NUTRITION

1. IODISED SALT
a. What is the level of iodine at production level?
A: Production level 30 ppm
b. What is the level of iodine at consumer level?
A: Consumer level 15 ppm
c. Mention its two deficiency diseases.
A: Goitre, Hypothyroidism, Endemic cretinism, Mental retardation, Sub normal intelligence, Hearing
& speech defects.
d. What is the RDA of iodine for an adult?
A:150mcg
e. What is the RDA of iodine for a pregnant woman?
A: 250 mcg

2. SOYA BEAN
a. Mention its protein content.
A: Protein-43.2g/100gram.
b. Mention its calorie content.
A: Calorie-432 kcal/100 gram.
c. Name two micronutrients rich in it.
A: Calcium, iron, thiamine, riboflavin, niacin
d. Which group of food it belongs to?
A: Pulses
e. How does it differ from animal protein?
A: It is deficient in methionine
3. RAGI
a. Identify the specimen and mention which group of food it belongs to.
A: Ragi; Millets
b. Mention its protein content
A: Protein-7.3gram/100 gram
c. Mention its carbohydrate content.
A: 72 gram/100 gram.
d. Mention its calorie content.
A: Calorie-432 kcal/100 gram.
e. Mention the nutrients which are rich in it.
A: Calcium, iron, minerals
4. PARBOILED RICE
a. Identify the specimen and mention its calorie content
A: PARBOILED RICE; Calorie-345 kcal/100 gram.
b. Mention one advantage of it.
A: Advantage: Vitamins and minerals are driven into the deeper layers, becomes harder and resistant
to insect invasion.
c. Mention one disadvantage of it.
A: Disadvantage: Peculiar flavour.
d. The disadvantage can be eliminated by adding
A: 0.05% sodium chromate
e.Mention the technique of parboiling recommended by CFTRI,Mysore.
A: Hot soaking process

5. RAW RICE
a. Identify and give the RDA.
A: Raw rice; RDA-sedentary male-460 gm, sedentary female-410 gm.
b.Mention which group of food it belongs to.
A: Cereals
c. Mention its protein content.
A: 6.8g/100g
d. Mention its caloric value.
A: 345 kcal/ 100g
e. Mention the benefit obtained by eating it along with pulses.
A: Complementary action by eating with pulses because rice contain lysine which pulses lack.
6. MAIZE
a. Identify the specimen and mention its calorie content
A: MAIZE: calorie-342kcal/100gm
b. Mention its protein content.
A: Protein-11.1g/100gm
c. Mention the disease caused by consumption of excessive maize.
A: Pellagra
d. How can you prevent it?
A: Niacin should be taken as a supplement with maize
e. What are the limiting amino acids in it?
A: Tryptophan and lysine.

7. WHEAT
a. Identify the specimen and mention its protein content.
A: WHEAT; protein-9 to 16 % (11.81g/100 gm).
b.Mention which group of food it belongs to.
A: Cereals
c. Mention its caloric value.
A: 346 kcal/ 100g
d. Mention any one micronutrient rich in it.
A: Vitamin B
e. What are the limiting amino acids in it?
A: Lysine and Threonine.

8. EGG
a. Identify the specimen and mention the vitamin deficient in it.
A: Egg, Vitamin – C.
b. Mention the calories available in 60gm.
A: Calories – 70 k cal / 60gm
c. Mention the proteins available in 60gm.
A: Protein – 6gm / 60gm.
d. Why egg protein is called the “reference protein”?
A: It contains all the 9 essential amino acids & in the right proportion.
e.What is the recommended method for consuming eggs? Why?
A: It is recommended to cook the egg before consumption. Raw egg contains avidin which prevents
absorption of biotin by the body. Cooking destroys avidin.

9. VANASPATI GHEE
a. Identify the specimen and mention from what it is derived from.
A:Vanaspathi; It is made synthetically from vegetable oils by hydrogenation.
b. Mention the advantage of hydrogenation.
A: Improves shelf life of vegetable oil.
c. Mention any one disadvantage of hydrogenation.
A: Unsaturated fatty acids gets converted into saturated fatty acids which are harmful
Trans fatty acids are produced which are more atherogenic than saturated fatty acids.
d. Mention the harmful effects of trans fatty acid.
A: They raise the plasma level of LDL cholesterol
They reduce the level of HDL cholesterol
e. How can it be fortified?
A:It can be fortified with vitamins A and D.
10. GROUNDNUT
a. Mention its calorie content.
A: Calories-567Kcal/100gm
b. Mention its protein content.
A: Protein-26.7%
c. Mention its fat content.
A: Fat-40.1%.
d.Comment on the quality of fat.
A: It is high in MUFA
e. Which toxin is produced if it is improperly stored?
A: Aflatoxin.
11. RED GRAM DAL (TUVAR/ ARHAR DAL)
a. Identify the specimen and mention its calorie value
A: Red Gram Dal (Tuvar/ Arhar Dal) ,Calories-335 kcal/gram
b. Mention its protein content
A: Protein – 22 g/100g
c. Name two limiting amino acids.
A: Methionine, cysteine
d. Which item is feared to contaminate red gram?
A: Khesari dal (Lathyrus)
e. Which toxin is responsible for causing neurolathyrism?
A: Beta oxalyl amino alanine (BOAA)

12. GREEN GRAM DAL (MOONG DAL)

a. Identify the specimen and mention its calorie value.
A: Calories-348kcal/100grams.
b. Mention its protein content
A: Protein-24g/100 grams.
c. Mention its fat content.
A: 1.2g/100 grams
d. Mention which group of food it belongs to.
A: Pulses
e.Name one limiting amino acid
A: Methionine.
13. BENGAL GRAM DAL (CHANA DAL)
a. Mention its calorie content.
A: Calories-360 kcal/100 gram.
b. Mention its protein content
A: Protein-17.1g/100 gram
c. Mention its fat content
A: Fat-5.3 g/100gm
d. Name two limiting amino acid.
A: Methionine and cysteine.
e. Which amino acid is it rich in?
A: Lysine
14. HORSE GRAM
a. Identify the specimen and mention its calorie content.
A: Horse Gram. Calories-321kcal/100g
b. Mention its protein content
A: Protein-22g/100g.
c. Mention its fat content
A: Fat-0.5 g/100gm
d. Name two micro nutrients present in it.
A: Calcium, Iron, Vitamin – C.
e. Mention which group of food it belongs to.
A: Pulses

15. MILK
a. Identify the specimen and name the types of proteins in it.
A: Milk; casein, lactoglobulin, lactalbumin.
b. Write the test used to assess the bacterial activity present in raw milk
A: Methylene blue reduction test.
c. Mention the tests for pasteurised milk.
A: Phosphate test, standard plate count, Coliform count
d. Mention any 2 micronutrients rich in it.
A: Calcium, vitamin A&D, Thiamine, Riboflavin
e. Mention the carbohydrate present in it.
A: Lactose

16. DATES
a. Mention its calorie content.
A: 317 K Cal/ 100 gm.
b. Mention its iron content.
A: 7.3mg/100g
c. Name one micro nutrient rich in it.
A: Calcium, Iron, carotene, vitamin C.
d. Mention any 2 iron rich foods.
A: Green leafy vegetables, meat, fish, jaggery, legumes, nuts, oil seeds, dry fruits
e. Mention which group of food it belongs to.
A: Dry fruits
 IMMUNIZATION

1. VACCINE VIAL MONITOR

a. Identify the specimen and mention its use.
A: Vaccine Vial Monitor. To check whether vaccines have been damaged by exposure to heat.
b. What action should be taken when the square is the same colour as the surrounding circle?
A: Discard the vaccine.
c. What action should be taken when the square is lighter than the surrounding circle?
A: The vaccine can be used
d. What action should be taken when the square is darker than the surrounding circle?
A: Discard the vaccine.
e. What is the test used to check whether freeze sensitive vaccines have been damaged?
A: Shake test

2. VACCINE CARRIER
a. Identify the specimen and mention any one use of this equipment?
A: VACCINE CARRIER; used for transporting vaccines for the immunization session after which the
unused vaccines are to be returned back to the ILR.
As reverse cold chain for – Carrying stool samples from a suspected polio case, carrying sample
vaccines from the outreach centre to the lab for checking the potency of the vaccines.
b. What is the hold over time?
A: 12 - 24 hours
c. Which vaccines should n?
A: DPT, DT, TT & diluents
d. How many ice packs are to be placed in this?
A: 4
e. How many vaccines can be carried in this?
A: 16-20 vials

3. ICE PACKS
a. Write its two uses in public health.
A: For maintaining cold chain by using frozen ice packs in the vaccine carriers and cold boxes.
Used in ILR as inside lining to improve & maintain holdover time during electricity failure.
b. What precautions are to be taken while filling these?
A: Do not fill water level higher than the mark on the bottle.
c. Mention any 2 freeze sensitive vaccines.
A: DPT, DT, TT, Hepatitis B
d. what do you mean by conditioning of icepacks?
A: Conditioning is done by keeping the ice pack at room temperature till condensation of water is seen
on surface and can be confirmed by splashing of water while shaking it. This is done to avoid damage to
freeze sensitive vaccine.
e. What all vaccines should be kept inside the holes of the ice pack?
A: BCG, measles

4. COLD BOX
a. Identify the specimen and mention any one use of it.
A: COLD BOX; safe storage of vaccines during the maintenance of ILR or during power failure.
b. What is the hold over time?
A: 2-7 days.
c. Mention any 2 freeze sensitive vaccines.
A: DPT, DT, TT, Hepatitis B
d. How many ice packs are needed to load vaccines safely in it?
A: Large cold box- 50 ice packs
Small cold box - 24 ice packs
e. What is the ideal temperature for maintaining cold chain?
A: 2 to 8 degree Celsius

5. BCG VACCINE
a. What type of vaccine is this ?
A: Live attenuated vaccine
b. Mention its route & site of administration?
A: Intradermal, Left upper arm
c. What is the strain used?
A: Danish 1331
d. What is the maximum age of administration of this vaccine?
A: Till 1 year
e. What is the dose recommended for new born below 1 month?
A: 0.05 ml.

6. DPT VACCINE
a. What type of vaccine is this ?
A: Killed vaccine
b. When is it scheduled to be administered?
A: 6,10,14 weeks , booster -1 at 16-24 months and booster- 2 at 5-6 years
c. What are the components of pentavalent vaccine?
A: DPT, Hepatitis B, Hemophilus influenza type B
d. What is the route of administration?
A: Intramuscular.
e. Mention the adverse effects following it?
A: Local reaction & fever

7. OPV VACCINE
a. What type of vaccine is this?
A: Live vaccine
b. When is it scheduled to be administered?
A: At birth, 6,10,14 weeks
c. What are strains present in a bivalent vaccine?
A: Type 1 and 3
d. What type of immunity is provided by this vaccine?
A: Herd immunity
e. Mention the immunization campaign under which it is administered?
A: IPPI (Intensified pulse polio immunization).
8. MEASLES VACCINE
a. What type of vaccine is this?
A: Live attenuated.
b. What is the strain used?
A: Edmonston-Zagreb strain.
c. What is the site of administration?
A: Right upper arm
d. What is the route of administration?
A: Sub-cutaneous.
e. Mention the adverse effects following it?
A: Local reaction, irritability, malaise & fever

9. MR VACCINE
a. What type of vaccine is this?
A: Live vaccine
b. What is the route of administration of this vaccine?
A: Sub cutaneous
c. What is the time of administration of this vaccine?
A: 9 completed months, 16-24 months (booster).
d. Mention the adverse event following immunization with this vaccine?
A: pain & redness over injection site, low grade fever, rash, muscle ache
e. What is the site of administration?
A: Right upper arm

10. HEPATITIS ‘B’ VACCINE

a. How many doses are given and when?
A: At birth 3 doses at 6, 10 and 14 weeks
b. What is the dose to be given for adults and children?
A: Adult: 1ml, children (till 10years) 0.5 ml.
c. What type of vaccine is this?
A: Recombinant
d. What is the route of administration of this vaccine?
A: Intramuscular
e. what is the ideal time of administering the birth dose of this vaccine?
A: Within 24 hours of birth

11. TETANUS DIPTHERIA (Td)

a. What type of vaccine is this?
A: Killed (toxoid).
b. What is the route of administration of this vaccine?
A: Intramuscular
c. What is the recommended dose?
A: 0.5ml
d. As per the national immunization schedule, when it is administered?
A: At 10 & 16 years and during pregnancy
e. Mention any 1 heat sensitive vaccine.
A: OPV,IPV,JE,MR

12. PENTAVALENT VACCINE

a. What are its components?
A: Diphtheria, pertusis, tetanus, Hepatitis- B, Haemophilus influenza-B.
b. Mention its schedule for vaccination?
A: 1st,2nd,3rd doses at 6,10,14 weeks respectively.
c. What is the route of administration of this vaccine?
A: Intra muscular
d. What is the recommended dose?
A: 0.5ml
e. What is the site of administration?
A: Antero lateral side of left midthigh

13. ANTI RABIES VACCINE

a. Write its dose, site and route of administration?
A: 1 ml, deltoid, intra muscular or 0.1 ml in each deltoid intradermal
b. Mention the schedule of post exposure prophylaxis.
A: 0,3,7,14, 28 days.
c. What is the diluent used?
A: Distilled water
d. For which category of bites it is administered?
A: Type 2 & 3 categories of bites
e. A 5 year old boy was scratched by a dog, no bleeding. Mention the category of dog bite.
A: Type 2

14. ROTA VACCINE

a. What type of vaccine is this?
A: live attenuated
b. Mention the schedule for this vaccine?
A: 3 doses (6,10,14 weeks)
c. What is the route of administration of this vaccine?
A: Oral
d. What is the recommended dose?
A: 5 drops
e. What is the age of the child after which this vaccine should not be initiated and why?
A: Vaccination should not be initiated for infants aged >12 weeks, because there is potentially high risk
of intussusception

15. VITAMIN A
a. Mention its dosage and schedule.
A: First dose at 9 months (1,00,000 IU), second dose at 16 to 18 months, 3rd ,4th, 5th, 6th, 7th, 8th, and 9th
dose at 6 monthly intervals (2,00,000 IU from 2nd dose to 9th dose).
b. How many prophylactic doses of vitamin A should be given& till what age under the National
Immunization Schedule?
A: 9 doses ; till 5 years
c.What should be the minimum gap between 2 doses of vitamin A?
A: 6 months
d. Mention any 2 natural sources of vitamin A.
A: Eggs, liver, fish, meat, papaya, mango, green leafy vegetables, carrots
e. Mention two deficiency manifestations of this nutritive component.
A: Night blindness, corneal and conjunctival xerosis, bitot’s spot, keratomalacia.

16. COVID VACCINE (COVISHIELD)

a. What is the type of vaccine?
A: Recombinant
b. What is the route of administration?
A: Intramuscular
c. What is the recommended age group for this vaccine?
A: 18 years and above
d. Mention its dosage?
A: 2 doses given at an interval of 8-16 weeks, 1 precaution dose given at an interval of 6 months after 2nd
dose
e. Mention any 2 side effects of this vaccine.
A: Headache, fever, myalgia, malaise, nausea

FAMILY PLANNING

1. CONDOM
a. What category of contraceptive is it ?
A: Physical (barrier)
b. What is its failure rate?
A: Failure rate-2-14/HWY.
c. Write its mechanism of action ?
A: Prevents deposition of sperm into vagina.
d. Mention any one non contraceptive benefit.
A: Non contraceptive benefit-prevents STDs, used to cover ultrasound probe during Transvaginal
ultrasonography, used in balloon tamponade to control PPH, used as a mould for vagina during
vulvoplasty.
e. What is the name of the condom supplied by the Government of India?
A: Nirodh

2. IUCD (Copper -T)

a. Write its mechanism of action.
A: 1. Induces foreign body reaction in the endometrium
2. Alters the cervical mucus and affects motility of sperms
3. Makes endometrium unsuitable for implantation
b. Mention one side effect of its use.
A: Bleeding, pain abdomen, perforation.
c. Mention one example of a third generation IUCD.
A: Progestasert, Mirena
d. Mention its failure rate.
A: 1/HWY in the first year of insertion, 2/HWY over 10 years of use
e. What is the Contraindication for IUCD?
A: Pregnancy or Pregnancy Suspected , ectopic pregnancy, congenital uterine malformation,
Puerperal sepsis, Vaginal bleeding, PID,STD, Cervical or endometrial cancer.

3. OCP
a. Write its mechanism of action.
A: Acts on hypothalamic-pituitary-ovarian axis. Inhibits ovulation by suppressing LH surge.
b. Name two side effects of their use.
A:CVD - MI, cerebral thrombosis, venous thrombosis
Liver disorder - hepatocellular adenoma, cholestatic jaundice
Ectopic pregnancy
Common unwanted side effects - Breast tenderness, Weight gain, aggravation of migraine, bleeding
disturbances.
c. Mention the components present in it ?
A: Ethinylestradiol & levonorgestrel along with ferrous fumarate
d. What is failure rate of OCP?
A: 0.1 to 0.5 HWY.
e. What advise to be given if a patient misses 1 or 2 pills in the first week ?
A: Take the missed pill as soon as she remembers and continue the scheduled pills. Use barrier method
for first 7 days if the missed pill is taken after 12 hours.

4. EMERGENCY PILL
a. Write any two indications of its use.
A: Unprotective sexual intercourse, rape, contraception failure.
b. How many hours after the unprotected act, can they be used?
A: within 72 hours.
c. Which drug is approved as emergency contraception in India ?
A: Levonorgestrel 0.75 mg.
d. Mention any one side effect of emergency pill.
A: Nausea, vomiting, Bleeding irregularities.
e. What are other methods of emergency contraception?
A:

 IUD (within 5 days)

 Mifepristone 10 mg once within 72 hours
 2 OCP containing 50 mcg of ethinyl estradiol within 72 hours after intercourse & the same dose
after 12 hours
 4 OCP containing 30 or 35 mcg of ethinyl estradiol within 72 hours & 4 tablets after 12 hours

5. ANTARA
a. What category of contraceptive is this ?
A: Hormonal contraceptive (Injectable).
b. What is its failure rate?
A: Failure rate – 0.3 to 3/ HWYs.
c. What is the content of this contraceptive?
A: DMPA – Depot Medroxyprogesterone Acetate.
d. Route of Administration ?
A: Intramuscular Injection.
e. Mechanism of Action ?
A: Inhibiting ovulation, thickening of cervical mucus, thinning of endometrial lining.

6. CHHAYA
a. Mention the content of this contraceptive?
A: Centchroman (ormeloxifene)
b. Mention the recommended schedule for Chhaya?
A: For first 3 months: one tablet twice aweek on fixed days.
After the initial 3 months: one tablet once a week till contraception is needed.
c. Mention any one Contraindication?
A: PCOD , Cervical Hyperplasia.
d. Failure rate for Chhaya?
A: 1.63 HWY
e. What is the mechanism of action for Chhaya?
A: Works primarily by preventing or delaying release of eggs from ovaries (ovulation) .

ENTOMOLOGY

1. AFB SLIDES
a. Identify the organism seen
A. Mycobacterium Tuberculosis
b. Name the staining method used here and the chemical used for decolourisation
A. Ziehl-Neelsen Technique, 25% Sulphuric acid
c. Mention two causes for false positive sputum smear microscopy?
A. Accidental transfer of AFB from a positive slide, contamination of slide by environmental
mycobacteria, presence various acid-fast particles
d. What does 2+ grading of sputum smear for AFB indicates?
A. 1-10 AFB per oil immersion field
e. What is the treatment regimen for drug sensitive TB?
Ans. 2HRZE+4HRE

2.A) MALARIA PARASITE -PLASMODIUM VIVAX

a. Identify the organism
A. Malaria parasite (P. vivax)
b. why there is relapse in illness with this parasite?
A. Due to exoerythrocytic phase, the schizont remains persistent in the liver tissue leading to relapse.
c. Name the vector transmitting this disease
A. Female Anopheles mosquito
d. What is the incubation period?
A. 8-17 days
e. What is the treatment of choice?
A. Treated with Chloroquine 25 mg/kg divided over 3 days. For the prevention of relapse Primaquine is
given at a dose of 0.25 mg/kg daily for 14 days
B) MALARIAL PARASITE-PLASMODIUM FALCIPARUM
a. Identify the organism
A. Malaria parasite (P. Falciparum)
b. What are the changes seen in RBC after infection with this organism
A. Change in size, shape of RBC and lysis of RBC too
c. Name the vector transmitting this disease
A. Female Anopheles mosquito
d. What is the incubation period?
A. 9-14 days
e. What is the treatment of choice?
A. Artemisinin combination therapy (ACT) (Artesunate 3 days + Sulphadoxine-Pyrimethamine 1 day)
along with single dose of Primaquine 0.75 mg/kg on day 2

3. CULEX ADULT FEMALE

a. Identify and give reasons
A. Culex adult female
Reasons- Short palpi, Non-bushy antennae, non-spotted wings
b. What are the diseases transmitted by this mosquito?
A. Bancroftian filariasis, Japanese encephalitis, West nile fever, Viral arthritis
c. Mention its common breeding place
A. Dirty polluted water (sewage & sullage water collections, septic tanks, drains)
d. Mention the anti-adult control measures
A. Indoor Residual sprays with DDT, Space sprays includes fogging with pyrethrum or malathion,
Genetic control with sterile male technique, gene replacement
e. What is the National program related to the control of mosquito borne diseases?
A. National vector borne disease control program

4. ANOPHELES ADULT FEMALE

a. Identify and give reasons
A. Anopheles adult female
Reasons- Spotted wings, long palpi, non-bushy antennae
b. Write at least two public health importance
A. Malaria, Filariasis (not in India)
c. Mention its breeding places
A. Clean water without organic matter
d. Mention its control measures
A. Anti-larval measures- Environmental control, Chemical control, biological control
Anti-adult measures- Indoor Residual sprays, Space sprays, Genetic control
Protection against mosquito bites- Mosquito nets, screening, Repellents
e. Mention its resting habits.
A. Rests during daytime in human dwellings and cattle sheds.

5. ANOPHELES MALE MOUTH PARTS

a. Identify and give reasons
A. Anopheles male mouth parts- long palpi with club at the tips, bushy antennae
b. Name one larvicide, which can be safely used in overhead tanks?
A. Abate (temephos)
c. Write are the diseases caused by this mosquito?
A. Malaria, Filariasis (not in India)
d. Mention its breeding places
A. Clean water without organic matter
e. What are the control measures
A. Anti-larval measures- Environmental control, Chemical control, biological control
Anti-adult measures- Residual sprays, Space sprays, Genetic control
Protection against mosquito bites- Mosquito nets, screening, Repellents

6. CULEX FEMALE MOUTH PARTS

a. Identify and give reasons
A. Culex female mouth parts, Short palpi
b. What are the diseases caused by this mosquito?
A. Bancroftian filariasis, Japanese encephalitis, West nile fever, Viral arthritis
c. Mention its breeding place
A. Dirty water
d. What is the flight range of this mosquito
A. 1-3km
e. Mention the anti-adult control measures
A. Indoor Residual sprays with DDT, Space sprays includes fogging with pyrethrum or malathion,
Genetic control with sterile male technique, gene replacement

7. ANOPHELES LARVA
a. Identify and give reasons
A. Anopheles larva, larva has no siphon tube
b. How do they rest in water?
A. Rests parallel to the water surface
c. What are the control measures?
A. Anti-larval measures- Environmental control (source reduction), Chemical control (application of
mineral oils/mosquito larvicidal oils), biological control (larvivorous fish like Gambusia affinis and
Lebister reticulates)
d. Write at least two public health importance
A. Malaria, Filariasis (not in India)
e. Mention any two personal protection methods against mosquito bite?
A. Mosquito net/medicated mosquito net, Screening, Mosquito repellent creams and lotions

8. CULEX LARVA
a. Identify and give reasons
A. Culex larva, larva has siphon tube at the tip of its abdomen.
b. How do they rest in water?
A. Rests at an angle inclined to the water surface
c. What are the anti-larval control measures?
A. Anti-larval measures- Environmental control (source reduction), Chemical control (application of
mineral oils/mosquito larvicidal oils), biological control (larvivorous fish like Gambusia affinis and
Lebister reticulates)
d. Write any two diseases caused by this mosquito?
A. Bancroftian filariasis, Japanese encephalitis, West nile fever, Viral arthritis
e. Mention the flight range of the adult mosquito
A. 1-3 Km

9. ANOPHELES EGGS
a. Identify and give reasons
A. Anopheles eggs, has lateral floats and are boat shaped
b. How are these laid on water surface
A. Eggs are laid as singles
c. What are the control measures?
A. Anti-larval measures- Environmental control, Chemical control, biological control
Anti-adult measures- Residual sprays, Space sprays, Genetic control
Protection against mosquito bites- Mosquito nets, screening, Repellent
d. Write at least two public health importance
A. Malaria, Filariasis (not in India)
e. Mention 2 larvivorous fish used as a control measure.
A. Gambusia affinis and Lebister reticulates

10. HEAD LOUSE

a. Identify the specimen.
A. Head louse
b. Name 2 diseases transmitted by this insect.
A. Epidemic typhus, relapsing fever, trench fever
c. Mention the causative organism of Epidemic typhus.
Ans. Rickettsia prowazekii
d. Mention 2 control measures
A. 0.5% malathion lotion applied to head, left for 12 to 24 hours, washed later
Mass delousing
Anti lice shampoos: 0.2 - 0.4% Fentrothion, 0.03% Deltamethrin
e. Mention two preventive measures
A. Regular bath, Maintaining personal hygiene ,Health education

11. HARD TICK MALE

a. Identify and give reasons
A. Hard tick male; Oval body, no distinction of body into head thorax abdomen, dorsal surface has scutum
b. Name any three diseases transmitted by this genus?
A. Tick typhus, viral encephalitis, KFD, tularaemia, tick paralysis, human babesiosis
c. Mention 2 insecticidal control measures
A. Malathion, Lindane, DDT, dieldrin, toxaphane
d. Mention 2 repellants used as a personal protective measures
A. Indalone, Diethyl toluamide, Benzyl benzoate
Periodic examination of body and removal of tick by persons visiting tick infested areas

12. HOUSE FLY ADULT

a. Name any 2 diseases transmitted by this insect
A. Typhoid, Paratyphoid, Cholera, Amebiasis, Polio, trachoma, anthrax, yaws
b. Mention 2 insecticidal control measures
A. DDT (5%), lindane (0.5%), fenthion (2.5%), malathion (5%), diazinon (1-2%) etc. as residual/space
spray/Baits
Larvicides: Diazinon – 2% Dichlorovos – 2% Dimethoate – 1%
c. Mention the porters of infection
A. Flies transmit disease by mechanical transmission, vomit drop, defecation
d. Name any 2 diseases transmitted by faeco oral route?
A. Polio, Hepatitis A

13. ABATE
a. Mention the group of insecticides to which it belongs?
A. Organophosphorus
b. This insecticide is most effective against which part of mosquito life cycle?
A. Larva
c. How it is different from other larvicides?
A. Suitable for treating domestic water sources at dose not more than 1 ppm
d. What is the mechanism of action in mosquito control?
A. Affects the central nervous system through inhibition of cholinesterase
e. What is the dose used?
A. It is used in a dose not greater than 1.0 ppm

14. DDT
a. What is the mechanism of action in mosquito control?
A. Contact poison-acts on nervous system
b. What is the dose of DDT used in IRS?
A. 5% suspension sprayed at the rate of 1 gallon over 1000 sq. feet i.e 200 mg/sq feet.
c. What are the physical properties of DDT?
A. White amorphous powder with mild unpleasant smell.
Insoluble in water but dissolve in organic solvent.
d. Mention its disadvantage?
A. Environmental pollutant. Adverse effect on certain wild animal
e. Expand DDT
A. Dichloro dipheny ltrichloroethane

15. PYRETHRUM
a. What is the dose and frequency of use in mosquito control?
A. 0.1% pyrethrins, ½ to 1 oz of spray solution per 1000 cu feet, 2-3 times for a week
b. How is it used for mosquito control?
A. Space spray
c. What is the mechanism of action in mosquito control?
A. These all are NERVE poisons used as space spray
Highly effective against adult mosquitoes.
d. What are the active principle present?
A. Pyrethrins 1 and 2
Cinerins 1 and 2
e. Mention 1 disadvantage
A. Does NOT possess residual action

CHARTS
1. TB TREATMENT CARD
a. Identify the specimen
A. TB Treatment card
b. Where is the card maintained and who fills up this?
A. In PHC by DOTS provider/ TB-HV (AWW, Community volunteers, Teacher, Relative of TB
patient)
c. Mention the online portal which provides all the details of a TB patient
A. NIKSHAY
d. What is the treatment regimen for drug sensitive TB.
A. 2HRZE+4HRE
e. Mention 2 common side effects of first line ATT drugs.
A. Hepatotoxicity (jaundice, itching), orangish discoloration of urine, peripheral neuritis, impaired vision, joint
pains

2. WHO ISH CHART

a. Identify the chart
A. WHO ISH chart
b. Mention the purpose of using this chart
A. Prediction of risk of ischaemic heart disease
c. What is the risk for a 60-year-old male, smoker of diabetic who has a total cholesterol of 6 mmol/L &BP of
160/100 mmHg
A. More than equal to 40%
d. Mention the national health programme related to the above mentioned risk.
A. NPCDCS (National programme for prevention & control of cancer, diabetes, cardiovascular diseases
and stroke)
e. What is the risk for a 40-year-old male, non-smoker of non-diabetic who has a BP of 140/90 mmHg
A. <10%

3. WEIGHT FOR AGE WHO GROWTH CHART

a. Identify the specimen
A. Weight for age growth chart (WHO using Z score)
b. Mention any 2 uses of growth charts
A. Growth monitoring tool
Diagnostic tool for identifying high risk children
Tool for teaching
Evaluation of corrective measures and impact of a programme
c. What does a value less than 2 SD indicates?
A. Under nutrition
d. Mention 2 age independent anthropometric measures used in an under-5 child.
A. Mid upper arm circumference, weight for height, chest/head circumference ratio, skinfold thickness
e. A Three-year-old girl child weighs 10 kgs and is 75 cm tall, use this growth chart and comment on her
nutrition status
A. Under nutrition

4. HEIGHT FOR AGE WHO GROWTH CHART

a. Identify the specimen
A. Height for age growth chart (WHO using Z score)
b. Mention any 2 uses of growth charts
A. Growth monitoring tool
Diagnostic tool for identifying high risk children
Tool for teaching
Evaluation of corrective measures and impact of a programme
c. Mention the frequency of growth monitoring of a child in an Anganwadi.
A. Monthly once for the initial 6 months of birth and 3 months once thereafter.
d. A Three-year-old girl child weighs 10 kgs and is 75 cm tall, use this growth chart and comment on her
nutrition status
A. Severe stunting
e. Mention 2 age independent anthropometric measures used in an under-5 child.
A. Mid upper arm circumference, weight for height, chest/head circumference ratio, skinfold thickness

5. WEIGHT FOR HEIGHT WHO GROWTH CHART

a. Identify the specimen
A. Weight for height growth chart (WHO using Z score)
b. Mention any 2 uses of growth charts
A. Growth monitoring tool
Diagnostic tool for identifying high risk children
Tool for teaching
Evaluation of corrective measures and impact of a programme
c. What does a value less than 2 SD indicates?
A. Wasting
d. A Three-year-old girl child weighs 10 kgs and is 75 cm tall, use this growth chart and comment on her
nutrition status
A. No wasting
e. Mention 2 age independent anthropometric measures used in an under-5 child.
A. Mid upper arm circumference, weight for height, chest/head circumference ratio, skinfold thickness

6. CHILD IMMUNIZATION TRACKING CARD

a. Identify the specimen
A. Child immunization tracking card
b. What are the components of pentavalent vaccine?
A. DPT, Hepatitis B, Hemophilus influenza type B
c. Mention the live vaccines under national immunization schedule?
A. BCG, OPV, MR, Rotavirus vaccine, JE
d. Mention the route & schedule of Japanese encephalitis vaccine.
A. Subcutaneous (live attenuated vaccine), intramuscular (killed vaccine)
JE-1 : 9-12 months, JE-2 : 16-24 months
e. Mention the initiative intended to boost the routine immunization coverage.
A. Mission Indradhanush

DRUGS AND INSTRUMENTS

1. METFORMIN
a. Which group of drug does it belong to and what is the starting dose for this drug?
A. Biguanides, 500mg BD
b. What are the side effects of this drug?
A. Gastric upset, diarrhoea
c. What is the mechanism of action?
A. Suppress hepatic gluconeogenesis and glucose output from liver,
Enhance insulin mediated glucose disposal in muscle and fat
Retard intestinal absorption of glucose, other hexoses, amino acids and Vitamin B12
Interfere with mitochondrial respiratory chain- promote peripheral glucose utilization by
enhancing anaerobic glycolysis
d. Mention 2 contraindications
A. Renal dysfunction, Acute or chronic metabolic acidosis, Impaired hepatic function
e. What is the diagnostic criteria for diabetes according to ICMR?
A. Symptoms of diabetes plus random plasma glucose more than 200 mg/dl
Fasting plasma glucose >126 mg/dl
HbA1c >6.5%

2. DAONIL (GLIBENCLIMIDE)
a. Which group of drugs does it belong to and what is the starting dose for this drug
A. Sulfonylureas, starting dose 2.5mg OD
b. What are the side effect of this drug?
A. Hypoglycemia
c. What is the mechanism of action?
A. It acts on sulfonylurea receptors on the pancreatic β cell membrane- causes depolarization by
reducing conductance of potassium channels. This enhances calcium influx and degranulation. This
provokes a brisk release of insulin from pancreas.
d. What is the daily dosage?
A. 5-15mg (Starts with 2.5mg OD)
e. What advice would you give to a diabetic patient on Daonil?
A. The most common side effect is hypoglycemia, so educate the patient about the symptoms of
hypoglycemia also advise them to carry sugar cubes or chocolates with them.

3. ANTI TB DRUGS
a. Which is the first line bacteriostatic drug?
A. Ethambutol
b. Which first line drug causes peripheral neuritis?
A. Isoniazid
c. What is the treatment regimen for drug sensitive TB?
A. 2HRZE+4HRE
d. Name the scheme under NTEP that has been formulated with the objective of providing nutritional support
to TB patients?
A. NPY (Nikshay Poshan Yojana)
e. Mention the online portal under NTEP which provides the details of a TB patient.
A. NIKSHAY
f. A 40 year old male came with history cough more than 2 weeks, evening rise of temperature and significant
weight loss. Sputum microscopy was done, Diagnosed as newly diagnose drug sensitive Pulmonary TB, What
is the treatment regimen for this patient?
A. 2HRZE+4HRE

4. INSULIN SYRINGE AND INSULIN

a. What is the indication for starting insulin in Type 2 diabetes?
Ans. Noncompliance with OHA, not under control with Metformin & 1 Sulfonylurea (both high dose).
FBS >250 mg/dl
b. What is the route of administration of insulin?
A. Subcutaneous
c. What are the sites of injection?
A. Anterior abdomen, Upper arm, Anterior thigh, Buttock. Rotating between injection sites and
rotating within injection sites, at least 1 cm apart
d. List any two rapid acting insulin
A. Insulin lispro, aspart, glulisine
e. Mention the storage of insulin.
A. Stored in Temperature (15–25°C). Currently unused vials/refill cartridges (meant to be used in
future) should be refrigerated. If frozen, insulin should be discarded
f. What are the side effects of insulin injection?
A. Local reactions such as swelling, erythema, lipodystrophy

5. MONOFILAMENT
a. Identify the instrument
A. Semmes-Weinstein Monofilament
b. What are the sites where the test is performed?
A. Plantar surface of hallux and 3rd toe and 1st 3rd and 5th metatarsal heads of both feet
c. Mention the use
A. It is used for rapid screening of diabetic neuropathy
d. What are the advantages of this test?
A. Inexpensive, portable, easy to use for the screening of diabetic neuropathy
e. Mention the national health programme related to Diabetes mellitus.
A. NPCDCS (National programme for prevention & control of cancer, diabetes, cardiovascular diseases
and stroke)

6. ATENOLOL
a. Which group of anti-hypertensive drugs does it belong to?
A. Beta blockers
b. What is the starting dose and frequency for this drug?
A. 25-100 mg OD
c. What is the mechanism of action?
A. Selective β1 blocker (cardio-selective) lowers vascular resistance, decrease heart rate and cardiac
output.
d. What are the adverse effects?
A. Rebound hypertension on sudden discontinuation of β blocker
e. According to JNC 8 guidelines what is the cut off value of blood pressure to start pharmacological
management in patients more than 60 years?
A. 150/90 mmHg

7. AMLODIPINE
a. Which group of anti-hypertensive drugs does it belong to?
A. Calcium channel blockers
b. What is the starting dose and frequency for this drug?
A. 2.5-10 mg OD
c. What is the mechanism of action?
A. Lowers blood pressure by decreasing peripheral resistance without compromising cardiac output.
d. What are the adverse effects?
A. Palpation, flushing, ankle oedema, hypotension, headache, accentuate bladder voiding difficulty in
elderly males
e. According to JNC 8 guidelines what is the cut off value of blood pressure to start pharmacological
management in patients more than 60 years?
A. 150/90 mmHg

8. LASIX (FUROSEMIDE)
a. Which group of anti-hypertensive drugs does it belong to?
A. Loop diuretics
b. What is the starting dose and frequency for this drug?
A. 40 mg OD
c. What is the mechanism of action?
A. It acts on Na+-K+-2Cl- co-transporter in thick ascending limb of loop of Henle. Reduction in plasma
volume and cardiac output
d. What are the adverse effects?
A. Hypokalemia, acute saline depletion, dilutional hyponatremia, hearing loss, hypocalemia,
hyperglycemia hyperlipidemia, magnesium depletion, erectile dysfunction
e. According to JNC 8 guidelines what is the cut off value of blood pressure to start pharmacological
management in patients more than 60 years?
A. 150/90 mmHg

9. CHLOROQUINE
a. What is the mechanism of action of this drug?
A. Schizonticidal
b. What is the dose of this drug for management of vivax malaria?
A. 10mg/kg on day 1 and day 2 , 5mg/kg on day 3
c. What are the contraindications?
A. Patients with retinal or visual field changes, Hypersensitivity to hydroxychloroquine
d. What are the uses?
A.Treatment of uncomplicated Plasmodium vivax malaria
Chemoprophylaxis for travellers from non-endemic region to endemic area
Extra Intestinal amoebiasiss, Rheumatoid arthritis
Discoid lupus erythematosus, Lepra reaction
e. What is the dose for travellers from non-endemic region to endemic region?
A. 300mg once a week, on the same day each week and to be started 2-3 weeks prior to departure

10. PRIMAQUINE
a. What is the mechanism of action of this drug?
A. Gametocidal
b. What is the dose of this drug for management of vivax and falciparum malaria?
A. P. vivax- 0.25mg/kg for 14 days , P. falciparum- 0.75mg/kg stat
c. Mention the rational for its use in the treatment of P.vivax
A. It will prevent the relapse due to hypnozoites (exoerythrocytic phase)
d. What are the uses?
A. Treatment of uncomplicated Vivax malaria (0.25mg/kg body weight for 14 days)
Treatment of uncomplicated falciparum malaria (0.75mg/kg body weight on day2)
e. Mention any 2 Contraindications?
A. Contraindicated in G6PD deficiency, Pregnant women, infants

11. DEC
a. What is the dose of DEC under MDA?
A. Bancroftian filariasis -6mg/kg/day for 12 days. Brugian filariasis- 3-6 mg/kg
b. What is the mechanism of action?
A. Alteration of microfilaria membranes so that they are readily phagocytosed by tissue fixed
monocytes.
c. What are the uses?
A. Chemotherapy of microfilaria (6mg/kg body weight of 12 doses to
be completed in 2 weeks i.e., 6 days in a week orally)
Preventive therapy- Annual administration of albendazole (400mg) and DEC (6mg/kg) to an entire high
risk population for 5 years
d. What are the adverse effects?
A. Fever, local inflammation, orchitis, lymphadenitis, transient lymphoedema and hydrocele due to
destruction of microfilaria and adult worms.
e. Mention any 2 contraindications
A. Pregnancy, Children <2 years

12. IFA TABLETS

a. Name the national program related to it and mention any two beneficiaries for it
A. National nutritional Anaemia prophylaxis program, The beneficiaries are Adolescent girls, Pregnant
and lactating mothers & children
b. Mention recommended strength for pregnant women under the national program
A.100 mg of elemental Iron and 500 micro gram Folic acid
c. What are the adverse effects?
A. Epigastric pain, nausea, vomiting, staining of teeth, metallic taste, blotting, colic, constipation
d. What advises would you give for better iron absorption?
A. Advice the patient to consume citrus fruits along with iron tablets and avoid foods rich in calcium &
phytates (eg. milk, tea, coffee, etc) within 2 hours of IFA intake.
e. What is the ICMR cut-off of haemoglobin level to diagnose anemia in pregnancy?
A. 11 gm/dl

13. ORS
a. What are the contents of this packet and mention its one indication?
A. Nacl, glucose, KCl, trisodium citrate
Mild and moderate dehydration
b. At the village level who will provide the ORS packets?
A. ASHA, ANM, AWW
c. What is the osmolarity of WHO based ORS?
A. 245 mOsm/L
d. A 2 year old baby was bought to the OPD with complaints of passing loose stools for 2 days, on
examination baby is restless and irritable eyes are sunken, skin pinch goes back slowly, blood pressure
is normal. How will you grade the dehydration as per IMNCI guidelines?
A. AGE with some dehydration
e. What is super ORS?
A. Rice based / glycine based ORS

14. SAHIL’S HAEMOMETER

a. Identify the instrument
A. Sahil’s Haemometer
b. Mention its use and write any one advantage?
A. To measure the haemoglobin level of an individual
Advantage-easy to perform, inexpensive
c. What is the ICMR cut-off of haemoglobin in a non-pregnant women?
A. 12gm
d. What are the complications of anemia during pregnancy?
A. PPH, Premature birth, low birth weight baby
e. Name few iron rich foods.
A. Spinach, dates, liver

15. IODINE TEST KIT FOR SALT

a. What is the indicator used for the test?
Ans. Starch
b. Name the food item fortified with iodine?
A. Iodised salt
c. What are the advantages of this method?
A. The kits are inexpensive, completely user friendly and offer simple method of monitoring iodine in
salt at field level.
d. What is the recommended Iodine level in salt?
A. At production level-30 ppm, At consumer level- 15 ppm
e. What are the health issues associated with iodine deficiency?
A. Hypothyroidsm, goiter, In pregnant women it can cause miscarriage, still birth, preterm delivery

ENVIRONMENT
1. HORROCK’S APPARATUS
a. Identify the instrument
A. Horrock’s apparatus
b. Mention the uses
A. To calculate the dose of bleaching powder required for given water sample
c. What does the appearance of blue colour indicates?
A. It indicates the presence of free residual chlorine
d. How many grams of bleaching powder is required for preparing stock solution?
A. 2 grams
e. Mention any two diseases caused by contaminated water
A. Cholera, typhoid, hepatitis A, acute gastro enteritis
f. What is the minimum contact period you will allow before water is drawn for use from a well just
chlorinated?
A. 1 hour

2. CHLOROSCOPE
a. Identify the instrument
A. Chloroscope
b. Mention the uses and name the reagent used in it
A. Estimation of residual chlorine in drinking water, OT reagent
c. What is the minimum recommended level of free residual chlorine in drinking water?
A. 0.5mg/L (ppm)
d. What is the inference if the test shows clear white colour?
A. Residual chlorine is absent
e. Mention 3 methods of household purification of water
A. Bleaching powder, Chlorine solution, Chlorine tablets, Filtration

3. HYDROMETER
a. Identify the instrument
A. Hydrometer
b. Mention its uses
A. To measure the specific gravity of liquids
c. What is the underlying principle of its action?
A. A floating body displaces a volume of liquid whose weight is equal to its own weight. (Archimedes
principle)
d. Hydrometer used for measuring density of milk is known as
A. Lactometer
e. Name 2 water-related diseases.
A. Chikungunya, filaria, malaria, dengue fever

4. BLEACHING POWDER
a. What is the percentage of available chlorine in it?
A. 33%
b. What is the mechanism of action of water disinfection?
A. Disinfects water by producing HOCl (major) and also by HCl
c. Mention the use of bleaching powder?
A. Disinfection of water
d. What should be the frequency of disinfection of the wells during epidemics?
A. During epidemics of cholera wells should be disinfected daily
e. What is the minimum contact period you will allow before water is drawn for use from a well just
chlorinated?
A. 1 hour

5. ANEMOMETER
a. Identify the specimen
A. Anemometer
b. Mention its use
A. To measure the unidirectional wind (air) velocity
c. How will you classify anemometer
A. Velocity anemometer and Pressure anemometer
d. Mention 2 green house gases.
A. Methane, carbondioxide, nitrous oxide
e. Mention the sustainable developmental goal that deals with climate change.
A. SDG 13

6. DRY AND WET THERMOMETER

a. Identify the specimen
A. Dry and wet thermometer
b. Mention its use
A. For calculating the relative humidity of air
c. What is the difference between dry and wet bulb thermometer
A. In wet bulb thermometer the bulb is kept wet by a muslin cloth, so it shows a lower temperature
than dry bulb thermometer
d. What is relative humidity?
A. Ratio of amount of atmospheric moisture present relative to the amount that would be present if the
air were saturated
e. Mention health related effects due to high humidity?
A. Sunstroke, Heat cramps, heat exhaustion

7. DIAL THERMOMETER
a. Identify the specimen
A. Dial thermometer
b. Mention its use
A. To measure temperature during storage of vaccines in ILR and deep freezers
c. List any three vaccines which can be stored between +2 deg c to +8 deg c
A. OPV, Hep B, DPT, DT, TT
d. Mention any two heat sensitive vaccines
A. OPV, MR
e. Mention any two freeze sensitive vaccines?
A. DPT, DT, TT
8. MINIMUM AND MAXIMUM THERMOMETER
a. Identify the specimen
A. Minimum and maximum thermometer
b. Mention the uses of two arms
A. Left arm records minimum temperature, right arm records maximum temperature
c. what is the name of the liquid inside minimum thermometer?
A. Spirit

9. TDS METER
a. Identify the specimen
A. TDS meter
b. Mention its use
A. To measure the total dissolved solids of a given solution
c. What are the methods of purification of water on a small scale
A. Chemical disinfection, filtration, ultraviolet irradiation
d. Mention 2 water borne disease.
A. Cholera, typhoid, hepatitis A
e. Explain the difference between hard water and soft water.
A. Hard water contains excess of calcium and magnesium while soft water is free from these minerals.