Introduction to Health and Primary Health Care

(D) ADH

ADH (antidiuretic hormone, or vasopressin) is the hormone associated with the posterior pituitary — it is produced in the hypothalamus and stored and released by the posterior pituitary. FSH, LH and ACTH are all secreted by the anterior pituitary.

(C) Abdominal cavity

The abdominal cavity is the largest body cavity. It extends from the diaphragm above to the pelvic brim below and contains the stomach, liver, intestines, kidneys and other large organs. The cranial cavity is small (holds only the brain), while the thoracic and pelvic cavities are smaller than the abdominal cavity.

(d) Hyperemesis gravidarum

Hyperemesis gravidarum means severe, persistent vomiting in pregnancy that causes dehydration, weight loss and electrolyte imbalance — a danger sign needing hospital care. Morning sickness, mild constipation and mild feet swelling are common normal discomforts of pregnancy.

(C) 18 September

Nepal observes National Family Planning Day every year on 18 September (Asoj 1) to promote awareness of family planning services and reproductive health.

(C) Urinary incontinence

In uterine prolapse the uterus descends and presses on/drags the bladder and urethra, so stress incontinence, frequency and difficulty in passing urine are common. The backache of prolapse is typically lower backache (with a bearing-down sensation), not upper back pain, and diarrhoea and fever are not features of prolapse.

(B) Pain

Cramping lower abdominal pain during and immediately after insertion is the most common side effect of IUD insertion; it is usually mild and settles within a few hours to days.

(A) Bacillary dysentery

Blood and mucus mixed stool with tenesmus and fever is the classic picture of bacillary dysentery (caused by Shigella). Amoebic dysentery also shows blood and mucus, but its stool is typically described as "anchovy sauce" and is less associated with tenesmus.

(C) Pyridoxine

Isoniazid interferes with the metabolism of pyridoxine (vitamin B6) and causes its deficiency, which leads to peripheral neuropathy. Therefore pyridoxine (10 mg/day) is given as prophylaxis along with INH, especially in children, pregnant women, malnourished persons and those with HIV.

(b) Autoclaving

Culture media are sterilized by autoclaving (moist heat at 121 °C, 15 psi for 15–20 minutes), because moist heat at high pressure kills spores without altering the composition of the medium. A hot air oven is used for glassware and metal instruments, not for media.

(B) Paramecia

Reading the question as "which is not a parasitic protozoan": Amoeba (Entamoeba histolytica), Giardia and Trypanosoma are all disease-causing parasitic protozoa, whereas Paramecium is a free-living, ciliated freshwater protozoan that does not cause human disease. (All four are protozoa in the strict taxonomic sense, so the question only makes sense in this parasitic reading.)

(C) Hansen's diseases

Leprosy is caused by the bacterium Mycobacterium leprae and is named Hansen's disease after the Norwegian physician Gerhard Armauer Hansen, who discovered the bacillus in 1873. Manson's disease refers to filariasis, and Mycobacterium leprae is the causative organism, not another name for the disease.

(A) E.Coli

Traveler's diarrhoea is most commonly caused by enterotoxigenic Escherichia coli (ETEC), which contaminates food and water in areas with poor sanitation. Vibrio cholerae causes cholera and Giardia causes giardiasis, but these are less frequent causes of traveler's diarrhoea.

(A) Typhoid fever

Relative bradycardia means the pulse rate is slower than expected for the degree of fever. It is a classic feature of typhoid fever (Faget's sign), along with step-ladder fever, coated tongue and splenomegaly.

(B) Amoebic Dysentery

Entamoeba histolytica trophozoites from the large bowel travel through the portal vein to the liver and form an amoebic liver abscess — the commonest complication of amoebic dysentery. Bacillary dysentery (Shigella) causes colonic ulcers and toxaemia but not liver abscess.

(A) Common cold

Hoarseness of voice is most commonly caused by acute laryngitis, which usually follows a viral upper respiratory infection (common cold) spreading to the larynx. Tonsillitis, rhinitis and pharyngitis affect other parts of the throat and are less often the direct cause of hoarseness.

(D) All of the above

Common cold (viral rhinitis) typically presents with a runny nose (rhinorrhoea), sore throat and sneezing, often along with nasal congestion, mild cough and low-grade fever — so all three listed features are signs/symptoms of the common cold.

(d) All of the above

Gastritis (inflammation of the stomach lining) typically presents with upper abdominal pain or burning, heartburn, and nausea with vomiting — so all the listed features are recognised symptoms.

(B) 5–15 years

Rheumatic fever is most common in school-age children between 5 and 15 years, the age group in which group A streptococcal pharyngitis (sore throat) occurs most frequently. It is rare below 3 years and uncommon after 15 years.

(a) Fluid in tunica vaginalis

Hydrocele is the abnormal accumulation of serous fluid in the tunica vaginalis (the sac surrounding the testis), causing painless scrotal swelling. Blood in the scrotum is called haematocele.

(A) Haematoma

A haematoma is a closed wound — blood collects in the tissues beneath unbroken skin. Incised, punctured and abrasion wounds all break the skin surface, so they are open wounds.

(D) All of the above

Rational use of drugs means the patient receives the right medicine in the right dose, by the right route, at the right time, for the right duration — so right patient, right drug and dose, and right time are all components of it.

(A) Codeine

Among the given options, only Codeine, an opioid with antimotility action, is an antidiarrhoeal, so it is the keyed answer for पेचिस. Note that in true infectious dysentery, antimotility drugs are used with caution or avoided; the cause is treated with ORS and antimicrobials (e.g. ciprofloxacin for bacillary dysentery, metronidazole for amoebic dysentery). Morphine is a strong analgesic, Diazepam a sedative/anticonvulsant, and Albendazole an anthelmintic for worm infestation.

(c) Cell wall को संश्लेषण

पेनिसिलिन एउटा β-lactam antibiotic हो, जसले bacteria को cell wall को मुख्य संरचनात्मक component पेप्टिडोग्लाइकन (peptidoglycan) को cross-linking मा अवरोध गर्छ। यसले transpeptidase enzyme लाई बन्द गरेर cell wall को संश्लेषण रोक्छ, जसले गर्दा bacteria फुटेर (lysis) मर्छ। यसले DNA वा protein को संश्लेषणमा असर गर्दैन।

(C) Live attenuated pathogens

A vaccine is made from weakened (attenuated) live organisms such as BCG, measles and OPV, or from killed organisms or toxoids, which stimulate the body to make its own antibodies (active immunity). Antisera are ready-made antibodies that give passive immunity and are not vaccines, so option (A) is wrong and (D) cannot be correct. Option (B), weakened pathogens, describes the same idea as (C).