Community medicine McQ points by Masoom haider
MCH (Maternal and Child Health)
1 it is a general indicator of overall health of population MMR
2 most common cause of maternal death is hemorrhage
3. Prematurity is period less than 37 week
4 post maturity is 41 week later
5 Hb in pregnancy less than 11 is high risk
6. Minimum no of visits required is 4
7. Visits
- before 12 week
- 2 at 24 week
- btw 32-34 week
- at 36 week
8. Backbone of MCH service is home visits
9. Weight gain in pregnancy should be 10-12 kg
10. Total cal in pregnancy is 60000kcal
11. Sleep required in pregnancy is 8 hr daily with 2hr after mid day meals
12. If mother suffers measles in first trimester termination of pregnancy is suggested
13 RH immunoglobulin is given 28-34 week
14 dose of Rh immunoglobulin is 200-300ug
15 mother should be motivated to limit family to 2-3 children
16. 1 dai is for 100 births or 300 people
17 in institutional care mother stay in bed for 1 day
18 in institutional care mother is discharged at 3-4 days
19. In post natal Care last visit is at the end of 6 week
20. AGAR score
- 7-10. Excellent
- 4-6. Moderately depress
- 0-3 severely depressed
21. Normal birth weight is 2.5kg
22. Indicator of fetal well being and maturity is birth weight
23. Term consist of 259-293 days of gestation
24. More than 294 days are post term
25. Prevention of infection is most important function in an ICU
26. Principle of growth chart is weight for age
27. Most important age group is 0-3 year
28 GMP focus on age group 0-5
29 baby require no other food untill 4-5 months
30 daily secretions of milk is 450-600ml
31 energy value of Breast milk is 65-75kcal/100ml
32. Secretions of breast during first 2/3 days after birth is. Colostrum
33. According to Who breast feeding is recommended for 4 month
34. 0.1 ml vit K should be administered IM after birth
35. NMR in Pakistan is 40/1000 live births
36 PNMR is from 4-52 week
37. IMR is from 0-52 week
38. NMR is affected by endogenous factors
39. PNMR is dominated by exogenous factors
40. Birth weight of 1000g is equlent to gestational age of 28 week
41. Quality and quantity of health care given to mother determine by still birth
42. Death of fetus after 28 week of pregnancy is still birth
43 SMI was launched in 1987
44 a mother’s body required a gap of 2 years to recover from pregnancy and childbirth
45. Single best indicator of social development and we’ll being is Under 5 mortality rate
46 incidence of malnutrition is maximum during 4months – 2 year
47. Diahrrea in child more than 2week is difficult to treat
48 fits in child on artificial feeling due to hypernatremia due to high salt content in cow milk
49 cow milk contain too much casein
50 Albumin/ casein in human milk is 2:1
Disaster management
1 diastaser due to harsh weather is metropological disaster
2 In organization each assestent should be given single task
3 disaster mitigation involve protection of vulnerable population
4 Most important factor in successful management of disaster is communication
- triage system
- red. High priority
- yellow. Medium priority
- green. Ambulatory
- black. Dead or morbid
5 if cadaver conteminate drinking water it leads to gastroenteritis and food poisoning
6. Vaccines recommend for health workers are cholera and typhoid
- residual cl can be increase to 0.7mg
- earthquake comes under telluric disaster
- Community medicine McQ points by Masoom haider
Parasitology
1 toxoplasma spread by feces of cat
2 only human reservoir in entamoeba histolytica
3. Leaf like unsegmented worms are trematodes
4. Intermediate host of liver fluke is snail
5 adult worm liver fluke is found in herbivores like goat ship
6. Clonorchis is caused by eating infected fish
7. Intermediate host in Clonorchis is fresh water fish
8. Eggs are passed in mainly urine in case of blood fluke
9 eggs are only infective to snail in blood fluke
10. Blood fluke penetrate human through intact skin
11 CUSO4 is used in prevention of schistosoma
12. Schistosoma is diagnosed by finding eggs in urine
13. Appendicitis is caused by trichuris trichura
14. It resemble small pieces of cotton thread is Entrobious vermicularis
15. Entrobious vermicularis is common in children
16. Dilute ammoniated mercury ointment used in Entrobious vermicularis treatment
17. It requires only one host to complete life cycle
18. Long boot should be used in prevention of ancylostoma dudenale
19. Adult form of cestodes in intestinal canal.
20 tenia solium in man due to eating pig fish
21 larvae of teania solium in muscles
22 eating undercooked beef cause tenia saginata infection
Community medicine McQ points by Masoom haider
Family planning
1 only family planning alone can reduce mother death 25% and child mortality 20%
2 high risk pregnancies are in age below 20 and above 35
3 an interval of 2/3 year is between births is desirable to reduce child mortality
4. To reduce net reproduction rate dominant factor is CPR
5. Target couple have 2/3 children
6 20% of eligible couple are in age 15-24
7 condom failure rate can be 2/3 % to upto 14%
8 diaphragm size is 5-10cm
9 duration for which diaphragm is placed is 6hrs
10 failure rate of diaphragm is 6-12%
11 diaphragm not protective against HIV infection
12 diaphragm can cause toxic shock syndrome
13 sponge is less effective than diaphragm
14 sponge contains spermicide nonoxynol9
15 failure rate of sponge in parous women is 20-40% and in nulliparous woman it is 9-20%
16 NovaT and Tcu380 are distinguish by silver core
17 T variety are used for 5 year
18 Lippes loops contain BaSo4
19 most commonly used hormonal Device is progestasert
20 In hypertensive patient 3rd generation of IUCD is used
21 burning and irritation are seen in sponge
22 contraceptive methods that can be used by breast feeding mother’s is IUCDS
23. IUD 10-20% cause bleed…
24 IUD cause 15-40% cause pain
25 IUD increase risk if PID 2-8 times
26 failure rate of IUD is 3%
27. Ectopic pregnancy cause by IUD is 6.8 times more
28. Chance of ectopic pregnancy is less with levonorgestral
29. Combined pills should be taken at 5 day of menstrual cycle
30. Combined pills contain 30-35 ug of estrogen and 0 .5-1 mg progesterone
31. If a female is taking combined pills forget to take pills for 3 days she should stop taking pills
32. Oral pills interact with rifampin
33. Progesterone only pills are used in cardiovascular disea and lactating mother
34 post coital contraceptive methods are effective upto 120 hrs after intercourse
35 in hormonal methods 4 pills are used
36 2 pills are used within 72 hrs these are ethyinal estradiol
37 2 pills remaining are used after 12 hrs of
38 most effective method is 1 .5 mg of levonorgestral after unprotected intercourse
39. Lactating mother and cvs disea patient can also use DMPA
40. Female having complete family use sub dermal levonorgestral
41. Aspiration of uterine cotent occur by 6-14 days
42. Cervical mucus method aslo called billings ovulation method
43 vesectomy is done under local Anastasia
44 person remain fertile 6-8 week after (30 ejaculation) after vasectomy
Occupational health
1 most fibrinogenic pneumoconiosis is silicosis
2 nodular fibrosis is seen in silicosis
3 fibrosis is apical in silicosis whereas basal in asbestos
4 years required to develop silicosis is 6
5 mesothelioma associated mewith crocodolite type of asbestos
6 safe type of asbestos are chrysolite and amosite
7 distinctive feature of silicosis is egg shell calcification8 little Mg is found in Amphibole type asbestos
9 large dense masses are seen in anthracosis
10 main cause of farmers lung disea is Micropolyspora faeni
11 least toxic lead compound is lead sulphide
12 greatest source of environmental lead is gasoline
13 inorganic compounds of lead are not absorbed through skin
14 organic lead mainly affect cns like headache etc
15 CPU in urine is important screening test for non exposed person
16 CPU level in urine is 150ug/L
17 if level of ALA is more than 5mg/litre it indicates absorption
18 if lead is more than 0.8mg in urine it indicates lead absorption
19 if lead is more than 70ug/100ml indicates lead absorption
20 in the working atmosphere lead should be below 2mg /10cu meter
21 d penicillamine is used as a chellating agent
22 factory list contains disease
23 white p cause phossy jaw in match industry
24 white wash should be at least once a year
25 zinc and iron paint should used
26 silver salt should be used instead of Mercury
27 working hours for a work are 9, working hrs in week not exceed 60
28 Coal tar causes skin and scrotum Cancer
29 75 percentage occupational cancer are skin cancer
30 coal tar cause skin and scrotum cancer
31 benzol cause leukemia
32 employer contributes 4.75 percentage of total wages bill where as employee 1.75 percentage
Mental health and drug of abuse
1 450million people are suffering from neuropsychiatric disorder
2 measles and rubella in prenatal infection can cause mental disorder later
3 psychotropic antifungal drug is griseofulvin
4 metals which can cause mental health issue
- Tin
- lead
- Mercury
- Manganese
5 components of community health program are 9
6 hard drugs are narcotics
- Opium
- Morphine
- Heroin
7 drugs which cause distortion of senses are Merijuina LSD
8 some countries alcohol drinking is 8g or 10ml
9 1 unit =8g
10 weekly allowed is 21unit
11 cocaine cause no tolerance no dependences
12 therapeutic dose of amphetamine is 20-30 mg
13 components of sleeping pills are barbiturates
14 most common drug of abuse is cannabis
15 alterations of perception is by LSD
16 maximum concentration of alcohol reaches 1hr after consumption
17 tobacco effect are more in women than men
18 most commonly used drug is caffeine
19 1 cup of coffee is equal to 180ml
20 Smoking cessation cause withdrawal symptoms lasting for 4-6 week
Craving remains for month
Primary health care
1 HFA(health for all) achieve through primary health care
2. HFA slogan was given in 2000
3 goal of HFA is to achieve basic health faculty within radius of 2-3km
4 5%of GNP is spent on health
5 HFA indicator are 12
6 BHU covers 25000 person and area of 24-40km
7 5-10 bhu are linked to RHC
8 imperest money of rupee1000 given to MO in BHU
9. RHC covers 100000 person and radius of 240-400km
10 20-25 beds are in a RHC
11 40-60 bed are in THQ
12 training of LHW is about 12 week basic+ field training
13 scale of LHV is 9
14 a LHW cover 1000 person or 200 house
15 selective phc came in 1982
16. GOBI FFF in Africa cause reduction of imr 40%
17. No of bed in BHU are 1-2
18 there should be 2 rooms for family of 5
19 floor space of each room should not be less than 120sqft
20. 2/3 area of house should be open
Demography
1 basic mortality measure is CDR
2 in Pakistan CDR is declining but CBR is same
3 In Pakistan IMR is 57/1000 live births
4 world population growth rate is 1.1%
5 Pakistan is 6 amongst most populous country
6 total fertility rate in Pakistan is 3.2
7 averge age of marriage is 18 year
8 if marriage age increase from 18 to 21 decrease in fertility is 25%
9 maximum fertility is between 25-29 year of age
10 NRR is a demographic. Indicator
11 NRR =1 only if contraceptive prevelence rate is 60%
12 if birth registration statics are inadequate CWR is used
13 CWR is determined by census
14 population pyramid is same for all ages in Sweden
15 broad centered pyramid in singapur
16 broad base pyramid in Pakistan
17 more children are in developing countries
18 dependency ratio in Pakistan is 66% while in Japan is 44%
19. Very unsatisfactory rate is marriage rate
20 Pakistan has entered in late expanding or 3 stage
21 Africa and south Asia are in early expanding stage or 2 stage
22 Sweden in low stationary or 4 stage
23 German is in 5stage
24. In Pakistan population under 15 is 36%
25 population density in Pakistan is 618 milesq
26 according to 2017 census Pakistan in world 5 most populous country
27. Growth rate in Pakistan is 2.1%
28 study of encouragement is called ecology
Accident+ snake bite
1 Accident cause physical and mental death
2 Globally accident is 8th leading cause of death
3 globally 2nd leading cause of death is stroke
4 globally ist leading cause of death is. IHD
5 Pakistan rank 4th in vehicle accident
6 female are good drivers
7 conc of alcohol causing impairment is 50mg/100ml
8 future accident prevention is called accidentology
9 species of snake in Pakistan are 200
10 no of snake bite per year worldwide are 300000
11 no of families of poisonous snake is 5
12 snake venom is produced in parotid gland
13 sea snake cause neck stiffness within 1 hr
14 polyvelent antivenom contain against
- Cobra
- Krait
- Saw scaled vipers
- Russles viper
15 test dose of antivenom is 0.1 ml
Community medicine McQ points by Masoom haider
Demography
1 basic mortality measure is CDR
2 in Pakistan CDR is declining but CBR is same
3 In Pakistan IMR is 57/1000 live births
4 world population growth rate is 1.1%
5 Pakistan is 6 amongst most populous country
6 total fertility rate in Pakistan is 3.2
7 averge age of marriage is 18 year
8 if marriage age increase from 18 to 21 decrease in fertility is 25%
9 maximum fertility is between 25-29 year of age
10 NRR is a demographic. Indicator
11 NRR =1 only if contraceptive prevelence rate is 60%
12 if birth registration statics are inadequate CWR is used
13 CWR is determined by census
14 population pyramid is same for all ages in Sweden
15 broad centered pyramid in singapur
16 broad base pyramid in Pakistan
17 more children are in developing countries
18 dependency ratio in Pakistan is 66% while in Japan is 44%
19. Very unsatisfactory rate is marriage rate
20 Pakistan has entered in late expanding or 3 stage
21 Africa and south Asia are in early expanding stage or 2 stage
22 Sweden in low stationary or 4 stage
23 German is in 5stage
24. In Pakistan population under 15 is 36%
25 population density in Pakistan is 618 milesq
26 according to 2017 census Pakistan in world 5 most populous country
27. Growth rate in Pakistan is 2.1%
28 study of encouragement is called ecology
Nutrition
1 there are about 50 kind of nutrients
2 food and relationship with energy
- Protein. 10-15%
- Carbs. 50-80%
- Fats. 15-30%
3 practical method to evaluate protein status of person is NPU
4 best measurements of state of protein of individual is estimation of albumin
5. Fats are solid at 20 degree c
6 1kg adipose tissue provide 7700kcal
7 richest source of linoleic acid is safflower oil
8 richest source of arachnoid acid is meat eggs
9 richest source of linolenic acid is soyabean oils
10 richest source of ecosapentaenoic acid is fish oil
11 lactating mother should have 30 g of visible fat
12 gums in fenugreek seeds is effective to reduce cholesterol and glucose level
13. Carbohydrates reserve of adult is 500g
14 daily intake of 60g of fiber cause bowl irritation
15. Early stage of xerophthalmia can be reversed by giving 200000IU of vit A for succseive 2 days
16 RDA of vit A
- Adult 600ug
- Pregnancy. 800ug
- Lactation. 950ug
17. Normal amino acids score is 50-60%
18 1 g of protein=6.25g N
19 children above 13 has same energy requirements as adults
20 bmr decline 2% each decade
21 in pregnancy additional requirements is 350kcal
22 in lactating mother additional requirements is 600kcsl ist 6 month and 520 kcal next 6 month
23 simple measure of growth and nutrition in child less than 5 is weight for age
24 determination of early pem is by chest head circumference
25. Most common parameters for nutritional assessment is anthropometric measurements
26. Moon-face psychomotor changes and dispigmentition seen in kwashiorkor
27 most common cause of anemia is due to iron deficiency
28. If Hb is less than 10 blood transfusion is required
29. Milk is best source of ca
30 cd found in shellfish
31 hg found in fish
32 soda citerate is added to enhance digestibility of casein
33 if sacchrine is added in milk process is called A sophistication
34. During process of mailing thiamine is lost
35 washing and cooking of rice cause loss of thiamine
36 index to nutrition status of group of children is prevelence of angular stomatitis
37. In chronic alcoholic Mg deficiency is seen
Immunology
1 acquired immunity only in vertebrates
2 immunoglobulin are taken from human
3 antisera taken from animal
4 subclinical infection cause immunity in polio and diphtheria
5. Small pox eliminated due to elimination of source
6 herd immunity determine by serological surveys
7. If case reproductive no is less than 1 all population enjoy herd immunity
8 herd immunity is not shown by tetanus vaccine9 4 doses of polio vaccine required for immunity development
10. Live vaccine are
- Bcg
- Typhoid
- Polio
- Yellow fever
- Mumps
- Measles
11. Live vaccine should be administered with at least interval of 3 week
12. Water in oil is adjuvant vaccine
13 inactive vaccine
-Heamophlis influenza
-Cholera
-Typhoid
-Meningitis
-Hep b
14 high complement fixing ability is possessed by IGG
15 ,Human IG are used against
Hep A and measles
16. Specific human IG have 5 times higher potential
17 specific human IG are used in hepB and teatanus prophylaxis
18 cold box carry large quantities of vaccine
19 vaccine carrier transport small quantity of vaccine
20 day pack contain 6-8 vials
21 flask are used only if carrier are not available
22 vaccine carrier contain 16-20 vials
23 temperature of vaccine is -2 to -8 c
24 vaccine in freezers are bcg measles and polio
25 DP typhoid and tetanus toxoid are diluents
26. DT is given at 24 month
27. Polio vaccine causes diahrrea within 3 week of tonslectomy
28 swine inuenza vaccine cause GB syndrome
29 scar of bcg formed within 2-3 months
30 efficacy of bcg is 80%
31. Yellow fever vaccine is for 6-10 years
32 TAB vaccine is preserved in phenol
33 immunity of BCG develop 10-12 week after scar formed
34. 012 month schedule for hep b is included in EPI
35. Flu vaccine is recommended for 6 month above child
Biostatistics
1 pulse rate is continuous data
2 line diagram and scattered diagram represent quantitative data
3. If data is large no of groups can be 20
4 if data is small no of groups 5
5 convenient no of groups are 5-15
6. Bar chart are for categorical type of data
7. Trend of event with the passage of time is represented by line diagram
8. Scattered diagram show relationship between 2 variables
9. Mean is influenced by extreme value in distribution
10. Median is not affected by extreme value
11 mode is also not affected by extreme value
12 mode is not used in medical science
13. Range has no practical value as it indicates extreme value
14. SD gives idea of dispersion
15. If value of X2 is less than 3.84 null hypothesis will be true
16. Mean distribution curve is unimodal
17. When null hypothesis is true and we reject it error is Alpha or type 1
18. If sample size less than 30 test applied is T test
19. To be effective pie chart should not have more than 5/6 Centers
20. If person is counted at place where he or he is present at time of census is De facto
21 registration of birth not done in tribal area
22. Each year each hospital and dispensary sends record to DHO/CS
23 most used statistical averge is mean
Epidemiology
1 syndrome of association btw dysphagia and iron deficiency anemia is Patterson kally syndrome
2 crude rate also known as unstandardized rate
3. Mid year population is taken at 1st July
4. Actual observed rates are specific rates
5 killing power of disea is case fatality rate
6 case fatality rate closely related to virulence
7 case fatality rate is used for acute infection
8 survival rate describe prognosis
9 simplest and most useful form of standardization is SMR
10 case fatality rate is index of severity
11 to control the disea SAR is used
12 rate used for short term plaining and research is SAR
13 magnitude of disea is estimated by prevelence rate
14 community selected for study should be large
15 best short term fluctuatation in disea is epidemic
16 influenza pandemic occur after interval 7-10 years
17 oral cavity and uterine cavity cancer are more in India
18 stomach cancer is more in Japan
19 measles is common in childhood
20 prevelence is measured by cross sectional study
21 incidence is given by longitudinal study
22 prevelence study is more useful in chronic diseases
Analytical epidemiology
1 only newly diagnosed cases are eligible
2. Estimation of disea risk associated with exposures is obtained by index known as relative risk or risk ratio
3 RR can be exactly determined by cohart study
4 indirect measure of strength of association btw risk factor and outcome is odd ratio
5. To calculate odd ratio disease under consideration should be rare
6 prophylaxis and evaluation of therapy of disea is not given by case control study
7 for prevelent diseas cohart study is done
8 direct measure of association is relative risk
9 estimate of amount by which a disea can be reduced is given by population attributable risk
10 best method to evaluate new therapies is RCT
11 heart of control trial is randomization
12 Pap smear is uncontrolled trial
13 if natural plays role no intervention made it is observational study
14. If information needed on trend of disease best survillance type is sentinel surveillance
Screening and sampling
1 Mps provide no benefits to population in terms of mortality and morbidly reduction
2 sensitivity detects true positive a
3 slection of high risk population increases yield
4 qouta sampling is not a good technique
5 to avoid error small size sample should be taken
Compiled by: Masoom Haider
Reference books for Community Medicine:
- K Park
- Ilyas insari