Below are full-length, detailed 10-mark answers for each topic exactly in the K. Park (South
Asian Edition) style, written for PSM Paper – 10M.
Language: British English, structure: Definition → Epidemiology →
Agent/Host/Environment → Modes → Clinical features (brief) → Prevention & Control
(expanded) → National Programs (if any).
These answers match the expected depth for 10 marks (approx. 3.5–4 pages each).
1) RESPIRATORY SYSTEM
MEASLES – 10 Marks
Definition:
Measles is an acute, highly communicable viral disease caused by the measles virus
(Paramyxoviridae; genus Morbillivirus), characterised by fever, cough, coryza, conjunctivitis,
Koplik spots and a generalised maculopapular rash.
Epidemiology (Park-based)
● Agent: Measles virus, RNA virus; only one serotype.
● Source of infection: Case (overt or subclinical; subclinical very rare).
● Infectivity:
○ Highly infectious; secondary attack rate > 90%.
○ Infectious period: 4 days before to 4 days after rash.
● Host factors:
○ Age: Mainly affects children 6 months–3 years.
○ Immunity: Life-long after natural infection; vaccine gives long-lasting immunity.
○ Malnutrition, vitamin A deficiency ↑ severity.
● Environmental factors:
, ○ Overcrowding, poor ventilation.
○ Occurs in epidemics every 2–3 years in unvaccinated populations.
● Global burden: Still a leading cause of vaccine-preventable deaths in children in low-
resource settings.
● India: Part of Universal Immunisation Programme (UIP); major outbreaks still occur in
low-coverage districts.
Modes of Transmission
● Droplet infection or aerosol spread during coughing or sneezing.
● Virus remains suspended in air for long periods in closed spaces.
Clinical Features (brief for PSM)
1. Prodromal stage:
○ Fever, cough, coryza, conjunctivitis (“3 Cs”).
○ Koplik spots – pathognomonic.
2. Eruptive stage:
○ Maculopapular rash: behind ears → face → trunk → limbs.
3. Complications:
○ Pneumonia (most common cause of death), diarrhoea, otitis media, encephalitis,
SSPE.
Prevention and Control – PSM Emphasis
1. Immunisation (most important):
● MR vaccine (Measles–Rubella):
○ 1st dose at 9–12 months,
, ○ 2nd dose at 16–24 months (UIP schedule).
● Campaigns: MR campaign, Mission Indradhanush, Intensified MI 2.0.
2. Vitamin A prophylaxis:
● WHO: High-dose vitamin A given with measles diagnosis, reduces mortality.
● Under RCH: 2 lakh IU on diagnosis.
3. Surveillance:
● Integrated Disease Surveillance Programme (IDSP).
● Case-based surveillance under Measles–Rubella elimination plan.
● Target: Elimination of measles by 2023 (shifted timelines).
4. Outbreak control:
● Rapid detection through IDSP.
● Ring vaccination of susceptibles.
● Isolation of case for 7 days.
● Vitamin A supplementation for all contacts < 5 years.
5. Health education:
● Promote immunisation, nutrition, early reporting of fever with rash.
National Programme Link
● Universal Immunisation Programme (UIP).
● Measles–Rubella (MR) elimination initiative.
● Mission Indradhanush for improving coverage.
Conclusion:
, Measles is a highly contagious vaccine-preventable disease with significant
morbidity and mortality in children. Sustained high vaccination coverage (≥95%),
strong surveillance, and effective outbreak response are essential to achieve
elimination.
TUBERCULOSIS – 10 Marks
Definition:
Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis,
affecting primarily the lungs but capable of involving any organ.
Epidemiology
● Agent: Mycobacterium tuberculosis (human type).
● Reservoir: Human cases (pulmonary smear-positive most infectious).
● Host factors:
○ Age: Common in young adults (productive age group).
○ Risk ↑ with undernutrition, HIV, diabetes, smoking, silicosis.
● Environmental factors:
○ Overcrowding, poor ventilation, poverty, slums.
● Transmission:
○ Airborne droplet nuclei (1–5 microns).
● Period of infectivity:
○ While sputum smear-positive; reduced after 2–3 weeks of effective treatment.
● Global burden:
○ TB remains one of top 10 causes of death; India accounts for nearly 27% of
global TB burden.
● India-specific:
Asian Edition) style, written for PSM Paper – 10M.
Language: British English, structure: Definition → Epidemiology →
Agent/Host/Environment → Modes → Clinical features (brief) → Prevention & Control
(expanded) → National Programs (if any).
These answers match the expected depth for 10 marks (approx. 3.5–4 pages each).
1) RESPIRATORY SYSTEM
MEASLES – 10 Marks
Definition:
Measles is an acute, highly communicable viral disease caused by the measles virus
(Paramyxoviridae; genus Morbillivirus), characterised by fever, cough, coryza, conjunctivitis,
Koplik spots and a generalised maculopapular rash.
Epidemiology (Park-based)
● Agent: Measles virus, RNA virus; only one serotype.
● Source of infection: Case (overt or subclinical; subclinical very rare).
● Infectivity:
○ Highly infectious; secondary attack rate > 90%.
○ Infectious period: 4 days before to 4 days after rash.
● Host factors:
○ Age: Mainly affects children 6 months–3 years.
○ Immunity: Life-long after natural infection; vaccine gives long-lasting immunity.
○ Malnutrition, vitamin A deficiency ↑ severity.
● Environmental factors:
, ○ Overcrowding, poor ventilation.
○ Occurs in epidemics every 2–3 years in unvaccinated populations.
● Global burden: Still a leading cause of vaccine-preventable deaths in children in low-
resource settings.
● India: Part of Universal Immunisation Programme (UIP); major outbreaks still occur in
low-coverage districts.
Modes of Transmission
● Droplet infection or aerosol spread during coughing or sneezing.
● Virus remains suspended in air for long periods in closed spaces.
Clinical Features (brief for PSM)
1. Prodromal stage:
○ Fever, cough, coryza, conjunctivitis (“3 Cs”).
○ Koplik spots – pathognomonic.
2. Eruptive stage:
○ Maculopapular rash: behind ears → face → trunk → limbs.
3. Complications:
○ Pneumonia (most common cause of death), diarrhoea, otitis media, encephalitis,
SSPE.
Prevention and Control – PSM Emphasis
1. Immunisation (most important):
● MR vaccine (Measles–Rubella):
○ 1st dose at 9–12 months,
, ○ 2nd dose at 16–24 months (UIP schedule).
● Campaigns: MR campaign, Mission Indradhanush, Intensified MI 2.0.
2. Vitamin A prophylaxis:
● WHO: High-dose vitamin A given with measles diagnosis, reduces mortality.
● Under RCH: 2 lakh IU on diagnosis.
3. Surveillance:
● Integrated Disease Surveillance Programme (IDSP).
● Case-based surveillance under Measles–Rubella elimination plan.
● Target: Elimination of measles by 2023 (shifted timelines).
4. Outbreak control:
● Rapid detection through IDSP.
● Ring vaccination of susceptibles.
● Isolation of case for 7 days.
● Vitamin A supplementation for all contacts < 5 years.
5. Health education:
● Promote immunisation, nutrition, early reporting of fever with rash.
National Programme Link
● Universal Immunisation Programme (UIP).
● Measles–Rubella (MR) elimination initiative.
● Mission Indradhanush for improving coverage.
Conclusion:
, Measles is a highly contagious vaccine-preventable disease with significant
morbidity and mortality in children. Sustained high vaccination coverage (≥95%),
strong surveillance, and effective outbreak response are essential to achieve
elimination.
TUBERCULOSIS – 10 Marks
Definition:
Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis,
affecting primarily the lungs but capable of involving any organ.
Epidemiology
● Agent: Mycobacterium tuberculosis (human type).
● Reservoir: Human cases (pulmonary smear-positive most infectious).
● Host factors:
○ Age: Common in young adults (productive age group).
○ Risk ↑ with undernutrition, HIV, diabetes, smoking, silicosis.
● Environmental factors:
○ Overcrowding, poor ventilation, poverty, slums.
● Transmission:
○ Airborne droplet nuclei (1–5 microns).
● Period of infectivity:
○ While sputum smear-positive; reduced after 2–3 weeks of effective treatment.
● Global burden:
○ TB remains one of top 10 causes of death; India accounts for nearly 27% of
global TB burden.
● India-specific:
