28.6.2013(SPM,national Health Programs) Flashcards
(176 cards)
0
Q
National rural health mission was started on
A
2005-2012
1
Q
Programmes started in 2004-2009
A
Integrated disease surveillance project(IDSP)
Reproductive and child health programme II
2
Q
National vector borne disease control programme was started on
A
2003-2004
3
Q
National AIDS control programme III was started on
A
2006-2011
4
Q
Modified leprosy elimination campaign
A
1998-2004
5
Q
Yaws eradication project
A
1996-1997
6
Q
National iodine deficiency disorders control programme
A
1992
7
Q
RNTCP
A
1992
8
Q
National mental health programme
A
1982
9
Q
Kala azar control programme
A
1977
10
Q
Modified plan of operation
A
1977
11
Q
National programme for control of blindness
A
1976
12
Q
Integerated child development services scheme
A
1975
13
Q
National family planning programme
A
1951
15
Q
Child survival and safe motherhood
A
1992
16
Q
RCH programmes
A
RCH 1 1997
RCH 2 2004-2009
17
Q
Malaria control programmes
A
National malaria control programme 1953 National malaria eradication programme 1958 Urban malaria scheme 1971 MPOA 1977 Enhanced malaria control programme 1997 National anti malaria programme 1999 NVBDCP 2003-2004
18
Q
AIDS control programmes
A
National AIDS control programme 1987
NACP 1 1992-97
NACP 2 1999-2004
NACP 3 2006-2011
19
Q
ARI
A
Annual risk of infection
Tuberculin conversion index
20
Q
ARI in India
A
1-2%(1.7%)
21
Q
For every 1% of ARI how many sputum positive cases of TB occur
A
50 per 1 lash population
22
Q
Incidence of TB in India
A
1.7 per 1000
23
Q
Prevalence of infection
A
Standard tuberculin test
40%
24
Q
Prevalence of disease
A
0.2%
25
Every TB positive individual can infect __________ individuals in a year
10-15
26
Barometer of social welfare in India
TB
27
Life span of TB bacilli
Sputum 1 day
| Droplet nuclei 10 days
28
MC opportunistic infection in HIV in India
TB
29
Elimination level for tuberculosis
Less than 1 case per million
30
National tuberculosis institute
Bangalore
31
Tuberculosis research centre
Chennai
32
Best indicator of control of TB unaffected by current control measures
ARI
33
Appearance of TB bacilli in ZN staining
Rod shaped with beaded appearance
| Beading(mycolic acid)
34
Minimum bacillary load for a positive result
More than 10,000 bacilli per ml sputum
35
Number of fields examined in ZN staining
Minimum 100 fields
36
Grading of sputum smears
0 no bacilli in 100 oil immersion fields
Scanty 1-9 bacilli in 100 oil immersion fields
1+ 10-99 bacilli in 100 oil immersion fields
2+ 1-10 bacilli per field
3+ more than 10 bacilli per field
37
Success of DOTS depends on
```
Political commitment
Good quality sputum microscopy
Directly observed treatment
Uninterrupted supply of drugs
Accountability
```
38
DOTS agents
MPW
Dai
Anganwadi workers
Voluntary workers
39
Incentive paid for DOTS agents
150 rs per patient completing course
40
TB blister packs
Contains 1 day mediciation(Intensive phase)
| Contains 1 week medication(continuation phase)
41
Drug intake in DOTS
```
Alternate regimen
Intensive phase
In front of DOTS agent
Continuation phase 1 weeks tablets are given to patient
First tablet infront of DOTS worker
```
42
Objectives of RNTCP
1. to achieve a cure rate of 85%
| 2. to achieve a case detection rate of 70%(after achievement of first objective)
43
RNTCP was launched as a national programme in
1997
44
Number of RNTCP established microscopy centres
1 per 1,00,000 population
1 per 50K in hilly areas
45
STLS
Senior TB laboratory supervisor
46
Role of STLS
Rechecks all positive slides and 10% of negative slides
47
Number of STLS
1 per 5 lake population
48
ZN staining
Primary stain: carbol fuschin
Decoloriser: 25% sulphuric acid
Counter stain: 0.1% loeffler methylene blue,1% picric acid,0.2% malachite green
49
Number of sputum smears required for diagnosis of TB
2
50
Sputum smears in TB
Day 1 spot sample
| Day 2 morning sample
51
Chances of detecting smear positive cases in samples
Spot sample 80%
| Morning sample 93%
52
TB suspect
```
Productive cough for 2 weeks with/without
Hemoptysis
Fever for 2 wks
Chest pain
Weight loss
Night sweats
Loss of appetite
```
53
Sputum positive TB after smear examination
Even if one sample is positive
54
Both sputum samples negative
1.give antibiotics for 10-14 days
Cough relieved- no TB
Cough not relieved- repeat 2 sputum samples
No sputum positive- X ray chest
55
Seriously ill extra pulmonary
```
Meningitis
Disseminated TB
B/L or extensive Pleurisy
Tuberculous pericarditis or peritonitis
Spinal disease with neurological complaints
SS-ve with extensive parenchymal involvement
Intestinal TB
Genitourinary TB
```
56
Cat 1 TB
```
Red color pack
New SS+ve cases,new SS-ve seriously I'll extra pulmonary
IP 2(HRZE)3
CP 4(HR)3
Rx for 6 months
```
57
Cat II TB
Blue pack
Failure,relapse,default
Rx for 8 months
2(HRZES)3+1(HRZE)3+5(HRE)3
58
TB control
Prevalence of natural infection in age group of 0-14yrs is of order 1%
59
Cat IV
MDR TB
duration of Rx : 18-24 months
IP- 4(KOCZEEt)
CP-12-18(OCEEt)
60
Indication for Non DOTS regimen
Pt compliance not possible or adverse reaction to drugs
61
Non DOTS regimen
ND1
SS+ seriously ill or extra pulmonary seriously ill
2(SHE)+10(HE)
ND2
SS-ve not seriously ill or extra pulmonary not seriously I'll
12(HE)
62
Drug susceptibility testing in TB
```
Phenotypic - culture
Direct
Indirect(gold standard)
Genotypic
Mutations
Results within a day
```
63
XDR TB
Rifampicin
Isoniazid
One or more of injectables(AK,Kn,Cap)
FQs
64
Rx of XDR TB
IP(6-12 months)
| CP(18 months)
65
SS+ve at end of intensive phase
Extend intensive phase for 1 more month
| Transfer the patient to continuation phase irrespective of SS status after 1 month
66
Treatment Failure in TB
SS+ve even after 5 months of treatment
67
New case of TB
Person with TB who has never taken any treatment or taken treatment for less than 4 weeks
68
Follow up sputum samples in Non DOTS regimen
2,6,12 months
69
TB defaulter
A person who at any time after registration has not taken anti TB drugs for 2 or more months consecutively
70
Practical approach to lung health
WHO initiative aimed at managing respiratory patients in primary health care settings
71
Diseases included in PAL
Asthma
Acute bronchitis and other acute respiratory infections
TB
COPD
chronic bronchitis and other chronic respiratory conditions
72
Follow up smear examination timings,CAT 1
If SS-ve at end of IP
2,4,6months
If SS +ve at end of IP
2,3,5,7
73
Follow up smear examination timings,CAT2
If SS-ve at end of IP
3,5,8 months
If SS+ve at end of IP
3,4,6,9 months
74
Follow up smear examination timings,category IV
IP: once a month
CP: once in 3 months
75
Cured case of TB
Completed treatment
Sputum smear negative on two occasions
One exam at end of treatment
76
Types of Resistance to TB
Initial resistance/primary
Person contracts infection from a person with resistant TB bacilli
Secondary/Acquired resistance
Person develops resistance during course of TB
MDR TB
Resistant to H and R with or without resistance to other drugs
XDR TB
resistant to H,R,one injectable,FQs
77
Preferred FQ for TB
Moxifloxacin
78
XDR TB is common in
HIV Pts
79
Order of usage of drugs in MDR TB
1. aminoglycosides
2. Z
3. Ethambutol
4. FQs
5. rifabutin
6. cycloserine
7. thioamide
8. PAS
9. macrolide
10. linezolid
11. high dose INH
12. INF A
13. thioridazine
80
Percentage of MDR TB in India
3-42%
81
Which type of drug resistance is more in India
Acquired
| Resistance is more to INH
82
Other name for PPD test
Pirquet test
83
Dose of PPD
1 tuberculin unit in 0.1ml
84
WHO advocated PPD preparation
PPD RT-23 with
| Tween-80
85
Tuberculin test conversion
An increase of more than 10mm within a 2 yr period regardless of age
86
Negative tuberculin reactions
Less than 6mm
87
False positive tuberculin infection
```
Faulty technique
Deep injection
Infection with other mycobacteria
Prior BCG vaccination
Repeated PPD testing
Using degraded tuberculin
```
88
False negative mantoux
```
Malnutrition
High fever
Per allergic phase
Measles
Chicken pox
Pertussis
HIV
anti allergic medications
Use of immunosuppressants
```
89
First line drugs that is bacteriostatic
Ethambutol
90
Second line drugs that are bactericidal
Kanamycin,Capreomycin,Amikacin
| Ciprofloxacin,ofloxacin
91
Anti TB drugs that act on both intracellular and Extracellular bacilli
H,Z
only intracellular- pyrazinamide
92
Only bactericidal drug effective against persistors in solid caseous TB
Rifampicin
It acts best on slowly or intermittently(spurters) dividing bacilli
93
Anti TB drug that acts on sites of inflammatory response
Pyrazinamide
94
Dosage of anti TB drugs,daily regimen
```
Isoniazid 5mg/kg
Rifampicin 10mg/kg
Streptomycin 15mg/kg
Ethambutol 15mg/kg
Pyrazinamide 25mg/kg
```
95
Dose of antiTB drugs,thrice weekly regimen
```
10-15mg/kg(H)
10mg/kg(R)
15mg/kg(S)
30mg/kg(E)
35mg/kg(Z)
```
96
Most effective antiTB drug
Rifampicin
97
Most toxic anti-TB drug
INH
98
Most bactericidal anti-TB drug
Rifampicin
99
anti-TB causing rapid sputum conversion
INH
100
anti-TB drug first to develop resistance
INH
101
anti-TB drug CI in HIV pts taking protease inhibitors
Rifampicin
102
anti-TB drug contraindicated in HIV and why?
Thiacetazone
| Causes Exfoliative dermatitis
103
anti-TB drug contraindicated in pregnancy
Streptomycin
104
Type of color blindness in ethambutol toxicity
Red green
105
Pulse polio immunisation immunisation programme was started on
1995-96
106
Intensive PPI
Additional rounds at fixed booths followed by house to house search and vaccinate component
107
Strategies to eradicate polio in India
Routine immunisation
PPI
NID/sub NID
Mop up campaigns
108
DD for AFP
```
GBS
transverse myelitis
Traumatic neuritis
Non polio enteric viruses
coxsackie,mumps,entero70 and 71,ECHO
```
109
AFP
Acute Paralysis(less than 4 weeks) in a child less than 15 yrs or person of any age when polio is suspected
110
Incubation period of polio
4-25 days before paralysis onset
111
Adequate stool sample collection in AFP
2 stool samples
24-48hrs apart
Each 8g or one adult thumb size
Within 2 weeks of onset of paralysis(maximum 8weeks)
112
Container for stool sample collection
Clean,dry screw capped container(need not be sterile,no preservative or transport media required)
113
Reverse cold chain
Transport of AFP stool at a temp of 2-8 C
114
Outbreak response immunisation
In areas where a new AFP case has arisen
All children aged 0-59 months are given 1 OPV dose irrespective of previous immunisation status
All children in locality to which the child travelled
At least 500 children must be immunised
115
Follow up of AFP cases
DIO(district immunisation officer) checks for residual paralysis after 60 days
116
Minimal residual weakness
Midarm or midthigh circumference reveal wasting on one side
| Assymetry of skin folds on medial aspects of thigh
117
Critical indicators of AFP surveillance
Non polio AFP cases of greater 1 in 1 lakh
| Greater than 80% AFP cases are reported with 2 stool samples collected within 14days
118
AFP cases that should undergo 60 day follow up
Inadequate or no stool sample collection
Vaccine virus isolated from stool sample
Wild virus isolated from stool sample
Hot case( any case the investigator thought was strongly suggestive of polio on initial examination)
119
Turn around time
Time from collection of specimen to reporting of results
Should be less than 28 days
Target >80%
120
Which AFP indicator has a target of 90%
Completeness of weekly zero reporting
121
Which AFP indicator has a target of greater than 10%
Stool specimens from which non polio enterovirus specimen is isolated
122
Strain of last detected polio case
P2(VDPV)
123
Components of RCH
```
Integerated needs of child and mother
MTP services at PHC and safe abortion
Control and prevention of RTI/STI
adolescent health
Services in urban slums
Involvement of panchayat raj,NGOs
```
124
Indicator of contraceptive prevalence in community
CPR
125
CPR needed to achieve a NRR of 1
60%
126
Content of IFA tablets
100mg elemental iron,500ug folate(Adults)
20mg elemental iron,100ug folate(children)
Preterm infants iron is 10-15mg
127
Vision 2020,population served
```
Vision guardians 1 for 5000
Vision centres 1 for 50,000
Service centres 1 for 5lakh
Training centres 1 for 50lakhs
Centre for excellence
```
128
Number of ophthalmologists needed according to vision 2020
1 per 50,000 population
129
Centres according to vision 2020
Vision centres 20,000
Service centres 2,000
Training centres 200
Centres of excellence 20
130
Iron deficiency in India is common in
Children btw 6months-5 yrs of age
131
Curative components of IMNCI
```
Diarrhoea
Measles
Malaria
Pneumonia
Malnutrition
```
132
Diff btw IMCI and IMNCI
Inclusion of early neonates
Incorporation of guidelines on malaria,anaemia,vit A,immunisation
Skill based
Proportion of training time devoted to sick infant and sick child almost the same
133
Most common cause of blindness in India
Cataract
134
Quality indicators of RCH
Number of AEFI(adverse events following immunisation)
| Number of newborns with birth weight recorded
135
NPCB criteria for blindness
Less than 6/60 in better eye
136
WHO criteria for blindness
Less than 3/60
137
States with highest and lowest prevalence of blindness in India
J and K
Lowest prevalence- Meghalaya
138
Prevalence of blindness in India
1.1%
139
Revised strategies of NPCB
Involvement of NGOs
Shift from eye camp approach to fixed facility surgical approach
Coverage of eye services in tribal and underserved areas
To expand world bank project activities
140
Apex institute for ophthalmology
Dr.Rajendra prasad centre for ophthalmic sciences
141
Cataract surgery rate required to clear the backlog of blindness
340 operations per lac population
142
Goal for blindness in national health policy 2002
Reduce prevalence of blindness to 0.5% by 2010
143
Most prevalent mosquito borne viral disease in India
Japanese encephalitis
144
Legal blindness
WHO Category 2
Visual acuity less than 6/60 or visual field less than 20 C in BEBPC
same criteria for economic blindness
145
Social blindness
WHO Category 3
| 3/60 to 1/60
146
NPCB criteria,low vision
WHO Category 1
| Less than 6/18-6/60
147
Manifest blindness,NPCB criteria
WHO Category 4
| 1/60-PL+
148
Absolute blindness,NPCB criteria
WHO category 5
| Perception of light negative
149
School eye screening programme is for
10-14yrs old children
| 5th to 8th standard(middle school)
150
SES program number of children covered by 1 teacher
150
151
Number of children to be screened per block by SES programme
1,50,000
152
Visual cut off for referral to nearest PHC in SES programme
Less than 6/9 in either eye
153
International agencies involved in vision 2020
WHO
rotary international
International association of lions club
154
Targets under vision 2020
Increase cataract surgery rate to 450 per 1 lakh population
Vision after cataract Sx >6/18
Greater than 80% IOL implantation after cataract surgery
50 pediatric ophthalmology units in district hospitals
Screening for diabetic retinopathy in all diabetics
Screening for glaucoma in pts aged greater than 35 yrs
Basic refraction services available in all districts
4000 vision centres with optometrist/ophthalmic assistant/refractionist
Low vision centres at 50 centres of excellence/tertiary centres
25 fully functional,accredited safe eye banks
MMR replace measles,coverage >60%
75% coverage for regular vit A supplementation
155
Cataract blindness control project is supported by
World bank
156
3/5 initiative
Providing ART to 3million people with HIV in developing countries by end of 2005
157
3/5 initiative was announced by
WHO and UNAIDS
158
Opportunistic infections diagnosis is done in which labs
Intermediate and central labs
159
Tests done in peripheral lab
Rapid HIV test
Hb estimation
TB microscopy
Pregnancy test
160
Tests done in intermediate lab
```
Peripheral lab tests
Total blood count
RFT
LFT
Total lymphocyte count
CD4 count(NFC)
2nd HIV detection test
```
161
Tests done in central lab
```
Intermediate lab tests
CD4 count(FC)
EQAS for FC
resistance studies
Viral load
```
162
Screening tests for HIV
ELISA
RAPID
SIMPLE
163
Screening strategies for HIV
S1: either one of 3 tests,done for screening donors before blood transfusion
S2: two of three tests,done for persons with AIDS defining illness
S3: all three tests done for screening of asymptomatic HIV pts
164
Man is the definitive host for
```
T.solium
T.saginata
Trypanosomiasis
Wucheriria bancrofti
Drancunculiasis
Kala azar
```
165
Western blot test detects
Viral core protein p24 and envelope gp41
166
Molecular tests for HIV detection
Nucleic acid based testing(highly conserved regions in gag gene)
RT-PCR
Quantiplex bDNA or branched DNA test
167
Targeted interventions in NACP covers
```
CSW
truckers
MSM
migrants labourers
Street children
Injecting drug users
```
168
Culex species that usually transmits filariasis
C.quinquefasciatus
169
Culex species that usually transmits Japanese encephalitis
C.tritaeniorhynchus
170
NVBDCP covers
```
Malaria
Filaria
Dengue
Japanese encephalitis
Leishmaniasis
Chikungunya
```
171
Plasmodium falciparum containment programme was developed with assistance from
SIDA(Swedish international development authority)
172
Role of SIDA in India
Support to national tuberculosis control programme
173
Role of DANIDA in India
Denmark
| Supports National blindness control program
174
Fever treatment depots
Collection of blood samples
Giving presumptive treatment
Impregnation of bed nets
Promotion of larvivorus fishes
DRUG distribution centres do all the above except collection of blood samples
175
Insecticide spray based on API
API>2
Regular insecticide spray at interval of 6 weeks
DDT 1g/sq.m two rounds(Non refractory to DDT )
Malathion 2g/sq.m three rounds(refractory to DDT)
Pyrethroids 0.5g/sq.m two rounds(refractory to malathion)
API less than 2
Focal sprays if Pf occurs in the area
189
National tuberculosis programme
1962
