COMMUNITY MEDICINE SORTED OUT

SEND UPS SEQS FOOD & NUTRITION 1. A researcher wants to find out the nutritional status of medical students.

Describe how he should take a sample of 30 students from a class of 200 by

using the “Simple Radom sampling technique” (MMDC)

2. Define “protein energy malnutrition”. Tabulate five major differences between

“marasmus” and “Kwashiorkor”. (MMDC)

3. (a) Define malnutrition?

b) Briefly described the control of “Protein Energy Malnutrition” (NSMC)

4. District health management wants to initiate a program evaluation of nutritional

status of the school children in schools.

a) Enlist 05 methods she would employ to serve this purpose.

b) Enumerate 06 the Socio-cultural factors that affect the nutritional status of

people.

c) Name public health measures that can be used to prevent malnutrition in the

rural community. (RMC)

5. In a BHU, a mother brings her one year old child to you for growth monitoring.

His reported birth weight is 3 kg and his present weight is 6 kg.

a) What is your opinion about the weight of this baby?

b) What advice will you give to his mother keeping the current status of the baby

in mind? (SIMS)

6. a) What is Nutritional anemia?

b) Discuss different strategies to prevent nutritional anemia in a community.

(SMC)

7. A mother reports to you with her two years old child with the complaints of

skin pigmentation, cracks & Changes in hair color. Examination showed weight

slightly below the standard for age but it was masked by generalized body edema.

(UMDC)

8. A research was conducted in obstetrics department regarding the effects of

nutritional status of pregnant women on their deliveries and outcomes. It was

observed that 60% of women who presented during pregnancy with pallor,

palpitations and dyspnea on exertion: developed complications at the time of

delivery and their babies were below 2.5 Kg of weight at birth:

a) Which nutritional condition is hinted by the signs in these pregnant women?

b) Suggest measures to decrease the prevalence of this condition among pregnant

Women? (UMDC)

MCH, REPRODUCTIVE HEALTH & FAMILY PLANNING 1. A 28 years old primigravida came to a MCH centre at 36 weeks of pregnancy for

ante-natal cheek-up and advice:

a) What specific examination will you perform at this stage of pregnancy?

b) What specific advice you will give her in relation to micronutrients?

c) Write down complications of anemia? (NMC)

2. Enlist the components of antenatal service? (NSMC)

3. a) Define low birth weight?

(b) What prenatal advice should be given to a pregnant Woman seeking antenatal

care? (NSMC)

4. a) Classify Contraceptives?

(b) How would you screen a patent for oral Contraceptive pills? (NSMC)

5. In spite of so many efforts infant mortality rate is still high in our country.

a) As in charge of rural health centre, how will you reduce it in your area?

b) What is child survival index? Enlist five causes of under-five mortality. (QAMC)

6. Population growth rate in Pakistan is still very high, which reflects upon the great

need of promoting family planning services.

a) What are the objectives of family planning?

b) Classify contraceptive methods and discuss the oral contraceptives in particular.

c) Enlist the absolute contraindications of hormonal contraceptives. (RMC)

7. Mother with normal obstetric history may be advised to have home delivery by

health worker or a trained Dai.

a) Give the advantages and disadvantages of domiciliary midwifery services.

b) What do you understand by risk approach in antenatal care?

c) What are the basic parameters to measure the growth of a new born baby?

(RMC)

8. In a village of 5000 population crude birth rate is 40 per 1000 population and 20

infants die every year.

a) Calculate infant mortality rate.

b) Enlist 4 main causes of infant mortality. (SIMS)

9. A married couple with 2 children comes to you for advice of contraception for 4

to 5 years. The man is not motivated for using any contraceptive method. The wife

aged 35 has been a known hypertensive for many years.

a) Which type of contraceptive method would you advise for the lady?

b) How would you counsel the woman regarding the use of this method? (SIMS)

10. A baby was delivered by an untrained birth attendant in a village, She cut the

timed of the baby with an unsterilized dusty blade; baby died within seven days

after developing serve muscular spasm, arching of the back and respiratory failure:

a) What do you think was the possible cause of death?

b) Could this death be prevented? If yes; how? (SMC)

11. A 4 months pregnant mother visited an RHC for the first time for antenatal

checkup. LHV checked her and gave her schedule for rest of the antenatal visits.

a) What are essential Lab investigations at first visit?

b) What is the schedule for rest of antenatal visits?

c) What is the nutritional and other important advice given to her during antenatal

visits? (SZMC)

12. A 30 year old mother died during child birth due to hemorrhage. Despite he

efforts Pakistan has not achieved the desired level of fertility and maternal

mortality.

a) Define maternal mortality ratio. What is MMR in Pakistan?

b) Enlist 6 factors responsible for high fertility in Pakistan? (SZMC)

13. A mother brought her 3-year-old child to the Paeds OPD with complaints of on

and off diarrhea. On examination the child was irritable and his weight was 70% of

the standard weight for age.

a) Categorize condition of the baby?

b) List EIGHT contributory factor responsible for the above condition. (WMC)

ENVIRONMENT 1. Name important “AIR POLLUTANTS”. What measures should be adopted to

prevent and control AIR POLLUTION? (MMDC)

a) What is super chlorination?

b) Name two sources of outdoor air pollution

c) Name two methods of artificial illuminations

d) Enumerate two characteristics of waste suitable for incineration. (NSMC)

2. Rainy Season often results in floods causing displacement of large population

every ear. In such circumstances water borne diseases are likely to spread which is

a great concern for Public Health authorities.

a) Name five methods to purify water on small scale.

b) Name hazards of exposure to extreme hot and cold weather

c) How can you prevent such hazards? (RMC)

3. You are working as medical officer in-charge of BHU Maraka. In the village one

of the hand pump water having bad taste and odor. There was heap of garbage

with lots of flies present within 20 feet distance.

a) How will you take sample from this band pump for bacteriological examination

and send it to laboratory.

b) How will you interpret the report of water testing lab in light of WHO standards

for safe drinking water? (SIMS)

4. The century has been declared “century of noise”. Noise is resulting in many ill

effects on health. Suggest measures to control this menace? (SIMS)

5. According to a research carried out by the students of Environment sciences

department, concentration of certain harmful gases was increasing in atmosphere

owing to which the surface of earth had become hotter than it was before:

a) What is this effect called?

b) What are the harmful effects of rising temperature of earth? (SMC)

6. A villager reports about the dirty linen and utensils being washed in the area

around the well.

a) List THREE disadvantage of the practice.

b) What measures can be taken to make the well water safe for drinking. (WMC)

OCCUPATIONAL HEALTH

1. A man 40 years of age is working in sugar cane industry for 20 years. He is

suffering from whistling and buzzing in the ears.

a. Name the immediate effects due to noise.

b. What is the acceptable level of noise in hospital wards? (QAMC)

2. A pottery industry worker reported to you with the complaints of cough,

dyspnoea on exertion and pain in chest. His x-ray chest showed snow storm

appearance:

a) What is the likely diagnosis?

b) What is the role of pre-placement examination in the prevention of the above

disorder? (SMC)

3. a) Define “Ergonomics”

b) What particular engineering measures would you recommend for prevention

of “Bagasossis” in industrial workers?

c) Enlist important problems of industrialization. (RMC)

4. A person aged 40, who had been working as a laborer in the grain market for the

last 25 years presented with history of repeated attacks of respiratory infections in

the last 1 year. X-ray showed pulmonary fibrosis.

a) Give the likely diagnosis?

b) What is the role of occupational health service in the prevention of the given

problem? (UMDC)

5. During screening of the workers of glass industry two were found to have “snow

storm appearance” on chest X-ray.

a) What actions would you take for the above patients on the basis of social security

service?

b) List FOUR broad strategies to prevent the condition? (WMC)

PARASITES, ENTOMOLOGY &SNAKE BITES

1. (a) Enumerate mosquito control measures?(NSMC)

(b) Give two sequel of snake bites (NSMC)

2. An 18 year old farmer how works barefooted for 10-12 hours on his fields daily,

complains of weakness, breathlessness on exertion and diminished capacity for

sustained hard work. On examination he looks pale:

a) What is the likely diagnosis?

b) How would you prevent and control this problem? (SMC)

3. A farmer in month of July working in his filed was bitten by a snake. He

suddenly developed ptosis, slurred speech, weakness, and numbness in body and

difficulty in breathing.

a) What type of poisonous snake might have bitten him?

b) Outline plan of management.

c) How can SNAKE BITES be prevented? (UMDC)

4. A farmer from Gilgit reported to a health facility with history of intermittent

fever and generalized pigmentation of the body. Clinical examination showed

anemia and hepatosplenomegaly. Liver biopsy showed leishmania donovani

bodies.

a) Name the vector that transmits the above disease.

b) Give FOUR broad strategies to control the problem. (WMC)

MENTAL HEALTH & BEHAVIORAL SCIENCES

1. a) How the drug dependence is different from Addiction.

b) Name the six drugs/substances which produce dependence.

c) What public health measures can be taken to prevent and control drug abuse in

the community? (RMC)

2. A man is brought to you with history of inadequate dietary intake and signs of

Thiamine deficiency. On further interviewing, he is found to be taking 30 units of

Alcohol weekly (1 unit = 9 grams):

a) What is your opinion about the quantity of Alcohol intake in this person?

b) What SOCIAL and PSYCHOLOGICAL EFFECTS are likely in this person? (SMC)

3. Inflation and terrorism are outrageous in Pakistan which is expected to have

bearing on mental health of the future generation.

a) List SIX possible problems that the future generation can have in the situation.

(3) (WMC)

DENTAL HEALTH, SCHOOL HEALTH & HEALTH EDUCATION 1. In order to find the mean height of the school children, we took the sample of

625 students. The results a were as follow:

The mean height = 165 cm, The Standard Deviation = 10

Find the true (population) mean height, with 95 % confidence. (MMDC)

2. a) Enlist all types of communication?

b) Which one is the best, justify your answer? (NMC)

3. Smoking is highly prevalent among students of Islamia University Bahawalpur.

You health educate against smoking to these university students.

a) Which type of barriers may affect communication?

b) Enlist three communication method for these student and purpose. (QAMC)

4. a) Describe the benefits of “Minus Desk”?

b) Describe ‘dental fluorosis

(c) Name two principals of health education (NSMC)

5. How will you control the common diseases and health problems in school

children? (SMC)

6. a) Define Health Promotion.

b) Describe in brief, different well known interventions in Health Promotion.

(SZMC)

7. A 40 years old man came to a hospital with complains of gastritis. He also has

dependence on a substance. On examination he had sings of peripheral

neuropathy and cirrhosis of liver. His gait was ataxic and speech slurred.

a. Name the likely abused substance.

b. List the factors responsible for substance use disorders (SIMS)

8. Give the role of a teacher in the school health service. (WMC)

ACCIDENTS & DISASTERS 1. For a person wounded in a road side accident with loss of font,

a) Apply the following terms in order of occurrence Disease-Hand leap-Disability-

Impairment

b) Write down preventive measures for accidents (NMC)

2. District DG Khan is facing a problem of flood.

a) What type of disaster it is?

b) How will you manage this situation? (SIMS)

3. A school purchased furniture for a new section of class. Four After 6 month the

school medical officer noticed that many pupils of this section had complaints of

backache and eye strain.

a) What type of desk has been there in this class?

b) List 4 objectives of school health services. (SIMS)

4. On accidental fire in a factory numerous lives have suffered.

a) Categorize the type of casualty.

b) What are the engineering measures to prevent occupational hazards? (SIMS)

5. Vast area in Pakistan was stricken by FLOOD this year, disrupting lives of many

people,

a) Give the type of disaster and the health problems that occurred in those areas?

b) What do you understand by DISASTER PREPAREDNESS? (SMC)

6. Recently massive fire broke out in factory at Karachi, leading to more than 300

death number of casualties:

a) Is it Disaster or an Accident?

b) Write the plan to manage this type of incidents.

c) Define Triage. (UMDC)

7. Heavy rains have affected large areas of Southern Punjab and upper Sindh.

Scores of families are either forced to stay in open or take shelter in camps.

a) Identify FIVE health hazards that they face under the prevailing situation.

b) Suggest measures for prevention of the identified health risks. (WMC)

8. Last month, a fire broke out in factory claiming 289 deaths.

a) Categorize the incident.

b) What health education should be provided to the related stakeholders for

avoidance of such incident? (WMC)

IMMUNOLOGY 1. Suppose you are in charge of EPI centre. Describe how you would keep the

vaccine in different compartments of refrigerator?(MMDC)

2. Give the schedule of vaccination both pre-exposure and post exposure for

Rabies Vaccine? (NMC)

3. (a) Name the diseases against which universal immunization is offered in

Pakistan free of cost?

(b) What do you understand by the primary response in immunity? (NSMC)

4. A mother brought her 1 year old child to3 the vaccination centre BVH for

Vaccination. She gave history of only one injection given to this baby at 2 and½

months of age. How will you proceed for vaccination of this child? Give

schedule, dose and site of administration. (QAMC)

5. A child, 6 years old, who received only a single dose of vaccine in the past and

his parents are not aware about name of that vaccine, reports to you for

vaccination, how will you proceed with the vaccination in this child? (SMC)

6. Dr. Samina is working as programme associate in an NGO working in neonatal

health. She has to deliver lecture to pregnant women on mother & child

immunization.

a) What schedule of EPI vaccines would tell the audience?

b) What immunization should she recommend to women of child-bearing age?

(RMC)

7. A woman has brought her 4-week-old son to you for vaccination. He was born

at home and no vaccination had been given so far.

a) Which vaccines should be given at once?

b) Give the schedule along with does and routes of administration for the

remaining diseases of EPI (WMC)

BIOSTATISTICS 1. a) What in the type of graphical presentation of data in the Diagram gram

below?

b) What is the type of the skewed distribution of data?

c) Name manures of central tendency for A, B and C. (NMC)

2. a) what is meant by standard error?

(b) Enlist 12 method of presentation of data? (NSMC)

3. a) What is normal distribution curve?

b) In nine families surveyed, the number of children per family were

4,6,2,2,4,3,2,,1 and 7.

Calculate the mean, median & mode from this data? (NSMC)

4. Weight in kilogram for ten students of 4th year MBBS class was taken which

was as under:

48, 49, 85, 39, 48, 60, 70, 72, 30, 65

Calculate

a) Standard Deviation

b) Median.

c) Mean (QAMC)

5. Cholesterol level of patients in OPD of SZH were recorded as following.

175, 180, 190, 250, 220, 195, 160, 150, 170, 245, 200, 220, 230, 235, 240, 270,

295, 250 and 250.

a) Calculate mean, mean, median and mode.

b) Give frequency and percentage distribution of this data at cut off values, >200,

201 to 250 and 250.

c) Draw histogram for the above data? (SZMC)

DEMOGRAPHY & POPULATION CONTROL 1. With the help of a “line graph” (line diagram), describe the “Demographic

Transition” of a developed country. (MMDC)

2. a) Briefly explain “Population Pyramid?

b) Describe the Demographic Cycle (Transition)?(NSMC)

3. Human Development index (value 0 to 1) has three important components as

1. Life expectancy index 2. Education index 3. GDP per capita index. The

minimum and maximum value of life expectancy at birth has been

fixed/constant 25 and 85 years. If life expectancy in Pakistan is 65 years, then

calculate life expectancy index for Pakistan.(QAMC)

4. Pakistan is in late expanding stage of demographic transition.

a) What consequences may occur if it is not passed speedily?

b) What opportunity may be availed at this stage of proper policy is formed/

(QAMC)

5. In Pakistan during recent years decline in death rate and birth rate has been

observed. Productions of agricultural and industrial products are increased and

life style is improved.

a) Name the phase of demographic transition though which Pakistan is passing?

b) Name other phases of demographic transition. (SIMS)

6. The population of Pakistan is growing at the rate of 1.8% annually and the total

fertility rate is 5.2 per woman:

a) What do you think; given figures indicate about the trend of population

growth?

b) What short and long term measures do you recommend to control this rate of

population growth? (SMC)

7. a) What are the health problems of the aging population in Pakistan?

(b)What preventive measures will you take to deal with such problems?

(SMC)

8. Major bulk of population is residing in rural areas of Pakistan. Each year large

number of people migrate to urban areas for better living and other reasons.

a) Name the process of migration to urban areas.

b) Name different hazard that arise due to mass movement of rural population to

urban areas? (SZMC)

9. Population of Pakistan is growing at an explosive rate, giving rise to many

problems relating health, education and available resources:

a) How will you differentiation between GROWTH RATE & NATURAL INCREASE

RATE in population?

b) Draw & label process of demographic transition. (UMDC)

10. Population in Pakistan grows at a rate of 1.8%

a) What measures would the government take to address the population issued

arising due to the current Growth Rate?

b) List FOUR components of Reproductive Health. (WMC)

PUBLIC HEALTH PHC & HEALTH AGENCIES 1. Enumerate the components of primary health care. Describe briefly the

constraints in achieving these components. (MMDC)

2. What functions are being carried out by “UNICEF” in Pakistan? (MMDC

3. Write a note on health related “Millennium Development Goals”. (MMDC)

4. a) Name First Level Care Facilities (FLCF) OF Pakistan.

b) List the preventive and curative services provided at FLCF. (NMC)

5. Define Health Care System & what do you mean by

Input and output in health care delivery system? (NSMC)

6. a) Define planning in health

b) Draw and label “Planning Cycle”

c) Differentiate between “Cost-benefit analysis and Cost-effectiveness analysis

techniques of health management. (RMC)

7. As COMPREHENSIVE PRIMARY HEALTH CARE is said to be beyond the reach of

must developing countries, UNICEF proposes a selective approach with emphasis

on mother and Child health called GOBI-FFF:

a) What is meant by GOBI-FFF?

b) Write the constraints for comprehensive Primary Health care in Pakistan. (SMC)

8. In a remote village, a Basic Health Unit (BHU) is present but it is not functional

on account of non-availability of staff, so the village people go to a Tertiary Care

Hospital if the need arises:

a) Dose this situation indicate integration of Health system?

b) List the services that should be provided at a BHU. (UMDC)

9. A family traveled all the way from a remote village to Benazir Bhutto Hospital

for their child who had acute diarrhea.

a) What relevant question should you ask to prove the deficiency in the PHC

service in their village?

b) List FOUR uses of HMIS in Pakistan. (WMC)

HEALTH AND DISEASE, GENERAL EPIDEMIOLOGY, RESEARCH

& DISEASE TRANSMISSION

1. Describe the stamps of a “Case Control Study”. (MMDC)

2. In a primary school there are 1,000 students. Out of those only 80% have been

measles. From this child 40 children get measles ……….. Short period of time.

Calculate “secondary attack rate” of measles. (MMDC)

3. In a study 100 blood recipients and 100 non blood recipients were followed for

one year for HCV, Out of 100 blood recipient 10 developed HCV while out of

100 non blood recipient only 2 develop HCV.

Groups Blood recipient

Not blood recipient

Total

HCV +ve

10 2 12

HCV-ve

90 98 188

Total

100 100 200

What is disease risk index in this study? Calculate it and comments on result.

(NMC)

4. A worker applied 2 vaccines A & B on randomized mass group and observed the

incidence of disease in them. The following table summarizes the result.

Vaccine

Study Group

Developed disease

Incidence Rate

A 100 20 20%

B 100 10 10% Total 200 30 15%

The worker wishes to apply chi square test of significance as a research worker of

this study. What will be?

a) The NULL & ALTERNATE HYPOTHESIS.

b) The Degree of Freedom (DF)

c) Define CONFIDENCE INTERVAL. (UMDC)

5. a) Give two differences between case control & Cohort studies

(b) Define secondary attack rate (NSMC)

6. Keeping in view adult hypertension disease, answer the following:-

a) Define “paradoxical effect of Prevalence”?

b) Give two uses of prevalence? (QAMC)

7. Ten people live in a house (8children, father and one mother). Two children

suffered from chicken pox last years. From the remaining 8 family members, one

child suffered from chicken pox from last 7 days, within incubation period, two

more children are also suffering from the same disease.

a) Calculate Secondary Attack Rate of this disease from the above mentioned

data.

b) Interpret your results. (QAMC)

8. The investigators want to establish an evidence for association between intake

of oral contraceptives and risk of cardio vascular diseases (CVDs) in women. One

sub-Objective of the study is to know incidence of CVD in the exposed.

a) Name the epidemiological study design that can best used for the purpose.

b) Describe 03 measures of strength of association that can be calculated from

the study design used.

c) What are the disadvantages of the study design used? (RMC)

9. In a union council of Rawalpindi having population 100,000 50 new eases of

chronic liver diseases (CLD) were registered during 2010, whereas 30 cases were

on record since last year. At the end of Dec 2010, 20 of new cases and 5 of the

older eases were treated but unfortunately 3 of the older group and 7 of the new

cases died in September 2010.

a) Find out incidence-rate and Prevalence-rate of CLD for this union council for

year 2010.

b) What was point prevalence of CLD on 1 Jan 2011?

c) Calculate case fatality for CLD IN this scenario. (RMC)

10. a) Define “Null Hypothesis”

b) Explain type-I and Type-II errors in Hypothesis testing.

c) Write down 04 objectives of “Literature review” in research. (RMC)

11. Death rate in emergency dept. of Punjab Institute of Cardiology is higher than

the death rate in the emergency dept. of Services Hospital.

a) What type association it (explain)

b) Enlist the criteria for association. (SIMS)

12. A researcher wanted to verify the statement that working in bank increases

the risk of blood pressure.

a) What type of study he will conduct to verity the statement.

b) He steps for conducing this study. (SIMS)

13. A group of 20 students, after the school, went to the nearest fast food outlet

and had burgers. Within 3 hours of eating, 10 students developed vomiting and

diarrhea one hour later 7 more were affected, sparing only 3.

a) The distribution of the cases in time suggests which kind of epidemic.

b) Outline the steps taken to investigate the epidemic. (SMC)

14. In a village with 20,000 populations, 60% are Muslims, 20% Christians, 10%

parsies and 11% Hindus. A researcher in interested to take a 20% sample of the

population for a study;

a) Name the best method of selecting true representative sample?

b) How will he draw this sample? (SMC)

15. A public health physician plans to conduct a research to study the risk of lung

cancer with smoking. He selects the patients with lung cancer and without lung

cancer and evaluate the status of smoking.

a) What could be the study design?

b) Enlist different steps for conduction of study?

c) What is the formula to estimate risk? How would you interpret the inference?

(SZMC)

16. A medical student determined the level of 100 pregnant women during

pregnancy and after delivery, he took weight of the newborn. Out of 110 women,

60 were anemic and 40 had normal Hb. out of 60 anemic, 30 had low birth rate

babies and 30 had normal weight babies. Out of 40 with normal Hb, 10 had low

birth weight babies and 30 had normal weight. For this scenario,

a) What is the study design?

b) Construct 2x2 table to determine association between maternal anemia and

low birth weight?

c) Calculate appropriate measure of association and interpret results.(SZMC)

17. A researcher wanted to study the risk of Perinatal Mortality (PNM for 100,000

births) caused by maternal anemia during pregnancy and found the following

observations:

Incidence of PNM / 100,000 Births

Among Anemic Pregnant Women

4000

Among Non-Anemic Pregnant Women

200

a) Calculate the ATTRIBUTABLE RISK (risk difference) and ATTRIBUTABLE

FRACTION (percent)

b) Interpret the result.

c) Define FREQUENCY DISTRIBUTION TABLE (FDT) (UMDC)

SCREENING & SAMPLING 1. Enumerate the measures used to evaluate a “Screening test? (3)(NSMC)

2. You want to launch a screening programme for a disease in Bahawalpur City.

a) What will be the criteria of a disease for which you want to launch a

screening programme?

b) What criteria you will select for decision of a screening programme.(QAMC)

3. Screening for Hepatitis C is to be done on the employees of a garment history.

a) What criterion for the screening test is required for this purpose?

b) How the problem of false positive and false negative is dealt with.

c) What lead time of screening. (RMC)

4. You want to launch a screening programme for a disease in Bahawalpur City.

a) What will be the criteria of a disease for which you want to launch a screening

programme?

b) What criteria you will select for decision of a screening programme. (QAMC)

COMMUNICABLE & NON-COMMUNICABLE DISEASES,

CONTROL & PREVENTION 1. What were the reasons of failure of “malaria eradication program”? (MMDC)

2. Hepatitis C is spreading very rapidly in an urban community. How would you

educate the people about this health hazard? (MMDC)

3. Enumerate 4 criteria for assessment of severity of diarrhea in Children under 5

year of age: (NSMC)

4. A patient came to you with high grade fever, pallor, flushing and headache. He

is living in an area where mosquito density is adequate. On blood complete

examination there is raised hematocrit value and moderate

thrombocytopenia.

5. a) What is the most probable diagnosis? Name three mosquito born infections.

b) What personal protective measures can be adopted against mosquito bite?

(QAMC)

6. Cancers are associated with multiple risk factors. In developing countries,

almost 25% of all the cancers are attributed to chronic infections.

a) Enlist the three prevalent infections leading to cancers.

b) How will prevent cancers due to chronic infections. (QAMC)

7. a) Differentiate between MDR-TB and XDR TB.

b) What are the most common reason for the development of drug resistance?

c) What is the congenital rubella syndrome? (RMC)

8. Asad, a grade 5 student, was brought to Family ER department with history of

dog bite. On examination minor abrasions on lower extremities were noticed by

the doctor. His father, who was Professor in Science College, told the doctor that

Asad had been bitten by a dog six months earlier, and had undergone a full course

of anti-rabies treatment.

a) What vaccination schedule should the doctor recommend for Asad 3

b) What is the standard intramuscular regimen of rabies anti-serum,

recommended by WHO in previously unvaccinated persons. (RMC)

9. What is roll back malaria? What are the causes of failure of this program in

Pakistan? (SIMS)

10. A 2 year old boy who was partially vaccinated presented with high grade

fever, red eyes, runny nose and a maculopapular rash on whole body

a) Diagnosis?

b) Complications? (SIMS)

11. For the last many years Pakistan in trying to eradicate Polio but as such there

is no much success. Many cases of Polio have been reported from different

provinces.

a. What are the reasons of these new cases from given areas?

b. Describe current strategies to eradicate Polio from Pakistan as recommended

by WHO? (SZMC)

12. For the preventive options for TB, developed countries have controlled this

before the advent of BCG and chemotherapy. BCG vaccine not seems to be very

effective and there are limitations in improvement of socioeconomic conditions of

Pakistan.

a. What is the strategy being implemented in Pakistan to control TB?

b. What are specific measures being taken to control TB by national tuberculosis

Program?

c. What are five indicators that are used to measure the impact of TB control

Program? (SZMC)

13. a) what are risk factors for breast cancer?

b) What are the primary and secondary preventive measures that can be taken to

control cancer in Pakistan? (SZMC)

14. A 4 Class student of a school was seen by a school health medical officer with

low grade fever and maculopapular rash behind the ears and on the face.

a. What is the probable diagnosis?

b. What measures will you recommend for this class mates and the child himself?

(UMDC)

15. A 25 years old boy was admitted in Mayo Hospital Lahore with fever 103 F. His

tourniquet test positive. Lab investigation showed increased value of Hematocrit

and mark thrombocytopenia.

a) What is the likely diagnosis?

b) What immune prophylaxis is available against this disease?

c) Enlist preventive strategies against this disease. (UMDC)

16. a) Ahmad is a medical student wants to know about anti rabies vaccines. Can

you write to name of available anti rabies vaccines? Which is the best and why?

b) He further enquires: Why RIG & Rabies vaccine is given simultaneously in PEP

of Rabies he asked about importance of initial wound management and rationale

of injecting for in to the wound? He likes to be explained the logic of giving RIG &

vaccine simultaneously in the form of graphic presentation. (UMDC)

17. A young boy of 14 years is brought in the emergency department of POF

hospital with history of dog bite on the left leg.

a) Outline the steps of management.

b) Give measures to control urban rabies. (WMC)

18. There is a progressive increase in the incidence of Dengue Fever as per

diagram in Lahore over the last couple of years.

a) Which name can be given to the rising incidence of the disease?

b) Give FOUR control strategies for Pakistan in the given situation. (WMC)