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357. a. b. c. d. 358. a. b. c. d. Prudent diet is: (Maharashtra 2005) Diet for dietary goal achievement Diet, which contains variety of foods to safe guard from deficiencies Diet on which a person or group lives Diet, which fulfills recommended daily allowances The Reference protein is: (JIPMER 1986; UPSC 1986) Milk Meat Egg Pulses

359. The guidelines under the CSSM programme recommend that a low birth baby with good suckling and without any signs of illness can be managed at home with special care even if the birth weight of baby is as low as: (UPSC 1997) a. 2200 grams b. 2000 grams c. 1800 grams d. 1500 grams 360. Positive health indicators of nutritional status include all of the following EXCEPT: (BHU 1985) a. Anthropometric measurements of pre-school children b. Height of school children at school entry c. Weight of antenatal mothers d. Prevalence of low birth weight 361. a. b. c. d. Severe wasting is: (ORISSA 2000) < 60% <70% <80% <90%

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362. BMI (Body Mass Index) is defined as: (JIPMER 2000, AI 2005) Weight (kg) a. ———————————————— (Height)2 (meters) Weight (kg) b. —————————————————— (Height)1.6 (cm) Mid-arm circumference (cm) c. ————————————————————— Head circumference (cm) d. Midarm circumference (cm) between ages of 1-5 years 363. ‘Cut-off’ point to define obesity in “Body Mass Index” for females is: (Delhi 2002) a. 30 b. 28.6 c. 26 d. 25 364. One of the following is not true about PONDERAL INDEX: (Kerala 2000) a. It is a measure of obesity b. It is independent of height and weight c. It is height and weight dependent d. Age independent e. Used for measurement of body weight in adults 365. Which of the following indices is not an index of measurement of obesity? a. Body mass index b. Ponderal index c. Broca index d. Sullivan’s index 366. a. b. c. d. 367. a. b. c. d. True about NPU (Net protein utilization) is all EXCEPT: (DNB 197) NPU of cow’s milk = 80 % NPU of average Indian diet =50-80 % Low NPU requires increased protein requirement NPU is weight gain per unit protein consumed All are true about NPU EXCEPT: (AI 2000) NPU of milk is 75% NPU of Indian diet is 50-80% NPU is weight gain per unit consumption of proteins If NPU is more, requirement of proteins is more

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368. Most essential fatty acid which serves as a basis for production of other fatty acids (EFA) in the body, is known as: (UPSC 2005) a. Amino acid score b. Net protein utilization c. Biological value d. Protein efficiency ratio 369. According to maternal health programme the daily dose of folic acid for pregnant women should be: (Bihar 2001) a. 100 mg b. 200 mg c. 300 mg d. 400 mg 370. a. b. c. d. RDA of folic acid in adult pregnant woman is: (JIPMER 1995) 50 mcg 150 mcg 300 mcg 500 mcg

371. The dose of iron and folic acid given as supplement during pregnancy is: (AIIMS 1986) a. 200 mg and 500 mg b. 60 mg and 500 mg c. 200 mg and 500 mg d. 200 mg and 1 mg 372. The extra energy allowances needed per day during pregnancy is: (AI 2006) a. 150 KCals b. 200 KCals c. 300 KCals d. 550 KCals 373. All of the following are nutritional requirements during pregnancy EXCEPT: (UP 2002) a. 2 gm Sodium b. 500 mg Calcium c. Energy 20% extra d. Protein 10 gms/day 374. Extra energy required in first trimester of pregnancy: (ORISSA 2004) a. 350 kcal b. 450 kcal c. 550 kcal d. 650 kcal

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375. The recommended daily energy intake of an adult woman with heavy work is: (AIIMS 2001). a. 1800 b. 2100 c. 2300 d. 2900 376. a. b. c. d. The highest % of essential fatty acid is found in: (Orissa 1999) Butter fat (Ghee) Sunflower seed oil Corn oil Groundnut oil

377. Which one of the edible oil yields highest quantity of polyunsaturated fatty acids? (UPSC 2004) a. Coconut oil b. Corn oil c. Groundnut oil d. Sunflower seed oil 378. According to WHO criteria the adult pregnant female is said to be anaemic when her hemoglobin level in venous blood is less than: (Kar 1999, ESIS 2005) a. 10 gm/dl b. 11 gm/dl c. 12 gm/dl d. 13 gm/dl 379. Which of the following vitamin deficiency diseases occurs in maize eating population? (MP 2004) a. Beriberi b. Megaloblastic anaemia c. Pellagra d. Night blindness 380. a. b. c. d. 381. a. b. c. d. Maize is deficient in: (MH PGM CET 2000) Methionine Lysine Lucine All Lysine is deficient in: (UP 2004) Cereals Pulses Jowar Soyabean

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382. Limiting amino acid in Soya bean is: (PGI 1978, AIIMS 1985, DNB 1994, AIIHPH 2001) a. Threonine b. Lysine c. Methionine d. Tryptophan 383. a. b. c. d. 384. a. b. c. d. 385. a. b. c. d. 386. a. b. c. d. 387. a. b. c. d. Net protein utilization of fish is: (UPSC 2004) 57% 67% 74% 87% Practically fish does not have: (ESIS 2005) Carbohydrates Fat Protein Vitamin A Dates are rich source of: (AP 2004) Calcium Iron Vitamin C Carotene Which of the following toxin causes Lathyrism? (MP 2003) Berberine Pyrazolidone Sanguinarine BOAA Which of the toxins causes epidemic dropsy? (UPSC 1986) BOAA Sanguinarine Pyrazolidine None

388. Consumption of which of the following causes epidemic dropsy? (Delhi 2002) a. Keshri dal b. Mustard oil c. Argemone oil d. Ergot

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389. To check the efficiency of pasteurization following tests are done EXCEPT: (JIPMER 2003) a. Phosphatase test b. Standard plate count c. Coliform count d. Milk ring test 390. a. b. c. d. 391. a. b. c. d. 392. a. b. c. d. 393. a. b. c. d. 394. a. b. c. d. Daily need of calories in pregnancy is (CUPGEE 1999) 1500 kCals 2000 kCals 2500 kCals 3500 kCals Parboiling of paddy helps in retraining: (Kar 1994) Vitamin C Vitamin A Niacin Thiamine Reference protein is: (AIIHPH 2001) Egg Milk Meat Fish Daily requirement of protein is (AI 1988; JIPMER 1986) 1 g/kg body weight 1.2 g/kg body weight 0.9 g/kg body weight 1.5 g/kg body weight Average weight of newborn in India is (in kg): (J and K 2004) 2.5 2.8 3 3.5

395. The best indicator for monitoring the impact of Iodine Deficiency Disorders Control programme is: (NIMHANS 2004) a. Prevalence of Goiter among school children b. Urinary iodine levels among pregnant women c. Neonatal Hypothyroidism d. Iodine level in soil

176 396. a. b. c. d.

Social and Preventive Medicine Dose of vitamin D in children: (UP 2002) 100 IU 200 IU 300 IU 400 IU

397. Which one of the following has highest “Glycemic Index”? (AIIMS 2003) a. Corn flakes b. Brown rice c. Ice cream d. Whole wheat bread

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Answers
357. Ans. a (Diet for dietary goal achievement) (Ref. Park PSM 18th ed. 461) Prudent diet is diet developed by National nutrition and food policy for achievement of “dietary goal”. The Prudent diet recommended by WHO is: · Dietary fat < 20-30 % of total daily intake · Saturated fat <10% of total energy intake. · Avoid excessive consumption of refined carbohydrates. · Energy rich sources (fat and alcohol) restricted. · Salt intake should not be more than 5gm per day. · Proteins should be 15 to 20% of daily intake. · Junk foods should be reduced. 358. Ans. c (Egg) (Ref. Park PSM 17th ed.-429) Egg: · It is a standard protein against which quality of other proteins is compared (reference protein). · An egg weighing 60 g contains 6 g of protein, 6 g of fat, 30mg of calcium and 1.5 mg of iron and supplies about 70 kCal of energy. · Except for vitamin C and carbohydrates, egg contains all the nutrients. · It has all 9 essential amino acids. · Net protein utilization (NPU) which combines in a single value the biological value and digestibility, is 100 for egg, 80 for meat and 75 for milk. · Cholesterol content of egg is 250mg/egg. · Biotin deficiency is caused by antibiotic overuse and ingestion of raw eggs (avidin in egg white AVIDLY binds to biotin). 359. Ans. c (1800) (Ref. Park PSM 18th ed. 344, OP Ghai 6th ed. 157) Child Survival and Safe Motherhood Programme (CSSM) Was started in 1992. Its components were: 1. Advice on food, nutrition and rest 2. Birth spacing 3. Clean deliveries by trained personnel 177

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Social and Preventive Medicine 4. Detection of high risk pregnancies and prompt referral 5. Early registration of pregnancy 6. Minimum 3 ANC check-up 7. Promotion of institutional deliveries 8. TT for all pregnant women LBW babies weighing over 1800 grams constitute 90% of all neonates and can be managed at home following the same principles of management of LBW neonates. RCH Programme (RCH) RCH Programme has integrated the CSSM services and the major interventions are essential obstetric care, 24 hour delivery services at PHCs /CHCs, emergency obstetric care, medical termination of pregnancy, prevention of reproductive tract infection (RTI) and sexually transmitted diseases (STD), and district surveys. The main highlights of the RCH programme are 1. The programme integrates all interventions of fertility regulation, maternal and child health with reproductive health for both men and women. 2. The services to be provided will be client oriented, demand driven high quality and based on needs of community through decentralized participatory planning and target free approach. 3. The programme envisages up-gradation of the level of facilities for providing various interventions and quality of care. The First Referral Units (FRUs) being set-up at sub-district level will provide comprehensive emergency obstetric and newborn care; similarly RCH facilities at PHCs will be substantially upgraded. 4. It is proposed to improve facilities of obstetric care, MTP and IUD insertion in the PHCs. Also for IUD insertion at subcentres. 5. Specialist facilities for STD and RTI will be available in all district hospitals and in fair number of sub-district level hospitals. 6. The programme aims at improving the out-reach of services primarily for the vulnerable group of population. Interventions in All Districts 1. Child Survival interventions, i.e., immunization, vitamin A (to prevent blindness), oral rehydration therapy and prevention of deaths due to pneumonia. 2. Safe motherhood intervention, e.g., antenatal check-up, immunization for tetanus, safe delivery and anaemia control programme. 3. Implementation of target free approach. 4. High quality training at all levels. 5. Elective activities.

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6. Specially designed RCH package for urban slums and tribal areas. 7. District sub-projects under local capacity enhancement. 8. RTI/STD clinics at district hospitals (where not available). 9. Facility for safe abortions at PHCs by providing equipment, contractual doctors, etc. 10. Enhanced community participation through panchayats, women’s groups and NGOs 11. Adolescent health and reproductive hygiene. This programme had the following components 1. Early registration of pregnancy 2. To provide minimum three antenatal check-ups 3. Universal coverage of all pregnant women with TT immunization 4. Advice on food, nutrition and rest 5. Detection of high risk pregnancies and prompt referral 6. Clean deliveries by trained personnel 7. Birth spacing, and 8. Promotion of institutional deliveries. 360. Ans. c (Weight of antenatal mothers) (Ref. Park PSM 18th ed.24) Nutritional status indicators Nutritional status is a positive health indicator. Three nutritional status indicators are considered important indicators of health status: a. Anthropometric measurements of pre-school children b. Height of school children at school entry c. Prevalence of low birth weight (< 2.5kg) 361. Ans. b (<70%) (Ref. Park PSM 18th ed.464) Nutritional status Normal Mildly impaired Moderately impaired Severely impaired 362. Stunting Wasting (% of height/age) (% of weight/age) >95 87.5-95 82 87.5 < 80 >90 80-90 70-80 <70

(Weight (kg) Ans. a. ————————————— (Height)2 (meters) (Ref. Park PSM 18thed.316, 470)

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Social and Preventive Medicine Body Mass Index (BMI) ♦ It is most useful index for obesity in young children and adolescents. ♦ Overweight when BMI > 85th percentile of that age sex. ♦ Obesity when BMI > 95th percentile of that age sex. ♦ Obesity is also classified as BMI > 30 ♦ Normal BMI value range from 18.5 to 24.99. ♦ It does not distinguish between weight associated with muscle and weight associated with fat. (Weight (kg) BMI (Quetlet’s index) = ————————————— (Height)2 (meters) Weight (kg) Dugdale’s Index = ——————————————— (Height)2 (meters) Weight (kg) Rao’s index = ————————————— (Height)1.6 (cm) Mid-arm circumference (cm) Kanawati’s Index = ————————————————————— Head circumference (cm)

363. Ans. a (30) (Ref. Park PSM 18thed.316) Classification of adults based on BMI Classification Underweight Normal range Overweight Pre-obesity Obese class I Obese class II Obese class I II BMI <18.50 18.50-24.99 ≥ 25 25-29.99 30-34.99 35-39.99 30-34.99 Risk of co-morbidities Low Average Increased Moderate Severe Very Severe

364. Ans. b, d, e (Ref. Park PSM 18th ed.318) Height in cm Ponderal Index = ——————————————————— Cube root of body weight in cm

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365. Ans. d (Sullivan’s index) (Ref. Park PSM 18th ed. 124, 318) Body weight, though not an accurate measure of excess fat is a widely used index. For adults, various other indicators for measurement of excess fat are: ♦ BMI ♦ Ponderal index ♦ Broca’s index ♦ Lorentz index ♦ Corpulence index 366. Ans. a (NPU of cow’s milk = 80 %) (Ref. Park PSM 18th ed.459) Net protein utilization (NPU) Nitrogen retained by the body x 100 Nitrogen intake ♦ It is a product of digestibility co-efficient and biological value divided by 100. ♦ NPU of rice is 63% ♦ NPU of meat is 85% ♦ NPU of milk is 75% ♦ NPU of Egg is 100% ♦ NPU of average Indian diet = 50-80 % ♦ Low NPU requires increased protein requirement Protein - Energy Ratio Energy from protein PE percent = ———————————— Total energy in diet NPU =

x 100

367. Ans. d (If NPU is more, requirement of proteins is more) (Ref. Park PSM 18th ed.459) ♦ NPU is a product of digestibility co-efficient and biological value divided by 100. ♦ NPU of rice is 63% ♦ NPU of meat is 85% ♦ NPU of milk is 75% ♦ NPU of Egg is 100% ♦ NPU of average Indian diet =50-80 % ♦ Low NPU requires increased protein requirement

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368. Ans. b (Net protein utilization) (Ref. Park’s Textbook of PSM 18 th Ed. – 459 and above Q for explanation) Most essential fatty acid which serves as a basis for production of other fatty acids (EFA) in the body, is known as Net protein utilization. 369. Ans. d (400 mg) (Ref. Park PSM 18th ed. 447) Folic acid supplementation during pregnancy has been found to increase birth weight of infants and decrease the incidence of low birth weight babies. Intake values of folic acid recommended by ICMR (1989): Status Healthy adults Pregnancy Lactation Children In mg/Per day 100 400 150 100

370. Ans. d (500 mcg) (Ref. Park PSM 18thed. 465) Supplemental dose of iron and folic acid in pregnancy is 60 mg elemental iron and 500 mg of folic acid. 371. Ans. b (60 mg and 500 mg) (Ref. Park PSM 18thed. 465) ♦ Supplemental dose of iron and folic acid in pregnancy is 60 mg elemental iron and 500 mg of folic acid. ♦ One tablet of iron and folic acid containing 60mg of elemental iron (180mg ferrous sulphate) and 0.5 mg of folic acid should be given to mothers. ♦ A total of 100 tablets of iron and folic acid are given to a pregnant woman by the health worker. 372. Ans. c (300 KCals) (Ref. Park PSM 18thed. 458) —————————————————————————————— Group Type of work Energy allowances (kcals/day) —————————————————————————————— Adults Males Light work 2425 Moderate work 2875 Heavy work 3800 Adults Females Light work 1875 Moderate work 2225

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2925 +300 1st 6 months +550 6-12 months +400 —————————————————————————————— Recommended daily nutrients for female of 50 kg weight —————————————————————————————— Nutrient’s Non-pregnant Pregnancy Lactation —————————————————————————————— Kcals 2200 2500 2900 Proteins (gm) 50 60 70 Calcium (gm) 500 1000 1500 Iron (mg) 18 40 30 Vitamin A (IU) 5000 6000 8000 Vitamin D (IU) 400 400 400 Vitamin B12(mcg) 2 2 2 —————————————————————————————— Female Basic Kcals Pregnancy+300 Kcals Sedentary work Moderate work Heavy work 1875 2175 2925 2175 2474 3225

373. Ans. d (Protein 10 gms/day) (Ref. Park PSM 18thed. 465) Female Sedentary work Moderate work Heavy work Basic Kcals 1875 2175 2925 Pregnancy+300 Kcals 2175 2474 3225

Requirements in Pregnant women (50 kg) ♦ Net energy + 300 Kcal/d ♦ Protein + 15 g/d ♦ Fat 30 g/d ♦ Calcium 1000 mg/d ♦ Iron 38 mg/d ♦ Retinol 600 microgm/d ♦ Beta carotene 2400 microgm/d ♦ Thiamin +0.2 mg/d ♦ Riboflavin +0.2 mg/d ♦ Nicotinic acid +2 mg/d ♦ Pyridoxine 2.5 mg/d ♦ Ascorbic acid 40 mg/d

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Social and Preventive Medicine ♦ Folic acid 400 microgm /d ♦ Vitamin B12 1 microgm/d

374. Ans. a (350 kcal) (Ref. Park PSM 18thed. 458) —————————————————————————————— Group Type of work Energy allowances per day (kcals) —————————————————————————————— 2425 2875 3800 Adults 1875 2225 2925 Pregnancy +300 Lactation 1st 6 months +550 6-12 months +400 —————————————————————————————— 375. Ans. c (2300) Recommended daily nutrients for female of 50 kg weight —————————————————————————————— Nutrient’s Non-pregnant Pregnancy Lactation —————————————————————————————— Kcals 2200 2500 2900 Proteins (gm) 50 60 70 Calcium (gm) 500 1000 1500 Iron (mg) 18 40 30 Vitamin A (IU) 5000 6000 8000 Vitamin D (IU) 400 400 400 Vitamin B12(mcg) 2 2 2 —————————————————————————————— 376. Ans. c (Corn oil) (Ref. Park PSM 18th ed. 440) —————————————————————————————— Type of oil % of Essential fatty acid (PUFA) —————————————————————————————— Coconut oil 2% Palm oil 9% Mustard oil 15% Sunflower seed oil 56% Corn oil 57% Groundnut oil 39% Adults Males Light work Moderate work Heavy work Females Light work Moderate work Heavy work

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Safflower oil 73% Soyabean oil 7% Meat, eggs 0.5-0.3% Milk (fat) 0.4-0.6 Leafy greens varied Fish oil 10% —————————————————————————————— 377. Ans. b (Corn oil) (Ref. Park PSM 18th ed. 440) —————————————————————————————— Type of oil % of Polyunsaturated fatty acid (PUFA) —————————————————————————————— Coconut oil 2% Butter 3% Margarine 50% Palm oil 10% Cottonseed oil 50% Groundnut oil 31% Sunflower seed oil 65% Corn oil 65% Safflower oil 75% Soyabean oil 62% —————————————————————————————— 378. Ans. b (11 gm/dl) (Ref. Park PSM 18th Ed. 450) Cut-off points for the diagnosis of anaemia: Category Venous blood (g/dl) 13 12 11 11 12 MCHC (%) 34 34 34 34 34

Adult male Adult non-pregnant female Adult pregnant female Children, 6 months to 6 years Children, 6 years to 14 years

379. Ans. c (Pellagra) (Ref: Park, PSM, 17th ed., 427) Cereal and pulse proteins complement each other and provide a more balance and “complete” protein. Germinating pulses, however, contain higher concentration of vitamins, especially vitamin C and B; pulses are called “poor man’s meat”.

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—————————————————————————————— Food material Rich in Deficient in —————————————————————————————— Cereals Maize Rice Fat, excess leucine (Pellagra) Lysine and Vitamin B Lysine and tryptophan. Vitamins A, D and C, Ca++, Iron Lysine and threonine Thiamine, riboflavin, niacin, proteins

Wheat Milled rice (Polished rice)

Protein, Vitamin B -

Millets Jowar Ragi Bajra Excess Leucine (Pellagra) Calcium Calcium, iron, vitamin B Lysine and threonine. Lysine and threonine

Pulses (Legumes) Pulses 20–25% of proteins, Lysine, Mineral, vitamin B 40% of protein, 20% of fat, and 4% of minerals. Methionine and cystein.

Soya bean:

Methionine

Vegetables : “protective foods” High vitamin and mineral content, leaf proteins (2 to 4%) are good sources of lysine, Leafy vegetables are high in water content and dietary fibre, Low caloric value. The recommended daily intake of green leafy vegetables 40g for an adult. Milk: Milk is a good source of all vitamins except vitamin C. 380. Ans. a (Methionine) (Ref. Park PSM 17th ed.-427) Wheat: The limiting amino acids are lysine and threonine. Maize: Proteins of maize are deficient in tryptophan and methionine. Jowar (sorghum and bajra): The protein content varies from 9 to 14% and the proteins are limiting in lysine and threonine. It is pellagrogenic due to excess Leucine content. Ragi: is rich in calcium. Pulses (Legumes) ♦ Pulses contain 20–25% of proteins.

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♦ Pulse proteins are poor in methionine and to a lesser extent in cystein. ♦ Germinating pulses, however, contain higher concentration of vitamins, especially vitamin C and B. ♦ Pulses are called “poor man’s meat”. 381. Ans.a (Cereals) (Ref. Park PSM 17th ed.-426) Cereals ♦ Cereal proteins are poor in nutritive quality, being deficient in the essential amino acid, lysine. ♦ Proteins of maize are still poorer, being deficient in lysine and tryptophan. ♦ Cereal and pulse proteins complement each other and provide a more balance and “complete” protein (AI-2002). ♦ Rice proteins are richer in lysine than others and devoid of vitamins A, D and C. 382. Ans. c (Methionine) (Ref. Park PSM 18thed.554) Soyabean: 40% of protein, 20% of fat, and 4% of minerals. ♦ Limiting amino acid is methionine. ♦ Highest amount of protein is found in it (40%). 383. Ans. c (74%) (Ref. A.P. Kulkarni Community Medicine 2nd Ed. – 609) NPU of various eatables: Milk – 85 Egg – 96 Meat – 76 Rice – 77 Wheat – 61 Bengal gram – 61 Fish NPU – 74% 384. Ans. a (Carbohydrates) (Ref. Park PSM 18th ed. 456) Fish is rich in unsaturated fatty acids, vitamin D and vitamin A, and proteins. It practically does not contain carbohydrates. 385. Ans. a (Calcium) (Park PSM 18thed. 448) Sources of calcium ♦ Milk and its products ♦ Green leafy vegetables

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Social and Preventive Medicine ♦ Cereals and millets ♦ Ragi ♦ Sitaphal ♦ Drinking water ♦ Dates

386. Ans.: d (BOAA) (Park’s textbook of PSM – 18th ed. 564) Lathyrism ♦ Neurolathyrism is a crippling disease of the nervous system characterized by gradually developing spastic paralysis of lower limbs, occurring mostly in adults consuming the pulse, Lathyrus sativus, is commonly known as “Khesari Dhal”. ♦ The toxin present in Lathyrus is beta oxalyl amino alanine (BOAA). ♦ It is common in Madhya Pradesh (MP). ♦ The disease affects mainly young men in the age group of 15–45 years and manifests itself in stages: a) Latent stage b) No-stick stage c) One-stick stage d) Two stick stage e) Crawler stage. Interventions a) Vitamin C prophylaxis b) Banning the crop c) Removal of toxin i) Steeping method ii) Parboiling iii) Education iv) Genetic approach v) Socio-economic changes 387. Ans. b (Sanguinarine) (Ref: Park, PSM, 18thed., 479) Epidemic Dropsy · Caused by a toxic alkaloid sanguinarine from argemone oil. · This toxic substance interferes with the oxidation of pyruvic acid which accumulates in the blood of sudden, non-inflammatory, bilateral swelling of legs, diarrhea. · Dyspnoea, cardiac failure and death may follow glaucoma. · Following tests may be applied for the detection of argemone oil: (1) Nitric acid test (2) Paper chromatography test - the most sensitive test as yet 388. Ans. c (Argemone oil) (Ref: Park, PSM, 18thed.479; Refer above Q. for explanation)

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Ergot is not a storage fungus, but a field fungus, e.g., Claviceps fusiformis. Symptoms are acute but rarely fatal and include nausea, repeated vomiting, giddiness and drowsiness extending peripheral gangrene due to vasoconstriction of capillaries have Ergot-infested grains can be easily removed by floating them in 20% salt water. 389. Ans. d (Milk ring test) (Ref. Park’s textbook of PSM – 18th ed. 477) Pasteurization ♦ It may be defined as the heating of milk to such temperatures and for such periods of time as are required to destroy any pathogens that may be present while causing minimal changes in the composition, flavour and nutritive value. ♦ Pasteurization kills nearly 90% of the bacteria in milk including the more heat resistant tubercle bacillus and the Q fever organisms. ♦ Neither themoduric bacteria nor the bacterial spores are killed. ♦ To check the growth of microorganisms, pasteurized milk is rapidly cooled to 40C. Methods of Pasteurization: 1. Methylene Blue Reduction Test: It is an indirect method for detection of micro-organisms in milk. The milk that remains blue the longest is considered to be of the best quality. 2. Holder (Vat) Method: In this process, milk is kept at 63–660C for at least 30 minutes, and then quickly cooled to 50C. 3. HTST Method: “High temperature and short time method”. Milk is rapidly heated to a temperature of nearly 720C, is held at that temperature for not less than 25 sec, is then rapidly cooled to 40C. This is now the most widely used method. 4. UHT Method: “Ultra-high temperature method”. Milk is rapidly heated usually in 2 stages to 1250C for few seconds only. To check the efficiency of pasteurization: 1. Phosphatase test: to check the efficiency of pasteurization. The test is used to detect inadequate pasteurization. 2. Standard plate count: Bacteriological quality of pasteurized milk is determined by the standard plate count 3. Coliform count: Their presence in pasteurized milk is an indication either of improper pasteurization or post-pasteurization contamination. 390. Ans.: c (2500 kCals) (Park’s textbook of PSM – 17th edition – 435; A.P.Kulkarni 2nd ed.627,628) For moderately working woman it is 2225 kCals / day + 300 kCals / day for pregnancy)

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Social and Preventive Medicine Female Sedentary work Moderate work Heavy work Basic Kcals 1875 2175 2925 Pregnancy+300 Kcals 2175 2474 3225

391. Ans. d (Thiamine) (Ref. Park PSM 18th ed. 453) ♦ Parboiling (partial cooking in steam) is ancient Indian technique of preserving the nutritive quality of rice. ♦ Technique of parboiling recommended by Central food technological research institute, Mysore is known as the ‘hot soaking process’. ♦ The process starts with soaking the paddy (unhusked rice) in hot water at 65-70oC for 3-4 hours, which swells the grain, which is followed by draining of water and steaming the soaked paddy in the same container for 5-10 minutes. The paddy is then dried, and later home-pounded or milled. 392. Ans. a (Egg) Egg: · It is a standard protein against which quality of other proteins is compared (reference protein). · An egg weighing 60 g contains 6 g of protein, 6 g of fat, 30mg of calcium and 1.5 mg of iron and supplies about 70 kCal of energy. · Except for vitamin C and carbohydrates, egg contains all the nutrients. · It has all 9 essential amino acids. · Net protein utilization (NPU) which combines in a single value the biological value and digestibility, is 100 for egg, 80 for meat and 75 for milk. · Cholesterol content of egg is 250mg/egg. · Biotin deficiency is caused by antibiotic overuse and ingestion of raw eggs (avidin in egg white AVIDLY binds to biotin). 393. Ans. a (1 g/kg body weight) (Ref: Park, PSM, 17th ed., 413, 432) —————————————————————————————— Criteria Indian Indian Reference man Reference woman —————————————————————————————— Weight 60 kg 50kg Age 20-39 years 20-39 years Occupation Moderate Moderate Working hours 8 8 BMR kCal/hr/m2 35.5 31.6

Nutrition and Health Surface area m Energy needed (kCal) Protein requirement
2

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1.62 1.40 1380 1062 60gm/day 50gm/day (1 gm/kg/day) (1 gm/kg/day) —————————————————————————————— 394. Ans. b (2.8) (Park PSM 17th ed.377) Average weight of newborn in India is 2.8 kg. —————————————————————————————— Age (months) 0 5 12 24 36 60 120 Weight (kg) 2.8 x2 x3 x4 x5 x6 x10 Height (cm) 50 73 90 105 130 HC (cm) 35 45 438 52 —————————————————————————————— 395. Ans: c (Neonatal Hypothyroidism) Epidemiological assessment of iodine deficiency Indicators are useful in this regard a)Prevalence of goiter. b)Prevalence of cretinism. c) Urinary iodine excretion. d)Measurement of thyroid function by determination of serum levels of thyroxine (t) and pituitary thyrotropic hormone (TSH) and prevalence of neonatal hypothyroidism. 396. Ans. b (200 IU) Dose of vitamin D in different age group: Infants and children 200 IU (5.5 mcg) Adults 100 IU (2.5 mcg) Pregnancy and lactation 400 IU (10 mcg) 397. Ans. a (Corn flakes) Glycemic index ♦ It measures how fast food is likely to raise the blood sugar and helps in managing the blood sugar in diabetic patients. ♦ It indirectly measures effect of foods on blood sugar. ♦ It indicates area under blood glucose curve. ♦ Corn has highest “Glycemic Index” ———————————————————— Food Glycemic Index ———————————————————— Corn 83 Wheat 66 Bran 51 ————————————————————