INICET May 2022 PSM Recall questions

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1. INICET May 2022 – PSM Recall Dr Venkatesh Karthikeyan AIIMS Patna t.me/ drvkspm Dr Venkatesh Karthikeyan, AIIMS Patna 1

2. Q1) A person presented to you with single hypopigmented patch with loss of sensation. Choose the correct treatment A for 6 months A for 12 months B for 6 months B for 12 months A B Dr Venkatesh Karthikeyan, AIIMS Patna 2

3. Q1) A person with single hypopigmented patch with single hypopigmented patch with loss of sensation . Choose the correct treatment Diagnosis ? Dr Venkatesh Karthikeyan, AIIMS Patna 3

4. Q1) A person with single hypopigmented patch with single hypopigmented patch with loss of sensation . Choose the correct treatment Dr Venkatesh Karthikeyan, AIIMS Patna 4

5. Q1) A person with single hypopigmented patch with single hypopigmented patch with loss of sensation . Choose the correct treatment Dr Venkatesh Karthikeyan, AIIMS Patna 5

6. Q1) A person presented to you with single hypopigmented patch with loss of sensation. Choose the correct treatment A for 6 months A for 12 months B for 6 months B for 12 months Reference: IAPSM’s Textbook of Community Medicine, Edition 2, Page 449 A B Dr Venkatesh Karthikeyan, AIIMS Patna 6

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8. Q2) According to WHO SAGE, How many doses of HPV is/are given to 9 – 14 years girl? 1 dose 2 dose 1 or 2 dose 3 dose Dr Venkatesh Karthikeyan, AIIMS Patna 8

9. Q2) According to WHO SAGE , How many doses of HPV is/are given to 9 – 14 years girl? WHO SAGE – Strategic Advisory Group of Experts on Immunization Dr Venkatesh Karthikeyan, AIIMS Patna 9

10. Q2) According to WHO SAGE, How many doses of HPV is/are given to 9 – 14 years girl? SAGE recommends updating dose schedules for HPV as follows: One or two-dose schedule for the primary target of girls aged 9-14 One or two-dose schedule for young women aged 15-20 Two doses with a 6-month interval for women older than 21. Dr Venkatesh Karthikeyan, AIIMS Patna 10

11. Q2) According to WHO SAGE, How many doses of HPV is/are given to 9 – 14 years girl? Dr Venkatesh Karthikeyan, AIIMS Patna 11

12. Q2) According to WHO SAGE, How many doses of HPV is/are given to 9 – 14 years girl? 1 dose 2 dose 1 or 2 dose 3 dose Reference: https://www.who.int/news/item/11-04-2022-one-dose-human-papillomavirus-(hpv)-vaccine-offers-solid-protection-against-cervical-cancer#:~:text=%E2%80%9CSAGE%20urges%20all%20countries%20to,the%20course%20of%20their%20lifetimes.%E2%80%9D Dr Venkatesh Karthikeyan, AIIMS Patna 12

13. Q3) A female had two kids – Ram and Shyam . One day Shyam complained of fever and rash all over the body. After 3 days, Ram also complained of fever and rash, following which she took her children to doctor where they were diagnosed as measles. Which of the following is true? Ram is index case Shyam is primary case Post exposure prophylaxis in Ram could have prevented disease in him Ram got infected from Shyam Options: Only 1 is true Only 2,3 is true Only 2,3,4 is true All are true Dr Venkatesh Karthikeyan, AIIMS Patna 13

14. Q3) A female had two kids – Ram and Shyam . One day Shyam complained of fever and rash all over the body. After 3 days, Ram also complained of fever and rash , following which she took her children to doctor where they were diagnosed as measles . Which of the following is true? Dr Venkatesh Karthikeyan, AIIMS Patna 14

15. Q3) A female had two kids – Ram and Shyam . One day Shyam complained of fever and rash all over the body. After 3 days, Ram also complained of fever and rash, following which she took her children to doctor where they were diagnosed as measles. Which of the following is true? Ram is index case Shyam is primary case Post exposure prophylaxis in Ram could have prevented disease in him Ram got infected from Shyam *The term primary case can only apply to infectious diseases that spread from human to human, and refers to the person who first brings a disease into a group of people —a school class, community, or country. *The index case, however, is the patient in an outbreak who is first noticed by the health authorities , and who makes them aware that an outbreak might be emerging. Dr Venkatesh Karthikeyan, AIIMS Patna 15

16. Q3) A female had two kids – Ram and Shyam . One day Shyam complained of fever and rash all over the body. After 3 days, Ram also complained of fever and rash, following which she took her children to doctor where they were diagnosed as measles. Which of the following is true? Ram is index case Shyam is primary case Post exposure prophylaxis in Ram could have prevented disease in him Ram got infected from Shyam *In unimmunized/partially immunized – vaccination within 72 hours *Passive immunization with Ig – within 6 days of exposure Dr Venkatesh Karthikeyan, AIIMS Patna 16

17. Q3) A female had two kids – Ram and Shyam . One day Shyam complained of fever and rash all over the body. After 3 days, Ram also complained of fever and rash, following which she took her children to doctor where they were diagnosed as measles. Which of the following is true? Ram is index case Shyam is primary case Post exposure prophylaxis in Ram could have prevented disease in him Ram got infected from Shyam Options: Only 1 is true Only 2,3 is true Only 2,3,4 is true All are true References: Reference: IAPSM’s Textbook of Community Medicine, Edition 2, Page 253 Dr Venkatesh Karthikeyan, AIIMS Patna 17

18. Bonus point Dr Venkatesh Karthikeyan, AIIMS Patna 18

19. Q4) All increases confidence interval except Increase in sample siz e Decrease in sample size Increase in variability None of the above Dr Venkatesh Karthikeyan, AIIMS Patna 19

20. Q4) All increases confidence interval except It is a range of values within which we are 95% confident that the true population value lies 95% CI for population mean= sample mean+/- 1.96 Standard error SE = SD/Root of Sample size 95% confidence interval for the population mean indicates that there is 95% probability that the population mean actually lies within that particular confidence interval Example: Dr Venkatesh Karthikeyan, AIIMS Patna 20

21. Q4) All increases confidence interval except Dr Venkatesh Karthikeyan, AIIMS Patna 21

22. Q4) All increases confidence interval except Wider CI = less accurate or less reliable CI can be decreased by increasing the sample size Variability (also called spread or dispersion) refers to how spread out a set of data is. Increased variability  SD increases  SE increases  CI increases Dr Venkatesh Karthikeyan, AIIMS Patna 22

23. Q4) All increases confidence interval except Increase in sample siz e Decrease in sample size Increase in variability None of the above Source : Essentials of Biostatistics and Research Methodology by Indranil Saha , 3 rd edition, Pg 126 Dr Venkatesh Karthikeyan, AIIMS Patna 23

24. Q5) Which of the following research method is used to describe the collected data? Theoretical statistics Descriptive statistics Analytical statistics Inferential statistics Dr Venkatesh Karthikeyan, AIIMS Patna 24

25. Q5) Which of the following research method is used to describe the collected data? Dr Venkatesh Karthikeyan, AIIMS Patna 25

26. Q5) Which of the following research method is used to describe the collected data? Dr Venkatesh Karthikeyan, AIIMS Patna 26

27. Q5) Which of the following research method is used to describe the collected data? Dr Venkatesh Karthikeyan, AIIMS Patna 27

28. Q5) Which of the following research method is used to describe the collected data? Theoretical statistics Descriptive statistics Analytical statistics Inferential statistics Dr Venkatesh Karthikeyan, AIIMS Patna 28

29. Q6) Vaccines for which of the following vaccine preventable diseases can be given to elderly? Diphtheria Mumps Zoster Malaria Options: 1,2,3 only 2 and 3 only 1 and 3 only All of the above Dr Venkatesh Karthikeyan, AIIMS Patna 29

30. Q6) Which of the following vaccine preventable diseases can be given to elderly? Dr Venkatesh Karthikeyan, AIIMS Patna 30

31. Q6) Which of the following vaccine preventable diseases can be given to elderly? Diphtheria Mumps Zoster Malaria Options: 1,2,3 only 2 and 3 only 1 and 3 only All of the above Source: https://ncdc.gov.in/WriteReadData/linkimages/February_Final_020862513827.pdf Dr Venkatesh Karthikeyan, AIIMS Patna 31

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33. Q7) A female known to be on ART gave birth to a child by vaginal delivery. Which one is true regarding prophylaxis to neonate? a) In Exclusive replacement feeding, prophylaxis of Nevirapine to be given for 6 weeks b) In Exclusive breast feeding , there is no need of nevirapine prophylaxis c) In Exclusive replacement feeding, nevirapine prophylaxis should be given after testing and subsequently repeat testing after 6 weeks d) In Exclusive replacement feeding, no need of nevirapine prophylaxis Dr Venkatesh Karthikeyan, AIIMS Patna 33

34. Q7) A female known to be on ART gave birth to a child by vaginal delivery. Which one is true regarding prophylaxis to neonate? Dr Venkatesh Karthikeyan, AIIMS Patna 34

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36. Q7) A female known to be on ART gave birth to a child by vaginal delivery. Which one is true regarding prophylaxis to neonate? a) In Exclusive replacement feeding, prophylaxis of Nevirapine to be given for 6 weeks b) In Exclusive breast feeding , there is no need of nevirapine prophylaxis c) In Exclusive replacement feeding, nevirapine prophylaxis should be given after testing and subsequently repeat testing after 6 weeks d) In Exclusive replacement feeding, no need of nevirapine prophylaxis Source : http://naco.gov.in/sites/default/files/National_Guidelines_for_PPTCT.pdf Dr Venkatesh Karthikeyan, AIIMS Patna 36

37. Q8) A 50 year old male has fasting blood glucose of 160 mg/ dl. Which one is true regarding Non pharmacological treatment ? Calories from alcohol should not be more than 10% of total calories Total calories from fat should be less than 30% of total calories C) Total salt intake should be less than 5000 mg / day D) Should include more dietary fibres Dr Venkatesh Karthikeyan, AIIMS Patna 37

38. Q8) A 50 year old male has fasting blood glucose of 160 mg/ dl . Which one is true regarding Non pharmacological treatment ? Dr Venkatesh Karthikeyan, AIIMS Patna 38

39. Non pharmacological management of Diabetes Q8) A 50 year old male has fasting blood glucose of 160 mg/ dl. Which one is true regarding Non pharmacological treatment ? Nutrients % of total calories Carbohydrate 50 – 60% Protein 15 – 20% Fat <30% (saturated fat <10%) Cholesterol <300 mg/day Fiber 25-40 g/day – same as general population Sodium <2000 mg/day Alcohol Not >5% of total calories Vitamins and Minerals Same as general population Dr Venkatesh Karthikeyan, AIIMS Patna 39

40. Q8) A 50 year old male has fasting blood glucose of 160 mg/ dl. Which one is true regarding Non pharmacological treatment ? Calories from alcohol should not be more than 10% of total calories Total calories from fat should be less than 30% of total calories C) Total salt intake should be less than 5000 mg / day D) Should include more dietary fibres Dr Venkatesh Karthikeyan, AIIMS Patna 40

41. Q9) A one year old child has come to your OPD. He received his last DPT vaccine at 6 weeks of age. Which one is true? A) Skip DPT B) Give 2nd dose of DPT C) Give 1st dose of DPT again and restart schedule D) None of the above Dr Venkatesh Karthikeyan, AIIMS Patna 41

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46. Q9) A one year old child has come to your OPD. He received his last DPT vaccine at 6 weeks of age. Which one is true? A) Skip DPT B) Give 2nd dose of DPT C) Give 1st dose of DPT again and restart schedule D) None of the above Dr Venkatesh Karthikeyan, AIIMS Patna 46

47. Q10) Routine screening is cost effective and recommended in VDRL Bacteriuria GDM ECHO Dr Venkatesh Karthikeyan, AIIMS Patna 47

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49. Q10) Routine screening is cost effective and recommended in VDRL Bacteriuria GDM ECHO Dr Venkatesh Karthikeyan, AIIMS Patna 49

50. Q11) Which of the following is true regarding genetic screening? Screening requires genetic mapping Screening tests define risk of passing genetic disorder Screening is more accurate than diagnostic tests It is usually invasive Dr Venkatesh Karthikeyan, AIIMS Patna 50

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53. Q11) Which of the following is true regarding genetic screening? Screening requires genetic mapping Screening tests define risk of passing genetic disorder Screening is more accurate than diagnostic tests It is usually invasive Dr Venkatesh Karthikeyan, AIIMS Patna 53

54. Q12) True regarding Human Genome project? It is done with international collaboration 20,000 genes were identified Uses next generation sequencing Takes more than 20 years to complete Dr Venkatesh Karthikeyan, AIIMS Patna 54

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58. Q12) True regarding Human Genome project? It is done with international collaboration More than 20,000 genes were identified Uses next generation sequencing Takes more than 20 years to complete Dr Venkatesh Karthikeyan, AIIMS Patna 58

59. Q13) Which of the following Leprosy contacts should be considered for post exposure prophylaxis? Age <2 years Sharing clothes with the patient Living in contact with patient for >6 months Living in contact with the patient for >20 hours a week Dr Venkatesh Karthikeyan, AIIMS Patna 59

60. Post Exposure Prophylaxis – Inclusion criteria A person who has been living/working/having social activities for more than 3 months and have 20 hour/week with a newly detected case of leprosy in last 1 year Age older than or equal to 2 years. Made in India vaccine – Mycobacterium Indicus Pranii vaccine (2017) Dr Venkatesh Karthikeyan, AIIMS Patna 60

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62. Q13) Which of the following Leprosy contacts should be considered for post exposure prophylaxis? Age <2 years Sharing clothes with the patient Living in contact with patient for >6 months Living in contact with the patient for >20 hours a week Dr Venkatesh Karthikeyan, AIIMS Patna 62

63. Q14) Admission to isolation room is advised for which airborne infection? Measles Nipah encephalitis Aseptic meningitis CJD Dr Venkatesh Karthikeyan, AIIMS Patna 63

64. Q14) Admission to isolation room is advised for which airborne infection? Measles - Airborne Nipah encephalitis – Fomite/droplet Aseptic meningitis - ? CJD – No person to person transmission Dr Venkatesh Karthikeyan, AIIMS Patna 64

65. Q15) Which of the following is not routinely screened for – before blood transfusion? Malaria Dengue HBV HIV Dr Venkatesh Karthikeyan, AIIMS Patna 65

66. Q15) Which of the following is not routinely screened for – before blood transfusion? Dr Venkatesh Karthikeyan, AIIMS Patna 66

67. Q15) Which of the following is not routinely screened for – before blood transfusion? Dr Venkatesh Karthikeyan, AIIMS Patna 67

68. Q15) Which of the following is not routinely screened for – before blood transfusion? Malaria Dengue HBV HIV Dr Venkatesh Karthikeyan, AIIMS Patna 68

69. Q16) Which of the following is true regarding typhoid control? Immunization is the most important measure Drug resistance in typhoid is not as big as in TB Person to person transmission is present in 10% of cases Safe disposal of human excreta, safe water supply and personal hygiene is more important than immunization Dr Venkatesh Karthikeyan, AIIMS Patna 69

70. Q16) Which of the following is true regarding typhoid control? Immunization is the most important measure Drug resistance in typhoid is not as big as in TB Person to person transmission is present in 10% of cases Safe disposal of human excreta, safe water supply and personal hygiene is more important than immunization Dr Venkatesh Karthikeyan, AIIMS Patna 70

71. Q17) A patient presents to you with 3 weeks fever and abdominal distension. Antibiotics and antimalarials were not helpful. He turned out to be rk39 dipstick test positive. Which drug can be used? Fluconazole Bedaquiline Amphotericin B Penicillin Dr Venkatesh Karthikeyan, AIIMS Patna 71

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73. Q17) A patient presents to you with 3 weeks fever and abdominal distension . Antibiotics and antimalarials were not helpful. He turned out to be rk39 dipstick test positive. Which drug can be used? Dr Venkatesh Karthikeyan, AIIMS Patna 73

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75. Q17) A patient presents to you with 3 weeks fever and abdominal distension. Antibiotics and antimalarials were not helpful. He turned out to be rk39 dipstick test positive. Which drug can be used? Fluconazole Bedaquiline Amphotericin B Penicillin Dr Venkatesh Karthikeyan, AIIMS Patna 75

76. Q18) A 25 year old male presents will fevers & chills for one week and altered sensorium for one day. RDT Pf is positive. Which of the following is not a complication? Creatinine >3 mg/dl RBS < 40 mg% Unarousable coma Arterial pH > 7.4 Dr Venkatesh Karthikeyan, AIIMS Patna 76

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78. Q18) A 25 year old male presents will fevers & chills for one week and altered sensorium for one day. RDT Pf is positive. Which of the following is not a complication? Creatinine >3 mg/dl RBS < 40 mg% Unarousable coma Arterial pH > 7.4 Dr Venkatesh Karthikeyan, AIIMS Patna 78

79. Q19) As per NTEP, high priority TB – HIV district is defined as? >10% population of known HIV+ among TB patients tested for HIV in district >12% population of known HIV+ among TB patients tested for HIV in district >15% population of known HIV+ among TB patients tested for HIV in district >20% population of known HIV+ among TB patients tested for HIV in district Dr Venkatesh Karthikeyan, AIIMS Patna 79

80. Q19) As per NTEP, high priority TB – HIV district is defined as? >10% population of known HIV+ among TB patients tested for HIV in district >12% population of known HIV+ among TB patients tested for HIV in district >15% population of known HIV+ among TB patients tested for HIV in district >20% population of known HIV+ among TB patients tested for HIV in district Dr Venkatesh Karthikeyan, AIIMS Patna 80

81. Q20) Which of the following is false regarding Rabies immunoglobulin? IM dose is 20 IU/Kg Not given after 7 days of 1 st vaccine dose Equine RIG can be used when Human Ig is not available Maximum dose of Ig must be given at deltoid Dr Venkatesh Karthikeyan, AIIMS Patna 81

82. Q20) Which of the following is false regarding Rabies immunoglobulin? IM dose is 20 IU/Kg Not given after 7 days of 1 st vaccine dose Equine RIG can be used when Human Ig is not available Maximum dose of Ig must be given at deltoid Dr Venkatesh Karthikeyan, AIIMS Patna 82

83. Q21) Endogenous transmission in India is reported for Ebola virus Hendra virus Yellow fever CCHF Dr Venkatesh Karthikeyan, AIIMS Patna 83

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86. Q21) Endogenous transmission in India is reported for Ebola virus Hendra virus Yellow fever CCHF Dr Venkatesh Karthikeyan, AIIMS Patna 86

87. Q22) India is a diverse country with various culture and languages. Which of the following is correct? Give due emphasis on patient’s cultural extent Leave Communication to interpreter Physician may consider giving emphasize on communication Treat patients regardless of their perception Dr Venkatesh Karthikeyan, AIIMS Patna 87

88. Q22) India is a diverse country with various culture and languages. Which of the following is correct? Give due emphasis on patient’s cultural extent Leave Communication to interpreter Physician may consider giving emphasize on communication Treat patients regardless of their perception Dr Venkatesh Karthikeyan, AIIMS Patna 88

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90. Thank you! t.me/ drvkspm www.drvenkateshkarthikeyan.com Dr Venkatesh Karthikeyan, AIIMS Patna 90