Questions for Community Medicine MD 4

1. The infection that never spreads from man to man

A) Rabies B) Japanese encephalitis C) plague D) human salmonellosis

2) A disease that is constantly present at a high incidence and or prevalence rate and affects all age
groups equally
A) hyperendemic B) haloendemic C)epidemic D)pandemic

3) Malaria is reguarded as a disease caused by
A) protozoa B) bacteria C) virus D) prions

4) Which among the following are true about dengue
A) bleeding manifestations are usually present in classical dengue fever
B) It is transmitted by Aedes mosquito by a "man-mosquito-man" cycle
C) Dengue shock syndrome hemodilution
D) Dengue fever rash will not desquamate

5) Leishmaniasis is caused by
A) protozoa B) bacteria C) virus D) prions

6) Inanimate objects of transmission is reguarded as
A) vector B) fomites C) vehicle D) droplets

7) Disease on the verge of immediate irradication
A) polio B)small pox C)measles D)mumps

8) Measles vaccination is given at age of
A) 10 weeks B) 9 months C) 14 weeks D) 6 months

9) Which of the following does not have a non-human reservoir?
A) Polio B) salmonella typhi C) Neisseria D) CI tetani

10) Prevention of human brucellosis depends primarily on pasteurization of dairy products derived from
goats, sheep or cows AND
A) Treatment of human cases
B) Control of the insect vector
C) Immunization of farmers and slaughter house workers
D) Destruction of infected animals

11) Which of the following vaccines is contraindicated during pregnancy?
A) Hep B vaccine B) varicella vaccine C) influenza vaccine D) tetanus toxoid

12) Which of the following dimensions is not included in the WHO definition of health?
A) Physical well-being B) occupational well-being C) mental well-being D) social well- being

13) Sickness is a state of
A) Social dysfunction
B) Subjective state of a person feeling unwell
C) Impaired physiological function
D) Impaired psychological function

14) In the natural history of disease, the 'pathogenesis phase' is deemed to start upon
A) entry of the disease agent in the human host
B) interaction between agent, host and environmental factors
C) appearance of signs and symptoms
D) appearance of complications

15) The term 'disease control' employs all of the following except
A) reducing the complications B)reducing the risk of further transmission
C) reducing the incidence of disease D)reducing the prevalence of the disease

16) Which level of prevention is applicable for implementation in a population without any risk factors
A) primary prevention B) secondary prevention
C)primordial prevention D) tertiary prevention

17) Which of the following is not primary prevention?
A) pulse polio immunization
B)vitamin A supplementation
C) breast self-examination for tumor
D)isoniazid (INH) to a baby breastfed by a sputum positive tubercular mother

18) Any restriction or lack of ability to perform an activity in the manner or within the range considered
normal for a human being is called
A) impairment B) handicap C) disability D) disease

19) Choose the correct sequence in order of occurrence
A) Disease> disability>impairment>handicap B) disease>impairment>handicap>disability
C) Handicap>disease>impairment>disability D) disease >impairment>disability>handicap

20) Epidemiology is
A) branch of medical science which treats epidemics
B)science of the mass phenomenon of infectious diseases
C) study od disease, any disease, as a mass phenomenon
D) all of the above

21) Prevalence of a disease depends upon the following
A) incidence B) duration C) all of the above D) none of the above

22) If a drug prevents mortality but does not affect cure then which of the following will be true
A) incidence will decrease B) incidence will increase
C) Prevalence will decrease D) prevalence will increase

23) A disease is called 'endemic' when it
A) occurs in more than one geographical area
B) occurs in more than one season
C) is constantly present at low rates in a specified geographical area
D) occurs in a frequency more than expected in a specified geographical area

24) A clinically manifest disease of man or animal resulting from an infection is called
A) infectious disease B) contagious disease C) iatrogenic disease E) nosocomial disease

25) Endemic disease means that a disease
A) Exhibits seasonal trends B) is constantly present in a given population group
C) Occurs clearly in excess of normal expectancy D) is prevalent among animals
26) Immunizaton of preschool children with diphteria toxoid results in
A) Protection against the diphteria carrier state
B) lifelong immunity against diphtheria
C) Detectable antitoxin or immunologic memory for about 10 years
D) Frequent adverse reactions

27) Which patient is most likely to become a chronic carrier following an acute episode of Hepatitis
A) A newborn
B) a 20 year old female following vaginal sexual transmission
C) A 50 year old male following rectal sexual transmission with a partner positive for HBeAg
D) A 30 year old health care worker following a percutaneous injury

28) A 25 year old man presents with a single , indurated , painless ulcer on the penis that appeared 2
days ago. His most recent unprotected sexual contact was 21 days before. An immediate plasma reagin
(RPR) test is negative.The most likely diagnosis is
A) syphilis B) herpes C) chancroid D) lymphogranuloma venereum

29) To which patient would the MMR be safe to administer
A) A 15 month old HIV infected child with a CD4 count of 700
B) A 25 year old pregnant woman
C) A 12 year old asthmatic on 20mg of oral prednisalone daily for the last 20 days
D) A 17 year old with a life threatening anaphylactic reaction to egg ingestion

30) A nurse sustains a needle stick injury from a known HIV infected patient. Which of the following
factors carries the greatest risk for transmission of HIV to the health care worker?
A) depth of the injury B) stage of illness of the source patient
C) presence of visible blood on the needle D) use of gloves during the procedure
31) Which is the most appropriate action for the nurse above?
A) reassure her of the low risk of infection and offer no prophylaxis for HIV infection
B) offer single drug antiretroviral therapy
C) offer two-drug antiretroviral therapy
D) offer triple-drug antiretroviral therapy

32) Which of the following infections is transmitted chiefly from person to person
A) California encephalitis B) St. Louis encephalitis
C) West Nile like viral encephalitis D) meningococcal meningitis

33) Widespread use of the Haemophilus influenza type b vaccine has resulted in a dramatic decrease in
the number of cases of meningitis due to this bacterium. Which agent is now the leading cause of
bacterial meningitis in children in the USA.
A) Streptococcus pneumoniae B) Group B Streptococcus pyogenes (hemolyticus)
C) Escherichia coli K-1 D) Neisseria meningitidis

34) The medical evaluation of a 25 year old intravenous drug user reveals liver enzymes and a positive
anti- HBsAg. The most likely cause of the abnormal liver profile is Hepatitis
A) A B) B C) C D) D

35) The time interval between entry of an infectious agent into a host and the onset of symptoms is
called
A) The communicable period B) the incubation period
C) The preinfectious period D) the non-contagious period

36) An 8 year old child is brought to the emergency room with profuse bloody diarrhoea. The symptoms
started about 3 days ago, but gradually worsened. He has no fever. His platelet count is 40 000. The
most likely source of the enteric infection is
A) fish 0 B) chicken C) milk D) beef

37) What is the most appropriate counseling message to offer to HCV(Hepatitis C Virus) positive
pregnant women
A) Caesarian section should be performed
B) The probability of transmission to the newborn is 5%
C) Breast feeding should be discouraged
D) Infants should receive IgG at birth

38) For which patient is pneumococcal vaccine PPV23 not beneficial?
A) A 15 month old HIV infected child B) A 20 year old about to undergo a splenectomy
C) A 70 year old healthy female D) A 5 year old with sickle cell

39) A 10 month child is brought to your office by the mother because of vomiting and profuse diarrhoea
for the past 24 hours. Temperature is 100 F and signs of dehydration are present. No other person is the
household is ill. The most likely etiologic agent is
A) adenovirus B) rotavirus C) parvovirus D) coxsackievirus

40) A 5 year old who attends a preschool is diagnosed with Hepatitis A . The doctor is concerned about
the staff and children attending the school center. Which is the most appropriate management of
susceptible contacts
A) immune globulin to all staff and children B) vaccine to all staff and children
C) vaccine to staff and immune globulin to all children D) immune globulin only to classroom contacts

41) A 20 year old male presents with dysuria and urethral discharge for 3 days. He engaged in
unprotected sex 8 days ago with a new female sex partner. Examination reveals a yellow urethral
discharge. Organism responsible is

A) Chlamydia trachomatis B) Treponema pallidum
C) Herpes simplex virus infection D) Neisseria gonorrhoeae

42) Within 4 hours after attending a church supper, 25 persons report the abrupt onset of nausea ,
vomiting and diarrhoea. The most likely infectious agent is
A) Staphylococcal enterotoxin B) Clostridium botulinum toxin
C) Enterotoxic E. Coli D) Clostridium perfringens

43) One week after arriving in Africa, 25 persons report the abrupt onset of nausea, vomiting and
diarrhoea. The most likely infectious agent is
A) Giardia lamblia B) cryptosporidium
C) Enterotoxic E. Coli D) Camplylobacter

44) One third of the persons who attended a school banquet developed abdominal cramps and watery
diarrhoea 8 to 12 hours later. These symptoms end within 24 hours. The most likely infectious agent is
A) Staphylococcal enterotoxin B) Giardia lamblia
C) Clostridium botulinum toxin D) Clostridium perfringens

45) Which of the following are the components of the epidemiological triad?
A) Sensitivity, specificity and predictive value B) time, place and person distribution
C) Agent, host and environment factors D) prevalence, incidence and attack rate

46) Consider the following
1) Hep A outbreak
2) Polio outbreak
3) Gonorrhoea outbreak through prostitution.
Which of these outbreaks is/are classified under propagated epidemics?
A) 1 only B) 1 and 2 only C) 2 and 3 only D) 1, 2 and 3

47) Which one of the following is an absolute contraindication for administration of killed vaccine?
A) pregnancy B) immunodeficiency C) hodgkin's disease D) severe reaction to a previous dose

48) Which one of the vaccines is a killed vaccine?
A) yellow fever vaccine B) rubella vaccine C) mumps vaccine D) hepatitis B vaccine

49) Consider the following Hepatitis Viruses: 1) Hep A 2)Hep B 3) Hep C 4) Hep E. Which of these can be
commonly transmitted through The faeco-oral route?
A) 1 and 3 only 0 B) 2,3 and 4 C) 1 and 4 D) 1,2 and 3

50) Which one of the following is the most important indicator for measuring the communicability of a
disease?
A) primary attack rate B) prevalence rate
C) secondary attack rate D) incidence rate

51) The larvae of which one of the following mosquitos can be successfully killed by spreading oil on the
surface of its breeding water sources
A) anopheles B) aedes C) mansonioides D) culex

52) All of the following are modes of direct transmission of communicable disease except
A) Droplet infection B) contact with soil C) transplacental D) droplet nuclei

53) All of the following diseases are transmissible by contact with soil except
A) ancylostomiasis B) leptospirosis C) anthrax D) leishmaniasis

54) Cyclodevelopmental mode of transmission is seen in
A) Malaria B) filariasis C) cholera D) plague

55) The time interval between receipt of infection by a host and maximal infectivity of that host is
A) incubation period B) period of communicability
C) generation time D) latent period

56) Which of the following vaccines must be stored in the freezer compartment of the refrigerator
A) oral polio B) measles C) both of the above D) none of the above

57) All of the following are characteristics of the chicken pox rash except
A) rash occurs in crops B) pleomorphism is present
C) is centripetal in distribution D) scabs are infectious

58) The infectivity of chicken pox lasts for
A) 3 days after the onset of rash 0 B) 5 days after the appearance of first crop of vesicles
C) till the last scab falls 0 D) till the fever subsides

59) The most appropriate test to assess the prevalence of tuberculosis infection in a community is
A) sputum examination B) mass miniature radiography
C) tuberculin test D) clinical examination

60) Criteria for declaring an epidemic of polio are all of the following except
A) two or more cases B) all cases caused by the same virus
C) all cases occurring in some locality D) all cases occurring within a 8 week period