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Important One-Liners in Public Health & Community Medicine (PSM)

Nov 25, 2024

Point Source, Single Exposure	Common Source Continuous exposure	Propagated epidemic
- Rapid rise & Rapid fall of cases - Occurs over one IP - Explosive in nature - Eg: Food poisoning, Bhopal gas tragedy	- Gradual smooth rise and gradual fall of cases - Occurs over multiple IP - Nonexplosive in nature - Eg: Contaminated well, commercial sex worker	- Gradual, unsmooth rise of cases with multiple spurts - Occurs over multiple IPs. - Nonexplosive in nature - Eg: Polio, Covid

Constant presence of disease in a population—endemic
Disease occurring clearly in excess of normal expectancy is epidemic
in addition to it, the following definitions are also given for it:
- occurrence of a single case of a previously eliminated disease
- occurrence of a single case of an exotic disease
Disease has crossed at least 2 continents or 2 WHO-specific regions
Live Vaccines
- Mnemonic: I LOVE CHICK EMBRYO
- Influenza (Nasal)
- Chickenpox (Oka stain)
- Jap. Encephalitis (SA-14-14-2)
- Measles (Edmonston Zagreb)
- BCG (Danish 1331 strain)
- Yellow fever
- Rotavirus
- OPV
Prevention of occurrence of risk factors – Primordial
Prevention of occurrence of disease—Primary
Prevention of occurrence of complications from disease—Secondary
Prevention of occurrence of disability or fertility (tertiary) due to a complication from the disease

PQLI	HDI
- Infant mortality rate - Life expectancy at 1 year - Literacy rate - Score 0-100 - Current score: 65	- Knowledge Index - Gross national income - Life expectancy at Birth - Score 0-1 - Current score – 0.633 - Rank – 132 - Given by United Nations Development program

Vitamin A Deficiency classification	Primary signs
X1A	Conjunctival xerosis
X1B	Bitot's spots
X2	Corneal xerosis
X3A	Corneal ulceration
X3B	Keratomalacia
	Secondary Signs
XN	Night Blindness
XF	Fundal Changes
XS	Corneal scarring

Most common sign of Vitamin A deficiency: conjunctival xerosis
Most specific sign of vitamin A Deficiency is Bitot's spots
Most common presentation of Vitamin A deficiency: night blindness

Also read: Doctor-Patient Relations, Health Economics, and Social Security

New Energy Guidelines

	Adult Man	Adult woman
Sedentary	2110	1660
Moderate	2710	2130
Heavy	3970	2720

Additional Requirements

Pregnancy +350 (According to NIN) in all 3 trimesters Lactation

0-6 months +600

7-12 months +320

In pregnancy, the first-trimester requirement is usually less, but excess calorie intake in the first trimester will worsen nausea and vomiting. Hence,

Pregnancy	Extra calories to be added
1 trimester	No extra calories
2 trimester	230-270 kcal/day
3 trimester	390-460 kcal/day

Increased nutrients required during Pregnancy	Iron, folic acid, protein, zinc
Increased nutrients required during lactation	Ca, Vit A, Vit C, Iodine, Carbohydrate

Protein requirement per day is 0.83 g/kg/day.
Normal fluorine: 0.5-0.8 mg/l
Dental fluorosis: >1.5 mg/l
Skeletal fluorosis: 3-6 mg/l
Crippling fluorosis: >10 mg/l

Also read: FMGE Previous Year Questions for PSM

Food Adulteration

	Adulterant	Food item	Management
Neuro lathyrism	Toxin: beta-oxalyl amino alanine in khesari dal	Kesari Dal mixed with arhar dal	Vit C, Par boring Ban crop
Epidemic dropsy	Sanguinarine in argemone oil	Mustard oil mixed with argemone oil	Paper chromatography test
Endemic ascites	Pyrrolizidine is crotolaria, jhunjhunia seeds	Millets	Deweeding of jhunjhunia, filtration, sieving

Prophylactic iron and folic acid administration

Beneficiary	Iron requirement	Folic Acid	Schedule
6-9 months	20mg	100mcg	Weekly
5-9 yrs	45mg	400mcg	Weekly
10-19 yrs	60mg	500mcg	Weekly
Reproductive-age women	60mg	500mcg	Weekly
Pregnant and Lactating women	60mg	500mcg	Daily

The time interval between entry of organisms and appearance of first sign and symptoms—incubation period
IP for Noncommunicable disease—latent period
The first case of infection origin introduced is the population – Primary case.
Cases developing following exposure to a primary case – Secondary case
Time Interval between the occurrence of primary case and secondary case – Serial interval
Time Interval between entry of organism and maximum infectivity – Generation time

Also read: Spectrum of Disease and The Iceberg Phenomenon

Unit of Study

Type of Study	Unit
Ecological/Correlational	Population
Cross-Sectional	Individual
Case-control/case reference	Individual
Cohort	Individual
Randomized control trials	Patient
Field trial	Individual
Community trail	Community

Forrest's plot is drawn for meta-analysis.
Funnel plot is drawn for both meta-analysis
Systematic Review

Contraindication of OCP.

Absolute contraindication of OCP: (Mnemonic: CULT)
- Cancers: Breast and genital
- Cardiac abnormalities
- Congenital hyperlipidemia
- Undiagnosed abnormal uterine bleeding
- Liver disease
- Thromboembolism—past or present history
Drug of choice for emergency contraception: Levonorgestrel-only pill (15 mg tab taken within 72 hrs)
Best choice of emergency contraception—IUD
Horrocks Apparatus
- To estimate the chlorine demand of water
- Indicator: Starch iodide
- majority of disinfecting property of chlorine is due to hypochlorous acid
Occupational health
- Byssinosis–Textile industry
- Bagassosis-Cane sugar factor
- Silicosis: Sandstone industry
- Asbestosis: Lower lobe involved

Also read: Screening of Disease - NEET PG PSM

International Organization

	HQ	Functions
United Nations UNDP	New York	Formed SDG Formed SDG, HD
UNICEF	New York	GOBI-FFF
FLO	GENEVA	Labor
FAO	ROME	Food, forest, fisheries, nutrition
USAID	Washington	Family planning, TB, and HIV program
World Bank	Washington	Assist financially
International Red Cross	Geneva	War Victims, First acid

HIV Management

Treatment: Daily FDC tablets for HIV positives
Adults: Tenofovir + Lomivudine + Delutegrovie
Children: Zidovudine + Lamivudine + Dolvtegrane
Newborn: Zidovudine + Lamivudine + Raltegraes
In the case of HIV-TB coinfection, the patient is always started first on ATT, followed by ART after 2 weeks.
MDR TB: Resistant to Rifampicin and isoniazid
Pre XDR TB: Resistant to INH + Rif + any fluroquinolone
XDR TB: Resistant to INH + Rif + any FQ + any second-line injectable drugs
Minimum number of antenatal visits as per GOI guidelines = 4
Minimum number of antenatal visits as per WHO = 8

Population Norm

Subcentre	1/5000 (plain)	1/3000 (Hilly area)	MPW(M), MPW, ANM
PHC	1/30000	1/20000	MO, HA(M)
CHC	1/120000	1/80000	Specialists HS(M), HS(F)

1 ophthalmologist for 5 CHC

Also read: How to prepare Medicine for FMG Exam?

ASHA Workers:

Women Residents of local area 25-45 years of age
Selected by village panchayat under the supervision of the medical officer
Educational criteria: 10th pass

National Immunisation Schedule

Birth	BCG, OPV∘, Hep B
6 Week	Opv₁, RV₁, Penta, FIPV₁ , PCV
10 Week	Opv₁, RV₂, Penta 2₂
14 week	Opv₃, RV₃, Penta₃, FIPV₂ PCV₂
9 completed months	MR, JE₁ FIPV₃ PCV Booster, Vit A
16-24 months	MR₂ JE₂ opv booster , DPT Booster
5-6 yrs	DPT2nd Booster
10-16 yrs	Td₁, Td 2₂

Vit A – 1 ml or 1 lakh IU @ 9 months, then after every 6 months till 5 years of age 2ml or 2 lakh IU given
Primi or multi with last childbirth > 3 years ago: 2 doses of Td vaccine given st
- 1st dose-ASAP in pregnancy
- 2nd dose—28 days later
Multi with last childbirth <3yrs – Booster ID @ 7th month of pregnancy
Vaccines following open vial policy

Mnemonic	All T-series vaccines	PI0
	DPT	PCV
	Td	IPV
	Penta	Opv
	Hep B
	Rotavirus
	JENVAC

JENVAC is given under NIS for Japanese encephalitis. It is a killed vaccine.
JE (Live) vaccine (SA-14-14-2) is not given under NIS
Vaccines that don't follow open vial policy
- BCG, MR, YF, JE (live)

Also read: Important Health & Disease Questions for PSM Exam Prep

Adverse Events

Influenza (inactivated)	GBS
TT, Td	Brachial Neuritis
OPV	Paralysis
Hep B > DPT	Hypersensitivity, shock
Measles	Toxic shock syndrome, febrile seizures
Rotavirus	Intussusception
Pertussis	Inconsolable crying, high fever, HHE
BCG	Osteomyelitis, Lymphadenopathy
MMR	Thrombocytopenia

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