🌏 Community Medicine · Part 7 revision hub

Respiratory, Contact and Sexually Transmitted Infections

Everything you need to revise this Part in one place — the one‑page note for every concept, a rapid‑revision sheet, exam‑style questions that point you back to the right concept, flashcards, staged cases and viva practice.

11 concepts20 MCQs20 flashcards4 cases15 viva questions

📝 The plate wall

Every concept in this Part as a one‑page handwritten note. Open one to read it in full and zoom.

⚡ Rapid revision

The whole Part on one screen — read it the night before.

Vaccine‑preventable respiratory infections

Diphtheria: pseudomembrane, bull neck, myocarditis; DAT on suspicion + penicillin/erythromycin; contacts get prophylaxis + vaccination. Outbreaks in school‑age children = missed boosters.
Pertussis: catarrhal → paroxysmal (whoop) → convalescent; azithromycin; adolescents and adults are sources for infants.
Tetanus: soil spores, not communicable; MNT eliminated 2015 (< 1/1,000 live births per district); 5 cleans; Td in pregnancy; TIG 250 IU for tetanus‑prone wounds in the unimmunised.
Varicella: centripetal, pleomorphic crops; VZIG for high‑risk exposed; no aspirin (Reye's). Mumps: parotitis; orchitis in post‑pubertal males.
Influenza: drift (seasonal) vs shift (pandemic, A only); MoHFW categories A, B(i), B(ii), C; oseltamivir for B and C.
COVID‑19 lessons: ventilation, genomic surveillance (INSACOG), oxygen, CoWIN (> 220 crore doses), continuity of essential services; PM‑ABHIM.
IMNCI fast breathing: ≥ 60 (< 2 months), ≥ 50 (2–12 months), ≥ 40 (12–59 months). Danger signs/stridor → refer; chest indrawing or fast breathing → oral amoxicillin. SAANS 2019.

Tuberculosis

India incidence 187/lakh (2024; −21% since 2015); mortality 21/lakh; ≈ 26 lakh notified; ≈ 25–27% of global burden.
Undernutrition has the largest PAF; HIV the highest RR. RATIONS trial: nutrition cut TB in contacts.
Presumptive TB → upfront NAAT (CBNAAT/Truenat: MTB + RIF resistance). Universal DST. Serological tests banned (2012). Mandatory notification (2012; penal provisions 2018) on Ni‑kshay.
DS‑TB: 2HRZE/4HRE daily weight‑band FDCs. Hr‑TB: 6 months REZ + Lfx.
MDR = H + R resistance; pre‑XDR = + FQ; XDR = + FQ + Bdq and/or Lzd. BPaLM 6 months (≥ 14 years, eligible).
TPT: 3HP, 6H; 6Lfx for MDR contacts. Ni‑kshay Poshan ₹1,000/month (since November 2024); Ni‑kshay Mitra (PMTBMBA 2022); TB Mukt Bharat Abhiyan (7 December 2024).
Outcomes: cured, completed, failed, died, LTFU (≥ 1 month), not evaluated. Success = cured + completed.

Leprosy

Cardinal signs: anaesthetic patch, thickened nerve with sensory/motor loss, AFB in slit‑skin smear (any one).
PB 1–5 lesions; MB > 5 lesions, nerve involvement or smear‑positive. When in doubt, MB.
🆕 Uniform 3‑drug MDT from 1 April 2025: rifampicin 600 mg + clofazimine 300 mg monthly; clofazimine 50 mg + dapsone 100 mg daily. PB 6 months, MB 12 months.
Type 1 reaction (BT–BL; DTH) vs type 2 ENL (BL–LL; immune complex; fever, nodules). Continue MDT; prednisolone.
G2D = visible deformity; high G2D among new cases = late detection. Child cases = recent transmission.
NLEP: LCDC, Sparsh (30 January), SDR‑PEP, DPMR, RCS (₹12,000), zero transmission by 2027.

HIV and STIs

India (2023): ≈ 25 lakh PLHIV; adult prevalence ≈ 0.2%; ≈ 68,000 new infections/year.
Three‑test diagnostic strategy; EID by DNA PCR from 6 weeks.
NACP‑V (2021–26): 95‑95‑95; Test and Treat (2017); TLD first‑line; viral load monitoring; U = U.
PEP within 72 h for 28 days. HIV/AIDS Act 2017. Helpline 1097.
Syndromic kits 1–7 (grey, green, white, blue, red, yellow, black). 4 C's. Suraksha Clinics.
EMTCT: ANC‑1, testing and treatment ≥ 95%; ≤ 50 paediatric HIV and congenital syphilis cases/100,000 live births. BPG 2.4 MU for syphilis.

🎯 Single‑best‑answer MCQs

Pick an answer to see the explanation — and the concept to revisit if you missed it. Your answers are saved on this device.

Score 0 / 00 of 20 answered

Question 1
Diphtheria antitoxin should be given:
Question 2
Maternal and neonatal tetanus elimination is defined as fewer than:
Question 3
Pandemics of influenza are caused by:
Question 4
The chickenpox rash, compared with smallpox, is characteristically:
Question 5
India's genomic surveillance consortium for SARS‑CoV‑2 is:
Question 6
A 2‑year‑old with cough is classified as having fast breathing when the respiratory rate is at least:
Question 7
Under IMNCI, a child aged 2 months to 5 years with chest indrawing but no danger signs is treated with:
Question 8
The risk factor with the largest population attributable fraction for TB in India is:
Question 9
BCG vaccine provides the most reliable protection against:
Question 10
The upfront diagnostic test recommended for presumptive TB under NTEP is:
Question 11
A patient previously treated for TB for 3 weeks who now has TB is classified as:
Question 12
The intensive phase of treatment for drug‑sensitive TB consists of:
Question 13
XDR‑TB (current WHO definition) is MDR/RR‑TB plus resistance to:
Question 14
Ni‑kshay Poshan Yojana support since November 2024 is:
Question 15
Which is NOT a cardinal sign of leprosy?
Question 16
A high proportion of child cases among new leprosy cases indicates:
Question 17
Under India's revised regimen from April 2025, PB leprosy is treated with:
Question 18
WHO grade 2 disability in leprosy includes:
Question 19
The current preferred first‑line ART regimen in India is:
Question 20
The NACO STI kit for genital ulcer (non‑herpetic) is:

🃏 Flashcards

Say the answer out loud before you flip. Shuffle once you know the order.

Card 1 of 20

🩺 Staged clinical cases

Read the presentation, decide what is going on and what you would do — then reveal the reasoning.

Case 1 — The coughing household

Stage A: A 38‑year‑old construction worker (BMI 16.5, daily alcohol) has a 4‑week cough and weight loss. NAAT: MTB detected, rifampicin resistance not detected. He lives with his wife, mother and two children (3 and 9 years) in one room.

Linked concepts: 61. Tuberculosis — Infection and Disease, 62. Finding Tuberculosis, 63. Treating TB and India's TB Programme

Case 2 — The painful nerve

Stage A: A 30‑year‑old woman with 8 patches and a positive skin smear is in month 5 of MDT. She develops fever, crops of tender red nodules on her forearms and face, and pain at the elbow.

Linked concepts: 64. Leprosy — Early Signs and Types, 65. Curing Leprosy and Preventing Disability

Case 3 — Fast breathing at seven months

Stage A: An ASHA sees a 7‑month‑old with cough for 3 days. Respiratory rate is 54/min, with no chest indrawing. The child is breastfeeding well, with no danger signs.

Linked concepts: 60. Pneumonia in Children

Case 4 — A positive test at the first ANC visit

Stage A: A 22‑year‑old primigravida at 10 weeks has a reactive rapid HIV test and a reactive rapid syphilis test at her first ANC visit.

Linked concepts: 66. HIV — Prevention to Treatment, 67. Sexually Transmitted Infections and Safe Births

🎤 Viva practice

Answer aloud as if an examiner asked you — then check the model points.

Viva 1

Clinical features and treatment of diphtheria?

Viva 2

Define neonatal tetanus.

Viva 3

Antigenic drift vs shift?

Viva 4

IMNCI classification of cough or difficult breathing?

Viva 5

What is presumptive TB?

Viva 6

Which diagnostic tests are used under NTEP?

Viva 7

Drug‑sensitive TB regimen?

Viva 8

Define MDR, pre‑XDR and XDR‑TB.

Viva 9

What is BPaLM?

Viva 10

What patient supports exist under NTEP?

Viva 11

Cardinal signs of leprosy?

Viva 12

Differentiate type 1 and type 2 lepra reactions.

Viva 13

What are the 95‑95‑95 targets?

Viva 14

What is PEP for HIV?

Viva 15

What is syndromic management of STIs?

Keep going

📘 Foundation contents 🩺 Clinical Reasoning contents 🎯 More practice

Educational only — not a substitute for clinical judgement, supervision, or local guidelines.

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