#Kathmandu University
#BIRAT MEDICAL COLLEGE
Budhiganga-02, Tankisinuwari, Morang
Level: III MBBS (Batch: 2023)
Semester: 6th
Time: 2 hrs. 30 mins.
Date: May 07, 2026
Examination: Mid-Semester
Subject: Community Medicine
Marks: 50
#INSTRUCTION TO THE CANDIDATE
Answer each section in a separate answer book.
Write brief, relevant and legible answers.
Illustrate your answer with well labeled diagrams where required.
All questions are compulsory.
#SECTION ‘B’
#Short Answer Questions [6Q. × 5 = 30 marks]
#1.
Write the epidemiological triad of SARS. Enlist the prevention and control measures of SARS. [3+2=5]
#2.
Write the epidemiological triad of “Yellow Fever”. Name the international document required as proof of yellow fever vaccination for travelers. [3+2=5]
#3.
Draw the epidemiological triad of Lymphatic Filariasis. Enlist the types and clinical features of it. Describe the prevention and control measures of it. [1+2+2=5]
#4.
Describe the epidemiological determinants of malaria. Explain the 1–3–7 approach to malaria surveillance implemented in Nepal. [2+3=5]
#5.
Mention the post-exposure prophylaxis of rabies according to WHO classification of dog bite injuries. Outline the One Health approach to rabies prevention and control. [2+3=5]
#6.
List the modes of transmission of plague. Write its preventive approach. [2+3=5]
#SECTION ‘C’
#Long Answer Questions / Situational Based Questions [2Q. × 10 = 20 marks]
#Problem–I
A 24-year-old male from a dengue-endemic area presents with acute onset high-grade fever for 4 days, associated with severe headache, retro-orbital pain, myalgia, and maculopapular rash. Laboratory investigations show thrombocytopenia and leukopenia, and NS1 antigen test is positive, suggestive of dengue infection.
Despite supportive management, the fever persists beyond 7 days. The patient subsequently develops abdominal discomfort, constipation, and relative bradycardia. Further evaluation with blood culture grows Salmonella Typhi, indicating a concurrent typhoid infection.
#Questions:
a. Mention the initial diagnosis based on early presentation. [2]
b. Enlist any three clinical and laboratory features supporting the initial diagnosis. [3]
c. Mention confirmatory investigation for the second disease. [2]
d. Brief the name, dose and timing of vaccine as per EPI schedule of Nepal to prevent second disease. [3]
#Problem–II
A 32-year-old woman from a riverside village of Budhiganga presents to the local health post with acute watery diarrhoea for 1 day and repeated vomiting. Her neighbours report that 5 more people in the same lane developed similar symptoms since early morning. The settlement depends on a hand-pump located near an open drain, and residents recently noticed foul smell and muddy water. Water testing reveals high levels of contamination.
#Questions:
a. What is the diagnosis and epidemiological triad of the given condition? [3]
b. What are the clinical manifestations of the above condition? [3]
c. Enlist the prevention and control measures of the above condition. [3]
d. What is WASH intervention? [1]
