Final Hygiene Test PDF

Hygiene Part-1 FOOD HYGIENE Energy and Protein Requirements 1. The recommended daily energy intake of an adult pregnant woman with heavy work is: (a) 2100 kcal (b) 2500 kcal (c) 3200 kcal (d) 2900 kcal Recommended...

Hygiene Part-1 FOOD HYGIENE Energy and Protein Requirements 1. The recommended daily energy intake of an adult pregnant woman with heavy work is: (a) 2100 kcal (b) 2500 kcal (c) 3200 kcal (d) 2900 kcal Recommended daily energy and protein intake: Group Particulars Energy (Kcal/(d) Proteins (g/(d) Adult Male Sedentary worker 2320 60 Moderate Worker 2730 60 Heavy Worker 3490 60 Adult Female Sedentary worker 1900 55 Moderate Worker 2230 55 Heavy Worker 2850 55 Pregnancy +350 +23 Lactation (0 - 6 m) +600 +19 Lactation (6 - 12 m) +520 +13 Infants 0 - 6 months 92/kg 1.16/kg 6 - 12 months 80/kg 1.69/kg In the given question, for an adult pregnant woman with heavy work recommended daily energy intake will be: 2850 + 300 = 3150 Kcal Similarly, daily protein intake for such a woman will be 78 gm Total additional energy requirement in a pregnancy, over and above normal metabolic requirements is + 60,000 Kcal On an average a healthy adult woman gains 12 kg in pregnancy (6.5 kg in poor Indian women). 2. Extra calories required by lactating mother during first six months over and above daily requirement is: (a) 550 kcal (b) 400 kcal (c) 300 kcal (d) 250 kcal Also Remember Requirement of Iron and Folic Acid: Pregnancy > Lactation Requirement of Calcium and Pyridoxine: Pregnancy = Lactation Requirement of other Nutrients: Pregnancy < Lactation Requirement of Iron: Non-pregnant state = Lactation Requirement of Vitamin B12 and C: Non-pregnant state = Pregnancy 3. The recommended daily energy intake of an adult woman with heavy work is: (a) 1800 (b) 2100 (c) 2300 (d) 2900 4. Consumption Unit, the coefficient of Dietary Intake, for an adolescent is of value: (a) 0.9 (b) 1.0 (c) 1.2 (d) 1.7 A 'Consumption Unit' is a coefficient of dietary intake, which varies between individuals based on the basis of their age, sex and physical activity Appraisal of dietary intake of very family by weighment method is worked out in terms of consumption units Consumption Unit Coefficients (CUC) of an adolescent = 1.0 5. Protein requirement of an adult is: (a) 0.7 gm/kg in terms of Egg protein & 0.7 gm/kg in terms of mixed vegetable protein (b) 1.0 gm/kg in terms of Egg protein & 1.0 gm/kg in terms of mixed vegetable protein (c) 1.0 gm/kg in terms of Egg protein & 0.7 gm/kg in terms of mixed vegetable protein (d) 0.7 gm/kg in terms of Egg protein & 1.0 gm/kg in terms of mixed vegetable protein Protein requirement of an adult: – 0.7 gm/kg/day in terms of Egg protein or – 1.0 gm/kg/day in terms of mixed vegetable protein (NEW GUIDELINE: 0.83 g/kg/d) Egg protein has the highest NPU of 96 Indian Council of Medical Research (ICMR) has recommended 1.0 gm protein per kg of body weight for an Indian adult, assuming a NPU of 65 for dietary proteins. 6. In calculating RDA for a particular nutrient, 2 SD are not added for: (a) Iron (b) Calcium (c) Energy (d) Vitamin A Recommended Dietary Allowance (RDA): Is a level of intake corresponding to Mean + 2 Standard Deviation, which covers requirement of 97.5 % of population RDA is safe level of intake which is likely to be inadequate in not more than 2.5 % population RDA 'safe level approach' is NOT USED FOR ENERGY since excess energy intake is undesirable; For energy only mean or average requirement is defined as RDA. Reference Indian Man Reference Indian Woman Age 18-29 years 18-29 years Weight 60 kg 55 kg Height 1.73 metres 1.61 metres BMI 20.3 21.2  Others Free from disease, fit for active work; engaged in 8 hours of occupation (usually moderate activity), 8 hours in bed, 4-6 hours in sitting & moving about and 2 hours in walking and in active recreation or household duties Calculation Average of values of age category 18-19 years, 20-24 years and 25-29 years 7. For a 60 kg Indian male, the minimum daily protein requirement has been calculated to be 40 g (mean) ± 10 (Standard deviation). The recommended daily allowance of protein would be: (a) 60 g/day (b) 70 g/day (c) 40 g/day (d) 50 g/day In the given question, For a 60 kg Indian male, the minimum daily protein requirement with 40 g (mean) ± 10 (Standard deviation), will be, Mean + 2 SD = 40 + 2(10) = 60 g/day RDA 'safe level approach' is Not used for energy since excess energy intake is undesirable; For energy only mean or average requirement is defined as RDA. 8. The recommended daily energy intake of an adult woman with heavy work is: (a) 1800 kcal (b) 2100 kcal (c) 2300 kcal (d) 2900 kcal Reference Man requires daily energy intake of 45 Kcal/kg Reference Woman requires daily energy intake of 40 Kcal/kg. WHO recommends reduction in energy intake after age of 40 years – 5% per each decade till age 60 years and – 10% per each decade thereafter 9. For an adult Indian male the daily requirement of protein is expressed as: (a) 0.5 g/kg body weight (b) 0.75 g/kg body weight (c) 1 gm/kg body weight (d) 1.50 g/kg body weight 10. In 13-15 year female child, recommended daily protein intake (gm/kg/day) is: (a) 0.68 (b) 0.95 (c) 1 (d) 1.33 11. Energy requirement in late pregnancy for a moderate worker is: (a) 2500 cal (b) 1400 cal (c) 1000 cal (d) 500 cal 12. Indian reference man: (a) 55 kg (b) 60 kg (c) 65 kg (d) 70 kg 13. Reference weight of Indian men and women is: (a) 60 and 50 kg (b) 55 and 50 kg (c) 65 and 55 kg (d) 45 and 50 kg 14. Extra calories per day in lactating mothers in first six months: (a) 300 (b) 500 (c) 600 (d) 1000 15. The daily extra colorie requirement is first trimester of pregnancy is: (a) 50 (b) 150 (c) 350 (d) 450 16. Which of the following trace element cannot be Completely supplemented by diet during pregnancy: (a) Fe (b) Ca++ (c) Zn (d) Mn 17. Additional Calories regarding for lactation: (a) 550 (b) 440 (c) 300 (d) 130 18. True statement regarding RNTCP includes all except: (a) Sputum microscopy (b) Exclusion of private practitioners (c) Participation of all health workers (d) Provide latest equipments 19. Energy requirement of a sedentary female is: (a) 2200-2400 Kcal (b) 2400-2800 Kcal (c) >2800 Kcal (d) 0.5% Corneal xerosis/corneal ulceration/ > 0.01% keratomalacia Corneal ulcer > 0.05% Serum retinol (< 10 mcg/dl) > 5.0% Prevalence is measured in population at risk, i.e., pre-school children 6 months - 6 years. 81. Recommended Daily Allowance of free folate in pregnancy is: (a) 500 mcg (b) 150 mcg (c) 300 mcg (d) 400 mcg Body stores of folate are not large (about 5 - 10 mg), therefore folate deficiency can develop quickly Recommended daily intake values of folate: Group Intake per day Healthy adults 200 mcg Pregnancy 500 mcg Lactation 300 mcg Children 100 mcg An adult tablet of IFA contains: 100 mg elemental Iron and 500 mcg Folic acid (to be given for 100 days minimum in pregnancy) A pediatric tablet of IFA contains: 20 mg elemental Iron and 100 mcg Folic acid (to be given for 100 days minimum every year till 5 years age of child) 82. Under National Programme for Prevention of Nutritional Blindness, a child in the age group of 6-11 months is given a mega dose of vitamin A equal to: (a) 50,000 IU (b) 1 Lakh IU (c) 1.5 Lakh IU (d) 2 Lakh IU 83. First clinical sign of Vitamin-A deficiency is: (a) Night blindness (b) Conjunctival xerosis (c) Bitot’s spots (d) Keratomalacia All the ocular manifestations of Vitamin-A deficiency are collectively known as 'Xerophthalmia' (Dry Eye) – Xerophthalmia is most common in children aged 1 - 3 years 'First clinical sign' of Vitamin-A deficiency: Conjunctival xerosis 'First clinical symptom' of Vitamin-A deficiency: Night blindness Conjunctival xerosis in Xerophthalmia has a characteristic appearance of 'emerging like sand banks at receding tide 'Bitot's Spots' are triangular, pearly-white or yellowish, foamy spots on bulbar conjunctiva, on either side of cornea; In young children they indicate Vitamin-A deficiency, whereas in adults they are often inactive sequelae of earlier disease 84. Under National Immunisation Schedule, total dose of Vitamin-A given to a child is: (a) 5 lac IU (b) 6 lac IU (c) 9 lac IU (d) 13.5 lac IU Under National Immunisation Schedule (NIS), Vitamin-A is given; (Older Guidelines) – 1 lac IU at 9 months age (along with measles vaccine), – 2 lac IU every six months thereafter, till the age of 3 years (at 18, 24, 30 and 36 months of age) – A total of 9 lac IU is given Vitamin-A is administered by a '2 ml spoon' Strength of Vitamin-A solution: 1 lac IU per ml Under the New Guidelines in Nis, Vitamin-A is given; – 1 lac IU at 9 months age (along with measles vaccine), – 2 lac IU every six months thereafter, till the age of 5 years (at 18, 24, 30, 36, 42, 48, 54 and 60 months of age) – A total of 17 lac IU is given 85. Vitamin-A solution contains: (a) 25,000 IU per ml (b) 50,000 IU per ml (c) 1,00,000 IU per ml (d) 2,00,000 IU per ml 86. Xerophthalmia is a problem in a community if the prevalence of Bitot’s spots is more than: (a) 1 % (b) 0.5 % (c) 5 % (d) 25 % 87. Daily requirement of Vitamin-A by an adult man is: (a) 350 mcg (b) 100 mcg (c) 600 mcg (d) 2000 mcg Recommended daily requirements: Vitamin Recommended daily requirement Vitamin A 600 mcg retinol Vitamin B1 (Thiamine) 0.5 mg per 1000 Kcal of energy intake Vitamin B2 (Riboflavin) 0.5 mg per 1000 Kcal of energy intake Vitamin B3 (Niacin) 6.6 mg per 1000 Kcal of energy intake Vitamin B5 (Pantothenic Aci(d) 10 mg Vitamin B6 (Pyridoxine) 2 mg Vitamin B9 (Folic Aci(d) 100 mcg Vitamin B12 (Cobalamin) 1 mcg Vitamin D 100 IU (2.5 mcg calciferol) Vitamin E (Tocopherol) 0.8 mg per gm of essential fatty acids Vitamin K 0.03 mg per kg 88. Minimum amount of sunlight exposure necessary for adequate synthesis of Vitamin-D in the human body is: (a) 5 min (b) 30 min (c) 2 hrs (d) 5 hrs Vitamin D can be synthesized in the body in adequate amounts by simple exposure to sunlight even for 5 minutes per day Vitamin D is synthesized in sunlight when '7-dehydrocholesterol (present in abundance in skin) is converted to cholecalciferol' 'UV-B rays' (wavelength 270 - 300 nm) play an important role in Vitamin D synthesis Vitamin D is 'Kidney Hormone' Two major forms of Vitamin D are D2 (Ergocalciferol/ calciferol) and D3 (Cholecalciferol) There is no plant source for Vitamin D (and Vitamin B12) Vitamin D deficiency leads to rickets, osteomalacia, osteoporosis and colon cancer. 89. Besides 3 D’s (Diarrhoea, Dermatitis & Dementi(a) of Niacin deficiency, 4th D indicates: (a) Disability (b) Destruction (c) Debilitating (d) Death 90. ‘Burning Sole Syndrome’ is seen in deficiency of: (a) Riboflavin (b) Pyridoxine (c) Pantothenic acid (d) Vitamin B12 Pantothenic acid deficiency was thought to be cause of 'Burning Feet/Sole Syndrome' among prisoners of World War II Pantothenic acid is required by adrenal cortex. 91. Dose of vitamin A prophylaxis in 6-11 months old child is: (a) 2,00,000 IU (b) 30,000 IU (c) 60,000 IU (d) 1,00,000 IU Community based intervention against nutritional blindness: – Evolved by National Institute of Nutrition (NIN), Hyderabad Strategy: – Administer a single massive dose of 200,000 IU of Vitamin A (Retinol palmitate) orally every six months to preschool children (1 - 6 years age) – Half that dose (100,000 IU) be administered to children between 6 months - 1 year age – Also known as 'Immunization against Xerophthalmia' – Incidence of Keratomalacia reduced by 80%. 92. Niacin deficiency can result in: (a) Pellagra (b) Anemia (c) Peripheral neuropathy (d) Beri beri 93. Incidence of Bitot spots to label it as a public health problem is: (a) 0.1% (b) 0.5% (c) 1% (d) 5% 94. Vitamin A deficiency can cause all of the following except: (a) Night blindness (b) Seborrheic dermatitis (c) Respiratory infection (d) Bitot spots 95. Vit. A deficiency is characterized by: (a) Bitot’s spot (b) Xerophthalmia (c) Night blindness (d) Tranta’s spot 96. Daily requirement of Vitamin K (a) 3 mg/kg (b) 0.3 mg/kg (c) 0.03 mg/kg (d) 30 mg/kg 97. Vitamin A deficiency in 18 months old child what is recommended dose: (a) 200 IU (b) 2,000 IU (c) 200,000 IU (d) 20,000 IU 98. Vitamin A requirement in infant is: (a) 350 mcg (b) 600 mcg (c) 800 mcg (d) 1000 mcg 99. Vitamin D is maximum in: (a) Milk (b) Fish fat (c) Eggs (d) Cod liver oil 100. False statement regarding folic acid supplementation? (a) Fortified in all wheat products in India like as in USA (b) Preconceptionally given for prevention of neural tube defects (c) It is present in leafy vegetables, spinach, paneer (d) Requirement per day in pregnancy is 500 mcg FOLIC ACID India has NOT YET adopted recommendation of fortification of all wheat products in India with Folic acid Preconceptionally given for prevention of neural tube defects It is present in leafy vegetables, spinach, paneer Requirement per day in pregnancy is 500 mcg 101. Pellagra in Jowar eating population is due to: (a) Niacin in bound form (b) Deficiency of Tryptophan (c) Excess of Leucine (d) High consumption of milk and milk products 102. Avidin has affinity for: (a) Folic acid (b) Thiamine (c) Biotin (d) Riboflavin 103. Physiologically most active form of Vitamin D is: (a) Calciferol (b) Cholecalciferol (c) Ergocalciferol (d) Calcitriol 104. Bitot’s spots are seen in: (a) Conjunctiva (b) Cornea (c) Retina (d) Vitreous 105. In Xeropthalmia, what is X1B: (a) Conjunctival xerosis (b) Bitot's spot (c) Corneal xerosis (d) Corneal ulcer WHO Classification of Xerophthalmia Primary signs Secondary signs X1A Conjunctival xerosis XN Night blindness X1B Bitot spots XF Xerophthalmic fundus X2 Corneal xerosis XS Xerophthalmic scarring X3A Corneal ulceration X3B Keratomalacia 106. Prevalence of Vitamin A deficiency in a community is assessed as: (a) Night blindness-10% (b) Corneal ulcer-0.01% (c) Bitot spots-0.5% (d) Decreased serum retinol level-0.05% 107. Earliest feature of vitamin A deficiency is: (a) Dryness of conjunctiva (b) Nyctalopia (c) Keratomalacia (d) Hyphema 108. Earliest feature of vitamin A deficiency is: (a) Dryness of conjunctiva (b) Nyctalopia (c) Keratomalacia (d) Hyphema 109. Which of the following is supposed to prevent congenital neural tube defect: (a) Thiamine (b) Riboflavin (c) Pyridoxin (d) Folic acid 110. Vitamin E rich Foods are: (a) Sunflower oil (b) Wheat germ oil (c) Soya bean (d) All of the above 111. Daily requirement of vitamin D in children: (a) 100 IU (b) 200 IU (c) 400 IU (d) 600 IU 112. Papilledema is caused by: (a) Vitamin A intoxication (b) Vitamin D intoxication (c) Vitamin E intoxication (d) Vitamin B intoxication 113. Vitamin C content of which of the following is >5 mg per 100 grams? (a) Human milk (b) Dates (c) Egg (d) Sitaphal 114. Vitamin D is least in: (a) Milk (b) Eggs (c) Fish fat (d) Shark liver oil 115. Deficiency of folic acid produces: (a) Carcinoma stomach (b) Spinal degeneration (c) Changes in central nervous system (d) Megaloblastic anaemia 116. The daily requirement of Vitamin D in infants and children is: (a) 2.5 mcg (100 IU) (b) 5.0 mcg (200 IU) (c) 10.0 mcg (400 IU) (d) 20.0 mcg (800 IU) 117. In measles which vitamin deficiency occurs: (a) Vitamin A (b) Vitamin B (c) Vitamin C (d) Vitamin D 118. Richest source of vitamin B1: (a) Rice (b) Milk (c) Egg (d) Groundnut 119. What is the characteristic feature of vitamin “A” deficiency? (a) Bitot’s spot (b) Koplik’s spots (c) Erythema marginatum (d) Aschoff’s nodules 120. Peripheral neuritis is deficiency sign of: (a) Folic acid (b) Niacin (c) Thiamine (d) Tocopherol 121. Which of the following is NOT a criteria for determining xerophthalmia problem in the community? (a) Bitot’s spots 0.05% (b) Corneal xeroxis 0.01% (c) Corneal ulcer 0.05% (d) Serum retinoal level less than 10 mcg/dl 10% 122. Which of the Following vitamin deficiency diseases occurs in maize eating population? (a) Beriberi (b) Megaloblastic anaemia (c) Pellagra (d) Night blindness 123. Bitot’s spots are found in: (a) Measles (b) Mumps (c) Vit. A deficiency (d) Diphtheria 124. Vit. A requirement in adult male is (Microgram per day): (a) 400 (b) 600 (c) 800 (d) 1000 125. Highest amount of vit. C is found in: (a) Orange (b) Lemon (c) Indian goose berry (d) Grapes 126. Decreased level of serum Vit B6 is seen in: (a) CRF (b) CHF (c) INH therapy (d) Alcohol Iron 127. Best test to detect iron deficiency in community is: (a) Serum transferrin (b) Serum ferritin (c) Serum iron (d) Hemoglobin Evaluation of iron status in the body can be done by: – Hemoglobin concentration: A relatively insensitive index of nutrient depletion – Serum iron concentration: Normal range is 0.80 - 1.80 mg/L – Serum ferritin: 'Most sensitive tool for evaluation of iron status', especially in populations with low prevalence of anemia – Serum transferring saturation: Normal value is 30% 128. An adult pregnant female is termed anemic if her hemoglobin (venous bloo(d) is: (a) Less than 11 g/dl (b) Less than 12 g/dl (c) Less than 13 g/dl (d) Less than 14 g/dl Cut-off points for diagnosis of anemia (WHO): Group Hb (g/dl) MCHC (%) Adult males 13 34 Adult females, non-pregnan 12 34 Adult females, pregnant 11 34 Children, 6 m - 6 y 11 34 Children, 6 y - 14 y 12 34 129. Which one of the following pulses has the highest content of iron? (a) Bengal gram (b) Black gram (c) Red gram (d) Soya bean Only Bengal gram contains Vitamin C among the common pulses Iron requirements (mg per day): Groups Particulars Iron intake Iron to be absorbed Adult male 17 0.84 Adult female Menstruating 21 1.65 Pregnancy 1st half 35 0.8 Pregnancy 2nd half 35 2.80 Lactation 21 1.65 Infant 6 - 12 months 05 0.7 Children 1 - 12 years 10 0.6 Adolescent Boys 13 - 16 years 32 1.6 Girls 13 - 16 years 27 1.4 Iron absorption from Indian diets is less than 5%. 130. Iron absorption from habitual Indian diets is approx: (a) < 5 % (b) 15 –20% (c) 40 –50% (d) 70 – 80% Iron absorption from habitual Indian diets is less than 5% Iron absorption is low in Indian diets due to presence of inhibitors (phytates, tannates, oxalates, calcium) Vitamin C (Ascorbic aci(d) is a facilitator of iron absorption 131. Most sensitive tool for evaluating iron status of the body is: (a) Hb level (b) Serum iron (c) Serum transferring saturation (d) Serum ferritin 132. Lowest iron content is present in: (a) Milk (b) Liver (c) Meat (d) Fish Iron content of food items: Food item Iron content (mg per 100 grams) Jowar 4.1 Bajra 8.0 Ragi 3.9 Bengal gram 4.6 Horse gram 6.7 Peas dry 7.0 Soyabean 10.4 Banana 0.5 Mango 1.3 Sitaphal 4.3 Raisins 7.7 Dates 7.3 Milk 0.2 - 0.3 133. Oral iron pills or iron injections must be taken along with: (a) High doses of Vitamin A (b) High doses of Vitamin C (c) High doses of Essential fatty acids (d) High doses of Vitamin D 134. Total Iron requirement in pregnancy: (a) 1000 mg (b) 35 mg (c) 500 mg (d) 800 mg 135. Iron is maximum in: (a) Pista (b) Cashew nut (c) Meat (d) Milk 136. Poor man’s iron source is: (a) Almond (b) Grapes (c) Soya (d) Jaggery 137. Daily dose of Fe for adult man: (a) 18 mg/d (b) 24 mg/d (c) 34 mg/d (d) 40 mg/d Iodine & Fluorine 138. Fluoride content in drinking H2O normally safe is: (a) 0.5-0.8 mg/l (b) 0.8-1.0 mg/l (c) 0.2-0.8 mg/l (d) 0.2-0.5 mg/l The recommended level of fluorides in drinking water in India is accepted as '0.5 - 0.8 mg/litre' (0.5 - 0.8 ppm) In temperate countries where water intake is low, the optimum level of fluorides in drinking water is accepted as 1 – 2 mg/litre 'Fluorine is a double edged sword': Inadequate intake is associated with 'dental caries' whereas excess intake with 'dental and skeletal fluorosis'. 139. Dental fluorosis is best seen in: (a) Central & Lateral Incisors (b) Central Incisors & 1st Molars (c) 1st & 2nd Molars (d) Canines Dental fluorosis occurs when excess fluoride is ingested during first 7 years of life (years of tooth calcification) – It occurs at levels above 1.5 mg/litre intake – It is characterized by 'Mottling', which is best seen on incisors of upper jaw. Major source of fluorine to man: Drinking water Optimum level of fluorine in drinking water: 0.5 - 0.8 ppm (0.5 - 0.8 mg/litre) – Level > 1.5 ppm: Dental fluorosis (mottling) – Level 3.0 - 6.0 ppm: Skeletal fluorosis – Level > 10.0 ppm: Crippling fluorosis 140. ‘Twin fortified salt’ contains: (a) Iodine + Fluorine (b) Iodine + Calcium (c) Iodine + Iron (d) Iodine + Chlorine National Institute of Nutrition (Hyderabad) developed 'Twin Fortified Salt' also known as 'Double Fortified Salt' (DFS) – DFS contains Iron and Iodine DFS contains salt, potassium iodate, ferrous sulphate and sodium hexa meta phosphate DFS provides 40 mcg Iodine and 1 mg Iron per gram of salt. Iodised Salt: Level of iodisation in salt (PFA Act' 1954) is '30 ppm at production level and 15 ppm at consumer level' Iodised salt is most convenient, effective and economical method of mass prophylaxis in endemic areas – DEC Medicated Salt: 1 - 4 gm DEC (diethylcarbamazine) per kg salt is used for mass treatment of Filariasis; Treatment should be continued for 6 - 9 months. 141. 1 gram of ‘Twin fortified salt’ provides: (a) 1 mcg Iodine + 40 mg Iron (b) 40 mcg Iodine + 40 mg Iron (c) 1 mcg Iodine + 1 mg Iron (d) 40 mcg Iodine + 1 mg Iron 142. PFA Act’1954 has laid down standard for level of Iodisation of salt: (a) 90 ppm at Production level & 60 ppm at Consumer level (b) 60 ppm at Production level & 15 ppm at Consumer level (c) 30 ppm at Production level & 60 ppm at Consumer level (d) 30 ppm at Production level & 15 ppm at Consumer level Iodisation of salt is the 'most widely used prophylactic measure against prevention of goiter' – Iodised salt is most convenient, effective and economical method of mass prophylaxis in endemic areas According to Prevention of Food Adulteration (PFA) Act' 1954: – Level of iodisation: Minimum'30 ppm at production level and 15 ppm at consumer level' – Moisture content: < 6.0% by weight – Sodium chloride: > 96.0% by weight. Iodine requirement: 150 mcg per day ( 90% 143. Iodised oil ( usual dose of 1 ml i/m) gives protection for: (a) 3-4 weeks (b) 3-4 months (c) 3-4 years (d) 10-12 years Intramuscular Iodised Oil (poppy-seed oil): Average dose 1 ml injection provided protection for 4 years Oral Iodised Oil: 2 ml dose is effective for 2 years 144. Daily requirement of Iodine in adults is: (a) 50 mcg (b) 100 mcg (c) 150 mcg (d) 200 mcg The daily requirement of iodine is 150 mcg supplied normally by well balanced diets and drinking water. Indicators for epidemiological assessment of iodine deficiency: – Prevalence of goitre – Prevalence of cretinism – Urinary iodine excretion – Measurement of thyroid function (T4, TSH) – Prevalence of neonatal hypothyroidism Some noteworthy daily requirements: Nutrient Recommended daily requirement Calcium 400 - 500 mg Iron 17 mg (males); 21 mg (females) Iodine 150 mcg Fluorine 0.5 - 0.8 mg/litre 145. As per the World Health Organization guidelines, iodine deficiency disorders are endemic in a community if the prevalence of goiter in school age children is more than: (a) 1% (b) 5% (c) 10% (d) 15% Epidemiological criteria for assessing severity of IDD: – Total Goitre Rate (TGR) - Grade I + Grade II – Median Urinary Iodine Excretion – Thyroid volume (ultrasound) – Salt iodine content Criteria for Sustainable Elimination of IDD: – Median Urinary Iodine Excretion 100 mcg/l – Level of iodization: 1. 30 ppm at production level 2. 15 ppm at consumer level – Total Goitre Rate (TGR) < 5%. 146. Acceptable fluoride concentration in drinking water is: (a) 1 ppm (b) 2 ppm (c) 3 ppm (d) 4 ppm 147. Under the Prevention of Food Adulteration (PFA) Act, the expected level of iodine in iodized salt at production level is NOT less than: (a) 30 ppm (b) 25 ppm (c) 20 ppm (d) 15 ppm 148. Recommended Iodine dose in pregnancy is: (a) 15 mcg (b) 100 mcg (c) 150 mcg (d) 250 mcg India has recently adopted WHO guideline of 250 mcg per day in pregnancy  Iodine requirement in Adult: 150 mcg per day 149. Endemic cretinism is seen when iodine uptake is less than: (a) 5 micro gram/day (b) 20 micro gram/day (c) 50 micro gram /day (d) 75 micro gram/day 150. Iodine comes in iodine salt. Requirement in humans at consumer level: (a) 5 PPM (b) 15 PPM (c) 25 PPM (d) 35 PPM 151. Prevalence of iodine deficiency in India: (a) 1:100 (b) 1:10 (c) 3:100 (d) 3:10 152. Maximum Permitted level of fluoride in drinking water is ——meq/L: (a) 0.5 (b) 0.8 (c) 1.0 (d) 1.5 153. The Iodine content in iodized salt at production point should be: (a) 10 ppm (b) 20 ppm (c) 30 ppm (d) 40 ppm 154. In Iron deficiency anemia, after haemoglobin level has returned to normal so that iron stores are replenished. The Iron tablets should be recommended for: (a) 0 – 3 months (b) 3 – 6 months (c) 6 – 12 months (d) 12 – 24 months 155. Poor source of Iron is in: (a) Butter (b) Green leafy vegetable (c) Jaggery (d) Meat 156. In pregnancy content of Iron in IFA tablet is: (a) 100 mg (b) 200 mg (c) 500 mg (d) 800 mg Other Nutrients 157. How much amount of energy is yielded by one ml of alcohol in the body? (a) 1 cal (b) 4 cal (c) 7 cal (d) 9 cal Alcohol supplies about 7 Kcal/gm  Energy yield of macro-nutrients (Proximate principles): Nutrient Energy yield Carbohydrates 4 Kcal per gram (17 KJ) Proteins 4 Kcal per gram (17 KJ) Fats 9 Kcal per gram (37 KJ) 158. Daily requirement for Dietary Fibre by an adult is approx: (a) 1 gm (b) 4 gms (c) 40 gms (d) 100 gms Dietary fibre is a non-starch polysaccharide and a physiologically important component of diet; there are two types of dietary fibres: – Insoluble fibres: Cellulose, hemi-cellulose and lignin – Soluble fibres: Pectins, gums and mucilages A daily intake of about 40 grams of fibre is desirable Indian diets provide about 50-100 grams of fibre per day Cereals and pulses are good sources of fibre (>10 gm fibre per 100 gms). 159. Which of the following is the non-essential micronutrient? (a) Iron (b) Manganese (c) Lead (d) Sodium Macronutrients: Proximate Principles which form the bulk of the diet – Carbohydrates – Fats – Proteins Micronutrients: Vitamin and Minerals (which are required in small quantities). – Major minerals: Sodium, Potassium, Magnesium, Calcium, Phosphorus – Trace elements: Iron, Iodine, Fluorine, Zinc, Copper, Cobalt, Selenium, Chromium, Manganese, Molybdenum, Nickel, Tin, Silicon, Vanadium – Trace contaminant with no known function in body: Lead, Mercury, Barium, Boron, Aluminium. 160. One of the following is not reported to be a clinical manifestation of Zinc deficiency in children: Ans. None of the choices (a) Dwarfism and hypogonadism (b) Liver and spleen enlargement (c) Impaired cell-mediated immunity (d) Macrocytic anaemia Zinc deficiency Growth failure Sexual infantilism Impaired immunity Decreased insulin synthesis Delayed wound healing Loss of taste (Aguesia) Liver disease (Hepatomegaly + Splenomegaly), Pernicious anemia, Thalassemia, Myocardial infarction Megaloblastic anemia (due to reduced absorption of Folyl-glutamates) Maternal zinc deficiency: Spontaneous abortion, Congenital malformation (Anencephaly), Low birth weight, IUGR, Preterm delivery. 161. Zinc supplement given in 12 month baby: (a) 20 mg/day (b) 10 mg/day (c) 5 mg/day (d) 15 mg/day 162. Adult non-pregnant female requires, calcium per day: (a) 400 mg (b) 600 mg (c) 800 mg (d) 1000 mg 163. Daily calcium requirement of infants is: (a) 300 mg (b) 500 mg (c) 600 mg (d) 1200 mg 164. Keshan cardiomegaly occur due to deficiency of: (a) Selenium (b) Copper (c) Zinc (d) Iron 165. RDA of calcium in normal adult male is: (a) 800 mg (b) 400 mg (c) 1200 mg (d) 100 mg 166. Daily elemental calcium requirement for an elderly woman is: (a) 1200 mg (b) 300 mg (c) 2000 mg (d) 2500 mg Calcium Requirements (Indian Guidelines) Adult male: 600 mg Adult female: 600 mg Pregnancy: 1200 mg Lactation: 1200 mg Post-menopausal: 800 mg Infants: 500 mg Children: 600 mg Adolescents: 800 mg 167. Acrodermatitis enteropathica is: (a) Inherited disorder of excessive excretion of zinc from body (b) Inherited disorder of impaired uptake of zinc from body (c) Inherited disorder of excessive excretion of copper from body (d) Inherited disorder of impaired uptake of copper from body 168. Trace element is what percent of body weight: (a) 0.001% (b) 0.01% (c) 0.1% (d) 1% 169. Which of the following trace element has vitamin E like action: (a) Selenium (b) Cheomicin (c) Copper (d) Zinc 170. Under the prevention of Food Adulteration Act (PFA) the level fo iodine salt at consumer level is: (a) 0 -5 ppm (b) 5 -10 ppm (c) 5 -15 ppm (d) 5 -30 ppm 171. Spectrum of IDD cretin does not include: (a) Still births (b) Hyperactivity (c) Deafness (d) Delayed development 172. The daily requirement of Iodine for adults is placed at: (a) 10 mg (b) 100 mg (c) 50 mg (d) 150 microgram 173. The recommended level of fluorides in drinking water in this Country is accepted as: (a) 0.5 to 0.8 mg per litre (b) 1 to 2 mg per litre (c) 3 to 6 mg per litre (d) 7 to 12 mg per litre 174. The level of fluorine in drinking water highly associated with dental fluorosis is: (a) 0.5 mg/L (b) 1.0 mg/L (c) 1.5 mg/L (d) 2.0 mg/L 175. In drinking water fluoride levels should be less than _____mg/L: (a) 1.5 (b) 1 (c) 05. (d) 0.1 176. In drinking water recommended fluoride level is _____ ppm: (a) 0.5 (b) 0.5-0.8 (c) 1.5 (d) 1.1 177. Iodine requirement of adult male is (Micro gram/day): (a) 150 (b) 300 (c) 500 (d) 700 178. Recommended fluoride level in drinking water is (mg/ Liter): (a).3-5 (b)0.5- 0.8 (c) 1-2 (d) 2-5 179. Defloridation of water is done by which technique: (a) Nalgonda (b) Nagpur (c) Patna (d) Kasauli 180. Water fluoride is removed by: (a) Boiling (b) Nalgonda technique (c) Patna. Technique (d) Filtration 181. Daily requirement of lodine is: (a) 50-100 (b) 100-200 (c) 200-300 (d) 25-50 182. Micronutrient associated with rash and diarrhea: (a) Manganese (b) Copper (c) Zinc (d) Iron 183. Highest calcium concentration is present in: (a) Dates (b) Guava (c) Amla (d) Mango 184. Zinc deficiency is characterized by: (a) Sexual infantilism (b) Poor growth (c) Poor wound healing (d) All of the above 185. Copper deficiency is characterized by: (a) Myelopathy (b) Neutropenia (c) Anemia (d) All of the above 186. Egg are “reference protein” because: (a) High caloric content (b) Increased protein/100 gms (c) Increased biological value and +NPU (d) Decreased digestibility coefficient Egg 187. Egg is poor in: (a) Proteins (b) Carbohydrate & Vitamin C (c) Calcium & Iron (d) Fats Food Items as Poor Sources of Nutrients: Milk is a poor source of Vitamin C and Iron Meat is a poor source of Calcium Fish is a poor source of Carbohydrates Egg is a poor source of Vitamin C and Carbohydrates An egg (60 grams) contain: 6 gm proteins, 6 gm fat, 30 mg calcium, 1.5 mg iron, 250 mg cholesterol and 70 kcal energy Egg protein is best among proteins (NPU = 96), thereby making it 'Reference Protein' 188. NPU value for Egg is: (a) 140 (b) 96 (c) 81 (d) 52 Net Protein Utilization (NPU): Provides a complete expression of 'protein quality' NPU =Nitrogen retained by body ×100 Nitrogenintake NPU = Biological value× Digestibility coefficient 100 NPU of selected food items: Food Item Net Protein Utilization Egg (hen) 96* Milk (cow) 81 Meat 79 Fish 77 Rice 65 Soyabean 55 Wheat 51 Grams (pulses) 45-50 Groundnut 50 (*NPU of egg is 96. Since egg is 'reference protein', its NPU is taken as 100 for comparison) 189. Egg has all vitamins except: (a) B1 (b) B6 (c) C (d) E 190. Egg is deficient in which of the following: (a) Fat (b) Protein (c) Carbohydrate (d) Vitamin 191. Egg are “reference protein” because: (a) High caloric content (b) Increased protein/100 gms (c) Increased biological value and +NPU (d) Decreased digestibility coefficient 192. Egg is ideal protein because it has: (a) High digestibility (b) It has best quality of protein (c) High proteins (d) High protein and fats 193. Egg lacks the following: (a) Protein (b) Cholesterol (c) Carbohydrate (d) Vitamins 194. In Egg, Egg white contributes: (a) 50% (b) 58% (c) 30%  (d) 70% 195. One egg yield about kcal of energy: (a) 50 (b) 60 (c) 70 (d) 80 196. What is not found in egg? (a) Cholesterol (b) Vit. C (c) Calcium (d) Fat 197. Egg has all vitamin except: (a) B1 (b) B6 (c) C (d) E Milk 198. Pasteurization by Holder method is heating milk at: (a) 60° C for 45 minutes (b) 65° C for 30 minutes (c) 100° C for 15 minutes (d) 136° C for 15 minutes Methods of Pasteurization: Method Temp Time Remarks Holder/Vat Method 63-66°C >30 min For small and rural communities HTST Method 72°C 15 sec> Most widely used; for large quantities; 'Flash Pasteurization' HHST Method 68°C 30 min 'Batch Pasteurization' UHT Method 125°C Few sec Heating in 2 stages; 2nd stage under pressure Some other noteworthy temperatures: Method/Procedure Temperature Incineration Primary Chamber: 800° ± 50°C Secondary Chamber: 1050° ± 50°C Autoclave 121°C at 15 psi for 15 min 135°C at 3 - 10 psi for 30 min Cold Chain +2° to +8°C OPV (Long term storage) –20° to –40°C Yellow fever vaccine –30° to +5°C Reverse Cold Chain +2° to +8°C Parboiling (Hot Soaking) 65° - 70°C Comfort Zone (Effective temp) 25 - 27°C Heat exhaustion > 102°F Heat hyperpyrexia > 106°F Heat stroke > 110°F 199. Which one of the following is NOT used in testing for adequate pasteurization of milk? (a) Phosphatase test (b) Coliform count (c) Standaed plate count (d) Methylene blue reduction test Tests of Pasteurized Milk (for adequacy/sufficiency of pasteurization): – Phosphatase Test: Widely used test – Standard Plate Count: Enforced limit is 30,000 bacterial count per ml of pasteurized milk – Coliform Count: Standard is coliforms be absent in 1 ml of milk 'Methylene Blue Reduction Test': – Is an indirect method for detection of microorganisms in milk – The test is 'carried out on milk accepted for pasteurization' – Blue colour disappears from milk when held at a uniform temperature of 37° C: Milk which remains blue the longest is of best quality 200. Milk is a good source of all vitamins except: (a) Vitamin A (b) Vitamin B (c) Vitamin C (d) Vitamin D Milk is a good source of all vitamins except Vitamin C. Milks available in India: Milk Type Fat content SNF (Solid-not-fat) content Full cream 6.0 % 9.0 % Standardised 4.5 % 8.5 % Toned 3.0 % 8.5 % Double toned 1.5 % 9.0 % Skimmed 0.5 % 8.7 % 201. Level of proteins in human milk (per 100 ml) is: (a) 0.5 gms (b) 2.6 gms (c) 1.1 gms (d) 4.7 gms 202. The following tests are used to check the efficiency of pasteurization of milk except: (a) Phosphatase test (b) Standard plate count (c) Coliform count (d) Methylene blue reduction test Methylene Blue Reduction Test' (MBRT): Is an indirect method for detection of microorganisms in milk – MBRT test is 'carried out on milk accepted for pasteurization' 'Cold Pasteurization': The use of ionizing radiation or other means (e.g. chemical) to kill bacteria in food 'Electronic pasteurization': Food irradiation 203. Milk is rich in all except: (a) Vitamin A (b) Vitamin D (c) Iron (d) Vitamin E (e) Vitamin C 204. True about cow’s milk are all except: (a) Cow’s milk contains 80% whey protein and not casein (b) Has more protein than breast milk (c) Has more K+ and Na+ than breast milk (d) Has less carbohydrates than mothers milk 205. Pasteurised milk is most commonly tested by: (a) Phosphatase test (b) Coliform test (c) Catalase test (d) Oxidase test 206. Milk borne diseases are: (a) Brucellosis (b) Tuberculosis (c) Chickenpox (d) Q-fever (e) Leptospirosis Infections of animals transmitted to man Primary importance Lesser importance Tuberculosis Anthrax Brucellosis Cow pox Streptococcal infections Foot and mouth disease Staphylococcal poisoning Leptospirosis Salmonellosis Tick-borne encephalitis Q fever Infections primary to man Diarrhoeal diseases Non-diarrhoeal diseases Typhoid and para-typhoid fevers Tuberculosis Shigellosis Diphtheria Cholera Streptococcal infections E. coli Staphylococcal food poisoning Enteroviral infections 207. Human’s breast milk is essential for the newborn as it contains: (a) Linoleic acid (b) Linolenic acid (c) Docosahexanoic acid (d) Arachidonic acid Breast milk contains higher amounts of Docosahexaenoic acid (DHA) – DHA is an omega-3 fatty acid required for brain development – Levels in breast milk depend on mother’s consumption of foods rich in omega-3 fatty acids namely, flax and fish – Longer the duration of breast feeding, higher the DHA levels in infants. 208. Colostrum has in compared to normal milk: (a) Decreased Vitamin A (b) Decreased Na+ (c) Increased proteins (d) Increased calories 209. What is absent in breast milk? (a) Vitamin K (b) Vitamin C (c) Vitamin D (d) Vitamin A 210. Phosphatase test in milk is done to know (a) Quality of pasteurization (b) Contamination of milk (c) Nutritive value (d) Coliform count 211. According to WHO, exclusive breast milk is given upto: (a) 6 months (c) 8 months (d) 10 months 212. Pasteurization of milk is achieved by boiling at: (a) 65°C for 30 min (b) 72° for 10 sec (c) 100° for 20 sec (d) 136° for 30 sec 213. A child is exclusively fed on cow’s milk, the deficiency seen in: (a) Iron (b) Riboflavin (c) Vitamin A (d) Thiamine 214. Phosphatase test in Milk is done to know: (a) Quality of Pasteurization (b) Contamination of Milk (c) Nutritive value (d) Coliform count 215. All are true about human milk except: (a) Low lactose (b) Contains more Vitamin-D (c) Higher percentage of linoleic acid and oleic acid (d) Better iron bioavailability 216. Milk transmits all except: (a) Q fever (b) Typhoid fever (c) Brucellosis (d) Endemic typhus 217. Which of the following contains least amount of protein in 100 gm of milk: (a) Human milk (b) Cow milk (c) Buffalo milk (d) Goat milk 218. Milk is deficient in the following: (a) Tryptophan containing amino acids (b) Linoleic acid (c) Ascorbic acid (d) Calceferol 219. Percentage of lactose in human milk is: (a) 2.5 gm (b) 5 gm (c) 7.2 gm (d) 10 gm 220. Compared with cow’s milk, mother’s milk has more: (a) Lactose (b) Vitamin D (c) Protein (d) Fat 221. Match List I correctly with List D and select your answer using the codes given below: List I List D a. Papaya fruit I. Calcium b. Soya beans II. Vitamin C c. Ragi III. Protein d. Amla fruit IV. Vitamin A (a) a-I, b-III, c-II, d-IV (b) a-IV, b-I, c-III, d-II (c) a-IV, b-III, c-I, d-II (d) a-I, b-III, c-IV, d-II Among common vegetables, cabbage is the richest source of Vitamin C. (But also a Goitrogen) 222. Rice is poor in all except: (a) Calcium (b) Iron (c) Vitamins A, D, C (d) Lysine Rice is a poor source of Thiamine, Calcium, Iron and Vitamins A, D, C Protein content of rice varies from 6 - 9% – 'Rice proteins are better than other cereal proteins' as rice is richer in lysine Rice is staple food of > 50 % population globally. Food Items as Rich Sources of nutrients: – Halibut Liver Oil is richest source of Vitamin A and Vitamin D – Indian Gooseberry (amla) is richest source of Vitamin C – Gingelly seeds are richest source of Vitamin B1 (Thiamine) – Sheep liver is richest source of Vitamin B2 (Riboflavin) – Ragi (millet) is a rich source of calcium 223. Soyabean contains protein to the tune of: (a) 20 % (b) 40 % (c) 60 % (d) 80 % Protein content of some foods: Food Item Protein content (gm % per 100 gms) Soyabean 43 Pulses 22-25 Fish 21 Meat 20 Egg (hen) 13 Wheat 12 Rice 7 Milk (cow) 3 224. Fish is the source of all except? (a) Iron (b) Iodine (c) Vitamin A (d) Phosphorus Richest source of Vitamin A and D is fish liver oils (especially Halibut fish) Rich source of proteins (15-20%) Rich source of Calcium, phosphorus, fluorides Good source of iron Poor source of Carbohydrates Poor source of iodine (barring few sea fish) 225. Nutritional value(s) of dates (per 100 grams) include: (a) Iron 10 mg (b) Calcium 39 mg (c) Beta carotene 6 micrograms (d) Calories 280 Kcal (e) Vitamin C 100 mg 226. Tomatoes are rich in: (a) Oxalic acid (b) Citric acid (c) Acetic acid (d) Formic acid 227. Banana is good source of: (a) Calcium (b) Phosphorus (c) Vitamin B6 (d) Vitamin C (e) Potassium Banana is a good source of: - Vitamins A, B6, C - Carbohydrates, Energy - Fibre - Potassium, Phosphorus Banana is NOT a good source of: - Calcium, Iron (Due to presence of phytates) - Zinc 228. Which of the following has highest protein content: (a) Mutton (b) Soyabean (c) Egg (d) Milk 229. Lysine is deficient in: (a) Pulse (b) Wheat (c) Both (d) None 230. Tomatoes are rich in: (a) Oxalic acid (b) Citric acid (c) Acetic acid (d) Formic acid 231. Among the pulses, the highest quantity of protein is present in? (a) Green gram (b) Red gram (c) Soyabean (d) Black gram 232. Which amino acid is deficient is wheat? (a) Lysine (b) Methionine (c) Tryptophan (d) None 233. One of the following contains maximum calcium: (a) Rice (b) Wheat (c) Ragi (d) Jowar 234. Paraboiling of rice reduces: (a) Beriberi (b) Pellagra (c) Dermatitis (d) All of the above 235. Dates are rich source of: (a) Calcium (b) Iron (c) Vitamin C (d) Carotene 236. Highest calorie content is found in: (a) Banana (b) Apple (c) Guava (d) Orange 237. The food item rich in calcium is: (a) Rice (b) Wheat (c) Jowar (d) Ragi 238. An amino acid found in excess in some strains of maize is: (a) Leucine (b) Valine (c) Lysine (d) Tryptophan 239. Lysine is deficient in: (a) Cereals (b) Pulses (c) Jowar (d) Soyabean 240. Which of the following is deficient in maize? (a) Leucine (b) Lysine (c) Tryptophan (d) Methionine 241. Sorghum is pellagrogenic due to excess content of: (a) Lysine (b) Threonine (c) Leucine (d) Tryptophan 242. Maize is pellagrogenic due to excess of: (a) Lysine (b) Leucine (c) Tryptophan (d) Methionine 243. Maximum calories per 100 gm are in: (a) Jaggery (b) Pulsles (c) Green vegetables (d) Egg 244. Pulses are deficient in: (a) Lysine (b) Leucine (c) Methionine (d) All Food Adulteration 245. Endemic ascites is caused by: (a) Aflatoxin (b) Sanguinarine (c) Pyrrolizidine (d) Ergot alkaloid Food Adulteration diseases: Disease Toxin Adulterant Lathyrism BOAA Khesari Dal (Lathyrus Epidemic Dropsy Sanguinarine sativus) Endemic Ascites Pyrrolizidine alkaloids Argemone mexicana (oil) Aflatoxicosis Aflatoxin Crotolaria seeds (Jhunjhunia) Ergotism Clavine alkaloids Aspergillus flavus/parasiticus Claviceps fusiformis Lathyrism Lathyrism is of two types: – Neurolathyrism: In human beings – Osteolathyrism (Odoratism): In animals Neurolathyrism is caused by eating the pulse 'Khesari Dal (Lathyrus sativus)'. Diets containing over 30 % of this dal consumed over a period of 2 - 6 months result in neurolathyrism Toxin: present in lathyrus seeds is 'Beta oxalyl amino alanine (BOAA) Interventions for prevention and control of lathyrism: – Vitamin C prophylaxis – Banning the crop – Removal of toxin: Steeping method and Parboiling – Education – Genetic approach – Socio-economic changes Epidemic Dropsy Is caused by contamination of mustard oil with 'Argemone oil' Toxin: 'Sanguinarine' is the toxin contained in argemone oil Sanguinarine interferes with oxidation of 'pyruvic acid', which accumulates in blood: It may lead to sudden non-inflammatory edema of bilateral lower limbs, diarrhea, dyspnoea, cardiac failure and death; It can also lead to glaucoma; It may sometimes manifest as 'Sarcoids' (dilatation of skin capillaries)  Epidemic dropsy may occur in all ages except breast-fed infants. Endemic Ascites: Toxin: Pyrrolizidine alkaloids (Hepatotoxins) Adulterant: Crotolaria plant (Jhunjhunia) 246. Epidemic dropsy is caused by: (a) Sanguinarine (b) BOAA (c) Pyruvic Acid (d) Mustard oil Edema in Epidemic dropsy occurs due to proteinuria (specifically loss of albumin). Argemone oil may be detected by following tests: – Nitric acid test – Paper chromatography test: Most sensitive test 247. BOAA is the toxin responsible for: (a) Epidemic Dropsy (b) Neurolathyrism (c) Endemic Ascitis (d) Fluorosis Neurolathyrism is caused by eating the pulse 'Khesari Dal (Lathyrus sativus)'; Diets containing over 30 % of this dal consumed over a period of 2 - 6 months result in neurolathyrism Toxin present in lathyrus seeds is 'Beta oxalyl amino alanine (BOAA)' 248. BOAA, the toxin responsible for Neurolathyrism, contains which amino acid: (a) Aspartate (b) Arginine (c) Alanine (d) Butyrate 249. The active principle responsible for causing epidemic dropsy is: (a) Pyruvic acid (b) BOAA (c) Sanguinarine (d) Phenylpyruvic acid 250. Ingestion of which of the following can result in ergotism? (a) Bajra (b) Maize (c) Kesari dal (d) Mustard Ergotism: – Occurs due to food toxicant - ergot fungus 'Claviceps fusiformis' – Food items having a tendency for ergotism: Bajra Rye Sorghum Wheat – Removal of ergot: Float them in 20% salt water Hand-picking Air-floatation – Upper safe limit for ergot: 0.05 mg per 100 grams food material 251. Lathyrism is due to consumption of: (a) Red gram dhal (b) Contaminated ground nuts (c) Bengal gram dhal (d) Khesari dhal 252. Which of the following statement (s) is/are true about Lathyrism: (a) Vitamin C prophylaxis (b) Banning of crop (c) Flaccid paralysis (d) Parboiling detoxicate pulses (e) BOAA is causative toxin 253. Manifestation(s) of Epidemic dropsy is/ are: (a) Glaucoma (b) CHF (c) GI bleed (d) Gut telangiectasia (e) Dyspnoea 254. Ergotism is due to toxic alkaloids produced by fungus: (a) Trichophyton (b) Claviceps purpurea (c) Fusarium species (d) Absidia 255. Endemic ascites is caused by: (a) Argemone Mexicana seed (b) Khesari dal (c) Jhunjhunia seeds (d) Ergot poisoning (e) Aspergillus flavus 256. Argemone oil contamination of mustard oil can be detected by: (a) Phosphatase test (b) Nitric acid test (c) Coliform test (d) Methylene blue test 257. Most sensitive test for sanguinarine is: (a) FeC13 (b) Paper chromatography (c) HCl (d) Nitric Acid 258. Cause of epidemic dropsy is: (a) Pyrolizidine (b) Sanguinarine (c) Fusarium toxin (d) BOAA 259. Lathyrism results due to: (a) Aflatoxin (b) BOAA (c) Pyruvic acid (d) Sanguinarine 260. Neuro lathyrism results due to: (a) Aflatoxin (b) BOAA (c) Pyruvic acid (d) Sanguinarine 261. Cause of endemic ascites is: (a) Pyrolizidine (b) Beta-oxaloacetate (c) Sanguinarine (d) Aflatoxin 262. Epidemic dropsy is due to: (a) Sanguinarine oil (b) BOAA (c) Drug induced (d) Ergot alkaloids 263. Toxin present in lathyrus sativa: (a) Pyrazolone alkaloids (b) Sanguinarine (c) BOAA (d) Aflatoxin 264. Lathyrism from Khesari dal can be prevented by which process: (a) Parboiling (b) Heating (c) Soaking (d) Filtration 265. Test to detect contamination of mustard oil with argemone oil? (a) Nitric acid test (b) Sulphuric acid test (c) Chromic acid test (d) All of the above Miscellaneous 266. Indian reference man is: (a) 55 kg (b) 60 kg (c) 65 kg (d) 70 kg 267. Which of the following statements about Recommended Dietary Allowance is false? (a) RDA is decided by a panel of experts and is based on scientific research (b) RDA caters to dietary requirements of all people (c) RDA is often higher than the recommended minimum requirement (d) RDA is based on Estimated Average Requirement RDA is often higher than the recommended minimum requirement: RDA includes both daily requirement and some additional requirement for periods of growth or illness. RDA 'safe level approach' is not used for energy since excess energy intake is undesirable; for energy only mean or average requirement is defined as RDA 268. A man weighing 68 kg, consumes 325 gm carbohydrate, 65 gm protein and 35 gms fat in his diet. The most applicable statement here is: (a) His total calorie intake is 3000 kcal (b) The proportion of proteins, fats and carbohydrates is correct and in accordance with a balanced diet (c) He has a negative nitrogen balance (d) 30% of his total energy intake is derived from fat In 'Balanced Diet', – Proteins should constitute 10 - 15 % of total daily energy intake – Fats should constitute 15 - 30 % of total daily energy intake – Carbohydrates, rich in fibre, should constitute the remaining of energy In the given question, a man weighing 68 kg, consumes 325 gm carbohydrate, 65 gm protein and 35 gms fat in his diet  Energy (Kcal Amount Energy % of total per gram) consumed consumed (Kcal) energy (grams) consumed Carbohydrate 4 325 1300 68% Fats 4.2 65 275 15% Proteins 9.0 35 315 17% Total 1890 Kcal His total energy intake is 1890 Kcal 15% of his energy is derived from fats Thus, the proportion of proteins, fats and carbohydrates is correct and in accordance with a balanced diet. 269. Food standards in India have to achieve a minimum level of quality under: (a) Codex Alimentarius (b) Bureau of Indian Standards (c) Agmark standards (d) PFA standards Food Standards: – Codex Alimentarius: Joint FAO/WHO standards for international markets; Food standards in India are based on Codex Alimentarius – PFA standards: Laid under 'Prevention of Food Adulteration Act 1954'; to obtain a minimum level of quality of food stuffs attainable under Indian conditions – Bureau of Indian Standards: Purely voluntary; express degree of excellence above PFA standards – Agmark standards: Purely voluntary; express degree of excellence above PFA standards 270. Weight of an Indian reference woman is: (a) 45 Kg (b) 50 Kg (c) 55 Kg (d) 60 Kg 271. True about midday meal programme: (a) Provides 1/2 the total energy requirement & 1/3 the total protein requirement in a child (b) A substitute for home diet (c) Main objective of this scheme is to eliminate malnutrition (d) None of the above Mid-day meal programme (MDMP): Also known as 'School Lunch Programme', it has been in operation since 1961 The major objective of MDMP: To attract more children for admission to schools and retain them so that literacy improvement of children could be brought about. The meal is a supplement and not a substitute to the home diet The meal should supply 1/3 of the total energy requirement and 1/2 of the total protein requirement. MDMP is being operationalised under the Ministry of Education National Institute of Nutrition, Hyderabad is of the view that minimum number of feeding days in year be 250 to have the desired impact on children Mid-day meal scheme (MDMS) (National Programme of Nutritional Support to Primary Education): Launched in 1995 with the main objective universalisation of primary education by increasing enrolment, retention and attendance and simultaneously impacting on nutrition of students in primary classes – It aims at providing 450–700 calories and 12–20 gm proteins per day to all children class I to VIII. 272. Mid day meal contains proteins and calories in what proportions: (a) 1/2 proteins and 1/2 calories (b) 1/2 proteins and 1/3rd calories (c) 1/3rd proteins and 1/3rd calories (d) 2/3rd calories and 1/3rd proteins The mid-day meal should supply 1/3 of the total energy requirement and 1/2 of the total protein requirement Item Quantity per child per day Primary Upper primary Food grains 100 grams 150 grams Pulses 20 grams 30 grams Vegetables 50 grams 75 grams Oils & fats 5 grams 7.5 grams Salt As per need As per need TOTAL calories 450 Kcal 700 Kcal TOTAL proteins 12 grams 20 grams 273. Dietary changes advocated by WHO for prevention of heart diseases include all of the following except: (a) A decrease in complex carbohydrate consumption. (b) Reduction in fat intake to 20-30 per cent of caloric intake. (c) Consumption of saturated fats be limited to less than 10% of total energy intake. (d) Reduction of cholesterol to below 100mg per 1000 kcal per day. 274. ‘One Dietary Cycle’ comprises of: (a) 24 hrs (b) 48 hrs (c) 7 days (d) 1 month Assessment of dietary intake (Diet Survey) can be carried out by 'Dietary Cycle', where 'weighment of raw foods is done over a period of 7 days'. 275. All are examples of Food Fortification except: (a) Iodisation of salt (b) Vitamin A in Vanaspati (c) Fluoridation of water (d) Saffron colour in milk Food fortification: Is a public health, measure where nutrients are added to food (in relatively small quantities), to maintain/improve the quality of diet of a group, community or a population Examples of Food Fortification: – Iodisation of salt – Vitamin A and Vitamin D in Vanaspati – Fluoridation of water Food Fortification is an example of 'Primary Level of Prevention' Vanaspati is fortified with '2500 IU Vitamin A and 175 IU Vitamin D' per 100 grams. 276. Nalgonda Technique is used for: (a) Chlorination of water (b) Defluoridation of water (c) Iodisation of salt (d) Detoxification of contaminated mustard oil  'Nalgonda Technique' has been developed by National Environmental Engineering Research Institute (NEERI), Nagpur for defluoridation of water. It involves 'addition of lime, alum and bleaching powder' followed by flocculation, sedimentation and filteration. In Nalgonda technique, aluminium is major de-fluoridating agent. Household level de-fluoridation can be done by: – Nalgonda Technique – Alumina – Phosphates 277. Shakir’s tape is a useful method employed in the field to measure: (a) Head Circumference (b) Mid arm Circumference (c) Height/Length (d) Chest circumference Shakir's Tape is a useful field instrument for measurement of nourishment status of a child, through measurement of Mid-arm-circumference (MAC) MAC is measured for age group 1 - 5 years (as it remains practically constant during this age) Interpretation of Shakir's tape findings: MAC (cms) Color Interpretation Management Zone > 13.5 Green Satisfactory nutritional status – 12.5 - 13.5 Yellow Mild-moderate malnutrition At home; through diet < 12.5 Red Severe malnutrition Refer; Institutional Also Refer to Annexure 3. 'Bangle Test' (4 cm diameter) is also used for quick assessment of MAC 'Quac Stic' measures malnourishment by comparing MAC with height. 278. Salter’s Scale is a useful method employed in the field to measure: (a) Mid arm Circumference (b) Length at birth (c) Skin fold thickness (d) Birth weight Bathroom weighing scale is unreliable instrument for measuring weight of children; For field conditions, Salter's Spring Scale is quite satisfactory as it is easy to carry. 279. What will be the BMI of a male whose weight is 89 kg and height is 172 cm? (a) 27 (b) 30 (c) 33 (d) 36 Body Mass Index (BMI): A simple index of weight-for-height that is commonly used to classify under-weight, overweight and obesity in adults. – BMI is also known as 'Quetelet's Index' BMI = Weight (Kg) Height2 (m2) In the given question, weight = 89 kg and height = 172 cm, Thus, BMI = 89/(1.72)2 = 30.08. 280. Which of the following poisonings can result in spastic paraplegia? (a) Lathyrus (b) Strychnine (c) Sanguinarine (d) Organophosphates Neurolathyrism is a crippling disease of nervous system, characterized by gradually developing spastic paralysis of lower limbs, occurring mostly in adults. 281. Pellagra: (a) Is due to pyridoxine deficiency (b) Occurs with diet chiefly on maize (c) Night blindness is a presenting feature (d) Causes high output cardiac failure 282. Why cereals and pulses are combined: (a) 10% cereals contain protein and pulses contain 40% (b) Cereals are deficient in methionine and lysine is deficient in pulses (c) Cereals are deficient in lysine and methionine is deficient in pulses (d) Cereals are rich in essential AA 283. What is /are components of Nutrition surveillance? (a) Policy maker (b) AFP surveillance (b) Nutritional survey (d) DOTS Nutritional surveillance: Keeping a watch over nutrition, in order to make decisions that will lead to improvement in nutrition of population – Main strategy: Detection of malnutrition (nutritional survey) – Approach: Diagnostic-interventional – Sample: Representative, 50 - 100 size group – Objectives: 1. To aid health and development 2. To provide input for program management and evaluation (to policy makers) 3. To give timely warning and intervention (to prevent short-term food crises) 284. Weight of Indian reference man: (a) 60 (b) 55 (c) 50 (d) 45 285. Regular drinking of which of the following can help prevent Urinary tract infection (UTI)? (a) Grape juice (b) Orange juice (c) Cranberry juice (d) Raspberry juice Cranberry Juice Mechanism for prevention of UTI: Proanthocyanidins in Cranberry juice prevent bacterial fimbriae from attaching to wall of urinary bladder and urinary tract. 286. Which of the following are true regarding principles suggested for Mid-day meal programme? (a) Meal should be a supplement only not a substitute for home diet (b) Meal should provide 1/2 calories and 1/3 proteins (c) Meal cost should be low (d) Complicated cooking process must not be involved (e) Keep same menu of meals for longer periods Principles for Formulating Mid-Day Meals: Meal should be a supplement only not a substitute for home diet Meal should provide 1/3 calories and 1/2 proteins Meal cost should be low  Complicated cooking process must not be involved Use locally available foods Keep changing menu frequently 287. Common to both acute and chronic malnutrition is: (a) Weight for age (b) Weight for height (c) Height for age (d) BMI 288. Food with maximum cholesterol content: (a) Egg (b) Coconut oil (c) Hydrogenated fats (d) Ghee (hydrogenated) 289. True about Indian reference male is: (a) Age 18-29 yrs (b) Weight 65 kg (c) Work is mainly sedentary (d) Works for 10 hrs 290. For Indian reference male is true: (a) Weight 60 kg (b) Works for 15 hours (c) Age 20-25 yrs (d) Daily exercise 291. International food standards include: (a) BIS standards (b) Codex alimentarius standards (c) AgMark standards (d) PFA standards 292. Acute severe malnutrition diagnostic criteria include all except: (a) Bipedal edema (b) Visible severe wasting (c) Mid arm circumference below 115 mm (d) Weight for height below 2SD of WHO Growth Standards 2006 WHO & UNICEF’s Acute Malnutrition Criteria Presence of Bipedal edema Visible severe wasting Mid arm circumference below 115 mm Weight for height below 3SD of WHO Growth Standards 2006 293. Biological value is maximum of: (a) Egg (b) Milk (c) Soyabean (d) Pulses 294. True about Mid-day meal given in school is: Calories Proteins (a) 1/3 1/2 (b) 1/3 1/3 (c) 1/2 1/2 (d) 1/2 1/3 295. About protein energy malnutrition, following are true except: (a) Optimal protein supplementation is 1.5-2g/kg/day (b) Hepatomegaly is an essential feature (c) Hypothermia may be a cause of death (d) Common in developing countries 296. The best parameter for assessment of chronic malnutrition is: (a) Weight for age (b) Weight for height (c) Height for age (d) Any of the above 297. Richest source of cholesterol is: (a) Egg (b) Hydrogerated oil (c) Butter (d) Cheese 298. True about Mid-day meal given in school is: Calories Proteins (a) 1/3 1/2 (b) 1/3 1/3 (c) 1/2 1/2 (d) 1/2 1/3 299. Biological value is maximum of: (a) Egg (b) Milk (c) Soyabean (d) Pulses 300. Indian reference man? (a) 55 Kg (b) 60 Kg (c) 65 Kg (d) 70 Kg 301. In assessing the nutritional status of community the following are used except: (a) Mortality in 1-4 years age group (b) Low birth weight (c) Weight/height index in preschool children (d) Percentage of pregnant lady with less than 11.5% Hb 302. Vitamin A prophylaxis includes all except: (a) For infant 1,00,000 I.U. at 6 month interval (b) For more than 1 years 2,00,000 I.U at 6 month interval (c) For postpartum 3,00,000 I.U (d) 50,000 I.U at birth 303. Dental caries is due to deficiency of: (a) Fluorine (b) Zinc (c) Lead (d) Calcium 304. Nutritional status of community is measured by all except: (a) Mid-arm circumference in 0-1 year age group (b) Anemia detection in pregnancy (c) Child birth weight 0.5 mg per litre (ppm) 1 hour Water bodies, post disaster > 0.7 mg per litre (ppm) 1 hour Swimming pool sanitation > 1.0 mg per litre (ppm) 1 hour *(1 mg per litre = 1 ppm) Correct dose of chlorine to be applied: Chlorine demand + FRC 0.5 mg per litre. Bleaching powder (CaOCl2)contains: 33% available chlorine Chlorine acts best as a disinfectant for water at: pH around 7.0 Instruments used in chlorination of water: Instrument Utility Horrock’s Apparatus Chlorine demand estimation Chlorinator/ Chloronome Mixing or regulating dose of chlorine Chloroscope Measuring residual level of chlorine Tests for chlorination of water: – Ortho-toulidine (OT) Test: Measure the levels of, 1. Free chlorine 2. Free & Combined chlorine – Ortho-toulidine Arsenite (OTA) Test: Measure the levels of,  1. Free chlorine 2. Combined chlorine OTA test is better than OT test as: – Detects both free and combined chlorine separately – Not affected by interfering substances (nitrites, iron, manganese). 3. Nitrates in excess of—may cause infantile methaemoglobinaemia: (a) 15 mg/1 (b) 25 mg/1 (c) 35 mg/1 (d) 45 mg/1 Guideline value of nitrate in drinking water: < 50 mg/litre – Nitrates in drinking water indicate: Remote contamination – Is solely used for prevention of methemoglobinemia Guideline value of nitrite in drinking water: < 3 mg/litre – Nitrites in drinking water indicate: Recent contamination – May lead to ‘Blue baby syndrome’ Concentration of nitrate/Guideline value of nitrate + Concentration of nitrite/Guideline value of nitrite should be < 1 4. All the following provide evidence of faecal pollution except: (a) Faecal streptococci (b) Coliform (c) Cl. Tetani (d) Enterpathogenic virus Bacteriological indicators of water quality: – Coliforms (E.coli is most important microbiological indicator) – Fecal streptococci (Indicator of recent contamination) (Sodium Azide medium) – Clostridium perfringens (Indicator of remote contamination) Acceptable level of coliforms in drinking water: None – EXCEPTION: In large urban supplies, up to 5% samples are acceptable to be contaminated, if taken continuously for a period of 12 month 5. Per capita allowance of water per day is recommended at: (a) 70-80 lit (b) 80-120 lit (c) 120-150 lit (d) 150-200 lit Water supply considered adequate to meet the need for domestic purposes: – Urban: 150-200 litres per capita per day – Rural: 40-60 litres per capita per day Daily drinking water requirement: 2-3 litres per capita per day. Criteria for identification of ‘Problem Habitations’: – Not Covered (NC)/No Safe Source (NSS) Habitations: 1. Drinking water source point is not within 1.6 kms in plains or 100 m elevation in hilly areas 2. Water source affected with quality problems like excess salinity, iron, fluoride, arsenic, or other toxic materials or biologically contaminated 3. Quantum of availability of safe water is not enough to meet drinking and cooking needs – Partially Covered (PC) Habitations: 1. Drinking water source point is within 1.6 kms in plains or 100 m elevation in hilly areas 2. Capacity of system is 10 – 40 lpcd – Fully Covered (FC) Habitations: include all the remaining habitations. 6. Recommended standard for bacterial water quality in small community supplies is:  (a) No coliform (b) No E coli in 100 ml (c) Coliform less than 10/100 ml (d) Coliform less than 1/100 ml 7. Temporary hardness of water is primarily due to the presence of: (a) Calcium and magnesium sulphates (b) Calcium and magnesium chlorides (c) Calcium and magnesium bicarbonates (d) Calcium and magnesium nitrates Hardness of water is defined as the ‘soap destroying power of water’. Hardness of water is of two types: Type of Hardness Underlying causes Temporary hardness Calcium & Magnesium salts of Bicarbonates (Carbonate hardness) Permanent hardness Calcium & Magnesium salts of Sulfates (Non- Carbonate Calcium & Magnesium salts of Chlorides hardness) Calcium & Magnesium salts of Nitrates Hardness of water is expressed in terms of: milliequivalents per litre (meq/litre) of CALCIUM CARBONATE (CaCO3) –– 1 meq/litre hardness = 50 mg CaCO3 (50 ppm) per litre of water Classification of hardness in water: Classification Level of Hardness (mq/litre) Soft water < 1 (< 50 mg/l) Moderately Hard 1 – 3 (50 – 150 mg/l) water Hard water 3 – 6 (150 – 300 mg/l) Very Hard water > 6 (> 300 mg/l) –– Softening of water is recommended at level of hardness > 3 meq/ litre (>150mg/ litre of Calcium carbonate) 8. Horrock’s apparatus estimates: (a) Free chlorine (b) Combined chlorine (c) (a) + (b) (d) Chlorine demand Horrock ’s Apparatus Use: To find out the dose of bleaching powder required for disinfection of water, i.e. ‘Chlorine demand estimation of water’ Dose of bleaching powder required (Chlorine demand): – n × 2 gms to disinfect 455 litres of water (where n = no. of first cup which shows distinct blue colour). 9. Which one of the following methods is used for the estimation of chlorine demand of water? (a) Chlorometer (b) Horrock’s apparatus  (c) Berkefeld filter (d) Double pot method Chlorine demand of water: Is the amount of chlorine that is needed to destroy bacteria, and to oxidize all the organic matter amd ammoniacal substances present in water – Is the amount of chlorine added to water minus amount of residual chlorine remaining at the end of a specific period of contact (1 hr) – Estimation of chlorine demand of water (or dose of bleaching powder required for disinfection of water) is done by ‘Horrock’s apparatus’. 10. Ortho-toulidine test is used to determine: (a) Nitrates in water (b) Nitrites in water (c) Free and combined chlorine in water (d) Ammonia content in water 11. Most desired temperature range for drinking water is: (a) 0-5°C (b) 5-10°C (c) 10-15°C (d) 15-20°C Most desired temperature range for drinking water is 40 – 50° F (5-10°C). 12. Most undesirable metal in drinking water is: (a) Iron (b) Copper (c) Zinc (d) Lead Undesirable metals in drinking water: Iron, manganese, zinc, copper, aluminium, lead MOST undesirable metal in drinking water: Lead – Lead was earlier seen in drinking water when water was being supplied through lead pipes Undesirable salts in drinking water: Chlorides, Fluorides, Nitrites, Nitrates, Calcium, Magnesium Undesirable gases in drinking water: Ammonia, Hydrogen sulphide, Methane. 13. ‘Most reliable’ evidence of fecal contamination of water is provided by: (a) Coliform bacteria (b) Cl. Perfringens (c) St. fecalis (d) Cl. Welchii Coliform organisms: – Primary & most reliable bacterial indicator for water quality – E. coli is most important coliform indicator – Reasons for choosing coliforms as indicators of fecal pollution rather than water – Borne. pathogens: 1. Constant presence in great abundance in human intestine; foreign to potable waters 2. Easily detectable by culture methods 3. Longer survival period 4. Greater resistance to forces of natural purification. 14. Scabies, an infection of the skin caused by Sarcoptes scabiei, is an example of: (a) Water borne disease (b) Water washed disease (c) Water based disease (d) Water related disease Water washed diseases: Include infections of the outer body surface which occur due to inadequate use of water or improper hygiene. Examples: Scabies, Trachoma, Typhus, Bacillary dysentery, Amoebic dysentery  Scabies: Is a transmissible ectoparasite skin infection characterized by superficial burrows, intense pruritus (itching) and secondary infection – Scabies is caused by the mite Sarcoptes scabei, variety hominis (known as ‘Itch mite’) – Scabies is usually transmitted by close contact with an infested person; Scabies is transmitted readily, often throughout an entire household, by skin-to-skin contact with an infected person and thus is sometimes classified as a sexually transmitted disease (STD) – Drug of Choice for scabies: 5% Permethrin (Oral systemic DOC: Ivermectin) – Scabies was the first disease of man with known cause. 15. “Safe and Wholesome water” does not include being: (a) Free from pathogenic agents (b) Free from harmful chemical substances (c) Free from colour and odour (d) Free from chlorine 16. A daily water supply considered adequate to meet the need for all urban domestic purposes is: (a) 10 litres per capita (b) 20 litres per capita (c) 40-60 litres per capita (d) 150-200 litres per capita Norms of water supply for urban areas: Type of urban area Norm for water supply Towns with piped water supply, but no 70 lpcd sewerage system Cities with piped water supply & 135 lpcd existing/planned sewerage Metropolitan & Megacities with piped water 150 lpcd supply & sewerage Public stand post 40 lpcd (lpcd: litres per capita per day) 17. All are “Water-Washed Diseases” except: (a) Scabies (b) Trachoma (c) Typhoid (d) Conjunctivitis 18. All are true for Rapid Sand Filters except: (a) No preliminary storage of raw water is required (b) Operation requires highly skilled persons (c) Frequent washing is not required (d) Can be gravity type or pressure type Comparison of Rapid and Slow Sand Filters Rapid Sand Filter Slow Sand Filter Space Occupies very little Occupies very little space space Occupies large area  Rate of filtration 200 m.g.a.d. 200 m.g.a.d. 2 – 3 m.g.a.d. Effective size of sand 0.4 – 0.7 mm 0.2 – 0.3 mm Coagulation, Preliminary treatment sedimentation Plain sedimentation Washing By back-washing By scraping sand bed Frequent washing Required Not required Mechanism of action Essentially physical Both physical & mechanical Operation Highly skilled Less skilled Loss of head allowed 6 – 8 feet 4 feet Removal of turbidity Good Good Removal of colour Good Fair Removal of bacteria 98 – 99 percent 99.9 – 99.99 percent Suitability For big cities For small towns Vital layer (Schmutzdecke, Zoogleal layer or Biological layer): Slimy, gelatinous layer consisting of algae, planktons, diatoms and bacteria is formed in the slow sand filter – Vital layer is the ‘Heart of Slow Sand Filter’ – Formation of vital layer is known as ‘Ripening of the filter’ – It removes organic matter, holds back bacteria oxidizes nitrogen to nitrates and helps in yielding bacteria-free water. 19. Disinfecting action of chlorine on water is mainly due to: (a) Hydrogen chloride (b) Hypochlorous acid (c) Hypochlorite ions (d) Hydrogen ions 20. Which of the following agents have ‘residual germicidal effect’ when used for disinfection of water: (a) Chlorine only (b) Chlorine and Ozone gas (c) Chlorine and UV radiation (d) Chlorine, Ozone gas and UV radiation Ozone gas and UV radiation has got no residual action. Free Residual Chlorine (FRC) is allowed to accumulate in water till it reaches a level of 0.5 ppm (mg/litre) when it becomes fit for community supply. FRC has a bactericidal action that takes care of post-chlorination contamination of drinking water. Chlorine has no effect on bacterial spores, protozoal cysts and helminthic ova (except in higher doses). Viral agents of Infectious hepatitis (Hepatitis A) and Poliomyelitis are also resistant in normal doses, as are cyclops. 21. Proposed guideline values for Radioactivity in Drinking water is: (a) Gross a activity 0.1 Bq/L and Gross b activity 1.0 Bq/L (b) Gross a activity 1.0 Bq/L and Gross b activity 0.1 Bq/L (c) Gross a activity 1.0 Bq/L and Gross b activity 10.0 Bq/L (d) Gross a activity 10 Bq/L and Gross b activity 1.0 Bq/L Key guideline aspects of WHO recommended drinking water quality: – Colour < 15 true colour units (TCU) – Turbidity < 5 nephlometric turbidity units (NTU)  – pH: 6.5 – 8.5 – Total dissolved solids (TDS) < 600 mg/litre – Zero pathogenic microorganisms – Zero infectious viruses – Absence of pathogenic protozoa and infective stages of helminthes – Fluorine < 1.5 ppm (0.5 – 0.8 ppm: Optimum level) – Nitrates < 50 mg/litre – Nitrites < 3 mg/litre – Gross alpha radiological activity < 0.5 Bq/litre (New Guideline — Who) – Gross beta radiological activity < 1.0 Bq/litre (New Guideline — Who). 22. MPN Multiple Tube Method is done to: (a) Detect the presence of Coliform organisms in a sample of water (b) Detect the presence of Faecal streptococci in a sample of water (c) Detect the presence of Cl. perfringens in a sample of water (d) Do the colony count of bacteria Periodicity of water sample collection for bacteriological examination: Population served Minimum interval between successive samples < 20,000 1 month 20,001 – 50,000 2 weeks 50,001 – 100,000 4 days > 100,000 1 day 23. Level of hardness in soft water is ___ mEq/liter: (a) Less than 1 (b) 1-3 (c) 3-6 (d) Over 6 Methods of removal of hardness of water: Type of hardness Methods of removal Temporary Boiling hardness Addition of lime Addition of sodium carbonate Permutit process Permanent Addition of sodium carbonate hardness Base exchange process 24. To find out the dose of bleaching powder required for disinfection of water, following is used: (a) Chloroscope (b) Chloronome (c) Horrock’s apparatus (d) Winchester Quart Bottle 25. Indicator solution in Horrock’s Apparatus contains: (a) Ortho-toulidine (b) Starch iodide (c) Ortho-toulidine arsenite (d) Bromocresol purple  Indicator in Horrock’s apparatus: Starch iodide Indicator in Presumptive coliform test (MPN Multiple Tube Method): Bromocresol purple 26. The minimum recommended dose of “free” residual chlorine in water for routine chlorination (in mg/ lts) is: (a) 0.5 mg/l for a contact period of 1hr (b) 0.5 mg/l for a contact period of 1/2 hr (c) 1.0 mg/l for a contact period of 1hr (d) 1.0 mg/l for a contact period of 1/2 hr 27. True statement regarding chlorination is (a) Orthotolidine test measures combined chlorine separately: (b) Chlorine acts best when pH is around 7 (c) It kills bacteria, viruses and spores (d) Hypochlorite ions are mainly responsible for disinfecting activity 28. What is the amount of bleaching powder required to disinfect 455 litre of water if 4, 5, 6 cup shows distinct colouration in Horrock’s apparantus? (a) 2 g (b) 6 g (c) 8 g (d) 4 g 29. Temporary hardness of water is due to presence of: (a) Bicarbonates of calcium and magnesium (b) Chlorides of calcium and magnesium (c) Nitrates of calcium and magnesium (d) Oxides of calcium and magnesium 30. When the level of hardness in water is around 150-300 mg / litre it is classified as: (a) Very hard water (b) Hard water (c) Moderately hard water (d) Soft water 31. The minimum recommended level of residual chlorine in the drinking water is for one hour: (a) 0.25 mg/L (b) 0.5 mg/L (c) 1.0 mg/L (d) 2.0 mg/L 32. Slow sand filter is differentiated from rapid sand filter by: (a) Bacteria are removed more effectively (b) Skilled person is needed (c) Cost construction is cheaper (d) Sand particle are of smaller size (e) Longer duration is needed 33. Indication of Fecal contamination of water is due to presence of: (a) E. coli (b) Coliform (c) Enterococci (d) Clostridium difficile (e) Streptococcus pyogenes 34. Orthotoulidine test done for estimation of: (a) Free chlorine (b) Combined chlorine (c) Fluoride (d) Iodine content 35. NOT seen in fecal pollution: (a) Staphylococcus (b) Streptococcus (c) E.coli (d) Clostridium perfringens 36. All of the following statements about purification of water are true except: (a) Presence of Clostridial spores indicates recent contamination of water (b) Coliforms must not be detectable in any 100 ml sample of drinking water (c) Sodium thiosulphate is used to neutralize certain contaminants (d) Coliforms may be detected by multiple tube method and indole production 37. Chlorine demand estimated by: (a) Horrock’s apparatus (b) Berkefield filter (c) Chlorometer (d) Double pot method 38. Ortho-toulidine test (OT Test) is used to detect: (a) Chlorine (b) Nitrites (c) Ammonia (d) Nitratesx 39. All the following statements about purification of water are true except: (a) Presence of clostridial spores indicate recent contamination (b) Coliforms must not be detectable in any 100 ml sample of drinking water (c) Sodium thiosulphate is used to neutralize chlorine (d) Coliforms may be detected by multiple tube method and indole production at 44 degrees 40. In a slow sand filter, the element responsible for yielding bacteria free water is the: (a) Valve (b) Vital layer (c) Supernatant water (d) Under-drainage system 41. True about slow sand filter is: (a) Occupies less space (b) More expensive (c) Requires longer duration (d) Sand size 0.4-0.7 mm 42. Coliform test is for: (a) Air pollution (b) Water contamination (c) Sound pollution (d) None 43. Softening is recommended when hardness of water is more than: (a) 50 mg/litre (b) 75 mg/litre (c) 100 mg/litre (d) 150 mg/litre 44. The vital layer in a slow sand filter is: (a) Sand bed (b) Under drainage (c) Zoological layer (d) Supernatant 45. Horrock’s apparatus determines Chloride which has to have a holding level of: (a) 1.0 mg/L  (b) 1.5 mg/L (c) 2.0 mg/L (d) 0.5 mg/L 46. Process of deflouridation of water is: (a) Nalgonda technique (b) Soaking (c) Sand filter (d) Parboiling 47. Criteria for drinking water quality recommended by WHO includes: (a) Colour 500 mg/litre and Weak Sewage has suspended solids amount < 100 mg/litre. 4. A good trap should have effective seal of: (a) 2.5 cm (b) 5 cm (c) 7.5 cm (d) 10 cm The trap: Is a bent pipe in sanitary latrine, about 7.5 cms in diameter and connected with the pan – Trap is a ‘Water seal’: it holds water; prevents access by flies and suppresses the nuisance from smell – Depth of water seal in RCA sanitary latrine: 2 cms (¾ inch) – Water seal in sanitary latrine is an example of ‘Sanitation barrier’ Sanitation barrier: Barrier to prevent spread of faecal – oral diseases – Sanitation barrier is between 5F’s: Faeces on one side and Fingers, Flies, Fomites, Food (water, soil) on other side – Sanitation barrier can be provided by: 1. Sanitary latrine 2. Disposal pit 5. All are features of septic tank except: (a) Ideal retention period – 48 hrs (b) Minimum capacity – 500 gallons (c) Aerobic oxidation takes place outside (d) Sludge is solids setting down Septic Tank : Is a water-tight masonary tank into which household sewage is admitted for treatment Is a satisfactory method of disposing liquid and excreta wastes from individual dwellings, small groups of houses or institutions which have ‘adequate water supply but do not have access to a public sewerage system’ Design features of a septic tank: – Ideal retention period: 24 hours Steps of purification in a septic tank: – Anaerobic digestion: takes place in septic tank proper – Aerobic oxidation: takes place in sub-soil (outside septic tank). 6. Sullage consists of: (a) Solid vegetable waste matter (b) Inorganic waste [Recent Question 2013] (c) Waste containing human excreta (d) Waste water from kitchen 7. Most satisfactory method of Refuse disposal is: (a) Dumping (b) Controlled tipping (c) Incineration (d) Manure pits Sanitary Landfill (Controlled Tipping): Laying of dry & condensed refuse in layers with intervening earth partitions & coverings, followed by mechanical compression (Most Satisfactory Method) – Trench Method – Ramp Method – Area Method 8. The depth of Water Seal in RCA Latrine is: (a) 1 cm (b) 2 cms (c) 5 cms (d) 12 cms 9. Strength of sewage is expressed in terms of all except: (a) E-Coli Count (b) Suspended particles (c) Chemical oxygen demand (d) Biological oxygen demand 10. The biological oxygen demand (BOD) indicates: (a) Organic matter (b) Bacterial content (c) Anaerobic bacteria (d) Chemicals Biological Oxygen Demand (BOD): Is defined as ‘amount of oxygen absorbed by a sample of sewage’ during a specified period (Generally 5 days), at a specified temperature (generally 20° C) for aerobic destruction or use of organic matter by living organisms – BOD is most important test done for estimation of strength of sewage (done through Dilution method and Manometric method) – Strong Sewage has BOD > 300 g/litre and Weak Sewage has BOD < 100 g/litre. 11. Waste water without human excreta is called: (a) Sewage (b) Humus (c) Sullage (d) Effluent 12. Following latrines are suitable for camps and temporary use except: (a) Shallow trench latrine (b) Pit latrine (c) Borehole latrine (d) Septic tank 13. Biochemical oxygen demand is calculated to know: (a) Organic waste (b) Inorganic waste (c) Total solids (d) Toxic substances 14. Following are the waste types not to be incinerated except: (a) Pressurized gas containers (b) Reactive chemical waste (c) Halogenated plastics (d) Content of combustible matter above 60% 15. It waste water contain toxic substances, organic load is measured by: (a) Biological oxygen demand (b) Chemical oxygen demand (c) Suspended solid (d) None 16. The heart of activated sludge process is: (a) Aeration tank (b) Primary sedimentation (c) Digestion tank (d) Secondary sedimentation tank 17. Septic tank true is/ are: (a) Treatment of household sewage (b) Suitable in presence of public sewerage system (c) Aerobic oxidation outside septic tank (d) Anaerobic digestion inside septic tank (e) Retention period 6 hours 18. True about Sewage is/ are: (a) Does not contain human excreta (b) Strength measured by Biological oxygen demand (c) BOD >100 mg/L is strong sewage (d) Composed of 90% water (e) Dry weather flow is measured for 24 hours period 19. The sewage ground water is disposed by: (a) Oxidation pond (b) Soakage pit (c) Activated sludge process (d) Any of the above 20. If land is available the ideal method of disposal is: (a) Composting (b) Incineration (c) Controlled tipping (d) None 21. Not a feature of septic tank: (a) Used for personal and small public use (b) Water tight compartment (c) Used where water supply is adequate (d) Used where public sewerage system is adequate 22. Trickling filter is used in: (a) Primary treatment of sewage (b) Secondary treatment of sewage (c) Swage effluent treatment (d) Sewage farming treatment 23. Best method for disposal of refuse where land is available: (a) Burial (b) Dumping (c) Manure pit (d) Controlled tipping 24. Most important prerequisite in sanitary latrine is: (a) Water seal (b) Adequate drainage (c) Squatting plate/slab (d) Smooth slope of the pan 25. Septic tank true is: (a) Always double chamber (b) Minimum 200 galon capacity (c) Depth is from 5-7 feet (d) Retention period is of 24 hrs 26. The function of grit chamber in modern sewage plants is: (a) Formation of sludge (b) Removal of floating large objects (c) Settlement of heavy objects (d) Formation of Zoogleal layer 27. All the following wastewater contains human excreta except: (a) Sewage (b) Sullage (c) Faeces (d) None 28. Strength of sewage is expressed in terms of all except: (a) Biological Oxygen Demand (b) Chemical oxygen demand (c) Suspended solids (d) Coliform count 29. Sullage in rural area is disposed by: (a) Gobar gas plant (b) Septic tank (c) Sewage system (d) Incineration 30. Water not containing feces: (a) Sewage (b) Sullage (c) Both (d) None of these 31. Poliovirus transmission does not occur through: (a) Sewage (b) Sullage (c) Both (d) None of these Test control Theme 2. Methods for assessing the physical development of children and adolescents 1. Which of the following is age independent indicator of malnutrition? (a) Underweight (b) Stunting (c) Wasting (d) MAC 2. There are ____ types of growth charts used in India: (a) 50 (b) 20 (c) 49 (d) 5 3. The uppermost line of the ‘road to health card’ is equivalent to: (a) 80% for boys (b) 50% for girls (c) 50th percentile for boys (d) 3rd percentile for girls 4. Deficit in weight for height in a 3-year-old child indicates: (a) Acute malnutrition (b) Chronic malnutrition (c) Concomitant acute and chronic malnutrition (d) Under weight 5. In WHO growth chart ‘Lower reference curve’ represents: (a) 3rd percentile (b) 50th percentile (c) 80lh percentile (d) 95th percentile 6. All are true about growth chart except: (a) It is a tool for educating mothers (b) The position of dots is more important than direction (c) Between top 2 lines, it shows ‘Road-to-Health’ or ‘zone of normality’ (d) Lowermost line corresponds to children below 3 Percentile 7. Growth chart provides information on: (a) Chronological age, Weight-for-age, Immunization procedures, Birth date and weight (b) Chronological age, BMI-for-age, Immunization procedures, Birth date and birth weight (c) Chronological age, weight-for-stature, Immunization procedures, Birth date and birth weight (d) Chronological age, Length-for-age, Immunization procedures, Birth date and birth weight 8. Age independent anthropometric measure of malnutrition is (a) Weight/height (b) Mid arm circumference (c) Head circumference (d) Mid arm circumference/height 9. In WHO “Road to Health” chart, upper and lower limit of represents (a) 30 percentile for boys and 3 percentile for girls (b) 50 percentile for boys and 3 percentile for girls (c) 30 percentile for boys and 5 percentile for girls (d) 50 percentile for boys and 5 percentile for girls 10. The upper line in the road to health card corresponds to: (a) 95th percentile (b) 50th percentile (c) 3rd percentile (d) 90th percentile 11. Upper reference curve in growth chart of WHO is: (a) 50th percentile (b) 60th percentile (c) 70th percentile (d) 80th percentile 12. The upper line in the road to health card corresponds to: (a) 95th percentile (b) 50th percentile (c) 3rd percentile (d) 90th percentile 13. The best parameter for assessment of chronic malnutrition is: (a) Weight for age (b) Weight for height (c) Height for age (d) Any of the above 14. The best parameter for assessment of Acute malnutrition is: (a) Weight for age (b) Weight for height (c) Height for age (d) Any of the above 15. WHO growth chart is: (a) International based (b) National Based (c) Home based (d) Community based 16. Road to health card or the growth chart was first designed by: (a) Edwin Chadwick (b) David Morley (c) C. Gopalan (d) C.E. Winslow 17. The lower limit of the normal range in a growth chart curve is: (a) 80% median weight (b) 70% median weight (c) 60% median weight (d) 85% median weight 18. True about WHO growth chart is: (a) Used for monitoring growth and development of Child (c) Highest line corresponds to 80th percentile and above (d) Lowest line corresponds to 50th percentile and above 19. In WHO’ Road to health card’ (growth chart) the upper reference line corresponds to: (a) 3rd percentile for girls (b) 50th percentile for boys (c) 80th percentile for girls (d) 97th percentile for boys 20. Growth chart used in India has curves: (a) Two (b) Three (c) Four (d) Five 21. CDC recommends that health care providers: (a) Use the WHO growth standards to monitor growth for infants and children ages 0 to 5 years of age. (b) Use the CDC growth charts for children age 2 years and older. (c) Use the WHO growth standards to monitor growth for infants and children ages 2 to 19 years of age. (d) Use the CDC growth charts for children age 5 years and older. 22. Why CDC recommends using the CDC growth charts for children age 2 years and older: (a) The WHO charts reflect growth patterns among children who were predominantly breastfed (b) The WHO charts reflect growth patterns among formula-fed babies (c) Only CDC charts illustrate the distribution of selected body measurements in children (d) Only WHO charts illustrate the distribution of selected body measurements in children 23. The clinical charts for infants and older children are published in ___ sets: (a) 3 (b) 2 (c) 5 (d) 4 24. Growth chart is generally plotted between: (a) Weight and age (b) Weight for height (c) Height for age (d) Any of the above 25. Best indicator for growth measurement is: (a) Height (b) Weight (c) Arm circumference (d) None 26. Road to Health: (a) reflects modifications in the format of the individual charts (b) is a visible display of child’s physical growth and development (c) is the space between two growth curves (weight channel) (d) consist of a series of percentile curves that illustrate the distribution of selected body measurements in children 27. WHO reference curves are based on: (a) NCHS Standards (b) CDC Standards (c) WHO Standards (d) GOI Standards 28. The lower limit of the normal range in a growth chart curve is: (a) 80% median weight (b) 70% median weight (c) 60% median weight (d) 85% median weight 29. WHO Service Growth Chart Has ___ reference curves: (a) 5 (b) 6 (c) 3 (d) 8 30. All are Key Facts about Growth Charts except: (a) Growth chart is the ‘passport to child’s health care’ (b) Growth chart was first designed by ‘David Morley’ (c) Objective in child care: To keep the child above 3rd percentile (d) Single weight plot is more useful than a Periodic weight record Test «Breast-feeding» 1. The following statements about breast milk are true except: (a) The maximum milk output is seen at 12 months (b) The coefficient of uptake of iron in breast milk is 70% (c) Calcium absorption of human milk is better than that of cow’s milk (d) It provides about 65 Kcals per 100 ml 2. Compared with unprocessed cow’s milk, human breast milk contains more of: (a) Lipids (b) Proteins (c) Minerals (d) Carbohydrates 3. As compared to Cow’s milk, human milk has: (a) More proteins (b) Less carbohydrates (c) More iron (d) Less of Vitamins 4. Mean output of breast milk per day is maximum during the following months of lactation: (a) 0-2 months (b) 3-4 months (c) 5-6 months (d) 7-8 months 5. Human breast milk has more of: (a) Lipids (b) Carbohydrates (c) Proteins (d) Iron (e) Calcium 6. Not true about breast milk is: (a) Maximum output is at 12 months of lactation (b) Coefficient of iron absorption is 70% (c) Calciu