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Ques 1 incorrect  
All of the following statements are true about methylene blue reduction test
except:
It is an indirect method for detection of microorganisms in milk.
The milk which remains blue the longest is considered to be of the best quality
This test is widely used to check the efficiency of pasteurization.
It is based on the observation that bacteriae growing in milk bring about a

decrease in the colour imparted to milk.
Methylene blue reduction test : It is an indirect method for detection of

microorganisms in milk. The test is carried out on the milk accepted for
pasteurization. It .is based on the observation that bacteriae growing in milk
bring about a decrease in the colour imparted to milk. In conducting the test,
definite quantities of methylene blue are added to 10 ml of milk and the
sample is held at a uniform temperature of 37 deg C until the blue colour has
disappeared. The milk which remains blue the longest is considered to be of
the best quality and a scale of grading different milk samples, on the basis of
the time required to reduce a definite quantity of methylene blue has been
worked out. The test thus serves as confirmation of heavy contamination and
compared with direct counts of bacteriae, it saves time and money.

Tests of pasteurized milk
https://medical.prepladder.com/tests/analytics.php?checksum=ZjA1NzNkYzA2NmYwZDAzNmFmOWU= 1/43
(1) Phosphatase test : This test is widely used to check the efficiency of
pasteurization. The test is based on the fact that raw milk contains an enzyme
called phosphatase which is . destroyed on heating at a temperature which
corresponds closely with the standard time and temperature required for
pasteurization. At 60 deg C for 30 minutes phosphatase is completely
destroyed. Consequently, the test is used. To detect inadequate
pasteurization or the addition of raw milk.
(2) Standard plate count : The bacteriological quality of pasteurized milk is

determined by the standard plate count. Most countries in the West enforce
a limit of 30,000 bacterial count per ml of pasteurized milk.
(3) Coliform count : Coliform organisms are usually completely destroyed by

pasteurization, and therefore, their presence in pasteurized milk is an
indication either of improper pasteurization or post-pasteurization
contamination. The standard in most countries is that coliforms be absent in 1
ml of milk.
Park 24th edition; 693
Zooanthroponoses is:
Infections transmitted from man to lower vertebrate animals
Infections transmitted to man from lower vertebrate animals.
Infections maintained in both man and lower vertebrate animals that may be
transmitted in either direction
None of the above


The zoonoses have been classified in terms of their reservoir hosts, whether
these are men or lower vertebrate animals. Thus, the term anthropo-zoonoses
has been applied to infections transmitted to man from lower vertebrate
animals. The term zooanthroponoses is applied to infections transmitted from
man to lower vertebrate animals; however, these terms have also been used
interchangeably for all diseases found in both animals and man. A third term,
amphixenoses, has been used for infections maintained in both man and
lower vertebrate animals that may be transmitted in either direction.
Park 24th edition 316
Ques 3 correct  
A sexually active, long distance truck driver’s wife comes with vaginal
discharge. Under Syndromic Approach, which drug should be given?
Metronidazole, Azithromycin, Fluconazole
Metronidazole
Azithromycin
Metronidazole and Fluconazole
In this case, the woman has pathological leucorrhea, which can be due to
cervicitis or vaginitis. In case on clinical examination, differentiation was not
possible, both, kits 1 and 2 need to be given. Thus, she needs to be given-
Cefixime, Azithromycin, Fluconazole and Secnidazole. The closest option is A.
National Guidelines on Prevention, Management and Control of


Reproductive Tract Infections and Sexually Transmitted Infections, Maternal
Health Division Department of AIDS Control Ministry of Health and Family
Health Division, Department of AIDS Control, Ministry of Health and Family
Welfare Government of India, July 2014, page 20
The drug of choice for treating Cholera in pregnant women is-
Tetracycline
Doxycycline
Erythromycin
Cotrimoxazole
Erythromycin or azithromycin are recommended as first-line drugs for

pregnant women and children.
PAHO. Recommendations for clinical management of cholera.
http://www.paho.org/hq/index.php?
option=com_docman&task=doc_view&Itemid=0&gid=10813&lang=en
The food poisoning with highest mortality of the following is?
Salmonella food poisoning
Botulism

Staphylococcal food poisoning
Clostridium perfringens food poisoning
Botulism: 30% mortality
Salmonella – 1% mortality
Staphylococcus- mortality is rare
C. perfringens- no deaths reported
park 24/e p/253
Brucellosis can be transmitted by all of the following modes, except-
Contact with infected placenta
Ingestion of raw vegetables from infected farms
Person to person transmission
Inhalation of infected dust or aerosol
Brucellosis is a purely zoonotic disease and is not transmitted from person to

person

(Ref:Park 24/e p/308)
The "mottling" of dental enamel develops when fluorine level exceeds:
1.5 mg/l
3 mg/l
6 mg/l
10 mg/l
Endemic fluorosis
In many parts of the world where drinking water contains excessive amounts
of fluorine (3-5 mg/L), endemic fluorosis has been observed. Endemic fluorosis
has been reported to be an important health problem in certain parts of the
country, e.g., Andhra Pradesh (Nellore, Nalgonda and Prakasam districts),
Punjab, Haryana, Karnataka, Kerala and Tamil Nadu (60). The toxic.
manifestation of fluorosis comprise the following:
(a) Dental fluorosis : Fluorosis of dental enamel occurs when excess fluoride is
ingested during the years of tooth calcification - essentially during the first 7
years of life It is characterized by "mottling" of dental enamel which has been
reported at levels above 1.5 mg/L intake The teeth lose their shiny
appearance and chalkwhite patches develop on them. This is the early sign
of dental fluorosis. Later the white patches become yellow and sometimes
brown or black. In severe cases, loss of enamel gives the teeth a corroded
appearance. Mottling is best seen on the incisors of the upper jaw. It is almost
entirely confined to the permanent teeth and develops only during the
period of formation

(b) Skeletal fluorosis : This is associated with lifetime daily intake of 3.0 to 6.0
mg/Lor more (102). There is heavy fluoride deposition in the skeleton. When a
concentration of 10 mg/Lis exceeded crippling fluorosis can ensue It leads
concentration of 10 mg/Lis exceeded, crippling fluorosis can ensue. It leads
to permanent disability.
(c) Genu valgum : A new form of fluorosis characterized by genu valgum and
osteoporosis of the lower limbs has been reported in some districts of Andhra
Pradesh and Tamil Nadu. The syndrome was observed among people whose
staple was sorghum (jowar). Further studies showed that diets based on
sorghum promoted a higher retention of ingested fluoride than do diets
based on rice.
The desirable daily intake of dietary fibre per 2000 kcal is :
20 g
40 g
60 g
80 g
DIETARY FIBRE
Fibre have no metabolic effects. However, too much of fibre can decrease
the absorption of valuable micronutrients. There is conflicting evidence as to
whether fibre tends to bind some vitamins and minerals like calcium,
magnesium, iron and zinc, and reduce their bio-availability. People who eat
well-balanced diet obtain enough roughage. Considering the qualitative
and quantitative decrease in fibre content of diet over the past many

decades, an increase in dietary fibre, particularly from cereals emerge as a
recommendation. Intake in excess of 60 g of fibre over a day can reduce the
7/10/2018
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nutrient absorption and cause bowel irritation. A daily intake of about 40

grams of dietary fibre per 2000 kcal is desirable. The actual quantity of fibre
intake depends upon the nature of cereals, pulses, whole grain, vegetables
and millets used
Diet high in …………may increase the risk of cancer
Carbohydrates
Artificial sweeteners
Fats
Proteins
DIETARY RISK FACTORS:
Dietary factors are also related to cancer.

Smoked fish is related to stomach cancer, dietary fibre to intestinal cancer,
beef consumption to bowel cancer and a high fat diet to breast cancer
A variety of other dietary factors such as food additives and contaminants
have fallen under suspicion as causative agents.
Park’s text book of preventive and social medicine. 23rd edition.p 385

Q 10
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The net protein utilization is defined as-
The gain in weight of young animals per unit weight of protein consumed
The product of digestibility coefficient and biological value
The percentage of protein absorbed into the blood
The percentage of nitrogen absorbed from the protein absorbed from the diet
The gain in weight of young animals per unit weight of protein consumed is
protein efficiency ratio
The percentage of protein absorbed into the blood is digestibility coefficient
(ref-park 24th/e, p/648)
In case of meningiococcal meningitis carrier which antibiotic is used to

eradicate carrier stage?
Ampicillin
Erythromycin
Rifampicin
Amikacin 
Treatment with penicillin does not eradicate the carrier state; more powerful
antibiotics such as rifampicin are needed to eradicate the carrier state
24 ed Park p 176
Soil acts as reservoir of infection for all of the following, except-
Tetanus
Anthrax
Coccidiomycosis
Dracunculiasis
In Dracunculiasis the reservoir of infection is Human being.
The continent(s) free of Rabies is/are –
Antartica

Australia
Both of the above
None of the above
Certain islands are free of rabies like Japan, Australia, Antartica
Which of the following city in India has a Central Leprosy Teaching and
Training Institute
Chingelpettu
Madurai
Mysore
Hyderabad
Research into the basic problems of leprosy is also part of the activities of the
NLEP. This is mainly carried out in the Government sector, viz. the Central
JALMA Institute of Leprosy at Agra and the Central Leprosy Teaching and
Training Institute at Chingelput, Chennai supported by Regional Training and
Referral Institutes at Aska (Orissa), Raipur (Chhattisgarh) and Gouripur (West
Bengal).

24th edition of Park p 445
Jhunjhunia seeds contain which of the following toxin?
Sanguinarine
Pyrolizidine alkaloids
Beta oxalyl amino alanine
Aflatoxins
Endemic ascites
In Kusmi Block of Sarguja district in Madhya Pradesh,during 1973 and again

during 1976, an outbreak of rapidlydeveloping ascites and jaundice was
reported among theNagesiatribals. Both the sexes and all the age groups,
exceptinfants, were affected. The overall mortality was 40 per cent.Studies
conducted by the National Institute of Nutrition,Hyderabad showed that the
local population subsist on themillet Panicummiliare (known locally as
Gondhli) which gets contaminated with weed seeds of Crotalaria (locally
known as Jhunjhunia).On chemical analysis.Jhunjhunia seedswere found to
contain pyrrolizidinealkaloids which arehepatotoxins.
The preventive measures comprise educating the peoplein the affected

areas about the disease, deweeding of theJhunjhuniaplants which grow
along with the staple, andsimple sieving of the millet at the household level to
remove the seeds of Jhunjhuniawhich are considerably smaller thanthose of
the millet.
Park 24th edition; 695 

Which of the following statements is not correct under Baby friendly hospital
initiative?
Have a written breast-feeding policy that is routinely communicated to all health

care staff
Train all health care staff in skillsnecessary to implement this policy
Help mothers initiate breast-feeding within one and half hour of birth
Show mother, how to breast-feed and maintain lactation, even if they should be
separated from their infants
Baby friendly hospital initiative→
→Have a written breast-feeding policy that is routinely communicated to all

health care staff
→ Train all health care staff in skillsnecessary to implement this policy
→ Help mothers initiate breast-feeding within half hour of birth
→ Show mother, how to breast-feed and maintain lactation, even if they

should be separated from their infants
24 ed Park p 575


Weight divided by height raised to 2 is used as an index known as?
Broca’s index
Quetelet Index
Ponderal’s Index
Corpulence Index
Weight divided by the square of height in meters is BMI or Body Mass Index. It
is also called as Quetelet Index.
park 24/e p/418
Egg contain all the vitamins except
Vitamin A
Vitamin E
Vitamin C
Vitamin D
Egg
Egg contains all the nutrients except carbohydrate and vitamin C. About 12

per cent of egg is made of shell, 58 per cent of egg white, and 30 per cent of
egg yolk. An egg weighing 60 grams contains 6 g of protein, 6 g of fat, 30 mg
egg yolk. An egg weighing 60 grams contains 6 g of protein, 6 g of fat, 30 mg
of calcium and 1.5 mg of iron, and supplies about 70 kcal of energy. Egg
proteins have all the nine essential amino acids needed by the body in right
proportions. Nutritionists consider egg protein as the best among food
proteins. In fact, egg protein is the standard against which the quality of other
proteins is compared. Except for vitamin C, egg contains all the fat-soluble
and water-soluble vitamins in appreciable amounts. Important minerals such
as calcium, phosphorus, iron, zinc and other trace elements are present in the
egg. Barring milk, no other food can supply such a diverse range of nutrients.
Net protein utilization (NPU) which combines in a single value the biological
value and digestibility, is 100 for egg compared to 80 for meat and 75 for milk.
Raw egg white is not assimilated by the intestinal mucosa, therefore it must
be cooked before consumption. Boiling destroys 'avidin', a substance which
prevents the body from obtaining biotin, one of the B-complex vitamins.
Boiled egg is therefore nutritionally superior to raw egg. In recent years the
cholesterol content of egg (250 mg/egg) has generated a sense of fear
because of the risk of CHD. A reduction in intake of eggs is advised for those
at risk of CHD. This should not distract others from eating eggs. Eggs or no
eggs, cholesterol is formed in the body endogenously and is controlled by
what is known as feedback mechanism
Final cure of Kala-azar is defined as
Any initially cured patient who is symptom-free at one month after the end of
treatment.
Any initially cured patient who is symptom-free at Four months after the end of
treatment.
Any initially cured patient who is symptom-free at Six months after the end of 
treatment.
Any initially cured patient who is symptom-free at one year after the end of
treatment
Case definition of kala-azar: A case of kala-azar is defined as a person from

an endemic area with fever of more than 2 weeks duration and with
splenomegaly, who is confirmed by an RDT or a biopsy.
Treatment outcome definitions of kala-azar
a. Cure: a patient is considered clinically cured if he/ she has completed full
treatment and there are no signs and symptoms of kala-azar.
b. Non-response: Signs and symptoms persist or recur despite satisfactory

treatment for more than two weeks.
c. Relapse:: any reappearance of kala-azar signs and symptoms within a

period of six months after the end of treatment.
d. Treatment failure : non-response or relapse.
e. Final cure : an initially cured patient who is symptom-free at six months
after the end of treatment.
Case definition of PKDL
a. Probable PKDL : a patient from kala-azar endemic area with multiple
hypopigmented macules, papules or nodules, who is RDT positive.
b. Confirmed PKDL : a patient from kala-azar endemic area with multiple
hypopigmented macules, papules, plaques or nodules, who is parasite
positive in slitskin smear (SSS) or biopsy

All vaccines containing mineral carriers or adjuvants should be injected?
Subcutaneous
Intradermal
Intramuscular
Oral
Mode of administration : All vaccines containing mineral carriers or adjuvants

should be injected deep intramuscular. This applies to DPT also which may be
given in the upper and outer quadrant of the gluteal region. One of the
principal recommendations of the 1984 Global Advisory Group is that
"especially for children under one year of age, DPT should be administered in
(lateral aspect)the thigh
24 ed park p 172
All of the following statements about scrub typhus are true, except:
Caused by O. tsutsugamushi
Mites as reservoirs
Transmitted when adult mites feed on hosts
Tetracycline is the drug of choice


Mites act as Reservoirs of infection The true reservoir of infection is the

‘trombiculid mite’ belonging to the genus ‘Leptorombidium’ The infection is
maintained in nature trans – ovarially from one generation of mite to the next.
The larval stage of mite serves both, as a reservoir and as a vector for
infecting humans.
Park 24/e p/317
The number of maternal deaths in a given period time period per 100,000 live
births during the same time-period is known as:
Maternal mortality ratio
Maternal mortality rate
Adult lifetime risk of maternal death
The proportion of maternal deaths of women of reproductive age
Statistical measures of maternal mortality:

Maternal mortality ratio : Number of maternal deaths during a given time
period per 100,000 live births during the same time-period.
Maternal mortality rate : Number of maternal deaths in a given period per
100,000 women of reproductive age during the same time-period.
Adult lifetime risk of maternal death : The probability of dying from a maternal
cause during a woman's reproductive lifespan.
The proportion of maternal deaths of women of reproductive age (PM) : The
number of maternal deaths in a given time period divided by the total
deaths, among women aged 15-49 years.

Which of the following diet plans is to stop hypertension?

The paleo diet

The DASH diet

The Dukan diet
The Atkins diet

The DASH (Dietary approach to stop Hypertension) diet is based on the
research studies: Dietary Approaches to Stop Hypertension, and has been
proven to lower blood pressure, reduce cholesterol, and improve insulin
sensitivity. Blood pressure control with the DASH diet involves more than just
the traditional low salt or low sodium diet advice. It is based on an eating
plan proven to lower blood pressure, a plan rich in fruits, vegetables, and low-
fat or nonfat dairy. It emphasizes whole grains and contains less refined grains
compared with a typical diet. It is rich in potassium, magnesium, calcium,
and fiber.

THE other 3 are well known diet plans to reduce weight .
https://www.healthline.com/nutrition/9-weight-loss-diets-reviewed

Vagabond disease is transmitted by:-
Louse
Mite
Tick
Black fly
Vagabond disease refers to cutaneous infestation with lice.
Textbook of Public Health and Community Medicine, R Bhalvar, pg 945
In Measles, when do the Koplik’s spots appear?
On the day that fever occurs
On the day that rashes appear
1-2 days before the rashes appear
1-2 days before the fever occurs
Koplik’s spots are bluish-white spots, on the buccal mucosa opposite the first
and second lower molars. They are seen 1-2 days before the appearance of

rash
Park 24/e p/157
The prolonged pregnancy is referred to
5 days after expected dateof delivery
RISK APPROACH
The central purpose of antenatal care is to identify "high risk" cases {as early
as possible) from a large group of antenatal mothers and arrange for them
skilled care, while continuing to provide appropriate care for all mothers.
These are following:
Elderly primi (30 years and over)
Short statured primi (140 cm and below)
Malpresentations, viz breech, transverse lie, etc.
Antepartum haemorrhage, threatened abortion
Pre-eclampsia and eclampsia
Anaemia
Twins, hydramnios
Previous still-birth, intrauterine death, manual removal of placenta
Elderly grandmultiparas
Prolonged pregnancy (14 days-after expected date of delivery)
History of previous caesarean or instrumental delivery 
Pregnancy associated with general diseases, viz. cardiovascular disease,
kidney disease diabetes tuberculosis liver disease malaria convulsions
kidney disease, diabetes, tuberculosis, liver disease, malaria, convulsions,
asthma, HIV, RT!, ST!, etc.
Treatment for infertility.
Three or more spontaneous consecutive abortions
The "risk approach" is a managerial tool for improved MCH care
Leishmaniasis is transmitted by
Sandfly
Rat Flea
Tse-tse fly
None of the above
Leishmaniasis are a group of protozoa! diseases caused by parasites of the

genus Leishmania, and transmitted to man by the bite of female
phlebotomine sandfly.


Azithromycin mass treatment is given in community when prevalence of
Trachoma is more than:-
5%
6%
8%
10%
Mass chemoprophylaxis with Azithromycin is recommended when the

prevalence of Trachoma is more than 5%.
Park 24/e p/327
Secondary attack rate in unimmunized household contacts of pertussis is

about?
60
70
80
90
SECONDARY ATTACK RATE : Averages 90 per cent in unimmunized household


contacts
24 ed Park p 173
Smear examined for TB by one microbiologist should not exceed_____ per

day?
10
20
30
40
Laboratory technicians should examine both the sputum samples from each
TB suspect. They must record the result of each sputum sample with the
laboratory reference number in the laboratory register and on the sputum
request form. Results, as indicated above, are made available to the clinician
who can then categorize the patient.
It is advised that the smear examined by one microscopist should not exceed
20 per day as visual fatigue leads to a deterioration of reading quality
Park 24ed p 192
Ques 31 unattempted  


Ponderal index of baby of 2000gm and 50 cm?
16
1.6
2.2
2.6
Ponderal Index= Weight (kg) /cube of Height (meters)
Textbook of Community Medicine and Public Health, R Bhalvar, 874
Under Mid-day meal scheme, the cooked mid-day meal should provide
minimum of
200 cal& 6-8 gm protein
Mid-day meal scheme
Mid-day meal scheme is also known as National Programme of Nutritional


Support to Primary Education. It was launched as a centrally sponsored
scheme on 15th August 1995 and revised in 2004. Its objective being
universalization of primary education by increasing enrolment, retention and

attendance and simultaneously impacting on nutrition of students in primary
classes. It was implemented in 2,408 blocks in the first year and covered the
whole country in a phased manner by 1997-98. The programme originally
covered children of primary stage {classes I to V) in· government, local body
and government aided schools and was extended in Oct. 2002, to cover
children studying in Education Guarantee Scheme andAlternative and
Innovative Education Centres also.The central assistance provided to states
under theprogramme is by way of free supply of food grain fromnearest Food
Corporation of India godown at the rate of100 g. per student per day and
subsidy for transport of foodgrain. To achieve the objective, a cooked mid-
day meal withminimum 300 Calories and 8 to 12 grammes of proteincontent
will be provided to all the children in class I to V.
According to International health regulations, there is no risk of spread of

Yellow fever, if the aedes aegypti index remains below
1%
5%
8%
10%
To contain international spread of disease through the entry of the infected

mosquitoes in the aircrafts and seacrafts, it is mandated under International

health regulations to keep the airports and seaports and surrounding are free
of aedes mosquitoes with aedes aegypti index below 1
Park24th ,page301
The IQ scoring 70-84 is classified as
Mild mental retardation
Moderate mental retardation
Severe mental retardation
None of the above
Categories of mental retardation
Psychologists have used the concept of IQ to classify the degree of mental

retardation. The IQ scores rest on the assumption that intelligence distribution
in the general public follow the normal or Gaussian curve, with a mean of
100. The half of the general population achieve scores above 100, and one
half below. The lower 3 per cent or so of the population achieve scores of 70
or less. They are usually considered to be mentally retarded. The WHO gave
the following classification of mental retardation :
Mild mental retardation IQ 50-70
Moderate mental retardation IQ 35-49
Severe mental retardation IQ 20-34
Profound mental retardation IQ under 20
Children scoring above 70 are no longer described as mentally

handicapped.

In school health service, one urinal should be provided for:
40 students
60 students
80 students
100 students
School Environment
Site : The site should be on suitable high land, and not subject to inundation
or dampness and can be properly drained. The School Health Committee
(1961) had recommended that 10 acres of land be provided for higher
elementary schools and 5 acres for primary schools with an additional one
acre of land per 100 students. In congested areas, the nearest public park or
playground should be made available to the students.
Structure : Nursery and secondary schools, as far as possible, be single storied.

Exterior walls should have a minimum thickness of 10 inches and should be
heat resistant.
Classroom :No classroom should accommodate more than 40 students. Per

capita space for students in a classroom should not be less than 10 sq. ft.
Furniture : Furniture should suit the age group of students. It is desirable to

provide single desks and chairs.Desks should be of "minus" type. Chairs should
be provided with proper back-rests, with facilities for desk-work.

Doors and windows: The windows should be broad with the bottom sill, at a
height of 2'-6" from the floor level; combined door and window area should
be at least 25 per cent of the floor space; windows should be placed on
different walls for cross-ventilation; the ventilators should not be less than 2 per
cent of the floor area.
Color : Inside color of the classroom should be white and should be

periodically white-washed.
Lighting : Classrooms should have sufficient natural light, preferably from the
left,and should not be from the front.
Water supply: There should be an independent source of safe and potable

water supply, which should be continuous, and distributed from the taps.
Eating facilities : Vendors other than those approved by the school authorities
should not be allowed inside school premises; there should be a separate
room provided for mid-day meals.
Lavatory : Privies and urinals should be provided - one urinal for 60 students
and one latrine for 100 students. Arrangements should be separately made
for boys and girls.
All of the following sites are used for measuring skin fold thickness to assess
obesity except-
Mid-triceps
Biceps
Subscapular 
Anterior abdominal wall
The sites recommended for measuring skin fold thickness are mid-triceps,
biceps, subscapular and supra-iliac.
Park 24th/e, p/418
The WHO case definition for AIDS surveillance (> 12 years of age) includes
the following major signs to diagnose AIDS, except
Persistent cough for more than 1 month
Prolonged fever for more than 1 month
Weight loss ≥ 10% of body weight
Chronic diarrhoea for more than 1 month
For the purposes of AIDS surveillance an adult or adolescent (> 12 years of

age) is considered to have AIDS if at least 2 of the following major signs are
present in combination with at least 1 of the minor signs listed below, and if
these signs are not known to be due to a condition unrelated to HIV infection.
Major signs: weight loss > 10% of body weight, chronic diarrhoea for more
than 1 month, prolonged fever for more than 1 month (intermittent or
constant).
Minor signs: persistent cough for more than 1 month, generalized pruritic
dermatitis, history of herpes zoster, oropharyngeal candidiasis, chronic 
progressive or disseminated herpes simplex infection, generalized
lymphadenopathy
lymphadenopathy.
Which of following Parameter is found to be elevated in Kwashiorkor disease?
Serum albumin
Urinary urea per g creatinine
Hydroxyproline /creatinine ratio
Plasma/amino acid ratio
park 24th edition; 677


Which of the following statements regarding hepatitis B vaccine is false?
Neither pregnancy nor lactation is a contraindication for use of this vaccine
Hepatitis B vaccine is contraindicated for individuals with a history of allergic

reactions to any of the vaccine's components
The vaccine.should be stored at 2-8°C.
Freezing must be done as it associates antigen from the alum adjuvant
Hepatitis B vaccine is contraindicated for individuals with a history of allergic

reactions to any of the vaccine's components. Neither pregnancy nor
lactation is a contraindication for use of this vaccine. The vaccine.should be
stored at 2-8°C. Freezing must be avoided as it dissociates antizen from the
alum adjuvant.
24 ed Park p 231
Ques 40 unattempted  
All of the following has live births as denominator except:
Neonatal mortality rate
Post-neonatal mortality rate

Perinatal mortality rate
Perinatal mortality rate
Child death rate
Neonatal mortality rate: Number of deaths of children under 28 days of age

in a year X 1000
Total live births in the
same year
Post-neonatal mortality rate:
Number of deaths of children between 28 days and one year of age in a

given year X 1000
Total live births in the same year
Child death rate = No.of deaths of children aged 1-4 years during a year X
1000
Total no. of children aged 1-4 years at the middle of
the year
The predominant route of HIV transmission in India is
Injecting drug users
Blood and blood products
Heterosexual
Parent to child

The route of transmission of HIV in India is still predominantly heterosexual (88.2

%) followed by parent top child (5%), injecting drug users (1.7%), homosexual
(1.5%), blood and blood products (1%) and unknown (2.7%).
To eradicate Measles, the percentage of infant population to be vaccinated

is atleast
70%
80%
85%
95%
The herd immunity for achieving Measles elimination/eradication is possible

when atleast 95% of the population is immunized
Park 24/e p/159
Which of the following statements regarding botulism is true except? 

Incubation Period 18 to 36 hours.
If the heating of food (with botulism toxin) which may be subjected to 100 deg. C
for a few minutes before use will be still unsafe for consumption
The foods most frequently responsible for botulism are home preserved foods such
as home-canned vegetables, smoked or pickled fish
The prominent symptoms are dysphagia, diplopia, ptosis, dysarthria, blurring of

vision, muscle weakness and even quadriplegia
Most serious but rare. It kills two-thirds of its victims.

Agent: Exotoxin of Clostridium botu/inum generally Type A, B or E.
Source: The organism is widely distributed in soil, dust and the intestinal tract
of animals and enters food as spores. The foods most frequently responsible
for botulism are home preserved foods such as home-canned vegetables,
smoked or pickled fish, homemade cheese and similar low acid foods. In
fact, botulism derives its name from the Latin word for sausage (botulus).
Incubation Period 18 to 36 hours.
Mechanism of Food Poisoning: The toxin is preformed in food ("intradietetic")
under suitable anaerobic conditions. It acts on the parasympathetic nervous
system. Botulism differs from other forms of food poisoning in that the
gastrointestinal symptoms are very slight. The prominent symptoms are
dysphagia, diplopia, ptosis, dysarthria, blurring of vision, muscle weakness and
even quadriplegia. Fever is generally absent, and consciousness is retained.
The condition is frequently fatal, death occurring 4-8 days later due to
respiratory or cardiac failure. Patients who recover do not develop antitoxin
in the blood. Since the toxin is thermolabile, the heating of food which may
be subjected to 100 deg. C for a few minutes before use will make it quite
safe for consumption.
Park 24 ed., Page 253

Under the national program of control of blindness in India, medical colleges

are classified as eye centers of-
Primary level
Secondary level
Tertiary level
Intermediate level
Medical colleges are training centers in Vision 2020 human resource structure
Park 24/e p/459


JE is transmitted by
Culex
Aedes
Anopheles
Mansonia
JE is transmitted by Culex tritaenerhyncus or Culex vishnui
Park24th ,page302-305
Jai Vigyan Mission Mode project is related to which disease
Coronary heart disease
Hypertension
Rheumatic heart disease
Diabetes
Explanation- In India, RHD is prevalent in the range of 5-7 perthousand in 5-15

years age group and there are about 1 million RHD cases in India. RHD
constitutes 20-30% ofhospital admissions due to CVD in India .
Streptococcalinfections are very common especially in children livingin 
under-privileged conditions, and RF is reported to occurin 1-3 per cent of
those infections Jai Vigyan Mission Mode project on Community Controlof RF
those infections .Jai Vigyan Mission Mode project on Community Controlof RF
/RHD in India is being carried out with four maincomponents, viz. to study the
epidemiology of streptococcal sore throats, establish registries for RF and
RHD, vaccine development for streptococcal infection and conducting
advanced studies on pathological aspects of RF and RHD
Park’s text book of preventive and social medicine. 23rd edition.p 379
A person has received complete immunization against tetanus 10 years ago.

Now he presents with a clean wound without any lacerations from an injury
sustained 3 hours ago. He should be given-
Full course of tetanus toxoid
Single dose of tetanus toxoid
Human tetanus immunoglobulin
Human tetanus immunoglobulin and single dose of tetanus toxoid
This person was vaccinated 10 years ago. The injury is not severe and the
patient has not yet developed Tetanus. Taking this into consideration a single
dose of Tetanus Toxoid is sufficient.
Ques 48 correct

 
Which of the following statements regarding diagnosis of TB in people with

HIV is false?
HIV positive people with pulmonary tuberculosis may have a higher frequency of
negative sputum smears.
Chest radiography is useful in people with HIV because they have more cavitation.
The tuberculin skin test often fails to work in people who are HIV positive
Cases of extra-pulmonary tuberculosis seem to be more common in people who

are co-infected.
Diagnosis of tuberculosis in people with HIV In most people in the early stages
of HIV infection,symptoms of tuberculosis are similar as in people without HIV
infection. In areas where many people have HIV infection, tuberculosis
programmes should continue to focus on identifying infectious sputum-smear-
positive cases through microscopy. However, diagnosis of tuberculosis in
individual patients using the standard diagnostic tools can be more difficult if
they have advanced HIV infection because:
(a) HIV positive people with pulmonary tuberculosis may have a higher
frequency of negative sputum smears.Confirming the diagnosis may require
sputum culture.
(b) The tuberculin skin test often fails to work in people who are HIV positive
because it relies on measuring the response of a person's immune system. If
the immune system has been damaged by HIV, it may not respond even
though the person is infected with tuberculosis. HIV positive people with
tuberculosis, therefore, have a higher frequency of false negative tuberculin
skin test results.
(c) Chest radiography may be less useful in people with HIV because they
have less cavitation. Cavities usually develop because the immune response
to the tubercular bacilli leads to some destruction of lung tissue. In people
with HIV, who do not have a fully functioning immune system, there is less
tissue destruction and hence less lung cavitation.
{d) Cases of extra-pulmonary tuberculosis seem to be more common in

people who are co-infected.
24 ed park p 207
In yellow color coding for anaemia under IMNCI follow up is done in?
2 days
5 days
7 days
14 days
Severe palmar pallor Severe anaemia Refer urgently to hospital
Give iron folic acid

therapy for 14 days
Assess the child’s feeding
and counsel the mother
on feeding.
Some palmar pallor Anaemia - If feeding

problem, follow up in 5
days.
advise mother when to
return immediately
follow up in 14 days

Give prophylactic iron
No palmar pallor No anaemia folic acid if child 6
No palmar pallor No anaemia folic acid if child 6
months or older.
Park 24 ed p 641
Which one of the following statements about influence of smoking on risk of

coronary heart disease is not true?
Risk of death from CHD decreases from cessation of smoking
Filters provide a protection against CHD
Influence of smoking is synergistic to other risk factors for CHD
Influence of smoking is directly related to number of cigarettes smoked per day
Filters do not provide protection against the harmful effects of smoking.
Park 24th/e,p/386
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Ques 1 incorrect  

It is an indirect method for detection of microorganisms in milk.

This test is widely used to check the efficiency of pasteurization.

It is based on the observation that bacteriae growing in milk bring about a

Methylene blue reduction test : It is an indirect method for detection of

(2) Standard plate count : The bacteriological quality of pasteurized milk is

(3) Coliform count : Coliform organisms are usually completely destroyed by

Park 24th edition; 693

Ques 2 incorrect  

Infections transmitted from man to lower vertebrate animals

Infections transmitted to man from lower vertebrate animals.

None of the above

Park 24th edition 316

Ques 3 correct  

Metronidazole, Azithromycin, Fluconazole

Metronidazole and Fluconazole

National Guidelines on Prevention, Management and Control of

Ques 4 correct  

The drug of choice for treating Cholera in pregnant women is-

Erythromycin or azithromycin are recommended as first-line drugs for

PAHO. Recommendations for clinical management of cholera.

Ques 5 correct  

The food poisoning with highest mortality of the following is?

Salmonella food poisoning

Staphylococcal food poisoning

Clostridium perfringens food poisoning

Botulism: 30% mortality

Staphylococcus- mortality is rare

C. perfringens- no deaths reported

park 24/e p/253

Ques 6 correct  

Brucellosis can be transmitted by all of the following modes, except-

Contact with infected placenta

Ingestion of raw vegetables from infected farms

Person to person transmission

Inhalation of infected dust or aerosol

Brucellosis is a purely zoonotic disease and is not transmitted from person to

Ques 7 incorrect  

The "mottling" of dental enamel develops when fluorine level exceeds:

Park 24th edition; 682

Ques 8 correct  

The desirable daily intake of dietary fibre per 2000 kcal is :

nutrient absorption and cause bowel irritation. A daily intake of about 40

Park 24th edition; 652

Ques 9 incorrect  

Diet high in …………may increase the risk of cancer

DIETARY RISK FACTORS:

Dietary factors are also related to cancer.

The net protein utilization is defined as-

The product of digestibility coefficient and biological value

The percentage of protein absorbed into the blood

The percentage of protein absorbed into the blood is digestibility coefficient

(ref-park 24th/e, p/648)

Ques 11 correct  

In case of meningiococcal meningitis carrier which antibiotic is used to

Ques 12 incorrect  

Soil acts as reservoir of infection for all of the following, except-

In Dracunculiasis the reservoir of infection is Human being.

(Ref:Park 24/e p/101)

Ques 13 correct  

The continent(s) free of Rabies is/are –