COMMUNICABLE DISEASES

RESPIRATORY DISEASES

TB

Q1.Relapse mean

a.who has a positive smear at 5 months of treatment.

b.were declared cured and now diagnosed with as TB .

c.who have been previously treated for TB and whose treatment has failed at end of course

d.who received 1 month or more of anti TB drugs in past .

Ans:b

Tips: who has a positive smear at 5 months of treatment=Failure

who have been previously treated for TB and whose treatment has failed at end of course =
treatment after failure

who received 1 month or more of anti TB drugs in past=previously treated patients

A patient whose treatment was interrupted for 2 consecutive monthsor more =Default

Q2.Prevalece of Tb estimated by

a.tuberculin coversion index

b.tuberculin test

c.sputum smear examination

d.None

Ans:b

Tips: Incidence of TB infection- Tuberculin conversion index is the ‘best indicator for evaluation of TB problem
and its trend’ in the community

Prevalence of TB infection- Tuberculin test is the ‘only way of estimating the prevalence of infection in a
population’Q
• Incidence of disease- Sputum smear examination (AFB) is a reliable method for estimation

Prevalence of disease or case rate: Percentage of individuals whose sputum is positive

for TB bacilli on microscopic examinationQ
– ‘Best available practical index to estimate case load’ in communityQ

Q cat II treatment is done for

a. Default
b. New pulmonary cases
c. Extrapulmonary cases
d. None
ANs: a

Q Chancroid is caused by
a.treponema pallidum

b.H .ducreyii

c.n gonorrhoea

d.none

ANs b

INFLUENZA

SARS

VECTOR BORNE DISEASES

MALARIA

Q.radical cure of malaria is done by

a.artimisinin derivative drugs

b.primaquine

c.quinine

d.cholroquine

Ans:b

Q. peak of fever concide with release of successive broods of

a.sporozoites

b. merozoites

c.both

d. none

Ans: b

FILARIA

Q. chief Vector of Lymphilariasis in Nepal is

a.culex quinquefasciatus

b.Mansonia

c.Aedes aegypti

d.Anopheles

Ans:a
Q. topical pulmonary eosinophilia is

a.occult type filariasis

b.acute filariasis

c.chronic filariasis

d.asymptomatic microfilaremia

Ans:a

Q.wucheria bancrofti has vector of type

a.cyclopropagative

b.cyclodevelopmental

c.Both a and b

d.None

Ans: b

Q only reported parasite for filariasis in NEPAL is

a.wucheria bancroftio

b.brugia malayii

c.brugia timori

d.all of above

ANs: a

DENGUE

QExtrinsic incubation of period of dengue is

a.3 -5days

b.8-10days

c.12-14days

d.18-21days

Ans:b

LEISHMANIASIS

Q.RK-39 dip stick test is used for

a. typhoid

b.filariasis

c.leishmaniasis
d.malaria

Ans:c

INTESTINAL INFECTIONS

ACUTE DIARRHEAL DISEASES

VIRAL HEPATITIS

Q.Serum marker for infectivity of hepatitis is

a.HbcAb

b.HbsAg

c.HBeAg

d.Anti HBS

ANs: b

TYPHOID FEVER

Q.1Treatment of typhoid carrier is

a.ceftriaxone

b.ampicillin/amoxicillin

c.azithromycin

d.vancomycin

Ans:b

TIPS:

Treatment of case : ceftriaxone

Case depend on carriers .surgically

BIliary carriers –cholecystectomy

Intestinal carriers- Resection of loop

Urinary carriers – partial or total nephrectomy

Q.2.Disinfectant of stool of typhoid patients-

a.Cresol

b.Formaldehyde

c.chlorhexidine solution

d.Spirit

ANS:a
Q.convalescent carrier excrete bacilli for 3-8 weeks …

CHOLERA

ZOONOSIS

RABIES

JAPANESE ENCEPHALITIS, CHINGENGUNYA AND YELLOW FEVER

Q.1Amplifier host in JE is

a.horse

b.cat

c.pig

d.dog

Ans:c

Q.2.WHO recommended validity of vaccination certificate for International travel

a.lifelong

b.10 years

c.20years

d.35 years

Ans:10 years

Tips: live attenuated vaccine,strain17D

Dose 0.5ml route –subcutaneous

Immunity lasts from 7 days of vaccination till 35 years

YF is only vaccine that can be administered in pregnancy (if there is risk of exposure)

Q.3 chickenguniya is caused by vector

a.culex

b.anopheles

c.aedes aegypti

d.mansonides

Ans:c

Q.Aedes is not vector of

a.yellow fever
b.chickenguniya

c.Dengue

dJE

Ans d

PLAGUE

SURFACE INFECTIONS

STDS

Q.Primary prevention of STD

a.hand wash

b.promotion for one sexual partner

c.routine checkup

d.treatent of symptoms

Ans:b

HIV/AIDS

Q Risk of association of HIV in STD is

a.5 times

b.10 times

c.15 times

d.22 times

Ans: b

Q. Absolute CD4 count in AIDS is below

a.100micro/l

b.200micro/l

c.300micro/l

d.500 micro/l

Ans:b

Q. AIDS transimisson in Nepal is due to

a. IV injection

b.sexual contact

c.placental transmission

d.none

Ans: b

LEPROSY

Q.ENL lesions occurs in

a.tuberculoid leprosy

b.boarderline leprosy

c.lepromatous leprosy

d.all of above

Ans:c

Q.Lepromin rxn in leprosy indicates

a.diagnostic

b.prognosis

c.both

d.none

Ans: b

Q.A patient presented with abrasion and laceration whose has completed doses of vaccination 10
years back .following of which is correct?

a. single dose of tetanus toxoid is given

b. give full dose of tetanus toxoid

c no need of Tetanus toxoid

d.none

Ans: a

Q paucibacillary leprosy is treated by

a.dapsone and rifampicin for 6 month

b.dapsone and rifampicin for 12 month

c dapsone rifampicin and clofazimine for 6 month

d.dapsone rifampicin and clofazimine for 12 month

Ans: a

EMERGING AND RE-EMERGING DISEASES

HOSPITAL ACQUIRED INFECTIONS

CBIMCI

Q.14 months child cut off for fast breathing is

a.20

b.30

c.40

d.60

Ans:c

VACCINE PREVENTABLE DISEASES , EPI, COLD CHAIN

Q1.Vaccines given at 3.5 month is (NMC)

a.JE

b.OPV, IPV and Pentavalent

c.measles

d.none

Ans:b

Hints:JE (12 months)

OPV, Pentavalent (6,10,14) weeks of age

FIPV(6,14 weeks of age )

PCV(6,10 weeks and 9 months)

FOR VIVA AND MCQ : Tetanus toxoid:2 doses one month(16-20 weeks) apart in pregnant woman, or
a booster dose if previously immunized .

Q2.Diluents of BCG vaccine (NMC)

a.Normal saline

b.distilled water

c.phosphate buffer saline

d.dextrose solution

Ans: a
Hints:Diluents of Measles:Distilled water or sterile water

Diluents of JE : Phosphate buffer saline

BCG dose:0.1 ml

Route:Intradermal

Site:Skin over right deltoid muscle (NEPAL)

Protection duration :20 years

Q3.Diluents of Measles(NMC)

a.Normal saline

b.distilled water

c.phosphate buffer saline

d.dextrose solution

Ans: b

Additional points :

Measles vaccine route :Subcutaneous

Dose-0.5ml Time of administration (9 and 15 months)

Site-Anterolateral aspect of thigh, contraindicated in pregnancy.

Ideal gap b/w 2 successive doses of Measles vaccine:6 months

Protection duration : life long

Q.4.Diptheria is

a.killed

b.conjugated

c.live

d.toxoid

Ans: d

OCCUPATIONAL HEALTH

Q.1.Respirable dust particles is of size less than

a.10microns

b.8microns

c.5microns

d.3microns
Ans:c

Tips:>10 microns settle down to floor and smaller one suspended in air .<5 microns are directly
inhaled into the lungs and are retained there –this fraction of dust is ‘respirable dust ‘ and is mainly
responsible for PNEUMOCONIOSIS.

Qcommon occupational cancer is

a.skin ca

b.lung cancer

c.bladder ca

d.mesothelioma

ANs: a

Q.sugar cane dust causes

a.bysinnosis

b.farmer lung

c.baggasosis

d.acute rhinosinusitis

Ans: c

Tips:
AnthracosisQ- Coal dust
ByssinosisQ Cotton fibre
BagassosisQ Molasses (sugarcane)
Farmer’s LungQ Mouldy hay
Siderosis Iron dust
Stannosis Tin dust
Bird fancier’s lungQ Avian/ bird droppings
Disease AntigenQ
Bagassosis Thermoactinomyces sacchari
Farmer’s Lung Micropolyspora faeni
Compost lung Aspergillus
Chemical workers lung Isocyanates

Q. welder flash is due to

a.uv radiation

b.xrays

c.gamma rays

d.infra red rays

Ans:a

MENTAL HEALTH

Q.Highest sucide among

a.15-35 yr

b35-50yr

c.50-65yr

d.>65yr

Ans:15-35 yr

Q.drug dependency is

a.compulsion to take drugs for pleasure

b.

c.

d.

Ans:a

NON COMMUNICABLE DISEASES

Epidemiology of non-communicable diseases

Q.Gap in natural history of NCD is due to

a.multifatorial causation

b.is not communicable

c.no vector

d.slowly progressive

Ans: a

Some tips :

NCD donot have defined Incubation period.

Multifactorial

Natural history is uncertain.

Slowly progressive.

Usually non reversible and permanent pathology.

Leave some residual disability. Rehabilitation is necessary .

Definite LAG period b/w behavioural change and disease progression.

Q.Chronic disease has features of except

a.Weight loss

b.suicidal tenderness

c. slowly progressive

d.no definte incubation period

Ans: b

Nutritional disorders

Q.Iodine at consumer level should be

a.15

b.20

c30

d.40

Ans:c

Q.Vitamin A dose in child 2 years is

a.50000IU

b.100000IU

c.200000IU

d.20000IU

ANs:c

Rheumatic heart diseases

Q.Not a major criteria for RHD

a.carditis

b.polyarthalgia

c.chorea

d.erythema nodosum

Ans:b

Coronary heart diseases

Q.coronary heart disease risk factor is

a. mean serum cholesterol level <200mg/dl

b.HDL cholesterol >30mg/dl

c.cholesterol/HDL ratio <3.5

d.Transfatty acid

Ans:d

Tips:

Prudent Diet(dietary goals)-it is major preventive strategy for prevention of CHD.

• WHO recommended changes: [GOALQ : Cholesterol/HDL Ratio < 3.5]
– Reduction of fat intake to < 20 – 30 % of total energy intakeQ
– Consumption of saturated fats < 10 % of total energy intakeQ [<7% NEW
GUIDELINE]
– Reduction in dietary cholesterol to < 200 mg per day
– Increase in complex carbohydrate consumption
– Reduction of salt intake to < 5 gms per dayQ
– Avoidance of alcohol consumption

Q.Commonest manifestation of RF is

a.carditis

b.eryhthema marginatum

c.subcutaneous nodules

d.polyarthritis

Ans: d

Hypertension

Q.Rule of halves is for

a.diabetes

b.hypertension

c.coronary heart disease

d.blindness

Ans: b

Cancers

Q.Following statement are true except:

a.world cancer day each year on Feb 4th

b.can be prevented by vaccination

c.radiation exposure can cause cancer

d.can be prevented by control of tobacco and alcohol consumption.

Ans:b
Blindness

Q.commonest cause of blindness in Nepal is

a.glaucoma

b.cataract

c.Refractive error

d.trachoma

Ans: b

Diabetes

Q.which of following is true?

a.HbA1c 8% is normal.

b.it is indicator of long term glycemic control

c.HbA1c provides and index of average blood glucose level during past 6 month

d.All of above

Ans: b

TIpS: HbA1c provides and index of average blood glucose level during past 3 month.( Not 6
month.)

HbA1c <6% is normal

Obesity

Q1.Waist hip ratio are at high risk of metaolic complication if

a.men with WC >88 or women with >102cm

b.men with WC>102cm or women with WC>88cm

c.men with WC<88 cm or women with WC<102cm

d. men with WC <102 cm or women with WC <88cm

Ans:b

Hints: WHR >1(men) and WHR(women)>0.85 are at high risk of metabolic complication .

Q.2. Following statement is true except:

a. obesity is rare in low socioeconomic status

b. obesity can occur at any age

c.women have higher rate of obesity than men

d.obesity has familial tendency .

Ans:a
Hints:inverse relationship b/w socioeconomic status and obesity.Obesity has been found to be more
prevalent in the lower scio economic status (K.park)

Q.3.obesity starts from

a.25kg/m2

b.30 kg/m2

c.35 kg/m2

d.40 kg/m2

Ans:30 kg/m2

Normal BMI=18.5-24.9

Preobese 25-29.9

Obese I =30-34.9

Obese II 35-39.9

Obese III >40

Q.4.Brocca index include

a.weight

b.height

c.BMI

d.WHR

Ans: height

TIPs Brocca index- height(cm)-100 =expected weight. Suppose 150cm is height of someone then
expected weight is 150-100= 50kg .More than this is risk of obesity .

Accidents

Q. Not common accident in Nepal

a.RTA

b.plane crash

c.rail way accidents

d.snakebite

Ans: c

Q.Disability means

a.loss of anatomical parts of body

b.unable to carry out normal activities

c.social disadvantages due to anatomical loss

d.all

Ans:b

Tips: Disease process-An intrinsic situation

Impairment- defect in structure and function of an organ/system

Disability-inability to carry out expected activities

Handicapped – a disadvantage experienced such as loss of job due to impairment or diability.

Q.Loss of leg in RTA is

a.Impairment

b.disability

c.handicapped

d.Disease process

Ans:a

Q.Blind not getting job is

a.Impairment

b.disability

c.handicapped

d.Disease process

Ans:c

Q.Indicator of diability is

a.QALY

b.DALY

c. loss of both senory and motor function

d.all

Ans:b

REPRODUCTIVE HEALTH

Q.1.Unmet need of family planning means

 a. Those women who are not using any contraceptive method,but do not want any more
children
b. Use contraceptive method despite have interest of child
c. Using contraceptive method and do not want child
d. Don’t want to wait to have child by using contraceptive method
Ans:a

Q2.Criteria for recognition of the hospitals as ‘Baby Friendly’ except

a. Have a wtitten breastfeeding policy

b. Train all health care staff by mother
c. Practice Rooming in for 24 hour
d. Show mothers how to breastfed and to maintain lactation.

ANS:b

Q2.Choice of contraception for lactating mother

a.IUCD

b.lactation amenorrhoea

c.OCP

d.Depo

Ans:a

Tips: IUCD

side effect:1st m/c increased vaginal bleeding

2nd m/c common-pain

Pelvic infn

Uterine perforation and spontaneous expulsion

Absolute Contraindication:suspected pregnancy,pelvic infn,ca of cervix

Q3.Dose of estradiol in OCP

a.20mcg

b.30mcg

c.40mcg

d75mcg

Ans:30mcg

Q.4Mother milks contain

a.cystine and taurine

b.methionine and argemonine

c.methionine and cystine

d.cystine and arginine

Ans: a

Q.5.ANC visit should be minimum of

a.4 times

b.6 times

c.8 times

d.9 times

Ans: 4 times

Tips:ANC visits months: 4,6,8,9 months

PNC visits months:1st day 3rd day and 7th day

QN.6 dettol consists of

a. Cresol
b. Phenol
c. Povidone iodine
d. Chlorxylenol
ANS:d

Q7.Scabies is caused by
a. hard ticks
b. flies
c.mites
d.soft ticks
Ans:c

Q.8 rats are controlled by

a. cypermethrin
b.malathion
c zinc phosphide
d.parathion
Ans : c

NATIONAL HEALTH AND PROGRAMS for SPECIFIC AGE GROUPS

School health programs

Q.1. Ideal school desk according to school health is

a.plus desk

b.minus desk
c.zero desk

d.none

Ans: b

Q.2.Health ful school environment include

a.1 urinal per 100 students and 1 latrine per 60 students

b.1 urinal per 60 students and 1 latrine per 100 students

c.1 urinal per 40 students and 1 latrine 80 students

d.1 urinal per 80 students and 1 latrine 40 students

Ans: b

Tips :

Healthful school environment

– Location: Away from noisy surroundings; kept fenced
– Site: 5 acres for primary schools; 10 acres for higher elementary schools
– Structure: Exterior walls 10 inch thick and heat resistant
– Class room: 1 class room per 40 students maximumQ
– Per capita space: >10 sq. feetQ
– Furniture: Single desks of ‘minus (–) type’Q
– Doors and windows: Doors and windows area > 25% of floor areaQ
– Color: Inside color of walls should be white
– Lighting: Natural light from left side
– Water supply: Safe and potable and continuous supply through taps
Visual acuity cutoff for referral to PHC :<6/9
Q.3.True according to school health services
a. most light should be from left side
b.most light should be from right side
c.most light should be from front side
d.most light should be from backs side
Ans:a

HEALTH PLANNING AND MANAGEMENT

Q.1 Behavioural based management method is

a.cost benefit analysis

b.input output analysis

c.personnel management

d.Decisoon making

Ans:c

Q.2.Graphic plan of all events and activities to reach end objectives is

a.system analysis

b.input output analysis

c.planning programming budgeting system

d Critical pathway method .

Ans:d

Q.3.1st step in Planning cycle is

a.Analysis of health situation

b.Establishment of objectives

c.fixing priorities

d.programming

Ans:a

Q.4.PERT is

a. system analysis

b. network analysis

c.program budgeting planning system

d.cost accounting analysis

Ans: b

Q. objective means

a. end planned of all activities

b. ultimate desired state towards which objectives and resources are directed

c.sequence of activities designed to implement policies

d.time sequences for the work to be done

Ans : a

HINTS: ultimate desired state towards which objectives and resources are directed=goal

sequence of activities designed to implement policies =programme

time sequences for the work to be done =schedule

HEALTH DELIVERY SYSTEMS IN NEPAL

Q.1.Head of health post is

a. Medical officer (MO)

b.HA

c. District public health officer

.none

Ans: b

Hints head of PHC - MO

Q1.Neonatal mortality rate of Nepal is

a.15

b.23

c.28

d.32

Ans:23

Q2.Not in geriatrics group occur

a.BPH
b.Age related macular degeneration

c.cataract

d.senile deafness

Ans:senile deafness

INFERENTIAL STATISTICS

1.Z score = (Observation-mean ) _

= x- X (NMC)
SD SD

2.Probability Value ranges from 0-1(NMC)

3.Mean of binomial probability=np(NMC)
4.standard deviation of binomial probability is npq ,where q=1-p
5.type II error = beta
Type I error is more serious than Type II error.
6.Power of test=1-beta
7.Not required for chi square test is (NMC)
a.Mean and SD of the group
b.each expected cell frequency>5
c.Large sample
d. contingency table
Ans: a.Mean and SD of the group
Additional points :
CHI-SQUARE TEST
Is non parametric test of significance .
Is used to test significance of association b/w 2 or more qualitative characteristics
Application:test of proportions,test of association and test of goodness of fit
Essential requirements for calculation of CHI SQUARE test:Random sample,Qualitative
data and lowest expected frequency not <5

8.What will be the degree of freedom in no of row 3 and col 4

a.3
b.6
c.4
d.9
Ans: b.6
Hints: In Chi-square (x2) test, for independence of two
classifications, DF = (r – 1) (c – 1) where ‘r’ and ‘c’ are the
number of rows and number of columns in the table.

In unpaired ‘t-test’ of difference between the means,

degrees of freedom (DF) = n1 + n2 – 2, where n1 and n2
are the number of observations in each series.
In paired ‘t-test’ DF = n – 1.

9. Test of statistical significance

For qualitative data:
• For sample size more than 30
– Standard error of proportion
– Standard error of difference
between two proportions
– Chi-square test
For quantitative data:
• Sample size more than 30
– Standard error of mean
– Standard error of difference
between two means
– “Z” test
• Sample size less than 30
– Paired t-test
– Unpaired t-test

10.Sampling
1. Probability sampling methods (Random sampling
methods)
a. Simple random methods (Unrestricted random
sampling)
b. Systematic random sampling
c. Stratified random sampling
d. Multistage random sampling
e. Cluster random sampling
f. Multiphase random sampling
2. Nonprobability sampling methods
a. Accidental or incidental sampling
b. Judgement sampling or purposive sampling
c. Quota sampling
d. Convenience sampling
e. Sequential sampling.
DISASTER MANAGEMENT

INTERNATIONAL HEALTH

RESEARCH SKILLS