8

PSM
AIIMS MAY 2015

Sensitivity is
True positives
Interpretation of tuberculin test becomes difficult in
High BCG coverage area.
Data is collected and analysed. By mistake, highest
value is written as 85 which is actually 58. What
change will occur
Mean will increase but the median will remain the
same.
HDI includes
Life expectancy at birth, knowledge and decent
standard of living.
Test used for comparing birth weight measurements
of babies of mothers belonging to two group in
which mother of one group received supplemental
diet while mother in other group did not receive
supplemental diet
Students T test.
DBP of 200 people has been measured and arranged.
1st quartile 85, 3rd quartile 110. How many people
have DBP above 11050.
Haddon matrix can be used for
Prevention of injuries and accidents.
Nikshay is the software prepared by the government
for
Surveillance of TB cases.
Food safety and standard authority of India comes
under
Ministry of health and family welfare.
Immunization status of children is assessed by
District level household survey
A child is bitten by the dog unprovoked. Dog is
caught and appears healthy. What should be done

Start post exposure prophylaxis and observe the

dog.
In a community of 100 people, average of GFR is
measured to be 85ml/min with standard
deviation 25, what is 90% confidence range of
GFR
8189
A cigarette smoker thinks that he will not have
cancer as he takes less number of cigarettes and eats
healthy diet and does regular exercise. This theory
is called as
Self exclusion
Over few years, trend is changing from
communicable diseases to non communicable
diseases in a community. What type of trend is
nored
Secular trend
An epidemiologist is conducting a cohort study. He
selects a group that includes non smokers and
another group of smokers. But he thinks that non
smoker persons may be more health conscious and
more likely to do regular exercise. What type of bias
is likely in this study
Selection bias
True about Japanese encephalitis vaccine are
Not given in less than 6 months of age, two primary
doses should be given and protection lasts for 3
years.
AIIMS NOVEMBER 2014

Population attributable risk is

Incidence of disease/death in the total population
to those who were not exposed in relation to the
total population.
87

88

AIIMS and All Indian PGMEEReview Questions

If the association between smoking and CHD

increases from low level of physical exercise to high
level of physical exercise, then physical exercise in
relation to the association between smoking and
CHD is known as
Effect modifier
The objective criteria for detecting community
spread of pandemic influenza A H1N1 are
One or more cases should be laboratory confirmed
with pandemic influenza A H1N1, cases should be
reported over 2 weeks and presence of at least 25
linked epidemiologically suspect cases.
School closure is a common strategy to keep
pandemics of influenza under control in the
absence of vaccines in developing countries. This
rationale is based on
Children are the most susceptible age group, children
are the primary transmitters of influenza and
contact rates are particularly high in school context.
Form of vaccine derived polio virus (VDPV)
iVDPVs, aVDPV and cVDPVs
True about Chandlers index
Calculates the average number of hookworm eggs
per gram of faeces for the entire community,
indicates magnitude of public health problem and
indicates effectiveness of mass treatment.
Under RNTCP, test used for diagnosis of a TB case
Sputum staining
Strategy employed by the NPCB to evaluate post
operative visual outcomes following cataract
surgery extraction
Passive surveillance
The outcome indicator for NPCB is
Number of cataract surgeries with restored vision.
The chairman of district blindness control society is
District collector
True about cataract surgical rate (CSR)
It is the number of cataract surgeries performed per
million population per year, a CSR of 3000 is
recommended under vision 2020 and it indicates
the effectiveness of cataract services delivery.
True about Rashtriya Swasthya Bima Yojna(RSBY)
Only below poverty line families to be covered
under RSBY.
A medical officer wants to estimate the number of
children in a village. He can get a rough estimate
quickly from
Adult folifer consumption in the last 1 year.

The nutritional supplementation recommended

under ICDS for pregnant woman is
600 calories and 1820 grams of protein per day.
The most effective antilarval measure for control of
urban malaria is
Filling up of all ditches and cess pools.
True about inertization
Waste is mixed with cement, it is relatively inexpensive
and used for disposal of pharmaceutical waste.
Objectives of the National Mental Health Programme
Availability and accessibility for minimum health
services to all, promote community participation
in mental health service development and
application of mental health knowledge to general
health care.
True about Employees State Insurance Act 1948
The beneficiaries are entitled to funeral expenses
upto Rs 5000.
In a sampling, from a given sampling frame, every
10th person is selected starting from a random
person. This method of sampling is called as
Systemic sampling
The measure of variation used to compare two data
with different scales of measurement is
Coefficient of variation
AIIMS MAY 2014

The prospectively evaluated, double-blinded,

randomized clinical trial represents the gold
standard for providing evidence for therapeutic
decision making. This was first proposed by the
father of evidence based medicine
Sackett
True about the calculation of HDI
The minimum value for combined gross enrolment
ratio is fixed at 0%, the minimum value for adult
literacy rate is fixed at 0 and the maximum value for
per capita income is fixed at 40,000.
True about education in HDI
Countrys achievement is computed on the basis of
adult literacy.
Immune thrombocytopenic purpura is observed as
a complication with vaccine
MMR
Chemoprophylaxis is indicated for
Cholera, meningococcal meningitis and conjunctivitis.

PSM

True about INH chemoprophylaxis

It is not feasible to apply on a large scale, it has risk
of drug induced hepatitis and it is not highly
clinically effective.
Positive predictive value is a function of sensitivity,
specificity and
Prevalence
True about period of isolation
Chicken pox-6 days after onset of rash, measles-3
days after onset of rash and Herpes zoster- 6 days
after onset of rash.
True about OPV
Useful in epidemics, rapid antibody response and
protective even in presence of maternal antibodies.
HIV sentinel surveillance provides data
To monitor disease trends.
A boy complained of unprovoked bite by a local
dog in the community. The dog was later caught by
the local animal authorities and appeared to be
healthy. The most appropriate action
Give post exposure prophylaxis to the bitten person
with cell culture derived vaccine.
Evidence of decreased risk of cardiovascular
disease is associated with
Low to moderate daily alcohol consumption,
regular physical activity and potassium.
Under the school vision screening programme,
vision screening in schools is done by
Teacher
Under NRHM, an ASHA will receive financial
remuneration for
Institutional deliveries, 1st dose of DPT and OPV,
registration of birth.
The provision under Janani Shishu Suraksha
Karyakram include
Free food to the mother in the hospital, free
transport to the mother and baby to/from hospital
and free treatment of the neonate and infant in all
public health facilities.
Calculate the neonatal mortality rate for a
population with number of neonatal deaths-450,
number of stillbirths-212, total number of live
births-12, 450 in the year 2012.
36
Infant mortality rate includes
Early neonatal death, late neonatal death and post
neonatal death.

89

A girl is having white hair. 40% of her classmates

are also suffering from the same problem while
none of the other in the village is suffering from it
and her brother living in neighbouring village with
a aunt is also normal. Which explains the probable
cause of her white hair
Environmental
Severe acute malnutrition (SAM) in India is
suffering from
Very low weight for height (below-3Z scores of the
mean WHO standards for growth), by visible
severe wasting, or presence of nutritional edema.
The most sensitive indicator of environmental
iodine deficiency is
Urine iodine excretion
Which can cause epidemic in post-disaster period
Leptospirosis, rickettsiosis and acute respiratory
infection.
The hemoglobin levels of pregnant females in a
community was found to have a mean of 10.6 g/dl,
and a standard deviation of 2 g/dl. What is
minimum Hb level below which 5% of the pregnant
women would have their Hb levels
6.68
Universal health coverage in India was recommended by
High level expert committee
Provisions included in the primary health care
according to the Alma Ata declaration
Adequate supply of safe drinking water, provision
of food supply and basic sanitation.
AIIMS NOVEMBER 2013

True about Rashtriya swasthya bima yojna

Applies to BPL only
True about roll back malaria
Insecticide treated mosquito nets, strengthening
health system and training of health workers.
Recommended daily intake of iodine in pregnancy
250 g
To evaluate post operative vision effects after
cataract extraction surgery under NPCB, what is
used
Routine check up of all operated cases.
Common causes of epidemic after a disaster
Leptospirosis, rickettsia and acute respiratory
infections.

90

AIIMS and All Indian PGMEEReview Questions

GDP proportion spent on public in India

0.012
Under 5 mortality rate in the world by 2010
8 million
According to WHO classification,highly toxic
insecticide are coded as
Red
True about screw feed technology
Reduce weight by 30%, reduce volume by 80% and
non burn heat sterilization technique.
Vaccines given according to national immunization
schedule at 5 years of age
DT booster
Measles vaccination to all 9 months-14 years
children is part of WHO strategy
Catch up
True about ESI act
State govts share of expenditure on medical care is
1/8, ESIs share is 7/8 of total cost.
Area under normal curve with 1 standard deviation
0.34
In a study of 2000 population, mean value of
hemoglobin is 13.5 gm, which follows normal
distribution curve. Percentage of people having
higher hemoglobin than 13.5 gm is
50%
Statistical Q test is used for
To determine outliars
In assessing the literacy, the parameter used is
Age above 7 years
True about folic acid
Present in all grean leafy vegetables, proven to
decrease the occurrence of neural tube defects when
taken preconceptionally and methyl folate trap is
because of methionine synthase defect.
True about polio
Last case of wild polio virus was found on January
13, 2011
A 55 year old diabetic patient presents with
transient obscuration in vision for 23 days
followed by sudden loss of vision. Best test to
evaluate him
Serum creatinine levels
A drug that can replace valproate as montherapy
being taken by a female patient of child bearing age
for juvenile myoclonic epilepsy
Levetiracetam

A patient on amphotericin B develops hypokalemia

of 2.3 mEq/l, supplementation required
120160 mEq/over 24 hours
Investigation not done in patient with tubercular
meningitis on regular ATT for 1 month presenting
with altered sensorium
CSF examination
Recently approved drug by USFDA for treatment of
Lennox- Gestaut syndrome
Rufinamide.
A patient with native aortic valve disease came with
right hemiparesisdone. Done to prevent further stroke
Antiplatelet only
True about CML in children
Protein tyrosine kinase inhibitors are used in
treatment.
Coarse tremors of tongue seen in
Parkinsonism, alcohol and general paresis.
A lady developed breathlessness, pruritus,
urticaria 1 hour after eating NSAIDS for headache.
Chest showed rales and BP 80/50 mm Hg. Used for
initial management
Early respiratory support and oxygenation,
crystalloids infusion and adrenaline.
Which indicates renal impairment in contrast
induced nephropathy
Increase in serum creatinine.
A 50-years-old patient presented with progressive
jaundice. LFT showed total bilirubin-6.7%, direct
serum bilirubin- 4.8%, alkaline phosphatase-550 IU,
SGOT-50, SGPT-65. Most probable diagnosis
Jaundice due to choledocholithiasis
A 60 year old male patient with alcoholic liver
disease presented to emergency with a history of
hemetemesis. True about his management
Upper GI endoscopy is done initially, somatostatin
infusion is indicated and negative nasogastric
aspirate does not exclude variceal bleed.
A 50 year old male patient came to the emergency
with right hemiparesis and loss of speech for 2.5
hours. BP is 180/100. Next best step
Go for NCCT
A 30 yeaar old women from West Bengal presents
with fever for 48 hours with history of irrelevant
talk and 2 episodes of tonic clonic seizures on
succession on the way to the hospital. Drug given
while investigation is being carried out
IV acyclovir

PSM

A 14-years-old boy presents with abnormal body

movements with MRI showing signal changes in
corpus striatum, thalami, pons, medulla, centrum
semi ovale and asymmetric diffuse white matter
involvement. Most likely diagnosis
Wilsons disease
Glucocorticoid is used in
Severe typhoid
True about critical illness myoneuropathy
Diaphragmatic atony due to prolonged intubation
may cause it.
A patient developed sudden severe headache 2
hours ago and became unconscious. Upon regaining
conscious, patient developed photophobia and
neck rigidity. Next done
NCCT scan.
True about aspiration pneumonia- Aspiration of
2030 ml of contents with pH ? 2.5 is required,
posterior segment of the right upper lobe is most
commonly affected in the recombinant position and
aspiration is responsible for 515% of community
acquired pneumonia.
The most common type of Non-Hodgekins
lymphoma in India is
Diffuse large B cell lymphoma.
True about hemoptysis
Massive hemoptysis is bleeding ? 600 ml in 24
hours, in 90% cases, bleeding is from bronchial
arteries and in an unstable patient, rigid
bronchoscopy is done to identify the lesion.
Acquired cause of pure red cell aplasia are
ABO incompatability in bone marrow transplantatiojn, lymphoma and drug induced NSAID.
Criteria for admission in upper GI bleed are
Frank blood in nasogastric aspirate, BP ? 100 mmHg
and shock index ?1.5%.
True about iron deficiency anaemia
Transferrin saturation ? 16%, detected by serum
ferritin levels even in earlier states and latent
anaemia is most prevalent in India.
Drugs given in patients of primary pulmonary
hypertension
Bosentan
A 50 year old lady on junk food diet presented with
point hemorrhages in scalp, bleeding in joints and
erythematous lesions in the skin, X-ray of knee joint
was suggestive of hemarthrosis. Mechanism
defective

91

Hydroxylation of proline and lysine.

True about severe malaria- Hypoglycemia, blood
sugar ? 40 mg/dl, creatinine more than 3 mg/dl and
LDH ? 750 U/L.
Old age male patient, hypertensive, presents with
sudden onset headache, vomiting, neck rigidity,
but no focal neurological deficit. Most likely
diagnosis
Sub arachnoid hemorrhage.
AIIMS MAY 2013

THE PREVALENCE OF Candida glabrata infection

is found to be 80% in a diabetic sample of 100. If the
test is repeated for 95% confidence limits, then the
range of prevalence for the candida glabrata
infection
7288
The prevalence of a disease in a population is
expected to be 50%. An investigator is interested in
assessing the prevalence in the range of 45 to 55%
with 95% confidence limit. The minimum sample
size required for the study is
400
True about national programme for prevention and
control of cancer, diabetes, CVD and stroke
(NPCDCS)
Cardiac care and cancer care facility is to be
established at the district level hospital.
About deworming under national child health
programme, true are
It is done for all preschool and school children
yearly, albendazole 400 mg for ? 2 years and it is
linked with vitamin A supplementation programme.
Under NRHM, an ASHA will receive financial
renumeration for the following
Registration of births, 1st dose of DPT and OPV,
and institutional deliveries.
The estimation of prevalence of blindness by blind
school survey in place of population based survey
will lead to
Under estimation
When assessing the efficacy of a newly developed
drug in comparison to placebo, the 95% confidence
interval is used to extract
Both efficacy and non efficacy of the drug.
Growth monitoring by anganwadi workers under
ICDS programme is based on which guidelines
MGRS standards

92

AIIMS and All Indian PGMEEReview Questions

According to WHO definition, the criteria for

considering high endemic area for meningococcal
meningitis
> 10/1,00,000 population.
The 3 year bachelor of rural health care (BHRC) was
recommended by
High level expert group on universal health
coverage.
Human poverty index includes
Probability at birth of not surviving to age 40,
percentage of underweight children and
percentage of people without sustainable access to
an improved water source.
In the integrated disease surveillance project (IDSP)
diseases included
Acute respiratory infection, snake bite and
leptospirosis.
Polyvalent meningococcal vaccine is routinely
recommended to
Laboratory workers
The forth coming new mental health act in India is
named as
Mental health care bill
The number of millennium development goals
directly related to health is
3
The study regarding the brain and behavioural
changes in normal and damaged brain is known as
Neurodevelopmental psychology
Social pathology describes
Changes in the natural history of the disease due to
social factors.
Under vision 2020 the number of vision centres to
be set up is
20,000
Recommended oral dose of vitamin A in post
partum females is
2,00,000 IU
True regarding the period of isolation/quarantine
Chicken pox- 6 days after the onset of rash
Measles- 3 days after the onset of rash
Herpes Zoster- 6 days after the onset of rash.
AIIMS NOVEMBER 2012

True about OPV

Useful in epidemics, rapid antibody response and
protective even in presence of maternal antibodies.

Highest mean and lowest mode indicates

Positive skewing
Population of district-10 lakh. Under 16 years of
age-30%. Prevalence of blindness-0.8/1000 of
under 16 population. Total number of blind under
16 years of age 240.
If the prevalence is very low as compared to the
incidence for a disease. It implies
Disease is very fatal and/or easily curable.
Most common cause of neonatal mortality in India
Prematurity
True regarding tetanus
Herd immunity is not of much value, incubation
period is 610 days and the main reservoir is soil
and intestine of animals and humans.
New cancer patient in India reported annually
1 million
In a population of 200 people with normal
distribution, people included in 1 standard deviation
136
True about Rashtriya swasthya bima yojna(RSBY)
Applies to BPL families only
HIV sentinel surveillance is for
Detecting trend of the disease
Mass chemoprophylaxis is given for
Lymphatic filariasis, plague and vitamin
deficiency.
The pattern of change of disease trends of mortality
and morbidity where the pandemics of infection are
replaced by degenerative and man made disorders
as the main cause of morbidity and mortality is
known as
Epidemiological transition.
Current percentage of GDP of India spent on health
1.2%
True about Millenium development goals
Reduce by 2/3rd the under 5 mortality rate by year
19902015.
In a study to assess the prevalence of dating among
adolescents, schools were selected at random.
Among the schools, sections were selected at
random and among the sections students were
selected at random. This is an example of
Multistage sampling
In a population of 5000, 500 are myopic before 1st
January 2011 and number of new cases till 31st
December 2011 is 90. Incidence is
2%

PSM

According to blindness assessment , a person with

a best corrected vision of 4/60 in both eyes is having
a disability of
75%
True about national programme for prevention and
control of cancer, diabetes, CVD and stroke
(NPCDCS)
Cardiac care unit and cancer care facility is to be
established at the district level hospital.
True about roll back malaria
Develop new insecticides, strengthen health
system, train health workers and insecticide treated
bed nets.
Screening age for trachoma
19 years
AIIMS MAY 2012

In WHO road to health chart, upper and lower limit

represents
50 percentile for boys and 3 percentile for girls.
In 1315 year female child, recommended daily
protein intake is
1
Common to both acute and chronic malnutrition is
Weight for age
Rashtriya swasthya bima yojana is
Government run insurance scheme for all poor.
In vision 2020, the target for secondary service
centre is for how much population
5 lac
Leprosy is not yet eradicated because
No effective vaccine
Which of the following is best suited for the role of
social worker
Health professional involved in coping strategies,
interpersonal skills and adjustment with family.
In acute flaccid paralysis surveillance, evaluation
for residual paralysis is done at
60 days
Bias can be eliminated by all except
Multivariate analysis
Food with maximum cholesterol content
Egg
Not helpful for elimination of filariasis
Larvae are deposited on skin surface where they
can not survive.

93

Applications of incubation period

To differentiate co primary cases from secondary
cases, to find out time for quarantine and to prevent
infection to the contacts of the infected person.
True about Indian reference male
Age 1829 years.
Natural disaster causing maximum deaths
Hydrological
According to the Workmans compensation act,
1923, which is occupational disease
Anthrax
In vision 2020, ophthalmic personnel per population
ratio is
50,000
A sexually active , long distance truck drivers wife
comes with vaginal discharge. Under syndromic
approach, drugs given
Metronidazole, azithromycin and fluconazole.
AIIMS NOVEMBER 2011

Founding members of vision 2020

WHO, ORBIS and international agency for
prevention of blindness.
Factors affecting equilibirium in Hardy-Weinberg
law
Gene flow migration, gene mutation and small
population.
Fatty acid characteristically present in breast milk
and essential for body growth- Docosahexaenoic
acid.
False regarding principles of evidence based
medicine
EBM depends on clinical model and decision
analysis to base its recommendation.
AIIMS MAY 2011

A 30 years old female patient has sputum positive

TB. Her child is 3 years old. Recommended
chemoprophylaxis is
INH 5 mg/kg for 6 months
Late expanding stage of population of India is due to
Death declines more than birth rate
True about vaccines
Thiomersal is preservative in DPT vaccine,
magnesium chloride as stabilizer is used in OPV
and kanamycin is preservative in measles.

94

AIIMS and All Indian PGMEEReview Questions

Larval control measures

Paris green, Gambusia and intermittent irrigation.
True about DDT
Pyrethrum has synergistic action, it is a contact
poison and residual effect lasts for 18 months.
Incineration is done for
Cytotoxic drugs, cotton contaminated with blood
and human tissue.
True about BCG vaccination
WHO recommends Danish 1331 strain for vaccine
production.
Fish is deficient in nutrient
Iron
True about cluster sampling
Two stage sampling, cheaper and disadvantage of
higher sampling error.
True about breast milk is
Coefficient of iron absorption is 70%, calcium
utilization from breast milk is more than cows
milk, breast milk protein is reference protein.
True about randomized controlled trial
Baseline characteristics are comparable, bias can be
eliminated by double blinding and sample size
depends upon type of study.
Incidence can be calculated by
Prospective study.
True about purification of water
Coliforms must not be detectable in any 100 ml
sample of drinking water, sodium thiosulphate is
used to neutralize chlorine and coliforms may be
detected by multiple tube method and indole
production.
In India, most common cause for maternal mortality
is
Haemorrhage
True about net protein utilization
It is the ratio of total nitrogen retained by total
nitrogen intake multiplied by 100.
AIIMS NOVEMBER 2010

Neonatal mortality rate is

No. of neonatal deaths per thousand live births.
Cause of neonatal mortality in India
Prematurity > infection > birth asphyxia > congenital
anamolies (Mn: PIBC)
Small pox eradication was due to
Highly effective vaccine, subclinical infection do
not transmit the disease and life long immunity.

Sputum can be disinfected by

Autoclaving, boiling and cresol.
True regarding Clostridium tetani
The main reservoir is soil and intestine of animals
and humans, herd immunity is of not much
importance and the main mode of transmission is
through trauma and contaminated wound.
True about Varicella infection
SAR is 90%, lesions occur on flexor surfaces and
reactivation occur in 1030% cases.
True about Vi polysaccharide vaccine is
Can be administered with yellow fever and
hepatitis A vaccine.
According to a study, incidence of colon carcinoma
is less in pure vegetarians than non vegetarians so
concluded that beta carotene is protective against
cancer. This may not be true as vegetarians may be
consuming high fibre diet which is protective
against cancer. This is an example of
Confounding factor
Mass chemoprophylaxis is given for
Lymphatic filariasis, plague and vitamin A
deficiency.
True regarding Spauldings criteria
Non critical items require only decontamination,
semicritical items are those which come in contact
with mucous membrane or non intact skin and
cardiac catheters are examples of critical items.
Bias can be eliminated by
Matching, blinding and randomization.
Diseases spread by hard tick are
KFD, tularemia and tick paralysis.
In post operative ward of ICU, 5 patients developed
infection in the same wound. The best way to
prevent MRSA outbreak in indoor patients
Practise proper meticulous handwashing.
A person found some correlation between dietary
factors and a disease by collecting data from food
manufactures and hospitals, respectively, such a
study is
Ecological
AIIMS MAY 2010

Leprosy involves
Nerve, eye and ovary
True regarding global warming is
CO2 is the major greenhouse gas.

PSM

True about Aedes

Bites repeatedly, transmits dengue and it takes 78
days to develop the parasite and transmit the
disease.
Bacterial indicators of faecal pollution
E. coli, Clostridium perfringens and Streptococcus.
Vitamin A prophylaxis to a child is
Specific protection
Savlon contains
Cetrimide and chlorhexidine.
True about crude birth rate
It is a measure of fertility, it is independent of age of
population and numerator does not include still
births.
A test has high false positive rate in a community.
True is
Low prevalence
Weight of Indian reference man in kg
60
Chlorine demand of water is measured by
Horrocks apparatus
Included in vision 2020-right to sight immediate
goals
Trachoma, cataract and onchocerciasis.
True about lepromin test
Negative in most children in first 6 months of life,
important aid to classify type of leprosy disease and
BCG vaccination may convert lepra reaction from
negative to positive.
Diseases transmitted by lice are
Epidemic typhus, relapsing fever and trench fever.
Chikungunya is transmitted by
Aedes
In a study, interpretations obtained are very
satisfied, satisfied and dissatisfied. Type of scale is
Ordinal
Treatment of choice for sputum positive pulmonary
TB detected in first trimester of pregnancy is
Start category 1 immediately
Safe disposal of mercury is
Collect carefully and recycle
You have diagnosed a patient clinically as having
SLE and ordered 6 tests out of which 4 has come
positive and 2 negative. To determine the probability
of SLE at this point, you need to know
Prior probability of SLE, sensitivity and specificity
of each test of each test.

95

STEPS done for

Surveillance of risk factors of non communicable
disease.
The best graphic representation of frequency
distribution of data gathered of a continuous
variable is
Histogram
Vaccine with maximum efficacy
Measles
Arbovirus true is
Chikungunya is transmitted by Aedes aegypti.
AIIMS NOVEMBER 2009

Effective leprosy control programme may be

indicated by
Decreasing grade 2 disability, low MDR resistant,
multibacillary cases and high new case detection
rate.
The vaccines that can be given during pregnancy
is
Rabies, hepatitis B and diphtheria.
Included in NRHM are
Strengthening of JSY, state and district health
mission and recruitment and training of ASHA.
Impact indicator for evaluation of ASHAs
performance
Infant mortality rate
True about standard error of mean
Based on normal distribution, it depends on
standard deviation of mean and used to estimate
confidence limit.
A learned behavior which is permanent and
consistent but liable to change- Practise.
True about Japanese encephalitis
Transmitted by culex mosquito, pigs are amplifiers and primary dose of vaccine consists of two
dose.
Reliability of a screening test refers to
Gives same values even on repeated testing
(Note: Reliability is repeatability)
Disposal method of outdated cytotoxic drugs is
Destruction and dumping in a secured landfill.
Recall bias is most commonly associated with
Case control study
Positive predictive value of a test is
TP/TP + FP

96

AIIMS and All Indian PGMEEReview Questions

AIIMS MAY 2009

AIIMS NOVEMBER 2008

Inner subjective thought of a person towards an

individual or situation is best termed as
Attitude
A temporary provisional view held by the people
on a point of view is
Opinion
Most common mode of lead poisoning
Inhalation
Specificity of a test refers to its ability to detect
True negatives
Prevalence of cataract at one point of time can be
determined by
Cross sectional study
License to blood bank is given by
Drug controller general of India
Association can be measured by
Correlation coefficient, P value and odds ratio.
Targeted intervention for HIV is done for
Commercial sex worker, migrant laborers and street
children.
WHO stage 4 HIV includes
Toxoplasmosis, pneumocystis carini and HIV
wasting syndrome.
About NPCB true are
Increase cataract surgery rate to 450 operation per
lakh population, intraocular lens implantation in
more than 80% cataract surgery cases and
development of 50 paediatric ophthalmic units.
According to CDC recommendations, HIV screening
of pregnant women is
Opt out testing
Putting profit ahead of health as a cause of disease
is provided by which theory of sociology
Marxist
True about confounding factor
It is itself a risk factor for the disease.
Best contraceptive for the newly married couple
is
Oral contraceptives
Nested case control study is a type of
Prospective study
Approaches to the health education are
Service approach, regulatory approach and health
education approach.

True about isolation period of enteric fever is

Till 3 bacteriologically negative stool and urine
reports.
Cyclo developmental lifecycle is seen in
Filaria
Post pasteurized milk quality is tested by
Phosphatase test
Best index for measuring contraceptive efficacy is
Life table analysis.
Goals of national population policy are
Bring IMR to below 30 per 1000 live births, bring
MMR to below 100 per 100,000 live births and
achieve 100 % registration of births, deaths,
marriage and pregnancy.
Shortest incubation period is seen in
Influenza
In leprosy patient, lepromin test is used for
Prognosis
Kaplan Meier method is used for
Survival
True about Indian reference female
Age 2039 years, weight 55 kg and walking or other
activities for 2 hours daily and 8 hours of moderate
or active work.
Included in SAFE strategy
Antibiotics, face washing and improvement of the
environment.
Plastic wrapper of surgical syringe should be
discarded in
Black bag
AIIMS MAY 2008

Problem village is defined in national water supply

and sanitation programme as all
Distance of safe water greater than 1.6 km, water
exposed to the risk of cholera and water source has
excess iron and heavy metals.
Endemic ascites is associated with
Pyrrolizidine
Criteria for normal Indian reference male are
60 kg, 8 hours in bed and 2039 years of age
Adjuvant used in DPT vaccine is
Aluminium
Overall survival is increased by screening procedure in
Colon carcinoma

PSM

Best distribution to study the daily admission of

head injury patients in a trauma care centre is
Poisson distribution
Mean bone density amongst two groups of 50
people each is compared with each other. The test of
significance used would be
Student t-test
After applying a statistical test, an investigator gets
the P value as 0.01. It means that
The difference is not significant 1% times and
significant 99%.
If mean is less than the median, than the data is said
to be
Negatively skewed
Study done on a group of patients showed
coefficient of variance for BP and serum creatinine
to be 20% and 15% respectively. Inference is
Variation in BP is more than in serum creatinine.
In a study done in UK, association between sale of
antiarrythmic drugs and increase in death due to
asthma was found. It is example of
Ecological study
Occupational cancer involves
Lung, liver and bladder.
AIIMS NOVEMBER 2007

Kala-azar is transmitted by
Sandfly
Dietary reference intake recommendations include
Recommended dietary allowances, adequate intake
and upper tolerable level.
Toxins responsible for epidemic dropsy
Sanguinarine
In epidemiological study, the first case that comes
to the attention of the investigator is
Index case
Staff present at the subcentre level, under primary
health care
Multipurpose health worker
Primary health care, true are
Essential health care for all, placing peoples health in
peoples hand and sectors like agriculture, animal
husbandary, food industry and communication are
involved.
Under NPCB, screening of school children is first
done by
School teacher

97

Active search for disease in an apparently healthy

individual is known as
Screening
True regarding fluorosis are
It can cause fluorine deposition in bone, deflouridation is done by Nalgonda technique and flourosis
can cause genu valgum.
MMR is maternal mortality per 1000 live births.
True about pulse polio immunization
Mop up immunization is done in restricted
geographical areas, carried out in all children less
than 5 years of age and mopping up is done in areas
where wild polio virus is found.
Measures of dispersion are
Range, variance and standard deviation.
Disinfectants used for blood spills
Sodium hypochlorite
n-3 PUFA is present in
Mustard oil, fish oil and corn oil.
AIIMS MAY 2007

Example of disability limitation is

Resting affected limbs in neutral position.
Comprehensive emergency obstetric care includes
Manual removal of placenta, blood transfusion and
caesarean section.
What happens when confidence limit of a test is
increased
Previously insignificant value becomes significant.
IUCD acting for 10 years
CuT 380A.
Common complications of measles are
Diarrhea, pneumonia and otitis media.
Best method to compare new test and gold standard
test is
Bland and Altman analysis.
Accepted methods of randomization are
Computer drawn randomization, lottery and
random number table.
Thiamine deficiency is seen in
Chronic diarrhea, chronic alcoholism and food
faddist.
L-J chart is used for monitoring
Accuracy
Standard error of mean is calculated by
SD/square root of n

98

AIIMS and All Indian PGMEEReview Questions

Characteristics of importance in a screening test

Low cost, high safety margin and high sensitivity.
Brucella is transmitted by
Aerosol transmission ingestion of raw milk and
contact with aborted fetuses.
True about ASHA is
One per 1000 rural population, mobiliser of
antenatal care and female voluntary worker.
Richest source of vitamin D is
Fish oil
AIIMS NOVEMBER 2006

True about communicability of malaria

Gametocytes appear in blood 45 days after the
appearance of asexual parasite in vivax infection
and gametocytes appear in blood 1012 days after
appearance of sexual parasite in falciparum
infection and in early stage of infection, their
density may exceed 1000/cmm of blood.
Eicosapentaenoic acid is present in
Fish oil
Revised strategy for NPCB includes
Fixed facility surgery, IOL implantation for cataract
and uniform distribution.
Any loss or abnormality of psychological, physiological or anatomical structure or function is known as
Impairment
Hb estimation was done by a new techniqueand
repeated 10 times. The reports are-9.4, 9.3, 9.5, 9.7,
9.6, 9.9, 10.1, 10.4, 10.6 and 12.0. The new technique
has
Low validity and low reliability
Socialization of medicine leads to
Free medical care supported by state, eliminates the
competition among physicians in search of clients
and ensure social equity and universal coverage of
health services.
Causative toxin for endemic ascites is
Pyrrolizidine
True about ASHA is
Deployed 1/1000 population
True about point source epidemics are
No secondary curves, one single peak only and all
cases occur in one incubation period.
Epidemiological study giving the most accurate
result is
Meta analysis

PUFA consumption is associated with

Lowering of serum cholesterol and lowering of
LDL cholesterol.
AIIMS MAY 2006

Brucellosis can be transmitted by

Contact with infected placenta, ingestion of raw
vegetables from infected farms and inhalation of
infected dust or aerosol.
True about leptospirosis
It is a zoonosis, man is an accidental host and man
is the dead end host.
The mechanism by which cholera may be
maintained during interval between peak cholera
seasons is
Continuous transmission in man.
Disability limitation
Example is resting affected limbs in neutral
position.
Vitamin A deficiency is considered a public health
problem if prevalence rate of night blindness in
children between 6 months and 6 years is > 1%.
The highest percentage of PUFA is present in
Soybean oil
Chronic carrier state is found in
Typhoid, hepatitis B and gonorrhea
RCT comparing efficacy of two regimens showed
that difference is statistically significant with P <
0.001 but in reality the two tests do not differ in their
efficacy. This is example of Type I (alpha) error
Degree of freedom is
(Row-1) (Column-1)
A diagnostic test for a particular disease has a
sensitivity of a 0.90 and a specificity of 0.80. A single
test is applied to each student in the population in
which the diseased population is 30%. What is the
probability that a person, negative to this test has no
disease
95%
Histogram describes
Quantitative data for a group of patients
If birth weight of each of 10 babies born in a hospital
in a day is found to be 0.8 kgs, then the standard
deviation of this sample will be
Zero
Specificity of a test is the ability of a test to detect
True negatives

PSM

AIIMS NOVEMBER 2005

It is probable that physician have a higher index of

suspicion for TB in children without BCG scar than
those with BCG scar. If this is so and an association
is found between TB and not having BCG scar, the
association may be due to
Interviewer bias
The risk ratio in a study is
Incidence among exposed/incidence among non
exposed.
Incidence of tuberculin infection in a community is
most appropriately assessed by
Identifying new converters to tuberculin test.
When an intervention is applied to community to
evaluate its usefulness it is called
Effectiveness
Drug of choice for cholera treatment in pregnancy
Furazolidone
Most common cause of blindness in India is
Cataract
Under national programme for prevention of
nutritional blindness, a child in the age group of 6
11 months is given a dose of vitamin A equal of
1 Lakh IU
Incubation period for pertussis is
714 days
Maximum risk of damage of fetus by maternal
rubella is in
613 weeks of pregnancy
Deficit in weight for height in a 3 year old child
indicates
Acute malnutrition
A study shows that 85% of cases of lung cancer are
due to cigarette smoking. It is a measure of
Attributable risk
The distribution of random plasma sugar
measurements from 100 first year students have
mean of 3.0 mmol/L with a standard deviation of
3.0. True about shape of the distribution curve
Nothing can be said conclusively
The age group of children surveyed for assessment
of primary immunization coverage in WHO
recommended EPI cluster sampling
1223 months
According to a joint study Healthcare in India:
Road ahead by CII and Mckinsey and co in 2002
Indias exisiting bed population ratio is 1.4 : 1000

99

True about childhood mortality rates in India

Almost 3/5th of IMR occur in neonatal period,
almost 3/4th of under five mortality occur in
infancy and about one in ten children die before
they reach the age of five years.
The best design to study the association between
risk factor and disease is of
Cohort study
A known HIV patient is admitted in a ward
following surgery. The resident doctor who
changed the dressing next day found it to be soaked
in blood. Right method of discarding the dressing is
Put the dressing material directly in an appropriate
bag and send for incineration.
Distribution of FEV in 300 smokers-Median-2.5 L,
First quartile-1.5, Third quartile-4.5 L. No. of
persons in the sample expected to have FEV
between 1.5 L and 4.5 L is
150
If the distribution of IOP seen in 100 glaucoma
patients has an average 30mm with SD of 1. Lower
limit of average IOP that can be expected 95% of
times
28
A test for a disease has sensitivity 0.90 and
specificity 0.90. Diseased person in the population
in which single test is applied is 10% probability
that a person positive to this test has the disease is
50%
AIIMS MAY 2005

A bacterium divides every 30 minutes. Number of

bacteria after exponential growth for 3 hours,
starting with a single bacterium
512
One day census of inpatients in a mental hospital
could give good information about
The patients in that hospital at that time.
After applying a statistical test an investigator gets
the p value as 0.01. It mean that
The difference is not significant 1% times and
significant 99% times.
For a negatively skewed data
Mean will be less than the medium
If the prevalence is very low as compared to the
incidence for a disease, it implies
Disease is very fatal and/or easily curable.

100

AIIMS and All Indian PGMEEReview Questions

Mean and standard deviation can be worked out if

data is on
Interval/ratio scale
National family health survey has successfully
completed
3 rounds
The age and sex structure of a population may be
described as a
Population pyramid
The carrying capacity of any given population is
determined by its limiting resources.
True about prevalence and incidence
Incidence is a rate but prevalence is not
The most common cancer, affecting both male and
female of the world is
Lung cancer
The most common cause of maternal mortality in
India is
Haemorrhage
The rate adjusted to allow the age distribution of the
population is
Age standardized mortality rate
Characteristic of a single exposure common vehicle
outbreak
Explosive
Drug of choice for chemoprophylaxis of cholera
Tetracycline
The national level system that provides annual,
national as well as state level reliable estimates of
fertility and mortality
Sample registration system.
Pulse with highest content of iron
Soyabean
True regarding pre-post clinical trial
They use the patient as his or her own control
AIIMS NOVEMBER 2004

Indian state with maximum number of AIDS cases

reported
Tamilnadu
In two studies for association between natural
nutritional states and birth weight of members, p
value 0.02 and 0.04 were found. Inference about
magnitude of association
The magnitude of association in study with p = 0.02
is more than that in study with p = 0.04
Weakest study design to test the association
between risk factor and disease

Ecological study
The most appropriate measure of average for data
250, 350, 250, 5000, 110, 266, 325, 300, 155, the no of
malaria cases reported during test 10 years in a
town
Median
A total of 5000 patients of glaucoma are identified
and surveyed by interviewers regarding family
history of glaucoma. Study design is
Case series report
A physician notes down SBP of 50 patients and then
administers an antihypertensive drug to them. He
measures the SBP after one week again. Most
appropriate statistical test of significance
Paired T-test
Population is the unit of study in
Ecological study
A leprosy patient treated with paucibacillary
multidrug therapy for 6 months had persistent
erethema and indurations in the plaque. The next
step of recommendation by WHO
Stop antileprosy treatment
As compared to routine case control study, nested
case control study avoids problem related to
Temporal association
The literacy rate of Indian population as per census
2001 is
65.4%
Arboviral diseases reported in India
Japanese encephalitis, Chikungunya fever and
Kyasanur forest disease.
Orthotoludine test is used to determine
Free and combined chloride in water.
Weight of Indian reference woman
55 kg
True about quarantine
Absolute quarantine is restriction during the
incubation period, exclusion of children from
schools is modified quarantine and quarantine
should not be longer then the longest incubation
period.
True about mosquito
Definitive host in malaria, life cycle is completed in
3 weeks and the female can travel upto 3 km.
True regarding dracunculiasis
India has eradicated this disease. The disease is
limited to tropical and subtropical regions and no
animal reservoir has been proved.

PSM

Standard error is
Standard deviation/sample size.
Highest prevalence of blindness in the world per
100,000 population is found is
Sub-Saharan Africa
True about plague
Bubonic is the most common variety.
National health policy of India 2002 includes
Eradicate polio by year 2005, achieve zero level
transmission of HIV/AIDS by 2010 and eliminate
lymphatic filariasis by 2015.
The Incubation period of yellow fever is
36 days
Mode of transmission of Q fever is
Inhalation of aerosol
Characteristic features of staphylococci food
poisoning
Optimum temperature for toxins formation is 37C,
intradietetic toxins are responsible for intestinal
symptoms and incubation period is 16 hours.
Nodal ministry for integrated child development
Scheme (ICDS) programme centre
Ministry for HRD
The systemic distortion of retrospective studies that
can be eliminated by a prospective design is one of
the following
Recall bias
Null hypothesis true and rejected is
Type I error (Mn: NTR)
If a new effective treatment is initiated and all other
factors remain the same, true is
Incidence will not change
Relationship between different parameters of a
performance of a test
Sensitivity is inversely proportional to specificity.
20 year old female with category II Tuberculosis
(sputum positive relapse). The treatment regimen
recommended under DOTS is
2 (HRZES)3 + (HRZ)3 + 5 (HR)3
Sampling method for assessment of immunization
status of children
Cluster sampling
True about break point chlorination
Free chlorine is released in water after breakpoint
chlorination, chlorine demand is the amount
needed to kill bacteria, oxidize organic matter and
neutralize ammonia.

101

An investigator wants to study the association

between maternal intake of iron supplements (yes
or No) and incidence of low birth weight (<2500 or
> 2500 gms) in 100 pregnant women. Appropriate
statistical test of significance is
Chi-square test
Medical colleges are classified as eye care centres of
(under national programme for control of blindness
in India)
Tertiary level
Taking the definition of blindness as visual acuity
less than 3/60 in the better eye, the number of blind
persons per 100,000 population in India is estimated
to be
In a double blind, clinical drug trial
The patients do not know which treatment they are
receiving.
(Note: Doctors also donot know which treatment
they are giving)
The most sensitive index of recent transmission of
malaria in a community is
Infant parasite rate
Extra calories required during the first six months
for a lactating woman is
600 Kcal
Bagassosis is most likely caused due to the
inhalation of the dust of
Sugarcane (Mn: Both has g)
In defining general fertility rate, the denominator is
Woman between 15 and 49 years of age.
Mites are the vectors of
Scabies, scrub typhus and rickettsial pox
AIIMS MAY 2003

Most common cause of neonatal mortality in India

Low birth weight
In calculation of dependency ratio, the numerator is
expressed as
Population under 15 and above 65 years of age.
An adult male patient with complaints of cough
and fever for 3 months and haemoptysis on and off,
sputum positive for AFB and had already received
treatment with HRZ for 3 weeks and discontinued.
Categorization for management of patient
Category I and start 2 (HRZE)3.
Entire village was asked to participate in a study to
identify cholera carrier and everyone present at the
time submitted to examination due to recent

102

AIIMS and All Indian PGMEEReview Questions

cholera deaths. The proportion of people who were

carriers were computed and compared with regard
to water supply. This is a type of
Cross sectional study
True about New family
All nuclear families of less than 10 years duration.
A new pregnancy test was applied on 100 pregnant
(Known) women and 100 non-pregnant women. 99
and 10 showed positive result in respective groups.
Sensitivity of the test is
99%
A man with fever and chills 2 weeks after a louse
bite. There was a maculopapular rash on the trunk
which spread peripheraly. The cause of this
infection can be
Epidemic typhus
True regarding Q fever
Zoonotic infection, human disease is characterized
by an interstitial pneumonia and no rash is seen.
Reservoir of Indian Kala-azar is
Man
Features suggestive of asbestosis
The disease progresses even after removal of
contact, can lead to neural mesothelioma and
sputum contains asbestos bodies.
The proportion of false positive results of a
screening test is lower in population A then
population B because the prevalence of disease is
Higher in population A
An investigator wants to study the association
between maternal intake of iron supplements (Yes
or No) and weights (in gms) of new born babies. He
collects relevant data from 100 pregnant woman
and their new born. Test of hypothesis advised
Unpaired or independent T test
To test the statistical significance of the difference in
heights of school children among three socioeconomic groups, test used is
One way ANOVA
For the field diagnosis of trachoma, the WHO
recommends that follicular and intense trachoma
inflammation should be assessed in
Children aged 010 years
AIIMS NOVEMBER 2002

Drug of choice for chemoprophylaxis in contacts of

a patient of pneumonic plague is
Tetracycline

National population policy aims to achieve NRR of

1 by
2010 year
Same reading on repeated testing by a chemical test,
the measurement is
Precise
True about rheumatic fever/heart disease in
epidemidogy
The prevalence varies between 2 to 11 per 100
children aged 516 years, occurs equally in females
and males and rheumatic fever occurs in about 2%
of streptococcal sore throats.
True about DPT vaccine
Exposure to direct sunlight, when in use should be
avoided, store stocks are needed for three months at
PHC level and half used vials should not be put
back into the cold chain after the session.
The preferred public health approach to control non
communicable diseases is
Shift the population curve of risk factors by a
population based approach.
True for occupational lead poisoning
Inhalation is the most common mode of
absorption, lead in blood and urine provide
quantitative indicator of exposure and basophilic
stippling is a sensitive parameter of hematological
response.
In Community needs assessment approach as part
of RCH the targets for various health activities are
set at the level of
District
True about case control study of a suspected
association between breast cancer and the
contraceptive pill
The control should come from a population that has
the same potential as the cases, control should
exclude women taking OCP at time of survey and
all the control needs to be healthy.
Prevalence of a disease describes
The balance between incidence, mortality and
recovery.
The main purpose of randomization in a controlled
drug trial is
To ensure that two groups will be similar in
prognostic factors.
The number of patients required in a clinical trial to
treat a specific disease increases as the drop out rate
increases.

PSM

According to WHO, goiter is endemic if its

prevalence in school age children is more than 5%.
A 46 year old female presented to the eye OPD with
right eye 6/60, and left eye 3/60. Under NPCB, she
is classified as
Low vision
Cut off visual acuity in school vision screening
programme in
India is 6/9
When a diagnostic test is used in series mode than
Specificity increases but the sensitivity decreases.
The active immunity offered by
TT is effective in nearly 100% patients
AIIMS MAY 2002

Leprosy eradication programme best evaluated by

Detection of new cases
Secondary attack rate is
Number of exposed persons developing the disease
within the range of incubation period following
exposure to the primary case.
Presumptive treatment of malaria in a choloroquine
resistant area
Sulphalene and pyrimethamine
HbsAg positivity is found is a pregnant women of
32 weeks of pregnancy. To prevent infection, new
born is given
Hepatitis B vaccine and immunoglobulins
Schedule for sputum examination after beginning
the chemotherapy in RNTCP is
2, 4 and 6 months
The side effects of DMPA contraceptive
Weight gain, irregular bleeding and increased
reproductive tract infection.
True morbidity in a population can be calculated by
Active surveillance
Epidemic of plague is controlled by
Isolation of contacts, surveillance and
chemoprophylaxis with tetracycline.
Best indicator for monitoring of syphilis treatment
VDRL
True regarding relative risk and attributable risk in
a study on comparison of a common drug (NSAID)
and rare drug (Dypirone) causing disease
NSAID has higher relative risk and attributable risk
than Dypirone.

103

ALL INDIA 2012

Intervention trials with individual as a

randomization unit
Drug, surgery and vaccine
The sex ratio for age group 06 years as per 2011
census
914
The concept of design effect is applied to
Cluster sampling
A state of disease endemicity where the disease
transmission has been stopped but the agent is
present in the environment is called
Elimination
Efficacy of a new drug with an existing drug for
treatment of particular disease is compared in
Phase 3 trial
The p value stands for
The probability of concluding that a difference
exists, while , in reality, such a differentiation does
not exist.
Median is a good measure for central tendency of
Health expenditure, incubation period and survival
time.
Surveillance summaries are prepared
To provide information on disease patterns and
trends.
In natural history of the disease, true about
pathogenesis phase are
Start after entry of agent into host body, subclinical
phase of an illness is included and tertiary
prevention is applicable.
Aedes, anopheles and culex are vectors for which
disease worldwide
Lymphatic filariasis
True about millennium development goals
Reduce MMR by 3/4th between 1990 and 2015,
reduce under 5 mortality rate by 2/3rd between
1990 and 2015 and have halted by 2015 and
reversed, the spread of HIV/AIDS.
Vaccination recommended for elderly population
Tetanus, influenza and pneumovax.
Larvicidal for malaria control
Abate, copper acetoarsenite and malathion.
The resource persons for training ASHA under
NRHM are
AWW and ANM

104

AIIMS and All Indian PGMEEReview Questions

A cohort study differs from case control study as

Cohort studies require longer time frame( years)
but case control studies not.
DALY expresses years of life lost to
Premature death and years lived with disability
adjusted for the severity of disability.
ALL INDIA 2011

Indicators of HDI
Life expectancy at birth, education and GDP.
Good index of severity of acute disease
Case fatality rate
Denominator in estimating MMR
Total number of live births
Chronic carrier state is seen in
Diphtheria, typhoid and gonorrhea.
Tetracycline is used in prophylaxis of
Cholera
Vectors may transmit infection by methods
Regurgitation, rubbing of infected faeces and
contamination with body fluids.
Non deliberate cultural practice leading to anti
mosquito effect
Use of alkaline detergent
Factors responsible for resurgence of malaria
Drug resistance in parasite, insecticide resistance in
vectors and antigenic mutations in parasite.
Insects that have developed resistance to DDT are
Musca domestica, xenopsylla species and
anopheles species.
Arboviral disease not found in India
Yellow fever virus
True about Japanes encephalitis
Two to three cases per village suggest an epidemic,
children are more frequently affected than adults
and ratio of inapperent to apperent infection is >
100:1.
True about leptospirosis
Rats are prime reservoirs.
A sewage worker presents to the emergency
department with fever and jaundice. Lab findings
are elevated BUN and serum creatinine suggestive
of renal failure. Antibiotics recommended is
Penicillin G
True about yaws
Caused by Treponema pertenue, transmitted non
venerally and secondary yaws can involve bone.

According to McKeonns theory, reduction in

mortality from tuberculosis was a consequence of
Social and environmental factors.
Tests performed to assess the efficiency of
Pasteurization
Phosphatase test
Orthotoluidine test is used for detecting
Chlorine
Causes of indoor air pollution
Carbon monoxide, nitrogen dioxide and radon.
Diseases with national screening control programme
are
Diabetes mellitus, refractive errors and carcinoma
cervix.
Reform proposed by world health report (2008)
Policy reform, leadership reform and service
reform (Mn: PLUS and universal reform)
Direct standardization is done to compare the
mortalty rates between 2 countries. This is done
because of difference in
Age distributions
A village is divided into 5 relevant subgroups for
purpose of a survey. Individuals from each
subgroup are then selected randomly. This is
Stratified sampling
A region is divided into 50 villages for the purpose
of a survey. 10 villages are then selected randomly
for the purpose of a study. This is known as
Cluster sampling
A new test for diabetes mellitus is performed in a
group containing diabetics and non diabetics. If 120
mg/dl of blood sugar is taken as cut off, area
shaded in graph represents
False negative
Punett square is used to
Predict genotype of offspring
An investigator observes that 5 independent risk
factors influence the occurrence of a disease.
Statistical test applied to assess the relationship
between them is
Multiple logistic regression
Pearsons coefficient of skewness is defined as
(Mean-mode)/Standard deviation
True regarding disposal of biomedical waste
Human anatomical waste is disposed in a yellow
bag, contents from a red bag may be a source of
contamination and black bags are used for disposal
of ash from incineration.

PSM

Biological agent carrying the highest potential for

use as a biological weapon for microbial
bioterrorism is
Plague (Yersinia pestis)
Biological weapon with least potential for use as a
biological weapon
Brucellosis
ALL INDIA 2010

Movement across socioeconomic level is termed as

Social mobility
Associated with emotional valence and most likely
to be influenced by motivation is
Practise
ASHA is posted at
Village level
JSY stands for
Janani suraksha yojna
Provision of primary health care was done by
Alma Ata declaration
Essential components of primary health care are
Provision of essential drugs, immunization against
major infectious diseases and health education.
Current trend in health care is
Community participation
Highest level of community participation is
Planning of intervention by community.
True regarding MMR
Numerator includes total number of female deaths
within 42 days of delivery, expressed as a rate and
expressed per 1000.
Perinatal mortality rate includes
Stillborns and death within 7 days of birth.
IMNCI differs from IMCI in following
Malaria and anaemia are included, 07 days
neonates are included and emphasis on
management of sick neonates over sick older
children.
Mass chemoprophylaxis in endemic area is
recommended for
Yaws, trachoma and filaria
Rural and urban difference in prevalence is seen in
Lung cancer, mental illness and chronic bronchitis.
True about TB annual rate of infection(ARI)
The average estimated ARI for India is 1.7%, ARI
reflects current trend and effectiveness of control
measures and ARI represents the percentage new
infections.

105

True about scrub typhus

Caused by O. tsutsugamushi, mites act as reservoirs
and tetracycline is the drug of choice.
Factors contributing to resurgence of malaria
Drug resistance in parasite, drug resistance in
vectors and antigenic variations in parasite.
A case of acute flaccid paralysis must be observed
for residual weakness for
60 days
India aims to eliminate the following disease by
2015
Filariasis
The screening strategy for prevention of blindness
from diabetic retinopathy according to NPCB
involves
High risk screening
True about confidence limit/interval
95% confidence interval will cover 2 standard errors
around the mean.
A standard Z score is related to
Normal distribution
The sensitivity of a test is
TP/ TP + FN
Incidence of TB in a community
Number of cases per mid year population in that
year multiplied by 1000.
True about red cross emblem
Size of bars in the cross is equal horizontally and
vertically, misuse of emblem is punishable offence
under Indian law and was convened in Geneva.
Synthetic pyrethroid compounds are
Permethrin, proparthin and cypermethrin.
ALL INDIA 2009

Criteria suggesting causality in non communicable

diseases
Strength of association, specificity of association
and dose response relationship.
Analytical studies are
Case control study, cohort study and ecological
study.
Incidence can be calculated by
Cohort study
Which causes an increase in the prevalence of
disease
Longer duration of disease

106

AIIMS and All Indian PGMEEReview Questions

The most suitable method for presenting frequency

distribution of data gathered from continuous
variables is
Histogram
True about standard distribution curve is
Mean = median
True about simple random sampling is
Every element in the population has an equal
probability of being included.
The guidelines according to baby friendly hospital
initiative includes
Mother and infant to be together for 24 hours a day,
giving newborn infants no food or drinks other than
breast milk and encouraging breast feeding on
demand.
The latest WHO protocol for classification and
measurement of disability is
ICF
Components of IDEAS include the following
Self care, communication and understanding and
performing in work.
IMCI initiative was taken to prevent mortality and
morbidity from
Malaria, malnutrition and otitis media.
Part of targeted intervention in preventive strategy
in spread of AIDS
Treating STD, providing condoms and behavior
change communication.
Chemoprophylaxis can be done for
Diphtheria, cholera and meningitis.
Q fever is transmitted by
Ticks
Toxic shock syndrome is caused by
Infected measles vaccine.
Exposure carrying the maximum risk of
transmission of HIV
Blood transfusion
Desired end result that is not operationally
measurable
Goal
Assessment of final outcome of a predetermined
objective is termed as
Evaluation
ALL INDIA 2008

Iceberg phenomenon differentiates

Apparent and inapparent

Type of bias reduced by allowing equal interview

time
Interviewer bias
Vaccine contraindicated in pregnancy
MMR
True regarding live vaccines
Booster doses are not required when live vaccines
are administered, single dose gives life long
immunity and live vaccine contains both major and
minor antigens.
The completed family size may be estimated by
Total fertility rate
As per RCH, the community health centre is
First referral unit
True about nutritional surveillance
It is a diagnostic approach, assessment involves
precise measurement of weight and height and
assessment is done by trained persons.
True about recommended daily allowance
RDA is decided by a panel of experts and is based
on scientific research, RDA is often higher than
recommended minimum requirement and RDA is
based on estimated average requirement.
Highest amount of saturated fatty acid is seen in
Palm oil
Psychrometer is used to measure
Humidity
Concurrent list encompasses
Prevention of extension of communicable disease
from one unit to another , prevention of
adulteration of food stuffs and regulation and
development of medical profession.
Following are zoonosis
Plague, Japanese encephalitis and TB.
Soil forms an important reservoir for infections
Coccoidomycosis, anthrax and tetanus.
Soft tick transmits
Relapsing fever
Isolation is strictly recommended for
Pneumonic plague
True about measles
High secondary attack rate, only one strain auses
infection and infection confers life long immunity.
True about yaws are
Caused by Treponema pertenue, has cross
immunity with syphilis and can not be
differentiated serologically from Treponema
pallidum.

PSM

107

Dharmendras index and Jopling classification

deals with
Leprosy
KAP study in India was first used to study
Family planning
Most common occupational cancer in India is
Skin cancer
True about Delphi method
Method involves formation of a team to undertake
and monitor a Delphi on a given subject, selection of
one or more panels to participate in the exercise,
customarily the panelists involved are experts in
the area to be investigated and first round of Delphi
method involves development of questionnaire.
Standard deviation is a measure of
Deviation from the mean value.

Impact and efficiency of iodine control programme

can be estimated by
Neonatal thyroxine levels
Compared to cows milk, mothers milk has more
Lactose
The highest percentage of PUFA are present in
Soyabean oil
The major purpose of randomization in clinical trial
is to
Reduce selection bias in allocation of treatment.
A study conducted to test if use of herbal tree
played any role in prevention of common cold. Data
was collected on the number of people who
developed cold. The analytical test of choice to test
this study is
Chi square test

ALL INDIA 2007

ALL INDIA 2006

Indicators included in PQLI are

IMR, literacy rate and life expectancy at age one.
85% of lung cancer among smokers was due to their
smoking. This is an example of
Attributable risk
True regarding herd immunity are
Mostly due to subclinical infection, can be acquired
by immunization and spread of epidemic is
influenced by it.
Vaccines included in EPI schedule are
OPV, BCG and DPT
Under eradication of congenital rubella syndrome
programme, the first priority group for rubella
vaccination is
All non pregnant woman of 15 to 34 years of age.
Strategies for prevention of neonatal tetanus
includes
5 clean practices, 2 doses of TT to all pregnant
woman and immunizing all married woman.
Case finding in RNTCP is based on
Sputum microscopy
True regarding endemic typhus
Flea is a vector of the disease
Common causes of blindness in children in India
are
Malnutrition, ophthalmia neonatarum and
glaucoma.
BMI to classify obesity should be ? 30.

True about standardization

It allows comparisons to be made between two
different population, for direct standardization age
specific death rates of study populations are used
and for indirect standardization, age specific death
rates of standard population are used.
The double blinding in clinical trials is to avoid
observer and subject bias.
True about randomized controlled trial
Baseline characteristic of control group and
intervention group should be same, sample size
required depends on the hypothesis and
investigators bias is minimized by double
blinding.
Positive predictive value of diagnostic test in a
population is
TP/TP + FP
Sensitivity of a diagnostic test is
TP/TP + FN
Strongly associated with coronary heat disease
Apolipoproteins
Vision screening of school children is conducted
under national programme for control of blindness
by
School teachers
WHO definition of blindness is
Visual acuity of < 3/60 in the better eye with best
correction.

108

AIIMS and All Indian PGMEEReview Questions

Most common cause of ocular morbidity in India is

Refractive error
Transplantation of human organs act was passed in
1994
The extra callories allowances needed per day
during pregnancy is
350
The Premium of community based universal health
insurance scheme launched during 200304 is
Rs.1 per day for poor and individual to Rs. 2 per day
for a family of seven.
ALL INDIA 2005

Infant mortality rate includes

Early neonatal mortality, late neonatal mortality
and post neonatal mortality.
Endemic disease
Constantly present in a given population group.
True regarding herd immunity for infectious
diseases
In case of tetanus, it is affected by the presence and
distribution of alternate animal hosts and it refers to
group protection beyond offered by the protection
of immunized individuals.
2 yr girl with cough and fever for 4 days, inability to
drink, 5 kg weight and 45/min respiratory rate. The
girl is defined as
Very severe disease
True regarding treatment of class III dog bite
patient
Immediately wash wound with soap and water,
give ARV and give immunoglobulins for passive
immunity.
Drug of choice for cholera treatment in an adult
with a single dose of
Doxycycline
True about congenital rubella syndrome
Diagnosed when infant IgM antibodies at birth,
diagnosed when IgG antibodies persists for > 6
months and most common congenital defects are
sensorineural deafness, cardiac malformations and
cataract.
The most common cancer affecting Indian women
in Mumbai and Delhi is
Breast cancer
BMI of a male whose weight is 89 kg and height 172
cm is
30 (kg/m2)

True regarding influence of smoking or risk of

cororory heart disease
Smoking is independent risk factor, smoking is
synergistic to other risk factors and influence of
smoking is directly related to number of cigarettes
per day.
Viral infection transmitted by Tick is
KFD
Anti larval measures are
Intermittent irrigation, Paris green and Gambusia
affinis (and Malathion though as antilarval not
recommended).
Tools for checking efficiency of pasteurised milk are
Phosphatase test, standard plate count and
coliform count (Mn: PSC).
The RDA of energy intake for an adult woman with
heavy work is
2790 Kcal
Colour of bag for human anatomical waste
Yellow
True about standard normal distribution
Has variance 1.0
The PEFR of a group of young girl following normal
distribution has mean 300 l/min and standard
deviation 20 l/min
True is 95% of the girls have PEFR between 260 and
340 l/min.
Z score is
Observed value - mean value/standard deviation.
The events A and B are mutually exclusive,
therefore, prob (A or B) = Prob (A) + Prob (B).
The diagnostic power of a test to correctly exclude
the disease is reflected by
Negative predictivity
Highly significant correlation coefficient (r = 0.90, p
= 0.01) between the systolic blood pressure values
and serum cholesterol values of patients were
found. Correct interpretations are
A patient with high level of SBP is also likely to have
a high level of serum cholestrol, a patient with low
level of SBP is also likely to have a low level of
serum cholesterol and about 80% of the variation in
SBP among his patients can be explained by their
serum cholesterol values and vice versa.
Total cholesterol level = a + b (calorie intake) + c
(physical activity) + d (body mass index) is an
example of
Multiple linear regression

PSM

Percent prevalence of disease = Total diseased/

Total population 100
The best indicator for monitoring the impact of
Iodide deficiency disorders control programme is
Neonatal hypothyroidism
Under the WHO vision 2020 programme, SAFE
strategy is adopted for
Trachoma
WHO definition of adolescent age is between
1019 yrs of age
Information technology act was passed by
Government of India in 2000
Source of managers power is
Reward, coercive and legitimate
ALL INDIA 2004

A study beginning in 1975 with a group of 5000

adults asking about their alcohol consumption and
occurrence of cancer was studied in 19952000. This
study is
Concurrent cohort study
Proxy measures for incubation period are
Latent period, serial interval and generation time.
A 3 1/2 yr old child has not received primary
immunization. Best vaccination advice to such a
child is
BCG, DPT, OPV, measles, vitamin A
True about DPT vaccine
Aluminum salt has an adjuvant effect, whole cell
killed bacteria of Bordetella pertussis has an
adjuvant effect and presence of acellular pertussis
component increases its immunegenecity.
A 37 weeks pregnant woman attends an antenatal
clinic at PHC. No antenatal visit prior to it. Tetanus
immunization in this case can be best approached
by
Give a dose of TT and explain to her that it will not
protect the new born and she should take the
second dose after four weeks even if she has
delivered in the meantime.
4 month old child had cough, fever, chest
indrawing and respiratory rate 45 per minute. Best
way to manage the child is
Refer urgently to hospital after giving the first dose
of an antibiotic.
The most appropriate test to assess the prevalence
of TB infection in a community
Tuberculin test

109

According to international health regulations, there

is no risk of spread of yellow fever if the
Aedes aegypti index remains below 1%.
Mode of transmission of Leprosy are
Breast milk, insect bite and droplet infection.
True regarding leprosy
Multi bacillary leprosy is diagnosed when there are
> 5 skin patches, new case detection rate is an
indicator for incidence of leprosy and the target for
elimination of leprosy is to reduce the prevalence to
less than 1 per 10,000 population.
A 10 month old child weighing 8 kg has Bitots spots
in both eyes. Most appropriate schedule to
prescribe Vitamin A to this child is
1 lakh units IM on day 0, 1 and 14
The current recommendation for breast feeding is
that
Exclusive breast feeding should be continued till 6
months of age followed by supplementation with
additional foods.
True for breast milk
The coefficient of uptake of iron in breast milk is
70%, calcium absorption of human milk is better
than that of cows milk and it provides about 65 kcal
per 100 ml.
True about intrauterine devices
The pregnancy rate of lippes loop and Cu 250 are
similar, IUD can be used for emergency
contraception within 5 days and LNG releasing
IUD has an effective life of 5 years.
Goals of the national population policy of India
includes
To reduce IMR to 30 per thousand live births, To
reduce MMR to 100 per 100000 live births and 100
percent registration of births, deaths marriages and
pregnancies.
Essential component of RCH programme in India
includes
Prevention and management of unwanted
pregnancies, maternal care including antenatal
delivery and postnatal services and management of
reproductive tract infection and sexually
transmitted infections.
Five clean practices under strategies for elimination
of neonatal tetanus includes
Clean surface for delivery, clean hand of the
attendant and new blade for cutting the cord.
Dietary changes advocated by WHO for prevention
of heart diseases include

110

AIIMS and All Indian PGMEEReview Questions

Reduction in fat intake to 2030 percent of caloric

intake, consumption of saturated fats to be limited
to less them 10% of total energy intake and
consumption of cholesterol to below 100 mg per
1000 Kcal per day.
Multipurpose worker scheme in India was
introduced following the recommendation of
Kartar Singh committee.
If each value of a given group of observations is
multiplied by 10, standard deviation of new
observation is original standard deviation 10.
If SBP in a population has mean = 120 mm Hg and
median 125 mm Hg, the distribution is said to be
Negatively skewed.
It prevalence of diabetes mellitus is 10% the
probability that three people selected of random
from the population will have diabates is
0.001
The usefulness/utility of a screening test in a
community depends on
Sensitivity
ALL INDIA 2003

Denominator in secondary attack rate is

All susceptibles amongst close contact.
Necessary for calculation of sample size for a
prevalence study
Prevalence of disease in population, significance
level and desired precision.
The parameters of sensitivity and specificity are
used for assessing
Criterion validity
True about meningococcal meningitis
The disease is more common in dry and cold
months, chemoprophylaxis of close contacts of
cases is recommended and the vaccine is not
effective in children below 2 years of age.
24 months old child with cough, fever for 2 days, 11
kg weights, respiratory rate 38/min, and chest
indrawing present. Management is
Classify as severe pneumonia, start antibiotics and
refer urgently.
For controlling an outbreak of cholera, measures
recommended are
Proper disposal of excreta, chlorination of water
and early detection and management of cases.
The organism most commonly causing genital
filariasis in most parts of Bihar and Eastern UP is
Wuchereria bancrofti.

Class II exposure in animal bites includes

Licks on a fresh wound.
True about endemic typhus
Is transmitted by the bite of fleas.
Leprosy is considered a public health problem if the
prevalence of leprosy is more than 1 per 10,000.
Lepromin test is most useful for
Prognosis
Scope of family planning services include
Screening for cervical cancer, providing services for
unmarried mothers and providing adoption
services.
Most important epidemiological tool used for
assessing disability in children is
Wings handicaps, behaviour and skills schedule
(HBS).
The vitamin A supplement administered in
prevention of nutritional blindness in children
programme contain 1 laks IU/ml.
The protein efficiency ratio is defined as
The gain in weight of young animals per unit
weight of protein consumed.
Under national programme for anaemia
prophylaxis, elemental iron and folic acid contents
of iron and folic acid tablets are
100 mg elemental iron and 500 microgram of folic
acid.
Under RCH programme, elemental iron and folic
acid contents of pediatric iron
Folic acid tablets are 20 mg iron and 100 microgram
folic acid.
A measure of location which divide the distribution
in the ratio of 3:1 is
Third quartile
The P value of RCT comparing operation A (new
procedure) and operation B (Gold standard) is 0.04.
Conclusion is the probability of a false positive
conclusion that operation A is better than operation
B, when in truth it is not is 4%
Chi-square test is used to measure
The degree of association between two variables.
Elements of primary health care includes
Adequate supply of safe water and basic sanitation,
providing essential drugs and health education.
The response graded on agree or disagree
continuum is based on
Likert scale

PSM

ALL INDIA 2002

Iron and folic acid supplementation forms

Specific protection.
The most important function of sentinel
surveillance is
To find out the total amount of disease in a
population.
Serial interval is
Time gap between primary and secondary case.
Advantages of case control studies are
Useful in rare diseases, odds ratio can be calculated
and cost effective and inexpensive.
Odds ratio is
ad/bc
In a prospective study of 1000 subjects, 600 person
were put on beta carotene and 400 were not. 3 out of
first 600 developed lung cancer and 2 out of other
400 developed lung cancer. Interpretation is
Beta carotene and lung cancer have no relation to
each other.
True about direct standardization
Standard population is needed, population should
be comparable and two populations are compared.
Vaccine contraindicated in pregnancy
Rubella
True regarding pertussis
Erythromycin prevents spread of disease between
children.
The infectivity of chicken pox lasts for
6 days after onset of rash
Carriers are important in
Polio, typhoid and diphtheria
Acute flaccid paralysis is reported in a child aged
015 years.
2 year old child with cough, fever, difficulty in
breathing, RR 50/min, bilateral crepitations but no
chest indrawing
Diagnosis is pneumonia

111

Active and passive immunity should be given

together in
Tetanus, rabies and hepatitis B
Cereals and pulses are considered complementary
because cereals are deficit in lysine and pulses are
deficient in metheonine.
For a reference Indian man minimum daily protein
requirement is 40 g (mean) and standard deviation
is 10. The RDA of protein is
60 g/day
The best method to show the association between
height and weight of children in a class is by
Scatter diagram
The correlation between two variable was found to
be 1.1 in a study. This is
Computational mistake in calculating correlation.
The biological oxygen demand indicates
Organic matter
In a surveillance centre for hepatitis B, in a low
prevalence area, method for testing for hepatitis B
changed from single ELISA to double testing in
series. The parameters of the test affected are
Specificity and positive predictive value
In a study, variation in cholesterol was seen before
and after giving a drug. The test of significance is
Paired t test
Ram and Shyam stay in the same hostel. Ram
developed infection with group B meningococci
and Shyam developed infection due to group C
meningococci. True statements are
Educate students about meningococcal
transmission and take preventive measures,
chemoprophylaxis to all against both group B and
group C and vaccine prophylaxis of contacts of
Shyam.
Common causes of post neonatal infant mortality in
India are
Malnutrition, diarrhoeal diseases and acute
respiratory infection.