1. Most important reason for recommending oral polio vaccine in the polio eradication campaign
despite availability of a safe injectable vaccine that, it
a) Provides 90% immunity in one dose
b) Does not interfere with vertical
immunity
c) Has been donated by WHO
d) Provides herd immunity
2. A 5 year old child comes to the immunization centre without BCG scar on his arm; what would
you prefer?
a) Give BCG vaccine
b) Perform mantoux if positive then
give BCG
c) No need of BCG
d) Perform mantoux if negative then
given BCG
3. A woman reports for vaccination against tetanus only 25 days before delivery; she has not
received the first dose what will you do?
a) Give anti tetanus immunoglobulin
b) Give two doses of tetanus toxoid with 2 weeks interva
c) Advise appropriate antibiotic course during delivery
d) Give one dose of tetanus toxoid and advice the second dose after delivery
4. A woman in the seventh month of pregnancy reports to you in the antenatal clinic for the first
time. The recommended immunization is by:
a) Tetanus toxoid
b) Hepatitis B vaccine
c) Rubella vaccine
d) Pneumococcal vaccine
5. A doctor was attending a patient suffering from Hepatitis B; he accidentally got a prick from a
contaminated syringe for maximum preventive use of Hepatitis B Immunoglobulin (HBIG), it is
given as:
a) 0.5 ml / kg body weight within 2 hours
b) 0.5 ml / kg body weight within 24 hours
c) 0.06 ml / kg body weight within 3 days of exposure & repeating after one month
d) 0.06 ml / kg body weight preferably within 3 days
6. A mother brought her six weeks old child to an EPI centre for routine immunization. She was
enquired about history of Epilepsy in the family and febrile fits. The doctor took this history to
avoid complication with:
a) Diphtheria toxoid
b) Tetanus toxoid
c) Hepatitis B vaccine
d) Pertussis vaccine
7. A conference is being held for prevention of haemorrhagic fever in our country. The people
from South Africa are also invite your opinion as a health expert is sought regarding transmission
of prevalent infection in South Africa to Pakistan. The infection that you should be most
concerned about is.
a) Dengue fever
b) Typhus
c) Hay fever
d) Yellow fever
8. An M.S student of Wah Medical College got an accidental prick while drawing blood of hepatitis
B positive patient. He had completed his course of immunization against hepatitis B last year.
What would you recommend for him?
a) Booster dose of HB Vaccine
b) Single dose of passive immunization
c) Both active and passive
immunization
d) Two doses of immunoglobulins 30
days a part
9. A forty years old guard of forestry presented in emergency with complaint of dog bite on his
left leg. On examination a deep transdermal wound was found. He gave history of completing
the course of immunization against rabies last year. His serum antibody titre was > 0.5 IU/ml of
blood. What would you advise?
a) Complete course of active immunization & passive immunization
b) Only passive immunization
c) Two booster doses of HDC vaccine
d) Three booster doses of HDC vaccine + RIG
10. A 20 years old lady read an article in a newspaper on vaccination against tetanus. She is very
conscious of herself being vaccinate The best schedule that you would suggest for her at this age
is:
a) Single dose of TT
b) Two doses of TT one month apart
c) Two doses one month apart with
booster after five years
d) Five doses of TT
11. A 30 years old man went in Benazir Bhutto’s rally at Rawalpindi, where in a suicidal attack he
got a penetrating injury on his leg. The emergency treatment was given. His immunity status
against tetanus is not known. The required anti tetanus measures are
a) Toxoid one dose
b) Toxoid one dose + TIG
c) Toxoid complete course
d) Toxoid complete course + TIG
12. A primigravida came for antenatal. Her base line investigations along with screening for
Hepatitis B and C were done. She was diagnosed HBV positive. What measure would you suggest
to prevent the infection in her child after delivery?
a) Active immunization only
b) Active & passive Immunization
c) Only passive immunization
d) Chemoprophylaxis
13. A 6 weeks old boy came for DPT, polio & HBV vaccination. He was given initial doses of all and
was called after 4 weeks to have the next doses. The likely reason for calling him again was:
a) Loss of immune memory
b) Stimulation of macrophages
c) Summation of immune responses
d) Replication of lymphocytes
14. A GP purchased BCG vaccine for his clinic. He should store this vaccine at his clinic in:
a) A dark place
b) Deep freezer
c) Water carrier
d) Refrigerator
15. A mother brought her four year old child to the doctor. She gave the history that her child
was in close contact with a case of diphtheria in school. She was very anxious about her child and
gave history of booster dose of DT 2 years ago. What would be line of management for such a
child?
a) Booster dose of DT with penicillin
b) Active and passive immunization
c) Active and passive immunization with chemoprophylaxis
d) Only keep under surveillance for 1 week
16. A General Practitioner purchased BCG vaccine for his clinic He should store this vaccine at his
clinic in
a) A dark place
b) Deep freezer
c) Water carrier
d) Refrigerator
17. A 5 years old boy is brought to the emergency department with history of dog bit Examination
revealed multiple transdermal bites on left leg. The best management for such a patient is:
a) Anti-rabies serum, suturing of wound, TT
b) Anti-rabies serum, suturing of wound, Vaccine
c) Vaccine, leave wound open, TT, ARS
d) Vaccine, leave wound open, TT
18. 1 year old child is being treated in Shaukat Khanam Hospital Lahore and getting radiotherapy
for carcinoma. A polio case has been detected in his residential locality. Pediatrician decides to
protect him against poliomyelitis by giving:
a) Human normal immunoglobulin
b) Human specific immunoglobulin
c) Oral polio vaccine
d) Inactivated polio vaccine
19. Most important reason for recommending oral polio vaccine in the polio eradication
campaign despite availability of a safe injectable vaccine is that, it:
a) Provides 90% immunity in one dose
b) Does not interfere with vertical immunity
c) Has been donated by WHO
d) Provides herd immunity
20. A 6 months pregnant lady comes for antenatal checkup for the first tim Her baseline
investigation and screening for HBSAG and Anti HCV was don On screening she was found to have
HBSAG. What would you prefer for this lady?
a) Active and passive immunization
b) Passive immunization
c) Active immunization
d) Advice for active and passive immunization of the baby at birth.
21. In Sir-Syed Model School a student of class 3 developed measles. The child was isolated from
rest of the class. The school medical officer advised for the contest of this child:
a) Active immunization within 3 days
b) Passive immunization
c) Chemoprophylaxis
d) Isolation
22. A primigravida delivered a baby boy in the obstetric ward of POF hospital the doctor referred
the baby on the same day to the EPI centre for vaccination of:
a) BCH only
b) BCG OPV
c) DPT only
d) DPT HBV +OPV
23. The population living in Wah Cantt is using water from a deep spring, which is considered to
be relatively free from organic contamination but rich in calcium bicarbonates and sulphates. On
account of properties that spring water has, protects people from:
a) Gastroenteritis
b) Ancylostomiasis
c) Atherosclerosis
d) Renal problem
24. A well was present in a rural area where an unsanitary bore-hole latrine with lots of flies was
present within 10 feet of distance. The disease more likely to be transmitted through drinking
this well water is:
a) Leishmaniasis
b) Typhoid
c) Dental caries
d) Ancylostomiasis
25. If a child has been drinking water containing 30 mg/L of nitrates the condition likely to occur
is:
a) Infantile Methemoglobinemia
b) E-coli enteritis
c) Botulism
d) Dental caries
26. Required amount of chlorine was added to a large body of water after sedimentation. The pH
of water was 4.0 and level of sulphides was negligible. A contact period of one hour was ensure
Eventually, it was found that chlorination was not successful. The likely reason was:
a) Low pH
b) Less contact time
c) Less amount of chlorine
d) Suspended impurities
27. People of a village reported a high prevalence of bacterial gastroenteritis even after proper
chlorination of water supply for the recommended duration. On water analysis, level of chlorine
in water was 0.01 mg/L and pH of water was 6.5. There were no suspended impurities; levels of
sulphides and ferrous were low. The likely reason of increased bacterial gastroenteritis even after
chlorination is:
a) Low residual chlorine
b) High pH leading to chlorination failure
c) Presence of sulphides
d) Low level of ferrous
28. A water sample was taken from a source where catchment area included a large agricultural
land. It was declared unfit for human consumption on account of raised concentration of a
chemical. The likely chemical which has resulted in making this water unfit is
a) Iodine
b) Calcium
c) Zinc
d) Nitrite
29. During a sanitary inspection of a rapid sand filtration plant, slowing of the filtration rate was
observed owing to loss of head. Which method will you suggest to give head to water in such a
situation?
a) Addition of alum
b) Scraping the top layer
c) Increasing duration of storage
d) Back washing of sand bed
30. You were required to chlorinate well water; you added required amount of bleaching powder
solution to the water and allowed an overnight contact tim What is your recommendation
regarding consumption of this water for drinking.
a) Fit for consumption
b) To be used after 12 hours
c) To be used after another 24 hours
d) Rechlorinate
31. A dental surgeon appointed in rural health centre reports an increased incidence of dental
carries in the children of that are the relevant preventive measure that he should suggest to the
health authorities is:
a) Fluoridation of water
b) Chlorination of water
c) Use of bacterial filter
d) Use of boiled water
32. Chlorination of water was done by addition of bleaching powder solution containing 10%
available chlorine One hour contact time was ensure What is your recommendation regarding
use of this water for drinking?:
a) Fit for consumption
b) Use after 06 hours
c) Use after 12 hours
d) Rechlorinate
33. Water samples from two villages of Punjab were sent to Health laboratory for examination.
Lab reports show fluoride levels ranging from 5.26 to 6.32 mg/lit. Use of this water for drinking
may lead to:
a) Dental caries
b) Dental fluorosis
c) Gingivitis
d) Periodontitis
34. An out-break of scabies was reported in a Kachi abadi consisting of 500 people. The
appropriate preventive measures suggested by you would be to:
a) Filter the water
b) Improve accessibility to water
c) Destroy breeding sites of insects
d) Chlorinate water
35. A sample of water taken from a water storage tank of a residential area was to be examined
bacteriologically. A positive test of water sample by multiple tube method refers to the presence
of
a) Coli-form organisms
b) Fecal streptococci
c) Nitrites
d) Cl. Perfringens
36. An epidemic of gastroenteritis affected more than 500 people in a city. Samples of water were
taken from different sites of the supply system. Bacteriological examination was positive for coli
forms. Chemical analysis of water showed the presence of high fluoride, nitrate, chloride and ph
of 6. Which content is suggestive of water born epidemic
a) Nitrates
b) Chlorides
c) High pH
d) Coli-forms
37. Different agents are used for chlorination of water on large scale. If after chlorination taste
of water is not much altered; level of residual chlorine is more stable and persistent. The likely
agent to be used for chlorination was:
a) Bleaching powder
b) Chlorine gas
c) Chloramines
d) Perchloron
38. In a poor community, there is high prevalence of acute diarrhea cases. The best method for
preventing this health problem in the long run is:
a) Anti-diarrheal drugs.
b) Immunization against cholera and typhoid
c) Provision of sanitary latrine
d) Provision of sanitary latrine
39. Six of the ten family members living in a single room house complain of intense itching with
scratching in axillae, groin and hands; it is more marked at night. The most likely diagnosis is
a) Scabies
b) Dermatitis
c) Eczema
d) Psoriasis
40. In a house consisting of two living rooms, the door and windows are facing each other. This
will provide:
a) Low humidity
b) Aspiration
c) Cross ventilation
d) Diffusion
41. A 12 members family was living in a house consisting of two rooms. Which disease is most
likely to be common in the given situation?
a) Asthma
b) Tuberculosis
c) CA Bronchus
d) Cystic fibrosis
42. A 5 member family was residing in a small house. The available floor space to one person was
30 sq ft. The problem which is more likely to be associated with this available space is:
a) Psychosocial
b) Malnutrition
c) Typhoid
d) Enterobius vermicularis
43. A water sample was taken from a village near Taxila On chemical analysis the fluoride level
was found to be 0.03 mg/lit. The likely effect on the body is:
a) Dental flourosis
b) Dental caries
c) Skeletal flourosis
d) Caries spine
44. A water sample taken from a water storage tank of a residential area was sent for
bacteriological examination in the laboratory. A test of water sample by multiple tube method
was found positive, which referred to the presence of:
a) Coli-form organisms
b) Fecal streptococci
c) Nitrites
d) Fungi
45. An army troop while being transported to Himalayan station had to stay at the altitude of
12,000 feet for 04 days. One of the soldiers developed pulmonary edema. The best immediate
measure to be taken is
a) Antibiotic therapy
b) Suction of pulmonary fluids
c) Artificial respiration
d) Shift the patient to lower altitude
46. A Person working in compressed air chamber presented with symptoms of cough, dyspnoea
and joint pains. This clinical presentation is suggestive of:
a) Pulmonary edema
b) Fat embolism
c) Air embolism
d) Rupture of spleen
47. The atmospheric pressure at earth’s surface close to the sea level averages 760 mm of Hg. If
a man lives at an altitude of 13000 feet above the sea level for few years, the main physiological
effect is
a) Decrease in respiration
b) Increase in concentration of
hemoglobin
c) Decrease in concentration of
hemoglobin
d) Decrease in cardiac output
48. Husband and wife belonging to low socioeconomic status of a village are brought to the
hospital with mental confusion, loss of memory, labored breathing eventually leading to coma.
There is history of using coal fire, what is the most probable diagnosis
a) CO2 poisoning
b) CO poisoning
c) Hydrogen sulphides poisoning
d) Sulphur dioxide poisoning
49. In the “Blake Hole of Kalkata”, 146 prisoners were imprisoned in a room 18x14x10 out of
whom only 23 survive There were two small windows which were adequate to supply all the
oxygen needs – even than only 23 survive What is the most likely cause of death?
a) Decreased oxygen
b) Increased carbon dioxide
c) Increase ammonia
d) Heat retention
50. A survey on air pollution was conducted in an urban area to determine the major contaminant
in air. The major contaminant estimated in all air pollution is:
a) Grit and dust
b) Sulphur dioxide
c) Carbon monoxide
d) Nitrogen dioxide
51. A person presented with hearing loss after 12 hours of noise exposure. This hearing loss
disappeared shortly afterwards. The frequency of noise is likely to be between the ranges of:
a) 1000 – 2000 Hz
b) 2000 – 4000 Hz
c) 4000 – 6000 Hz
d) 6000 – 8000 Hz
52. To impart health education regarding child care to large number of mothers visiting MCH
centre it is decided to resort to method of group discussions. What could be appropriate strength
of each group for this purpose?
a) 3-5
b) 4-6
c) 6-12
d) 20-25
53. To develop effective AIDS control strategy for Pakistan, the experts from all over the world are
invited to devise the plan after relevant discussion. What name is given to this method?
a) Seminar
b) Group discussion
c) Symposium
d) Panel discussion
54. Persuasive communication was deliberately employed to manipulate feelings, attitudes and
beliefs of people regarding smoking, this method is known as:
a) Counseling
b) Motivation
c) Propaganda
d) Advising
55. Health education is the responsibility of
a) Health educationalist
b) Doctor
c) Paramedical staff
d) Every health worker
56. Diarrhoeal cases among children of an urban slum are on a rise. Almost all the mothers are
illiterate and belong to lower socioeconomic class. It seems difficult to make them understand
the use of ORS. What method can provide the best solution in this scenario?
a) Role playing
b) Poster competition
c) Radio Programme
d) Lectures
57. There was a tableau held in POF Hospital, Wah Cantt on the world children’s day to
demonstrate the importance of ORS in dehydration with a back drop of ORS, breast feeding and
MCH service. This method is known as:
a) Poster competition
b) Role playing
c) Symposium
d) Lectures
58. After a thorough study of socio-demographic characteristics of a population in Dhok Ratta, a
relevant method of health education against smoking was employed to this population. Upon
assessing the population habits even after lapse of 2 years, no change in the behaviour of the
smokers was note what is likely to be missing in this programme to achieve the desired results
a) Reinforcement
b) Knowledge of cultures
c) Knowledge of beliefs
d) Required devotion
59. In Pakistan about 50% population is illiterate and smoking is mostly prevalent among the poor.
Government has started giving pictorial warnings instead of written, to have a greater impact of
health education on people: This strategy is more focused on:
a) Message
b) Receiver
c) Sender
d) Channel
60. A pregnant woman presented with pallor, shortness of breath, lethargy and palpitation. Her
blood examination revealed hemoglobin level of 9 gm/dl. In your opinion what could be the
probable deficiency in the woman?
a) Iron
b) Niacin
c) Vitamin C
d) Iodine
61. A 30 years old pregnant lady, gravidity 2 parity 1, visited the antenatal clinic at 32 weeks of
gestation. She was a known smoker. On physical examination blood pressure was found to be
120/80 mm Hg. Blood examination showed Hb level of 12.5 g/dl. Ultrasound was suggestive of
intrauterine growth retardation. Which factor during pregnancy would have contributed to
intrauterine growth retardation?
a) Age
b) Parity
c) Anemia
d) Smoking
62. A 28 years old pregnant lady, gravidity 1 parity1, visited the antenatal clinic at 32 weeks of
gestation. She was a known alcoholic. On physical examination blood pressure was found to
be120/80 mm Hg. Blood examination showed Hb level of 12.5 g/dl. Ultrasound was suggestive
of intrauterine growth retardation, Microcephaly and developmental delay. Which factor during
pregnancy would have contributed to the fetal conditions?
a) Maternal age
b) Parity
c) Anemia
d) Alcohol consumption
63. A newly married couple visits family planning centre for contraception. Upon investigation the
woman has hyperlipidemia. The method of contraception which would be used cautiously in this
woman is:
a) Condom
b) Combined oral contraceptive pill
c) Second generation IUCD
d) Mini pill
64. A 35 years old woman was brought to hospital with toxic shock syndrome. She was using some
method of contraception. The method of contraception which had likely lead to this condition is
a) Condom
b) Diaphragm
c) Vaginal douching
d) Oral pills
65. A 34 years old woman presented in the emergency department to a lady doctor with painful
vulvar ulceration. On examination the ulcer had irregular margins with undermined edges. The
ipsilateral inguinal lymph nodes were swollen and tender. The most likely diagnosis is:
a) Syphilis
b) Herpes
c) Chancroid
d) Lymphogranuloma venereum
66. A 30 years old lady having two kids wants to plan her family. On examination she is found to
be anemia. She also gives history of ectopic pregnancy last year. The best method of
contraception for her would be:
a) Lippe’s loop
b) Injectable contraceptives
c) Progestasert
d) Multi-load
67. A 42 years old female wants to use oral contraceptive pills. She is 55 kg of weight and beetle
chewer. On general examination she was found to be suffering from mild depression. This
contraceptive method should be used cautiously in this woman because of her:
a) Age
b) Excess weight
c) Low weight
d) Beetle chewing habit
68. For long term contraception, a sub -dermal implant known as “nor-plant” is being used now a
days. The main disadvantage of Norplant is:
a) Spontaneous expulsion
b) Irregular menstrual bleeding
c) Pelvic inflammatory disease
d) Ectopic pregnancy
69. A primary Gravida with O- ve blood group comes to labour room with labour pains. Her
husband’s blood group is O+v In order to avoid Rh incompatibility in pregnancy, which measure
would you take:
a) Administer AntiRh immunoglobulins at delivery
b) Serial ultrasonography
c) Chorionic villous biopsy
d) Amniocentesis
70. An 8 weeks pregnant lady comes to gynae OPD for antenatal visit for the first time. She told
the doctor that she has come from far off area and it’s not possible to come for her monthly
antenatal visits. The doctor advised the minimum number of essential antenatal visits is:
a) 3
b) 4
c) 5
d) 6