Spots

CLASS ON SPOTS Department of Community Medicine Maulana Azad Medical College

Community Medicine Practical Examination

• Marks distribution:

– Theory = 150 marks • 60 marks x 2 papers = 120 • Internal assessment = 20 • Viva Voice = 10

– Practical = 50 marks • Long case = 20 • Epidemiological cum statistical exercise = 5 • Spots: 1 x 5 = 5 • Internal assessment = 20

MAJOR AREAS • Vaccines and associated equipments • Nutrition • Drugs/medicines • Contraceptives • Entomology • Microbiology • Biostatistics

IMPORTANT POINTS • 5 spots • 2 questions on each spot • Each question carries ½ a mark • Time of 1 minute is given for each spot • In the examination, either live spots or spots on LCD projector would be used. • Sample questions are given with the spots. However, do not restrict to these questions. • Appropriate instructions will be given

• • • • • • • • • • • • • •

VACCINES

Type of vaccine Composition Immunization schedule Age at administration/eligible age Dose Route Site Contraindications Side effects Diluents used, if any Precautions/specific instructions Efficacy Vaccine preventable diseases Applied aspects etc.

EVERY ASPECT OF VACCINES IS

BCG

Diluent for BCG- Normal Saline

OPV VVM

Vaccine Vial Monitor (VVM) Stages

Stage I

Stage II

Stage III

Stage IV

Hepatitis B Vaccine

DPT Vaccine

DT Vaccine

TT Vaccine

Look here If label is missing

MEASLES

MEASLES, MUMPS, RUBELLA (MMR)

Diluent for Measles, MMR- Sterile water

Typhoid Vaccine – Vi polysaccharide

HAEMOPHILUS INFLUENZAE b VACCINE

HEPATITIS- A VACCINE

JAPANESE ENCEPHALITIS VACCINE

POLYVALENT PNEUMOCOCCAL VACCINE

VARICELLA (CHICKEN POX)VACCINE

DIPHTHERIA

POLIOMYELITIS

MUMPS

MEASLES

Equipments • Cold chain equipments – – – –

Vaccine carrier Day carrier Ice pack Household refrigerator

• BCG/ Tuberculin syringe and needle • Syringe – Disposable – Auto- disable (AD) – Glass

VACCINE CARRIER

DAY CARRIER

ICE PACK

Ice packs OPV BCG, OPV, Measles, MMR DPT, DT, TT, Hep B, Typhoid, Diluent, Returned vaccines Water bottles

BCG/ Tuberculin syringe

26 G needle

Disposable syringe

Disposabl needle

Glass syringe

NUTRITION • Food stuff: Cereals, Pulses, Nuts, Oil seeds, fruits etc. • Questions: – Important nutrients per 100 gm – Limiting amino acids/ Rich source of…

• Salt: Compound used for iodization, Iodine content, National programme • Vitamin A: Dose, age, side effects of excessive dose. • Growth chart: Interpretation. • Food adulteration: Toxic principle, Disease caused, Prevention • Deficiency diseases: Identify, Cause, Prevention

CEREALS

Wheat

Rice

PULSES

SUGAR

SALT

CONCENTRATED VITAMIN A SOLUTION

GROUNDNUT

MUSTARD SEEDS

CITRUS FRUITS

GREEN LEAFY VEGETABLES

GROWTH CHART

GROWTH CHART

GROWTH CHART

GROWTH CHART

BITOT’S SPOT

RICKETS

CONTRACEPTIVES • • • • • • • • •

Advantages Disadvantages Mechanism of action Failure rate OCPs: Contents, Dosage schedule, Side effects, Instructions to user Cu T: Time of insertion, Side effects, Instructions to user Condoms: Number used/couple/year E pill: Contents, Dosage schedule, Side effects, Instructions to user Saheli: Contents, Dosage schedule, Side effects, Instructions to user

CONDOM

ORAL CONTRACEPTIVE PILLS

EMERGENCY CONTRACEPTIVE PILL

CENTCHROMAN (SAHELI)

IUCD- Cu T

IUCD- Cu T

DRUGS/ MEDICINES • IFA • ORS • Chlorine tablets • Chloroquine tablets • Anti Tubercular Therapy used in RNTCP • Multi Drug Therapy for Leprosy • Benzyl benzoate

IRON AND FOLIC ACID TABLET

ORAL REHYDRATION SALT

CHLORINE TABLETS

CHLOROQUINE TABLETS

BLISTER PACK- ATT

BENZYL BENZOATE

MISCELLANEOUS • Horrocks apparatus • Gloves

HORROCK’S APPARATUS

GLOVES

POPULATION PYRAMID

ENTOMOLOGY • Adult forms – – – – –

Housefly Rat flea Sandfly Mosquito (Culex, Aedes, Anopheles) Others

• Larval forms – Anopheles/ Anopheline – Culcine (Culex/Aedes)

Some questions • Identify, giving reasons • Diseases transmitted • Control measures: – In general – Form specific: Larval/ Adult

• National programmes

MOUNTED SPECIMEN IN A GLASS BOTTLE

SPECIMENS FIXED ON SLIDES (shown under a magnifier)

HOUSEFLY

HOUSEFLY

RAT FLEA

RAT FLEA

SAND FLY

CULEX

AEDES

AEDES

ANOPHELES

ANOPHELES

ANOPHELES

ANOPHELES

ANOPHELES

ANOPHELES

AEDES

AEDES

AEDES

CULEX

CULEX

ANOPHELINE LARVA

ANOPHELINE LARVA

ANOPHELINE LARVA

CULCINE LARVA

CULCINE LARVA

CULCINE LARVA

CULCINE LARVA

CULCINE LARVA

CULCINE LARVA

Siphon tube

CULCINE LARVA Siphon tube

Source: RC Russell

Source: RC Russell

PARASITOLOGY • Identify, giving reasons • Life cycle • Disease/ Morbidity caused • Prevention • Treatment/ Drug of choice

ADULT ROUNDWORM

EGG OF ROUNDWORM

EGG OF HOOKWORM

EGG OF TRICHURIS

BILE PLUG

MICROFILARIA

MICROFILARIA

MALARIAL PARASITE

MICROBIOLOGY • Identify, giving reasons • Disease/s caused • Staining method used • Q’s related to disease

ACID FAST BACILLI

BIOSTATISTICS • Identify • Use

Figure: Distribution of study subjects in relation to duration of diminished vision (N=69) 62.3%

15.9%

21.7% Less than 3 years

3 to 6 years

More than 6 years

Figure: Materials used by study subjects to dry hands after washing* (N=151) 90.0 83.4

80.0

% age of study subjects

70.0 60.0 50.0

45.7

40.0 30.0

20.5 20.0 10.0 0.0

Personal hand towel * Responses are not mutually exclusive

Clothes / apron

Materials used

Common hand towel

Figure: Relation between body weight and 350.0 time spent in physical exercise

Exercise time (min)

300.0

250.0

200.0

150.0

100.0

50.0

0.0

0

20

40

60

80

Body weight (kg)

100

120

140