Spots

Community Medicine
 Write the Nutritive value of given food.
Name the limiting amino acid.
Wheat(RDA=460/410 mgs per day)
• Nutritive value
Protein-11.81g, carbohydrate-71.2g, Energy-
346Kcal.
• Limiting amino acid-lysine & threonine
• Rich in vitaminD,Iron, Calcium, Phosphorus & other
minerals.
• Refined wheat flour(Maida) is flour minus husk,
poor in nutrients & fiber.(Vitamins & minerals)
Write the Nutritive value of given food.
Name the limiting amino acid.
Write the nutrients lost during washing & cooking.
What is parboiling
Rice:
• Nutritive value-
Protein 6.8g, Carbohydrate78.2g, Energy-345Kcal
• Limiting amino acid-Theronine
• Devoid of vitamins-A,D, C , calcium & iron & rich in vitamin-B group of
vitamins especially thiamine & amino acid lysine.
• Polishing, washing, cooking with excess of water & draining deprives
nutrients like Thiamine, riboflavin & niacin
• Using under milled rice than highly polished rice is advised.
• Parboiling is partial cooking in steam to preserve the nutritive value of
rice, by soaking the paddy in hot water at 65-70 deg C for 3 to 4 hours,
followed by draining the water ^ steaming the soaked paddy for 5-10
minutes, than dried & milled
Write the Nutritive value of given food.
Name the limiting amino acid.
Maize:
• Nutritive Value-
Protein 11.1g,Carbohydrate 66.2g,Energy-342Kcal.
Limiting Amino acid- lysine & tryptophan.
Rich in leucine which prevents conversion of
tryptophan in to niacin(causing pellagra)
 Write the Nutritive value of given food.
Name the limiting amino acid.
Jowar(Sorghum):
• Nutritive Value: Protein-10.4g, Carbohydrate-72.6g,
Energy-349Kcal.
• Limiting Amino acid-Lysine & threonine.
Rich in leucine which prevents the conversion of
tryptophan in to niacin(causing pellagra)
Rich in Iron(4mg/100g).phosphorus.
Fungi (Aspergillus flavus) will infest during improper
storage & produce aflatoxins, which is a potent
hepatotoxins & carcinogenic)
 Write the Nutritive value of given food.
Name the limiting amino acid.
Bajra(Pearl millet):
• Nutritive Value-Protein-11.6g, Carbohydrate-
67.5g, Energy-361Kcal.
• Limiting Amino acid-Lysine & threonine.
• Rich in B group of vitamins & minerals such as
calcium & iron.
Write the Nutritive value of given food.
Name the limiting amino acid.
Ragi:(cheapest Millet)
• Nutritive value-Protein 7.3g, Carbohydrate-72.0g,
Energy-328Kcal.
• Limiting amino acid-Lysine
• Rich in calcium(344mg),iron4mg/100gm)
• Advised for diabetics & obese.
• Used in multipurpose food.
 Write the Nutritive value of given food or identify
this pulse known as poor’s man meat
Name the limiting amino acid.
Pulses:(Nutritive value)also called as poor man’s meat(RDA=40 gm)
Bengal gram- P-17.1g,ENERGY-360Kcal.
Red gram-P-22.3g, Energy-335Kcal.
Green gram-P-24.5, Energy-348Kcal.
Black gram-P-24g, Energy 347.
Peasdry-P19.7g, Energy-315Kcal.
Soyabin-P-43.2g,Energy-432Kcal.
Limiting amino acid-Methionine & cysteine, but rich in lysine, in minerals
iron & calcium& B group vitamins(riboflavin & thiamine).
Anti nutritional factors are phytates& tannins, are destroyed by heat.
Presence of high amount of certain sugars, like oligosacchridociated is
known to be associated with flatulence.
Germination increase the concentration of vitamin C & B complex.
Name the adulterant/toxicant & disease commonly
associated with given food item.
What preventive measure can be taken to prevent
the same.
Khesari dal-Lathyrus sativus.
Toxin- Beta oxalyl amino alanine(BOAA)-water soluble.

vitamin C prophylaxis
Banning of crop.
Removal of toxin by steeping method,(soaking in hot
water for 2 hours, than soaked water is drained off.
Paraboiling(for large scale, simple soaking in lime water
overnight followed by boiling, destroys the toxin.
Write the nutritive value .
Mention amino acid which is richly present
Mention the fungi which infest the given spot under improper storage
conditions and the toxins produced by the same.

Groundnut(Peanut) & Other nuts

Nutritive value:
Protein- 26.7g, Fat-58,7%, Energy-560Kcal.
Concentrated source of protein, fat & energy.
Protein is rich in lysine.
Rich in thiamine, nicotinic acid, calcium, phosphorus & iron
Used mainly for oil extraction(Monosaturated fatty
acids(MUFA),low cost, high nutritive value, delicious.
Aspergilius flavus which produce Aflatoxin.
 Write the nutritive value of given food.
It is a rich source of ?
Cow Milk(RDA=150 ml for adult/250ml for pregnancy &
lactation)
• Fat-4g,Protein-3g, Calcium 210mg,Lactose-5.1g, Energy-70Kcal
• Rich in cystine,tryptophan, calcium, vitamin A, Thiamine,
Riboflavin & vitamin-D.
• Poor in vitamin C & iron.
• Milk is frequently adulterated.
• Pasteurized milk is safest milk.
• Lactose is not easily digested, raerly induce lactose intolerance
diarrhea.
• Good media for growth of microbes, vehicle of transmission for
bovine TB,streptococcal & staphylococcal food poisoning
How is the given spot manufactured?
Name the different methods of pasteurization.

• Pasteurized full crème/toned /double toned milk.

• By pasteurization-which is a process of raising temperature & for
specific time periods that destroy the pathogens but minimal
damage to composition, flavor & nutritive value of food.
• Holder(Vat) method-63-66deg.C for 30 minutes(for small
quantities.
• HTST-method-72degC for 15 seconds, than rapidly cooled to
4deg.C-widely used method for large quantities.
• Pasteurized milk maintain the quality for 8-12 hours at 18 deg.C
• Coliform count-absent in 1 ml of milk.
• Standard plate count-30,000/ml.
 Write the nutritive value.
Mention NPU.
Why it is called reference protein
Why boiled egg is preferred over raw egg
• Egg (weighing 60gms)(one egg daily)
• Proteins-6gms, 6gm of fat, energy-70Kcal.
• Does not have carbohydrates & Vitamin C.
• Egg protein have all the 9 amino acids in right proportions.
• Egg proteins are considered best, against which the quality of other
proteins is compared.(reference protein)
• It supplies all the fat soluble & water soluble vitamins except vitamin C.
• NPU which combines in a single value the biological value & digestibility,
is 100.
• Boiled egg is preferred over raw egg, as boiling destroys “avidin”, a
substance which prevents the body from obtaining biotin, one of B
complex group of vitamins.
(I)The given food item is a good source of_
(ii) What is the caloric content (per 100gm of edible portion) of the given spot?

• Fruits:(RDA=85 gms.)
• Protective, rich in cellulose, fiber & water, vitamins, minerals,
• Papaya & mango are excellent source of carotene.
• Orange & Guava & Amla are rich in Vitamin C.
• Watermelon, apple, apricots are rich in iron.
• Musambi,musk melon, peaches are rich in potassium.
• Calories- 74 in mango & 104 in banana.
• Seasonal & locally available fruits are advised for daily
consumption.
• Fibre in fruits help in preventing hyperglycaemia &
hyperlipidemia.
Comment on bio-availability of iron from given spot
and the reason of the same.
Write recommended quantity of given spot for an
adult and for a pregnant female
Green leafy vegetables(protective)
RDA= 50-100gms.
• Fibers helps in reduction of hyperglycemia &
hyperlipidemia.
• Rich source of carotene, calcium, iron & vitamin C.
• Good source of riboflavin & folic acid.
• Poor bioavailability of iron due to presence of oxalates &
phytates.
• 40 gram daily & 150 gram daily for pregnant woman.
What is the recommended requirement?
It is a rich source of?
By what process it is prepared from oil?
Cooking oil: (Fat=900 cals)
RDA=40 mgs for male & 20 gms for female.
Rich in fat soluble vitamins(A,E ,D & K).
Total fat intake should not exceed 20% of total energy.
Hydrogenated oil is vansapati.
Fat can be fortified with vitamin A & D.
Consumption of excess oil & saturated fatty acids leads
to risk of developing IHD & dyslipidemia.
Repeated heating the oil(trans fatty acids) liberates free
Write calories and iron content of the given spot.
Where does the iron content of given spot come from?

Jaggery(RDA= 30gms for male & 20gms for female)

– 383 kcal/100 gm and 11.4 mg / 100 gm of jeggery
– From the iron pots in which the Jaggery is prepared.
– Consumption in excess quantity leads to obesity &
dental caries.
Which process is involved in production of given spot and
Comment on its effect on fatty acid content?
Name 2 essential fatty acids.

Vanaspati ghee
– It is produced by “hydrogenation” of vegetable oils. This
process increases levels of saturated fatty acids and trans
fatty acids.
– Linoleic acid, Linolenic acid, Arachidonic acid,
Eicosapentanoic acid
 What is the basic function of given spot?
Excess consumption of the spot may lead to
what?
Coffee & Tea:
• Are stimulant & relieves fatigue.
• Contains caffeine, tannic acid & volatile oil.
• Energy per 100 ml is 100Kcal for coffee & 80 Kcal for
tea.(comes from milk & sugar).
• Excess consumption increase blood pressure, cause
insomania,tachycardia,gastritis.
• Anti-oxidants in tea have health benefits.
Used in which kind of disorders & write the amount of
fortified element.
Under IDDCP, which type of sample is taken to identify the
“proportion of population consuming iodized salt.
Daily requirement of iodine.

Iodized Salt.
• Iodine deficiency disorders.
• 15ppm at the consumer level & 30ppm at
manufacturing level.
• Urine iodine excretion.
• 150 micrograms for adults & 250 micrograms for
pregnant women.
What is sodium intake in hypertension.
Classify blood pressure(JNC-VIII)
What is DASH strategy.
Salt: Not more than 5gms. Per day.(2.4 gm of sodium).
JNC VIII: Systolic Diastolic
Normal- 100-119 60-79
Prehypertension- 120-139 80-89
Hypertension I- 140-159 90-99
Hypertension II >160 >100
DASH: (Over all goal)
Maximize the opportunities for primary prevention of
HIV/STD and pregnancy among teens .
What is the use of given spot.
What should be the level of fortified element in test
sample at manufacturing and consumer level.
Name the indicator/ agent used in given spot.
If testing kit is not available how to know iodine in salt
at domestic level.
• Iodine Testing Kit
• To measure the level of iodine in salt.
• 15ppm at the consumer level & 30ppm at
manufacturing level.
• Indicator in iodine kit is starch & iodine.
 Write the dosage schedule.
Mention the Ocular & extra-ocular sign & symptoms of Vitamin A deficiency .
What are VAD criteria.(WHO)

Vitamin A:
• 1 lac IU at the age of 9 months & than 2 lac IU at the age of 16 months,
than after every 6 months up to 5 years(total 9 doses), solution given
orally
• Night blindness,conjuctival Xerosis , Bitot’s spots, corneal Xerosis,
Keratomalcia.
• Increase in infections(respiratory & intestinal)
• Follicular hyperkeratosis, anorexia & growth retardation.
• Daily requirement for adult man & woman-600mcg,pregnant-800mcg
& lactating-950mcg.
• VAD criteria –night blindness->1%,bitot”s spots->0.5%, corneal xerosis-
>0.01%, corneal ulcer->0.05% & serum retinol less than 10mcg/dl->5%.
Mention the chemical composition of adult tablet.
How many tablets are given to a female during pregnancy under
national program & rationale for its use in pregnancy in India.
Writ down the cut off point for Hb for diagnosing anemia in
pregnant female.
How will you evaluate iron status.
Mention two common side effects of given spot.
Iron & Folic acid Tablet:
Dose- 100mg of elemental iron & 0.5 mg of folic acid.
One tablet a day, for 100 days during pregnancy.
Less than 11g/dl.
Hb concentration, serum iron concentration(,50 mg/L),serum ferritin(,10mcg/L) &
serum transferrin saturation(,15%).
Daily requirement for adult male is 17mg,female & lactating mother-21mg,pregnant
woman 35mg.
Constipation & diarrhea.
Nausea & vomiting.
Stomach upset & heart burn
 Mention two advantages & disadvantages of
contraceptive.
What is its failure rate.
Condom: (Thin latex rubber device)
• Prevents the semen being deposited in vagina
• Easily available
• Safe & inexpensive.
• Easy to use & does not require medical supervision.
• No side effects.
• Light , compact & disposable.
• Provide protection against STD.
• 2-3 per 100 women years of exposure to more than 14 in typical
users.
• Disadvantages-may slip off or tear, interferes with sex.
• Spermicide jelly may be used with it to reduce the failure
 Write the mechanism of action of the contraceptive.
What are its absolute contraindications.
What is its failure rate.
What are the timing of its insertion.
Disadvantages.
Copper-T:
• Foreign body reaction in uterus causing cellular & biochemical changes
in endometrium & uterine fluids, impairing viability of gamete-reducing
chances of fertilization. Copper ion also changes biochemical
composition of cervical mucosa-affecting sperm motility.
• Suspected pregnancy, PID,Cancer of cervix,vaginal bleeding, Previous
topic pregnancy.
• 0.5-0.8 per cent.
• Within 10 days of beginning of menstruation period, during first
week after delivery, or 6-8 weeks after delivery.
• Requirement of trained person for insertion and removal
• Need to follow up for initial few months
 Write the failure rate of the contraceptive.
Mention non-contraceptive health benefits.
Mention chemical composition.
Write the mechanism of action.
Mention absolute contraindications
Oral pills:
• Less than one percent.
• Protection against diseases like benign breast disorders, ovarian
cysts,PID, ectopic pregnancy, iron-deficiency anemia, ovarian cancer.
• Levongestrel 0.15 mg& ethinyl estriodiol0.03 mg.
• To prevent the release of ovum from ovary by blocking the pituitary
secretion of gonadotropin.
• Cancer of breast & genitals, Liver disease, previous or present history of
undiagnosed abnormal uterine bleeding, thromboembolism, cardiac
abnormalities, congenital hyperlipidemias, und
 Write down two indications for which it should be
used.
Mention the time period during it should be taken
• Emergency pill(Levnorgestrel 0.75mg) is approved for
emergency contraception.
• It should be used within 72 hours of unprotected sex,rape
or contraceptive failure
• One tablet should be given within 72 hours of unprotected
sex & second tablet is given 12 hours after that.
• Failure rate is less than 1%.
• Disturbs ovum release, fertilization & implantation.
• Side effects are lower abdominal pain, nausea, vomiting,
tenderness in breast, headache, irregular menstrual
bleeding.
Mention the use of apparatus.
Mention the name of the test to find out free & combined
chlorine.
Mention the indicator used while using the given spot?
Describe how to prepare that indicator solution?
What is the “stock (mother) solution” with reference to given
spot, and describe how to prepare the same?
Horrock's apparatus.
• To find out the demand of bleaching powder to disinfect the
water.
• Orthotoludine test(OT).
• Starch Iodide.( 1.5 gm of starch is added to 100ml of distilled
water, boiled & cool, 7.5 gm of potassium iodide is added.
• 2gm of bleaching powder in black cup, make a paste, add
more water up to the mark(Stock solution)
 Mention the name of indicator used in this apparatus
Calculate the amount of bleaching powder for a well having
4550 liters of water, with horrock’s apparatus showing blue
color in third cup
Horrock’s apparatus.
• Starch iodide.
• 3x2 = 6 g are required for 455 liters.
• 6/455 x 4550 = 60 g.
 Identify the equipment.
Mention its uses
Vaccine Carrier
• To transport vaccine in small quantities(16-20)
vials for the outreach sessions
• Temperature is maintained at 4-8 degree C.
• 4 fully frozen ice packs are used for lining the
sides
• Vials of DPT,DT & TT & diluents should not be
placed in direct contact with frozen ice packs.
Identify the equipment
Mention its use
What is “conditioning” with reference to given spot?
How do you ensure that conditioning is complete?
Mention advantage of conditioning.

Ice Packs(Flat plastic bottles, filled with water and

frozen by keeping in deep freezer)
• To maintain the temperature in vaccine carriers &
cold boxes.
• To bring the frozen ice packs to +2deg C to +8 deg C.
Name the spot; at which level of health care delivery system it is used and what is the
rationale for the same?
What do you understand by “hold over time” for any cold chain equipment? What is
the “hold over time” for given spot

ILR
– ILR, at PHC level, because electricity supply at PHC level is
not reliable. ILR can maintain the required temperature
(2-8 degree C) for 48 hours in absence of electricity.
– “Hold over time” of cold chain equipment is the time
taken by equipment to raise the inside cabinet
temperature without electricity from its temperature at
the time of cut to maximum temperature of its
recommended range, provided that equipment is
maintained & functioning well. In case of ILR cabinet
temperature is +4deg. C, time taken to reach 8deg.C will
be hold over time.“Hold over time of ILR = 48 Hours.
Write the dose, route of administration& its schedule.
Name the diluent used for its reconstitution.
Mention adverse affects of this vaccine
Mention the strain recommended for production of given spot.
Discuss the phenomenon after BCG vaccination.
BCG Vaccine:
• Dose-o.1ml, less than 4 weeks-0.05ml.
• Intradermal at the insertion of deltoid.
• At birth or as early as possible till one year.
• Diluent is normal saline.
• Prolonged severe ulceration at the site,suppurative
lymphadenitis,osteomylitis,,disseminated BCG infection & death.
• Contraindications are-patient with generalized eczema, Infective dermatosis, to
those with a history of deficient immunity, treatment on steroids or other
immunosuppressant drugs.
• “Danish1331” strain recommended by WHO.
• Two to three weeks after the vaccination, papule develop at the site which
increase in size in about 5 weeks(4-8 mm),breaks in to a shallow ulcer, healing
 Mention the dose, route & schedule of the vaccine.
Comment on the stage of VVM of the vaccine

Polio Vaccine(Live trivalent)

Magnesium chloride is used as stabilizer.
• At birth-(zero dose)or as early as possible within the
first 15 days, , at 6,10,14 weeks & booster at 16-24
months.
• Two drops, orally.
• Stage of the vaccine- I, II, III, IV.
• Protective value lifetime.
Mention dose, route, site & schedule of the vaccine.
Name two contraindications for administering next
dose of vaccine.
Open vial policy applies to which vaccines
DPT/Pentavalent vaccine(Adjuvant- Aluminum phosphate)
• Dose 0.5 ml, intramuscular, antero-lateral side of mid-thigh.
• At 6,10,14 weeks, booster at 16-24 weeks, at the age of 5-6
years.
• Severe reaction after previous dose, which include collapse or
shock like state, persistent screaming episodes, temperature
above 40deg. C, convulsions & other neurological symptoms .
• DPT,DT,TT, HepatitisB,Oral Polio Vaccine,& liquid pentavalant.
• Protective value –Durable.
 Mention the dose, route & schedule.
Write the diluent used for reconstitution.
Mention two conditions in which it should not be given.
Mention the protective efficacy & protective duration.
Measles:
0.5 ml, sub-cutaneous, right upper arm.
9 completed months-12 months.
Second dose 16-24 months.
Diluent used is distilled water.
Child having high fever or other serious disease, who are
severely immunocompromised due to congenital disease,
severeHIV infection, serious cancers, on high doses of
steroids etc.
Write protective efficacy of given spot for the diseases
covered.
How can you make sure, weather the given spot has been
frozen in the past?

DT vaccine:
• 100% against diphtheria & tetanus.
• Shake test.
 Mention the dose, route & schedule.

Tetanus toxoid:
• 0.5 ml, intramuscular,, upper arm.
• TT-1- Early in pregnancy.
• TT-2- 4 weeks after the TT-1,
• TT-Booster-If received2 TT doses in a pregnancy
within last 3 years.
• In children at the age of 10 & 15 years.
• Contraindications are H/o previous allergy, acute
& severe infections
 Mention the dose, route & schedule
JE Vaccine:
• Inactivated(Nakayama strain)
• Dose-3 dose, first on selected day, second on 7th &
third on 30th day.(0.5 ml for 1-3 year of age & 1ml
for>3 years, subcutaneous, upper arm)
• Booster-before one year of primary & every 3 years.
• Powdered vaccine with diluent.
• Protective value about 3 years.
 Mention the dose, route & schedule
Rotavirus Vaccine:
• Tetravalent(4 serotypes G1 to G4)
• Primary-3 doses at 2,4 & 6 months.
• Protective value -80%.
Round Worm
Name the helminth.
What is the infective stage of given spot.
What is the treatment of given spot.
Ascaris.
– It infects humans when an ingested fertilised egg becomes a larval worm
(called rhabditiform larva) that penetrates the wall of the duodenum and
enters the blood stream.
– Albendazole 400 mg stat , Albendazole is not recommended during
pregnancy; pyrantel pamoate is the drug of choice in these
cases.Alternative therapy is mebendazole (100 mg bid for 3 d or 500 mg
as a single dose). Mebendazole is not recommended during pregnancy;
pyrantel pamoate is the drug of choice in these cases.
• Primary: Sanitary disposal of human excreta,, provision of safe
drinking water, use of sanitary latrine by community.
• Secondary prevention: Albendazole, dose for adult & children
above 2 years is 400 mg as a single dose.
Mebendazole: 100 mg twice a day for 3 days for all ages above 3
years.
Hook Worm
Name the helminth.
What is the drug of choice for its treatment.
Which index is used for epidemiological study of the given spot? Describe the interpretation of same.

Hook worm.
• Causes chronic blood loss
• Prevention & control:
• Sanitary disposal of faeces, Chemotherapy
(Albendazole or Mebndazole), correction of anaemia
& health education.
Rat Flea
Name the disease transmitted by this organism.
Write two control measures used against this
organism
Rat flea(Dark brown in color, bilaterally compressed wingless
body, head is conical attached directly to thorax)
• Plague by bite of blocked flea, endmic typhus by
contamination of skin with faces of flea
• Insecticides-DDT & BHC should be used as dusts containing 10%
& 3% of the active ingredient. If resistant to both malathion 5%
is used.
• Rat burrows should be insufflated with insecticidal dust with the
help of dust blower.
• Flea index is the measurement of density of fleas per rat, kept
below 1, useful in evaluation of control measures & forecast
Anopheles(Female)
 Identify the organism with identification feature. & the
stage of life cycle.
Name two insecticides with their mechanism of action
used against it.
Name the disease transmitted by it
• Adult anopheles.
• Proboscis & palpi are equal in length.
• Wings are spotted, antennae are not hairy.
• DDT, BHC, Malathion.
• Contact poison.
• Personal protection.
• Larvicidal measures(Gambusa fish)
• Malaria(plasmodium species)
Culex(Female)
Identify the organism& identification features.
Name two diseases transmitted by it.
Name two insecticides with their mechanism of action
used against it.
Genetic control measures.
– Culex (Adult)
– 3 compartment body – head, thorax, and abdomen. 3 pair legs and 1
pair wings. Unspotted wings, no white stripes on body and legs, palpi
shorter proboscis.
– C. fatigans, C. vishnui, C.tritaeniorhynchus
• Filariasis- Wuchereria bancrofti, Japanese encephalitis-
Arboviruses.
• DDT, BHC, Malathion.
• Contact poison.
• Genetic control-Sterile male technique,cytoplamic
Aedes
 Identify the organism with identification features.
Mention methods used for control of breeding places
of mosquitos
Name the disease transmitted by it

• Aedes(Palpi are smaller than proboscis, wings not spotted,

ornamented with white stripes on black body)
• Remove artificial collections of water.
• Add K oil to collection of water.
• Insecticides like DDT, BHC, Malathion for adults.
• Personal protective measures.
• Dengue & DHF-Arboviruses B, Chikungunya, Yellow fever.
• Aedes aegypti index-% of houses in the are showing breeding
places of Aedes aegypti- should be <1%
House Fly
 Identify the organism with identification features.
Mention two important measures to prevent its
breeding
Name the diseases transmitted by it
• House fly.( Mouse gray in color, body covered with
sticky hair, large compound eyes, dark strips on
thorax)
• Stop open defecation.
• Sanitary disposal of excreta & garbage.
• Insecticides-DDT 5%.
• By mechanical transmission- Typhoid,
cholera,gastroentritis, Amoebiasis, polio, trachoma,
Itch Mite
 Identify the organism.
Mention methods used for control of breeding
places of mosquitos
Name the disease transmitted by it.
• Sarcoptes scabiei. (Dirty white colored small insect, no
demarcation of body segments,4 short stumpy legs, no
wings.)
• Burrows in epidermis of skin, spread by close contact.
• Disease: scabies.
• Treatment: Benzyl benzoate 25%, HCH(Linden) 0.5%, applied
to the body below chin after scrub bath, repeated after 12
hours, 12 hour after the second application bath is given, all
infested & close contacts are treated simultaneously, Post
treatment- laundering of clothes.
Head Louse
Name the organism. & its identification feature
Mention methods used for control of breeding places
of mosquitos
Name the disease transmitted by it.
Head louse.
Body= oval in shape, dorso-ventrally flat; divided in 3 parts – head, thorax
& abdomen;
• One pair of antennae, each with five segments, protrude from the
insect's head. Head lice also have one pair of eyes;
• 3 pairs of limbs attached to thorax;
• abdomen has 9 segments.
• Pediculosis (Epidemic typhus, relapsing fever, trench fever, heavy
infestation cause dermatitis, insomnia due to irritation)
• Delousing: Head louse- 0.5% malathion is applied to head after
hot bath, 12-24 hours later second application is done.
Sand Fly
 Identify the organism.
Mention methods used for control of breeding places
of mosquitos
Name the disease transmitted by it.
• Sand fly.(Dark brown hairy body, second vein of the
wings divide twice, 3 pairs of very long slender legs,
pair of large compound eyes.
• Kala Azar- L donovani(bite),Sand fly fever-
Virus(wound contamination with saliva), Oriental
Sore- L tropica.
• Control: Insecticide- DDT- 1-2 gm/meter square,
Source reduction- clearing, filling of cervices, Personal
protection: sand fly nets impregnated with
Soft Tick
 Identify the organism.
Mention methods used for control of
breeding places of mosquitos
Name the disease transmitted by it.
• Soft tick(Oval shaped leathery body,no antennae, no
wings, 4 pairs of legs.
• Disease transmitted: Q fever, Relapsing
fever,Kyasanur forest disease(KFD)
• Control: Environment- filling up cracks & cervices,
Chemical- Indane, malathion, DDT, Personal
protection- Insecticide repellents,(benzyl
benzoate),wearing full clothing
Hard Tick
 Identify the organism.
Mention methods used for control of
breeding places of mosquitos
Name the disease transmitted by it.
• Hard tick( Oval body grey white in color, head thorax &
abodmen are fused, 4 pairs of legs, no antennae, no
wings), dorsum is covered by Chitinous shield(Scutum)
• Disease transmitted: KFD,Typhus,Spotted fever,
Encephalitis & tick paralysis.
• Control: Insecticide- Malathion. Lindane, DDT, are
dusted on animals, vegetations & premises, Personal
protection- Repellent(benzyle benzoate)
 List the type of patients included in this
category of anti-TB treatment.
What is the drug regimen for above category of
patients
• New cases(Category-I)-Red Box
• New sputum smear positive.
• New sputum smear negative.
• New extra pulmonary.
• New others.
• 2(HREZ) + 4(HRE)
 List the type of patients included in this
category of anti-TB treatment.
What is the drug regimen for above category of
patients
• Previously treated(category-II)-Blue box:
• Sputum smear positive relapse.
• Sputum smear positive failure.
• Sputum smear positive treatment after default
• Others.
• 2(HRZES) +1(HREZ) + 5(HRE)
Mention indication and route of given spot under DOTS.
Mention mechanism of action and two side effects of given spots.

Streptomycin
– Previously treated TB patients, route I.M.
– Protein synthesis inhibitor. It binds to the small 16S rRNA
of the 30S subunit of the bacterial ribosome, interfering
with the binding of formyl-methionyl-tRNA to the 30S
subunit.
• Adverse effect:- nephrotoxicity, ototoxicity
Write the composition of new WHO approved ORS.
Write the uses of ORS & Mechanism of action.
What is the importance of osmolality of solution prepared using the
given spot?
What is “super ORS”? & its advantages.
• For one liter of water(Helps in hydration)
• Glucose-13.5g(Glucose-75mEq/L)promotes sodium & water absorption)
• NaCl-2.6g(Sodium-75mEq/L, chloride-65mEq/L) (prevents hypernatremia)
• KCl-1.5g(Potassium-20mEq/L, Chloride-65mEq/L) (Prevents hypokalemia)
• Trisodium Citerate-2.9g( 10mEq/L,Increase absorption of sodium &water, prevents
acidosis)(Total-245mmol.)
• To treat dehydration& maintaining rehydration.
• Reducing osmolarity avoids adverse effects of hypertonicity on net fluid absorption.
• Super-ORS contain complex sugar instead of monosugar.It may be food based(rice
based) or starch free(glycine/alanine based)
• Provide rehydration.
• Reduce stool out put,frequency & duration.
• Increased nutrition-180Kcal/liter.
• With gradual release of glucose-prevent secondary diasaccharide intolerance.
• Contribute to weight gain.
 Mention the use of given spot in public health.
Write its dose
Write the mechanism of action.
Alum( Aluminium sulphate, white in color)
• Used to remove turbidity of water before subjecting to
rapid sand filtration.
• 5-40 mg/liter, depending upon turbidity, color,
temperature & pH value of water.
• Chemical coagulant.
• Helps in sedimentation(settles down the impurities &
bacteria in water) by neutralizing the electronic double
layer surrounding the fine particles & allowing them to
flocculate.
 Mention the concentration of chlorine in fresh
bleaching powder
Write its mechanism of action
Mention its uses.
How it can be used continuously.
• Bleaching Powder(White powder with pungent smell of
chlorine)
• 33% of available chlorine.
• Rapidly loses its chlorine content on exposure to air, light &
moisture-hence stored in dark, cool & dry place)
• Germicidal effect is by hypochlorous acid, nascent oxygen
& chlorine.
• Disinfection of water, feces, urine & pus.
• By using “double pot” method.
Write mechanism of action of given insecticide.
Write dosage for its use in form of “IRS” against
mosquitoes
Malathion(Yellow or clear brown liquid with
unpleasant smell.)
– Organophosphorous insecticide act as Contact poison.
– Indoor Residual spray = 100-200 mg / square feet every 3
months.
– Because of its low toxicity, it has been recommended as
an alternative insecticide to DDT.
– As a low volume spray, widely used for killing
mosquitoes tom prevent DHF.
 Write its uses.
List two demerits of its usage for purification of
drinking water

KMnO4(Potassium per magnate)-Reddish brown

crystals.
It is used to disinfect aquariums & is also used widely
in community swimming pools to disinfect one’s feet
before entering the pool.(1:1000)
It is also used to disinfect fruits & vegetables.
Demerits are its colors everything it touches & odour.
 (i) Which type of insecticide is the given spot?
(ii) What is the mechanism of its action?

• Pyrethrum(insecticide of vegetable origin)

• Nerve poision.(Contact poision)
• Its extract is prepared by soaking flowers in one gallon of kerosine oil
for 72 hours.
• Ready to spray solution contains about 0.1% of pyrethrins.
• Excellent space spray for killing adult mosquitoes
• Sprayed at the rate of ½ to m1 oz of spray solution per 1000 cubic
feet of space.
• It does not have the residual action like DDT.
 (i) Which stage of mosquito life cycle does this
insecticide act upon?
(ii) What is the mechanism of its action?

• Paris green(Emerald-green powder)

• Copper-aceto-aresnite.
• Larvicidal-stomach poison foe anopheline larvae.
• No ill effects on fish.
• Does not render water unsuitable for domestic use.
• 200-500 gm/acre of water.
 Write the mechanism of action.
What is the active fraction?
Write its dosage.
• Dichloro-Diphenyle-Trichloroethane(DDT):
• White powder with fruity odor.
• Contact poision,acts on nervous system of insects.
• Residual action lasts up to 6 months.
• Para-isomer is active fraction.
• Widely used insecticide to destroy
mosquitoes,fleas,ticks & bugs.
• Residual spray-100 to 200mg/sq foot area.
 Write its mechanism of action.
Which fraction is active component.
What is the duration of residual effect?

• Benzene hexachloride(BHC/Gammexane)
• White colored powder with musty smell.
• Insecticide, acts as contact poision.
• Gamma isomer is active component.
• Residual effect for 3 months.
• 20-50mg per square foot of spraying area.
 Write its use in public health.
Active components of the spot are?
What is the dose?

• Halogen Tablets(Chlorine Tablets)

• White tablets containing chlorine.
• Germicidal effect is by hypochlorous acid, nascent
oxygen & chlorine.
• Disinfecting the water during travel, camps &
emergency.
• 0.5 gm for 20 liters of water.
• Less effective in turbid water.
Identify the spot.
Write its use in public health.
What are its disadvantages?
• Lime:
• 10-20% aqueous suspension is milk of lime
• Disinfection of feces, urine for two hour.
• Used for smearing the walls.
• Can be used for disinfecting the water, but increase
hardness of water.
 Identify the given curve.
Highlight the characteristics of given curve
• Point Source Epidemic Curve:
• Chronological distribution of cases in a point source
epidemic.
• Exposure is brief & simultaneous. Curve rise & fall
rapidly.
• Clustering of cases in one incubation period,
• No secondary cases.
• Gives clues about source and etiology of disease.
 Identify the spot.
For which type of data this is used?
Histogram:
• Quantitative data presentation in pictorial
form.
• Class intervals –on horizontal X axis.
• Frequencies-on vertical Y axis.
• Class interval & frequency is proportionally
represented.
• Create quick visual impression of data.
 Identify the diagram.
Comment on the significance of the diagram.
• Scatter diagram:
• To show relationship between two variables.
• Each dot represents the measurement of both
variables.
• If dots are aggregated, it is an evidence of
relationship.
• If dots are scattered-it is an evidence of no
relationship.
• High-lights the co- relationship of two variables.
 (i) Identify the instrument.

(ii) Write its use in Public Health.

(iii)What is the difference between dissecting microscope & compound microscope.

• Dissecting microscope.
• It is designed for low magnification observation of a sample
using light reflected from the surface of object rather than
transmitted through it.
• It is used with a dye on the slide to view tissue samples,
blood, microorganisms.
• Each eye have one objective so that 3D objects can be seen.
It has low magnification(10X to 40X) with higher resolution.
(i) Identify the instrument.

(ii) Write its use in Public Health.

• Weighing balance (food stuff) .

• For weighing of raw food & cooked
food(nutritional assessment) by balancing the
mass against the known mass.
(i) Identify the instrument.
(ii) Write its use in Public Health.
• Max & mini thermometer:
• Maximum thermometer is a mercury thermometer, rise
of temperature mercury expand, end of mercury thread
at distal end gives maximum temperature.
• Minimum thermometer is having spirit,which is
immersed in a dumb-bell shaped index. When
temperature falls, spirit drags the index towards bulb
end, when temperature rise, spirit expands & runs past
the index...
(i) Identify the instrument.
(ii) Write its use in Public Health
• Wet/Dry bulb thermometer.
• Used to measure humidity.
• Has two similar thermometers, mounted side by
side.
• DBT measures the air temperature.
• WBT (bulb covered with a guage & kept wet), have
lower temperature.
• After having the readings from both, RH can be
found by specially constructed psychometric charts
(i) Identify the instrument.
(ii) Write its use in Public Health.

• Sling Psychrometer:
• Used to find out RH.
• Have 2 mercury thermometers(wet & dry), mounted side by side
on a wooden frame, provided with a handle for rotating the
instrument.
• Wet bulb is moistened & than instrument is rotated for about 15
seconds at the rate of 4 revolutions per second to obtain the
desirable speed of 5 meters/second.
• Reading of wet bulb is taken, again rotated, second reading is
taken,repeated till 2 readings are same.
• Now take the reading of dry thermometer.
• By using suitable charts, RH of the air is obtained.
(i) Identify the instrument.
(ii) Write its use in Public Health.

• Salter’s weighing scale.

• To measure the weight of younger children(for
growth monitoring-weight for age).
• It calculate the weight(mass X gravity) on the force
on the spring.
• Not effected by gravity.
(i) Identify the instrument.

(ii) Write its use in Public Health.

• Clinical thermometer
• To measure the human body temperature.
• Usually it is mercury thermometer, it is accurate & sensitive
because it has a narrow space where mercury level rises very
fast.
• We use maximum thermometer, temperature reached is
maintained even after it is removed from the body.
•
What is measured by given spot? Write cut-off values for the
interpretation of measurements by same.
Which age group assessed by using given spot?

Shakir tape

• It is used to measure MUAC (mid upper arm

circumference)
• <11.5 cm = sever acute malnutrition (red zone), 11.5-
12.5 cm = mild-moderate acute malnutrition (yellow
zone), >12.5 cm = normal
6 months to 59 months old children
i) Identify the instrument.
(ii) Write its use in Public Health.
III Which reagent is used while using the given spot?
Iv What is the recommended level of residual chlorine in drinking water?

Chloroscope
It used to measure free and combined chlorine content in
water.
Used in water treatment plants,industrial concerns,
community water supply schemes, railway,defence & state
govt. departments.
Reagent used= Orthotolidine dissolved in 10% HCL
(hydrochloric acid).
Recommended level of free residual chlorine is 0.5 mg/L
(i) What is the role of this spot in National
Immunisation Schedule (NIS, India)?
(ii) What is the cold chain temperature at which it
should be stored?

• Sterile water
• Used as diluent for BCG vaccination.
• +2 to + 8 deg.C.
(i) Identify the given spot.
(ii) Write it’s TWO uses in Public Health.
• Tuberculin syringe.
• Omega microstat syringe fitted with a 1 cm steel 26 gauge
intradermal needle.
• Used for doing tuberculin test.
• Used foe giving BCG vaccination.
(i) Identify the given spot.
(ii) Write it’s use in Public Health
• N95 mask
• It is respiratory protective device designed to fit the face & does very efficient
filtration of airborne particles.
• N-95 filter means 95% of particles>(0.3 microns) are filtered by it.(Respirable
dust is 0.5-3 micron in size)
• It is required to prevent the transmission of Measles, SARS, Varicella, TB etc.
• It can also protects from wild fire smoke.
• Blue side should be inside & white outside if you want to protect yourself &
vice versa if you want to protect others from you.
• Ergonomics is fitting the job to the worker.
• X-ray in silicosis show snow storm appearance due to nodular fibrosis in upper
part of lungs, while in asbestosis it is ground glass appearnace in lower 2/3 of
lungs due to diffuse fibrosis.
Identify the spot.
Write its mechanism of action.
Write its use.
Autoclave:
• It attains the temperature of 122 deg.C under
15 lbs/sq. inch pressure.
• It acts by giving off latent heat.
• Used in hospitals & labs.
• It destroys all forms of life including spores.
• It is the most effective method for sterilization
of linen, dressings,gloves, syringes & culture
media.
Identify the spot.
Write its use in public health.

• Berkefeld Filter:
• It is a ceramic filter for purification of water on
small scale .
• Essential part of the filter is candle made of
infusorial earth.
• Filter candles are liable to be logged with impurities
& bacteria.
• Should be cleaned by scrubbing with head brush
under running water & boiled at least once a week.
• Only clean water should be used .
Write type / name of items for which the given spot is used
according to latest rules.
Write treatment/ disposal options for the same

• White bag (BMW disposal)

• Waste sharps including metals(needles, syringes with fixed
needles, scalpels, blades.(used, discarded & contaminated
sharps)
• Puncture proof, leak proof, tamper proof containers.
• Autoclaving or dry heat sterilization followed by shredding or
mutilation & sent for final disposal to iron foundries or to
sanitary land fills or to designated waste sharp pit.
(i) Which Categories of Biomedical waste are disposed off in this bag?

(ii) What is the disposal mechanism(s) of this bag?

Blue bag (BMW disposal):

• Glassware(broken or discarded & contaminated glass
including medicine vials & ampules except those
contaminated with cytotoxic wastes.
• Metallic body implants.
• Cardboard boxes with blue colored marking.
• Disinfection (by soaking the washed glass waste after
cleaning with detergent) or autoclaving, microwaving &
than sent for re-cycling.
(i) Which Categories of Biomedical waste are disposed
off in this bag
(ii) What is the disposal mechanism(s) of this bag?
• Yellow bag (BMW disposal)
• Human anatomical waste, Animal anatomical waste,
Soiled waste, Expired or discarded medicines, Chemical
waste,, Chemical liquid waste,Discarde linen &
Microbiology & other clinical lab. Waste.
• Yellow colored, non-chlorinated plastic bags.
• Incineration or Plasma pyrolysis
Write type / name of items for which the given spot is
used according to latest rules.
Write treatment/ disposal options for the same
Red Bag
– Contaminated Waste (Recyclable) (a) Wastes generated from
disposable items such as tubing, bottles, intravenous tubes and
sets, catheters, urine bags, syringes (without needles).

– Red colored non-chlorinated plastic bags or containers.

– Autoclaving / microwaving/ hydroclaving/chemical disinfection

followed by shredding /mutilation or combination of shredding and
sterilization. After the treatment final disposal in secured / sanitary
landfill or disposal through registered or waste to energy plant or
authorized recyclers, whichever is applicable. In case the occupier
does not wish to opt for recycling, the incineration may be opted.
Mention the public health importance of given spot.
Write about the different categories/color coding
used in it.

• Identification/classification tag of patients in case of disaster.

• It helps in classification /categorization of the patients on the
basis of the severity of their injuries &likely hood of their
survival with prompt medical intervention.
• Red indicates immediate(high priority) treatment or transfer.
• Yellow indicates(medium priority)
• Green indicates(low priority), ambulatory patients with minor
injuries to be treated at their own homes.
• Black for dead or moribund patients.(shifted to mortuary)
Name the type of given graph/ plot. In which type of statistical
analysis, we use it?
What is the interpretation from given spot.
Scatterplot between weight and EMG; Correlation.
Negative relationship (negative correlation) between weight and EMG
What is third hand smoking with reference to given spot?
Name the act/legislation to prevent use of given spot in India.
What is MPOWER.

Cigarette
– Third hand smoke= Residual nicotine and other chemicals of tobacco smoke, left on
indoor surfaces (e.g. clothes, curtains etc). people are exposed to these chemicals
by touching contaminated surfaces or breathing in off-gassing from these surfaces.
– Cigarettes and other tobacco products (Prohibition of Advertisement and
Regulation of trade and commerce, production, supply and distribution) Act, 2003.
– No Tobacco Day on 31st May every year(tobacco & heart disease-2018)
– To expand the fight against the tobacco epidemic, WHO has introduced the
MPOWER package of six proven policies:
– • Monitor tobacco use and prevention policies,
– • Protect people from tobacco smoke,
– • Offer help to quit tobacco use,
– • Warn about the dangers of tobacco,
– • Enforce bans on tobacco advertising, promotion and sponsorship, and • Raise
taxes on tobacco.
– The MPOWER policy package can reverse the tobacco epidemic and prevent
millions of tobacco related deaths.
 Identify the equipment.
Mention its use

• Herpender’s caliper.
• To measure skin fold thickness or body fat
percentage.
• Pinch the fold of skin away from muscles &
measure with instrument & match the reading with
chart to find out body fat percentage.
• Normal body fat percentage for young male is 8-
19% & for female is 21-33%.
 Identify the equipment & write its use

• Sterilizer.
• To destroy the microorganisms by obtaining high
temperature with steam, dry heat or boiling liquid.
• Used to sterilize the instruments.
 Identify the spot.
Write its principle of working.
Write its use in public health.
Centrifuge Ramix:
• Works on the principle of sedimentation, where centripetal
acceleration is used to separate the substances of different
densities.
• Used for biochemical analysis of body fluids,like blood cells
from serum.
• Used in molecular biology to separate cellular components
& DNA fragments.
• In Public Health Labs. For water chemistry analysis.
Identify the spot.
Write its use in public health.
• Fortin Barometer:
• It is mercury based.
• Used in industrial labs, Public Health Labs.
Meteorological departments to measure the
atmospheric pressure.
• At high altitudes, atmospheric pressure decreases,
causing motion sickness(headache, insomnia, nausea,
vomiting, pulmonary edema.
• Below sea level atmospheric pressure increases, leading
to Caisson’s disease( High level of dissolved nitrogen in
blood) – air embolism, convulsions & death.
 Identify the spot.
Write its use in public health.
• Infantometer:
• To measure the length of newly born & infants
in lying down position.
• It is used to monitor the growth of the child-
height for age.
 Identify the spot.
Write its use in public health.
What is the optimal temperature?

• Incubator:
• Lab. Incubator is used to grow & maintain
microbiological & cell cultures.
• It is a insulated device with adjustable heater to
maintain temperature, humidity & other conditions
like amount of gases (Co2 & O2) inside.
• To grow most of the bacteria & mammalian cells
optimal temperature of 37deg. C is required.
Identify the instrument.
Write its uses in public health.
• Spirometer:
• Used to measure the volume & rate of air inspired & expired
by the lungs over a specified time.
• Output produced by spirometer is called kymograph, from this
vital capacity, tidal volume, breathing rate & ventilation rate
are calculated.
• Used for screening of high risk individuals(smokers)
• Measuring the effect of disease on pulmonary functions.
• Pre-operative risk assessment.
• Assessment of therapeutic interventions(bronchodilators)
• In public health, used for epidemiological surveys &
Identify the spot.
Write its use in public health.
• Lactometer(Hydrometer):
• It is a device to measure cream content by
measuring specific gravity of milk.
• Thus it tells purity & richness of milk.
• Measurement should be taken when lactometer is
floating freely in milk.
• It helps to check water adulteration of milk.
Identify the spot.
Write its use in public health.

• Soil Testing Kit:

• To detect the available plant nutrients in the
soil(Major nutrients are Nitrogen, phosphorus &
Potassium, Secondary nutrients are Sulphur,
calcium,& magnesium, Minor nutrients are
Iron, Magenese,Copper,Zinc, chlorine etc.)
• Do it yourself kits usually tests for major nutrients,
acidity & Ph level.
Identify the instrument.
Write its use in public health.
What is an insulin pump?
• Glucometer:
• To determine the approximate concentration of
glucose in blood.
• Normal values are 72-99 in fasting & 140 after 2
hours of taking breakfast
• Insulin pumps are used by diabetics to manage their
blood glucose level.
• CGM component of insulin pump-has glucose
sensor, transmitter & external monitor to view your
blood glucose level.
Identify the spot.
Write its use in public health.
• Water Testing Kit:
• Designed for microbiological testing, hardness of
water, chlorine content of water etc.
Identify the spot.
Write its use in public health.
• Electronic Fat Compiler:
• To measure the fat component of milk.
• Milk fat consists of triglycerides(98%)
• Milk fat contains about 65% of saturated fatty acids,
30% of monounsaturated fatty acids & 5% of
polyunsaturated fatty acids.
Identify the spot.
Write its use in public health.
• Digital Photo calorimeter:
• Measure the transmittance & absorbance of light passing through a
liquid sample.
• Measure intensity or concentration of light, when specific reagent is
added to solution.
• used to determine the concentration of colored compounds in
solution." ... The concentration of a sample can be calculated from
the intensity of light before and after it passes through the sample by
using the Beer–Lambert law.
• It measures the absorbance of particular wavelengths of light by a
specific solution.[1] This device is commonly used to determine the
concentration of a known solute in a given solution by the application
of the Beer-Lambert law, which states that the concentration of a
• Digital Sound Level Meter:
• It measure sound levels work by calculating
the pressure of the sound waves traveling through the
air from a source of noise.
• Used to measure sound level(30-130dB).
• OSHA PEL reccomends:The maximum exposure time
for unprotected ears per day is 8 hours at 90 dB
• Used in factories, offices, traffic, family, audio system
by Industrial safety engineers, sound quality control.
Identify the spot
Write its use in public health.
• Solar Power Meter:
• Used to measure sun’s intensity(solar power)
• Measurement expressed by BTU(ft-sq h)
• Solar radiation measurement.
• Car window light intensity measurement.
• Measurement of sun’s transmission through
transparent & film glass.
 Identify the spot.
Write its use in public health.
• Digital Anemometer:
• Air velocity & temperature measurement.
• To measure maximum, minimum, average current
air velocity.