport
*Maintenance of equipment
*Monitoring
The equipment included in the so-called 'cold chain' is expected to provide 'EPI standard' vaccine storage. The capacity needs to provide for transport and storage of all vaccines required for routine immunization of all children under 1 years of age (4%) and all women of childbearing age, groups that constitute 4% and 23% of the total population in Ethiopia, respectively. The cold chain is also expected to provide for the needs related to various supplementary immunisation activities at any given time.
In August/September 2002, the Ministry of Health in collaboration with the World Health Organization, carried out a national inventory exercise in Ethiopia. The inventory was analysed mid-2003 and the following is a summary of the findings:
1.Only 66% of the cold chain equipment was found functional at the time of the inventory. Excluding 3% of the equipment for which no record was available, 31% of the equipment was therefore not available to support immunization activities.
2.Of the 31% non-functional equipment, over 600 units were reportedly awaiting spare parts and repair work.
3.Of the non-functional units, 522 are over 10 years of age, thus making them uneconomical to repair. The average lifespan of EPI cold chain equipment is 7 to 10 years depending on environment and use.
4. 51 different manufacturers account for the 4,833 equipment inventoried - a situation that makes it difficult to maintain adequate spare part stock for maintenance.
Three key observations/recommendations are included at the end of the report, based on analysis of the inventory and technical considerations. They revolve around three key issues established in the report; the need for:
1.Standardization of equipment,
2.Development of a five-year rehabilitation plan and,
3.Establishment of sustainable equipment maintenance system and guidelines.
The three recommendations have been incorporated into the WHO/EPI Logistics work plan for 2004 with intention to address them in collaboration with the Ministry of Health over the next five years. In addition, a four-week training of 35 regional cold chain technicians has recently been conducted by the Ethiopian Science and Technology Commission (ESTC) on behalf of the Ministry of Health in collaboration with UNICEF and WHO. This training is expected to further enhance the capacity of the regions to independently run effective maintenance of their cold chain equipment.
Multiple Choice Questions in Epidemiology and Community Medicine (Revision MCQs)
Thursday, January 28, 2010
Monday, September 21, 2009
59 - Incubation Period of Diseases ( according to 20th edition PARK )
RESPIRATORY INFECTIONS :
1. Chicken pox = 14-16 days ( can range from 10-21 days )
2. Measles = 10 days for the appearance of fever from the day of infection and 14 days for the appearance of rash from the day of exposure to infection .
3. Rubella = 2-3 weeks ( average of 18 days )
4. Mumps = 2-3 weeks ( usually 18 days )
5. Influenza = 18-72 hours
6. Diptheria = 2-6 days
7. Whooping cough ( Pertussis ) = 7-14 days ( not more than 3 weeks )
8. Meningococcal meningitis = 3-4 days ( may vary from 2-10 days )
9. SARS = 2-7 days ( commonly 3-5 days )
10. Tuberculosis = 3-6 weeks from the time of exposure to positive tuberculin test appearance, but the actual incubation period may vary from weeks, months to years.
1. Chicken pox = 14-16 days ( can range from 10-21 days )
2. Measles = 10 days for the appearance of fever from the day of infection and 14 days for the appearance of rash from the day of exposure to infection .
3. Rubella = 2-3 weeks ( average of 18 days )
4. Mumps = 2-3 weeks ( usually 18 days )
5. Influenza = 18-72 hours
6. Diptheria = 2-6 days
7. Whooping cough ( Pertussis ) = 7-14 days ( not more than 3 weeks )
8. Meningococcal meningitis = 3-4 days ( may vary from 2-10 days )
9. SARS = 2-7 days ( commonly 3-5 days )
10. Tuberculosis = 3-6 weeks from the time of exposure to positive tuberculin test appearance, but the actual incubation period may vary from weeks, months to years.
Saturday, August 29, 2009
58 - Categorization of wastes
category 1 : Human anatomical wastes
category 2 : Animal wastes
category 3 : Microbiology and Biotechnology wastes
category 4 : Waste sharps
category 5 : Discarded medicines and Cytotoxic drugs
category 6 & 7 : Solid wastes
category 8 : Liquid wastes
category 9 : Incineration ash
category 10 : chemicals used in the production of biologicals
category 2 : Animal wastes
category 3 : Microbiology and Biotechnology wastes
category 4 : Waste sharps
category 5 : Discarded medicines and Cytotoxic drugs
category 6 & 7 : Solid wastes
category 8 : Liquid wastes
category 9 : Incineration ash
category 10 : chemicals used in the production of biologicals
Monday, March 23, 2009
57 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 47
236q: the most common cause of blindness in India is ?
237q: under national programme for prevention of nutritional blindness , a child in the age group of 6-11 months is given a mega dose of vitamin A equal to ?
a. 50000 IU
b. 1 lakh IU
c. 1.5 lakh IU
d. 2 lakh IU
238q: the usual incubation period of pertussis is ?
239q: risk of damage of fetus by maternal rubella is maximum if mother gets infected in ?
a. 6-12 weeks of pregnancy
b. 20-24 weeks of pregnancy
c. 21-25 weeks of pregnancy
d. 32 – 36 weeks of pregnancy
240q: deficienct in weight for height in a 3 year old child indicates
a. acute malnutrition
b. chronic malnutrition
c. concomitant acute and chronic
d. underweight
241q: several studies show that 85 % of cases of lung cancer are due to cigarette smoking . it is a measure of ?
a. incidence rate
b. relative risk
c. attributable risk
d. absolute risk
56 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 46
231q: if the birth weight of each of the babies born in a hospital in a day is found to be 2.8 kgs , then the standard deviation of the sample will be ?
a. 2.8
b. 0
c. 1
d. 0.28
232q: a diagnostic test for a particular disease has a sensitivity of a 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 ?
233q: according to WHO , blindness is defined as a visual acuity of the better eye , less than ?
a. 6/60
b. 5/60
c. 4/60
d. 3/60
234q: the drug of choice for treating cholera in a pregnant women is ?
a. tetracycline
b. doxycycline
c. furazolidine
d. cotrimoxazole
235q: when an intervention is applied to community to evaluate its usefulness , it is termed as a trial for
a. efficacy
b. effectiveness
c. efficiency
d. effect modification
55 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 45
226q: 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 ?
a. 0.01 %
b. 0.05 %
c. 0.1 %
d. 1.0 %
227q: the highest perecentages of PUFAs are present in ?
a. groundnut oil
b. soyabean oil
c. margarine
d. palm oil
In the decreasing order of content of PUFA :
1. SAFFLOWER OIL ,
2. SUNFLOWER OIL,
3. CORN OIL,
4. SOYABEAN OIL,
5. COTTON OIL,
6. MARGARINE OIL,
7. GROUNDNUT OIL,
8. PALM OIL,
9. BUTTER and
10. COCONUT OIL .
228q: a randomized trial comparing efficacy of two regimens showed that difference is statistically significant with P greater than 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-beta
229q: histogram is used to describe ?
a. quantitative data of a group of patients
b. qualitative data of a group of patients
c. data collected on nominated scale
d. data collected on ordinal scale
230q: 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
54 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 44
221q: which of the following is not transmitted by lice ?
a. Q fever
b. Trench fever
c. Relapsing fever
d. Epidemic typhus
222q: true about endemic typhus ?
a. man is the only reservoir of infection
b. flea is a vector of the disease
c. the rash developing into an eschar is characteristic of the disease
d. culture is the diagnostic modality
223q: brucellosis can be transmitted by all of the following modes except ?
a. contact with infected placenta
b. ingestion of raw vegetables from infected farms
c. person to person transmission
d. inhalation of infected dust or aerosol
224q: 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 vectors of infection
225q: 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
53 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 43
216q: 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
217q: the highest percentages of PUFAs are present in ?
a. ground nut oil
b. palm oil
c. margarine
d. soya bean oil
218q: cluster sampling all are true except ?
a. obtained by stratification of population
b. according to study design the sample size will vary
c. can be done by random sampling from groups
d. similar to simple random sampling
219q: the major purpose of randomization in clinical trials is to ?
a. facilitate double blinding
b. help ensure that the study subjects are representative of the general population
c. ensure that the groups are comparable on baseline characterisitics
d. reduce selection bias in allocation of treatment
220q: about IUCD all are true except ?
a. efficiency of lippes loop and copper-T are almost same
b. used as an emergency contraception upto 5 days post exposure
c. LNG IUCD has a life span of 5 years
d. Multiload copper-T belongs to third generation
52 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 42
211q: chronic carrier state is seen in all except ?
a. measles
b. diphtheria
c. herpes
d. cholera
212q: 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
213q: treatment of severe ulnar neuritis in borderline tuberculoid leprosy ?
a. MDT only
b. MDT + steroid
c. Wait and watch
d. MDT + thalidomide
214q: BMI of obese ?
a. 20
b. 30
c. 40
d. 51
215q: a study was conducted on the use of herbal tea in prevention of common cold . data is collected on the number of people who had cold and those who did not have it . the following data is obtained :
| | HERBAL TEA | HERBAL TEA |
| | Consumed | Not consumed |
| Had cold | 12 | 23 |
| Did not have cold | 34 | 38 |
- student – t
- chi square test
- paired – t test
- pearson’s correlation coefficient
51 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 41
206q: the experiment study for which most accurate result is obtained
a. randomized CT with double blinding
b. retrospective cohort study
c. cross sectional study
d. meta analysis
207q: any loss or abnormality of psychological , physiological or anatomical structure or function is ?
a. impairment
b. disability
c. handicap
d. disease
208q: a data is arranged as satisfied , very satisfied , dissatisfied . this is a ?
a. nominal data
b. ordinal data
c. interval data
d. ratio
209q: all can be incenirated except ?
a. cytotoxic waste
b. sharps
c. anatomical waste
d. infectious waste
210q: herd immunity all are true except ?
a. herd structure is constant
b. it is mostly due to subclinical infection
c. can be aquired by immunization
d. spread of epidemic is influenced by it
50 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 40
201q: in RNTCP the method used to confirm cases is ?
a. sputum rapid culture
b. sputum microscopy
c. chest radiograph
d. PCR antibody detection
202q: assessment of impact of iodine supplement therapy in a community is best done by ?
a. goiter in pregnant women
b. goiter in children of age 12-18
c. neonatal thyroxine levels
d. urinary iodine levels in pregnant women
203q: 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
204q: all of the following are indicators included in the Physical Quality Of Life Index ( PQLI ) except ?
a. infant mortality rate
b. life expectancy at age one
c. literacy rate
d. per capital income
205q: 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
49 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 39
196q: chlorine demand is measured by ?
a. horrock’s apparatus
b. chlorimeter
c. double pot
d. berkfeld filter
197q: in a study in UK they found an association between sale of asthmatic drugs and an increase in deaths due to asthma from 1979 to 1990 . this is an example of ?
a. ecological study
b. cohort study
c. case reference study
d. experimental study
198q: a newly found technique for estimating Hb found the values as 9.4, 9.0, 9.3, 12.4, 9.2, ………. 10.3 and 12.2 . by calorimetry the Hb was estimated to be 10.2 gram percent . so the new test has ?
a. low validity and high reliability
b. high validity and high reliability
c. low validity and low reliability
d. high validity and low reliability
199q: problem village is all except ?
a. distance of safe water is greater than 1.6 kilometer
b. depth is more than 16 metres
c. waer is polluted with inorganic substance
d. water infested with guinea worm
200q: best method used to find the difference between a newly found test and gold standard test ?
a. correlation study
b. regression study
c. bland and altman analysis
d. none
48 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 38
191q: SAFE in trachoma programme refers to all except ?
a. screening
b. antibiotics
c. facial cleaning
d. environmental control
192q: endemic ascites is caused by ?
a. afltotoxin B
b. ergot
c. sanguinarine
d. pyrrolizidine
193q: specificity of a test refers to its ability to detect ?
a. true positives
b. true negatives
c. false negatives
d. false positives
194q: socialization of medicine leads to all except ?
a. reduces competition among physicians for clients
b. supported by the state and provides free medical service
c. universal coverage of health services
d. ensures the complete utilization of services by all people
195q: active method to detect undiagnosed cases in apparently healthy people ?
a. screening
b. surveillance
c. case finding
d. notification
47 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 37
186q: chlorine demand is measured by ?
a. horrock’s apparatus
b. colorimeter
c. double pot
d. berkfeld filter
187q: which of the following is not transmitted by lice ?
a. Q fever
b. Trench fever
c. Relapsing fever
d. Epidemic typhus
188q: which of the following statements about lepromin test is false ?
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 the type of leprosy
d. BCG vaccine may convert lepra reaction from negative to positive
189q: true about Accredited Social Health Activist ( ASHA ) is ?
a. mental health worker
b. deployed per thousand people
c. to replace anganwadi worker in ICDS programme
d. minimum need program worker
190q: true about point source epidemic are all except ?
a. the curve has rapid rise and slow decline
b. all cases occur in one incubation period
c. one single peak only
d. no secondary curves
46 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 36
181q: richest source of vitamin D is ?
a. egg
b. milk
c. vegetables
d. fish
182q: which is an example of diability limitation ?
a. resting the affected limb in neutral position
b. arranging for schooling of a child suffering from PPRP
c. reducing occurrence by polio immunization
d. providing calipers for walking
183q: for allocation of control and placebo groups in RCT , which of the following is least useful ?
a. odd and even registration numbers in hospital
b. computerized sequence selection
c. random table
d. drawn by lots
184q: best method to find the difference between a newly found test and the gold standard test ?
a. correlation study
b. regression study
c. bland and altman analysis
d. kongarov smrinov test
185q: least common complication of measles is ?
a. SSPE
b. Pneumonia
c. Otitis media
d. Keratomalacia
45 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 35
176q: 100 women with a mean Hb of 10 gms % . SD is 1 . what is the standard error?
177q: atkins diet is severe restriction of ?
a. carbohydrate
b. protein
c. fat
d. vitamin
178q: LJ chart is used for ?
a. accuracy
b. precision
c. sensitivity
d. specificity
179q: which of the following dietary interventions reduces the further risk in MI patients ?
a. n3 PUFA
b. high fiber diet
c. sterol ester
d. potassium supplement
180q: group of diabetic patients , insulin was administered and long term monitoring of HBA1C level and blood glucose adjusted for age and sex was done . this test is best explained by ?
a. logistic regression
b. linear regression
c. pearson correlation coefficient
d. student T test
44 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 34
171q: which of the following characteristics is not of much significance in a screening test ?
a. high sensitivity
b. high specificity
c. low cost
d. high safety margin
172q: ASHA – which of the following is wrong ?
a. a female health worker
b. one for thousand rural population
c. mobilization for antenatal care
d. skilled birth attendant
173q: when the confidence level of a test increases which of the following will happen ?
a. no change in significance
b. previously significant value becomes insignificant
c. previoiusly insignificant value becomes significant
d. no change in significance results
174q: in which of the following diseases , screening for the disease has greatly reduced the incidence ?
a. carcinoma lung
b. carcinoma colon
c. carcinoma larynx
d. CML
175q: what is standard error ?
a. SD X n
b. SD / n
c. SD / square root of n
d. SD X SD
43 - AIIMS community medicine mcqs or social and preventive medicine mcqs ( spm or psm ) from all previous years AIIMS papers with answers - part 33
166q: target of couple protection rate in WHO goal of HEALTH FOR ALL by 2000 AD is ?
a. 60
b. 40
c. 80
d. 100
167q: magnitude and trend of tuberculosis in a community is assessed by ?
a. fatality rate
b. incidence rate
c. prevalence rate
d. tuberculin conversion index
168q: vector for KFD ?
169q: best indicator of malarial prevalence in community is ?
a. adult parsite rate
b. spleen rate
c. infant parasite rate
d. new cases in community
170q: which intervention is associated with increased birth weight in pregnancy ?
a. bed rest
b. calcium and magnesium supplement
c. cessation of smoking
d. aspirin
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