FMGE Community Medicine (Psm) Flashcards

24 sample cards from the Community Medicine (Psm) deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. What are the main components/services of the Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) strategy?

   It is the continuum-of-care approach covering: Reproductive health, Maternal health, Newborn health, Child health, and Adolescent health, plus the +A (adolescent) component, linked across life stages and levels of care.

2. What are the three core principles/dimensions used in health planning, and what is the typical duration of a Five-Year Plan?

   Health planning addresses availability, accessibility, and acceptability/affordability of services through assessment, priority-setting, resource allocation, implementation and evaluation. Five-Year Plans traditionally ran 5 years (planning now under NITI Aayog since 2015).

3. What body replaced the Planning Commission of India and in what year?

   NITI Aayog (National Institution for Transforming India) replaced the Planning Commission in 2015.

4. Describe the three-tier rural health care delivery system in India with population norms (plains).

   Sub-Centre: 1 per 5,000 population (3,000 in hilly/tribal). Primary Health Centre (PHC): 1 per 30,000 (20,000 hilly/tribal). Community Health Centre (CHC): 1 per 1,20,000 (80,000 hilly/tribal), serving as first referral unit.

5. What is the staffing of a Sub-Centre and a PHC in India?

   Sub-Centre: one ANM/MPW(F) and one MPW(M), now upgraded to Health & Wellness Centre with a Community Health Officer (CHO). PHC: one Medical Officer plus 14 paramedical/other staff.

6. Which international agency is the directing/coordinating authority for international health within the UN, and in what year was it established?

   The World Health Organization (WHO), established on 7 April 1948 (World Health Day), headquartered in Geneva; its supreme body is the World Health Assembly.

7. Match these international agencies to their primary health roles: UNICEF, UNFPA, and the World Bank.

   UNICEF: child health, nutrition, immunization and welfare. UNFPA: population, reproductive health and family planning. World Bank: major funder of health/development programmes and investments.

8. Define out-of-pocket expenditure (OOPE) and catastrophic health expenditure.

   OOPE is direct payment by households for health care at the time of use. Catastrophic health expenditure occurs when OOPE exceeds a threshold (commonly 10% of total household income or 40% of non-food/capacity-to-pay expenditure), pushing families toward impoverishment.

9. What is Ayushman Bharat (PM-JAY) and the insurance cover it provides?

   Ayushman Bharat has two components: Health & Wellness Centres (comprehensive primary care) and PM Jan Arogya Yojana (PM-JAY), which provides health insurance cover of Rs 5 lakh per family per year for secondary and tertiary hospitalization to eligible poor families.

10. What is the recommended minimum quantity of water per capita per day for domestic use, and what is the acceptable residual chlorine level in piped drinking water?

    Minimum ~150–200 litres per capita per day for urban domestic use (40–50 L bare minimum). Free residual chlorine should be 0.5 mg/L after 1 hour of contact time.

11. What is the principle of the 'horsfall' calculation / dose of bleaching powder for water disinfection, and what is the available chlorine content of fresh bleaching powder?

    Fresh bleaching powder contains about 33% available chlorine (deteriorates on storage). The chlorine demand is found by the Horrocks apparatus, and the required bleaching powder dose is calculated to leave 0.5 mg/L free residual chlorine.

12. Differentiate the night-soil/sewage disposal methods: name two safe excreta disposal methods for non-sewered areas.

    Sanitary methods for unsewered areas include the bore-hole latrine, dug-well/pit latrine, water-seal (RCA/sanitary) pour-flush latrine, septic tank, and aqua privy. The sanitary barrier prevents faecal contamination of soil, water, food and hands.

13. Classify hospital/biomedical waste by colour-coded bags (India BMW Rules 2016): yellow, red, white, and blue.

    Yellow: infectious/anatomical/soiled waste, chemicals (incineration/deep burial). Red: contaminated recyclable plastics, tubing, IV sets (autoclave/disinfect then recycle). White (translucent puncture-proof): sharps/needles. Blue: glassware and metallic implants (disinfect/recycle).

14. Name the deficiency disorders of: Vitamin A, Vitamin D, Vitamin B1 (thiamine), niacin, and Vitamin C.

    Vitamin A: night blindness/xerophthalmia. Vitamin D: rickets (children)/osteomalacia (adults). Thiamine (B1): beriberi & Wernicke encephalopathy. Niacin (B3): pellagra (3 Ds—dermatitis, diarrhoea, dementia). Vitamin C: scurvy.

15. What are the WHO classifications of acute malnutrition using weight-for-height/MUAC, and the MUAC cut-off for Severe Acute Malnutrition (SAM)?

    Moderate Acute Malnutrition (MAM): MUAC 11.5–12.5 cm. Severe Acute Malnutrition (SAM): MUAC <11.5 cm or weight-for-height < −3 SD, or bilateral pedal oedema. Kwashiorkor (oedema/protein deficiency) and marasmus (severe wasting) are forms of severe PEM.

16. List the four eligible/spacing and terminal contraceptive methods and which is the most effective reversible spacing method.

    Spacing methods: barrier (condoms), IUCD (CuT, LNG-IUS), oral pills, injectables, implants. Terminal methods: vasectomy (male) and tubectomy (female). IUCD/implants (LARC) are among the most effective reversible spacing methods.

17. Define couple protection rate (CPR) and the contraceptive eligible couple.

    An eligible couple is a currently married couple with the wife in the reproductive age (15–45 years). Couple Protection Rate = percent of eligible couples effectively protected against childbirth by any approved contraceptive method (target ~60% or more for population stabilization).

18. What is the demographic cycle / demographic transition, and which of its stages is India currently in?

    The demographic cycle has stages: (1) high stationary (high birth & death), (2) early expanding (high birth, falling death), (3) late expanding (declining birth, low death), (4) low stationary, (5) declining. India is in the late expanding stage (Stage 3), with falling birth rates and low death rates.

19. Define Total Fertility Rate (TFR) and the replacement level of fertility.

    TFR = average number of children a woman would bear during her reproductive life span (15–49) at current age-specific fertility rates. Replacement-level fertility is a TFR of about 2.1; India's TFR has reached around the replacement level (~2.0).

20. Differentiate primary, secondary, and tertiary prevention in the context of occupational disease (e.g. silicosis/lead poisoning).

    Primary: substitution, enclosure, ventilation, PPE, pre-placement medical exams. Secondary: periodic medical examination/biological monitoring for early detection. Tertiary: treatment, compensation and rehabilitation under ESI Act/Factories Act.

21. Name three occupational lung diseases (pneumoconioses) and their causative dusts.

    Silicosis (silica/free silica dust), Anthracosis/Coal-worker's pneumoconiosis (coal dust), Asbestosis (asbestos fibres, also causes mesothelioma), Byssinosis (cotton dust), Bagassosis (sugarcane dust).

22. List the phases of disaster management cycle.

    The disaster management cycle includes: Prevention/Mitigation, Preparedness, Response (relief), and Recovery/Rehabilitation & Reconstruction. (Pre-disaster, impact, and post-disaster phases.)

23. In disaster triage, what do the four colour codes red, yellow, green, and black signify?

    Red: immediate/first priority (life-threatening but salvageable). Yellow: delayed/second priority (serious but stable). Green: minor/walking wounded (can wait). Black: dead or expectant (beyond help/lowest priority).

24. What are the components of comprehensive geriatric assessment / key health concerns of the elderly (the geriatric giants)?

    The geriatric giants are Immobility, Instability (falls), Incontinence, and Impaired cognition/memory (the 4 I's), with assessment of medical, functional (ADL/IADL), psychological and social domains. The National Programme for Health Care of the Elderly (NPHCE) addresses these in India.

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