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Community medicine

1. Stages of demographic cycle


a. 1st Stage (High stationary) high birth rate & death rate
b. 2nd Stage (early expanding) high birth rate & death rate declining
c. 3rd Stage (Late expanding) death rate declines further & birth rate starts
declining
d. 4th Stage (Low stationary) both rates low & stable
e. 5th Stage (Declining) birth rate lower than death rate
2. Judgement of counselling and casuality (smoking and CAD)
3. Write on epidemiology of ca cervix and obesity.
4. Case Control study- advantages
a. Odds ratio (Cross product ratio)
It is the Estimation of association between the risk factors and the
outcome. Incidence is not needed.
ad/bc
Based on 3 assumptions disease investigated is relatively rare.
Cases are representatives of Diseased.
Controls must represent those without disease.
b. AR, RR
c. Biasi. Bias d/t Confounding factors
ii. Recall (Memory) bias
iii. Interviewer bias
iv. Selection bias
v. Berkesonian bias
d. observational and p
e. Cohort and case control study
f. Five features of cohort study
i. Cause to effect study
ii. Cohorts are identified before appearance of disease
iii. RR, AR, Population AR can be calculated
iv. Incidence can be calculated
v. Lengthy study
g. 3 advantage of case control study
i. Easy, short, less expensive, rare disease can be studied
ii. Multiple risk factors of single disease can be studied
iii. No attrition, ethical problem, no risk to subjects
5. Sensitivity, Specificity.
a. I and prevalence
b. Incidence-characteristics
6. Bimodal distribution-characteristics
7. Mortality measures
8. Cohort study- elements
a. Selection of Cohort
b. Obtaining data on Exposure
c. Selection of Comparison group
i. Internal

ii. External
iii. Comparison with general population
d. Follow up
e. Analysis
i. RR, AR, Population AR
ii. incidence
9.
10. Net reproductive rate
It is the total number of daughters a newborn girl will have if she passes
through her reproductive age (15-49) with the age specific fertility rate and mortality.
11. Total Fertility Rate
It is the average no. of children a woman will have if she were to pass
through her reproductive age with current age specific fertility rates and assuming no
mortality.
12. PMR
13. Steps in investigation of an epidemic.
a. Confirmation of the disease
b. Verification of the existence of Epidemic
c. Defining the Population at risk
i. Get the Map, population
d. Rapid search for cases and their characteristics
i. Search for more cases
e. Data Analysis
i. Time, Place and Person
f. Generation of Hypothesis
g. Testing of hypothesis
h. Evaluation of ecological factors
i. Further investigation of population at risk
j. Writing of Report
14. DefineEpidemic occurance of any disease or health related event in excess of
expected occurrence.
15. IP, specific protection
16. Primary prevention each- 2 examples- DM, neonatal tetanus, pneumoconiosis,
STI
17. Ix of measles epidemic
18. polygon, Random sampling, Frequency
19. Ratio
20. Indicators of morbidity
21. Rate, ratio, program
22. Specific mortality rate, Couple protection rate, Contraception prevalence rate,
Total fertility rate
23. HDI, QOL, Purchasin partiy
24. EPI
a. Sub NID and its use. How many districts?
b. Vitamin A program in Nepal, Prevention of vitamin A deficiency

c. Main objectives and problems of EPI, strategies


d. Define AFP
i. What is the most probable dx?
ii. When DHO should be informed?
iii. Stool collection and how many, duration, gap
iv. Rationale for pulse polio immunization for eradication
v. Sub NID- how many districts
e. Cold chain temperature for DPT and OPV
f. For or against eradication polio, Herd immunity
MEQ1. Screening, True +, True , PPV, NPV, Specificity, sensitivity
Use of screening
2. Mean , Mode, Median
Confidentiality limits- calculate
3. Diagrams, Frequency diagram/dispersion, Standard deviation
4. Kala A program and its constituents
5. Functions of TBA. How does sutketi samagri help in SCCM
6. Micronutrient- defn
7. FCHV, role in ARTI
8. Objectives of TBA program
9. Indication of safe motherhood program
10. Nutritional program- targets
11. Community based ARI and CDD program
12. Counselling HIV, STI
13. Strategies for controlling IDD
14. Define septic tank, work and maintenance
15. Components of rapid sand filter
16. 3 ways of sanitary waste disposal
17. High risk approach? High rf for pregnancy?
18. Child with grade 3 PEM (wt, age given)
a. Write IAP grade
b. Mx
c. How to assess dehydration?
d. Advice to parents on weaning
19. ANC in harinagar for normal preg
a. When to visit
b. Advice
c. Drugs
20. Write on depoprovera
21. Suspected PTB
a. When to refer?
b. What category?
c. DD
d. T/t with doses

22. Occupational lung disease (Dysp+hemop+cement factory)


a. DD
b. Ix
c. Probable dx
d. Preventive measures
e. Engineering method of decreasing occupational health hazard
f. Define ergonomic and its implications in occupational health
g. Define counseling, ppls
h. Personal protection in occupational disease
i. Sound- extraauditory effects
j. Medical measures of protection against occupational diseases
23. Ppls of health education
24. PHC-ppls
a. Principles of PHC outreach
b. Elements of primary health delivery
25. Cost effectiveness and cost benefit ration- analyze the difference betn them
MEQ AIDS
Net reproductive rate
Fn-failure in Nepal
Risk assessment in analytical step of primordial process. Definition of IHD.
New attitude towards health practices
Slow sand filter
Malaria stigmata
Filariasis index
Quantitive management methods
Health policy- staff
Pasturization
Food addictions egs
Rabies- prevention, prophylaxis
Example of zoonosis--bacterial/viral/parasitic
Vector transmission of giardiasis. Biological transmission of typhoid
Drug abuse- cardinal sxs
Waterlow classification of PEM
MEQ1. AIDS,
2. CAD,
3. KA,
4. dehydration,
5. TB

1.
2.
3.
4.

5 diff between Active and passive immunization


Cultural beliefs in child care
IEC
Function of DHO

5. Strategies for controlling IDD


6. Short notes- WHO, Health planning, DOTS in Nepal, ICT, MDT leprosy
MEQ
1. rabies- local tt, bite, PEP
1.
2.
3.
4.
5.
6.

Components of environmental sanitation.


Diptheria antitoxin
5 methods of waste disposal
Network analysis
Missed pill in mid cyclemx
Signs and sxs of vit A deficiency

MEQ
Umbilical sepsis
1. Advice to mother
2. ANC h/o tetanus, how elicitated
3. 5 cause
4. Who should attend the delivery from SHP?
Geriatrics
1. Reasons for decreased vision
2. Physical illnesses
3. Psychological illnesses
4. 2 remedies
5. Social rehabilitation centre
MEQ Malaria
Manure pit
IEC
Tap- figure
Salk vs Sabin vaccine
What is BCG? Role in TB program? Limitation
Epidemiology and prevalence of RHD
Epidemiological surveillance
1. Fever, cough 1 month
a. 2 important history
b. Inv TB program

c. Cat I
d. If sputum +ve at 2 months then further management
2. You are the DHO of rangelicommittee plans to install Xray machine
a. What mx technique you could apply?
b. Describe graphically the steps you will take
c. With is PERT and CPI
3. JE
a.
b.
c.
d.
e.

DD of sudden fever with chills and rigors


What other info is required for confirmation of its epidemic
With ix to confirm it?
2 steps to confirm JE epidemins
Vaccine

4. Function and staff of a health post


HA, AHW, ANM, Mukhiya, VHW, Peon
Sub HP
AHW, ANM, MCHW, VHW
How information is transferred from grass root to the center
Objectives of TBA program