11 Community Medicine

VVK11-001
What is the full form of following abbreviations of national programs?

a. IMNCI
b. NSSK
c. VHNDs
d. HBNC
e. JSY
f. JSSK
g. RBSK

Answer

a. IMNCI: Integrated Management of Neo-natal and Childhood Illness
b. NSSK: Navjaat Shishu Suraksha Karyakram
c. VHNDs: Village Health and Nutrition Days
d. HBNC: Home Based Newborn Care
e. JSY: Janani Suraksha Yojana
f. JSSK: Janani Shishu Suraksha Karyakram
g. RBSK: Rashtriya Bal Swasthya Karyakram

VVK11-002
National institute of nutrition.

a. Where is it located?
b. Mention 2 centers working under NIN.
c. State TRUE or FALSE:
- i. Gives special reference to protein energy malnutrition
- ii. Was established in 1918
- iii. Had previous names as 'Beri-Beri' enquiry unit, deficiency disease enquiry, nutrition research laboratories.

Answer

a. Hyderabad
b. Food And Drug Toxicology Research Centre (FDTRC) in 1971, National Nutrition Monitoring Bureau (NNMB) in 1972 and National Centre for Laboratory Animal Sciences (NCLAS) in 1976
c. i. True, ii. True, iii. True

VVK11-003
NACO

a.	Was launched in
b.	Provide leadership through HIV/AIDS prevention and control Societies
c.	Year of NACP-I ()
d.	Year of NACP-II ()
e.	Is a division of
f.	What are goals and objectives of NACO-4.

Answer

a. Was launched in: 1992
b. Provide leadership through 35 HIV/AIDS Prevention and Control Societies
c. Year of NACP-I: (1992–1999)
d. Year of NACP-II: (1999–2006)
e. Is a division of the Ministry of Health and Family Welfare
f. Goals and Objectives:
- Objective 1: Reduce new infections by 50% (2007 Baseline of NACP III)
- Objective 2: Comprehensive care, support and treatment to all persons living with HIV/AIDS

VVK11-004
UIP Significant milestones - Mention the year:

a. Expanded program of immunization
b. UIP was launched
c. Measles was launched
d. Vitamin A was launched
e. Hepatitis B was added

Answer

a. Expanded program of immunization: 1978
b. UIP was launched in: 1985
c. Measles was launched in: 1985
d. Vitamin A was launched in: 1990
e. Hepatitis B was added in: 2007

VVK11-005
Japanese Encephalitis (JE vaccine) vaccine

a. True / False:
- i. Is a part of UIP
- ii. Was introduced in 112 endemic districts in campaign mode in phased manner
b. What is the most vulnerable age group?
- i. 0–1 Year
- ii. 1–5 Year
- iii. 5–10 Year
- iv. 10–15 Years
c. Enlist 5 focus states.
d. Enlist 4 states where JE Vaccination was provided in 2013–14.

Answer

a. i. True, ii. True
b. ii. 1–5 years
c. Assam, Bihar, Tamil Nadu, Uttar Pradesh and West Bengal
d. Bihar, Tamil Nadu, Karnataka, West Bengal

VVK11-006
Answer the following questions.

a. National Malaria Control Program (NMCP) was launched in India in _______ year.
b. National Malaria Eradication Program (NMEP) was launched in ________ year.
c. Name the four phases of NMEP.
d. Modified plan of operation under NMEP came into force from ______ year.
e. Endemic areas under modified plan of operation under NMEP is defined as annual parasite index (API) > ________.
f. Within the modified plan of operation an additional component known as "P. falciparum containment program" has been introduced from October 1977, through the assistance of ________________________ agency.

Answer

a. 1953
b. 1958
c. (i) Preparatory (ii) Attack (iii) Consolidation (iv) Maintenance.
d. 1977
e. 2
f. Swedish International Development Agency (SIDA).

VVK11-007
Answer the following questions.

a. When was National Tuberculosis Control Program started?
b. When was Revised National Tuberculosis Control Program started?
c. Under RNTCP treatment services will be made most accessible to the patients with a view to achieve a cure rate of at least ________% amongst all newly detected sputum positive cases.
d. In tuberculosis control program DTC stands for _________________.
e. One tuberculosis unit will function as managerial unit for __________________ lakh population. In tribal area, the population it caters to, is ______________ lakhs.

Answer

a. 1962
b. 1992
c. 85%
d. District Tuberculosis Center.
e. 5 lakhs; (in tribal area: 2.5 lakhs).

VVK11-008
National programs.

a. Define 'Problem Village' as described under National Water Supply and Sanitation Program.
b. Name four components of Minimum Needs Program (out of 8 components).
c. Name the technique invented by Environmental Engineering Research Institute Nagpur for defluoridation of water.

Answer

a. Problem village is one where:
- i. No source of safe water is available within distance of 1.6 km.
- ii. Where water is available at depth more than 15 meters.
- iii. Water source has excess of salinity, iron, fluorides and other toxic elements.
- iv. Water is exposed to risk of cholera.
b. Components of Minimum Needs Program:
- i. Rural health
- ii. Rural water supply
- iii. Rural electrification
- iv. Elementary education
- v. Adult education
- vi. Nutrition
- vii. Environmental improvement of urban slums
- viii. Houses of landless laborers
c. Nalgonda technique.

VVK11-009
Answer the following regarding Child Survival and Safe Motherhood (CSSM) program.

a. When was it initiated?
b. Name five child survival components of CSSM program.
c. Which drug does CSSM drug kit supply and for what purpose?

Answer

a. Initiated in 1992.
b. Child survival components:
- i. Neonatal care
- ii. Immunization
- iii. Vitamin A deficiency control and prophylaxis
- iv. Diarrhea control and ORT
- v. ARI control and therapy
c. Cotrimoxazole (for treatment of acute respiratory infections/pneumonia by trained peripheral health workers).

VVK11-010
Yearly data (for year 2000) pertaining to deliveries and their outcome in a community is as follows:

No. of total births: 10,000
No. of still births: 80
No. of preterm deliveries: 1500
No. of newborn deaths:
- In first week of life: 320
- During 2 to 4 weeks of life: 180
No. of deaths during first year of life: 500

Calculate perinatal and neonatal mortality rates for this community, demonstrating the steps taken to arrive at the results.

Answer

Perinatal Mortality Rate (PMR):
$P M R = \frac{80 + 320}{10, 000} \times 1000 = 40 per 1000 total births$
Neonatal Mortality Rate (NMR):
$N M R = \frac{320 + 180}{10, 000 - 80} \times 1000 \approx \frac{500}{10, 000} \times 1000 = 50 per 1000 live births$

VVK11-011
Answer the following questions.

a. Name different measures practiced for ensuring enhanced child survival under the CSSM program.
b. Name prophylactic measures advocated under the National Nutritional Anemia Control Program to reduce prevalence of anemia in children.
c. What measures are practiced by health care workers to improve nutrition of children under the ICDS?

Answer

a. Immunization, management of diarrhea with ORS, treatment of acute respiratory infections, vitamin A supplementation, essential newborn care.
b. Iron & Folic Acid supplements for at least 100 days of the year (Elemental Iron 20 mg + Folic acid 100 mcg) along with promotion of iron-rich foods.
c. Supplementary nutrition providing extra calories and proteins, Vitamin A supplementation, and use of iodized salt in food preparation.

VVK11-012
Answer the following questions regarding RNTCP.

a. What constitutes a case of relapse of tuberculosis as defined by the RNTCP?
b. Define a defaulter of treatment and a failure.
c. What is recommended management for each of these cases?

Answer

a. Relapse: Patient who returns smear positive, having previously been treated for tuberculosis and declared cured after completion of treatment.
b. Defaulter: Patient who returns sputum smear positive after having interrupted treatment for at least 2 consecutive months.
Failure: Patient who was initially smear positive, who began treatment and remained or became smear positive again at 5 months or later during the course of treatment.
c. Category II regimen of RNTCP: 2 (IP: SHRZE) + 1 (HRZE) + 5 (CP: HRE).

VVK11-013
What are the goals of the National Health Policy (MCH) 2010 in terms of:

a. Infant mortality rate.
b. Under 5 mortality rate.
c. Immunization of infants.
d. Immunization of pregnant women.
e. Maternal mortality rate.

Answer

a. Reduce to < 30 / 1000 live births.
b. < 10 / 1000 live births.
c. 100%.
d. 100%.
e. < 1 / lakh live births (< 100 / 100,000).

VVK11-014
Mid Day Meal Program:

a. Write down the composition of the meal in Mid Day Meal Program in terms of quantity of grain, calories and protein provided.
b. Give two examples of premixed foods used in this program.
c. According to National Institute of Nutrition minimum number of feeding days in a year should be _____________ (mention days) to have desired impact on the children.

Answer

a. Composition:
- Cereals and millets: 75 g/day/child
- Pulses: 30 g/day/child
- Oils and fats: 8 g/day/child
- Leafy vegetables: 30 g/day/child
- Non-leafy vegetables: 30 g/day/child
- Provides ~300–450 kcal calories and 8–12 g protein per day (Primary).
b. Premixes:
- Shakti Ahar: Roasted wheat 40g + roasted gram 20g + roasted peanut 10g + jaggery 30g.
- Hyderabad Mix: Whole wheat 40g + Bengal gram 16g + groundnut 10g + jaggery 20g.
c. 250 days/year (Beneficiary should attend school for at least 20 days/month).

VVK11-015
Radiation and Waste Management:

a. Match new units for the older units of radiation measurement:

Old units	New units
1. Curie (Ci)	a. Coulombs/kg
2. Rad	b. Becquerel (Bq)
3. Rem	c. Sievert (Sv)
4. Roentgen (R)	d. Gray (Gy)

b. Black bags/bins are meant for what type of waste?
- i. Infectious waste
- ii. Noninfectious waste like paper/glass
- iii. Organic waste like discarded food/vegetables
- iv. Both ii and iii
c. Name 4 syndromes with increased sensitivity to X-rays.

Answer

a. Matching:
- 1. Curie (Ci) $\to$ b. Becquerel (Bq)
- 1. Rad $\to$ d. Gray (Gy)
- 1. Rem $\to$ c. Sievert (Sv)
- 1. Roentgen (R) $\to$ a. Coulombs/kg
b. iv. Both ii and iii (Noninfectious waste like paper/glass and organic waste).
c. Syndromes: Ataxia telangiectasia, Basal cell nevoid syndrome, Cockayne syndrome, Down syndrome, Fanconi anemia, Gardner syndrome, Nijmegen breakage syndrome, Usher syndrome, Bloom syndrome.

VVK11-016
You are provided with:

Bin lined with black plastic bag
Blue puncture proof container
Bin lined with yellow plastic bag
Bin lined with red plastic bag

VVK-P-Osce 11. Community Medicine_page_3_Picture_27.jpeg

a. List which bag/container you will segregate the following items into:
- i. Used wound dressing material
- ii. Syringe wrappers
- iii. Needles
- iv. Used indwelling umbilical catheters
b. How will you dispose the following hospital waste?
- i. Non-infectious waste
- ii. Infected solid waste
- iii. Infected plastics
- iv. Sharps
c. What do these two symbols stand for?

Answer

a. Segregation:
- i. Used wound dressing material: Bin lined with yellow plastic bag
- ii. Syringe wrappers: Bin lined with black plastic bag
- iii. Needles: Blue puncture-proof container
- iv. Used indwelling catheters: Bin lined with red plastic bag
b. Disposal:
- i. Non-infectious waste: Landfill / municipal disposal
- ii. Infected solid waste: Incineration / deep burial
- iii. Infected plastics: Autoclave/microwave, chemical disinfection & shredding
- iv. Sharps: Puncture-proof container, disinfection, encapsulation / sharp pit
c. Symbols:
- First symbol: Biohazard
- Second symbol: Cytotoxic waste

VVK11-017
Give the nutritional value (calories and protein) of following cooked items:

a. One chapatti or one bread slice
b. One biscuit
c. One egg
d. One teaspoon mashed potato
e. One teaspoon cooked dal

Answer

Item (quantity)	Calories (kcal)	Proteins (g)
a. One chapatti or one bread slice	70	2
b. One biscuit	20	0.5
c. One egg	80	6
d. One tsp mashed potato	40	Nil
e. One tsp cooked dal	10	0.5

VVK11-018
Answer the following questions:

a. Dextrose content of 1 liter Ringer lactate.
b. ${Na}^{+}$ content of 1 mL of 3% NaCl.
c. ${Na}^{+}$ content of 100 mL of 0.9% NaCl.
d. Elemental Calcium in 1 mL of 10% calcium gluconate.
e. $K^{+}$ content of 1 liter of Isolyte-P.

Answer

a. Dextrose content of 1 liter Ringer Lactate is 0 g.
b. ${Na}^{+}$ content of 1 mL of 3% NaCl is 0.51 mEq (~0.5 mEq).
c. ${Na}^{+}$ content of 100 mL of 0.9% NaCl is 15.4 mEq.
d. Elemental Calcium in 1 mL of 10% Calcium Gluconate is 9 mg (0.45 mEq/mL).
e. $K^{+}$ content of 1 liter of Isolyte-P is 20 mEq/L.

VVK11-019
Answer the following questions:

a. Give 4 parameters for malaria surveillance under NMEP.
b. As per National Leprosy Eradication Program (NLEP), the aim is to reduce caseload to less than ______ per 10,000.
c. As per RNTCP, augmentation of case finding activities through quality sputum microscopy is to detect at least _____% of estimated cases.
d. As per RNTCP, achievement of at least _____% cure rate through supervised short course chemotherapy is aimed.

Answer

a. Parameters for malaria surveillance:
- i. Annual Parasite Index (API)
- ii. Annual Blood Examination Rate (ABER)
- iii. Annual Falciparum Incidence (AFI)
- iv. Slide Positivity Rate (SPR) / Slide Falciparum Rate (SFR)
b. < 1 per 10,000 population.
c. At least 70% of estimated cases.
d. At least 85% cure rate.

VVK11-020
Answer the following questions:

a. When was ICDS program started?
b. Mention nutritional components of ICDS.
c. Who supervises the work of anganwadi worker in ICDS?
d. As per Vitamin A prophylaxis schedule, what is the dose of Vitamin A given to children <12 months of age and how often?

Answer

a. 1975 (2nd October 1975).
b. Supplementary nutrition, Vitamin A prophylaxis, Iron & Folic Acid distribution.
c. Mukhyasevika (Supervisor).
d. Dose:
- <12 months (at 9 months with measles): 100,000 IU (1 lakh IU = 1 mL) single dose.
- 12 months (1–5 years): 200,000 IU (2 lakh IU = 2 mL) once every 6 months.

VVK11-021
State True / False:

a. The National School Health Program undertakes examination of school children by camp approach during 2 days on 3 consecutive months of a year.
b. National Blindness Control Program is a sponsored program.
c. All children in the age group 9 months to 3 years are administered 2 lac units of vitamin A at 6 monthly intervals as per vitamin A deficiency control program.
d. The Mid Day Meal Program is a Central Government Sponsored Program.

Answer

a. False (3 days on 2 consecutive months of a year).
b. True (100% Centrally sponsored).
c. True.
d. True / Centrally assisted program.