S8, E4 - Communicable and non communicable diseases

[00:00:01]Hello everyone, namaskar and a very warm welcome to the season 8 episode number four. Today we talk about the communicable disease and non-communicable disease. Of course this topic is a pretty important topic. It is uh actually a fivestar MCQ for topic for your exam because of course we are going to talk about a little bit about microbiology, pharmarmacology and here and there uh like left and right uh things will be there from communicable disease, non-communicable disease and so on.

[00:00:30]So MCQ number one match the trials or the programs with their objectives. So which are the trials like which are for communicable and non-communicable diseases MRI Jigan Monica Gvas and vital study. So beta please note that what are these study designs? If we talk about the first one that is the MRF trial. MRF trial it is to reduce the cardiovascular mortality and that is multiple risk factor intervention trial that is for uh cholesterol, BP management, smoking, cessations and so on. The second program that is there that is a very important program for government of India that is the J vigan mission. The JVAN mission it is for rheumatic fever and uh to understand the four important things that is the pathology of rheumatic fever, prevalence of rheumatic fever, prevalence of streptovocal infection and also to introduce or to work upon vaccine development. India is one of the few countries which are working for vaccine development for rheumatic heart fever. The third one is Monica trial.

[00:01:33]Monica trial is for monitoring the trends and determinants of cardiovascular disease. It's a WHO global project and it is to find out like uh what are the trends and determinance of uh cardiovascular disease. Gvas study it is a global study. It is a genomewide association study GVAS. So it is uh to study the association of uh various genotypes or or genotypic mutations uh along with non-communicable disease like insulin resistance, metabolic syndrome, type 2 diabetes, obesity, cancer even and this is what is a use of a genomewide association study. It's a it's a big trial global study. Last one that we have is the vital study. vital studies for vitamin D and omega3 fatty acids.

[00:02:22]It's a large clinical trial to find out the role of vitamin D as well as omega-3 fatty acids for cardiovascular diseases for two important conditions cardiovascular disease and cancer. So for cardiovascular disease and cancer.

[00:02:36]So if you just get all these. So MR fit is for what? MRFIT one will go with the decreasing cholesterol. One will go with B. Two will go with rheumatic fever that is option D. Three goes with Monica that is to assessment and trends that is A.

[00:02:55]JVA study is to have a genomic study that is E and vital study is for five is C. So 1 B 2 D 3 A 4 E 5 C that is the correct answer for you guys to mark in the exam. Let's go to the next one. All are true regarding tracking of blood pressure except done in young children.

[00:03:16]Objective is to diagnose hypertension.

[00:03:18]Concept is to prevent hypertension. It is a primary level of prevention. So please note that tracking of blood pressure. This is a frequently asked MCQ that tracking of blood pressure. It is done in young children and the objective is to prevent hypertension. So prevention of hypertension and it is done in young children. That is correct answer. We want to maintain we want to maintain a low blood pressure. Maintain a low blood pressure in uh all children so that they have a habit or they have a tendency to maintain the lower blood pressure. So obviously it becomes a primary level of prevention because you're preventing the disease. So obviously objective is to diagnose hypertension. That is incorrect because this one talks about a secondary level of prevention and it is the false one.

[00:04:05]So option B is the only one which is the best one for you guys to mark. Question three. The characteristic incubation period for measles from exposure to the onset of prodal fever is typically how many days? So if you just generally talk about like measles has incubation period which is ranging from 8 to 14 days. The lowest could be 7 days. It could maximum be 21 days. But the median incubation period we generally say 10 to 14 days.

[00:04:34]The median incubation period we generally say is 10 to 14 days. That is for chickenpox. However, I would also like you to remember for chickenpox, for measles and uh also for reubella, influenza, hepatitis A, uh maybe scabies, COVID 19, these are frequently asked MCQs. Influenza is the only disease which has the lowest incubation period among the all the communicable diseases like rapidly communicable disease. So generally like 21 to 28 days, 1 to 2 months. So obviously it's a factual MCQ. You are going to mark 10 to 14 days as your single best answer.

[00:05:13]Which of the following statement is not correct for polomiitis?

[00:05:17]Polomiitis uh 5 to 10 cases percent of cases are abortive polio. So what do we want to find out? We want to find the not correct one. Last case of polomiitis was in 2012 for P2. Balent is pink color. It contains P1 P3. VAP is due to immune response. So which of the following you think is not correct incorrect? So beta if you talk about polomiitis as far as I I'm sharing my flash card with you. So if you like this is full polomialitis you can remember in just 30 40 seconds. So last cases of polomiitis they were from Uttar Pradesh Jarkand or West Bengal. The last case as you can see was in 2011 from West Bengal. Most epidemics are due to polio one and the VDPV vaccine derived polio viruses they are because of mutations and they may communicate in people. On the other hand the vaccine associated paralytic polio these are random immune responses by the host and uh they are taken as the side effect of oral polio vaccines. The biolent contains both P1 and P3. Whereas the FIPV has all three that is P1, P2 and P3. All three are there in polomiumitis. So please remember this is a frequently asked MCQ that WDPV is vaccine VAP is a vaccine associated paralytic polio whereas WDPV is vaccine derived polio viruses. Polio viruses are due to mutations whereas the VAP is due to random immune response. So which of the following you think is not correct? So five to 10% cases yes this is correct answer. Last case was 2011 yes correct answer but not for P2 strain it was for P1 strain. So this is the false one. Balent OPV contains P1 P3 true VAP is due to immune response. That is true. Option B is the best one for you guys to mark. Question five. A patient from rural area presents with cyclical paroxisms paroxisms of fever cold stage hot stage sweating stage occurring every 48 hours which plasmodia species is most likely to cause this vivax faliparam malaria or oale well it's a very age-old MCQ frequently asked from microbiology so please remember which are the tersian malaras tertian malarias are which will have fever every alternate day so there'll be day one there'll be day three there'll be day So tersian malaria is for plasmodium vivax as well as oale sorry plasmodium vivax oale and also for plasmodium falsiparam. The ywax is called as benign tertian malaria and the plasmodia is called as malignant. So oale beta it is absent in India. It does not it is not there in India and therefore o we normally generally don't talk. So these are benign tersian malarias and day 1 3 and five plasmodium vivax and malignant tertian malaria is plasmodium falsiparam. Now the fever periodicipity in falsiparam that is also around 36 to 48 hours but the key point is that there is often irregular fever cycles.

[00:08:31]Plasmodia malaria is quatron malaria every 72 hours and noelc is every 24 hours. So if you look at the MCQ a whale could be the correct answer but a whale we don't have in India not found in India. So which is the single best answer for you guys to mark that is plasmodium Ywax is the single best answer which of the following is not correct for rabies profile axis raies it is a 10star MCQ every year they ask you lot of questions on rabies make sure that you study the full topic on rabies and go for your exam.

[00:09:05]So which is not correct? You have to find the wrong one. It is a secondary level of prevention in case of animal bites. ARV is given in both category 2 and category 3. Rabies imunoglobilin is not recommended in reexposure. Wound washing should be done for 15 minutes with soap and water. So which of the following you think is the wrong one?

[00:09:28]Which is the correct one? What do you think is happening over here? So if you talk about rabies beta, rabies is a pretty important disease. So one is that there are three categories. ARV is given to category 1 and category 2. This is a true answer. Rabies imunogloblin is never recommended in reexposure.

[00:09:47]Reexposure is given on day zero and day three. It can be intradermal or intramuscular injection and no rabies imunogloblin is included into it. There is no rabies imunogloblin which is included into it. Wound washing should be done for 15 minutes. This is also true answer. Well, it is not a secondary level prevention beta. That is the incorrect answer. That is the incorrect option. It is not a secondary level of prevention. It is actually a primary level of prevention. Why do we say primary? Because we are going to prevent the disease. Prevent the disease. So what is the disease we are talking of over here? The disease is rabies. So you are preventing the disease. Option A is the single best answer for you guys.

[00:10:33]Which of the following is not a target for NCD road map 2023 till 2030? So this is kind of an update for you. This is many students will be marking this wrong. So this is an update for us and uh there is a new uh uh NCD global road map 2023 till 2030 15% reduction in activity levels 33 in premature 20% in alcohol 50% reduction in hypertension.

[00:11:01]So you have to find the not correct one.

[00:11:04]Please note that as per the recent road map 2023 2030 this is the update that all those which are which are there in these boxes these boxes these things have been updated by the WHO these things have been updated by who that is the physical inactivity level to be having 15% reduction earlier it was uh 10% reduction premature mortality earlier it was 25% reduction now it is 33% reduction harmful use of alcohol bit last time before this it was 10% reduction now it has taken as 20% reduction so please remember these are the three things which are updated for you guys so in all the global health programs in non-communicable disease you can just update this information in your copies in your books in your notes and uh 15% this is true true and true 50% reduction in hypertension is incorrect one that is the single best for you guys to mark Coming to next one, which of the following is not correct for hookworm infections? Again, a very important three-star MCQ exam point. So, which is not correct for hookworm infections?

[00:12:14]Eggs are the infective form associated with chronic blood loss and humans are the reservoir lives in soft porous soil.

[00:12:21]So, which of the following you think is not correct? You have to find the wrong one. So if you just look at hookworms beta hookworms we are talking about enkyostoma dudinel or necatar americananis and uh there is it is associated with chronic blood loss. This has been asked multiple times in your exam. It is uh the one which is associated with chronic blood loss.

[00:12:43]Please remember most common soil transmitted is escariasis.

[00:12:47]But most common to be associated most common to be associated with chronic blood loss or anemia that is hookworm.

[00:12:55]Larva are the infective form. Why?

[00:12:58]Because the eggs will be there in the soil and eggs will hatch into larvae.

[00:13:02]Human will have barefoot walking barefoot walking in the in the fields and open defecation. So the larvae which are there in the soft porous soil. Larva which are there in the soft and porous soil.

[00:13:17]the larvae will will like uh penetrate through this human skin and enter into the blood and they may cause larvae migrants. The drug of choice we have for hookworms is alendazole. National deworming days we have 10th of February and 10th of August every year. So these are we give alendazole tablets to everyone to all the children to everyone for combating hookworm infections. So if you get this eggs are the infective form. Option A is itself the wrong answer. It is the larvae which is the infective form. Please remember eggs are the infective form. Eggs are the infective form but not in hookworm. They are there in escarases. Esserasis the infective form is egg. So it is associated with chronic blood loss.

[00:14:05]Humans are the reservoirs live in soft porous soils. All are true answers.

[00:14:10]Option A is the single best answer for you guys to mark. Question number nine, which of the following is not correct for typhoid? So that's again a tricky MCQ, important MCQ. Persons are infectious as long as the baseli appearance too. Fecal carriers are the more common type of carriers than the urinary carriers. Males have more carrier stage than females and indicators for the typhoid is the indicator for sanitation level in the community. Which of the following you think is the not correct? You have to find the false one. So just let's have a look at typhoid, salmonella, typhi, paraty. Please remember that the cases as far as the typhoid diseases, it is more in males compared to females.

[00:14:54]Whereas if you talk about the carrier stages, it is more in females compared to males. This is an important distinction. What is the peak age? Peak age is adolescent age group from 5 to 19 years. like it includes early like um pre-adolescent age group as well plus the adolescent age group. Most common carriers these are the fecal carriers compared to the urinary carriers and in typhoid the chronic carriers may shed the baseli even for more than one year.

[00:15:24][snorts] There are a lot of healthy carriers, chronic carriers, all types of carrier stages. All carrier stages are available or seen in typhoid.

[00:15:32]Transmission is of course everybody knows fural and mostly during the monsoon or the rainy season. management is by third generation syphalosporin sephix or uh quinolones or carriers can also be treated by penseline like agents amoxideline penseline proenicid for 6 weeks and choleiccystctomy and ampecylene is uh is like recommended for all the carrier stages. So if you just get this persons are infectious as long as the baseli appear in stools. We just now heard that fecal carriers are more important than the urinary carriers.

[00:16:07]This is true answer. Fecal is more important than urinary. This is also true. Males have more carrier stage. No, males have more like females have more females have more carrier stages. This is the only option which is the incorrect one. Option C is the wrong one. Indicator of sanitation level. Yes, this is a correct one. So also important is about the typhoid vaccine. Just two points about the typhoid vaccine. One we have is a oral ty ty typhoral we have is oral ty 21a oral ty 21a it is given in three doses of course we don't use it very often these days because we have some better vaccines but oral ty is given in three doses given on day 1 3 and five and uh proanel and antibacterial drugs are stopped from 3 days before giving the oral ty 21s so this is the standard vaccine which we were giving. Now we have some better vaccine that is a vi polyaccharide vaccine which is applicable for age more than 2 years. It is may be given in one to two doses. So you can give it in one to two doses and protection will start after 7 days. Now there is an update there is another third vaccine. So you learned about the typhoral vaccine the polyaccharide. Now there is a third vaccine which is there.

[00:17:28]This vaccine is called as a TCV vaccine.

[00:17:32]Typhoid typhoid conjugate vaccine. Typhoid conjugate vaccine. It's a very good vaccine. It's a very safe vaccine.

[00:17:41]Usually uh effective as a single dose and it is it has more than 85 to 90% effectivity. So typhoid vaccines are also uh typhoid conjugate vaccines are also available these days. Coming to question 10. Which of the following categories is on first priority for vaccination in cases of reubella outbreaks? So first priority in case of reubella outbreak. See reubella beta it's a self-limiting it's a self-limiting mild illness. It's a self-limiting mild type of illness. And uh this rebella whenever it uh it affects in large population in large communities we have to prioritize the vaccine should be given to some special group. Please remember the reubella vaccine. The vaccine which is available for reubella it is RA 27 by3 and I hope you remember it's a live vaccine. Because it is live vaccine common sense it is contraindicated to the pregnant female.

[00:18:42]So obviously option one is obviously the wrong answer. It is not the first priority. The first priority is always given to females in the reproductive age group and we have to ensure that the female are nonpregant. You have to ensure that the female should be nonpreg. There should be a minimum more than 1 month gap. There should be a gap between giving the reubella vaccine and once the female may get pregnant. WHO and CDC WHO and CDC recommend 3 months gap but in government of India they just say like anything more than 1 month gap is good enough. So 14 to 25 year of female it's not uh required. Uh the adults and girls yes they are the second priority. So what is the first priority?

[00:19:30]all the WRF females. After this we give to adolescent girls and after this we give to age less than one year children as well.

[00:19:41]So this is the vaccine strategy beta.

[00:19:43]This is the vaccine strategy for reubella which you have to remember.

[00:19:48]Let's go to the next one. So which statement is correct for dtheria?

[00:19:51]Dtheria is age-old MCQ. See it's very important that as you are preparing for your neat exams it is very important for you to understand that you have to go through 5 to 7 years of the PQs at least 5 years PSM meth at least 5 years you should do for all other topics like medicine surgery pathology pharmacology physiology at least do five seven years 7 years is good enough but at least do five years PSMA at least 5 years topics should be done and dtheria reubella rabies is one such like age old topic They keep on coming every now and then.

[00:20:25]So coming to this MCQ question 11. Which statement is correct for dtheria management? That is given that what is that? That is dtheria antitoxin.

[00:20:35]Dtheria antitoxin.

[00:20:38]So dtheria antitoxin is given to all cases in dtheria with age more than 5 years. So you have to find the correct one. You have to find the correct one.

[00:20:48]Healthy carriers are common in dtheria.

[00:20:50]Dtheria vaccine is given to all contacts who had had vaccine more than two years ago. 5 days of oral ariththramycin is drug of choice for contacts of dtheria.

[00:21:01]So which of the following you think is the correct one.

[00:21:06]So one thing is very simple that when we are treating a case of dtheria beta the dtheria antitoxin that is the standard regime. This is the drug of choice. This is the drug of choice. This is the drug of choice which has to be given dtheria antitoxin because that is the main thing. Now there is no age limit for this. It can be given to any age group.

[00:21:27]It is kind of a safe treatment we have.

[00:21:29]Now the antibiotic of choice these are two separate questions. The antibiotic of choice in dtheria that is penicellin G which should be given for at least 2 weeks. We should also do serial cultures. Why do we do serial cultures?

[00:21:42]Because the dtheria cases they have to be isolate till two negative throat cultures till two negative throat cultures 24 hours apart. So we have to isolate them. And of course dtheriatoxide you give it after the patients have recovered in convolesccent phase in carriers. Yes the drug of choice is oral ariththroycin but it is not for 5 days it is to be given for 10 days. So if we just come back to this that is given to all cases of dtheria age more than 5 years that's wrong answer it's false answer healthy carriers uh dtheria 5 days oral ariththroycine is drug of choice this is also a false answer okay so two points are done coming to the other part like what to do in case of contact so in case of contacts beta we have to give antibiotics oralithroycin for again 7 days and dtheria toxoid has to be given whenever the patient has taken more than 5 years. In case within 5 years no vaccine more than 5 years we have to give a single dose of dtheria and in case the person has taken less than three doses or still in the taking the primary doses of course you have to complete the immunization. So if you just get this point dtheria vaccine has to be given to contacts of dtheria who had taken vaccine more than 2 years ago.

[00:22:59]No this is not 2 years ago it is actually 5 years ago. So this is also a false answer. Healthy carriers are very common in dtheria. This is a correct answer. This is the true answer. Please note healthy carriers.

[00:23:13]The classical example you have to remember is community medicine is DPT.

[00:23:19]CMDPT. What is CMDP? Cola menitis, dtheria, polio and typhoid. Cola menitis, dtheria, polio, typhoid, cmdp.

[00:23:28]These are the examples typical examples of healthy carriers that we have. So option B is the single best answer for you guys to mark. Question 12. Which of the following statement is not correct for a match for ricketettsial disease? Q fever no vector. Endemic typhus is fleeborn. Epidemic typhus is lousborn.

[00:23:48]Scrub typhus is tickborn. So which one do you think is not correct? You have to find the false one. I think yeah false one. So there's a very important table.

[00:23:58]This is again a 10star important table.

[00:24:00]Make sure you study ricketettial disease for your exam. So one type of MCQ they will ask you is like what is the disease and what is the causitive agent. So remember this table. Next is if you look at all the vectors beta there is only one ricketettsial disease which is a fleborn and there is only one disease which has no vector in uh sorry there is only one disease which has no vector for for infection that is Q fever. If you talk about the reservoirs, humans are the main reservoirs in trench fever and humans can also be the reservoir in epidemic typhus. These are some very frequently asked MCQs. So if you just get this that Q fever has no vector, this is true. Epidemic typhus is lousborn. True. Endemic is fleborn.

[00:24:46]True. Scrub typhus is not tickborn beta.

[00:24:49]Scrub typhus is a mightborn illness. So scrub typhus is a might transmitted illness. It is not through tickborn. So obviously option D is the single best for you guys to mark. Coming to question number 13. Which of the following statement is not correct for measles outbreak? Now measles outbreak we recently had measles outbreak in few of the neighboring countries from India and uh there were medical aid and vaccine aid which was given to these countries.

[00:25:19]So measles is again kind of a you can say I don't know twostar MCQ for your exam. All cases of measles should be isolated for 7 days after the onset.

[00:25:30]Most common complication is otitis media. Give me misel vaccine to all children in the area whose age is below 15 years. Meisel's imunoglobulin should be given to pregnant females. So what do you want to find out? You actually have to find the not correct. You have to find the false one. So all cases to be isolated for 7 days. This is true answer. Most common complication is otitis. This is true. Rare and serious complication is SSP. Please note it is SSP subaccute sclerosing panensifphilitis. That's not the most common complication. It is a kind of a rare and u but serious complication.

[00:26:08]Yes. So option A is true. Option B is also true. Give me vaccine to all children in area who are below 15 years.

[00:26:17]This is wrong answer. Why wrong answer?

[00:26:20]I'll just explain to you that do you know that measles vaccine beta do you know that measles vaccine whenever measles outbreak is there in case of measles outbreak the first thing that we have to do is isolate the cases they should be isolated for 7 days after the onset of rash. Second is we have to give a measles vaccine zero dose. Please note that this is a zero dose. We have to give a measles vaccine zero dose to all children whose age is 6 months to 9 months of age. It is given to 6 months to 9 months of age. Why 9 months of age?

[00:26:57]Because uh we are already giving we are proud of this that the misel zobella first dose is already to be given at 9 months of age. So a measel vaccine zero dose is given at 6 months to 9 months of age. And please note misel rebella vaccine the first dose will be given will be given as per age will be given as per age but with a gap of with a gap of at least 4 weeks between the measles vaccine zero dose and the mr first dose.

[00:27:30]So option c that is the measles vaccine is given to all children in area age age more than below 15 years that is incorrect answer. It is not below 15 years. It is 6 months to uh 9 months of age. So option C is the best one for you guys to mark. And coming back to option D, measel's imunoglobulin should be given to pregnant females. It should be started within 72 hours of exposure. It should be given within 72 hours of exposure to all pregnant females. This is also a true option. So obviously option C is the single best one for you guys to mark in your exam. Question 14.

[00:28:08]An OT technician comes to your OPD with a history of clean cut. So there is a clean cut by sterile surgical blade one day ago while preparing the OT prior to surgery. He also remembers taking the TT vaccine 6 to 7 years ago. Which of the following is the best recommendation? So no TD vaccine as he has received last dose TD vaccine today. Give two doses with a gap of 4 weeks or give TD vaccine with imunogloblin. Which of the following you think is the correct answer? So if you talk about tetanus uh toxoid vaccination schedule that we have in India. So in India we have categorized these patients into category A B C and D. Category A is who has taken vaccine within 5 years. B is vaccine within 5 to 10 years. C is vaccine more than 10 years and D is unknown or never immunized.

[00:28:59]So you don't need a vaccine below 5 years. 5 to 10 years in case of clean wound beta no vaccine. But in case of unclean wound we give one TD vaccine.

[00:29:09]More than 10 years clean wound or unclean you have to give a vaccine. In unclean you also need to add a tetanus imunogloblin if the vaccine was more than 10 years ago. And unknown you obviously have to complete immunization with tetanus imoglobulin or without. So now if you understand this what is the best one for you guys to mark. So this OT technician comes to you with a history of clean cut by sterile blade one day ago. The main key feature over here was 1 day ago. Of course, many of you must be thinking that it is no vaccine is required as he has received the vaccine within 10 years. So over here uh obviously it is a clean wound or unclean wound that is what you have to decide. So because the vaccine the wound was there one day ago please note this is categorized as unclean wound. It is categorized as unclean wound. So what is the criteria to be called as unclean wound? It is any wound. Any wound which is contaminated that is called as unclean. And what is a clean wound?

[00:30:13]Clean wound is any wound which is due to with a sterile instrument.

[00:30:18]And it also presents within 6 hours.

[00:30:21]That 6 hours time duration is very important because after 6 hours we assume that the wound will become contaminated. So any wound which is after 6 hours it is called as contaminated wound. So of course this patient has uh done uh has got his vaccine 6 to 7 years ago. So he will be into category B and he will be given one TD vaccine because it is an unclean wound. So option uh B is the single best answer for you guys to mark in your exam. Coming to question number 15.

[00:30:54]Which of the following is not correct for a Chandipura virus? Chandipura virus it's an emerging disease a reemerging disease which we have seen in some of the rural areas in India. So it was seen in 2023 2024 2025 there are like here and there scattered cases which sporadic cases of chandura virus uh infection which we might see from rural areas. It usually affects so you have to find uh what uh the not correct you have to find the false one. So usually affects 25 to 45 year age group. Short incubation period transmitted by flabotamus argentipus has clinical symptoms in including neurological complaints and high case fatality rate. So if you talk about a chandura virus beta chundipura virus has shown to have explosive outbreaks in India. The key vectors for this is we we assume that there are multiple vectors through it like ticks could be there, mosquitoes could be there or sand flies could be there. The classical presentation could be with headache, altered sensorium but most commonly it is associated with neurological fe features like convulsions and along with fever. Now this uh target population for the Chandipura virus that is important. It is seen in children aged less than 15 years. The investigation of choice that is RTPCR. RTPCR is the investigation and the treatment is symptomatic treatment just to take care of any brain edema manitol can be given and just symptomatic management has to be there.

[00:32:29]So this chandibura virus it is a member of the rabdovid family. It's a negative sense RNA genome. So it is from rural areas. So usually affects 25 to 45 that is incorrect. It usually affects younger children less than 15 year age group. So obviously option A is the is the incorrect one. It has short incubation period. This is true. It is it may be transmitted by sandfly or the phabotamus argentipus. That is also true. And it has uh clinical features with neurological complaints. That is also true. So obviously option A is the single best for you guys to mark in your exam. And with that thank you so much for watching this whole module. Keep on revising and study hard for your exam.

[00:33:10]All the very best beta. Take care.

[00:33:12]Bye-bye.