Review of Preventive & Social Medicine (Including Biostatistics) Vivek Jain
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43Topic-Wise Theory Mcqs and Explanations
  1. History of Medicine
  2. Concepts of Health and Disease
  3. Epidemiology and Vaccines
  4. Screening of Disease
  5. Communicable and Non-communicable Diseases
  6. National Health Programmes, Policies and Legislations in India
  7. Demography, Family Planning and Contraception
  8. Preventive Obstetrics, Paediatrics and Geriatrics
  9. Nutrition and Health
  10. Social Sciences and Health
  11. Environment and Health
  12. Biomedical Waste Management, Disaster Management, Occupational Health, Genetics and Health, Mental Health
  13. Health Education and Communication
  14. Health Care in India, Health Planning and Management
  15. Biostatistics44

History of MedicineCHAPTER 1

 
PRIMITIVE MEDICINE
 
Homeopathy System of Medicine
  • Principles of Homeopathy system of medicine:
    • First principle – ‘similia similibus curenter’ Q : Homeopathy is system of pharmaco-dynamics based on treatment of disease by use of small amounts of a drug that, in healthy persons, produces symptoms similar to those of the disease being treated (known as ‘Human drug pathogenicity study’)
    • Second principle: Single medicine at the time of treatment
    • Third principle: Minimum dose to be used
  • Founding Father of Homeopathy: Samuel HahnemannQ (GermanyQ)
 
Ayurveda System of Medicine
  • Ayurveda means the ‘science of life’
  • Tridosha theory of disease Q : Disease occurs when there is disequilibrium in three doshas (humors), namely, Vata (wind), Pitta (gall) and Kapha (mucus)
 
Siddha System of Medicine
  • Siddha means ‘achievement’
  • Is practiced in Tamil speaking parts in India and abroad
  • Based on notion that medical treatment has to take into account the patient’s environment, age, sex, race, physiological constitution, etc.
 
Unani System of Medicine
  • Originated from GreeceQ
  • ‘Based on the humoral theoryQ: Blood, phlegm, yellow bile and black bile
  • Patient’s character: Sanguine, phlegmatic, choleric and malancholic
 
Profounders of Theories in Public Health
  • Germ theory of disease Q : Louis Pasteur
  • Multi-factorial causation of disease: PattenkofferQ
  • Spontaneous generation theory: AristotleQ
 
Discoveries, Inventions and Developments
  • First vaccine developed Q : Small pox (Edward Jenner)
  • Term ‘VaccinationQ : Edward Jenner
  • Term ‘VaccineQ : Louis Pasteur
  • Vaccines- Anthrax, Rabies: Louis Pasteur
  • First Polio Vaccine: Jonas Salk
  • Penicillin (First antibiotic): Alexander FlemingQ
  • Growth Chart: David MorleyQ
  • Homeopathy: Samuel Hahnemann
  • Blood group types: Karl Landsteiner
  • Citrus fruits in prevention of Scurvy: James Lind
  • Transmission of Yellow fever: Walter Reed
  • Life cycle of Plasmodium: Ronald RossQ
46
 
Authors of Important Books in Public Health
  • The Canon of Medicine: AvicennaQ
  • The Book on Healing: Avicenna
  • Antiseptic Principle of the Practice of Surgery: Joseph ListerQ
  • Air, Water and Places: HippocratesQ
  • Ayurvedic Text Nidana: Madhav
  • Charaka Samhita: Charaka
  • Susruta Samhita: Susruta
 
Important Contributors in Public Health
 
 
Hippocrates
  • Also known as: Father of Medicine, First True EpidemiologistQ
  • Wrote book: Air, Water and PlacesQ
  • First physician to reject superstitions, legends and beliefs that credited supernatural or divine forces with causing illness
  • Hippocratic school held that all illness was the result of an imbalance in the body of the four humors, blood, black bile, yellow bile and phlegm
  • First to describe clubbing
 
Sushruta
  • Wrote ‘Sushruta Samhita’
  • Is also known as ‘Father of Plastic Surgery and Cosmetic Surgery’
  • Is regarded as ‘Father of Indian Surgery’Q
 
SCIENTIFIC MEDICINE
 
John Snow
  • John Snow, an English epidemiologist, studied CholeraQ (1848-54) and established the role of drinking water in its spread (Causative agent was identified much later)
  • John Snow is also known as,
    • Father of Epidemiology/Modern Epidemiology Q
    • Greatest doctor
  • John Snow studied and calculated dosages for use of ether and chloroform as surgical anesthesia
 
History of Cholera
  • John Snow (1813-1858): Found the link between cholera and contaminated drinking water (1854 using Spot mapsQ)
  • William Budd concluded that spread of typhoid was by drinking water
  • Robert Koch microscopically identified V. cholerae as bacillus causing the disease (1885)
  • Father of Public Health: Cholera (Father of PH is a disease, not a person)
 
Some Important Honours
  • Father of (Modern) Medicine: HippocratesQ
  • Father of Indian Medicine: CharakaQ
  • Hindu God of Medicine: Dhanvantari
  • Father of (Modern) Surgery: Ambroise Pare
  • Father of Indian Surgery: SushrutaQ
  • Father of Epidemiology/Modern Epidemiology: John SnowQ
  • Father of Bacteriology: Louis PasteurQ
  • Father of Biology: Aristotle
  • 47 Father of Genetics: Gregor MendelQ
  • Father of (Modern) Anatomy: VesaliusQ
  • Father of Physiology: Claude Bernard
  • Father of Psychoanalysis: Sigmund FreudQ
  • Father of Homeopathy: Samuel HahnemanQ
 
Edward Jenner
  • Discovered Small Pox vaccine in 1796
  • Small pox vaccine was the ‘First Vaccine’ to be discoveredQ
  • Small Pox is the ‘First and Only’ disease to be eradicated
  • Term ‘Vaccination’ was coined by Edward Jenner
 
Louis Pasteur
  • Gave the ‘Germ theory of disease
  • Coined term ‘Vaccine
  • Developed ‘Vaccines for Rabies and Chicken Cholera
  • Techniques of ‘Sterilization’ and ‘Pasteurization
 
MODERN MEDICINE
 
AYUSHQ
  • ISM&H (Indigenous Systems of Medicine and Homeopathy) have been now re-designated as ‘AYUSH system’ of medicine
    • Ayurveda
    • Yoga and Naturopathy
    • Unani
    • Siddha
    • Homeopathy
  • Mainstreaming of AYUSH is a key component of National Rural Health Mission (NRHM) 2005-12
 
REVOLUTION IN MEDICINE
 
Types of Medicine
  • State Medicine: Provision of free medical services to the people at government expense
  • Socialized Medicine Q : Provision of medical service and professional education by the State (as in state medicine), but the programme is operated and regulated by professional groups rather than by government
    • Prevents competition between practitioners and clients
    • Provision of medical services supported by state government
    • Ensures social equity that is universally operated by professional health services
  • Social medicine: Study of the social, economical, environmental, cultural, psychological and genetic factors, which have a bearing on health
 
First Country Honours
  • First country to socialize medicine completely Q : Russia
  • First country to introduce compulsory sickness insurance Q : Germany
  • First country to start family planning programme: India
  • First country to start blindness control programme: India
  • First country to establish finger printing bureau Q : India (Calcutta, 1897)
48
 
MISCELLANEOUS
 
Isolation & Quarantine
  • Isolation’ is the separation for the period of communicability, of infected persons from others in such places/conditions as to prevent/limit transmission to those susceptible
    • It applies to persons who are known to be ill with a contagious disease
  • ‘Quarantine’ (meaning “40 Days”) is the restriction of activities of apparently healthy persons who have been exposed to a case of communicable disease during its period of communicability
    • It applies to those who have been exposed to a contagious disease but who may or may not become ill
    • Quarantine was first applied for plague Q
    • Quarantine period for Yellow fever Q : 6 days (maximum IP)
    • Quarantine currently has been ‘replaced with active surveillance’
  • Isolation
    Quarantine
    Separation of
    Cases
    Healthy contacts of casesQ
    Done for
    Cases themselves
    Other persons around
    Level of Prevention Q
    Secondary (Treatment)
    Primary (Specific Protection)
    Duration
    Till recovery
    (period of communicability)
    Till maximum incubation periodQ
 
Smallpox Eradication
  • Last case of smallpox in world Q : 26th October 1977 (Somalia)
  • WHO declared global eradication of smallpox Q : 8th May 1980
  • Last indigenous case of smallpox in India: 17th May 1975 (Bihar)
  • Last known case of smallpox in India: 24th May 1975 (Importation from Bangladesh)
  • India declared smallpox free: April 1977
 
Few Important Diseases in Public Health
  • Father of Public Health: CholeraQ
  • Barometer of Social Welfare: Tuberculosis
  • Slims’ Disease: HIV/AIDSQ
  • Black Sickness: Kala Azar (Leishmaniasis)Q
  • Black Death: PlagueQ
  • Cerebrospinal fever: Meningococcal meningitis
  • Break-bone fever: DengueQ
  • Monkey fever/ disease: KFD (Kyasanur Forest Disease)Q
  • 5-day fever: Trench fever
  • 8th day disease: Tetanus neonatorumQ
  • 100-day cough: Pertussis (Whooping cough)
  • Koch’s Phenomenon: TuberculosisQ
  • Hansen’s disease: LeprosyQ
  • Rubeola: Measles
  • Rubella: German measlesQ
  • Rubula: Mumps
49
 
Institutes of Public Health Importance in India
Institute
Location
Central Drug Research Institute (CDRI)Q
Lucknow
Central Leprosy Training & Research Institute (CLTRI)
Chengalpattu
Central Research Institute
Kasauli
Haffkine Institute
Mumbai
LRS Institute of T.B & allied Diseases
New Delhi
National Tuberculosis Institute (NTI)Q
Bangalore
National Environmental Engineering Research Institute (NEERI)Q
Nagpur
National AIDS Control Organisation (NACO)
New Delhi
National Institue of Communicable Disease(NICD)
New Delhi
National Institue of Virology (NIV)
Pune
National Institute of Nutrition (NIN)
Hyderabad
National JALMA Institute for Leprosy
Agra
Tuberculosis Research Institute (TRC)
Chennai
National Institute of Occupational Health (NIOH)Q
Ahmedabad
National Institute Mental Health and Neurosciences (NIMHANS)
Bangalore
50
 
MULTIPLE CHOICE QUESTIONS
 
PRIMITIVE MEDICINE
1. Samuel Hahneman is referred to as Founding Father of:
[AIIMS Nov 1993]
  1. Ayurveda
  2. Allopathy
  3. Homeopathy
  4. Yoga
2. Match the following authors and their books:
[AIIMS May 1995]
  1. Sushruta, I-Airs, Water and Places
  2. Avicenna, II-Sushruta Samhita
  3. Hippocrates, III-Canon of Medicine
  1. A-III, B-I, C-II
  2. A-III, B-II, C-I
  3. A-II, B-I, C-III
  4. A-II, B-III, C-I
3. Who is known as ‘First True Epidemiologist’ in history of medicine?
[AIIMS Sep 1996]
  1. John Snow
  2. Hippocrates
  3. James Lind
  4. Joseph Lister
4. Match the following:
[AIPGME 1994]
  1. Sushruta, I-Hindu God of Medicine
  2. Dhanvantari, II-Father of Public Health
  3. Hippocrates, III-Father of Medicine
  4. Cholera, IV-Father of Indian Surgery
  1. A-III, B-IV, C-II, D-I
  2. A-IV, B-III, C-II, D-I
  3. A-IV, B-I, C-III, D-II
  4. A-I, B-IV, C-II, D-III
5. Sushruta Samhita was translated by:
[PGI June 03]
  1. Galen
  2. Celsus
  3. Harnel
  4. Charak
  5. Hessler
6. Father of Indian Surgery is:
[Recent Question 2012]
  1. Dhanvantari
  2. Charaka
  3. Susruta
  4. Atreya
 
Review Questions
7. Cradle of civilization is:
[Bihar 2006]
  1. Mesopotamia
  2. Haddapa
  3. Mohenjodaro
  4. Sindhu ghati
 
SCIENTIFIC MEDICINE
8. Match the following:
[AIIMS Nov 1993]
  1. Pattenkoffer, I-Spontaneous Generation Theory
  2. Louis Pasteur, II-Germ Theory of Disease
  3. Aristotle, III-Multifactorial Causation of Disease
  1. A-III, B-I, C-II
  2. A-III, B-II, C-I
  3. A-II, B-I, C-III
  4. A-II, B-III, C-I
9. Match the following Pioneers of Preventive Medicine and their achievements:
[AIPGME 1996]
  1. Edward Jenner, I-Transmission of Yellow Fever
  2. James Lind, II-Vaccination against Smallpox
  3. Walter Reed, III-Prevention of Scurvy
  1. A-III, B-I, C-II
  2. A-III, B-II, C-I
  3. A-II, B-I, C-III
  4. A-II, B-III, C-I
11. Smallpox vaccine was introduced by:
[AIIMS Dec 1992]
  1. Paul Ehrlich
  2. Robert Koch
  3. Louis Pasteur
  4. Edward Jenner
12. Malarial parasite was discovered by:
[Recent Question 2013]
  1. Robert Koch
  2. Louis Pasteur
  3. Charles Alphonse Laveran
  4. Ronald Ross
51
13. Smallpox vaccine was invented by:
[DNB June 2011]
  1. Louis Pasteur
  2. Edward Jenner
  3. Paul Eugene
  4. John Snow
14. James Lind is related to the discovery of:
[DNB December 2010]
  1. Prevention of scurvy
  2. Cause of scurvy
  3. Pathogenesis of scurvy
  4. All
15. Theory of web of causation was given by:
[Recent Question 2013] [DNB December 2010]
  1. McMohan and Pugh
  2. Pettenkoffer
  3. John snow
  4. Louis Pasteur
 
Review Questions
16. Who discovered the transmission of malaria by Anopheline mosquitoes?
[TN 2003]
[Recent Question 2013]
  1. Ronald Ross
  2. Laveran
  3. Muller
  4. Pampana
17. Smallpox vaccine was invented by:
[MP 2003]
  1. Edward Jenner
  2. Ronald Ross
  3. Luis Pasteur
  4. Cross over study
 
MODERN MEDICINE
18. Elimination of following diseases in India is on the anvil except:
[AIPGME 2001]
  1. Yaws
  2. Leprosy
  3. Malaria
  4. Kala Azar
19. Yoga is considered a part of Modern medicine. It will be a part of:
[AIPGME 2012]
  1. Physiotherapy
  2. Preventive medicine
  3. Therapeutic medicine
  4. Caloric upsurper
20. The lawyer who designed the Public Health Act 1848 was:
[Recent Question 2013]
  1. John Snow
  2. Edwin Chadwick
  3. Joseph Lister
  4. William Farr
21. James Lind is known for:
[Recent Question 2012][Recent Question 2013]
  1. Germ theory of disease
  2. Multifactorial causation of disease
  3. Prevention of scurvy by citrus fruits
  4. Web of causation
22. Edward Jenner died in:
[Recent Question 2012] [Recent Question 2013]
  1. 1749
  2. 1775
  3. 1823
  4. 1920
 
REVOLUTION IN MEDICINE
23. Socialized medicine is:
[AIIMS Nov 2006]
  1. Health care at people’s expense
  2. Charitable care at government expense
  3. Free medical care at government expense, regulated by professional groups
  4. Integration of social medicine with health care
24. All of the following are true about Socialized medicine except:
[AIIMS November 2011]
  1. Ensures social equity - universal coverage
  2. Reduces competition among practitioners
  3. Use state funds for free medicine
  4. Increase utilization of health facilities
25. ‘Secret of national health lies in the homes of people’ statement by:
[Recent Question 2012]
  1. Indira Gandhi
  2. Abraham Lincoln
  3. Joseph Bhore
  4. Florence Nightingale
 
MISCELLANEOUS
27. Quarantine was first applied for:
[AIPGME 2005]
  1. HIV/AIDS
  2. Tuberculosis
  3. Leprosy
  4. Plague
52
28. Match the following:
[AIIMS May 2001]
  1. Edward Jenner, I- Rabies and Anthrax
  2. Louis Pasteur, II- Small pox
  3. Albert Calmette and Camille Guérin,
  4. III- Poliomyelitis
  5. Pierre Lépine, IV- Tuberculosis
  1. A-II, B-I, C-IV, D-III
  2. A-II, B-III, C-IV, D-I
  3. A-IV, B-I, C-III, D-II
  4. A-I, B-IV, C-II, D-III
29. WHO declared that smallpox has been eradicated in:
[AIPGME 1991]
  1. May 1978
  2. September 1984
  3. May 1980
  4. July 1987
30. Which of the following diseases is known as “Baro-meter of Social Welfare” ?
[AIIMS May 1995]
  1. Tuberculosis
  2. Cholera
  3. Leprosy
  4. Malaria
32. Black death is:
[Recent Question 2013]
  1. Plague
  2. Dengue
  3. Tuberculosis
  4. Cholera
33. World Health Day is celebrated on:
[DNB June 2011]
  1. 1st December
  2. 31st May
  3. 7th April
  4. 8th May
34. Who is regarded as Father of Public Health?
[DNB June 2011]
  1. Louis Pasteur
  2. Cholera
  3. John snow
  4. Robert Koch
 
Review Questions
35. 3 day disease is:
[Bihar 2004]
  1. Rubella
  2. Rubeola
  3. Roseola infantum
  4. Measles
36. Origin of SPM dates back to:
[TN 2005]
  1. 17th Century
  2. 18th Century
  3. 19th Century
  4. 20th Century
37. Socialization of medicine means:
[RJ 2007]
  1. Study of man as a social being in his total environment
  2. Provision of medical services and professional education by the state but operated and regulated by the government
  3. Provision of medical services and professional education by the state but operated and regulated by professional groups rather than by the government
  4. Study of man as a social being in his whole life
38. Benefit of socialization of medicine are all except:
[RJ 2007]
  1. It eliminate competition among physicians in search of clients
  2. It ensures social equity and universal coverage
  3. Medical care becomes free for the patients, which is supported by the state
  4. Patients can get good quality of treatment without cost
53  
EXPLANATION
 
 
PRIMITIVE MEDICINE
 
1. Ans. (c) Homeopathy [Ref. Park 21/e p2, Park 22/e p2]
  • Founding Father of Homeopathy: Samuel Hahnemann (Germany)
 
2. Ans. (d) A-II, B-III, C-I [Ref. Park 21/e p2-4, Park 22/e p2-4]
  • Authors of important books in Public Health:
    • The Canon of Medicine: Avicenna
    • The Book on Healing: Avicenna
    • Antiseptic Principle of the Practice of Surgery: Joseph Lister
    • Air, Water and Places: Hippocrates
    • Ayurvedic Text Nidana: Madhav
    • Charaka Samhita: Charaka
    • Susruta Samhita: Susruta
3. Ans. (b) Hippocrates [Ref. K. Park 21/e p3, Park 22/e p3]
HIPPOCRATES:
  • Also known as: Father of Medicine, First True Epidemiologist
  • Wrote book: Air, Water and Places
 
4. Ans. (c) A-IV, B-I, C-III, D-II [Ref. Park 21/e p2, 3, Park 22/e p2, 3]
See Annxure 17
54
 
5. Ans. (e) Hessler [Ref. Internet]
6. Ans. (c) Susruta [Ref. K. Park 22/e p2]
 
Review Questions
 
7. Ans. (a) Mesopotamia [Ref. Park 21/e p3, Park 22/e p3]
 
SCIENTIFIC MEDICINE
 
8. Ans. (b) A-III, B-II, C-I [Ref. Park 21/e p5, 32, Park 22/e p5, 31-32]
  • Profounder of theories in Public Health:
    • Germ theory of disease: Louis Pasteur
    • Multi-factorial causation of disease: Pattenkoffer
    • Spontaneous generation theory: Aristotle
 
9. Ans. (d) A-II, B-III, C-I [Ref. Park 21/e p6, Park 22/e p6]
10. Ans. (b) Cholera [Ref. Park 21/e p5, Park 22/e p5]
  • Father of Public Health is cholera disease, not a person
11. Ans. (d) Edward Jenner [Ref. K. Park 20/e p5, Park 21/e p6]
  • Edward Jenner discovered Smallpox vaccine in 1796
    • Smallpox vaccine was the ‘First Vaccine’ to be discovered
    • Smallpox is the ‘First and Only’ disease to be eradicated
    • Term ‘Vaccination’ was coined by Edward Jenner
 
12. Ans. (c) Charles Alphonse Laveran [Ref. Physiology of Medicine 1901-21 by J Lindsten, 1/e p261]
13. Ans. (b) Edward Jenner [Ref. K. Park 22/e p5]
14. Ans. (a) Prevention of scurvy [Ref. K. Park 22/e p6]
15. Ans. (a) McMohan and Pugh [Ref. K. Park 22/e p32]
 
Review Questions
 
16. Ans. (a) Ronald Ross [Ref. Park 21/e p6, Park 22/e p6]
 
17. Ans. (a) Edward Jenner [Ref. Park 21/e p6, Park 22/e p6]
55  
MODERN MEDICINE
 
18. Ans. (c) Malaria [Ref. Park 21/e p232, 279, 290, 315, Park 22/e p233, 278. 289, 314]
  • Malaria: Total cases in India annually were 1.31 million (2011)
  • Yaws:
    • Causative agent is Treponema pertenue
    • ‘Yaws has been declared Eliminated from India in September 2006’.
  • Leprosy:
    • ‘Leprosy Elimination was achieved in India by 31st December 2005’
    • Elimination level for Leprosy is ‘<1/10,000
  • Kala Azar:
    • Total cases in India annually were 33,133 (2011)
    • The National Health Policy (2002) had set the goal for ‘Elimination of Kala-Azar by year 2010
 
19. Ans. (b) Preventive medicine [Logical reasoning]
20. Ans. (b) Edwin Chadwick [Ref. K. Park 22/e p5]
21. Ans. (c) Prevention of scurvy by citrus fruits [Ref. K. Park 22/e p6]
22. Ans. (c) 1823 [Ref. K. Park 22/e p6]
 
REVOLUTION IN MEDICINE
 
23. Ans. (c) Free medical care at government expense, regulated by professional groups [Ref. Park 21/e p9, Park 22/e p9]
  • State Medicine: Provision of free medical services to the people at government expense
  • Socialized Medicine: Provision of medical service and professional education by the State (as in state medicine), but the programme is operated and regulated by professional groups rather than by government
    • Prevents competition between practitioners and clients
    • Provision of medical services supported by state government
    • Ensures social equity that is universally operated by professional health services
  • Social Medicine: Study of the social, economical, environmental, cultural, psychological and genetic factors, which have a bearing on health
 
24. Ans. (d) Increase utilization of health facilities [Ref. Park 22/e p9]
  • Socialized medicine cannot ensure increased utilization of health services alone; it requires ‘Community participation (Health by the people)’ also
 
25. Ans. (d) Florence Nightingale [Ref. Recent Advances in Public Health by JL Burn, 1/e p203]
 
26. Ans. (c) Anthrax bacillus [Ref. Living in a Microbial World by Bruce V Hopkin, 1/e p126]
 
MISCELLANEOUS
 
27. Ans. (d) Plague [Ref. Park 22/e p106]
 
28. Ans. (a) A-II, B-I, C-IV, D-III [Ref. K. Park 19/e p6; 20/e p5 and Internet, Park 21/e p6, 176, Park 22/e p6, 178]
56
 
29. Ans. (c) May 1980 [Ref. 21/e p132, Park 22/e p135]
  • WHO declared global eradication of smallpox: 8th May 1980
 
30. Ans. (a) Tuberculosis [Ref. Park 21/e p168, Park 22/e p172]
 
Review Questions
 
31. Ans. (c) 1st week of August [Ref. Disaster Nursing and Emergency Preparedness by TG Veenema, 3/e p2]
  • Theme for WBFW 2014: Breast feeding - A winning goal for life!
 
32. Ans. (a) Plague [Ref. Bubonic Plague: Black Death by S. Person, 1/e p1]
 
33. Ans. (c) 7th April [Ref. K. Park 22/e p859]
 
34. Ans. (b) Cholera [Ref. K. Park 22/e p5]
 
35. Ans. (a) Rubella [Ref. 21/e p140, Park 22/e p142]
 
36. Ans. (b) 18th Century [Ref. Park 21/e p5, Park 22/e p5]
 
37. Ans. (c) Provision of medical services and professional education by the state but operated and regulated by professional groups rather than by the government [Ref. Park 21/e p9, Park 22/e p9]
 
38. Ans. (d) Patients can get good quality of treatment without cost [Ref. Park 21/e p9, Park 22/e p9]