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MINISTÈRE DE L’ENSEIGNEMENT SUPÉRIEUR MINISTRY OF HIGHER EDUCATION

COMMISSION NATIONALE D’ORGANISATION NATIONAL COMMITTEEE FOR THE ORGANIZATION

DES EXAMENS OF EXAMS

NATIONAL EXAM OF HIGHER NATIONAL DIPLOMA 2024 SESSION

Field: Biomedical Sciences
Specialty/Option: NUS, MLS, MID and MIT
Paper: Public health
Credit value: 6 Time Allowed: 3 hours
Instructions to Candidates:This paper is divided into sections A; multiple choice questions, Section B,
Structural and Section C Essay questions

SECTION A: MULTIPLE CHOICE QUESTIONS (25 MARKS)

1. Occurrence in the community of a number of cases of disease that is unusually

large or unexpected
A. Endemic
B. Epidemic
C. Pandemic
D. Infection

2. Another name for parotitis is

A.Mumps
B.Tetanus
C.Flu
D. None of the above

3. Measures of central tendency, except

A. Mean
B. Median
C. Mode
D. Variance
4. The following are measures of disease frequency, except
A. Incidence rate
B. Prevalence
C. Cumulative incidence
D. Relative risk
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5. A study that measures the incidence of a disease
A. Case report
B. Cross sectional
C. Case control
D. Cohort
6. Type of design where both exposure and disease are determined simultaneously
for each subject
A. Case study
B. Cross sectional study
C. Case control study
D. Cohort study
7. The purpose is to limit the incidence of disease by controlling causes and risk
factors
A. Primordial prevention
B. Primary prevention
C. Secondary prevention
D. Tertiary prevention
8. When handling human waste or sewage, one of the recommended PPE itemsis

A. cloth coveralls.

B. liquid repellantcoveralls.

C. Nomex coveralls.

D. none of theabove.
9. When handling human waste and sewage, you’ll need
A. safety glasses and a face shield.
B. safety goggles and a splash proof face shield.
C. safety glasses and a splash proof face shield.
D. Safety goggles and a face shield.
10. According to the CDC, COVID-19 can survivein

A. food.

B. water.

C. sunlight.

D. Humanfeces.

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11. Another way to help avoid contracting and spreading COVID-19 is to avoid
gatherings of more than people

A. 10

B. 15

C. 20

D. 50

12.Which of the following factors play a key role in likelihood of infectious disease
acquisition?

A.Genetic profile
B.Human behavior
C.Environmental conditions
D.All of the above

13.The routes of entry for COVID-19 into the human body are believed to be through
A. contact with a mucus membrane.
B. inhalation.
C. contact with eyes, nose, or mouth.
D. inhalation and contact with mucus membranes.

14. Septicemia is:

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 A. Acute illness caused by agents circulating in the blood
B. Infection in a previously healthy person
C. Caused by secondary infection
D. An example of the carrier state

15. Tetanus is also called ;

A. Chancre
B. Lockjaw
C. Mumps
D. None of the above

16.The incubation period is the interval between:

A. The time of infection and death
B. Appearance of clinical symptoms and death
C. The time of infection and appearance of clinical symptoms
D. Time of infection and appearance of antibodies
E. Time of infection and the appearance of IgM agent specific immunoglobulins
17.A “fomite” is:
A. An agent conducting aerosol
B. A blanket, door handle or other inanimate article on the surface of which the
agent resides
C. A vector between an arthropod and the susceptible host
D. An agent bearing substance that is eaten or drunk

18. Cystitis is defined as ;

A . Inflammation of a cyst
B.Inflammation of the bladder
C. Inflammation of the cytoplasm
19.Comparing numbers and rates of illness in a community, rates are preferred
for:
A. Conducting surveillance for communicable diseases

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 B. Deciding how many doses of immune globulin are needed
C. Estimating subgroups at highest risk
D. Telling physicians which strain of influenza is most prevalent
20.When analyzing surveillance data by age, which of the following age groups is
preferred?

A. 1-year age groups

B. 5-year age groups
C. 10-year age groups
D. Depends on the disease

21.A propagated epidemic is usually the result of what type of exposure?

A. Point source
B. Continuous common source
C. Intermittent common source
D. Person-to-person

22.What role do non-governmental organizations (NGOs) play in protecting

water
quality?
A. they pass water protection laws, assign protection to an agency and provide
funding for
enforcement
B. they encourage passage of water protection laws and support their enforcement
C. they decide if a water quality protection law or regulation is being broken
D. they set specific standards for water protection laws, help people, businesses and
other
agencies follow them and enforce them when they are not followed
23.Which of the following is Not the example of a live attenuated vaccine?
A. Diphtheria vaccine
B. Measles vaccine

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 C. BCG vaccine
D. Oral polio vaccine
24.WHO/CDC recommends vaccination of children under six years of age to
protect themselves from several infectious diseases. The following are the
important vaccines administered in childhood, Except?
A. DTAP (diphtheria, tetanus, and pertussis)
B. Polio
C. Hepatitis A and B
D. Rabies
25.Virulence is the:
A. Ability to cause clinical disease
B. Ability to cause severe disease
C. The ability to evoke an immune response
D. All of the above

SECTION B: SHORT ANSWER QUESTIONS (25 MARKS)

1.How is typhoid fever be transmitted? 5marks

2.List 3 causes of non infectious meningitis.3marks

3.What are the risk factors for cholera? 5markS

4.What is school health? 5marks

5.List 7 roles of a school nurse.7marks

SECTION C: ESSAY (50 MARKS)

1. Discuss pneumonia under the following

a) Causes and types.10marks

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b) Signs and symptoms.5marks

c) Prevention.5marks

2. a) Define control measures as used in occupational health.6marks

b.) Discuss the various measures used in occupational health.24marks

MARKING GUIDE

SECTION A: MULTIPLE CHOICE QUESTIONS (25 MARKS)

1. B

2. A

3. D

4. D

5. D

6. B

7. B

8. B

9. B

10. D

11. A

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12. D

13. D

14. A

15. B

16. C

17. B

18. B

19. C

20. D

21. D

22. B

23. A

24. D

25. B

SECTION B: SHORT ANSWER QUESTIONS (25 MARKS)

1. Fecal-oral transmission route

Once they have been infected, they can spread it to others through the fecal-oral route.

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This means that Salmonella typhi is passed in the feces and sometimes in the urine of
infected people. If you eat food that has been handled by someone who has typhoid fever
and who hasn't washed carefully after using the toilet, you can become infected.

Contaminated water and food

In developing countries, where typhoid fever is established, most people become infected
by drinking contaminated water. The bacteria may also spread through contaminated
food ,and through direct contact with someone who is infected.

Typhoid carriers

Even after antibiotic treatment, a small number of people who recover from typhoid fever
continue to harbor the bacteria. These people, known as chronic carriers, no longer have
signs or symptoms of the disease themselves. However, they still shed the bacteria in their
feces and are capable of infecting others.

2. lupus.
o a head injury.
o brain surgery.
o Cancer.
o certain medications

3.Risk factors for cholera

 Poor sanitary conditions. Cholera is more likely to flourish in situations where a

sanitary environment — including a safe water supply — is difficult to maintain. Such
conditions are common to refugee camps, impoverished countries, and areas afflicted
by famine, war or natural disasters.

 Reduced or nonexistent stomach acid. Cholera bacteria can't survive in an acidic

environment, and ordinary stomach acid often serves as a defense against infection.

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 But people with low levels of stomach acid — such as children, older adults, and
people who take antacids, H-2 blockers or proton pump inhibitors — lack this
protection, so they're at greater risk of cholera.

 Household exposure. You're at increased risk of cholera if you live with someone
who has the disease.

 Type O blood. For reasons that aren't entirely clear, people with type O blood are
twice as likely to develop cholera compared with people with other blood types.

Raw or undercooked shellfish. Although industrialized nations no longer have large-scale

cholera outbreaks, eating shellfish from waters known to harbor the bacteria greatly
increases the risk

4. School health refer to the state of complete physical, mental and spiritual well being and
not merely the absence of diseases or infirmity among children, students and other
personnel in the school environment.

5. Provide direct care to students

o The school nurse Provides leadership for the provision of health services
o The school nurse provides screening and referral for health conditions.
o The school nurse provides a healthy environment
o The school nurse promotes health
o The school nurse serves a leadership role for health policies and programs
o The school nurse is a liaison between the family, school personnel, health
professionals and community

SECTION C: ESSAY (50 MARKS)

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2a.Classification according to the types of germs that cause it. pneumonia may be
caused by:
Bacteria. The most common cause of bacterial pneumonia is Streptococcus pneumoniae.
This type of pneumonia can occur on its own or after you've had a cold or the flu. It may
affect one part (lobe) of the lung, a condition called lobar pneumonia.
Bacteria-like organisms. Mycoplasma pneumoniae also can cause pneumonia. It typically
produces milder symptoms than do other types of pneumonia. Walking pneumonia is an
informal name given to this type of pneumonia, which typically isn't severe enough to
require bed rest.
Fungi. This type of pneumonia is most common in people with chronic health problems or
weakened immune systems, and in people who have inhaled large doses of the organisms.
The fungi that cause it can be found in soil or bird droppings and vary depending upon
geographic location.
Viruses, including COVID-19. Some of the viruses that cause colds and the flu can cause
pneumonia. Viruses are the most common cause of pneumonia in children younger than 5
years. Viral pneumonia is usually mild. But in some cases it can become very serious.
Coronavirus 2019 (COVID-19) may cause pneumonia, which can become severe.
Classification according to where the infection was acquired.
Community-acquired pneumonia
Community-acquired pneumonia is the most common type of pneumonia. It occurs outside
of hospitals or other health care facilities.
Hospital-acquired pneumonia
This pneumonia is acquired during a hospital stay for another illness. Hospital-acquired
pneumonia can be serious because the bacteria causing it may be more resistant to
antibiotics and because the people who get it are already sick. People who are on breathing
machines (ventilators), often used in intensive care units, are at higher risk of this type of
pneumonia.
Health care-acquired pneumonia
Health care-acquired pneumonia is a bacterial infection that occurs in people who live in
long-term care facilities or who receive care in outpatient clinics, including kidney dialysis

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centers. Like hospital-acquired pneumonia, health care-acquired pneumonia can be caused
by bacteria that are more resistant to antibiotics.
Aspiration pneumonia
Aspiration pneumonia occurs when somebody inhale food, drink, vomit or saliva into the
lungs. Aspiration is more likely if something disturbs the normal gag reflex, such as a brain
injury or swallowing problem, or excessive use of alcohol or drugs.
Others
Primary pneumonia is caused by the patient’s inhaling respirating a pathogen such as
bactria or virus
Secondary pneumonia come about as a result of lung damage that was caused by the
spread of bacteria from an infection else where in the body or by noxious chemical

b. Signs and symptoms of pneumonia may include:

 Chest pain when you breathe or cough
 Confusion or changes in mental awareness (in adults age 65 and older)
 Cough, which may produce phlegm
 Fatigue
 Fever, sweating and shaking chills
 Lower than normal body temperature (in adults older than age 65 and people with
weak immune systems)
 Nausea, vomiting or diarrhea
 Shortness of breath
Newborns and infants may not show any sign of the infection. Or they may vomit, have a
fever and cough, appear restless or tired and without energy, or have difficulty breathing
and eating.

c. Prevention of pneumonia
Get vaccinated. Vaccines are available to prevent some types of pneumonia and the flu..

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Make sure children get vaccinated.
Practice good hygiene. To protect yourself against respiratory infections that sometimes
lead to pneumonia, wash your hands regularly or use an alcohol-based hand sanitizer.
Don't smoke. Smoking damages your lungs' natural defenses against respiratory
infections.
Keep your immune system strong. Get enough sleep, exercise regularly and eat a healthy
diet.
Most types of bacterial pneumonia are not highly contagious. Even though it is possible to
spread bacteria from one person to another.

2.a) Control measures. These are actions that can be taken to reduce the potential of
exposure to harm, or remove the hazard or reduce the likelyhood of risk of exposure to the
hazard.

b.) Control measures include;

Eliminate the hazard.
This is removing the hazard completely thereby eliminating the risk of exposure.
Substituting the hazard
This may not totally remove all the hazard associated with the process or activity.
A different hazard is introduced but the overall harm or health effect is reduce.
For example, in lab research toluene is now used as a substitute for benzene.
Their solvent property are similar but toluene is less toxic and is not carcinogenic, it can
cause some severe neurogenic harm.
Using engineering control.
It involve redesigning a process to place a barrier between the person and hazard.
Use of administrative control
This include adopting standard operating procedures or safe work practices or providing
appropriate training, instruction or information to reduce potential harm and or adverse
health effect to the person.
Use of personal protective equipments (PPE)

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PPE is use to protect parts of the body.This include gloves, goggle, glasses, helmet, aprons,
safety foot wear, mask.
PPE is usually used in combination with one or more of the other control measures.

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