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MODEL QUESTIONS

IN
COMMUNITYMEDICINE
~ First Edition ~

An initiative by the students of the Faculty of Medicine

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This book is dedicated to the Professors, Lecturers & Junior Lecturers who
inculcated the ABCs of the Medical Sciences in us, for they are gods who walk
amidst men.

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~ PREFACE ~

This question book was compiled with the intention of making questions of community
medicine readily accessible to students. We hope that this compilation will serve as a useful
resource for many future batches of medical students, preventing the hassle of collecting sets
of questions from ad hoc sources in preparation for examinations.
The art of answering questions at undergraduate level, especially in the medical sciences is
glaringly different from the Advanced Level Examination at the secondary educational level,
one has to attempt many a question before one can firmly grasp this art of answering.
Though this book contains a comprehensive collection of questions on community medicine ,
solely relying on this book will not be enough to achieve good results at the examinations.
Daily, diligent studying is essential in order to succeed in the pre-clinical sciences.
We launch this book as an entirely non-profit venture where all proceeds from this book will
be channeled to the Patient Outreach Fund maintained by the Faculty of Medicine in order to
support needy patients.
Wishing you the best of luck in your endeavors.

April 2015
Sathya G.-4
Thimal S.-4
Geethika C.-5
Chenuri R.-5
Duniya K.-5
Ammar J.-5
Dasuni W.-5
Kavita A.-5
Chathurika B-5
Thusitha C-5

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COMMUNITY MEDICINE
MCQs

Surveillance & Notification


1.Notifiable diseases according to
international regulations.
a)
b)
c)
d)
e)
f)

cholera
Hepatitis A& B
Yellow fever
Paralytic polio
AIDS
Leprosy

2.Regarding notification of a disease;


a) All diseases of EPI schedule
should be notified
b) Diseases with short incubation
periods should be notified
c) Is done to quarantine housing
mates
d) Rabies is notifiable disease
e) Has no importance to preventive
measurements

3.Outbreak investigation;
a) should start after confirming
diagnosis
b) DDHS leads to the team
c) Done to strengthen the surveillance
at low level
d) Is done to calculate the relevant risk
e) Necessary to prepare the spot map

4.Special surveillance has to be carried out


(MOH should investigate personally);
a)
b)
c)
d)
e)
f)
g)

Dengue
TB
JE
Human Rabies
Neonatal tetanus
Malaria
Congenital rubella

5.When an MOH is notified about AFP of a


5 yr old boy, he should do ;
a) Send PHI to the place within 24
hrs
b) Chlorination of all wells of his
area
c) Obtain stool samples of patient &
other near contacts
d) Stool sample should be sent to
MRI
e) 2 OPV to everyone of his area

6.Which of the following T/F regarding


carriers of infectious diseases;
a) Include who sheds infectious
agents during the incubation
period
b)
Hepatitis A has healthy carriers
c)
Healthy carriers emerge from
subclinical diseases
d)
Chronic carriers infective agent for
indefinite period
e)
Occupation of a carrier is of
epidemiological importance

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7.Which of the following are true regarding


surveillance of Poliomyelitis in SL;
a) Every cases of suspected AFP should be
immediately notified to epidemiologist
b) Stool sample for virological examination
of polio is sent by a special culture bottle
obtained from the MRI
c) Sentinel sites are used for the active
surveillance of the disease
d) PHI investigates when there is an AFP
case been reported
e) Contacts should be given OPV before
stool samples are collected

8.The nortification procedure in SL;


a) HIV is a notifiable disease
b) Epidemiological unit gets reports
monthly
c) Hepatitis B should be confirmed before
notification
d) TB is notified to respiratory disease
control programme
e) Only purpose is to obtain
accurate statistics.

9.The epidemiological unit is responsible of


surveillance of ;
a)
b)
c)
d)
e)
f)

Measles
Rabies
Malaria
leprosy
Filariasis
Polio

10.T/F regarding screening;

a) Is better if there is a short period of


between first signs & final state of
disease
b) The diagnostic test should be
sensitive but need to be specific
c) Natural history of the disease
should be clearly understood
d) At the preclinical stage there
should be a low prevalence
e) It is not necessary to check
whether treatment facilities are
available & accurate

11.Which of the following statements are


true regarding investigation of an
outbreak/epidemic?
a) Attack rate is the number of exposed
persons developing the disease with
the range of the incubation period
following exposure to a primary case
b) To calculate the attack into primary
case is excluded from both the
numerator &denominator
c) An outbreak of measles will deplete
a propagated epidemic curve
d) All the cases should be confirmed by
laboratory investigations
e) The main objective is prevention of
further outbreaks

12.T/F regarding communicable disease


notification;
a) Only communicable diseases are
notifiable
b) Diagnosed cases are only notified
c) Cholera should be notified to WHO
d) Aim is to find the source of
epidemic]
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e) Weekly epidemiological return is


sent by DDHS on Wednesday

13)Notifiable disease according to


international regulation
a)
b)
c)
d)
e)

Cholera el tor
AIDS
Yellow fever
Polio
Hepatitis B

14)T/F regarding outbreak investigation


a) Comes once after commencing
diagnosis
b) MOH is the head person
c) Needs support of providing authorities
d) Done to strengthen the surveillance at
local level
e) Nessaciate to prepare the spot map

15)Information on injury can be gathered


from
a)
b)
c)
d)
e)

Judicial reports
CCU
Insurance companies
HEB
FHB

Rabies Control
1. T/F regarding Rabies
a) Auto-plunger is used to vaccinate stray
dogs
b) Oral rabies vaccine is used to
vaccinate domestic dogs
c) Promotion of birth control is a control
method

d) House to house vaccine is a new


strategy
e) 50% coverage of dog vaccination will
eliminate rabies from SL

2. Regarding Rabies in Sri Lanka


a)
Killing stray dogs is the most
successful strategy carried out by the
rabies control program
b)
There is marked decrease of deaths
due to domestic dog bite
c)
Dog to human ratio is 1:8
d)
More than 50% rabies cases are due
to domestic dog bite
e)
Rabies control measures are carried
out by Public Health Veterinary Services
3.
Strategies of Rabies control program
are
a)
Development of immunity against
rabies among 20%of dogs
b)
Provision of post exposure
vaccination to all victims
c)
Mobilization of community support
d)
Research of vaccine production and
new techniques of post exposure treatment
e)
Enforcement of Rabies control
legislation
4. Regarding Rabies in Sri Lanka
a) Dog is the main reservoir and
transmitter
b) Approximately 25 000 of patients are
admitted to hospital for post exposure
vaccination annually
c) Sterilization of dog is recommended
d) Vaccination of dogs should be done
annually

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e)
80%

Immunization coverage should be

5. T/F regarding Rabies


a) Control of Rabies is mainly done by
controlling stray dogs
b) Rabies control program includes post
exposure vaccination of all the victims
c) All the cases of death due to Rabies is
investigated by the DDHS
d) Establishment of herd immunity against
Rabies in the dog population is the key
strategy in prevention of Human Rabies
e) Mad Cow Disease can be identified in
anti-mortem examination
6. Regarding management of dog bite
a) Give tetanus toxoid if necessary
b) Immediately wash with soap and
water
c) Anti-rabies post exposure
vaccination following suspected
rabies
d) Anti-microbial Rx for all
e) Immunoglobulin following even
minor exposure

2) T/f regarding TB
a)
Is a leading killer in woman
b)
Southeast Asia has 40% of global TB
c)
1/3 of HIV infected deaths are due to
TB
d)
DOTS was introduced to SL in 2004
e)
Defaulter tracing is done to prevent
drug resistance TB
3) T/F regarding TB ;
a. 50% aids deaths are due to TB infection
b. Mostly affect the older population than
young population
c. All maternal deaths are less than TB
deaths among women
d. The most common cause of death in
European countries
e. Incidence rate for TB gives an idea about
the national problem of TB

4) Regarding TB in Sri Lanka ;


a. Drug treatment for pulmonary TB should
be continued for 9 months

TB control

1) Mantoux test
a)
Used in diagnosis of TB in adults
b)
If positive indicates TB bacillus
infection
c)
Useful in diagnosis of TB in children
d)
Useful in estimation of prevalence of
TB
e)
Not useful in estimating annual risk
of TB infection

b. Higher death rate is reported in the age


group between 15-28 years
c. Multi drug resistant is not reported in Sri
Lanka in 2002
d. Pulmonary TB is common between 15-24
age group
e. Tuberculosis is notified to area MOH

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5) T/F regarding TB ;
a. Active case finding is done by national
TB control programme
b. If untreated 25 % of TB patients are
infective after 5years.
c. Resistant to MDT is reported in certain
parts of Sri Lanka.
d. It should be noticed to the MOH.
e. DOTS have lowered the defaulter rate
from treatment.

Measles control
1) Regarding measles;
a. It is infective for one week after appearing
of rash.
b. Vaccine is given to the thigh.
c. Measles vaccine is contraindicated in past
history of measles
d. Fever and rash are the main adverse
effects of measles vaccine
e. Cant be given with a live vaccine

Leprosy control
6) T/F regarding DOTS;

1) Regarding leprosy control programme in


Sri Lanka;

a. Frequent recording system is used.


b. Political commitment.

a. It use a social market campaign to control


at national level

c. Treatment with all drugs is given for one


year.

b. It has been integrated to National Health


Service

d. Sputum smears examination.

c. Multiple drug therapy is only present in


tertiary care hospitals.

e. Mantoux test.

d. Medical officer in OPD is expected to


treat Leprosy patient.
7) Regarding BCG vaccination ;

e. Leprosy has been eradicated in Sri Lanka.

a. It has a limited value in preventing TB.


b. It is given subcutaneously.

Filarial control
c. It is postponed in a baby born to sputum
positive mother.
d. Prevent TB meningitis.
e. Dose 0.1ml(neonatal)

1)Regarding the control of filariasis


a)
Elimination of lymphatic fiariasis by
2010

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b)
Mass treatment is conducted
biannually, by administration of DEC
c)
Effects of vector control has varied
d)
Reduce disability due to
lymphedema
e)
AFC responsibility is carried out by
provincial health authority
2) T/F regarding fillarisis in SL
a) Central provinceis endemic for Ssl
b) Transmission is interrupted by annual
treatment with DEC and albendazole
c) Hydrocele repair by surgery will cause
for decrease in morbidity
d) Parasites live in lymphatic system for 46 years
e) DEC fortified salt given for prophylaxis
in endemic area
3)anti-filarial campaign includes
a)
b)
c)
d)
e)

Night blood examination


Treatment for positives with DEC
Mass treatment for single dose to all
people at once
Treatment for lymphoedema
Biological control for breeding sites
for mosquitoes

b) Aedes egypti infection can be


measured by breteau index
c) Vector surveys are done before the
cleaning procedure starts
d) Is an urban disease
e) DHF can cause circulatory failure
f) DHF is caused by secondary
infection
g) Better breading places of vectors are
small collections of polluted water
h) Fumigation is a better method of
control

JE control
a) Aedes albopictus is the vector found
in the rural areas
b) JE vaccine is incluses in EPI
c) Vaccination of pigs in an important
preventative method
d) Vectors breeds in paddy fields
e) Vaccination is carried out in junejuly months only

Sexually transmitted diseases


1)T/F regarding AIDS control strategies

Dengue control
1)T/F regarding the dengue fever
a) It is a rural disease
b) An outbreak can be predicted by
metrological data
c) Regular vector surveys are conducted by
MOH
d) COMBI is the latest control strategy
e) Breteau index asses Aedesegypti
infection
2)T/F regarding dengue fever
a) Outbreaks can be predicted by
meteorological data

a) Is transmitted by infected blood


products
b) Prevention of transmission of mother
to baby
c) Homosexual transmission is
commonest in SL
d) Spread via toilet seats
e) Persons who have STIs has a higher
chance to get HIV

2)Effective strategies to prevent HIV


infection in SL
a) Mass education
b) Prevent mother to baby transmission
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c) Treatment for STIs


d) Proper disposal of infectious waste
disposal
e) Free anti- retroviral therapy for HIV
infected patients
3)T/F regarding STD clinic attendance
a) 50% of infected people get services
fromSD clinics
b) syphilis is a commoner presentation
c) gonorrhea is more common
amongst females than males
d) genital warts are more common
amongst males
e) Genital herpes is more common in
females

6)Regarding hep B in SL
a) SL is a low to moderate prevalent
country
b) Vaccine was included in EPI since
2003
c) May spread via water
d) Organ transplant of recipient are at
a higher risk of getting infected
e) Infants are infected via beast milk
f) Vaccine is not effective when given
to new born
g) Virus is destroyed by boiling 60C
for 20 mins
h) Vertical transmission is a
recognized way of transmission

4)T/F regarding HIV


a) Transmission occurs viz
unprotected blood products
b) In SL spreads mostly homosexually
c) More prone to get when there are
multiple sex partners
d) Transmitted via toilet seats
e) Increased to get in prople having
STDs
f) Abs to HIV within one week of
initial infection can be detected by
ELISA

5) T/F regarding STD


a) They consists of one of the
notifiable diseases
b) To prevent transmission from
mother to baby , postpone the
pregnancy in one methord
c) Partner referral is one of the of the
methords of trace contacts
d) Syndromicapproach doesnot
request laboratory conformation
e) Herpes is the most common cause
of genital ulcers

Malaria control
1)T/F regarding malaria control program in
SL
a) Administrating primaquine to
pregnant women in malarial areas
b) Using Malathion impregnated bed
nets
c) Quarterly spraying of Malathion is
malarial areas
d) Using biological methods for vector
control
e) Community participation is used in
reducing breeding
2)the following are used for residual spray
in malaria areas
a)
b)
c)
d)

DDT
Malathion
Pyrethran
Fenitrothion
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e) Lambda-cylothrin

b) Maintenance of cancer death


registry
c) Provesion of screening programme
island wide
d) Provisssion of health education
programmes

3)T/F regarding malaria control programme


a) To eliminate mortality due to malaria
at year 2009 is an objective
b) tempos is used for larvae control
c) To eliminate malaria amongst
pregnant women at year 2009 in an
objective
d) etopenfrox 20%used for vector
control
e) Malathion is used for residual
spraying

3)T/F regarding breast


a) a)incidence reduce after menopause
b) moderate alcohol consumption
increases the risk
c) 80% of women with breast CA
survive more RCT
d) Screening reduces more mortality
according to RCT
e) Oestrogen therapy increases the risk

4)anti-malarial campaign
a) Premaquine is given for pregnant
mothers
b) Malathion impregnated nets are used
c) Malathion is sprayed quarterly in
malarial areas
d) Biological vector control is used
e) Community participation is carried
out to get rid of breeding places

4)T/F regarding the following


a) Arsenic can cause skin cancers
b) Asbastoses can cause liver
carcinoma
c) Nickel can cause bone cancer
d) aniline dye cause bladder carcinoma
e) Lead can cause bone cancer
f)

Cancer control
1)T/F regarding CA
a) In sl breast cancer is the
commonest amongst females
b) Oesophagial carcinoma in the 3rd
commonest ca in both males and
females
c) Mortality Data available in cancer
register
d) 60% of cases are due to any form
of tobacco intake
e) Scerrning for CA is done at well
women clinic
2)regarding cancer control programme in
SL
a) Provision for training for health
staff

5)Following cancers are showing upward


trend in SL
a)
b)
c)
d)
e)

Oropharangeal CA
Breast CA
Colorectal CA
Prostate CA
Cervical CA

6)Oral cancers are common in


a)
b)
c)
d)
e)

Females
>40 years
Urban areas
Low socio-economical background
Smokers

Diarrheal diseases

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1)Diarrhea is three or more loose stools per


day according to WHO
a) Exclusive breast feeding for 6
months will decrease the risk
b) jeevani contains NaHCO3 to
correct electrolyte balance
c) To prepare jeevani , a packet has to
be dissolved in 500ml of boiled cool
water
d) All diarrheal diseases in children
below 3 years should be treated with
antibiotics

e) Maternal and child healthcare is


an important component of PHC
in SL
2) Health Officers involved at district level
a) PHM
b) MO/ MCH
c) PDHS
d) DDHS
e) Regional Dentist

Food and Nutrition


1) T/F regarding protein energy
malnutrition
a) Urinary tract infection is a risk
b) The prevalence is measured by
proportion of underweight in less than 5
years of age
c) Always should be admitted to
hospital in early management
d) Is not a common health problem in
SL now
e) Heart failure can be seen as a
complication

2)T/F regarding diarrheal controlling


a) Food is restricted following diarrheal
episodes
b) Improved weaning practice prevents
occurrence
c) False attitudes may cause for
persistent high morbidity rate
d) The common agents are viruses in
children under 5 years of age
e) Development of drug resistance in
diseases such as shigella has been a
problem

Primary Healthcare Systems

a)

1) Regarding primary healthcare


a) Does not contain curative care
b) Key principle is to provide
access to healthcare for all
people
c) To provide PHC government
ministry should coordinate
d) One of the concepts of PHC is to
provide healthcare according to
the need of the population

b)
c)
d)
e)

2) T/F regarding nutritional deficiencies


Follicular keratosis can be seen in
Vitamin A deficiency
Cretinism can reverse if treated early
Bitot spots are pathognomonic in
Vitamin A deficiency
Can cause developmental delay
Complications of Vitamin A deficiency
are aggravated by Measles

3) Nutritional state of a 5 year old child


in the community is assessed by
Page | 12

a)
b)
c)
d)
e)

Weight for age


Head circumference
Mid arm circumference
Waist measurement
BMI

4) T/F regarding Vitamin A


a) Is a water soluble vitamin
b) Deficiencies seen more
commoner in adults than in
children
c) Mega dose is given IM
d) Mega dose should not be given to
the mother in two consecutive
pregnancies
e) Deficiencies can cause complete
blindness
5) Following are given routinely to
pregnant mothers from antenatal
clinics
a) Folate
b) Vitamin C
c) Calcium lactate
d) Multi vitamin
e) Vitamin B12
6) T/F regarding malnutrition
a) Gomezs classification is based
on weight to height
measurements
b) Waterlows classification
measures the severity of
malnutrition
c) Low weight for height is wasting
d) Low weight for age is stunting
e) Low height for age is
malnutrition
7) T/F regarding rice

a) Early introduction of rice to an


infant diet may lead to gluten
sensitive enteropathy
b) It is a food source of Vitamin B
c) Its protein is deficient in lysine
d) Parboiling preserves its
nutritional status
e) It is a good source of calcium
8) T/F regarding PEM
a) Energy deficiency itself can
cause PEM
b) When infants and children are
affected lit leads to physical
retardation only
c) Severe manifestations are
precipitated by infections
d) All forms of protein energy
malnutrition cause edema
e) Main contributory factor is
cultural practice
9) T/F regarding iron
a) Cows milk is a rich source of
Fe2+
b) Absorption of iron is improved
by Vitamin C and some amino
acids
c) Absorption of iron is inhibited by
phytates and oxalates
d) Absorption is better with Fe2+
than Fe3+ form
e) Iron deficiency in pregnancy
causes neonatal anaemia
10) T/F regarding PEM
a) Acute malnutrition is associated
with stunting
b) Kwashiorkor occurs at a later
stage than marasmus
Page | 13

c) Underweight is low weight for


age
d) In treatment of xerophthalmia
Vitamin A is given IM
e) PEM can clearly be detected by
anthropometry

11) T/F regarding protein


a) Intake depends on net protein
utilization value
b) Reference protein contains eggs
and milk
c) Protein requirement during
pregnancy is daily requirement
plus 15g/day
d) Some of the essential amino
acids are produced by healthy
babies
e) Soya protein contains more
protein than beef
12) T/F regarding iron
a) Iron store of newborn is adequate
up to 6 months
b) Iron deficiency in pregnant
mothers can cause premature
delivery
c) Iron deficiency in children gives
rise to cognitive function
impairment
d) Iron absorption from cows milk
is low
e) Iron content of breast milk can
satisfy the Fe requirement of SL
babies up to 6 months of age
13) T/F regarding nutrition
a) Low soluble fiber diet lowers the
glycemic index response

b) Quiflex index is a measure of


chronic malnutrition
c) Early use of complimentary
foods increases the risk of iron
depletion
d) Hb is an insensible indicator of
overall iron content
e) BMI of 25 35 means Stage I
obesity
f) Maternal iodine deficiency
correction can prevent cretinism
in fetus
14) Daily nutrient requirements of a
healthy adult
a) Energy from CHO should not be
more than 50%
b) Minimum 5% intake of energy
should be from free sugar
c) About 5% intake of fat should be
from PUFA
d) Protein intake should be 1g/Kg
e) Minimum amount of salt intake
daily is 6g/Kg

Reproductive Health &


Motherhood Care
1. MCH indicators are
a)
b)
c)
d)
e)

BR
IMR
Number of home deliveries
Dependency ratio
Incidence of whooping cough among
children below 5years

2)Regarding the Eligible couple register;


Page | 14

a) Maintained by SPHM
b) All women between 15-39yrs are
included
c) Can be used to evaluate SPHM
d) Indicates types of birth
e) Can be used to identify the target
population for family planning

2. The Antenatal care;


a) Starts with eligible couple registration
b) Is provided mainly by the state sector
c) Is to identify at risk mothers
d) PHM is the most responsible
personality
e) Thriposha supplement is given to all
pregnant mothers
3. Following are regarded as high risk
conditions in pregnancy;
a) Maternal age less than 21yrs
b) Primigravida
c) Still birth in previous pregnancy
d) Multiple pregnancy
e) Maternal height less than 155cm
f) Maternal age >35yrs

4. In the antenatal clinic visit, the


following are being done;
a) Hb estimation
b) Urine for sugar and albumin
c) Blood grouping and Rh typing
d) UFR
e) VDRL

5. The following are given routinely to


pregnant mothers from the antenatal
clinic;
a) Folate
b) Vitamin C
c) Calcium lactate
d) Mulitivitamins
e) Vitamin B12
f) Albendazole

6. Regarding maternal nutrients;


a) When a pregnant mother is on a well
balanced diet, she should not be on
vitamins or iron tabs
b) Weight gain in SL women during
pregnancy is 5kg
c) Low birth weight is due to poor
maternal nutrition
d) Should give thriposha irrespective of
mothers age
e) Additional thriposha packet is given
to mothers who are severely anemic
7. Duties and responsibilities of PHNS
includes;
a) Supervision of all health staff
b) Should report to work at 8am
c) Should conduct school health
supervisions
d) Maintain maps and charts
e) Supervise the activities of PHI
8. T/F regarding duties of PHM;
a) Investigate infant deaths if occurred
in the field
b) Register all births in pregnancy
record
c) Distribute ORS
Page | 15

d) Should attend all deliveries of


mothers in the area
e) Assist PHI during SMI

e) Progesterone only pills cause heavy


withdrawal bleeding
12. T/F regarding IUCD;

9. T/F regarding methods used to monitor


PHMs activities;
a) Proportion of pregnant mothers
registered within first 3months of
gestation
b) Number of atleast one postnatal visit
c) By the no. of pregnant mothers who
received thriposha
d) Presentation of mothers who had
hospital deliveries
e) No. of babies born with LBW
f) No. of polio and DPT vaccines given in
the area
g) Proportion of eligible couple register
10. T/F regarding the 3 most common
causes for neonatal death;
a) Birth asphyxia
b) Congenital abnormalities
c) Neonatal meningitis
d) Gastroenteritis
e) LBW
f) SIDS

11. Regarding OCP;


a) Valvular heart diseases are absolute
contraindication for OCP use
b) Hyperlipidemia may occur as a side
effect
c) Endometrial CA may occur as a
complication
d) Can use after 42 weeks following postpartum

a) More effective in preventing pregnancy


than OCP
b) Abdominal pain for 1-2 days after
insertion is normal
c) C/I in PID
d) Efficacy is 98%
e) Copper T loops are used in present
days
13. C/Is for IUCD include;
a) Nulliparus women
b) Pelvic infections
c) Past Hx of STIs
d) Irregular periods
e) Hx of ectopic pregnancy
14. T/F regarding Depot-provera;
a) Given in every 90days subcutaneously
b) Can be given to a mother at 6months of
post-partum
c) Cause weight gain due to increase of
appetite
d) When stopped returns to fertility within
6months
e) Injection site should not be massaged
15. Adverse effects following family
planning are;
a) Spotting occur in OCP than in DMPA
b) Irregular menstrual periods occur with
DMPA than in IUCD
c) IUCD cause weight gain
d) OCP cause ectopic pregnancies
Page | 16

e) Late return to fertility after stopping


both DMPA and IUCD

e) Energy requirement in the 1st half of the


infancy is less than the 2nd half
f) Fat requirement in the infancy is about
3-6g/kg BW

16. T/F regarding weaning food;


a) Should be started after 6months in
every baby
b) Energy requirement is high during the
first half of the infancy
c) Birth weight doubles in a normally
growing child at the 5th centile
d) A sudden drop of weight is due to
inadequate feeding
e) Delay in weaning is associated with Fe
deficiency anemia
17. About complimentary feeding;
a) Breast feeding should be done in same
frequency
b) Should be stopped temporarily during
the time of illness
c) Once the child has got familiarized, the
food variety should be increased
d) Should pay more attention on the taste
of food
e) This is the time to train the proper food
habits to the child

18. T/F;
a) Premature and LBW babies need high
dietary iron than normal
b) Infants start the life with high Zn stores
c) 2/3rds of the breast milk calcium is
stored in the body after intake by the
baby
d) Vitamin A cannot be utilized without
protein and vitamin C

19. Indicators regarding child health


includes;
a) Infant mortality rate
b) Maternal mortality rate
c) Percentage of low birth weight babies
d) Post natal mortality rate
e) Proportion of babies whos weight is
less than the 3rd centile
20. Regarding school health inspectors;
a) Medical officers from rural hospitals,
help the MOH in SMI
b) PHI is responsible for following
children with health problems
c) Teachers are responsible for
safekeeping of health records of
children
d) Every student is examined at SMI if the
no.of students are less than 500
e) Rubella vaccine is given
21. Regarding SMI in SL;
a) Scabies is the most commonest disease
amongst children
b) Dental caries are the most commonly
encountered condition
c) Children are screened for primary
immunization
d) SPHM is responsible for arranging the
SMI
e) Class teachers observation on children
is important

23) Proposed activities of mental health


program in SL
Page | 17

a) Development of mental wards in district


hospitals onwards
b) Development of referral system
c) Appoint PHNS (mental health) to
coordinate continuity of care
d) Training of care givers of patients
e) Provision of post-basic training in
psychiatry for female nurses

c) Stressful events in occupation


associated with duodenal ulcers
d) Leptospirosis is a common zoonotic
disease amongst health workers
e) Periodic medical examination helps
to prevent occupational disease

a)

Occupational Health
1) Regarding occupational diseases;
a) Raynauds syndrome is common in
person working with vibration tools
b) Chronic dermatitis is a common skin
condition caused by nickel
c) Arsenic causes skin cancer
d) Cadmium is one of the most toxic
substance used in industries
e) Mercury causes behavioral changes
2) Regarding occupational diseases;
a) Mesothelioma is common in asbestos
workers
b) Hyperlipidemia can be caused by
carbon disulphide
c) Psychiatric symptoms occur by heavy
metals
d) Chromium is a cumulative poisoning
e) Acute carbon dioxide poisoning can
occur from exhaustion of fumes of
motor vehicles
3) Regarding the occupational diseases;
a) Major cause of mortality are
respiratory tract infections
b) Most vulnerable group include female
migrants

T/F regarding ergonomics;


a. It is mainly concerned with
equipment only
b. Include supplying the sanitary
facilities
c. Consider only physical aspect of the
workers
d. Psychological limitations are not
concerned
e. Also consider about the working
environment
4)
a.
b.
c.

T/F regarding repetitive strain injury;


Due to repetitive movements
Commonly seen in typists
Very often these are associated with
X-ray changes
d. It commonly causes sickness
absentness
e. It is associated with injury to muscle
5) T/F regarding activities of
occupational health care;
a. Preplacement examination
b. Periodic examination
c. Notification of industrial accidents
d. Factory inspection
e. Maternal benefits
f. Sanitation
g. Factory inspection

Page | 18

6) The work in the following industries


and specialized cancers recognized
are well matched;
a. Dye industry

lung
cancer
b. Asbestos industry
Bowel
cancer
c. Oil refinery
skin
cancer
d. Coal mining
leukemia
e. Rice milling
nasopharyngeal cancer

f.
g.

It is not a form of a causative vibration


It is defined in the factories ordinance as
85dB
Exposure to high levels of noises can
give rise to non specific symptoms
It affects the hair cells of the internal ear
Classical feature of the audiometric
record is the 4kHz. Dip

h.
i.
j.

11)T/F regarding occupational hazards


a)
Inorganic lead may cause loss of
libido in males
b)
Organic solvents may cause
infertility in both males and females
c)
Psychological hazards may lead to
high labor turnover
d)
More chemicals are entered via the
skin to the body
e)
Explosives may cause physical as
well as chemical hazards

7) Under the factory ordinance


recommendations regarding the
following is/are induced by benefit
of the workers;
a.
Insurance scheme
b.
Wages
c.
Required cubic space
d.
Maternal benefits
e.
Leave

Environmental health
1) Proper waste management includes

8)
a.
b.
c.
d.
e.

In occupational health, the role of the


physician, includes;
Advising the patients on the nature and
the prognosis of the occupational health
Inform the DDHS with consent of the
patient
Inform the engineer of the industry
Give advices to get the compensation for
the disease
Inform the regional epidemiologist about
the disease

10)T/F regarding noise;

a)
b)
c)
d)
e)

Waste avoidance
Dumpling in selected locations
Re-cycling
Re-using
Burning in an open area with good
circulation

1) T/F regarding water pollution


a.
Domestic sewage is the main cause
for the water pollution by pathogens
b.
Sewage disposal gives rise to water
pollution in plantation areas
Page | 19

c.
Agrochemical cause water pollution
by increasing the nitrogen available for the
plankton in the water
d.
Dengue is classified as water born
disease
e.
Spraying agrochemicals may lead to
water pollution

Miscellaneous
1)Regarding healthy lifestyle
a.
Should start from adolescence
b.
Is successfully achieved through
community participation
c.
Is inevitable in persons leading
successful lives
d.
Has no effect on economy status of
the country
e.
Has no effect on reproductive life
2)Regarding stress
a.
b.
c.
d.
e.

Is a major impact for lifestyle


Is reduced by physical exercise
Is inevitable in successful person
Results substance abuse
Can be successfully treated by
medication

T/F regarding airborne disease;


f.a. May spread via droplets emmited by an
infected host
g.
b. Larger droplets expelled during
sneezing may become a part of dust.
h.
c. Droplet nuclei settle down on the
floor due to their sheer weight.
i. d. Chemotherapeutic agents are generally
useful.
j. e. Become contagious soon after
symptoms appear.
k.
f. Occupational measures are used in
preventive stratergies.
l. g. Useful vaccination is carried out
against almost all airbourn pathogens

Epidemiology
1) A cohort study differs from a casecontrol study as the former
a) Proceeds from effect to cause
b) Involves large number of subjects
c) Starts with the disease
d) Being useful for exploratory studies
e) Yields both relative and attribute
risks

2) In a case control study, showed that


people with specific disease drank coffee
more than the control group. What can
we conclude (the observed difference is
highly significant)
a) Drinking coffee is the cause for the
disease
b) There is no any other relation
between the disease and coffee
drinking
c) Elimination of coffee would prevent
the disease
d) Coffee ad disease is always going
together
e) It gives the relation between cause of
disease and coffee drinking

3) A case control study was carried out to


determine the association between bottle
feeding and diarrhea in infants
a) Only bottle fed babies are included
in cases
b) Infants admitted to hospital for
disease other than diarrhea can
include in control group
c) Infants both cases and controls who
die should be excluded from the
study
d) As an observed study need o consent
from patients
Page | 20

e) Results by OR

4) In a study regarding ischemic heart


disease, the serum cholesterol level
between 2 groups of normal healthy
individuals were measured
a) It is a case control study
b) Strength of association is measured
by odd ratio
c) Is a retrospective study
d) Loss of follow up is increased in this
study
e) Recall bias is the major draw back

5) In a simple random sampling


a) Each person has equal chance to be
chosen
b) Adjacent member of the population
is not included
c) Equal group of sample has equal
chance to be chosen
d) There should be a sample frame
e) Selection of sampling is based on
individual characteristics

d) Period prevalence is useful in


assessing mental illness than
incidence
e) Influence the predictive value of a
disease

8) T/F regarding cross sectional studies


a) Examination done at one time
b) Helps to identifies the risk factors
c) More useful in chronic diseases
d) Cannot get an idea of natural history
of disease
e) Start with hypothesis formation

9) T/F regarding paired T test


a) Useful for analysis of qualitative
data
b) Suitable for the very small samples
c) Based on normal distribution
d) Use for independent sample
e) Confident intervals are compared

6) The following provide information about


incidence
a) Longitudinal studies
b) Cross section studies
c) Randomized clinical trials
d) Cohort studies
e) Experimental studies

7) T/F regarding prevalence


a) Is not influenced by incidence
b) Time period of onset of disease is
not necessary to calculate the
prevalence
c) Helps to allocate health facilities
Page | 21

Structured Esssay Questions


Batch 01(F)
1. You are invited to deliver a lecture on preventing non-communicable diseases to a group of A/L
students list the topics that you would cover in this lecture. Give reasons (100 marks)
2. 2.1 Outline the trend of maternal mortality in Sri Lanka since the 1940s , giving reasons for the
change of trend.(25 marks)
2.2 List the services provided by PMH to a recently married female, who is expecting to conceive(25
marks)
2.3 List the responsibilities of an MOH regarding the provision of family planning services in this
area (25 marks)
2.4 Mention 5 goals of the national and child health programme in Sri Lanka (25 marks)
3

3.1 Define primary prevention (20 marks)


3.2 Outline the flow of information in the nortifiable process, starting from an individual patient until
it reaches the final destination (40 marks)
3.3 Describe the measures that should be followed to prevent the rising incidence of dengue fever in
some urban area (40marks)

write short notes of the following


4.1 Pre-placement medical examinations (25 marks)
4.2 Health hazards associated with improper disposal of household refusals (40 marks)
4.3 The national programme for prevention and control of rabies in Sri Lanka (35 marks)

5 5.1List 4 major nutritional problems in Sri Lanka and indicate the vulnerable groups of each problem
mentioned (30marks)
5.2 List the feeding recommendation for a young child from birth up to 2 years of age (30marks)
5.3 Discuss advantages and disadvantages of the thriposha programme in Sri Lanka (30 marks)

Page | 22

Batch 02(F)

1 The incidence of Type 2 diabetes mellitus in Sri Lanka has increased to such an extent that it has
become a major problem of health
1.1 List the reasons for this situation (20 marks)
1.2 If you were a medical officer of health (MOH) what steps would you take to bring down the
incidence of this disease in your MOH area (80 marks)
2

write short notes on the following


2.1 Control of dengue fever in Sri Lanka (40 marks)
2.2 Importance of taking occupational history from a patient (30marks)
2.3 Control of road traffic accidents in Sri Lanka (30marks )

3.1 Outline the antenatal care services provided through medical officer of health unit (25 marks)
3.2 Describe the role of public health staff in preventing infant deaths in the community (25 marks)
3.3 List the responsibly of a public health inspector with respect to school health programme (25
marks)
3.4 Describe the services provided through a well woman clinic (25 marks)

4.1 Describe the epidemiological surveillance (10 marks)


4.2 List 3 surveillance systems available within the Sri Lankan health system ( 30 marks)
4.3 List the roles of the following persons in the expanded programme on immunization
4.3.1 Regional epidemiologist (30 marks)
4.3.2 Public health nursing sister (30 marks)

5.1 List the current activities carried out by the ministry of health to prevent and control iron
deficiency anaemia in Sri Lanka. (40 marks)
5.2 A medical officer of health (MOH) has observed that a 2 year old child is having a weight below
-32 in the Child Heath and Development Report (CHDR).Describe the action you as the MOH
would take to address this problem. (60 marks)

Page | 23

Batch 03(F)

1.1 What is meant by term metabolic syndrome (20 marks)


1.2 List the diseases associated with metabolic syndrome. (20 marks)
1.3 You have been asked to deliver a health education talk to advanced level students on the
prevention of metabolic syndrome .list the important aspects that you will cover in your
lecture, giving reasons
(60 marks)
write short notes on
2.1 The importance of taking occupational history from a patient (30 marks)
2.2 The health problems associated with improper disposal of house hold refuse (40 marks)
2.3 Home accidents (30 marks)
3.1 Outline school health services provided through a medical officer of health unit (25 marks)

3.2 List the responsibilities of a public health inspector with respect to the school health
programme ( 25 marks)
3.3 Describe the role of the public health midwife in providing family planning services (25
marks)
3.4 Describe the services provided in a child welfare clinic (25 marks )
4

4.1 Define the term notification and list 5 notifiable diseases (30 marks)
4.2 Describe the processes notifying using a flow diagram (30 marks)
4.3 Outline the schedule of vaccines to be administered under the expanded programme of
immunization up to 2 years of age (40 marks)

5 5.1 Liist the common nutritional deficiency disorders in sri lanka , and the high risk groups for each
deficiency disorder (30 marks)
5.2 List the nutritional supplements given during antenatal care and give reasons for providing them.
5.3 Discuss the main reasons for protein-energy malnutrition amongst pre-school children in Sri
Lanka (40 marks)

Page | 24

Batch 04(F)
1

1.1 as medical officer of health , describe the measures you would take to reduce the incidence of
ischemic heart disease in your area. (60 marks)
1.2 list the risk factors associated with road traffic accidents in Sri lanka (40 marks)

write short notes on the following


2.1 micronutrient supplementation programmein Sri Lanka (30 marks)
2.2 growth monitoring programme in sri lanka (20 marks)
2.3 life cycle approach of nutritional intervention (50 marks)

3 3.1 Define maternal death (10 marks)


3.2 briefly describe the three delays of a maternal death (30 marks)
3.3 Describe the implementation of the family planning programme in sri lanka. (40 marks)
3.4 list the activities carried out by MOH under the school health programme (20 marks)
4 in the Kaduwela MOH area ,6 cases of dysentery were notified 2 days ago
4.1 briefly describe as MOH of this area how are you going to confirm an outbreak of dysentery
(40 marks)
4.2 briefly describe the responsibilities of you as MOH of this situation ( 60 marks)
5

5.1 List the types of health hazards that could be encountered in a gament factory giving 2 examples
for each hazard mentioned (40 marks)
5.2 A high incidence of chronic back ache was reported in the accounts department of a privet
company, resulting in poor work performance of its employees. The factory management it keen to
work with MOH to overcome the problem If you are the MOH in the relevant area , briefly explain
your responsibilities and how would you provide a solution to the problem. (60 marks)

Page | 25