1

SORTED 2008 T0 2018

3RD PROFESSIONAL MBBS PART-1

Community mediCine
By- ASHIS RONG

[Malda Medical College and Hospital]

EXAMINATION REGULATION:

TOTAL 200 marks in COMMUNITY MEDICINE

A. Written paper: 60 marks (paper I 60 + papers II 60 = 120 marks)

Paper-I:
General concepts of health & disease,
Epidemiology
Disease screening
Epidemiology of communicable (including childhood diseases like ARI, diarrhoea, VPDs) &
non-Communicable diseases
Health information
Biostatistics
Environmental health
Disaster management

Paper-II:
Demography
Maternal & child health
Nutrition & health
Social & behavioural sciences as relevant to community health
Occupational health
Health education & communication including counseling
Health planning & management
Health care delivery.

B. Viva: 10 marks

C. Practical: 30 marks
i. Epidemiological exercise = 5 marks
ii. Statistical exercise = 5 marks
iii. Problem solving exercise = 10 marks
iv. Project work = 5 marks
v. Family study exercise = 5 marks

D. Internal assessment: 40 marks (theory 30+ practical 30)

Group A
Paper-I
2018
1. What are the characteristics of ideal indicator? Enumerate the morbidity indicators. Describe briefly the Infant
mortality rate and case fatality rate.
2. Enumerate diseases under National Vector Borne Disease Control Programme (NVBDCP). Write down a brief
note on integrated vector control. Describe in brief the national drug policy 2014 on Malaria.

2017
1. Enlist the types of epidemiological studies. Discuss the importance of incubation period in epidemiological
studies. Describe different time trends in disease occurrence.
2. Name two important chemicals of health significance present in ground water of West Bengal. Describe in brief
the health effects and control measures of any one.

2016
1. Epidemiology. How can you estimate the disease risk in a case control study? What are the biases in case control
study including the process of elimination as applicable.
2. Enumerate the levels prevention and different modes of intervention in each level. Discuss the levels of
prevention in context to diabetes.

2015
1. What do you mean by indicators of health? Write down the different disability rates with example. What is the
concept of disability limitation?
2. Discuss in brief the strategies under the National Vector Borne Disease Control Programme (NVBDCP) for
prevention and control of vector borne diseases. Write down general guidelines for treatment of uncomplicated
malaria as per National Drug Policy on malaria 2013

2014
1. Describe the salient features of different types of time trends in disease occurrence with suitable examples. What
are the different possible changes that you should keep in mind while interpreting time trends.
2. Describe the natural history of disease. Discuss briefly the different levels of prevention and modes of
intervention as applied to pulmonary tuberculosis.

2013
1. What do you mean by multifactorial causation of disease? Describe with suitable examples.
2. What is sampling? What are the different types of sampling? Describe them briefly with their advantages and
limitations.

2012
1. What are the different types of epidemic? How will you investigate an epidemic of fever in a block?
2. What are the risk factors of coronary heart disease (CHD)? Discuss preventive strategies of CHD.
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2011
1. Enumerate the determinants of health. How do socioeconomic conditions act as one of the determinants of health?
2. Enlist major causes of blindness in India. Outline the strategies adopted for control of blindness under National
Program.

2010
1. Define epidemiology. Enlist the different epidemiological studies. Explain briefly the merits and demerits of case
control and cohort studies.
2. Illustrate how the levels of prevention and the modes of intervention can be applied in poliomyelitis.

2009
1. Define epidemiology. Classify epidemiological studies. Mention briefly the important differences between case
control and cohort studies.
2. Enumerate the cancers most commonly found in India. What are the early warnings signs of cancer? Describe
some preventive measures of cancer cervix.

2008
1. Define screening. How does it differ from diagnostic test? Describe the criteria of screening.
2. Enumerate different modes of intervention under levels of prevention. Discuss. in brief, the levels of prevention
in relation to leprosy.

Paper-II
2018
1. Enumerate the functions of primary health centre. What are the services provided by subcentre?
2. Mention the causes and detrimental effects of nutritional anaemia. Describe the measures undertaken to combat
anaemia among adolescents according to national programme.

2017
1. Enumerate the objectives of school health pregremme. Briefly mention the different components under the
programme.
2. Enlist the disorders caused by iodine deficiency. What are the strategies to control iodine deficiency in India?

2016
1. Define malnutrition. How will you assess the quality of protein? Name the nutritional programme currently
available in India. Discuss any one of them.
2. What are the eligibility criteria for enrolment in ESl Scheme? Write in brief the benefits available under ESI
scheme during and after working tenure. What are the services available under medical scheme?

2015
1. What do you mean by essential obstetric care? What are the services delivered under essential obstetric care
according to RCH-II programme? What is the importance of maternal death review?
2. Define 'Factory' under Indian Factories act 1948. Write in brief the provisions recommended in Indian Factories
Act 1948 to protect health of workers.
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2014
1. Define maternal mortality ratio and maternal mortality rate. Describe the important cultural and social factors
affecting infant mortality.
2. What are the health problems of adolescent? Mention the national programs concerning improvement of
adolescent health. Outline the important health educational messages for benefit of an adolescent girl.

2013
1. Enumerate different components of ICDS programme.
2.Name the types of occupational hazards. Describe the different medical measures to prevent occupational
diseases.

2012
1. Enumerate the 4 major nutritional problems in India. Discuss in brief, methods of nutritional assessment of Under-
5 children in a community.
2. Discuss the 3-tier system of Health Care Delivery in your state. What are the reforms made to give better service
to people? Discuss the role of PPP in efficient delivery of health services.

2011
1. Enumerate the principles of primary health care. How is it delivered in rural India?
2. What is malnutrition? Discuss its prevention strategies in terms of different levels of prevention.

2010
1. Enumerate types of family. Describe the stages of family cycle. Discuss the role of family in health and disease.
2. Define ergonomics. Discuss the importance of preplacement examination with suitable examples

2009
1. Define social security. Discuss briefly any one social security measure in India.
2. Enumerate fertility indicators. What do you mean by NRR = 1? Write in brief advantages and disadvantages of
contraceptive methods which an eligible couple should adopt in different phases of their reproductive life to achieve
‘small family norm’

2008
1. What is pneumoconiosis? Enumerate the different types of causative factor for the respective type of
pneumoconiosis. Enumerate the benefits provided under ESI Act. Describe one benefit under ESI Act which is
relevant to pneumoconiosis.
2. How RCH programme differs from CSSM programme? Describe briefly the package of services under RCH
programme.
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GROUP-B
Paper-I
2018
1. A 35 years sedentary obese man with smoking habit is found to have blood pressure of 126/100 mm. of Hg. How
will you classify this blood pressure? Describe the management with special emphasis on diet of the person.
2. In a block several cases of Dengue are reported for last one month. How Dengue can be diagnosed? What
measures do you like to suggest for its control and prevention?
3. Many school students in your block are found suffering from reduced ability to see the board-work by the teachers
in class room. As BMOH, how will you manage the situation?

2017
1. A sputum positive pulmonary TB patient was found sputum smear positive after 5 months of treatment with
category 1. What is your inference about the case? What is the next line of management as per RNTCP?
2. A six month old child was brought by the mother at OPD, presented with loose stools for more than three times
and vomiting from last night. On examination. the child was found restless and drinking eagerly. Classify diarrhoea.
Outline the management. What information you want to make the mother aware of the situation?
3. Significant no. of cases of jaundice was reported from an urban locality. As a public health expert how will you
investigate it and what remedial measures will you suggest for the problem?

2016
1. Mention the modes of transmission of HIV/AIDS. Explain the role of high risk group in HIV transmission.
Outline the strategies undertaken in National program to reduce transmission from high risk group.
2. A recent public demonstration has occurred in a Block primary health Centre about the disposal of biomedical
waste contaminating water body by the side of the hospital. As a BMOH of that hospital, what measures would you
like to adopt for proper waste management of your hospital.
3. In Kolkata and its suburbs, a few cases of dengue are being reported for last one month. How dengue can be
diagnosed? What measures do you like to suggest for its control.

2015
1. What do you mean by essential hypertension? What is its prevalence in lndia? What are the risk lactors for it?
What preventive measures should you take to reduce prevalence and complication due to hypertension?
2. What do you mean by disaster? What are the common causes of disaster? As a BMOH of a cyclone prone
block how will you proceed for preparedness to tackle the impending disaster in your block?
3. After having dinner with fried rice, egg curry and salad in a hostel, 20 students complained of vomiting and
diarrhoea at midnight and another 15 students reported the same complaints in the morning. How will you
investigate the outbreak and take control measures?

2014
1. Rising trends in the occurrence of diabetes has been observed throughout lndia. Describe the epidemiological
determinants of diabetes. Describe the methods of primary prevention of type 2 diabetes.
2. A person was bitten by a dog in the street. The bite was single and on the face. What is the category of bite?
Outline the management of the case. What is pre-exposure prephylaxis?
3. What are the functions of a BPHC? Mention the national programs under a BPHC. What is 'Record linkage and
what is 'Tracking of Beneficiaries' under MCH care?
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2013
1. Describe shortly the epidemiology and clinical presentation of dengue fever. Write the measures to be taken to
control dengue outbreak in a town.
2. What are the early signs of cancer? Describe in brief the epirlmnlnlngy of oral cancer and its primary levels of
prevention.
3. Define 'Safe and Wholesome water'?. Discuss the different tests for the bacteriological surveillance of drinking
water.

2012
1. A man comes to your health centre with lacerated injury of both legs caused by the bite of a dog about an hour
ago. Discuss steps of management. Suggest measures for minimising the risk of human rabies in the area.
2. Name the different types of waste generated in your hospital. Suggest measures for their safe disposal as per
national and state level rules. What is the importance of waste tracking?
3. Immunisation rate in your district has fallen to 50%. How would you investigate to find out the reason? How
would you concurrently try to increase the immunisation rate?

2011
1. A 2 year old child presented with history of frequent passage of loose stool for 2 days, irritability, excess thirst
and skin turgor going back slowly. Classify the condition with proper justification in accordance with national
programme guidelines. Outline the management of the child.
2. A 30 year old man, attended OPD with more than 5 hypopigmented patches on different parts of the body. Write
down the diagnosis. Outline the management of the case as per National guideline.
3. Enumerate different health hazards likely to occur during and following flood. As a BMOH, describe your
preparedness plan to mitigate such hazards in future.

2010
1. A 25 year old man reported in medical OPD with high fever, chills and retroorbitai pain. Outline the diagnosis,
case management and community intervention as per national guideline.
2. A 10 years old child reported with dog bite on call region in casualty OPD within 2 hours of bite. As CMO
suggest measures to prevent rabies in this child.
3. A 7 days old baby is brought to your CPU with excessive cry, refusal of feeds and convulsions. Discuss the
diagnosis, case management and preventive strategies as per national immunisation program.

2009
1. Your BPHC is situated by the side of a busy highway. Cases of road traffic accidents are common. Describe the
measures you would take as BMOH to reduce the problem.
2. Give a brief account of epidemiology of kalaazar. Briefly outline the strategies of control of kalaazar. Enumerate
the causes of resurgence of kala-azar.
3. A child bitten by a street dog on hands and fingers was brought to the casualty ward of medical college with'n an
hour of bite. As a MOI/C what measures will you suggest to prevent rabies in this case?

2008
1. The BMOH reported large number of cases clinically suspected to be Dengue. He also referred two cases to
district hospital and suspected an outbreak has occurred. As a BMOH how will you investigate and control the
outbreak?
2. What are the danger signals of cancer? Outline the epidemiology of oral cancer and methods of its prevention in
the community.
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3. A 2 years old child with history of passing watery stool every 2-3 hours, who is restless with dry mouth a sunken
eyes has been brought to the subcantre. How the health worker assess, classify and manage the case? What advice
should give to the mother for prevention of occurrence of such condition in future?

Paper II
2018
1. A 28 years old mother with children aged 4 year and 1 year, has come to you for family planning advice. Describe
different methods of contraception that can be offered to her with merits and demerits.
2. Describe different types of Pneumoconiosis. As a medical officer of a coal mine, what measure you like to adopt
to prevent Pneumoconiosis?
3. A recently delivered (2 weeks back) mother has come for check up. Mention the components of post natal check
up. What might be the post natal complications? What measures can be taken to improve post natal care at
community level?

2017
1. What is balanced diet? Enumerate different nutritional problems prevalent in lndia. How primary prevention
plays an important role in prevention of protein energy malnutrition.
2. In a block of West Bengal recent statistics showed lower rate of institutional delivery, As a health administrator
of the block what measures you like to adopt for improving institutional delivery of your block.
3. Enumerate different methods of diet survey. Briefly describe the methods you have applied to assess the
nutritional status in your ‘Family programme’.

2016
1. What do you mean by neonatal mortality? Why it is so important? Write in brief the components of Essential
New-born Care with special reference to breastfeeding.
2. What are the average populations catered in relation to health -in a village. subcentre, PHC, BPHC or CHC? Who
serves at the level of subcentre? What are the activities carried out at BPHC/CHC?
3. Immunisation drop outs and left outs are found to be quite high for consecutive years in a block. Mention the
possible reasons and outline the measures that can be adopted by the health administrator in that block to improve
the situation.

2015
1. Define sex ratio. What are the factors behind decline sex ratio in India? What are the measures adopted to correct
the situation?
2. Write the national sociodemographic goals for 2015? Outline the steps for evaluation of family Planning
Programme.
3. Define ‘Low Birth Weight'. What is its prevalence in India and the target to achieve? What measures would you
like to adopt as BMOH to reduce the Low Birth Weight in your block.

2014
1. Cases of AEFl are being reported from subcentres of a block. Due to apprehensions among people, dropouts for
immunisation are also increased. How the AEFl are classified mention with examples. Describe important health
managerial functions / measures need to be undertaken to address and overcome the problem in that block.
2. Many cases of silicosis were reported from a pottery and ceramic industry. As an industry health officer, what
measures will you recommend for prevention and control of the problem?
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3. In a block of Nadia district the couple protection rate is much less in comparison to neighbouring blocks. What
are the social causes of poor couple protection rate and what measures you will take up as a BMOH to improve the
situation?

2013
1. Mention the packages of services under RCH programme. Outline as to how the services are provided through
different levels health care facilities available in a block.
2. In a block 40% of eligible couples are protected by modern contraceptive methods. As BMOH outlines the
interventions to improve the situation.
3. Maternal mortality ratio in a block is found to be persistently high. As a BMOH outline the :
i. Investigation procedure to find out the causes of maternal mortality and
ii. Interventions to be adopted to reduce the MMR.
2012
1. There is sudden rise of infant mortality in a block. What are the measures you would like to adopt to reduce lMR
in the block?
2. Enumerate the different vector borne diseases. Describe the principle of vector control programme according to
existing national control programme.
3. What is a disaster? What are the different aspects of disaster management. Outline the management aspects of
disaster impact in a flood prone area.

2011
1. Percentage of fully immunised children is very low while drop out and left out rates are unexpectedly high in
your block. What measures you will adopt as a BMOH to improve the situation.
2. Proportion of institutional delivery is very low in your district. There is also poor utilisation of JSY, referral
transport and Ayushmati Scheme. What steps you would like to take as a CMOH to improve the situation?
3. Define health education. How it differs from BCC? Briefly outline the different health educational measures to
prevent cervical cancer in a block as a BMOH.

2010
1. IMR is high in your block. As a BMOH suggest measures to improve the situation.
2. Prepare an action plan to conduct an IEC campaign in your block to reduce anaemia among pregnant women.
3. Enumerate different types of food toxicants. Suggest measures to control epidemic dropsy in your area.

2009
1. Proportion of LBW babies in your block is very high. As a BMOH, what action will you take to tackle the
problem?
2. Outline your plan of action as BMOH to reduce the health hazards due to flood in your flood prone block.

2008
1. A 25 year old mother with 2 children aged 5 year and 1 year, has come to the OPD for family planning advice.
Discuss different methods of contraception that can be offered to her with merits and demerits.
2. Few cases of NNT is reported from a block of a district. As BMOH what measures will you take to prevent its
further occurrence?
3. Large no. Of PEM cases among Under 5s have been identified in your block. What social factors are responsible
for it? Name the nutritional programmes currently available in India. Describe briefly any one of them.
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GROUP-C
Paper-I
2018
Vaccination in disaster.
Indoor air pollution.
Sanitation barrier.
Multiphasic screening

2017
Modifiable risk factors of hypertension
Types of ventilation
DALY
Bacterial indicators of drinking water quality

2016
Cancer registry
Laboratory network under RNTCP
Triple blinding in epidemiological studies
Measures of dispersion

2015
Types of sampling
Health hazards of ionising radiation
Bacteriological surveillance of water quality
Principles of biomedical waste management

2014
DALY
Preventable blindness
Preventive services offered by your medical college and hospitals
Disaster preparedness

2013
Principles of chlorination of water
lntradermal rabies vaccination
Biological treatment of sewage
Normal curve

2012
Statistical averages
Chemotherapy of multibacillary leprosy
Integrated vector management
Interpretation of false negatives of a screening test
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2011
Human development index
Hazards of noise pollution
Sanitary land-fill
Sources of health information

2010
Standard normal curve
Hepatitis B vaccine
Water-borne diseases
Overcrowding

2009
Biological transmission of disease
Sampling
BCG vaccine (Bacille Calmette and Guerin)
Indicators of air pollution

2008
Quality of life
Risk factors of diabetes
Biological transmission
Disaster preparedness

Paper-II
2018
Family physician.
Triage.
Standard Normal curve.
Sources of health information.

2017
Indian Redcross
Endemic fluorosis
Neurolathyrism
Social stress

2016
Pasteurisation of milk
Principles of primary health care with examples
Facility based newborn care
Food safety
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2015
Role playing
Geriatrics health problems
Juvenile delinquency
Social mobilisation

2014
Modifiable risk factors of hypertension
Non-government organisation
Sickness absenteeism
Village health and nutrition day (VHND)

2013
Juvenile delinquency
Central government health scheme
Health problems of geriatrics
PNDT Act

2012
Measures of dispersion
Health insurance scheme
Child labour
Pre-placement examination

2011
Spectrum of iodine deficiency disorders
Ergonomics
Unmet need for family planning
Voluntary health agencies

2010
Principles of primary health care
Common home made oral rehydration solutions
Healthy life styles
CARE-India

2009
UNICEF
Channels of communication
Health problems of geriatrics
Elements of primary health care

2008
Indian Redcross
Interpretation of ICDS growth chart
Intersectoral coordination
BFHI
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GROUP-D
Paper-I
2018
Injection safety is important for the recipient, provider and community - Justify.
Zinc is given with ORS in treatment of ‘Diarrhea’- justify.
Data carry little meaning when considered alone.
Screening and diagnostic test differ.

2017
Sterilisation and disinfection are not synonymous.
Majority of blindness can be prevented Explain.
Biomedical waste should be segregated at source.
Carriers though less infectious are epidemiologically dangerous.

2016
Quarantine and isolation are not synonymous Explain.
Triage approach can provide maximum benefit in disaster situation-justify.
Integrated vector control management is the most effective method of vector control justify.
The census is an important tool of health information explain.

2015
Cohort studies are not always prospective Explain.
Screening test and diagnostic test are not synonymous Justify.
Sputum smear examination is the method of choice for case finding in TB Explain.
BMI is the best of all indices of obesity.

2014
ICTC should be supported by ART/Link ART centre Explain.
Prioritisation is an important step in health planning Explain why?
Sensitivity and specificity of a screening test is inversely related -justify.
For small sample median is a better measure of central tendency than mean, why?

2013
Screening and case finding are not synonymous Explain.
Carriers are more dangerous than cases -justify.
Overcrowding can influence health -justify.
Hepatitis B infection should be considered more dangerous than HIV infection Justify.

2012
All influenza pandemics were caused by influenza virus A and not by B or C Explain.
Lung cancer can be controlled by primary preventive measures justify.
RNTCP gives priority on detection of new smear positive cases Explain.
WHO definition of 'Health‘ has defects Explain.
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2011
HIV is a behavioural disease explain.
Vitamin A supplementation is necessary after measles infection-give reasons.
AEFI include events beyond side effects of vaccines explain.
Sanitation barrier aims at breaking the transmission cycle of faecal-borne disease explain.

2010
Role of pretest counselling for HIV/AIDS is useful explain.
Sentinel surveillance of disease is better than periodic mass screening explain.
Carrier stage of a disease is not amenable to control explain.
Role of IPV in polio eradication.

2009
Submerged part of the disease ice-berg has immense importance to an epidemiologist explain.
Syndromic management of STD is the most appropriate approach in India justify.
Carriers are more dangerous than cases justify
lndia is yellow fever receptive area Explain.

2008
The tem source and reservoir are not always synonymous explain with suitable example.
Live vaccines are more potent immunising agent than killed vaccine Explain.
Discuss health hazards of immunisation.
Discuss active surveillance in malaria.

Paper-II
2018
Cost effectiveness analysis is best suitable than cost benefit analysis in health sector.
ORS is an example of appropriate technology.
Family performs many functions: Explain.
Parboiled rice is nutritionally superior to milled rice.

2017
Supplementary and therapeutic nutrition are different
FRU can reduce MMR -Explain
Importance of genetic counselling in preventing genetic disorders.
Use of auto-disable syringe in national immunisation programme has several advantages.

2016
Prioritisation is an important step in health planning Justify.
Community participation is essential for success of a health programme.
India is in third stage of demographic cycle-explain.
Significance of a false positive screening test.
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2015
Feedback is very important in health planning.
Apart from growth monitoring growth chart has many other uses -explain.
Primordial prevention is a subset of primary prevention justify.
NRR is regarded as a superior method to GRR for measuring population growth -justify.

2014
Social security measures have a great role in preventing health problem explain with examples.
Accessibility cannot be equated with acceptability of health services justify.
Explain why family is considered as an epidemiological unit.
Population pyramid is important for public health.

2013
Food additives and food adulteration are not synonymous Explain.
Interpersonal communication is better than mass media for advocacy purpose Explain.
'Equittable distribution of health services” an important principle of primary health care justify.
Cost effective analysis and cost benefit analysis are not synonymous -explain.

2012
Cangaroo care.
Short term high dose of Vit. A is useful for prevention of xerophthalmia.
lDD is a social and preventable problem.
Fluorine is often called two-edged sword Explain.

2011
Revised lCDS growth chart currently in operation differ from the earlier one -explain.
Parboiled rice is nutritionally superior to milled rice explain.
Prioritisation is an important step in health planning Explain why?
Periodical examination is effective in prevention of occupational diseases justify.

2010
ASHA links health care delivery with community -Explain.
Networking with voluntary health agencies play an important role in health care delivery
Institutional deliveries can reduce maternal mortality to a great extent explain.
Growth chart can play multiple roles explain.

2009
FRU will reduce MMR Explain.
Subcentre is considered as pivot of health care delivery system in rural areas Explain.
Use of growth chart is a quick methodology for identification at under nutrition justify.
Management consists of four basic activities explain.

2008
Problems at industrialisation.
Different aspects of school health service
Medical care and health care are not synonymous.
Primary health care is basically the responsibility of the state.